Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship

Ngoma, Maty Tsumbu; Sitali, Doreen; Mudenda, Steward; Mukuma, Mercy; Bumbangi, Flavien Nsoni; Bunuma, Emmanuel; Skjerve, Eystein; Muma, John Bwalya

doi:10.1093/jacamr/dlae034

Cited by 4 publications

(1 citation statement)

References 139 publications

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“…As syphilis rates continue to rise, the current supply has been unable to meet clinical demand in high-income countries as well as LMIC settings. Further, appropriate use of antibiotics for all infections in Lusaka is low, further contributing to supply and demand issues [ 17 ]. As one strategy to improve the supply chain, the Zambian MOH has proposed a shift to local BPG production to ensure a more consistent supply.…”

Section: Discussionmentioning

confidence: 99%

Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia

Jones,

Manasyan,

Xue

et al. 2024

PLoS ONE

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Objective The prevalence of syphilis in Zambia remains high and is a critical public health concern. The Zambian Ministry of Health recommends universal screening and same-day treatment for syphilis in pregnancy, yet the syphilis screening rate is low, and treatment is poorly documented. The goal of this study was to document syphilis treatment rates and associated factors among pregnant women in care in Zambia. Methods This retrospective cohort study included pregnant women diagnosed with syphilis according to rapid plasma reagin (RPR) screening during routine antenatal care (ANC) in Lusaka, Zambia in 2018–2019. The main outcome of interest was lack of documented BPG treatment during pregnancy. Additional information about pregnancy and neonatal outcomes, partner referral for therapy, and facility level stockout data were included. Patient characteristics were compared by treatment status using Pearson Chi-Square Test and logistic regression models were created to estimate the association between individual level-factors, facility type, and lack of BPG treatment. A Cochran-Mantel-Haenszel test was used to evaluate facility-level data with significance set at p<0.05. Results Among 1,231 pregnant women who screened positive for syphilis at clinic, 643 (52%) lacked documented antibiotic treatment at the facility. BPG was the only antibiotic used to treat syphilis in the cohort and 8% of sex partners had evidence of referral for therapy. Preterm delivery rates were higher in women without documented BPG (43% vs 32%; p = 0.003). In adjusted models, only calendar year and hospital facility type were associated with lack of treatment. At the facility level, annual syphilis screening rates ranged from 37–65% and most (7/10) clinics reported at least one stockout of BPG. Conclusion Treatment rates for syphilis in pregnancy in Zambia were low and BPG medication stockouts at the facility level were common. A consistent supply of BPG at all ANC facilities is needed to facilitate timely treatment and improve birth outcomes.

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Section: Discussionmentioning

confidence: 99%

Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia

Jones,

Manasyan,

Xue

et al. 2024

PLoS ONE

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Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening

Yamba,

Chizimu,

Mudenda

et al. 2024

Journal of Hospital Infection

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Knowledge, awareness and practices of healthcare workers regarding antimicrobial use, resistance and stewardship in Zambia: a multi-facility cross-sectional study

Mudenda,

Chabalenge,

Daka

et al. 2024

JAC-Antimicrobial Resistance

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Background Antimicrobial resistance (AMR) poses a threat to public health globally. Despite its consequences, there is little information about the knowledge, awareness, and practices towards AMR among healthcare workers (HCWs). Therefore, this study assessed the knowledge, awareness and practices regarding antimicrobial use (AMU), AMR and antimicrobial stewardship (AMS) among HCWs who are involved in the implementation of AMS activities across eight hospitals in Zambia. Methods A cross-sectional study was conducted among 64 HCWs from October to December 2023 using a semi-structured questionnaire. Data were analysed using IBM SPSS version 25.0. Results Of the 64 HCWs, 59.4% were females, 60.9% were aged between 25 and 34 years, 37.5% were nurses, 18.7% were pharmacists, 17.2% were medical doctors and only one was a microbiologist. Overall, 75% of the HCWs had good knowledge, 84% were highly aware and 84% had good practices regarding AMU, AMR and AMS. Most of the HCWs (90.6%) responded that they had a multidisciplinary AMS team at their hospitals and were implementing the use of the WHO AWaRe classification of antibiotics. Conclusion This study found good knowledge levels, high awareness and good practices regarding AMU, AMR and AMS among HCWs who were involved in the implementation of AMS activities in hospitals in Zambia. Additionally, most hospitals have been conducting AMS training and implementing the use of the WHO AWaRe classification of antibiotics. However, there is still a need to address some identified gaps in AMU and AMR through the strengthening of AMS activities in hospitals.

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Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship

Cited by 4 publications

References 139 publications

Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia

Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia

Assessment of antimicrobial resistance laboratory-based surveillance capacity of hospitals in Zambia: findings and implications for system strengthening

Knowledge, awareness and practices of healthcare workers regarding antimicrobial use, resistance and stewardship in Zambia: a multi-facility cross-sectional study

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