Undergraduate Research Reports & Masters Dissertations

Permanent URI for this collectionhttps://research.unilus.ac.zm/handle/123456789/447

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Start date: 2021

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Now showing 1 - 10 of 86
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    Investigating the Prevalence and Predictors of Depression and Anxiety Disorders among Adolescents Living with HIV at Kabwe Women, Newborn and Children’s Hospital and Kabwe Central Hospitals
    (2026) MULENGA, Chiti
    Adolescents living with HIV (ALWHIV) face elevated risks of common mental disorders (CMDs), yet limited data exists on their prevalence and determinants in sub-Saharan Africa, particularly Zambia. This study examined the prevalence and factors associated with depression and anxiety among adolescents living with HIV in Kabwe, Zambia. A hospital-based cross-sectional study was conducted among 108 adolescents aged 10–19 years receiving antiretroviral therapy at two public referral hospitals in Kabwe, Zambia. Depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scale respectively, both validated for use in sub-Saharan African adolescent populations. Bivariate analyses using chi-square tests and multivariate logistic regression were conducted to identify independent predictors of each condition. The prevalence of depression was 26.9% and anxiety was 28.7%, with 17.6% experiencing both conditions concurrently. Experienced stigma and discrimination emerged as the strongest predictor for both depression (AOR=5.87) and anxiety (AOR=4.19). Perception that mental health was affected by social environment independently predicted both conditions. Depression-specific risk factors included living arrangements, with adolescents not living with parents showing threefold increased odds. For anxiety, low confidence in managing HIV treatment was a unique predictor (AOR=2.64). Cumulative risk analysis revealed a dose-response relationship, with CMD prevalence increasing from 16.1% among those with no risk factors to 84.6% among those with three or more factors. The substantial burden of CMDs among ALWHIV in Zambia, driven primarily by stigma and social environment factors, underscores the urgent need for integrated mental health services within HIV care programs. Interventions should address stigma reduction, strengthen social support systems, and provide targeted support for adolescents with multiple vulnerabilities. Keywords: Adolescents, HIV, depression, anxiety, stigma, Zambia
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    An Assessment of the Effects of weather variability on Malaria Transmission Patterns in North-Western Province, Zambia in the period of 2017 to 2024
    (2026) HIMOONGA, Nchimunya
    Malaria whose transmission is facilitated by Anopheles female mosquitoes has remained a major public health. Global malaria cases have increased in the recent years rising from 229 million in 2019 to 249 million in 2022 with over 95% of cases and deaths occurring in sub-Saharan Africa. Globally, Zambia accounts for 1.4% malaria burden with a record of 11 million cases in 2023. Evidence shows that climate change, through shifts in temperature, humidity and rainfall significantly affect malaria transmission by influencing mosquito breeding. Regional impacts, however, particularly in North-western province remain underexplored. The aim of the study was to investigate the impacts of weather variability on malaria transmission patterns in North-western province, Zambia. Malaria incidence data was collected from Ministry of Health while weather variables data was sourced from the Zambia Meteorological Department. Excel was used to manage, clean and analyse the data. Monthly weather variables and malaria cases were summarised using means, standard deviations, and frequencies using STATA software. Pearson’s correlation test was used to measure the strength and direction of the relationship between weather variables and malaria incidence. Negative binomial regression was run to determine the influence of weather variables on malaria incidence. Malaria incidence showed strong seasonality, with peaks during the rainy season and lower levels in the dry months. Precipitation and relative humidity exhibited high seasonal variability, while temperature and wind speed remained relatively stable. Time-series analysis revealed a substantial increase in malaria cases from 2020, with a sharp surge in 2022–2023 followed by stabilization. Although regression and correlation analyses showed weak and statistically non-significant associations between malaria incidence and individual climatic variables, descriptive and temporal patterns suggest that rainfall and humidity are key drivers of seasonal malaria transmission, with temperature and wind speed acting as moderating factors. In conclusion, malaria transmission in North-Western Province is strongly seasonal and primarily influenced by rainfall and humidity, while temperature and wind speed play moderating roles, underscoring the need for integrated climate-informed and socio-economic malaria control strategies.
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    Impact of HIV and Antiretroviral Therapy (ART) on Cervical Cancer Risk among Women at Maina Soko Medical Centre, Zambia
    (2026) MWEWA, Mando
    Cervical cancer remains a leading cause of cancer mortality among women in Zambia, with high HIV prevalence creating a syndemic that elevates risk. Global strategies advocate integrating screening into HIV care, with antiretroviral therapy (ART) hypothesized to modify cervical cancer risk through immune reconstitution. This study evaluated an integrated screening service at a tertiary hospital and assessed the role of ART on cervical cancer risk among women living with HIV. A retrospective cross-sectional analysis was conducted using routine service records from Maina Soko Medical Centre, Lusaka. The cohort included 270 women screened with Visual Inspection with Acetic Acid (VIA) between October 2024 and November 2025. Data on demographics, HIV status, ART documentation, VIA results, and clinical management were extracted. Descriptive statistics and multivariable logistic regression identified factors associated with screen-positive results and assessed the relationship between ART and cervical abnormalities. Mean age was 45.1 years (SD = 12.4); 46.3% (n = 125) were HIV-positive. Overall VIA positivity was 5.6% (n = 15). Positivity was higher among HIV-positive women (7.2% vs. 4.1%), but not statistically significant after adjustment (aOR = 1.72, 95% CI: 0.60–4.96). Only 40.0% of VIA-positive women received immediate definitive treatment. Service delivery was episodic, with 44.4% of screenings in a two-month period. ART history was missing for 68.0% of HIV-positive women, constraining analysis of ART duration and cervical outcomes. Integrated screening reaches high-risk populations, but impact is undermined by treatment cascade gaps, inconsistent service delivery, and incomplete ART documentation. Findings suggest ART attenuates but does not eliminate cervical cancer risk among HIV-positive women. Urgent action is needed to transition from campaign-based to routine screening and close the treatment linkage gap. Keywords: Cervical Cancer, Screening, Visual Inspection with Acetic Acid (VIA), HIV, Antiretroviral Therapy (ART), Health Services Integration, Zambia
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    Assessment of Determinants of Hospital Preparedness for Emergency Disease Outbreak in Zambia: A Case Study of Lusaka District
    (2026) MWALE, Thandiwe
    This study assessed the determinants of hospital preparedness for emergency disease outbreaks in Lusaka District, Zambia, focusing on Matero Level 1 Hospital and Chipata First-Level Hospital. A cross-sectional design was employed, targeting 125 outpatient health workers across both facilities, with a response rate of 70% (87 participants). Data were collected using structured self-administered questionnaires and analysed using STATA version 19. The study revealed mixed levels of preparedness: 23% of respondents rated their hospitals as highly prepared, 66.7% as moderately prepared, and 10.3% as poorly prepared. Key determinants influencing preparedness included institutional policies, financial resources, human resource capacity, and infrastructure and commodity availability. Institutional policies were the most significant contributor (β = 0.430, p < .001), highlighting the importance of structured frameworks. Financial resources also played a crucial role (β = 0.302, p = .005), while human resource capacity and infrastructure availability had weaker or non-significant impacts. Challenges included insufficient financial resources, inadequate staff training, poor infrastructure, and limited resource availability. To address these gaps, the study recommends regular staff training, improved drug supply systems, investment in medical equipment, and enhanced stakeholder involvement in policy development. Regular emergency drills and feedback systems were also emphasized as vital for continuous improvement. The study underscores the need for a multifaceted approach to enhance hospital preparedness, combining strategic planning, resource allocation, and capacity building. Future research should explore preparedness in higher-level hospitals and compare public versus private healthcare facilities to provide a broader understanding of emergency preparedness in Zambia. Keywords: Emergency preparedness, disease outbreak, hospital readiness, determinants, Lusaka District, Zambia, health systems.
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    An Assessment of risk factors associated with Preeclampsia among Antenatal Clients at Ndola Teaching Hospital
    (University of Lusaka, 2026) MISAPA, Chomba
    Pre-eclampsia is a major hypertensive disorder in pregnancy and among the leading cause of maternal morbidity and mortality in sub-Sahara Africa. However, evidence on the burden and associated risk factors especially in tertiary level hospitals in Zambia remains limited. Therefore, this study aimed to determine the risk factors associated with preeclampsia among antenatal clients at Ndola Teaching Hospital for the period January 2023 to December 2024. This was a cross-sectional study that was conducted at Ndola Teaching Hospital (NTH) by utilizing 440 maternity records from January, 2023 to December 2024. Data on social demographic characteristics, obstetric history, and clinical factors were extracted using a data extraction tool. Descriptive statistics were used to summarize participants characteristics and estimate the prevalence of pre-eclampsia. Bivariate analyses and multivariate logistics regression analysis to identify factors associated with pre-eclampsia. Model fit was assessed using Hosmer-Lemeshow goodness of fit test and variance inflation factor (VIF) analysis was conducted to determine multicollinearity. Statistical significance was set at p < 0.05. The prevalence of pre-eclampsia was 14.1% among the reviewed records. Factors associated with pre-eclampsia included maternal age less than 20 (AOR 2.7, CI 1.02 - 3.87, p = 0.04), maternal age more than 35 (AOR 2.9, CI 1.05 - 4.74, p = 0.03), previous history of preeclampsia (AOR 3.2, CI 1.57 - 6.56, p < 0.001), multiple pregnancy (AOR 2.4, CI 1.03 - 5.74, p value = 0.04), obesity (AOR 2.87, CI 1.48 - 5.56, p value < 0.001), chronic hypertension (AOR 4.1, CI 2.02 - 8.23, p value <0.001), and history of diabetes mellitus (AOR 2.6, CI 1.06 - 6.45, p value = 0.03). Socio-demographic factors such as education, residence, and HIV status were not associated with pre-eclampsia. Pre-eclampsia remains a burden at Ndola Teaching Hospital with a relatively high prevalence with identifiable maternal and clinical risk factors. Pre-eclampsia, obstetric factors, maternal factors, clinical factors, antenatal care
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    Clinical characteristics and survival analysis of aplastic anaemia patients at the University Teaching Hospitals, Lusaka
    (2026) MILIMO, Joseph
    The current study aimed at assessing the characteristics of patients with aplastic anaemia and determining survival rates and predictors of survival for patients diagnosed with aplastic anaemia at the University Teaching Hospitals (UTH), Lusaka, Zambia. A retrospective cohort study was conducted at UTH, Lusaka, Zambia. The included cases were patients diagnosed with aplastic anaemia from 2014 to 2023. Data was collected through review of patients’ medical records. Kaplan-Meier plots were used in the analysis of time-to-event data for estimation of survival probabilities. The log-rank test was utilized to make comparisons between survival curves. Cox proportional hazards regression was used to analyze risk factors for survival. Data analysis was done using R version 4.3.2. A total of 126 cases were included, 96 paediatric cases and 30 adult cases, from 2014 to 2023. For paediatric patients, 52.08%(n=50) were females while for adult patients, 73.33% (n =22) were male. The median age at diagnosis was 11 years (IQR =12) and 22.5 years (IQR = 36) in paediatrics and adults, respectively. The most common cause of aplastic anaemia was unknown in both paediatrics and adults. Most of the participants had NSAA followed by SAA and VSAA in both groups. The mortality rate was 21.88% and 46.67% in paediatrics and adults, respectively. The median survival time from diagnosis was found to be 65 months in the paediatric cases. The 1-year survival rate was found to be at 43% and 53% in paediatrics and adults, respectively. The study did not find any factors to be independent predictors of survival among paediatrics patients with aplastic anaemia in both groups. Analysis of all the patients revealed a slight male predominance, a median age of 12 years and a median survival time of 65 months. The study reports a mortality rate and a 1-year survival rate of 27.78% and 42%, respectively. The study found that being a paediatric conferred superior survival while (HR = 0.33, 95%CI 0.17 – 0.66, p =0.002) and presenting with bleeding was an independent predictor of inferior survival (HR = 2.90, 95% CI 1.25 – 6.71, p = 0.013). Paediatric aplastic anaemia patients have better survival and haemorrhage remains a major predictor for mortality. An improvement in the management of adult aplastic anaemia patients in needed. Prevention, early identification and treatment of bleeding is needed. Availability, accessibility and affordability of treatment are recommended. Key words: Aplastic anaemia, Survival analysis, Immunosuppressive therapy, pancytopaenia, Zambia
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    Multilevel Analysis of Challenges in Diagnosis and Treatment of Pediatric Tuberculosis at Facility and Patient Levels in Lusaka Province, Zambia
    (2026) KALUBA, Julius
    Tuberculosis (TB) remains a major public health challenge globally, with children disproportionately affected due to diagnostic and treatment complexities. In Zambia, pediatric TB continues to be underdiagnosed and undertreated, particularly in high-burden settings such as Lusaka Province. This study investigated the challenges affecting the diagnosis and treatment outcomes of pediatric tuberculosis at both patient and facility levels using a multilevel analytical approach. A cross-sectional quantitative study was conducted using secondary data extracted from tuberculosis registers in 20 health facilities across Lusaka Province. The study included 700 children aged 0–14 years who received TB treatment between January 2023 and December 2024. Descriptive statistics were used to summarize patient and facility characteristics, while inferential analyses, including chi-square tests, logistic regression, and ordinal logistic regression, were performed. Multilevel modeling was explored to account for the hierarchical structure of patients nested within facilities. Overall, 75.0% of children successfully completed treatment, while 15.3% defaulted and 9.7% died. Male children and younger age groups exhibited slightly poorer treatment outcomes. Facility-level clustering was minimal, with an intraclass correlation coefficient of 0.6%, indicating that most variation in treatment outcomes was attributable to patient-level factors rather than differences between facilities. A likelihood ratio test confirmed that single-level ordinal logistic regression was sufficient for analysis, although multilevel modeling was retained for robustness. All model assumptions were satisfied. The findings demonstrate that pediatric TB treatment outcomes in Lusaka Province are primarily driven by patient-level characteristics, including age, sex, and HIV status, while facility-level factors play a supportive but less decisive role. These results underscore the need for patient-centered, multi-level interventions that strengthen caregiver support, improve adherence, and complement existing health system investments. The study contributes methodologically by applying multilevel analysis and provides evidence to inform policy, program design, and future pediatric TB research in Zambia. Keywords: Pediatric Tuberculosis, Treatment Outcomes, Multilevel Analysis, Patient-Level Factors, Facility-Level Factors.
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    Specimen Referral System - Related Factors associated with Laboratory TB Case Detection: A Cross - Sectional Study
    (2026) CHIMBUMBYA, Robertson
    Tuberculosis (TB) remains a public health concern globally. To effectively fight and control TB, enabling timely access to rapid diagnostic tools is key for the detection of bacteriologically confirmed TB. A weak TB diagnostic network could lead to an increased number of undiagnosed TB cases due to limited access to improved rapid diagnostic tools. To determine the association between sample referral factors and the detection of bacteriologically confirmed TB cases. The researcher used an analytical cross-sectional design to evaluate the impact of specimen referral system factors on TB case detection in routine healthcare settings. The data on bacteriologically confirmed TB cases and number of presumptive TB were collected from the facility-based presumptive register from January to December 2024. The electronically generated questionnaire was used to capture information on factors such as availability of the refrigerator, type of facility, type of rider, frequency of sample pickup, distance between referring site and the diagnostic. The adjusted multivariable negative binomial regression was fitted to determine the association of outcome and predictors. The adjusted negative binomial regression revealed that frequency of sample picks up (p = 0.048) and number of samples submitted (p <0.0001) were highly associated with case detection. Other variables such as presence of the refrigerator, trained rider, type of rider, facility attendance and presumptive TB clients that submitted samples were not associated with TB case detection. This study was conducted to determine the association of bacteriologically confirmed TB and referral related factors. It has been noted that frequency of sample pickup and number of samples submitted had an impact on case detection. These findings suggest that investment specimen referral logistics may remarkably improve TB detection in the health facilities. Keywords: Specimen Referral, System-Related Factors, Tuberculosis Case Detection
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    Evaluation of the Implementation of Sanitation and Hygiene Programmes in Mwense District, Zambia
    (University of Lusaka, 2025) NYIRONGO, Albert
    Before and few years after Zambia got its independence in 1964, the sanitation crisis became more evident, this reviewed most of the people having lowly paid jobs and in eventuality led to low standards of living because of high illiterate levels. This resulted into a lot of adverse health effects such as diarrhea, cholera, dysentery and typhoid fever, mostly affecting children under the age of five years consequently leading to high mortality (WHO,2022. This study evaluated the implementation of sanitation and hygiene programs in mwense district, Zambia, were a mixed approach method was used which included both qualitative and quantitative methods. The study population was 772 people with a sample size of 58 household from both kampamba and mwenso village. A purposive sampling technique was in the study because not all the local people in the study area that did not have toilets. The research objectives included the following; to find out the households with improved sanitation and hygiene practices in Mwense District, to assess the effectiveness of existing sanitation and hygiene programs in Mwense District, to identify challenges faced during the implementation of the programs and recommend potential solutions for improvement in Mwense District. The findings provided critical insights for refining sanitation and hygiene strategies in Mwense District as the results showed that (42) 93.3% of the respondents had access to a sanitation facility while 2 (6.7%) did not have. The other findings showed that 15 (34.1%) said the programs were very effective in improving sanitation and hygiene inthe communities while 16 (36.4%) respondent that the programs are ineffective, 11 (25%) responded that the programs are neutral and 2 (4.5%) said the programs are ineffective. Lastly, the major challenge was inadequate funding and it was recommended that funding must be increased for sanitation and hygiene programs. Keywords: Sanitation, Hygiene Programs, Implementation, Evaluation, Public Health, Waterborne Diseases, Community Participation, Sustainability.
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    Investigating the Environmental Impact of the Sustainable Livestock Infrastructure Management Project (SLIMP) on Land Resources in Muchinga, Northern and Eastern Provinces
    (University of Lusaka, 2025) MBAMBARA, Zengani
    The study assessed the environmental impact of the Sustainable Livestock Infrastructure Management Project (SLIMP) on land resources in Muchinga, Northern, and Eastern Provinces of Zambia. The primary objectives were to: assess the impact of SLIMP activities on soil health and fertility; evaluate the extent of land degradation resulting from SLIMP infrastructure; and examine the effect of SLIMP on vegetation cover and plant biodiversity. A mixed-methods research approach was adopted, utilizing both qualitative and quantitative data. The research employed an exploratory and experimental design, with a sample of 285 livestock farmers selected through stratified and purposive sampling. Data was collected using soil sample analysis and vegetation samples, questionnaires, key informant interviews, and direct observations. Quantitative data was analyzed using SPSS, with statistical methods including descriptive statistics and findings presented in frequency tables, while qualitative data was analyzed through thematic analysis. Findings revealed that 65% of respondents reported improvements in soil health and fertility, attributed to SLIMP’s soil management practices. However, 18% raised concerns about soil compaction due to heavy machinery. Regarding land degradation, 72% reported minimal impact, although 28% in areas near infrastructure development observed significant soil erosion, with an average erosion severity score of 3.8/5. In terms of vegetation cover, 50% of respondents noted positive effects, while 38% reported a decline in plant biodiversity, especially due to overgrazing. The study concluded that SLIMP had a generally positive impact on soil health and vegetation, although challenges such as soil compaction, erosion, and biodiversity loss persisted. Recommendations included: enhancing grazing management practices, strengthening land restoration efforts, and increasing training for local farmers to sustain and amplify SLIMP’s positive environmental outcomes.