School of Medicine and Health Sciences Research Collection

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    An Assessment of the impact of Alternative Banking Channels on Financial Performance of Commercial Banks in Zambia
    (2026) MWALE, Chikumbutso
    The purpose of this study was to assess the impact of alternative banking channels (ABCs) on financial performance of Commercial Banks in Zambia which includes Internet banking, mobile banking, agency Banking and automated teller machines (ATMs), focusing on Stanbic Bank, First National Bank Zambia, and Zanaco from 2021 to 2023. The findings of the study confirmed that alternative banking channels exert a statistically significant and positive influence on the financial performance of commercial banks in Zambia. This suggests that the ongoing digital transformation in Zambia’s banking sector is generating measurable financial benefits, and that banks that invest in diverse and integrated alternative banking channels stand to achieve superior financial performance. Anchored on financial intermediation theory and agency theory, the research adopted a quantitative approach with a correlational research and causal-comparative design. Secondary data was sourced from various sources such as Bank of Zambia publications and banks’ annual reports. These were analyzed using panel regression, descriptive statistics and correlation matrix techniques through MS Excel and SPSS. The findings of the study revealed a statistically significant positive relationship between financial performance and Alternative Banking Channel adoption. Mobile banking showed stronger marginal effect (coefficient = 0.041, p = 0.000), followed by the aggregate Alternative Banking Channel index (coefficient = 0.468, p = 0.000). Agency banking, ATMs and internet banking also positively contributed to Banks net profits. However, cybersecurity risks, infrastructural deficits, and limited financial literacy constrain Alternative Banking Channels effectiveness. The study recommends enhanced financial literacy initiatives and more investments in digital infrastructure to maximize the benefits of Alternative Banking Channels and contribute to policy formulation and academic discourse in Zambia’s banking sector.
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    Determinants of Virologic Failure and Prevalence of Resistance Mutations among Human Immunodeficiency Virus (HIV) - Infected Children and Adolescents Aged 18 Months to 18 Years on Antiretroviral Therapy at Livingstone Teaching Hospital, Zambia
    (2026) MWEWA, Jones
    Virologic failure is a major challenge in the management of Human Immunodeficiency Virus (HIV) among children and adolescents on antiretroviral therapy (ART). This study aimed to identify the prevalence of virologic failure, identify its determinants, and describe the pattern of HIV drug resistance mutations among HIV-infected children and adolescents aged 18 months to 18 years receiving ART at Livingstone Teaching Hospital. A facility-based cross-sectional study was conducted among 418 children and adolescents living with HIV. Virologic failure was defined as a viral load of ≥1,000 copies/mL. Data on sociodemographic, socio-economic, and clinical characteristics were collected from medical records and patient interviews. Logistic regression analysis was used to identify factors associated with virologic failure. Genotypic resistance testing was performed among participants with virologic failure to assess resistance mutations.The prevalence of virologic failure was 19.14%. Poor adherence to ART was the strongest predictor of virologic failure, with affected participants having significantly higher odds of failure. Adolescents were more likely to experience virologic failure compared to younger children. Low caregiver income and food insecurity were also independently associated with virologic failure. Drug resistance analysis showed no major NRTI resistance mutations, while NNRTI resistance mutations were common, particularly the K103N mutation. Resistance to integrase strand transfer inhibitors was rare.In conclusion, virologic failure among children and adolescents at Livingstone Teaching Hospital was mainly driven by poor adherence and socio-economic vulnerability rather than widespread drug resistance. Strengthening adherence support, implementing adolescent-friendly HIV services, and integrating socio-economic and nutritional support into HIV care are critical to improving treatment outcomes in this population.
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    Investigating Human (Host) factors associated with Susceptibility and Resistance to Plasmodium Falciparum Infection in Rufunsa District: A Case - Control Study
    (2026) CHIBWALWE, Kelvin
    Malaria is a significant public health burden in Zambia, with Rufunsa District being particularly affected. Understanding host factors influencing susceptibility and resistance to Plasmodium falciparum malaria is crucial for developing effective prevention and treatment strategies. A total of 319 participants were included in the study. Malaria testing was done using first response Malaria RDT brands. Blood Grouping (ABO and Rh Typing) and Sickle SCAN test kit were used to screen for genetic traits. Host factors were collected using a structured questionnaire. Descriptive statistics and Logistic regression analysis were performed using Stata version 14. The study found that male participants were significantly more likely to test positive for malaria compared to females (aOR = 7.26; 95% CI: 2.77-19.03; p = 0.001). Malaria risk varied significantly by health facility, with participants from Chimusanya, Kanyongoloka, and Mpanshya having substantially higher odds of malaria. Prior malaria infection (aOR = 8.49; 95% CI: 3.07-23.50; p = 0.001) and inconsistent mosquito net use (aOR = 5.00; 95% CI: 1.46-17.09; p = 0.010) were also significantly associated with malaria susceptibility. The study highlights the need for strengthening malaria prevention strategies, including promoting consistent use of insecticide-treated nets and improving coverage of indoor residual spraying, particularly in high-transmission areas.
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    Prevalence and Hematological Patterns of Blood Disorders in Chitambo, Zambia: A Cross- Sectional Study Using CBC Testing
    (2026) ZULU, Diana
    Blood disorders, including anaemia, leukocyte abnormalities, and thrombocytopenia, represent a significant public health burden in sub-Saharan Africa, yet community-level data in rural Zambia remain sparse. This study aimed to determine the prevalence and associated factors of haematological disorders in Chitambo District, Zambia. A community-based cross-sectional study was conducted among 384 residents of Chitambo District, selected through systematic random sampling from the outpatient department of Chitambo District Hospital. Data were collected using a structured interviewer-administered questionnaire, and a complete blood count (CBC) was performed for each participant. Descriptive statistics, chi-square tests, and multivariable logistic regression were used for data analysis in STATA version 14. The prevalence of anaemia was 37.0% (95% CI: 32.1–42.1%), leukocyte abnormalities 15.1% (95% CI: 11.6–19.3%), and thrombocytopenia 8.6% (95% CI: 5.9–12.0%). In adjusted analyses, anaemia was significantly associated with female sex, infrequent consumption of iron rich foods, lack of iron supplementation, and recent malaria episodes. Leukocyte abnormalities were associated with malaria and HIV-positive status. Thrombocytopenia was strongly predicted by recent malaria episodes. This study documented a high burden of haematological disorders in Chitambo District, driven by modifiable nutritional and infectious factors, with malaria playing a central role. These findings highlight the need for integrated public health interventions combining nutritional support, malaria control, and strengthened laboratory-based surveillance to improve haematological health outcomes in rural Zambia. Keywords: Anaemia, leukocyte abnormalities, thrombocytopenia, complete blood count, malaria, nutritional factors, Chitambo, Zambia, cross-sectional study
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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