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Engineering（科研） 2014年第2期6卷 51-58页

作者： Ethel M’kandawire michelo syakalima Kaampwe Muzandu Girja Pandey Martin Simuunza Shouta M. M. Nakayama Yusuke K. Kawai Yoshinori Ikenaka Mayumi Ishizuka Animal Health Department Northwest University Mafikeng Campus Mmabatho South Africa Department of Biomedical Sciences School of Veterinary Medicine University of Zambia Lusaka Zambia Department of Disease Control School of Veterinary Medicine University of Zambia Lusaka Zambia Laboratory of Toxicology Department of Environmental Veterinary Sciences Graduate School of Veterinary Medicine Hokkaido University Sapporo Japan

The aim of this study was to characterize CYP1A1 and CYP3A in liver of the Kafue lechwe from Lochnivar and Blue Lagoon GMAs and to determine their mRNA expression levels as potential biomarkers of pollution. Increasing attention is paid to the problem of pesticide pollution by people. Risk assessment of pesticide should not be only based on the chemical analysis of environmental samples, since this method could not truly distinguish whether the pesticide was harmful to environment. Thus, biological assessment should be established.

关键词： Lochnivar Game Management Area Blue Lagoon Game Management Area Pestcides/Herbicides Biomonitoring Phylogenetic Relationships Real-Time RT-PCR

Selective expansion of human natural killer cells leads to enhanced alloreactivity

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Cellular & Molecular Immunology 2014年第2期11卷 160-168页

作者： Diana N Eissens Clive M michelo Frank WMB Preijers Bram van Cranenbroek Houwelingen Arnold van der Meer Irma Joosten Department of Laboratory Medicine--Laboratory of Medical Immunology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands and Department of Laboratory Medicine--Laboratory of Hematology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands These authors contributed equally to this work.

In allogeneic stem cell transplantation （SCT）, natural killer （NK） cells lacking their cognate inhibitory ligand can induce graft-versus-leukemia responses, without the induction of severe graft-versus-host disease （GVHD）. This feature can be exploited for cellular immunotherapy. In this study, we examined selective expansion of NK cell subsets expressing distinct killer immunoglobulin-like receptors （KIRs） within the whole human peripheral blood NK cell population, in the presence of HLA-Cw3 （C1） or Cw4 （C2） transfected K562 stimulator cells. Coculture of KIR＋ NK cells with C1 or C2 positive K562 cells, in the presence of IL-2＋ IL-15, triggered the outgrowth of NK cells that missed their cognate ligand. This resulted in an increased frequency of alloreactive KIR＋ NK cells within the whole NK cell population. Also, after preculture with K562 cells lacking their cognate ligand, we observed that this alloreactive NK population revealed higher numbers of CD107~ cells when cocultured with the relevant K562 HLA-C transfected target cells, as compared to coculture with untransfected K562 cells. This enhanced reactivity was confirmed using primary leukemic cells as target. This study demonstrates that HLA class I expression can mediate the skewing of the NK cell repertoire and enrich the population for cells with enhanced alloreactivity towards leukemic target cells. This feature may support future clinical applications of NK cell-based immunotherapy.

关键词： alloreactivity cytotoxicity immunotherapy KIR NK cells stem cell transplantation

Assessment of Knowledge, Attitude and Practices towards the Disposal of Unused and Expired Medications among Students of Private Medical Universities in Lusaka, Zambia

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Pharmacology & Pharmacy 2022年第2期13卷 49-68页

作者： Martin Kampamba Vewoerd Maingaila Tumelo Muyenga Akapelwa Steward Mudenda Luke Biete Webrod Mufwambi michelo Banda Margaret Phiri Christabel Nang’andu Hikaambo Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Physiological Sciences School of Medicine and Health Sciences Mulungushi University Livingstone Zambia Department of Clinical Pharmacy and Pharmacy Practice School of Pharmacy Eden University Lusaka Zambia Department of Pharmacy School of Medicine and Health Sciences Mulungushi University Kabwe Zambia

Background: The disposal of unused and expired medications has been a concern in many countries in that, the pharmaceutical waste enters the ecosystem and eventually causes a negative impact on human health and environment. Aim: To assess the knowledge, attitude and disposal practices of unused and expired medicines by students in the private medical universities in Lusaka of Zambia. Method: A cross-sectional survey was conducted over a period of 8 weeks among 391 respondents from three private universities in Lusaka. Respondents were polled using semi structured questions that focused on their knowledge, attitudes, and disposal practices for unused and expired drugs. In order to analyze data, the statistical package for social sciences (SPSS) version 20 was utilized. Results: The mean age of the participants was 23 years (SD: ±3). Out of the 391 participants, 320 (81.8%) knew about medicine waste and 391 (100.0%) responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. The drug-take-back system was unknown to a vast percentage of the respondent 371 (94.9%). The majority 274 (70.1%) of respondents had unused medicine stored at home, with antibiotics 215 (56.0%) and analgesia 111 (28.4%) being the most prevalent types of drugs kept in the households. The most commonly used disposal practice for unused 126 (32.2%) and expired medicines 274 (70.1%) was throwing them in household garbage. Only 27 (6.9%) and 30 (7.7%) reported returning unused and expired medicines to the nearest pharmacy respectively. The majority of respondents believed the risk stemmed from the presence of an undesired drug in the home, the potential for harm to children, a lack of proper information on safe disposal practices, and the necessity for a take-back program. Conclusions: The majority of the study participants used unsafe methods to dispose of unused and expired medicine. However, most of the participants acknowledged that un

关键词： Unused Medications Expired Medications Medicine Disposal Medicine Waste

Zambia’s Response to the COVID-19 Pandemic: Exploring Lessons, Challenges and Implications for Future Policies and Strategies

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Pharmacology & Pharmacy 2022年第1期13卷 11-33页

作者： Steward Mudenda Misheck Chileshe Moses Mukosha Christabel Nang’andu Hikaambo michelo Banda Martin Kampamba Kennedy Mwila David Chimbizgani Banda Webrod Mufwambi Victor Daka Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia MaryBegg Health Services Northrise Ndola Zambia Graduate School of Education Peking University Beijing China Department of Nursing Faculty of Health Sciences Chreso University Lusaka Zambia Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia

The coronavirus disease 2019 (COVID-19) pandemic is a global public health problem that has affected the globe in different ways. There is little information published on the challenges and lessons learnt in responding to the COVID-19 epidemic in Zambia. Objective: To establish Zambia’s response, lessons and the challenges experienced in the fight against COVID-19. Results: Since the emergence of COVID-19, Zambia has experienced three waves, with the third wave being the most severe. The Zambian government responded positively and effectively to all three pandemics with the help of cooperating partners. Zambia adopted the World Health Organization (WHO) recommended prevention methods such as hand hygiene, masking up in public, physical distancing, avoiding crowded areas and staying at home to prevent the further spread of the disease. Additionally, surveillance of COVID-19 was strengthened, which led to the early detection of cases. Besides, there has been a strong call for all Zambian adults to receive the COVID-19 vaccine as a way of controlling the epidemic. However, since the launch of the COVID-19 vaccination programs, there has been a high level of vaccine hesitancy, causing Zambia to fall below the 10% of the adult popu

Familiarity, Knowledge and Practices of Healthcare Professionals Regarding the Pharmacovigilance of Biological Medicines in Lusaka, Zambia: A Multi-Facility Cross-Sectional Study

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Pharmacology & Pharmacy 2022年第7期13卷 230-251页

作者： michelo Banda Katia Verhamme Webrod Mufwambi Steward Mudenda Billy Chabalenge Scott Kaba Matafwali Ronald Kampamba Mutati Christabel Nang’andu Hikaambo Martin Kampamba Lavina Prashar Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medical Informatics Erasmus MC Rotterdam Netherlands Department of Bioanalysis Ghent University Ottergemsesteenweg Ghent Belgium Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London UK Department of Physiological Sciences School of Medicine University of Zambia Lusaka Zambia

Background: Pharmacovigilance of biological medicines is crucial because it ensures that medicines meet the World Health Organization (WHO) standards. In Zambia, there is little information on healthcare professionals’ familiarity, knowledge and practices on the pharmacovigilance of biological and biosimilar medicines. Therefore, this study investigated the familiarity, knowledge, and practices related to the pharmacovigilance (PV) of biological and biosimilar medicines at selected hospitals in Lusaka, Zambia. Methods: The study was an analytical questionnaire-based cross-sectional study conducted among healthcare professionals (HCPs) at the Adult hospital, Cancer Diseases hospital, Paediatrics hospital and Women and New Born Hospital in Lusaka. Data were collected over four weeks in May and June 2021 and subsequently analysed using IBM SPSS version 21. The statistical significance was set at a 95% confidence interval. Results: Of 245 participants, only 115 (48.9%) of the HCPs were familiar with biological medicines to a basic understanding. Regarding the term biosimilars, most of the HCPs (40.9%) never heard of this word. The mean score for knowledge regarding the PV considerations of biological medicines was 4.1 out of 8 questions. Most HCPs used non-proprietary names (44.2%) when prescribing, dispensing, or administering biological medicines. Additionally, more than half (57.3%) of HCPs did not record batch numbers when dispensing or administering biological medicines. Conclusion: Healthcare professionals were more familiar with the term biological medicines than biosimilars. Healthcare professionals generally scored poorly when their knowledge regarding the PV considerations of biological medicines was assessed. Thus, there is a need to provide adequate training and continuous professional development among healthcare professionals on the pharmacovigilance of biological and biosimilar medicines.

关键词： Pharmacovigilance Biological Medicines Biosimilars Brand Batch Zambia

Challenges Affecting African Countries in the Fight against the COVID-19 Pandemic: Implications for Interventional Strategies in Low- and Middle-Income Countries

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Advances in Infectious Diseases 2022年第3期12卷 496-517页

作者： Steward Mudenda Kennedy Mwila Christabel Nang’andu Hikaambo Victor Daka Godfrey Mayoka Maisa Kasanga michelo Banda Moses Mukosha Ruth Lindizyani Mfune Martin Kampamba Lungwani Tyson Muungo Ronald Kampamba Mutati Webrod Mufwambi Misheck Chileshe Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Graduate School of Education Peking University Beijing China Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia Department of Pharmacology and Pharmacognosy School of Pharmacy Jomo Kenyatta University of Agriculture and Technology Nairobi Kenya College of Public Health Zhengzhou University Zhengzhou China Department of Pathology and Microbiology University Teaching Hospitals Lusaka Zambia Mary Begg Health Services Ndola Zambia

The coronavirus disease 2019 (COVID-19) has caused many global challenges, especially in resource-constrained countries. Africa, a continent with a large number of low-and middle-income countries (LMICs), shares this burden disproportionately compared to developed countries. Here we review some of the major challenges African countries face in the fight against COVID-19 and propose some mitigation measures. Studies have reported low adherence to COVID-19 prevention measures in most African countries. Additionally, there has been a shortage of healthcare workers, inadequate surveillance and diagnostic tools, unavailability of drugs in healthcare facilities, increased wrong beliefs, myths, misinformation and misconceptions about COVID-19 and vaccinations, and an already existing burden of infectious and non-infectious diseases across the African continent. Despite being very challenging to implement across African countries, telehealth is a critical solution to offer healthcare services during disease outbreaks. Many African countries have faced challenges in the fight against COVID-19. The training of healthcare workers (HCWs) must be strengthened to help address the shortage. In addition, African countries should strive to invest in research and capacity-building to be self-reliant regarding diagnostic tests. Thus, there is an urgent need to address the challenges faced by African countries in this fight, which may even include increased collaborations with other countries.

关键词： Africa African Countries Challenges COVID-19 COVID-19 Vaccines Pandemic Telehealth Vaccination

Antibiotic Prescribing Patterns in Adult Patients According to the WHO AWaRe Classification: A Multi-Facility Cross-Sectional Study in Primary Healthcare Hospitals in Lusaka, Zambia

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Pharmacology & Pharmacy 2022年第10期13卷 379-392页

作者： Steward Mudenda Mary Chomba Billy Chabalenge Christabel Nang’andu Hikaambo michelo Banda Victor Daka Annie Zulu Abraham Mukesela Maxwell Kasonde Peter Lukonde Enock Chikatula Lloyd Matowe Ronald Kampamba Mutati Tyson Lungwani Muungo Tobela Mudenda Shafiq Mohamed Scott Matafwali Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Department of Public Health Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia Bell Pharmacy Kabulonga Centro Mall Lusaka Zambia Ministry of Health Headquarters Ndeke House Lusaka Zambia Department of Pharmacy Levy Mwanawasa University Teaching Hospital Lusaka Zambia Faculty of Pharmacy School of Pharmacy Eden University Lusaka Zambia Department of Pathology Ndola Teaching Hospital Ndola Zambia Remedium Pharmaceuticals Limited Lusaka Zambia Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London UK

Introduction: Indiscriminate prescribing and using of antibiotics have led to the development of antimicrobial resistance (AMR). To reduce this problem, the World Health Organization (WHO) developed the “Access”, “Watch”, and “Reserve” (AWaRe) classification of antibiotics that promotes antimicrobial stewardship (AMS). In Zambia, there are gaps in practice regarding prescribing of antibiotics based on the AWaRe protocol. This study assessed antibiotic prescribing patterns in adult in-patients in selected primary healthcare hospitals in Lusaka, Zambia. Materials and Methods: This retrospective cross-sectional study was conducted using 388 patient medical files from September 2021 to November 2021, five primary healthcare hospitals namely;Chawama, Matero, Chilenje, Kanyama, and Chipata. Data analysis was performed using the Statistical Package for Social Sciences version 23. Results: Of the selected medical files, 52.3% (n = 203) were for male patients. Overall, the prevalence of antibiotic use was 82.5% (n = 320) which was higher than the WHO recommendation of a less than 30% threshold. The most prescribed antibiotic was ceftriaxone (20.3%), a Watch group antibiotic, followed by metronidazole (17.8%) and sulfamethoxazole/trimethoprim (16.3%), both belonging to the Access group. Furthermore, of the total antibiotics prescribed, 41.9% were prescribed without adhering to the standard treatment guidelines. Conclusion: This study found a high prescription of antibiotics (82.5%) that can be linked to non-adherence to the standard treatment guidelines in primary healthcare hospitals. The most prescribed antibiotic was ceftriaxone which belongs to the Watch group, raising a lot of concerns. There is a need for rational prescribing of antibiotics and implementation of AMS programs in healthcare facilities in Zambia, and this may promote surveillance of irrational prescribing and help reduce AMR in the future.

关键词： Antibiotic Prescribing Antimicrobial Resistance Antimicrobial Stewardship AWaRe Classification Prescribing Patterns Primary Healthcare Surveillance Zambia

Psychological Impact of COVID-19 on Healthcare Workers in Africa, Associated Factors and Coping Mechanisms: A Systematic Review

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Advances in Infectious Diseases 2022年第3期12卷 518-532页

作者： Steward Mudenda Billy Chabalenge Scott Matafwali Victor Daka Misheck Chileshe Webrod Mufwambi Ruth Lindizyani Mfune Josephine Chali Mukuka Chomba michelo Banda Racheal Mwaweza Ronald Kampamba Mutati Tyson Lungwani Muungo John Balidawa Christabel Nang’andu Hikaambo James Mwanza Maisa Kasanga Shafiq Mohamed Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia Department of Medicines Control Zambia Medicines Regulatory Authority Lusaka Zambia Clinical Research Department Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London United Kingdom Department of Public Health Michael Chilufya Sata School of Medicine Copperbelt University Ndola Zambia MaryBegg Health Services Ndola Zambia Faculty of Paediatrics and Child Health Lusaka College of Nursing Lusaka Zambia Unicaf University Kampala Uganda Department of Pharmacy School of Health Sciences University of Zambia Lusaka Zambia College of Public Health Zhengzhou University Zhengzhou China Department of Pathology and Microbiology University Teaching Hospitals Lusaka Zambia Remedium Pharmaceuticals limited Salama Park Lusaka Zambia

Background: The coronavirus disease 2019 (COVID-19) is a public health problem that has caused harm to the mental health of healthcare workers. In Africa, the COVID-19 pandemic has led healthcare workers to experience mental health disorders such as anxiety, depression, stress, insomnia and burnout. This study aimed to review published studies on the effect of COVID-19 on the mental health of healthcare workers, associated factors and coping strategies that have been employed in Africa. Methods: This was a systematic review that was conducted through searching databases including;PubMed/Medline and Google Scholar. The study included published literature from January 2020 to May 2022 that met the inclusion criteria. The selection of articles was conducted following the 2020 PRISMA guidelines. Results: A total of 39 articles were retrieved, of which only 18 met the inclusion criteria and were used in this study. Our review revealed that healthcare workers experienced mental health disorders such as anxiety, depression, insomnia, stress and burnout that were associated with the COVID-19 pandemic. Coping strategies such as religious practices, support from family members and colleagues and avoiding listening to social media about COVID-19 were used to minimize mental health problems. Conclusion: The COVID-19 pandemic has caused increased mental health disorders among healthcare workers in Africa. Identification of factors associated with mental health problems is cardinal in developing coping mechanisms against the psychological impact of COVID-19. Therefore, there is a need for governments to develop and implement strategies for protecting the mental health of healthcare workers during crises such as the COVID-19 pandemic.

关键词： Africa Coping Mechanisms COVID-19 Factors Healthcare Workers Mental Health Pandemic Psychological Impact