Kennedy Chishimba

Background: A propagative increase in SARS-CoV-2 transmission has been witnessed in Zambia since the index case was reported in March 2020. Although sociocultural factors including movement patterns, people’s livelihood, and way of life have been demonstrated to influence SARS-CoV-2 transmission dynamics, the role of environmental risk factors has not been adequately documented. The aim of the study was to investigate environmental risk factors contributing to the transmission dynamics of SARS-CoV-2 in Zambia using a cross-sectional study Results: The positivity rates were 10.5 % cell phones, 5.3% door knobs, 2.7% remote controls and 2.6% beddings. All the other surfaces came out negative. The sex proportion of the respondents was 55% and 45% males and females respectively. Regarding occupancy density, 37.5% (15/40) resided in a 2 to 3-roomed house, 32.5% (13/40) resided in a 4 to 7 roomed house and 30% (12/40) resided in > 7-roomed house. Of the 40 respondents, 75% (30/40) used recyclable face masks while 25% (10/40) used non-recyclable face masks. For the non-recyclable face masks, 30% of the respondents indicated incineration as a disposal method. A correlation coefficient of 0.25 was documented for the association between occupancy density and surface contamination. Conclusions: The study revealed that most environmental surfaces particularly mobile phones were rarely disinfected and were most likely to contribute to the transmission of SARS-CoV-2 in the community. Furthermore, the majority of the respondents used recyclable face masks which are easily washable. However, those who used non-recyclable face masks disposed of them indiscriminately which has the potential of contaminating the environment and further lead to the transmission of SARS-CoV-2.

Irrational and inappropriate prescribing of antibiotics is a major problem that can lead to the development of antimicrobial resistance (AMR). In Zambia, there is insufficient information on the prescribing patterns of antibiotics according to the World Health Organization (WHO) AWaRe classification. Therefore, this study assessed the prescribing patterns of antibiotics using the AWaRe classification during the COVID-19 pandemic at the University Teaching Hospital in Lusaka, Zambia. A cross-sectional study was conducted using 384 patient medical files at the University Teaching Hospital in Lusaka, Zambia, from August 2022 to September 2022. All antibiotics were classified according to the WHO “AWaRe” tool and assessed for appropriateness using the 2020 Zambian Standard Treatment Guidelines. Of the 384 patient medical files reviewed, antibiotics were prescribed 443 times. The most prescribed antibiotics were ceftriaxone (26.6%), metronidazole (22.6%), amoxicillin (10.4%), amoxicillin/clavulanic acid (5.6%), and azithromycin (5%). The prescribing of 42.1% of “Watch” group antibiotics was greater than the recommended threshold by the WHO. Most antibiotics were prescribed for respiratory infections (26.3%) and gastrointestinal tract infections (16.4%). The most prescribed antibiotic was ceftriaxone, a Watch antibiotic. This is a worrisome observation and calls for strengthened antimicrobial stewardship and implementation of the AWaRe framework in prescribing antibiotics.