Journal of Clinical Research

Introduction: Diabetes mellitus, a metabolic disease characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. It is one of the most common non communicable diseases in Zambia and there is no cure for it. Diabetes Mellitus (DM) is one of the major causes of morbidity and mortality among the non-communicable diseases worldwide. These are highly associated with a poor glycaemic controls. Hence, this study aimed at determining the factors associated with poor glycaemic control among diabetes mellitus outpatient at the Ndola Teaching Hospital, Ndola Zambia

Objectives: The main goal of this study is to determine or identify factors associated with poor glycaemic control among diabetes mellitus out patients at Ndola Teaching Hospital in Ndola.

Methodology: A hospital based cross sectional study with convenient random sampling was conducted on a total number of 92 participants. Data was collected through an interview using a questionnaire during hospital visits. The data was then analysed using SPSS V23. The prevalence of poor glycaemic control was calculated and the factors associated with it were deduced using chi square test.

Results: The factors significantly associated with poor glycemic control were lack of physical exercise, use of non-insulin medication, smoking and dyslipidaemia. Those who had regular blood sugar testing, following the recommended and attending the follow up meeting with the health care provider were less likely to have poor glycemic control so as those who did physical exercises.

Conclusion: Lack of physical exercises, not testing blood sugars regularly, dyslipidaemia and smoking were found to be associated with poor glycemic control. Staff managing DM patients should emphasize and include information education and communication sessions during the follow-up visits by DM patients on frequent monitoring of blood glucose levels, regular physical exercises and avoid smoking.

Aim: COVID-19 has created a global public health emergency with significant mortality and morbidity for People Living with HIV (PLWH). Preliminary data reveals persons with immune-compromised status are at risk of developing adverse clinical outcomes from SARS-CoV-2. This study intended to characterise clinical outcomes of HIV patients co-infected with SARS-CoV-2 infection at Kitwe Teaching Hospital (KTH).

Materials and methods: A retrospective cross-sectional study was conducted among patients admitted with COVID-19 at KTH between 1^st July and 30^th September, 2021. All necessary data was collected from files and records of patients admitted between 1^st July and 30^th September, 2021, using a data extraction sheet. Data was entered, coded and analysed using SPSS version 26*64.

Results: 17.4% of admitted patients were HIV positive, with 40.5% were HIV negative and 42.0% had their HIV status unknown. There was no correlation between HIV status and clinical outcomes (p-value=0.146), instead, there was significance between gender and clinical outcome (p-value=0.026). There was an observed overall mortality rate of 80% for all patients admitted due to COVID-19, regardless of their HIV status.

Conclusion and recommendations: There was no observed influence of HIV on clinical outcomes of COVID-19 patients. The increased mortality rate of HIV infected patients could be attributed to many other things. That is why recommendations to seek medical attention early, improving management of patients with special needs and encouraging seeking medical care for related symptoms were made.

Background: Teenage pregnancy in Zambia has continued to be a public health concern with 17% of women beginning their sexual activity before 15 years, and 69% before 18 years. 34% having given birth before 18 years and 29% between 15-19 years. Previous studies have outlined factors leading to teenage pregnancy as: low/no contraception use, poverty, poor sexual education and a bad parental relation. Due to the impact of teenage pregnancy (low birth weight, premature deliveries, and severe neonatal conditions, this study was undertaken with the aim of determining the prevalence and factors associated with an increase in teenage pregnancies in Chikupili village, Luano district-central province.

Method: A cross sectional design was used. The village was divided into clusters and simple random sampling was used to select 384 participants. A questionnaire tailored with both open and closed ended questions was used after informed consent had been granted by the participant. The statistical method used was the descriptive statistical analysis and Chi Square test method. The data was later entered and analyzed quantitatively using the Statistical Package for Social Scientists (SPSS) version 26.

Results: Out of the calculated sample size 384 a total of 384 individuals answered the questionnaire making the response rate to be 100%. The majority were female (n=278, 72.4%) while only 106 (27.6%) males took part in the study. Their ages ranged, with the highest frequency being among those 20 and below (210,54.7%), this study determined the prevalence of teenage pregnancies in Chikupili-Luano district to be 167 (48.8%), there was a correlation between age when first pregnant and marital status when first pregnant (p-value=0.036). This study determined that 69% of the participants had good knowledge regarding contraception and 70.7% of respondents had a good relationship with their parents. Correlations were found between the age when first pregnant and; marital status during first pregnancy (p value-0.036), sex of participant (0.000), age of participant (0.000). Another correlation was found between the relation level with parents and age of participant (0.000), level of education (p-value=0.02) and marital status during first pregnancy (p-value 0.000). On knowledge levels and relationship with parents, a correlation with p-value 0.03 was found. A P-value of less than 0.05 was considered significant.

Conclusion: This study showed that the prevalence of teenage pregnancy still remains high in Chikupili-Luano district despite the knowledge levels of contraception use and relationship with guardians being good. Other approaches can be taken such as ensuring girls getting educated to improve their education levels and providing better facilities for them to socialize and take part in social activities.

Background: Postpartum depression is a pregnancy related psychiatric condition that affects women of child bearing age and manifests in the first 6 months after giving birth persisting up to 12 months. Symptoms include sleep disturbance, low energy, lack of interest in daily activities as well thoughts of self-harm or harming the baby. However, there are no diagnostic tools or criteria hence the condition is usually underdiagnosed. This condition affects the mother, child and family as a whole. Associated risk factors include low socio-economic status, poor family and social support, unwanted pregnancy etc.

Aim: to determine the prevalence of postpartum depression and associated risk factors among women attending postnatal services at Ndolas New Masala and Lubuto clinics.

Study design: Cross sectional study

Study setting: postnatal clinic

Study population: 80 consenting women with 6 weeks old infants attending postnatal services at Ndolas New Masala and Lubuto clinics.

Method: The study participants were recruited from the women that came for the 6 weeks post-natal review and child immunization using simple random sampling. Eligible candidates were approached and required to consent voluntarily. The data was collected using an investigator administered structured questionnaire and depression screening was done using the Edingburg Postnatal Depression Scale (EPDS). Inclusion was done until the sample size of 80 was attained. The analysis was done using Statistical Package for the Social Sciences (SPSS) software which generated the relevant statistical frequencies and tables.

Results: All the 80 participants (recruited mothers) were analysed. 45% had EPDS scores >8 which indicated depression. 27.5%had a mild form of depression, 12.5% moderate and 5% scored in the severe depression range, an EPDS score of >13.Significant association were found with the following factors, mothers response to knowledge of pregnancy (p=0.033), type of feeding of the baby (p=0.026) and family involvement in child care (p=0.034). No significant association was observed with age of mother (p=0.184), marital status (p=0.960), level of education (p=0.146), fathers support (p=0.604), parity (p=0.266) and presence of chronic condition (p=0.917). No significant association was found with the mode of delivery (p=0.604) contrary to popular belief.

Conclusion: The prevalence of postpartum depression six weeks after delivery of 45% appears to be very high and necessitates routine screening of all postnatal mothers. Family involvement in child care, mothers response to knowledge of pregnancy and type of baby feeding are statistically significant associates of postpartum depression.