Prevalence and factors associated with COVID-19 vaccine acceptance in Zambia: a web-based cross-sectional study.

Introduction: vaccinations against COVID-19 have been instituted to contain the pandemic. However, information about the acceptability of COVID-19 vaccines in Zambia is lacking. Therefore, the study assessed the prevalence and factors associated with COVID-19 vaccine acceptance among the general population in Zambia. Methods: this was an online questionnaire-based cross-sectional study conducted from 13th April to 21st May 2021. We included adult Zambians who had access to Facebook and WhatsApp. A multivariable logistic regression model was fitted to determine factors influencing vaccine acceptability. Data were analysed using Stata version 16.1. Results: of the 677 participants, only 33.4% (n = 226) would accept the vaccine if made available to them. In multivariable regression analysis, respondents who were older than 41 years compared to the 18 to 23 years age group (aOR: 2.77, 95% CI: 1.03-7.48), those who agreed (aOR; 22.85, 95% CI: 11.49-45.49) or did not know (aOR; 3.73, 95% CI: 2.29-6.07) compared to those who disagreed that the COVID-19 vaccine passed through all the necessary stages to ensure its safety and effectiveness, and those who were aware (aOR; 11.13, 95% CI: 5.31-23.35) compared to those who were not aware that the COVID-19 vaccine reduces virus transmission, were more likely to accept the vaccine. Conversely, entrepreneurs compared to government employees (aOR; 0.24, 95% CI: 0.07-0.79) were less likely to accept vaccination. Conclusion: awareness of the COVID-19 vaccine was high despite low acceptability levels. These findings are significant as they highlight the need to develop strategies for improving vaccine acceptability in Zambia.

Method development and validation for simultaneous determination of ebastine and its active metabolite carebastine in human plasma by liquid chromatography-tandem mass spectrometry and its application to a clinical pharmacokinetic study in healthy Chinese volunteers.

A simple LC-tandem mass spectrometry (MS/MS) method to determine ebastine and carebastine (active metabolite) in human plasma was developed and validated. Analytes and internal standards were precipitated by protein precipitation and separated on Synergi Hydro-RP 80A column (4 µm, 50 mm × 2.0 mm; Phenomenex) by gradient elution with mobile phase A comprising 0.1% formic acid in 5 mm ammonium acetate (NH4 Ac) and B comprising 100% methanol at a flow rate 0.4 mL/min. Ions were detected in positive multiple reaction monitoring mode, and they exhibited linearity over concentration range 0.01-8.0 and 1.00-300 ng/mL for ebastine and carebastine, respectively. A clinical pharmacokinetic study was conducted in healthy Chinese volunteers under fasting and fed conditions after a single oral administration of 10 mg ebastine. The maximum plasma concentration (Cmax ), time to Cmax (Tmax ) and elimination half-life for ebastine were 0.679 ± 0.762 ng/mL, 1.67 ± 1.43 h and 7.86 ± 6.18 h, respectively, whereas these for carebastine were 143 ± 68.4 ng/mL, 5.00 ± 2.00 h and 17.4 ± 4.97 h, respectively under fasting conditions; the corresponding values under fed conditions were 4.13 ± 2.53 ng/mL, 3.18 ± 1.09 h and 21.6 ± 7.77 h for ebastine and 176 ± 68.4 ng/mL, 6.14 ± 2.0 h and 20.0 ± 4.97 h for carebastine.

Cost-effectiveness analysis of establishing a distance-education programme for health personnel in Swaziland.

There is a growing conviction among policy-makers that the availability of adequate numbers of well-trained and motivated human resources is a key determinant of health system' s capacity to achieve their health, responsiveness and fairness-improving goals. The objective of this study was to estimate the cost, effectiveness and incremental cost-effectiveness ratios of various distance-education strategies for the health sector in Swaziland; and recommend the most cost-effective option. The distance-education strategies evaluated included: Mobile library services (MLS); micro-resources centers WITHOUT video conferencing in five health centers and four regional hospitals (MRC-VC); micro-resources centers WITH video conferencing in five health centers and four regional hospitals (MRC+VC); centralized resource center WITHOUT video conferencing (CRC-VC); centralized resource center WITH video conferencing (CRC+VC); and status quo (SQ). The incremental cost-effectiveness ratio for MLS was Emalangeni (E) 41,846; MRC-VC was E42,696; MRC+VC was E45,569; CRC-VC was E43,578; CRC+VC was E40,827; the latter being the most cost-effective distance-education strategy. According to policy-makers, this study served to clarify the various distance-education strategies, their costs and their benefits/effectiveness. There is a need for developing in Africa a culture of basing policy and management decisions of such kind on systematic analyses. Of course, economic evaluation will, at most, be a guide to policy- and decision-making, and thus, the onus of decision-making will always be on policy-makers and health-care managers.