Qualitative assessment of infant sleep practices and other risk factors of sudden infant death syndrome (SIDS) among mothers in Lusaka, Zambia.

BACKGROUND: There is very little information on the beliefs and perceptions of mothers about SIDS and its related risk factors in Africa. To better understand parental decisions about infant sleep practices and other risk factors for SIDS, we conducted focus group discussions (FGDs) with mothers of infants in Lusaka, Zambia. METHODS: FGDs involved 35 purposively sampled mothers aged 18-49 years. FGDs were conducted using a semi-structured interview guide in the local language, Nyanja. These were translated, transcribed verbatim into English, and then coded and analyzed using thematic analysis in NVivo 12. RESULTS: Six FGDs were conducted with 35 mothers in April-May 2021 across two study sites. FGD Participants were generally aware of sudden unexplained infant deaths, with several describing stories of apparent SIDS in the community. The side sleeping position was preferred and perceived to be safer for the infant with most believing the supine position posed an aspiration or choking risk to the infant. Bedsharing was also preferred and perceived to be convenient for breastfeeding and monitoring of the infant. Experienced family members such as grandmothers and mothers-in-law, and health care workers were frequently cited as sources of information on infant sleep position. A heightened awareness of the infant's sleeping environment was suggested as a mechanism to prevent SIDS and smothering. CONCLUSIONS: Decisions about bedsharing and infant sleep position were guided by maternal beliefs and perceptions about what is convenient for breastfeeding and safer for the infant. These concerns are vital to designing tailored interventions to address sleep-related sudden infant losses in Zambia. Public health campaigns with tailored messages that address these concerns are likely to be effective at ensuring optimal uptake of safe sleep recommendations.

Project SEARCH (Scanning EARs for Child Health): validating an ear biometric tool for patient identification in Zambia.

Patient identification in low- to middle-income countries is one of the most pressing public health challenges of our day. Given the ubiquity of mobile phones, their use for health-care coupled with a biometric identification method, present a unique opportunity to address this challenge. Our research proposes an Android-based solution of an ear biometric tool for reliable identification. Unlike many popular biometric approaches (e.g., fingerprints, irises, facial recognition), ears are noninvasive and easily accessible on individuals across a lifespan. Our ear biometric tool uses a combination of hardware and software to identify a person using an image of their ear. The hardware supports an image capturing process that reduces undesired variability. The software uses a pattern recognition algorithm to transform an image of the ear into a unique identifier. We created three cross-sectional datasets of ear images, each increasing in complexity, with the final dataset representing our target use-case population of Zambian infants (N=224, aged 6days-6months). Using these datasets, we conducted a series of validation experiments, which informed iterative improvements to the system. Results of the improved system, which yielded high recognition rates across the three datasets, demonstrate the feasibility of an Android ear biometric tool as a solution to the persisting patient identification challenge.