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Introduction: Hepatitis B virus (HBV) is highly infectious and deadly disease that is transmitted through blood and body fluids. Health care workers (HCWs) have a high risk of contracting HBV in health care settings, the Hep-B vaccine one of the recommended prevention intervention/tools. However, uptake of the vaccine among HCWs remains low in Sub-Saharan Africa. We aimed to explore the barriers and facilitators to uptake of the vaccine offered free of charge to HCWs and nursing students in Kalulushi district, Copperbelt Province of Zambia. Methods: A total of 29 in-depth interviews (IDIs), either in person or via telephone, with participants before and after they received the vaccines were used to collect the data. We analysed the barriers and facilitators to full or partial vaccination using Penchasky and Thomas's (1981) 5A's (Access, Affordability, Awareness, Acceptance and Activation) taxonomy framework for vaccine hesitancy. Results: All participants had access to the vaccine, and it was free of charge, making it affordable. Regarding awareness, all participants were aware of HBV infection as an occupational hazard, however, HCWs felt that more sensitization would be needed to increase awareness and knowledge of the vaccine. Acceptability of the vaccine was high among all completers and some non-completers as they felt it was safe and offered them protection. One non-completer felt coerced to accept the first dose due to supervisor expectations and would have preferred to have been given more time to decide. Most felt that vaccination should be compulsory for HCWs. Lastly, activation (vaccine uptake) among non-completers was hindered by late or no notification of appointments as the main reason for not completing the full vaccination schedule. HCWs advised that for countrywide roll-out, at least one weeks' notification would be necessary for HCWs to plan and be mentally prepared to be at their workstations when the vaccination is taking place. Conclusions: The need to offer the vaccine free of charge locally to ensure easy access and affordability is essential to increase vaccine uptake. Vaccination policies and guidelines for health workers, ongoing training and knowledge sharing are required. Involving trained champions in the facility can also help encourage HCWs to get vaccinated.
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INTRODUCTION: Chronic kidney disease (CKD) has been a global public health problem and a major source of suffering and poor quality of life for those afflicted. Using data from the global burden of disease (GBD) study 2019, we estimated the magnitude of the burden of CKD as well as the underlying causes of CKD in the Zambian population. METHOD: The data used for this study were extracted from the GBD 2019 study. The GBD 2019 provides estimates of several metrics of disease burden including the commonly used disability-adjusted life year (DALYs) for over 369 diseases and injuries, and 87 risk factors and combinations of these in 204 countries and territories from 1990 to 2019. We estimated the burden of CKD as the number and rates (per 100,000 population) of DALYs, disaggregated by year, sex, and age group. We examined the underlying causes of CKD by estimating the population attributable fraction as the percentage contributions of risk factors to CKD DALY. RESULTS: The number of DALYs for CKD was estimated as 76.03 million (95% UI: 61.01 to 93.36) in 2019 compared to 39.42 million (95% UI: 33.09 to 45.90) in 1990, representing 93% increase whereas the DALYs rate per 100,000 population was estimated as 416.89 (95% UI: 334.53 to 511.93) in 2019 compared to 496.38 (95% UI: 416.55 to 577.87) in 1990, representing 16% reduction. CKD due to hypertension accounted for 18.7% of CKD DALYs and CKD due to diabetes (types 1 and 2) accounted for 22.7%, while CKD from glomerulonephritis accounted for the most DALYs at 33%. The age group most impacted from CKD were adolescents and young adults. CONCLUSION: The burden of CKD remains high in the Zambian population with diabetes, high blood pressure, and glomerulonephritis as important causes. The results highlight the need to develop a comprehensive action plan to prevent and treat kidney disease. Increasing the awareness of CKD among the public as well as adaptation of guidelines for treating patients with end stage kidney disease are important considerations.