Papers by Webrod Mufwambi
S Afr Med J, 2023
Background. Beta-adrenergic receptor blocker (BARB) drugs are a wide range of medicines that are ... more Background. Beta-adrenergic receptor blocker (BARB) drugs are a wide range of medicines that are used in various conditions, including chronic heart failure (HF). Several studies have reported a wide-ranging inappropriate use of evidence-based beta-blockers (EBBBs) in chronic HF in both inpatients and outpatients. Objectives. To assess the utilisation and optimisation of EBBBs among patients with HF who presented with a reduced ejection fraction (HFrEF). Methods. A hospital-based retrospective cross-sectional study was carried out at the Adult University Teaching Hospital (AUTH), in Lusaka, Zambia, where patient medical files for the period of 1 July 2018 to 31 July 2021 were reviewed. Patient information, including file number, age, sex, type of BARB and the dose used, was recorded on the developed and validated checklist. Multivariable regression analysis was performed to identify factors associated with utilisation of BARBs. Results. Of the 173 medical records reviewed, BARBs were utilised in 101 (58.4%) patients. Among the patients who utilised BARBs, 96 (95.0%) were taking EBBBs, while the rest (n=5, 5.0 %) were taking atenolol, which is a non-EBBB. Among the patients who were on EBBBs, none of them received the optimal dose. Age ≥65 years (adjusted odds ratio (aOR) 0.3, 95% confidence interval (CI) 0.17-0.64), previous hospitalisation (aOR 0.3, 95% CI 0.13-0.51) and furosemide dose ≥40 mg (aOR 0.4, 95% CI 0.21-0.64) were significantly associated with lower likelihood of BARB utilisation. New York Heart Association (NYHA) class II (aOR 3.4, 95% CI 1.08-10.7), NYHA class III (aOR 4.8, 95% CI 1.65-13.7) and patients using at least 5 medications (aOR 5.0, 95% CI 2.91-8.77) were independent predictors of BARB utilisation. Conclusion. This study showed that 95.0% of chronic HF patients were utilising EBBBs, and none received the optimal dose as recommended in the guidelines. Pharmacotherapy with EBBBs should be optimised among patients with chronic HfrEF, as these drugs reduce both morbidity and mortality.
Artificial Intelligence, 2024
Introduction: Artificial Intelligence (AI) is a field of computer science that mimics human intel... more Introduction: Artificial Intelligence (AI) is a field of computer science that mimics human intelligence in learning and problem-solving processes. There is a paucity of information regarding students’ knowledge, attitudes, and practices regarding AI. This study assessed the knowledge, attitudes, and practices of pharmacy students regarding AI. Materials and Methods: This descriptive cross-study was conducted among 262 pharmacy students at the University of Zambia using a structured questionnaire from August 2024 to September 2024. Data collected were analyzed using Statistical Package for Social Science (SPSS) version 23.0. The statistical significance was set at a 95% confidence level (p-value less than 0.05). Results: Of the 262 participants, 237 (90.4%) were aged between 20 and 30 years, 253 (96.6%) were familiar with the concept of AI, and 257 (98.1%) were aware of ChatGPT. Overall, 186 (71.3%) had inadequate knowledge, 186 (71.3%) had negative attitudes, and 135 (51.7%) had suboptimal practices towards AI. The results show a lower attitude compared to knowledge and practice levels. Inadequate knowledge and attitude were associated with gender (X2 = 11.612, p = 0.001 for knowledge level) and (X2 = 1.812, p = 0.003 for attitude level). Additionally, inadequate practice showed significant associations with years of study (X2 = 8.991, p = 0.028 for practice level) and residence (X2 = 5.593, p = 0.014 for practice level). Conclusion: The present study found that most pharmacy students had inadequate knowledge, attitudes, and practices concerning AI. As a result, there is a need to increase awareness about AI among healthcare students and its usefulness in the delivery of healthcare services. The study’s outcomes offer valuable insights for educating pharmacy students about AI and its applications within the pharmaceutical industry and the healthcare system. Therefore, we recommend that AI be incorporated into the curricula for the training of pharmacy students and continuous professional development programs for pharmacy personnel.
Patients’ Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program
Pharmacology & pharmacy, 2024
Roles of Community Pharmacists in Screening and Disseminating of Information about Non-Steroidal Anti-Inflammatory Drugs Risks: Implications for Drug Safety Assessment
Pharmacology & pharmacy, 2024
The coronavirus disease (Covid-19) pandemic has caused suffering and pain to mankind leading to m... more The coronavirus disease (Covid-19) pandemic has caused suffering and pain to mankind leading to many individuals practising self-medication and substance abuse that could elevate substance use disorders (SUDs). This study assessed the impact of Covid-19 on SUDs among Kanyama residents of Lusaka district, Zambia. We conducted a retrospective cross-sectional study using patient files at Kanyama First-Level Hospital from September 2021 to October 2021. Data analysis was done using IBM SPSS version 26.0. Of the 101 participants, 86.1% were male. The study showed that Covid-19 had an impact on SUDs with alcohol (83.2%) being the most abused substance. There was no significant difference in the type of substances abused (p=0.870) and intoxication symptoms (p=0.331) between the pre-Covid and post-Covid groups. There was a significant difference between substance use (p=0.001) and withdrawal symptoms (p=0.002) in both cohorts, with the post-Covid group consuming more substances and experiencing more withdrawal symptoms. Factors that influenced substance abuse included recent unemployment (p<0.001), boredom (p<0.001), overcrowding at home (p<0.001), and gender-based violence (p<0.001) influenced the change in the pattern of substance use. Recreational use was not associated with a change in the pattern of substance abuse (p=0. 667). This study found that the Covid-19 pandemic increased the practices of substance abuse among Kanyama residents, especially those who were unemployed, bored, overcrowded at home and experienced gender-based violence. There is a need to heighten the monitoring and restriction of substance use, especially among adolescents and youths to curb some mental health problems.
Utilisation and optimisation of beta-adrenergic receptor blockers over a 6-month period among chronic heart failure patients with reduced ejection fraction
PubMed, Aug 2, 2023
Background: Beta-adrenergic receptor blocker (BARB) drugs are a wide range of medicines that are ... more Background: Beta-adrenergic receptor blocker (BARB) drugs are a wide range of medicines that are used in various conditions, including chronic heart failure (HF). Several studies have reported a wide-ranging inappropriate use of evidence-based beta-blockers (EBBBs) in chronic HF in both inpatients and outpatients. Objectives: To assess the utilisation and optimisation of EBBBs among patients with HF who presented with a reduced ejection fraction (HFrEF). Methods: A hospital-based retrospective cross-sectional study was carried out at the Adult University Teaching Hospital (AUTH), in Lusaka, Zambia, where patient medical files for the period of 1 July 2018 to 31 July 2021 were reviewed. Patient information, including file number, age, sex, type of BARB and the dose used, was recorded on the developed and validated checklist. Multivariable regression analysis was performed to identify factors associated with utilisation of BARBs. Results: Of the 173 medical records reviewed, BARBs were utilised in 101 (58.4%) patients. Among the patients who utilised BARBs, 96 (95.0%) were taking EBBBs, while the rest (n=5, 5.0 %) were taking atenolol, which is a non-EBBB. Among the patients who were on EBBBs, none of them received the optimal dose. Age ≥65 years (adjusted odds ratio (aOR) 0.3, 95% confidence interval (CI) 0.17 - 0.64), previous hospitalisation (aOR 0.3, 95% CI 0.13 - 0.51) and furosemide dose ≥40 mg (aOR 0.4, 95% CI 0.21 - 0.64) were significantly associated with lower likelihood of BARB utilisation. New York Heart Association (NYHA) class II (aOR 3.4, 95% CI 1.08 - 10.7), NYHA class III (aOR 4.8, 95% CI 1.65 - 13.7) and patients using at least 5 medications (aOR 5.0, 95% CI 2.91 - 8.77) were independent predictors of BARB utilisation. Conclusion: This study showed that 95.0% of chronic HF patients were utilising EBBBs, and none received the optimal dose as recommended in the guidelines. Pharmacotherapy with EBBBs should be optimised among patients with chronic HfrEF, as these drugs reduce both morbidity and mortality.
Pharmacology & Pharmacy, 2022
Background: The disposal of unused and expired medications has been a concern in many countries i... more Background: The disposal of unused and expired medications has been a concern in many countries in that, the pharmaceutical waste enters the ecosystem and eventually causes a negative impact on human health and environment. Aim: To assess the knowledge, attitude and disposal practices of unused and expired medicines by students in the private medical universities in Lusaka of Zambia. Method: A cross-sectional survey was conducted over a period of 8 weeks among 391 respondents from three private universities in Lusaka. Respondents were polled using semi structured questions that focused on their knowledge, attitudes, and disposal practices for unused and expired drugs. In order to analyze data, the statistical package for social sciences (SPSS) version 20 was utilized. Results: The mean age of the participants was 23 years (SD: ±3). Out of the 391 participants, 320 (81.8%) knew about medicine waste and 391 (100.0%) responded that unsafe disposal of unused and expired medicine poses a threat to human health and can harm the environment. The drug-take-back system was unknown to a vast percentage of the respondent 371 (94.9%). The majority 274 (70.1%) of respondents had unused medicine stored at home, with antibiotics 215 (56.0%) and analgesia 111 (28.4%) being the most prevalent types of drugs kept in the households. The most commonly used disposal practice for unused 126 (32.2%) and expired medicines 274 (70.1%) was throwing them in household garbage. Only 27
Vaccines
The uptake of COVID-19 vaccines is critical to address the severe consequences of the disease. Pr... more The uptake of COVID-19 vaccines is critical to address the severe consequences of the disease. Previous studies have suggested that many healthcare workers (HCWs) are hesitant to receive the COVID-19 vaccine, further enhancing hesitancy rates within countries. COVID-19 vaccine acceptance and hesitancy levels are currently unknown among HCWs in Zambia, which is a concern given the burden of infectious diseases in the country. Consequently, this study assessed COVID-19 vaccine acceptance and hesitancy among HCWs in Lusaka, Zambia. A cross-sectional study was conducted among 240 HCWs between August and September 2022, using a semi-structured questionnaire. Multivariable analysis was used to determine the key factors associated with vaccine hesitancy among HCWs. Of the 240 HCWs who participated, 54.2% were females. A total of 72.1% of the HCWs would accept being vaccinated, while 27.9% were hesitant. Moreover, 93.3% of HCWs had positive attitudes towards COVID-19 vaccines, with medical ...
Antifungal resistance and stewardship: a call to action in Zambia
Pan African Medical Journal
Antifungal resistance (AFR) is a global problem that can be addressed using a multifaceted holist... more Antifungal resistance (AFR) is a global problem that can be addressed using a multifaceted holistic approach.
Global Strategies to Combat Antimicrobial Resistance: A One Health Perspective
Pharmacology &amp; Pharmacy
Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to... more Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to the inappropriate use of antimicrobials in humans, animals, and the environment. Developing and implementing strategies to reduce and combat AMR is critical. Purpose: This study aimed to highlight some global strategies that can be implemented to address AMR using a One Health approach. Methods: This study employed a narrative review design that included studies published from January 2002 to July 2023. The study searched for literature on AMR and antimicrobial stewardship (AMS) in PubMed and Google Scholar using the 2020 PRISMA guidelines. Results: This study reveals that AMR remains a significant global public health problem. Its severity has been markedly exacerbated by inappropriate use of antimicrobials in humans, animals, and the broader ecological environment. Several strategies have been developed to address AMR, including the Global Action Plan (GAP), National Action Plans (NAPs), AMS programs, and implementation of the AWaRe classification of antimicrobials. These strategies also involve strengthening surveillance of antimicrobial consumption and resistance, encouraging the development of new antimicrobials, and enhancing regulations around antimicrobial prescribing, dispensing, and usage. Additional measures include promoting global partnerships, combating substandard and falsified antimicrobials, advocating for vaccinations, sanitation, hygiene and biosecurity, as well as exploring alternatives to antimicrobials. However, the implementation of these strategies faces various challenges. These challenges include low awareness and knowledge of AMR, a shortage of human resources and capacity building for AMR and AMS, in adequate funding for AMR and AMS initiatives, limited laboratory capacities for surveillance, behavioural change issues, and ineffective leadership and multidisciplinary teams. Conclusion: In conclusion, this study established that AMR is prevalent among humans, animals, and the environment. Successfully addressing AMR calls for a collaborative, multifaceted One Health approach. Despite this, some gaps remain effectively implementing strategies currently recommended to combat AMR. As a result, it is essential to reinforce the strategies that are deployed to counter AMR across the human, animal, and environmental sectors.
Combating Antimicrobial Resistance , 2023
Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to... more Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to the inappropriate use of antimicrobials in humans, animals, and the environment. Developing and implementing strategies to reduce and combat AMR is critical. Purpose: This study aimed to highlight some global strategies that can be implemented to address AMR using a One Health approach. Methods: This study employed a narrative review design that included studies published from January 2002 to July 2023. The study searched for literature on AMR and antimicrobial stewardship (AMS) in PubMed and Google Scholar using the 2020 PRISMA guidelines. Results: This study reveals that AMR remains a significant global public health problem. Its severity has been markedly exacerbated by inappropriate use of antimicrobials in humans, animals, and the broader ecological environment. Several strategies have been developed to address AMR, including the Global Action Plan (GAP), National Action Plans (NAPs), AMS programs, and implementation of the AWaRe classification of antimicrobials. These strategies also involve strengthening surveillance of antimicrobial consumption and resistance, encouraging the development of new antimicrobials, and enhancing regulations around antimicrobial prescribing, dispensing, and usage. Additional measures include promoting global partnerships, combating substandard and falsified antimicrobials, advocating for vaccinations, sanitation, hygiene and biosecurity, as well as exploring alternatives to antimicrobials. However, the implementation of these strategies faces various challenges. These challenges include low awareness and knowledge of AMR, a shortage of human resources and capacity building for AMR and AMS, in adequate funding for AMR and AMS initiatives, limited laboratory capacities for surveillance, behavioural change issues, and ineffective leadership and multidisciplinary teams. Conclusion: In conclusion, this study established that AMR is prevalent among humans, animals, and the environment. Successfully addressing AMR calls for a collaborative, multifaceted One Health approach. Despite this, some gaps remain effectively implementing strategies currently recommended to combat AMR. As a result, it is essential to reinforce the strategies that are deployed to counter AMR across the human, animal, and environmental sectors.
Journal of Pharmacognosy and Phytochemistry
The global problem of antimicrobial resistance (AMR) has increased interest in natural products, ... more The global problem of antimicrobial resistance (AMR) has increased interest in natural products, such as honey in the treatment of diseases. This study evaluated the antibacterial activities of honey against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). This cross-sectional study was conducted from November 2020 to May 2021 using E. coli and S. aureus as indicator organisms. The antibacterial activities of honey were assessed using the agar well diffusion assay. The sensitivities of E. coli and S. aureus to honey were indicated by zones of inhibition which were measured using a ruler in millimetres. Data analysis was performed using Stata version 16.1. Honey produced a dose-dependent antibacterial activity against E. coli and S. aureus. Our study demonstrated that honey had stronger antibacterial activities against E. coli compared to S. aureus. This study highlights the need for further research on honey to investigate its potential use in treating bacterial infections.
Psychological Impact of COVID-19 on Community Pharmacists: A Cross-Sectional Study in Lusaka District, Zambia
Fortune journal of health sciences, 2022
Advances in Infectious Diseases
The coronavirus disease 2019 (COVID-19) has caused many global challenges, especially in resource... more The coronavirus disease 2019 (COVID-19) has caused many global challenges, especially in resource-constrained countries. Africa, a continent with a large number of low-and middle-income countries (LMICs), shares this burden disproportionately compared to developed countries. Here we review some of the major challenges African countries face in the fight against COVID-19 and propose some mitigation measures. Studies have reported low adherence to COVID-19 prevention measures in most African countries. Additionally, there has been a shortage of healthcare workers, inadequate surveillance and diagnostic tools, unavailability of drugs in healthcare facilities, increased wrong beliefs, myths, misinformation and misconceptions about COVID-19 and vaccinations, and an already existing burden of infectious and non-infectious diseases across the African continent. Despite being very challenging to implement across African countries, telehealth is a critical solution to offer healthcare services during disease outbreaks. Many African countries have faced challenges in the fight against COVID-19. The training of healthcare workers (HCWs) must be strengthened to help address the shortage.
A review of tenofovir and lamivudine dosing errors in patients on highly active anti retroviral therapy with renal impairment at the university teaching hospital in Lusaka,Zambia
The Lancet. Infectious diseases, 2018
Millions of HIV-infected people worldwide receive antiretroviral therapy (ART) in programmes usin... more Millions of HIV-infected people worldwide receive antiretroviral therapy (ART) in programmes using WHO-recommended standardised regimens. Recent WHO guidelines recommend a boosted protease inhibitor plus raltegravir as an alternative second-line combination. We assessed whether this treatment option offers any advantage over the standard protease inhibitor plus two nucleoside reverse-transcriptase inhibitors (NRTIs) second-line combination after 144 weeks of follow-up in typical programme settings. We analysed the 144-week outcomes at the completion of the EARNEST trial, a randomised controlled trial done in HIV-infected adults or adolescents in 14 sites in five sub-Saharan African countries (Uganda, Zimbabwe, Malawi, Kenya, Zambia). Participants were those who were no longer responding to non-NRTI-based first-line ART, as assessed with WHO criteria, confirmed by viral-load testing. Participants were randomly assigned to receive a ritonavir-boosted protease inhibitor (lopinavir 400 ...
Availability of Antimalarial Medicines in Community Pharmacies of Lusaka District, Zambia: Implications on Compliance to Malaria Treatment Guidelines
Pharmacology &amp; Pharmacy
Background: Malaria remains a major cause of morbidity and mortality in Zambia, affecting all lev... more Background: Malaria remains a major cause of morbidity and mortality in Zambia, affecting all levels of society, with children under the age of five and pregnant women being most at risk of serious illness. The availability of antimalarial medicines is one of the key interventions of malaria management. This study assessed the availability of antimalarial medicines in community pharmacies in Lusaka district, Zambia. Materials and Methods: This was a cross-sectional study that was conducted among 210 community pharmacies from September to November 2022 using a well-structured checklist in selected areas of Lusaka district. The availability was verified by a physical check of the product. The checklist contained the medicines listed both in the guidelines for diagnosis and treatment of malaria in Zambia as well as in the World Health Organization (WHO) malaria treatment guidelines. Results: This study found that all antimalarials listed in the local treatment guidelines for malaria were available in community pharmacies, though with the varying distribution. Of the 210 community pharmacies, 209 (99.5%) had artemether/lumefantrine in stock. The lowest available antimalarial was quinine/clindamycin, which was only available in 3 (1.4%) of the outlets. Conversely, 3 out of 16 (18.8%) antimalarials that were available in community pharmacies were not listed in the local treatment guidelines of malaria in Zambia, despite being listed in the WHO malaria treatment guidelines. This translated into a compliance level of 81.2% based on the local malaria treatment guidelines. Conclusion: This study concluded that antimalarials were How to cite this paper: Chimombe, T.,
Pharmacoepidemiology
Irrational and inappropriate prescribing of antibiotics is a major problem that can lead to the d... more 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...
African Journal of Pharmacy and Pharmacology, 2021
Medication administration omission errors (MAOE) are very common and often affect patient outcome... more Medication administration omission errors (MAOE) are very common and often affect patient outcomes and length of stay in the hospitals. This study was a cross-sectional study in which the frequency and causes of MAOE over four weeks at Ndola Teaching Hospital (NTH) was assessed. It involved reviewing patients' drug charts and observation of nurses during the administration of medications to inpatients to detect the MAOE. A total of 259 drug charts were reviewed using a checklist and administered semistructured questionnaires to 50 nurses who were involved in medication administration to solicit the cause of MAOE. To assess factors associated with MAOE, multivariate logistic regression was used. In this study, 259 drug charts were reviewed of which 220 (84.9%) had one or more MAOE. Of the 1100 doses prescribed to 259 inpatients, 317 doses were omitted resulting in an overall MAOE frequency of 28.8%. In multivariate regression analysis, increased number of medications that the patient used (AOR: 2.18, CI: 1.62-2.94; p=0.0001), being male (AOR: 2.42, Cl: 1.05-5.53: p=0.036) and surgical wards (AOR: 8.56, CI: 3.04-24.1; p=0.0001) were significant predictors of MAOE. The most common causes of MAOE were the unavailability of medication on the ward followed by work overload. The most omitted class of medication was anti-infective. Medication omission errors are common and affect adult inpatients at Ndola Teaching. There is a need to highlight the magnitude of this problem to promote awareness so that specific interventions are put in place to address the identified causes.
Advances in Infectious Diseases
Background: The coronavirus disease 2019 (COVID-19) is a public health problem that has caused ha... more Background: The coronavirus disease 2019 (COVID-19) is a public health problem that has caused harm to the mental health of healthcare workers. In Africa, the COVID-19 pandemic has led healthcare workers to experience mental health disorders such as anxiety, depression, stress, insomnia and burnout. This study aimed to review published studies on the effect of COVID-19 on the mental health of healthcare workers, associated factors and coping strategies that have been employed in Africa. Methods: This was a systematic review that was conducted through searching databases including; PubMed/Medline and Google Scholar. The study included published literature from January 2020 to May 2022 that met the inclusion criteria. The selection of articles was conducted following the 2020 PRISMA guidelines.
Uploads
Papers by Webrod Mufwambi