James Mwanza | DMI St-Eugene University (original) (raw)

Papers by James Mwanza

Journal of Preventive and Rehabilitative Medicine

Introduction:Antipsychotics are the main pharmacological treatment for psychosis. Anticholinergic... more Introduction:Antipsychotics are the main pharmacological treatment for psychosis. Anticholinergic drugs are sometimes prescribed with antipsychotics to treat or as prophylaxis for extrapyramidal side effects. Antipsychotic treatment guidelines recommend that anticholinergics should not be prescribed indiscriminately as prophylaxis for extrapyramidal side effects to patients using antipsychotic drugs, but only when there is high risk or evidence of extrapyramidal side effects, as they can cause significant central and peripheral side effects which have a potential to affect treatment outcomes. The objective of the study was to assess the trends in the prescribing of antipsychotics and anticholinergics.Methods:A cross sectional study was conducted at Chainama Hills College Hospital in Zambia. An open-ended questionnaire was administered to 26 prescribers and 311 files for patients were reviewed who had an antipsychotic or anticholinergic drug prescribed. The prescription pattern of pa...

Advances in Infectious Diseases

EAS Journal of Nursing and Midwifery

Background: Alcohol is a recognized teratogen in utero because of its potential to cause damage t... more Background: Alcohol is a recognized teratogen in utero because of its potential to cause damage to the brain resulting in developmental, cognitive and behavioral problems including Fetal alcohol spectrum disorders (FASDs) and mental health problems such as anxiety, depression, attention deficit hyperactivity disorders. Main objective: To explore the determinants of alcohol use among pregnant women at George Health Centre. Method: The study adopted a mixed convergent method approach. An analytical cross-sectional design recruited 255 pregnant women from which 24 participated in descriptive qualitative design collected through 4 focused group discussions from women who gave a history of drinking alcohol. Results: The study showed that 4 in every 10 pregnant women had a history of alcohol consumption prior to and during pregnancy. Significant factors associated with alcohol use included smoking which increased the odds of drinking alcohol 11.24 more times among smokers. Pregnant women’...

International Journal of Pharmacy Practice

Objectives Low job satisfaction levels among pharmacists are associated with poor motivation and ... more Objectives Low job satisfaction levels among pharmacists are associated with poor motivation and performance in the workplace. However, in Zambia, the job satisfaction levels of pharmacists remain unknown. Therefore, the aim of this article was to explore levels of job satisfaction among pharmacists from the public and private health sectors in Zambia. Methods We conducted a cross-sectional study among Zambian pharmacists between April and August 2019. We used a previously validated self-administered questionnaire to measure job satisfaction. We sent out 200 questionnaires, of which 156 (78.0%) were returned. Bivariate analysis and an adjusted general linear regression model were fitted to determine factors affecting job satisfaction levels. Key findings Among 156 respondents, 46 (29.5%) were males, 114 (73.1%) and worked in the public sector. Overall, the mean job satisfaction score of the responding pharmacists was 3.05 (SD = 0.64) (on a scale of 1–5). Job satisfaction scores were...

Objectives: To describe CD4 immunological failure in male and female HIV treatment naïve patients... more Objectives: To describe CD4 immunological failure in male and female HIV treatment naïve patients on HAART at Itezh-itezhi District Hospital. To achieve this objective the study was aimed at identifying and comparing CD4 immunological failure between male and female HIV treatment naïve patients on antiretroviral therapy. Study Method: A descriptive cross-section study was employed to collect secondary data from patient files. Data collected was serum CD4 cell count at baseline of ART enrolment and Six (6) months of treatment. The unit analysis was adult treatment naïve patients at least six months on antiretroviral therapy at Itezhi-tezhi District Hospital in Central Province of Zambia. A probability Simple random method of sampling was used to pick files of participants. The files were first entered on excel spreadsheet, allocated a random number and randomized. Thereafter,thefirst246files will be selected and used in this study. Results: As of June 2015, the cumulative ever on ART at Itezhi-tezhi district was 4073 and out of this figure 1465 (36%) had died, migrated or lost to follow. Currently, there were only 2508 on ART and out of this figure a higher population was that of the adult female. Using the Pearson Chi-square test, it was found that those gender differences were significantly associated with CD4 immunological failure and men were more vulnerable. Conclusion; Men on ART were found to have a higher prevalence of CD4 immunological failure compared to women, regardless of their baseline, Age, weight and CD4 count. However, additional studies are needed to confirm men`s susceptibility to treatment failure by incorporating virological and clinical monitoring in these studies.

Additional file 1: Table S1. Number of expected deaths and proportions with MCCD ICD-10 each year... more Additional file 1: Table S1. Number of expected deaths and proportions with MCCD ICD-10 each year (mainland Tanzania).

Additional file 2: Figure S1. Age distribution of deaths according to GBD broad causes and unusab... more Additional file 2: Figure S1. Age distribution of deaths according to GBD broad causes and unusable code severity level for the most recent year (2018). Red = Group 1 Communicable, maternal, neonatal and nutritional conditions. Blue = Group 2 Non-communicable diseases. Green = Group 3 External causes including injury. Grey = Unusable causes of varying levels of severity.

Additional file 3. Tanzania ANACONDA *.mqr files for 2014–2019.

Background: Cognitive behavioral therapy is a goal-oriented psychotherapy treatment that takes a ... more Background: Cognitive behavioral therapy is a goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. It has been documented in various studies to have an impact when used in the management of chronic pain. It has been shown to lack the drawbacks of pharmacological and surgical treatments such as addiction and toxicity; and cost and recovery time, respectively. Cognitive behavioral therapy has also been shown to target cognitive distortions such as pain catastrophizing among other things. The objective of the review is to evaluate the effectiveness of cognitive behavioral therapy in the management of chronic pain of degenerative conditions. Methods: This review article was conducted basing on the previous studies published from 2009-2019 and data analyzed was retrieved from Google Scholar, Elsevier and Science Direct. Only the articles that looked at effectiveness of cognitive behavioral therapy in the management of chronic pain from a phy...

In physiotherapy practice, a number of patients are known to suffer from chronic pain which resul... more In physiotherapy practice, a number of patients are known to suffer from chronic pain which results in reduced activity levels, interference in sleep, enjoyment of life, mood, and relations with others. Cognitive behavioral therapy, in this aspect will provide a holistic approach to the available treatment. Cognitive behavioral therapy has also been shown to target cognitive distortions such as pain catastrophizing, fear avoidance, overgeneralizing and others, all the while improving physical health, activity levels and quality of life. This study assessed the efficacy of cognitive behavioral therapy in the management of patients with chronic pain at the University Teaching Hospitals in Zambia. A randomized clinical trial utilizing a crossover design was utilized for the study. A random sample of 32 participants was used in the study after fulfilling the study criteria. Data was analyzed using ANCOVA with alpha of 0.05. The study recorded small effects in the reduction of pain inten...

Background:This study is hinged on the basis that in addition to knowledge updates, the attitudes... more Background:This study is hinged on the basis that in addition to knowledge updates, the attitudes of health care professionals toward current concepts about diabetes care are even more critical. The core philosophy of modern diabetes care puts emphasis on patient autonomy and optimal utilization of health care professionals’ different specialties. This study was undertaken to evaluate the knowledge and attitude of community pharmacists toward diabetes care. Materials/Methods :Eighty four conveniently selected community pharmacists were surveyed by the Diabetes knowledge Test (DKT) and Diabetes Attitude Survey (DAS) questionnaires. The Diabetes Knowledge Test evaluated the pharmacists’ diabetes knowledge based on a validated 23 item questionnaire, the Michigan Diabetes Knowledge Test (MDKT).The Attitude Survey involved the likert scale to determine the community pharmacist’s perceptions about the seriousness of type II diabetes, psychological impact of the disease, patient autonomy, ...

American Journal of Public Health, 2021

The complex and evolving picture of COVID-19–related mortality highlights the need for data to gu... more The complex and evolving picture of COVID-19–related mortality highlights the need for data to guide the response. Yet many countries are struggling to maintain their data systems, including the civil registration system, which is the foundation for detailed and continuously available mortality statistics. We conducted a search of country and development agency Web sites and partner and media reports describing disruptions to the civil registration of births and deaths associated with COVID-19 related restrictions. We found considerable intercountry variation and grouped countries according to the level of disruption to birth and particularly death registration. Only a minority of the 66 countries were able to maintain service continuity during the COVID-19 restrictions. In the majority, a combination of legal and operational challenges resulted in declines in birth and death registration. Few countries established business continuity plans or developed strategies to deal with the b...

Pan African Medical Journal, 2020

Increased number of brought-in-dead cases with COVID-19: is it due to poor health-seeking behavio... more Increased number of brought-in-dead cases with COVID-19: is it due to poor health-seeking behaviour among the Zambian population?

Expert Opinion on Pharmacotherapy, 2019

Introduction: Appropriately managing mental disorders is a growing priority across countries in v... more Introduction: Appropriately managing mental disorders is a growing priority across countries in view of the impact on morbidity and mortality. This includes patients with bipolar disorders (BD). Management of BD is a concern as this is a complex disease with often misdiagnosis, which is a major issue in lower and middleincome countries (LMICs) with typically a limited number of trained personnel and resources. This needs to be addressed. Areas covered: Medicines are the cornerstone of managing patients with Bipolar II across countries including LMICs. The choice of medicines, especially antipsychotics, is important in LMICs with high rates of diabetes and HIV. However, care is currently compromised in LMICs by issues such as the stigma, cultural beliefs, a limited number of trained professionals and high patient co-payments. Expert opinion: Encouragingly, some LMICs have introduced guidelines for patients with BD; however, this is very variable. Strategies for the future include addressing the lack of national guidelines for patients with BD, improving resources for mental disorders including personnel, improving medicine availability and patients' rights, and monitoring prescribing against agreed guidelines. A number of strategies have been identified to improve the treatment of patients with Bipolar II in LMICs, and will be followed up.

Trends in Parasitology, 2006

As a result of support from the Bill and Melinda Gates Foundation, schistosomiasis and intestinal... more As a result of support from the Bill and Melinda Gates Foundation, schistosomiasis and intestinal or soil-transmitted helminth infections have been the subject of national control programmes in three Eastern and Southern African countries: Uganda, the United Republic of Tanzania and Zambia. Here, we review the significant progress made in their control efforts and highlight the different approaches being adopted to ensure programme effectiveness and sustainability. Although a positive start has been made to reduce morbidity resulting from schistosomiasis and soil-transmitted helminth infections in these countries, it is imperative that support is identified to sustain the programmes until these infections are no longer a public health problem and children can therefore be given a healthy start to life.

Bulletin of the World Health Organization, 2020

BMC Health Services Research

Background Monitoring medically certified causes of death is essential to shape national health p... more Background Monitoring medically certified causes of death is essential to shape national health policies, track progress to Sustainable Development Goals, and gauge responses to epidemic and pandemic disease. The combination of electronic health information systems with new methods for data quality monitoring can facilitate quality assessments and help target quality improvement. Since 2015, Tanzania has been upgrading its Civil Registration and Vital Statistics system including efforts to improve the availability and quality of mortality data. Methods We used a computer application (ANACONDA v4.01) to assess the quality of medical certification of cause of death (MCCD) and ICD-10 coding for the underlying cause of death for 155,461 deaths from health facilities from 2014 to 2018. From 2018 to 2019, we continued quality analysis for 2690 deaths in one large administrative region 9 months before, and 9 months following MCCD quality improvement interventions. Interventions addressed g...