The study investigated the management practices that contribute to disease outbreaks in farmed tilapia in Lusaka and central and southern provinces in Zambia. It was a cross-sectional qualitative study undertaken from January to March 2021 in which questionnaires were administered to 49 farmers to assess their fish health management and biosecurity competence. Data were analysed using means, percentages, ratios, and logistical regression. The results showed that the majority of the farms had high stocking densities (>8 fish/m², 44.4%), reared Nile tilapia (67.7%), and sourced water for farming from rivers and streams (45.7%). A few farmers measured water quality parameters daily (16.7%) and removed dead fish from ponds daily (20.8%). The stocking density (p = 0.013), fish species (p = 0.031), dead fish disposal methods (p = 0.023), and control of predator birds (p = 0.016) influenced the total mortality recorded on farms, while pond type (p = 0.031 and p = 0.045), water source (p = 0.023), and stocking density (p = 0.027) influenced the duration of a mortality episode. It is evident that some fish health management practices and biosecurity concepts among tilapia farmers in the study area are inadequate and may not contain disease outbreaks or the spread of pathogens.

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/clavulanic acid (5.6%), and azithromycin (5%). The prescribing of 42.1% of “Watch” group antibiotics was greater than the recommended threshold by the WHO. Most antibiotics were prescribed for respiratory infections (26.3%) and gastrointestinal tract infections (16.4%). The most prescribed antibiotic was ceftriaxone, a Watch antibiotic. This is a worrisome observation and calls for strengthened antimicrobial stewardship and implementation of the AWaRe framework in prescribing antibiotics.

Bloodstream infections (BSI) caused by antimicrobial-resistant (AMR) Gram-negative bacteria (GNB) are a significant cause of morbidity and mortality. Third-generation cephalosporins (3GCs) have been used as empiric treatment for BSI and other invasive infections for years; however, their overuse could promote the emergence of extended-spectrum beta-lactamases (ESBLs). Thus, this study aimed to determine the epidemiological, clinical and microbiological features and the effects of antimicrobial resistance on the outcomes of BSIs at a referral hospital in Lusaka, Zambia. This was a six-month prospective facility-based study undertaken at a referral hospital in Lusaka, Zambia. As part of the routine diagnosis and patient care, blood samples for bacteriological culture were collected from patients presenting with fever and processed for pathogen identification and antimicrobial susceptibility testing using the VITEK 2 Compact instrument. ESBLs and plasmid-mediated quinolone resistance (PMQR) associated genes were determined using the polymerase chain reaction method. Patient information was collected using a structured data collection sheet and entered in CSpro 7.6. Data were analysed in WHOnet and STATA version 14. A total of 88 GNB were isolated, of which 76% were Enterobacterales, 14% Acinetobacter baumannii and 8% Pseudomonas aeruginosa. Resistance to third and fourth-generation cephalosporins was 75% and 32%, respectively. Noteworthy was the high prevalence (68%) of inappropriate empirical treatment, carbapenem resistance (7%), multi-drug resistance (83%) and ESBL-producers (76%). In comparison to E. coli as a causative agent of BSI, the odds of death were significantly higher among patients infected with Acinetobacter baumannii (OR = 3.8). The odds of death were also higher in patients that received 3GCs as empiric treatment than in those that received 4GCs or other (none cephalosporin) treatment options. Structured surveillance, yearly antibiogram updates, improved infection control and a well functional antimicrobial stewardship (AMS) program, are of utmost importance in improving appropriate antimicrobial treatment selection and favourable patient outcomes.

Antimicrobial resistance (AMR) is an emerging challenge to global public health. The use of antibiotics in the veterinary field is one of the contributing factors to AMR mostly due to poor knowledge, attitudes, and practices (KAP) of dispensers. Veterinary drug dispensers are expected to guide clients on indications, contraindications, and withdrawal periods of veterinary drugs. This study assessed veterinary drug dispensers’ KAP toward AMR and associated potential contributing factors. A cross-sectional study, using a structured questionnaire, was conducted in three main cities of Malawi, namely Mzuzu, Lilongwe, and Blantyre. A total of 68 agrovet shops were selected using a simple random sampling technique. The KAP level was presented descriptively. Bivariate and multivariable analyses were run to investigate the relationships between the independent and outcome variable. Overall, the KAP score for knowledge, attitude, and practices was 46.7%, 49.2%, and 41.6%, respectively. The significant determinants of the knowledge were the practice of asking for a written prescription (OR: 16.291, 95% CI: 11.6–24.2) (p = 0.024), female (OR: 0.609, 95% CI: 0.3–0.9) (p = 0.001), and old age (≥35) (OR: 0.227, 95% CI: 0.1–0.5) (p = 0.04). Poor knowledge, negative attitude, and poor practices were observed among most of the participants. Sensitization and training on AMR and antimicrobial stewardship are recommended to address the KAP score gaps and the observed determinants among veterinary drug dispensers.

To assess the emergence of Livestock-associated S. aureus including methicillin resistant S. aureus (MRSA) in the pig and pork production systems in Africa for the past two decades. PubMed and African Journals On-Line databases were searched for relevant primary studies from 2000 to 2019 using standardised key words. A total of 19 eligible articles were included in the review. Prevalence of S. aureus including MRSA ranged from 0 to 55 % among live pigs and raw pork and 9.4 to 30.8% among pig farm and abattoir workers. Risk factors associated with S. aureus carriage among workers were being male, working in an abattoir and medical-related occupation of a household member. S. aureus and MRSA from pigs and pork production systems in Africa are potentially pathogenic with diverse spa types and clonal complexes, genes encoding antimicrobial resistance, heavy metal resistance and virulence factors including secreted- and entero- toxins, proteases and immune evasion cluster. The typical Livestock-associated CC398 and mecC genes were reported in two studies. The review showed that pigs are a potential source of the emerging livestock-associated S. aureus in Africa. Continued monitoring using a "One Health" approach is recommended for effective infection prevention and control of these infections on the continent.

The epidemiology of Rift Valley fever (RVF) is poorly understood in Malawi. Here, a cross-sectional study was conducted (March–June 2020) to investigate the seroprevalence and potential risk factors of RVF virus (RVFV) in cattle, goats, and sheep in three ecological zones of Malawi. A total of 1523 serum samples were tested for anti-RVFV IgG and IgM antibodies by ELISA. Additionally, a questionnaire survey was used to assess potential RVF risk factors. The overall seroprevalence was 17.14% (261/1523; 95% CI = 15.33–19.11) for individual livestock and 33.24% (120/361; 95% CI = 28.18–38.11) for the livestock herd. Seroprevalence was significantly high in sheep (25.68%, 95% CI = 19.31–33.26) compared with cattle (21.35%, 95% CI = 18.74–24.22) and goats (7.72%, 95% CI = 5.72–10.34), (p = 0.047). At the individual livestock level, the risk was elevated in female livestock (OR: 1.74, 95% CI = 1.08–12.82) (p = 0.016), while at the herd level, areas receiving approximately 1001–1500 mm of rainfall (OR: 2.47, 95% CI = 1.14–5.37) (p = 0.022), areas of rainfall amount greater than approximately 1600 mm (OR: 2.239, 95% CI = 1.07–8.82) (p = 0.023), and mixed species herds (OR: 10.410, 95% CI = 3.04–35.59) (p = 0.001), were significant risk factors. The detection of IgM antibodies confirmed active circulation of RVFV in Malawi. Therefore, monitoring of RVF in animals, humans, and vectors using a “One Health” approach, along with community sensitization among the high-risk populations, could help mitigate the threat posed by this zoonotic disease in Malawi.