The Health Press-Zambia is an open-access and peer-reviewed public health bulletin published by the Zambia National Public Health Institute (ZNPHI). It was founded with the mission of offering a forum for the exchange and dissemination of health-related research and knowledge in Zambia and around the world. Its goals include spreading information on Zambia's public health security status and guiding policy direction on health security in the country. The Health Press-Zambia publishes research articles, outbreak investigations, field notes and integrated disease surveillance response reports.
Surveillance as a governance imperative: Renewing Zambia's commitment to non-communicable disease risk factor monitoring
Background: Non-communicable diseases (NCDs) pose a severe threat to public health in Zambia, accounting for approximately 30% of all national deaths. Historically, data-driven responses have been hindered by weak surveillance systems and the prioritization of acute communicable diseases. While the inaugural 2017 World Health Organization (WHO) STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey established a critical baseline, effective long-term governance requires continuous monitoring to capture evolving trends. Objectives: This editorial highlights the strategic importance of Zambia’s second national STEPS survey, launched in April 2026, as a governance imperative for evaluating current health milestones and shaping future national health frameworks. Discussion: The 2017 baseline data revealed a stark NCD burden, including low fruit and vegetable consumption (90.4%), overweight/obesity (24.4%), and a heavy clustering of risk factors, particularly among urban populations, women, and older adults. Since then, rapid urbanization, changing diets, and the emergence of unregulated novel nicotine products (e.g., e-cigarettes and shisha) have shifted the epidemiological landscape. The 2026 survey, targeting 5,762 adults across all ten provinces, arrives at a critical juncture. It coincides with World No Tobacco Day 2026 ("Unmasking the Appeal") and marks the final year of Zambia's National Health Strategic Plan 2022–2026, making the data essential for replacing assumptions with evidence in the next strategic planning cycle. Conclusion: The 2026 STEPS survey represents a vital step forward for the Zambia National Public Health Institute (ZNPHI) and the Ministry of Health. However, the ultimate utility of this surveillance exercise depends entirely on the rapid, widespread, and accessible dissemination of its findings to frontline clinicians, policymakers, and community health workers to successfully drive the next decade of Zambia's NCD response.
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Evaluation of measles and acute flaccid paralysis surveillance systems in Southern Province, Zambia, 2022 - 2024
Abstract Background: The Vaccine-Preventable Disease (VPD) surveillance system in Zambia integrates routine immunization monitoring with disease surveillance to guide control measures. In 2022, Zambia recorded 422 measles cases and 37 deaths, with Southern Province recording the highest case fatality rate (11.2%), suggesting possible weaknesses in surveillance performance and outbreak response systems. This evaluation assessed the measles and acute flaccid paralysis (AFP) surveillance systems in Southern province of Zambia from 2022 to 2024. Methods: We conducted a cross-sectional surveillance system evaluation following the Centers for Disease Control and Prevention (CDC) guidelines. We purposively selected three districts and three facilities from each district, based on measles and AFP case burden and vaccination coverage. We collected data on system’s simplicity, usefulness, and acceptability from 27 participants using structured questionnaires. We also collected data from the electronic Integrated Disease Surveillance and Response (eIDSR) system and World Health Organization databases to assess, data completeness, timeliness, and accuracy. Results were summarized using frequencies and percentages. Results: The measles and AFP surveillance systems comprised both passive and active surveillance operating across community, health facility, district, and provincial levels. The systems demonstrated high levels of simplicity (mean score: 84.6%), usefulness (90.5%), and acceptability (90.8%). However, surveillance performance was limited by suboptimal data quality, with mean completeness of 66.7%, timeliness of 51.1%, and data accuracy of 50%. We also identified key operational challenges of inadequate specimen transportation and insufficient program funding. Conclusion: The measles and AFP surveillance systems in Southern Province are functional, simple, acceptable, and well-integrated into routine services. However, significant gaps in data quality limit their effectiveness for early outbreak detection and timely public health response. Strengthening data management, specimen transport, and sustainable program financing will be critical to improving surveillance performance and accelerating progress toward vaccine-preventable disease control and elimination targets. Keywords: Acute Flaccid Paralysis (AFP), measles, surveillance systems, vaccine-preventable disease, Zambia.
Effect of pterygium excision on corneal astigmatism at the University Teaching Hospitals-Eye Hospital Lusaka Zambia
Abstract Introduction: A pterygium is a fibrovascular growth that extends from the conjunctiva to the cornea. It causes tractional forces which result in a flattened cornea, typically causing astigmatism. The study objective was to evaluate the effect of pterygium excision on corneal astigmatism. Methodology: This was a prospective single arm cohort study which was conducted at the University Teaching Hospital from May 2024 to March 2025. A total of 46 participants were recruited yielding 48 eyes with primary pterygium. Adult pterygium patients ≥18 years were evaluated before surgery and at 2 and 6 weeks postoperatively for best corrected visual acuity, keratometry, and refractive astigmatism. Results: Of the 48 eyes recruited, one eye was excluded due to loss to follow, hence 47 eyes were analysed. The mean age of the participants was 47.85 years, with the oldest and youngest participants aged 74 and 24 years, respectively. The results revealed best corrected visual acuity (BCVA) improved from 0.27±0.25 before surgery to 0.19±0.15 (p<0.001) and 0.14±0.12 (p<0.001) at 2- and 6-weeks post-surgery, respectively. The mean corneal astigmatism was 2.62±2.75D preoperatively. The mean corneal astigmatism at 2 and 6 weeks was 0.47±1.10 and 0.01±0.50D at 6 weeks post-operation. Significant differences in BCVA and astigmatism were maintained even between the 2 and 6 week post-operatively. Conclusion: Pterygium excision with autograft leads to a significant reduction in astigmatism and improvement in BCVA. Stability in BCVA and astigmatism was not established by week 2 postoperative follow up, highlighting the need for further follow-up assessments. Key words: Best Corrected Visual Acuity, Keratometry readings