NEURODEVELOPMENTALASSESSMENT OF CHILDREN IN
SELECTED LOCATIONS OF
KABWE, ZAMBIA.
By Mrs. Nosiku S Munyinda
Doreen Sakala
Sandra Shanungu
Lweendo HachambaWe made it to the top 10!!!

What is Lead?
Lead is a blush gray metallic element
which occurs naturally (in smallamounts) in the earth’s crust.
It is dense, hence its use as a ballast,ammunition, or radiation shield.
Lead is insoluble in water, but somesalts are soluble.

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Research Questions
What are the blood lead levels of themothers and children in selected locationsof Kabwe?
 “Is there any association between bloodlead level and neurodevelopmental
outcomes in selected communities inKabwe?”
Study Objectives
GeneralObjective

To quantify blood lead levels and study
neurodevelopment outcomes in childrenof selected communities in Kabwe.

Specific
objectives:

To measure lead levels in Mother and child pairs
in selected communities;
To describe lead exposure pathways at
community and individual levels;
To determine Neurodevelopmental outcomes inthe targeted populations;
To evaluate other factors that may be
associated with the observed outcomes.

How will this study bridge the researchgap?

It is the first study
done in Zambia
and Africa to link
exposure to leadand a healthoutcome.

It includes bothprenatal andpost natal
exposures
through multiple
routesIt evaluates theinfluence of othersocio-economic
and other factors
on theneurodevelopme
nt outcomes.

Study Design
Neurodevelopment
Assessment

Community Survey

Blood lead levelmeasurements

Sampling design
The 2010 Zambia Census Sampling Frame wasused for the study areas

One Census Supervisory Area (CSA) was selected
and thereafter Standard Enumeration Areas(SEAs) randomly selected.

After stratifying by zones within each area, theCHVs recruited mother and child pairs according
to the pre-calculated sample size.

BwachaclinicMahathma Gandhi clinic

Makululu clinic

KatondoclinicKasandaclinicChowa clinic

Eligibility criteria
Mother above 18
years of age
Consent was given
Singleton Birth
N= 185Makululu- 40; Chowa- 28;

Kasanda- 40;
Bwacha- 35; andMahatma-Ghandi- 42

Data Collection

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To determine
Neurodevelopmen
tal outcomes in thetargeted
populations.

Assessing children14

Add pictures of Sandra assessing children

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Cross- Sectional Study
Covariates
Neurodevelopmental
outcomes
Lead levels

Behavior/language

Cognitivefunctions

Motorfunctions

Blood lead level measurements
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Using a lancet, a trained laboratory
technician drew a 5ml sample of bloodfrom the thumb; This was stored at 40C pending analysis
using lead care kit;
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Anthropometric Measurements20Both height and weights of the mothers
and children were taken.

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Interviewer administered questionnaire.
Demographics- Medical History- Quality of life
- Family aspects- Chemicalusage- Dietaryaspects

Administering the questionnaire
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Community Team23CHV

Makululu

Lab Technicians

Mr Godfrey Bwalya

Mrs Beatrice Mulenga

Mrs Justina Mutale

Chowa

Mr Zulu

Mrs Bertha NankononaKasandaMr Seke

Mr Sumaili

BwachaMrs Theresa Libai

Mrs Mary Mukalipi

Mrs Mutale

Mahatma

Mr Banda

Transporter: Mr Bright Chishala

Ms. Sharon Sinyinza

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Ethical Considerations
Informed consent was obtained from the parents.
Presence of the parent/caregiver during the Neurodevelopmental
testing.
Blood was drawn by trained laboratory personnel and minimum
intrusion and risk were upheld.
Confidentiality was assured.
Milk was given to the mothers for the babies;
In instances where the assessment showed adverse outcomes, advice
was given to take the child for further assessment and therapy.

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Public Voice25

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Concerns from the Nurses in Charge
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What measures will be put in place for those with highlead exposure??
People in the community have been asking the healthpersonnel what will be done and the health personnel inthese centres have been the ones to face the wrath ofthe community when nothing is being done for them
Who will be the one to provide the intervention and whenwill intervention come?

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Concerns from Parents
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Mothers threatened not to have their children in the study ifthey are not given something.
Parents also wanted to find out what measures areavailable for them after all the exposure and issues thatthey face.
They would appreciate to see results in terms ofinterventions.

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Prevention of Lead Poisoning
Prevention of lead poisoning is asuperior public health measure;
medical treatment alone isdisappointing.
The key to treatment is cessation ofexposure, and the public health needis to consider and find other possible
victims.

Next Steps
Commence Data Analysis in line with Research Questions andObjectives

Disseminate results to Kabwe District Medical Team and thereafter themothers;

Liaise closely with the ZMERIP World bank Project to ensure interventionscommence for children with blood lead levels above 45µg/dl;

Plan and commence recruitment of expectant mothers for the birthcohort study.

Helpful Web Sites
ATSDR
http://www.atsdr.cdc.gov/HEC/CSEM/lead/index.html
 ATSDR Toxicological Profiles
http://www.atsdr.cdc.gov/toxpro2.html
 ATSDR ToxFAQs ™
http://www.atsdr.cdc.gov/toxfaq.html
 CDC-NCEH
http://www.cdc.gov/nceh/lead/lead.htm
 NIOSH
http://www.cdc.gov/niosh/leadpg.html
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“We do not inherit the earth from ourancestors, we borrow it from our children.”Thank You!!!!
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