Chifundo C Zimba

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Dr. Chifundo Colleta Zimba is a qualitative research expert, systems analyst, and global health specialist with over 20 years of experience in diverse Malawian communities. She holds a PhD in Nursing-Healthcare Systems from the University of North Carolina at Chapel Hill, USA, where she also completed a Graduate Certificate in Global Health. Dr. Zimba has a profound expertise in community health nursing, with extensive experience in research and leadership roles across various health initiatives, including sexual and reproductive health, HIV/AIDS, mental health, and non-communicable diseases.
Throughout her career, Dr. Zimba has demonstrated a strong commitment to improving health outcomes through participatory and human-centered approaches, working closely with local and global stakeholders. Her professional journey includes leading significant research projects, managing teams, and developing training programs that have significantly impacted healthcare delivery in Malawi.
Dr. Zimba’s work has been fundamental in enhancing HIV prevention from HIV infected mothers to their babies, family planning outreach, integrating mental health services into non-communicable disease care, and contributing to policy development in health systems. She has also been instrumental in mentoring and training future leaders in healthcare, reflecting her dedication to capacity building and sustainable development in the health sector.
With a robust background in both quantitative and qualitative research, Dr. Zimba continues to influence the global health landscape through her scholarly contributions and leadership in various health initiatives across Malawi and beyond.
Supervisors: Dr Jennifer Leeman
Address: Acacia, Airwing, Lilongwe, Malawi

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Two implementation strategies to support the integration of depression screening and treatment into hypertension and diabetes care in Malawi (SHARP): parallel, cluster-randomised, controlled, implementation trial

The Lancet. Global health/The lancet. Global health, Apr 1, 2024

Implementation strategies to build mental health-care capacity in Malawi: a health-economic evaluation

The Lancet. Global health/The lancet. Global health, Apr 1, 2024

Improving integrated depression and non-communicable disease care in Malawi through engaged leadership and supportive implementation climate

BMC Health Services Research, Dec 13, 2023

Safety, uptake, and use of a dapivirine vaginal ring for HIV-1 prevention in African women (HOPE): an open-label, extension study

The Lancet HIV, 2021

BACKGROUND Two phase 3 clinical trials showed that use of a monthly vaginal ring containing 25 mg... more BACKGROUND Two phase 3 clinical trials showed that use of a monthly vaginal ring containing 25 mg dapivirine was well tolerated and reduced HIV-1 incidence in women by approximately 30% compared with placebo. We aimed to evaluate use and safety of the dapivirine vaginal ring (DVR) in open-label settings with high background rates of HIV-1 infection, an important step for future implementation. METHODS We did a phase 3B open-label extension trial of the DVR (MTN-025/HIV Open-label Prevention Extension [HOPE]). Women who were HIV-1-negative and had participated in the MTN-020/ASPIRE phase 3 trial were offered 12 months of access to the DVR at 14 clinical research centres in Malawi, South Africa, Uganda, and Zimbabwe. At each visit (monthly for 3 months, then once every 3 months), women chose whether or not to accept the offer of the ring. Used, returned rings were tested for residual amounts of dapivirine as a surrogate marker for adherence. HIV-1 serological testing was done at each visit. Dapivirine amounts in returned rings and HIV-1 incidence were compared with data from the ASPIRE trial, and safety was assessed. This study is registered with ClinicalTrials.gov, NCT02858037. FINDINGS Between July 16, 2016, and Oct 10, 2018, of 1756 women assessed for eligibility, 1456 were enrolled and participated in the study. Median age was 31 years (IQR 27-37). At baseline, 1342 (92·2%) women chose to take the DVR; ring acceptance was more than 79% at each visit up until 12 months and 936 (73·2%) of 1279 chose to take the ring at all visits. 12 530 (89·3%) of 14 034 returned rings had residual dapivirine amounts consistent with some use during the previous month (>0·9 mg released) and the mean dapivirine amount released was greater than in the ASPIRE trial (by 0·21 mg; p<0·0001). HIV-1 incidence was 2·7 per 100 person-years (95% CI 1·9-3·8, 35 infections), compared with an expected incidence of 4·4 per 100 person-years (3·2-5·8) among a population matched on age, site, and presence of a sexually transmitted infection from the placebo group of ASPIRE. No serious adverse events or grade 3 or higher adverse events observed were assessed as related to the DVR. INTERPRETATION High uptake and persistent use in this open-label extension study support the DVR as an HIV-1 prevention option for women. With an increasing number of HIV-1 prophylaxis choices on the horizon, these results suggest that the DVR will be an acceptable and practical option for women in Africa. FUNDING The Microbicide Trials Network and the National Institute of Allergy and Infectious Diseases, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Mental Health, all components of the US National Institutes of Health.

Implementation of the Prevention of Mother to Child Transmission (PMTCT) of HIV Program: An Integrative Literature Review

Sigma Theta Tau International's 25th International Nursing Research Congress, Jul 27, 2014

JCO global oncology, Feb 1, 2023

Factors influencing utilization of postpartum CD4 count testing by HIV-positive women not yet eligible for antiretroviral treatment

Aids Care-psychological and Socio-medical Aspects of Aids/hiv, Feb 22, 2011

Delayed antiretroviral initiation is associated with increased mortality, but individuals frequen... more Delayed antiretroviral initiation is associated with increased mortality, but individuals frequently delay seeking treatment. To increase early antiretroviral therapy (ART) enrollment of HIV-positive women, antenatal clinics are implementing regular, postpartum CD4 count testing. We examined factors influencing women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s utilization of extended CD4 count testing. About 53 in-depth interviews were conducted with nurses, patients, social support persons, and government health officials at three antenatal clinics in Lilongwe, Malawi. Counseling and positive interactions with staff emerged as facilitating factors. Women wanted to know their CD4 count, but didn&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;t understand the importance of early ART initiation. Support from husbands facilitated women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s return to the clinic. Reminders were perceived as helpful but ineffectively employed. Staff identified lack of communication, difficulty in tracking, and referring women as barriers. Counseling messages should emphasize the importance of starting ART early. Clinics should focus on male partner involvement, case management, staff communication, and appointment reminders. Follow-up should be offered at multiple service points.

Systematic review of psychosocial interventions for adult cancer patients and their family caregivers in Sub-Saharan Africa

Global Public Health, Jan 2, 2023

Prevalence and correlates of major depressive disorders among patients with cancer at Kamuzu Central Hospital in Malawi

Research Square (Research Square), Mar 17, 2022

Background Depressive disorders, with prevalence varying widely by setting, are among the common ... more Background Depressive disorders, with prevalence varying widely by setting, are among the common debilitating mental health disorders in patients with cancer worldwide. An understanding of the prevalence of depressive disorders among a speci c patient population group should inform both their prevention and management. We conducted this study to estimate the prevalence and correlates of depressive disorders among patients living with cancer at Kamuzu Central Hospital (KCH), Lilongwe in Malawi. Methods We conducted a cross-sectional study nested in another larger quasi-experimental study evaluating the effect of integrating depression screening and management on clinical outcomes among cancer patients attending oncology services at a Cancer Unit based at Kamuzu Central Hospital in Lilongwe. A validated PHQ-9 tool was used to estimate prevalence of major depressive disorders. A total of 399 consented participants were enrolled from August to December, 2021. We estimated the prevalence and associated factors to depression among this patient group. Results The study comprised more females (64%) than males. Cervical cancer (33%), Kaposi's Sarcoma (16%), breast cancer (9%) and esophageal cancer (4%) were the top four common malignancies in the study. The prevalence of major depressive disorders was 11.5%; most (52%) of whom had moderate depressive symptoms on PHQ-9 scale. Patients receiving palliative care were associated with reduced odds of major depressive disorders [Odds ratio: 0.36 (95% CI: 0.14-0.94)]. Conclusion A high proportion of patients with cancer had major depressive disorders. Patients on palliative care were protected from having major depressive disorders. There is a need for integrating screening and treatment of depressive disorders among patients living with cancer to improve cancer care in Malawi. What Is Already Known On This Topic Cancers contributed to 16% of Disability-Adjusted Life Years (DALYs) due to Non-Communicable Diseases (NCDs). Depression prevalence range between 19 to 30% in general population in Malawi Depression highly prevalent among cancer patients in different parts of the world

Chifundo C Zimba

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