UNZA-UCLMS

Promoting equitable research and training partnerships in global health

Autopsy Studies

In 2002 UNZA-UCLMS conducted the largest autopsy study of children in sub-Saharan Africa ever performed (Chintu et al.. 2002), to resolve several clinical and epidemiological controversies in the management of respiratory infections in HIV-positive and negative children in Africa. Results of this study provided invaluable information for governments and the World Health Organization on the aetiology of  respiratory deaths. Pneumocystis Jiroveccipneumonia (PCJ), Tuberculosis (TB) and human cytomegalovirus pneumonia (HCMV pneumonia), previously  thought to be unimportant in African children, were found to be common causes of death. These findings lead to highly effective interventions (Chintu et al.. 2004), yet mortality rates among HIV infected and HIV exposed children are still high, despite widespread availability of anti-bacterial and anti-mycobacterial therapeutics.
A decade on, we are following up this study with a more comprehensive set of autopsy studies, funded by the UBS Optimus Foundation. This time around, UNZA-UCLMS is looking at both paediatric and adult deaths at the University Teaching Hospital, to determine missed causes of death and inform on new diagnostic and treatment needs. 

Under the Pandora-ID NET program, Sir Ali Zumla ideated and co-ordinated a series of sentinel whole body autopsy studies were conducted in Italy, France and Zambia to define the pathology, pathogenesis and causes of mortality in adult patients with COVID-19. Click here for a list of publications.

Publications

  1. Mucheleng’anga LA, Himwaze CM, Telendiy V, et al. Incidental Tuberculosis in sudden, unexpected, and violent deaths in the community Lusaka, Zambia – A descriptive forensic post-mortem examination study. Int J Infect Dis 2022. https://doi.org/10.1016/j.ijid.2022.03.005.
  2. Himwaze C, Mucheleng’anga LA, Telendiy V, et al. Cardiac cysticercosis and neurocysticercosis in sudden and unexpected community deaths in Lusaka, Zambia: a descriptive medico-legal post-mortem examination study. Int J Infect Dis 2022; 115: 195-200. https://doi.org/10.1016/j.ijid.2021.11.042.
  3. GBD 2019 Diabetes Mortality Collaborators. Global, regional, and national sex differences in the global burden of tuberculosis by HIV status, 1990-2019: results from the Global Burden of Disease Study 2019. Lancet Infect Dis 2022; 22(2): 222-41. https://doi.org/10.1016/s1473-3099(21)00449-7.
  4. GBD 2019 Diabetes Mortality Collaborators. Diabetes mortality and trends before 25 years of age: an analysis of the Global Burden of Disease Study 2019. Lancet Diabetes Endocrinol 2022; 10(3): 177-92. https://doi.org/10.1016/s2213-8587(21)00349-1.
  5. Mucheleng’anga LA, Telendiy V, Hamukale A, Shibemba AL, Zumla A, Himwaze CM. COVID-19 and Sudden Unexpected Community Deaths in Lusaka, Zambia, Africa – A Medico-Legal Whole-Body Autopsy Case Series. Int J Infect Dis 2021; 109: 160-7. https://doi.org/10.1016/j.ijid.2021.07.001.
  6. Himwaze CM, Telendiy V, Maate F, et al. Post-mortem examination of Hospital Inpatient COVID-19 Deaths in Lusaka, Zambia – A Descriptive Whole-body Autopsy Series. Int J Infect Dis 2021; 108: 363-9. https://doi.org/10.1016/j.ijid.2021.06.013.
  7. Colombo D, Falasca L, Marchioni L, et al. Neuropathology and Inflammatory Cell Characterization in 10 Autoptic COVID-19 Brains. Cells 2021; 10(9). https://doi.org/10.3390/cells10092262.
  8. Falasca L, Nardacci R, Colombo D, et al. Postmortem Findings in Italian Patients With COVID-19: A Descriptive Full Autopsy Study of Cases With and Without Comorbidities. J Infect Dis 2020; 222(11): 1807-15. https://doi.org/10.1093/infdis/jiaa578.
  9. Bates M, Shibemba A, Mudenda V, et al. Burden of respiratory tract infections at post mortem in Zambian children. BMC Med 2016; 14: 99. https://doi.org/10.1186/s12916-016-0645-z.
  10. Bates M, Mudenda V, Shibemba A, et al. Burden of tuberculosis at post mortem in inpatients at a tertiary referral centre in sub-Saharan Africa: a prospective descriptive autopsy study. Lancet Infect Dis 2015; 15(5): 544-51. https://doi.org/10.1016/s1473-3099(15)70058-7.
  11. Bates M, Mudenda V, Mwaba P, Zumla A. Deaths due to respiratory tract infections in Africa: a review of autopsy studies. Curr Opin Pulm Med2013; 19(3): 229-37. https://doi.org/10.1097/MCP.0b013e32835f4fe4.
  12. Mudenda V, Lucas S, Shibemba A, et al. Tuberculosis and tuberculosis/HIV/AIDS-associated mortality in Africa: the urgent need to expand and invest in routine and research autopsies. J Infect Dis 2012; 205 Suppl 2: S340-6. https://doi.org/10.1093/infdis/jir859.
  13. Lishimpi K, Kasolo F, Chintu C, et al. Identification of Pneumocystis carinii DNA in oropharyngeal mouth washes from AIDS children dying of respiratory illnesses. Aids 2002; 16(6): 932-4. https://doi.org/10.1097/00002030-200204120-00017.
  14. Kasolo F, Lishimpi K, Chintu C, et al. Identification of Pneumocystis carinii DNA by polymerase chain reaction in necropsy lung samples from children dying of respiratory tract illnesses. J Pediatr 2002; 140(3): 367-9. https://doi.org/10.1067/mpd.2002.122468.
  15. Chintu C, Mudenda V, Lucas S, et al. Lung diseases at necropsy in African children dying from respiratory illnesses: a descriptive necropsy study. Lancet 2002; 360(9338): 985-90. https://doi.org/10.1016/s0140-6736(02)11082-8.
  16. Lishimpi K, Chintu C, Lucas S, et al. Necropsies in African children: consent dilemmas for parents and guardians. Arch Dis Child 2001; 84(6): 463-7. https://doi.org/10.1136/adc.84.6.463.