Zambart 1 PopART HPTN 071 Research and Development to Improve Health for All Vol. 1 Edition # 1, 2015 PopART HPTN 071 Newsletter 3 PopART HPTN 071 inside this issue 5 HPTN 071 International Advisory Group representatives visit HPTN 071 sites Study on evaluation of uptake of universal HIV testing starts Zambart commemorates International Condom day HPTN 071/PopART Study Annual Workshop - 2015 PopART study Newsletter | 1 TABLE OF CONTENTS Welcome Note 3 Foreword 4 HPTN 071/PopART Study Annual Workshop - 2015 HPTN 071 International Advisory Group visit Chipulukusu, Kanyama, Chawama and Chipata sites Zambia - South Africa HPTN 071/PopART Study Community HIV Care Providers conduct joint field visits PopART study implementing partners to formulate new strategy to strengthen linkage to care The Search for Men: Kitwe intervention conduct “No Missed Opportunity” operation Man up Now!! Campaign Launched 2 5-6 7-8 9-10 11 12 12-13 Evaluation of universal HIV testing in PopART study underway 14 ‘Story of the Trial’ 15 Zambart joins LOVE Condoms Campaign 15 Zambart Stars 16 | PopART study Newsletter Welcome Note Welcome to the first edition of the quarterly HPTN 071/PopART study newsletter. The aim of the newsletter is to share stories and experiences from study staff, and is designed to give you a platform through which information about what is happening within PopART study sites can be found. Content to be featured in the newsletter will be sought from all study sites and will focus on what’s- happening-news, items of interest, and important updates, activities and achievements from all the 12 sites. The newsletter will offer a light, but informative read. I therefore want to encourage all study sites to send their reports and story ideas to our Communications Section at Head Office. The communications team will also continue to make efforts to reach all sites for site-specific stories and information. Do not wait to be reached, if you have anything of interest you would like to share with others on the PopART study, you’re welcome to send it through to the office. In this edition, you will find some humaninterest features and announcements on how Zambart is making in-roads in its efforts to helping to improve people’s lives through research. You will also get a chance to read about some of social activities happening in the study sites. I hope that you will find this first edition an informative read and take time to give us some feedback about the content. You can also find the on-line version of the newsletter on our website: www.zambart.org.zm Enjoy reading! Dr. Alwyn Mwinga CEO - Zambart PopART study Newsletter | 3 Foreword I am pleased to write the foreword for the first newsletter of the HPTN 071/PopART study. PopART is one of the biggest HIV prevention trials in the world currently underway and everyone in the study should be proud of being part of such a unique effort to reduce new HIV infections in the region. The first year of the study has had its own successes and challenges and we have learnt a lot of lessons. My sincere gratitude goes to the entire study staff who have made this study possible, particularly those who have been with us from the beginning of the study in 2013 and who are determined to contribute towards making a difference in HIV prevention research. I also hope that those of you who have joined us along the course of the study will stay with us until the end. I would also like to acknowledge the contribution of the various advisory boards, implementing partners and community stakeholders whose advice has been invaluable in ensuring that the 4 | PopART study Newsletter study is implemented well. As we move into the second year of the study, my hope is that everyone will continue putting in their best so that the study reaches its targets. Even as we face unforeseen challenges, everyone should remember that obstacles can be used as stepping stones to success. Don’t turn around and give up when you run into a wall, figure out how to climb it, go through it or work around it because it is those that endure who eventually achieve their goals. HPTN 071/PopART trial will not achieve what it was set to achieve without your individual and collective involvement. Lastly, thank you all for your hard work and may we continue to look to the Almighty God for the grace to carry on this study to its completion. Dr. Kwame Shanaube, MD, PhD. HPTN 071/PopART Study Manager HPTN 071/PopART Study Annual Workshop - 2015 HPTN 071/PopART study staff and implementing partners from all over the world gathered from 2nd-5th February 2015 in Lusaka, for their annual workshop to review progress in the on-going HIV prevention trial being conducted in Zambia and South Africa, and chart the way forward as the trial enters its second year. The Populations Effects of Antiretroviral Therapy to Reduce HIV Transmission study is a two country cluster-randomised trial of the impact of a combination prevention package on populationlevel HIV incidence. It is the single largest HIV prevention trial to be conducted yet involving over 1 million people, and is being carried out in 21 communities across Zambia and South Africa. therapy to see how far we can get in stopping new HIV infections. This is a big undertaking,” said HPTN principle investigator Dr Myron Cohen on the side lines of the workshop. Dr Cohen said through several aspects of implementation activities, PopART was benefitting individuals and communities. “In the treatment communities, you see that everyone with HIV who needs treatment is receiving treatment. For every new case of HIV we prevent, there is a dramatic benefit to the families and to the individuals who avoid infection to their communities.” Dr Cohen said PopART put together all the tools to prevent new cases of HIV. “HIV is the pandemic of the 20th century. We’ve spent 35 years getting ready to put these tools together and if we can maximise our prevention strategies and deploy them more generally, it will be a terrific advance.” HPTN 071 Principal Investigator Dr Richard Hayes, said the study had made tremendous progress in the first year whose main focus was getting people to test and know their HIV status. He said the Population Cohort had visited over 30,000 households with the Study leadership and partners had an opportunity to hear directly from country staff who shared their experiences and challenges in the main plenary sessions and through working groups. Zambart Communications caught up with the study leadership to get their views on the study progress. “PopART is a realisation of combination prevention centred on maximising the use of antiretroviral >> PopART study Newsletter | 5 >> “ I am confident that as long as we can deliver the intervention to a high quality and achieve that high coverage that we are looking for, we will be able to answer the question whether this can reduce the number of new HIV infections substantially in these severely affected communities” intervention arm providing services to a large number of people. “Overall, the achievement has been enormous. We’ve already got a lot of information that we did not have before on what are the challenges on delivering universal test and treat,” said Dr Hayes adding that the possibilities of delivering ART within the communities was now being considered. “We’re looking at how our Community HIV Care Providers can best support the process,” he said. The PopART intervention main objectives in year two will be addressing major problem areas such as access to care, adherence and retention, and increasing the uptake of medical male circumcision. “We found that we have much higher uptake of our services among women. This is something we need to work on very hard. It’s our number one challenge and we are looking at various strategies,” Dr Hayes said. Dr Richard Hayes- HPTN 071 Principal Investigator He expressed concern that unless clinical services, the intervention those testing HIV positive can get would not work. “We’ve been very to the clinics and start accessing good at getting people to test and finding out their status, but the next step is to get people into care and on to treatment and suppress the virus, and making sure we keep it suppressed all the time for years to come. This is critical,” he said. Dr Hayes said despite the change in national ART guideline in Zambia and South Africa, PopART study will still be able to answer the main questions. 6 | PopART study Newsletter HPTN 071 International Advisory Group visit popart study sites Co-funders of the HPTN 071/ PopART study and members of the International Advisory Group (IAG) visited Zambia in February, and took time to visit arm A and C sites in Chipulukusu (Ndola), Chipata, Kanyama, and Chawama (Lusaka) to get a ground level view of how the study is progressing. The IAG team comprised representatives from the Global Fund, World Health Organisation (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), US National Institutes of Health, and US National Institutes of Mental Health (NIMH), London School of Hygiene and Tropical Medicine (LSHTM). Local site staff were on hand to receive the IAG members who had split into groups for the respective site tours. From head office PopART study site PI Dr Helen Ayles, PopART study manager Dr Kwame Shanaube, Phylogenetics study manager Dr Mohammed Limbada, intervention manager Ephraim Sakala, population cohort manager Justin Bwalya, and HIV testing quality control manager Comfort Rutty Phiri, joined the sitebased staff who included respective district intervention coordinators, district administrators, Community HIV Care providers (CHiPs), and community mobilisers. The IAG members were able to observe day-to-day activities at the Kanyama, Chipata, and Chawama first level hospitals as well as Chipulukusu health clinic where their tour of the facilities were led by the respective sister in-charges. They met with the PopART clinical >> PopART study Newsletter | 7 >> research nurses and visited the ART clinics, ART pharmacies, laboratories and Data rooms where they interacted with heads of department on the number of cases, flow and processing of patients, and investigations carried out on clients and distribution of results, and filing of clients’ record. They also visited other hospital departments like the Mother and Child Health (MCH), main Laboratory. “ Meanwhile in the field where they had been paired to accompany the CHiPs in the community, the advisors got to observe CHIPs offering the intervention package This is the first time ever that I have been out with the community teams who have performed HIV rapid testing 100 per cent correctly- well done.” - Dr Rachael Baggeley, HIV Prevention Lead, World Health Organisation including conducting the HIV rapid tests. However, not all IAG teams were able to go out in the field because of rainy weather, for example in Chawama. . The IAG team noted a marked improvement in the delivery of the PopART intervention in the community and at the sites, and expressed satisfaction. Specifically, they noted the amount of work put in by the CHiPS when offering health education about the various PoPART interventions, and the fact that clients were not pressured into consenting to be enrolled in the study. The advisors were also able to directly the various field teams. 8 | PopART study Newsletter Zambia - South Africa Community HIV Care Providers conduct joint field visit HPTN 071/PopART study Community HIV Care Providers (CHiPs) got a chance to work side-by-side in delivering the study intervention package in Kanyama and Chipata PopART sites during the recently held HPTN 071 annual workshop held in Lusaka. Other workshop delegates also braved heavy rains to visit some PopART sites in Zambia. The field teams comprised Zambart and Desmond Tutu TB center (DTTC) comprised CHiP teams, District Administrators, CHiP supervisors, community mobilisers, social science research assistants, population cohort research assistants, district intervention coordinators, and Human Resources manager from DTTC also accompanied the teams. The teams were twinned according to their respective work in the field. This allowed the Zambian team to share experiences and lessons, and also interact with their South African counterparts on the work they do. It also gave the South African team a direct glimpse of the Zambian field situation. The teams drew more similarities in the PopART study implementation in both countries than differences, but noted some differences in the roles. In Zambia for example, the DICs have mixed professional backgrounds, while in South Africa DICs are nurses. It was also observed that under population cohort, quality control is done on site by the PC nurse in Zambia, while in South Africa, QC is done by the PC research assistant and where the PC nurses and research assistant’s daily targets are half of those for their Zambian counterparts. However, the number of clients an intervention team is expected to recruit per day was less for Zambia 8-9, than their South African colleagues recruit at 11 clients per day. However, notable differences included a violent work environment for South Africa, particularly for their research assistants who because of violence have to move in a >> PopART study Newsletter | 9 >> escort a sick client to the clinic, in South Africa we don’t, we refer them to other community health workers,” said Babalwa Solinjani, a South African CHiP among those paired with their Zambian colleagues at Chipata site. Phindiswa Malangeni, another Arm “A” CHiP noted the different ethical considerations. “In South Africa, we write a referral letter and indicate the client’s HIV status, in Zambia they give the client a referral slip to take to the clinic.” vehicle, than Zambia. In addition, it was learned that social science research assistants in in South Africa do not attend community meetings unlike their Zambian counterparts. The South African field teams reported that houses in South African study communities were very close together than in Zambia, making it easier for the intervention and PC to reach more people in a smaller catchment area. However, PopART zones in Zambia are much larger than those in South Africa and the large distances enabled the Zambian CHiPs to be more thorough and spend more time with clients. Zambart communications caught a group of the South African field staff upon their return from the site and they had this to say: “It was a great experience, they do exactly the same consent forms as us. What is interesting is that the PopART staff here Another CHiP Siziwe Makonza, noted that the relation between Zambart PopART and staff at the government clinic is good. “But the stigma experiences and most of the problems our Zambian counterparts face in the field, we are also encountering the same challenges,” she said. Chipata PopART site District Intervention Coordination Rosemary Zulu described the CHiPs twinning as a good initiative that should be encouraged as it helped field staff to interact with their counterparts. “This interaction made it possible for the field staff to share lessons learned from their respective countries,” she said. 10 | PopART study Newsletter PopART study partners map new strategy to strengthen linkage to care The HPTN 071/PopART study has been implemented in all study sites for a year now, with much of the output indicators reaching expected levels of achievement. However, linkage to care which is a central output among the services in the PopART intervention package has been relatively slow with sites recording few numbers of clients tested for HIV and referred to health facilities by the Community HIV Care Providers (CHiPs) accessing care. At end of year 1, Linkage to Care figures showed an average 34 per cent for all 8 intervention sites in Zambia, far below the expected 80 per cent by this end of year one of the study. To this end, PopART study staff and implementing partners gathered to map out new strategies and models that can help improve and strengthen linkage to care in year 2 of the study. A one day workshop at Zambart House, brought together critical PopART study staff and collaborators. The PopART study team from Zambart comprised study manager Dr Kwame Shanaube, Phylogenetic study manager Dr Mohammed Limbada; Statistician Ab Schaap; intervention manager - Ephraim Sakala; district intervention coordinators, Quality Assurance manager Comfort Rutty Phiri, Community Engagement and Social Science teams in PopART were led by Dr Virginia Bond. Meanwhile implementing partners and collaborators included Centre for Infectious Diseases Research in Zambia (CIDRZ), AIDS Relief, Churches Health Association Zambia (CHAZ), ZPCT II, Ministry of Health (MoH), CDC, and the District Community Medical Office (DCMO) under the Ministry of Community Development, Mother and Child Health. Giving a summary of on the status of Linkage to Care in the PopART intervention , Head of Zambart Data Unit, Ab Schaap, said at the close of year 1, figures showed an average 34 per cent for all 8 intervention sites in Zambia, far below the expected 80 per cent by the end of year one of the study. Dr Bond outlined possible barriers to linkage to care from observations made by social science research assistants deployed in all PopART intervention sites (Arm A & B), while Steve Belemu of community engagement highlighted various stigma related issues and stressed the need to strengthen antistigma advocacy within the study communities. Fear of stigma against those with HIV was reported to have a direct impact on access to care by clients referred by Community HIV Care Provides (CHiPs) for treatment to health facilities. ZPCT II shared lessons learned during field visits to the community, while CDC gave the statistical data on HIV linkage to care in Zambia from an outcome of a study they previously conducted. The workshop analysed various linkage to care models being used by respective PopART collaborators with the aim of adopting successful models into the study intervention package. Among the models discussed were the Community Model implemented by AIDS Relief, and Community Adherence Groups (CAG) by CIDRZ. The DCMO presented other models that employ the use of community volunteers at the health facility level to track clients accessing care in various departments such as TB, ART, as well the use of defaulter tracing and the mobile SMS reminder system. The workshop concluded that most models presented focused on retention to care of clients already on ART, while the challenge of getting clients into care still remained. It was agreed that an integrated model would be developed with assistance from MoH, after which a taskforce comprising all PopART implementing partners and collaborators would be set-up to come up with a single common model for adoption. Newsletter PopART study | 11 The Search for Men Kitwe intervention team acts to raise male enrollment in PopART Male involvement in health promotion and uptake can be difficult due to men’s reluctance to engage in health services. This has also been the experience during the on-going Population Effects of Antiretroviral Therapy to Reduce HIV Transmission HPTN071/PopART trial and has thus raised concern among the study researchers about the study outcomes. In Kitwe, following a review of data, it was discovered that 18 per cent of male household members were absent from the household each time a visit by the Community HIV Care Providers (CHiPs) was scheduled. The trend was gradually affecting the study indicators. Overall, as at 30 September, 2014 after 9 months of implementation, male inclusion in PopART trial was 72% i.e. 28% of males were not contacted with the door-to-door approach. This prompted key intervention staff in Kitwe to put their heads together and generate innovative initiatives to engage men in the community in an effort to increase their participation and scale up delivery of the PopART intervention package to in Chimwemwe community. An action plan dubbed “No Missed Opportunity” was soon initiated and the first task was to identify all possible work places and spaces where males could be found within particular zones, including crowded social places that men often frequent and where PopART tents could be mounted. This was followed by orientation of the CHiPs from all the zones about the objectives of the plan and allocate them specific tasks. No Missed Opportunity was rolled out in 4 days in all parts of Chimwemwe, which has 20 zones. These zones were subdivided into 5 zones each with the objective of reaching 90 to 100 males. In each zone, the coordination and mobilization was spearheaded by the CHiPs. The No Missed Opportunity intervention strategy managed to reach 179 people of which 8 were females and 171 were males against the targeted 100 by the end of the initiative. Of the total number of men reached, 147 were enrolled into the study and all the 8 females. All of these were tested and provided with their results on site in mounted tents. Issues attributed to low male participation in PopART activities included stigma and cultural norms, as well as economic issues where men are the breadwinners of the household. It was also observed that men preferred to be the first in the household to enrol, but would decline enrolment if a female household member had preceded them. Some of the men who accepted to be enrolled from the workplaces had refused enrolment where previously found at home by the CHiPs. Man up Now!! Campaign Launched Zambart, under the HPTN 071/ PopART trial launched a health campaign aimed at increasing uptake of the intervention by males in the trial, and raising their awareness and access to primary health services, particularly HIV prevention and care at community level. The trial aims to determine the impact of offering a house-to-house HIV combination prevention package (including universal test- and treat) on community-level HIV incidence. 12 | PopART study Newsletter >> The campaign named “Man up Now!” has been rolled out in 4 northern intervention communities so far and aims to reach an estimated an estimated 30,000 men. The event has been conducted in Makulu (Kabwe), which piloted the campaign, while the others are Chipulukusu (Ndola); Ndeke and Chimwemwe (Kitwe). PopART study manager Dr. Kwame Shanaube says the Man up Now! initiative is an unprecedented campaign by the study team seeking to raise male inclusion in primary health services at community level and promote male engagement in the on-going HPTN 071/PopART study. “Men’s reluctance to seek primary health services is well documented,” Dr Shanaube explained. Zambart is collaborating with the Ministry of Health, Ministry of Community Development, Mother and Child Health (MCDMCH), PopART study partners and stakeholders at district level to mobilize and sensitize the community on the need to access health services through this campaign. Community Engagement manager Musonda Simwinga said the Man up Now! campaign is designed to generate demand for primary health services in the community and also support the community engagement objectives of PopART. “The message we are trying to take to the community is that a health - conscious man raises a healthy family and this leads to a healthy community.” that will result into tangible sharing of resources and ideas. Hopefully, this can scale up efficiency in the delivery of services provided at community level,” said Musonda. The Man Up Now! campaign runs for 2 days and is usually characterized by various community-mobilisation and awareness activities. Free health screening services which include HIV voluntary counselling and testing, prostate cancer information, eye screening, blood pressure checkups, diabetes screening will be offered. Health talks are also conducted. The response from Community members from the target communities was overwhelmingly positive. Most people appreciated the ‘one stop’ provision of health services that were offered at the man up now campaign. The northern campaign events took place between October and December 2014, and the next health campaign is scheduled to take place in Dambwa, Livingstone in April, 2015. The Livingstone event will target both men and women screening for other communicable and noncommunicable diseases. Simwinga said the campaign is also an opportunity for community and faith-based organisations to pool and leverage their resources towards HIV prevention and treatment. “The campaign will create linkages between community stakeholders PopART study Newsletter | 13 Man up Now!! Campaign Launched >> Evaluation of universal HIV testing in PopART study underway A third study of the on-going HPTN 071/PopART study has started in the Zambia PopART sites. The Case Control Studies will seek to evaluate the uptake of home-based PopART intervention delivered houseto-house by the Community HIV Care Providers (CHiPs). The studies will specifically examine the HIV testing, a key component of the PopART intervention package, and will be progressively rolled out in arms A and B sites in Zambia. In March, the case Control studies will be extended to a further 6 intervention sites in South Africa. Clinical epidemiologist, Dr Kalpana Sabapathy working on the PopART trial and manager of the Case Control studies explained that the cases are randomly selected to represent the wider community to help PopART researchers understand the features and factors associated with the uptake and non-uptake of the PopART services in the first year of the PopART trial, and 14 adapt the intervention accordingly. “It was always anticipated that not everybody would accept the testing intervention, which is key in Universal Test and Treat approach. We planned this study as part of the main design of the trial to evaluate acceptability of the testing in the intervention after the 1st year to facilitate improvements which may be introduced in the 2nd and 3rd years,” Dr Sabapathy explained. She said that by looking at differences between 2 groups | PopART study Newsletter of cases, researchers will get insight into sub-sets of the community not accepting the PopART intervention and allow them to adapt it in a bid to get those people not accepting the intervention to accept it eventually: “To achieve overall PopART goal of universal home-based testing,” Dr Sabapathy said. The Case Control studies will run over a period of 2 months and involve 500 people in Zambia, and 300 in South Africa. ‘Story of the Trial’ During the intervention years, one major social science component within the HPTN 071/PopART study is to describe ‘The Story of the Trial’, namely how the study intervention is being implemented and how the communities respond to the intervention and research. at the clinics e.g. Any changes in how clients access treatment and care at the clinic, walking and talking in communities to notice the visibility of PopART and experiences with PopART, documenting stakeholder presence and activities, and, accompanying CHiPs and PC teams in the field. Currently, interviews are being conducted with study management In order to achieve this, the Social staff at Zambart headquarters to Science team (comprising 7 staff explore their role and experiences at headquarters and eight Social with implementing the PopART Science Research Assistants (RA) study in its first year. Similar in the intervention sites) have since interviews will be carried out with the beginning of the intervention, other stakeholders and site staff, carried out observations in the including group discussions with sites and interviews with various community members. Many of individuals that have been involved these activities will be repeated in the study implementation. These annually. observations involve identifying structural and procedural changes Additionally, the social science team is sometimes called upon to explain and discuss challenges and barriers to the intervention. For example, the social science team together with the community engagement team, has been documenting the community mobilization events including the ‘Man up Campaign!’ Similarly, social science has been instrumental in documenting and reflecting on factors affecting client linkage to care in the sites and factors influencing the lower uptake of HIV testing in particular sites. Zambart joins love Condoms Campaign Zambart joined local HIV stakeholders to mark the global 2015 International Condom Day which was held under the theme ‘Condoms are Cool’. The event held annually on Feb 13 in conjunction with Valentine’s Day, is organised by the AIDS Health Care Foundation (AHF) to promote safe sex through widespread access, usage and acceptance of condoms as a vital component of the global fight against the AIDS pandemic. In Zambia, the event attracted participation from the National AIDS Council (NAC), Ministry of Community Development, Mother and Child Health (MCDMCH), local HIV non-governmental organisations, students from higher learning institutions such as the University of Zambia, National Institute of Public administration (NIPA) and Evelyn Hone College. MCDMCH minister Emerine Kabanshi, the Guest of Honour at the event and said government planned to double the procurement of antiretroviral drugs and improve service delivery infrastructure. AIDS awareness activities characterised the event, which included live performances by local performing artists. Rapid HIV testing, accompanied by condom distribution and other HIV prevention services were also offered on-site by various organisations at the event. outreach work for the on-going HPTN 071/PopART study which is testing the impact of a combined package of several HIV prevention interventions at the community level on HIV transmission. Condom distribution to households and the community in intervention sites is part of the PopART study intervention package. Zambart teams from Kanyama and Chipata sites who included PopART intervention manager, district intervention coordinator, social science research assistants, Community HIV Care Providers (CHiPS) and their supervisors, took the opportunity to do some Created in 2008, International Condom Day is a campaign that seeks to put an estimated 20 million HIV positive people on ART by 2020. ADF wants sexually active people to consistently use condoms to help reduce the risk of new HIV infections. PopART study Newsletter | 15 Zambart Stars After disappearing from the soccer front for a couple of years, the Zambart soccer team has swung back into the local social league! Under a new name as Zambart Stars, they are now the official soccer side for Zambart. Man UP Now ! Despite a long absence from the scene, the all-new Zambart Stars are not to be underestimated. The last few months have seen the side -flying the Zambart flag high by entering fearlessly into the current league to compete with other renowned soccer sides in Lusaka, and have so far raised a lot of dust even among some of the strongest competitors. Men's Health Campaign The team drawn mostly from energetic Chipata Site Community HIV care Providers (CHiPs) and head office – make a lean and mean striking force as can be evidenced by their recent exploits. The technical bench comprises of two coaches, one team “doctor” and one team manager who together have built a strong and highly motivated team. Both the head office and site players train twice a week for match preparedness and general fitness. Some highlights of major competitions the Stars have played in the last season include the Vice President’s Cup last June, and in which the Stars white washed all competitors to emerge as winners and brought home the trophy. In September, they came runners-up in the Men United versus Cancer tournament organised by the Zambia Cancer Society to raise awareness about cancers in men and men’s health issues. In both of these matches, the man-of-the-match and golden boot were awarded to the Stars. Zambart soccer administrator Mr Kombe Kenani, said the current form and unmatched determination exhibited by Zambart Stars in commendable. He said the team’s management is considering entering into an even more competitive league which will see the Stars compete against some of the renowned clubs under the Football Association of Zambia. In 2015, the Zambart Stars are planning to start an inter-Zambart league where they will play with teams from other Zambart sites, Mr Kenani said. Below is a snapshot of some of the games Zambart Stars have played so far. Date Tournament Result March 2014 Zambia Army Zambart (1) vs Zambia National Service (1) Zambart (0) vs Libala (4) (Quarter final) April 2014 Vice President Zambart (6) vs Embassy of the People’s Republic of China (1) Zambart (3) vs Comedians (1) Zambart (1) vs Zambia National Broadcasting Corporation (0) June 2014 Zambart (7) vs ZCCM IH (0) Zambart (3) vs G4S (4) July 2014 Zambart (3) vs CHAWAZI (3) Zambart (3) vs Zambia Daily Mail (0) Aug. 2014 Sept. 2014 Zambart (0) vs NINAS FC (0) Men Vs Cancer Zambart (4) vs Cavmont Bank (1) Zambart (1) vs ZCCM IH (0) Zambart (0) vs Lamasat (2) (Final Game) Sept. 2014 Zambart (3) vs G4 Security (0) Zambart (0) vs Chilenje (0) vs Kamwala H EZambart A (2)LT H Rangers (1) Nov. 2014 Zambart (3) vs Town Centre Warriors (6) SFeb.E2015RV I C E SZambartN(1) E R1 YO U ! vs G4A Security Oct. 2014 Feb. 2015 Zambart (4) vs ZAF (1) March 2015 Zambart (5) vs Barclays (0) Zambart (1) vs Radian Stores (3) Zambart (4) vs Ninas FC (2) ..And many more Man up Now NATIONAL INSTITUTES OF HEALTH : National Institutes of Allergy and Infectious Diseases National Institute of Mental Health National Institute on Drug Abuse
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