{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:32:57Z","timestamp":1787031177258,"version":"build-2736575974"},"reference-count":16,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Lumbar puncture (LP) is a safe, standard procedure essential in the investigation of a variety of neurological disorders. However, in many regions, LP uptake and performance are low, even when it is strongly indicated. We sought to understand patient, caregiver, and healthcare worker perspectives in rural Zambia. We conducted a cross-sectional survey of adult patients, caregivers of adult and pediatric patients, nurses, doctors, and clinical officers at two rural hospitals in the Southern Province of Zambia. The survey consisted of questions on self-reported LP knowledge, an LP knowledge questionnaire, and open-ended questions about LP perceptions and, for healthcare workers, the LP consent process. Descriptive statistics are reported for quantitative questions, and qualitative responses were thematically coded using an inductive approach. Of 120 total participants, the majority (\n                    <jats:italic>n<\/jats:italic>\n                    = 97; 81%) reported they had previously heard of LPs and indicated having \u201ca little\u201d knowledge (\n                    <jats:italic>n<\/jats:italic>\n                    = 71; 59%), with the most common source of knowledge being friends and family members. Scores on LP knowledge questionnaire were low for patients and caregivers (median three out of seven possible points). Healthcare worker knowledge scores were higher than laypersons (mean = 6) but misperceptions about LPs were still common, with half of healthcare workers reporting LPs cause paralysis. This rural cohort essentially demonstrated the same knowledge gaps and misperceptions previously identified in an urban Zambian cohort, further supporting the need for interventions aimed at the community and healthcare workers regardless of urbanicity.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.24-0749","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T10:59:58Z","timestamp":1747738798000},"page":"445-451","source":"Crossref","is-referenced-by-count":2,"title":["Lumbar Puncture Knowledge and Attitudes among Patients, Caregivers, and Healthcare Workers in Rural Zambia"],"prefix":"10.4269","volume":"113","author":[{"given":"Deanna R.","family":"Saylor","sequence":"first","affiliation":[{"name":"Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Elafros","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Mang\u2019ombe","sequence":"additional","affiliation":[{"name":"Ministry of Health, Southern Province, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fridah","family":"Chiwanza","sequence":"additional","affiliation":[{"name":"Chikankata Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Mulonga","sequence":"additional","affiliation":[{"name":"Chikankata Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Chipoya","sequence":"additional","affiliation":[{"name":"Monze Mission Hospital, Monze, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Mabeta","sequence":"additional","affiliation":[{"name":"Chikankata Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oppah","family":"Kufa","sequence":"additional","affiliation":[{"name":"Monze Mission Hospital, Monze, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somwe","family":"Wa Somwe","sequence":"additional","affiliation":[{"name":"Paediatrics and Child Health, University of Lusaka, Lusaka, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gretchen L.","family":"Birbeck","sequence":"additional","affiliation":[{"name":"Chikankata Epilepsy Care Team, Chikankata Hospital, Mazabuka, Zambia;"},{"name":"Department of Neurology, University of Rochester, Rochester, New York;"},{"name":"University Teaching Hospitals Children\u2019s Hospital, Lusaka, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Neurology","first-page":"1988","article-title":"Lumbar puncture refusal in sub-Saharan Africa: A call for further understanding and intervention","volume":"84","author":"Thakur","year":"2015"},{"key":"b2","article-title":"CDC in Zambia","year":"2023"},{"key":"b3","article-title":"Developing a System of Neurologic Care in Zambia","author":"Saylor","year":"2018"},{"key":"b4","series-title":"HIV Med","first-page":"118","article-title":"HIV and new onset seizures: Slipping through the cracks in HIV care and treatment","volume":"17","author":"Sikazwe","year":"2016"},{"key":"b5","series-title":"Am J Trop Med Hyg","first-page":"1429","article-title":"Factors associated with lumbar puncture performance in Zambia","volume":"105","author":"Saylor","year":"2021"},{"key":"b6","series-title":"Trans R Soc Trop Med Hyg","first-page":"1138","article-title":"A qualitative study of factors resulting in care delays for adults with meningitis in Zambia","volume":"116","author":"Elafros","year":"2022"},{"key":"b7","series-title":"Trans R Soc Trop Med Hyg","first-page":"322","article-title":"A qualitative study of patient, caregiver, doctor, and nurse views of factors influencing lumbar puncture uptake in Zambia","volume":"116","author":"Elafros","year":"2022"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"1925","article-title":"Lumbar puncture-related knowledge, attitudes, and practices among patients, caregivers, doctors, and nurses in Zambia","volume":"104","author":"Elafros","year":"2021"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"1052","article-title":"Patient, provider, and health systems factors leading to lumbar puncture nonperformance in Zambia: A qualitative investigation of the \u201ctap gap.\u201d","volume":"108","author":"Saylor","year":"2023"},{"key":"b10","series-title":"Am J Transl Res","first-page":"4179","article-title":"Public acceptability of lumbar puncture in the diagnosis of Alzheimer\u2019s disease: A questionnaire-based single center study in China","volume":"15","author":"Guo","year":"2023"},{"key":"b11","series-title":"Pediatric Health Med Ther","first-page":"91","article-title":"Mothers\u2019 views about lumbar puncture for their children in a maternity and children\u2019s hospital in Najran, Saudi Arabia","volume":"12","author":"Alshaibari","year":"2021"},{"key":"b12","series-title":"Pediatr Emerg Care","first-page":"661","article-title":"Parental attitudes about lumbar puncture in children with suspected central nervous system infection","volume":"39","author":"Sahin","year":"2023"},{"key":"b13","series-title":"Res Involv Engagem","first-page":"49","article-title":"Impact of community engagement and social support on the outcomes of HIV-related meningitis clinical trials in a resource-limited setting","volume":"6","author":"Kwizera","year":"2020"},{"key":"b14","series-title":"JAMA Netw Open","first-page":"e2431512","article-title":"Neurological symptoms and cause of death among young children in low- and middle-income countries","volume":"7","author":"Ajanovic","year":"2024"},{"key":"b15","series-title":"Chin Med J (Engl)","first-page":"1786","article-title":"Central nervous system involvement in 179 Chinese children with hemophagocytic lymphohistiocytosis","volume":"131","author":"Zhao","year":"2018"},{"key":"b16","series-title":"Clin Infect Dis","first-page":"1694","article-title":"Outcomes of cryptococcal meningitis in Uganda before and after the availability of highly active antiretroviral therapy","volume":"46","author":"Kambugu","year":"2008"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p445.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p445.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/2\/article-p445.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T14:00:06Z","timestamp":1754488806000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/2\/article-p445.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,6]]},"references-count":16,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.24-0749","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,6]]}}}