Mobilizing for the Lilongwe Diabetes Peer Support Programme in Malawi.

Diabetes has become a significant cause of morbidity and mortality in Malawi but there are shortages of drug supply and healthcare providers to support quality care and treatment. Diabetes self-management support is necessary to improve patient outcomes, and peer support has gained acceptance as a solution for improving diabetes self-management. In this programme summary, we describe the components and facilitators essential to implementing a diabetes peer support programme in Lilongwe, Central Malawi.

Pneumocystis carinii pneumonia in patients being registered for smear-negative pulmonary tuberculosis in Malawi.

The National TB Control Programme of Malawi registers and treats large numbers of patients with chronic cough for smear-negative pulmonary tuberculosis (PTB). Smear-negative PTB is diagnosed according to clinical and radiographic criteria, as mycobacterial cultures are not routinely available. In an area of high HIV seroprevalence there is a concern that other opportunistic infections apart from TB, such as Pneumocystis carinii, may be missed owing to lack of diagnostic facilities.

'Smear-negative' pulmonary tuberculosis in a DOTS programme: poor outcomes in an area of high HIV seroprevalence.

Setting: Lilongwe Central Hospital, Malawi.

Objectives: To investigate 1) treatment outcome of a cohort of smear-negative pulmonary TB (snPTB) patients in an area of high human immunodeficiency virus (HIV) seroprevalence, and 2) whether poor treatment outcomes are due to non-TB patients being mistakenly treated for TB due to lack of diagnostic facilities.

Design: Patients about to be registered for snPTB treatment by the National TB Programme underwent further assessment including TB culture, bronchoscopy and bronchoalveolar lavage.

What causes smear-negative pulmonary tuberculosis in Malawi, an area of high HIV seroprevalence?

Setting: The Central Hospital and the District Tuberculosis (TB) Registry in Lilongwe, the capital of Malawi. In this setting smear-negative pulmonary tuberculosis (PTB) is diagnosed using clinical and radiographic criteria for TB, and mycobacterial cultures are not routinely available.

Objective: To determine the proportion of patients being registered for smear-negative PTB treatment in Lilongwe who have TB that can be confirmed microbiologically.