Prediction of inpatient mortality in hospitalised children in low- and middle-income countries: An external validation of paediatric mortality risk scores.

Background: Risk prediction tools for acutely ill children have been developed in high- and low-income settings, but few are validated or incorporated into clinical guidelines. We aimed to assess the performance of existing paediatric early warning scores for use in low- and middle-income countries using clinical data from a recent large multi-country study in Africa and South-Asia.

Methods: We used data (children across three nutritional strata) from the Childhood Acute Illness and Nutrition (CHAIN) Network cohort study (n = 3101).

Demographic and clinical characteristics of older people with multimorbidity accessing primary healthcare in Malawi: A cross-sectional study.

Background: Multimorbidity is a growing global concern, affecting patient outcomes and healthcare costs. In low- and middle-income countries, data on multimorbidity in primary care beyond prevalence is limited. Our study explored the demographic and clinical characteristics of multimorbidity among older people attending primary health care in Malawi.

Assessing informed consent in surgical patients at Queen Elizabeth Central Hospital in Blantyre, Malawi: a cross-sectional study.

Introduction: Informed consent is critical to medical practice, and a clearly outlined process that results in signing the consent form may improve the validity of the given consent. There is a paucity of studies in Malawi that have assessed the informed consent process in surgical patients.

Aim: To assess the informed consent process for patients undergoing surgery at QECH in Malawi.

Hydrocephalus, healing, and disrupted daily living: exploring maternal experiences at Queen Elizabeth Central Hospital in Blantyre, Malawi.

Background: Each year, nearly 400,000 new cases of paediatric hydrocephalus are estimated to occur worldwide, and almost half of these cases are expected to affect children in Africa. At Queen Elizabeth Central Hospital (QECH), an urban tertiary hospital in Blantyre, Malawi, located in south-east Africa, around 200 children received neurosurgical treatment for hydrocephalus in 2023. These children require lifelong follow-up and care, which places significant demands on their caregivers.

Quantifying natural amyloid plaque accumulation in the continuum of Alzheimer's disease using ADNI.

Brain amyloid beta neuritic plaque accumulation is associated with an increased risk of progression to Alzheimer's disease (AD) [Pfeil, J., et al. in Neurobiol Aging 106: 119-129, 2021].

Topographic and morphometric characterization of the humerii nutrient foramina and their implications for fracture repair and healing.

Fractures of the humerus are common on the midshaft of the bone, often causing injury to the nutrient artery. Successful fracture repair and healing requires preservation of the blood supply to the long bones which is conveyed through the nutrient foramina (NF). The topography of long bone NF varies in different populations.

Evaluation of Tele-Education in Malawi for Detection of Macular Features Using Optical Coherence Tomography.

Purpose: The study aimed to assess the reliability of tele-education in training a Malawian ophthalmology resident to interpret optical coherence tomography (OCT) images of patients with macular conditions.

Methods: This was a retrospective analysis of 1000 macula-centered OCT image series from 1000 eyes of 1000 consecutive patients from Malawi, which involved initial interpretation by a German retina specialist (observer 1) (T). Observer 1 then trained a Malawian resident (observer 2) via email, and observer 2 independently interpreted images at T, followed by face-to-face training in Malawi and reinterpretation at T and T (3-month intervals).

An exploration of unusual antimicrobial resistance phenotypes in Salmonella Typhi from Blantyre, Malawi reveals the ongoing role of IncHI1 plasmids.

Typhoid fever is a significant public health problem endemic in Southeast Asia and Sub-Saharan Africa. Antimicrobial treatment of typhoid is however threatened by the increasing prevalence of antimicrobial resistant (AMR) Typhi, especially in the globally successful lineage (4.3.

Creating codes of ethics for public health professionals and institutions.

Background: The World Health Organization and the Association of Schools of Public Health in the European Region called for the professionalization of the public health workforce, including the creation of codes of ethics. In this article, the Public Health Ethics and Law Network provides guidance on creating such codes, based on values and principles commonly identified for public health.

Methods: Our interest was in codes addressing public health broadly rather than disciplines within public health.

Mixed vulnerabilities: the biological risk of high parity is aggravated by emergency referral in Benin, Malawi, Tanzania and Uganda.

Identification of interacting vulnerabilities is essential to reduce maternal and perinatal mortality in sub-Saharan Africa (SSA). High parity (≥ 5 previous births) is an underemphasized biological vulnerability linked to poverty and affecting a sizeable proportion of SSA births. Despite increased risk, high parity women rarely use hospitals for childbirth.

Heme oxygenase/carbon monoxide system affects the placenta and preeclampsia.

Preeclampsia affects 2% to 8% of pregnancies worldwide and results in significantly high maternal and perinatal morbidity and mortality, with delivery being the only definitive treatment. It is not a single disorder, but rather a manifestation of an insult(s) to the uteroplacental unit -whether maternal, fetal, and/or placental. Multiple etiologies have been implicated, including uteroplacental ischemia, maternal infection and/or inflammation, maternal obesity, sleep disorders, hydatidiform mole, maternal intestinal dysbiosis, autoimmune disorders, fetal diseases, breakdown of maternal-fetal immune tolerance, placental aging, and endocrine disorders.

Factors associated with delayed referrals of patients with sepsis from primary to tertiary healthcare in Blantyre, Malawi: a qualitative study.

Background: Sepsis is defined as invasion of pathogens into the blood stream together with the host response to this invasion. Thus, sepsis consists of the systemic inflammatory response syndrome (SIRS)caused by infection. It is a life-threatening condition that requires prompt detection and early definitive medical intervention.

A retrospective review of the common childhood illnesses and the indications for antibiotic prescription at community hospital in Malawi.

Background: Childhood remains a vulnerable period and a key determiner for adult health. Various illnesses experienced by children in their early years determine future performance and contribution to society. Acute and chronic infectious diseases, undernutrition, and early childhood non-communicable diseases have greatly been linked to intellectual disability, poor childhood development, increased morbidity, and household and healthcare economic costs.

Living with psychosis in West and Southeast Africa: SUCCEED Africa's four-country situation analysis.

As part of the formative work of the SUCCEED Africa consortium, we followed a participatory process to identify existing gaps and resources needed for the development and implementation of a rights-based intervention for people with lived experience of psychosis in Malawi, Nigeria, Sierra Leone and Zimbabwe. In 2021, we conducted a desk review of published and grey literature on psychosis in the four SUCCEED countries. Using an adapted version of the PRIME situation analysis template, data were extracted across the five domains of the WHO Community-Based Rehabilitation (CBR) Matrix: health, education, livelihoods, social and empowerment.

Avoidable factors associated with maternal death from postpartum haemorrhage: a national Malawian surveillance study.

Background: Despite strong evidence-based strategies for prevention and management, global efforts to reduce deaths from postpartum haemorrhage (PPH) have failed, and it remains the leading cause of maternal mortality. We conducted a detailed review of all maternal deaths from 33 facilities in Malawi to identify health system weaknesses leading to deaths from PPH.

Methods: Data were collected regarding every maternal death occurring across all district and central hospitals in Malawi.

Using ESPEN data for evidence-based control of neglected tropical diseases in sub-Saharan Africa: A comprehensive model-based geostatistical analysis of soil-transmitted helminths.

Background: The Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN) was launched in 2019 by the World Health Organization and African nations to combat Neglected Tropical Diseases (NTDs), including Soil-transmitted helminths (STH), which still affect over 1.5 billion people globally. In this study, we present a comprehensive geostatistical analysis of publicly available STH survey data from ESPEN to delineate inter-country disparities in STH prevalence and its environmental drivers while highlighting the strengths and limitations that arise from the use of the ESPEN data.

Assessing the reliability and validity of pictorial-assisted 24-h recall for measuring hand hygiene and child faeces disposal: A cross-sectional study in Malawi.

Whilst improving hygiene and sanitation behaviours is key to cost-effective and sustainable water, sanitation and hygiene interventions, measuring behaviour change remains a challenge. This study assessed the validity and reliability of pictorial 24-h recall (P24 hR), a novel method using unprompted recall of past activities through pictures, compared to structured observation for measuring handwashing with soap (HWWS) and safe child faeces disposal in rural Malawi. Data were collected from 88 individuals across 74 households in Chiradzulu district using both methods over a two-day period, with the recall period of the P24 hR corresponding to the period of structured observation completed the previous day.

How macrophage heterogeneity affects tuberculosis disease and therapy.

Macrophages are the primary host cell type for infection by Mycobacterium tuberculosis in vivo. Macrophages are also key immune effector cells that mediate the control of bacterial growth. However, the specific macrophage phenotypes that are required for optimal immune control of M.

Schistosoma mattheei and zoonotic schistosomiasis.

We highlight the epidemiological importance of Schistosoma mattheei, a common parasite of livestock with an underappreciated ability to infect people, being recently incriminated in both female and male genital schistosomiasis. Through hybridisation(s) with other schistosome species, its public health importance will grow as its zoonotic potential expands across southern Africa.

Ferric carboxymaltose for anemia in late pregnancy: a randomized controlled trial.

Over 46% of African pregnant women are anemic. Oral iron is recommended but often suboptimal, particularly late in pregnancy. Intravenous ferric carboxymaltose (FCM) could treat anemia in women in the third trimester in sub-Saharan Africa.

Duration of Breastfeeding and Risk Reduction of Breast Cancer among Mothers Who Have Ever Breastfed: A Case-Control Study Conducted in Bahir Dar, Ethiopia.

Introduction: Breast cancer is currently the most frequently detected cancer in women and the primary cause of cancer-related deaths globally. The incidence of breast cancer has significantly increased in countries across sub-Saharan Africa, counting Ethiopia. There are multiple determinants of breast cancer, a few of these can be changeable whereas others are not.

Barriers and facilitators to implementing six monthly multi-month dispensing of antiretroviral therapy in two urban HIV clinics during the COVID-19 Era in Malawi.

Following the COVID-19 pandemic, the Malawi Government released a policy that promoted the scale-up of six-monthly multi-month dispensing (6-MMD) of antiretroviral therapy (ART) to people living with HIV in order to decrease congestion at health facilities and transmission of COVID-19. We evaluated the barriers and facilitators to implementing the scale-up of 6-MMD.We conducted a cross-sectional study and collected quantitative and qualitative data from 13 January 2022 to 5 February 2022 at two high-volume primary health facilities in urban Blantyre, Malawi.