Diagnostic radiographers' experiences with paediatric patients during radiography examinations in Malawi - A qualitative study.

Introduction: Performing radiography examinations on paediatric patients is challenging and requires expertise from diagnostic radiographers. The patient needs to remain still in radiography to acquire a diagnostic image. In Malawi, diagnostic radiographers continue to experience challenges when imaging paediatric patients.

Pharmacist-Led Antimicrobial Stewardship Programme in Two Tertiary Hospitals in Malawi.

The ultimate goal of antimicrobial stewardship (AMS) programmes is to decrease the occurrence and spread of antimicrobial resistance (AMR). In response to this, a pharmacist partnership was established between Malawi and Wales (UK) with the aim of strengthening antimicrobial stewardship (AMS) activities in Malawi, with the initial project focusing on two tertiary referral hospitals. The Global Point Prevalence Survey (GPPS) was undertaken for the first time in Malawi at these sites and demonstrated a prescribing rate slightly lower than the African average, with ceftriaxone indicated for almost every bacterial infection.

Emotional and behavioural difficulties among children and adolescents attending "ART teen clubs" in Mzuzu City in northern Malawi: a cross-sectional study.

Background: While triple anti-retroviral therapy (ART) has improved HIV-infected children surviving into adolescence and adulthood, these children remain vulnerable to HIV-related psychological disturbance due to both the direct HIV infection effects on the brain and indirect effects related to coping with a range of medical, psychological and social stresses associated with HIV, which makes it vital to identify their mental health needs. This study assessed the emotional and behavioural challenges of HIV perinatally infected children and adolescents with a completed disclosure process attending "ART teen club" in Malawi.

Methods: A cross-sectional descriptive study design was conducted to obtain quantitative descriptive descriptions of emotional and behavioural challenges among HIV-infected children and adolescents between 10 and 22 years of age.

Lessons learned from the Global Polio Eradication Initiative: A roadmap for the international COVID-19 vaccination campaign.

The COVID-19 vaccine is lauded by many as one of the greatest accomplishments in modern medicine, with the potential to definitively contain the deadliest pandemic of the last century. With the vaccine rollout now underway in the developing world, a robust, methodical, and swift global distribution effort is required to ensure that it will be done in an equitable manner. Taking into account the vast geographic, socioeconomic, cultural, and political diversity of countries around the world, global vaccination efforts have historically required multifaceted, time consuming, and labor-intensive approaches to be effective.

Fight against cholera outbreak, efforts and challenges in Malawi.

Cholera is endemic in many African countries with recurrent seasonal outbreaks in parts of the region. Malawi has been experiencing seasonal outbreaks of Cholera since 1998, and it is one of the major public health problems. The current cholera outbreak is one of Malawi's worst cholera outbreaks in the past 10 years.

A comparison of clinical outcomes among people living with HIV of different age groups attending queen Elizabeth central hospital outpatient ART Clinic in Malawi.

Introduction: Adherence to Antiretroviral Treatment (ART) in children and adolescents living with HIV in low-resource settings is not extensively studied in large cohort studies including both adults and pediatric patients. We compared rates of virological suppression, adherence and defaulting among children, adolescents and adults attending a family ART clinic at Queen Elizabeth Central Hospital; a tertiary hospital situated in the southern region of Malawi.

Methods: The study was longitudinal and made use of routinely collected data for all 27,229 clinic attendees.

Dynamics of viral disease outbreaks: A hundred years (1918/19-2019/20) in retrospect - Loses, lessons and emerging issues.

Infectious diseases continue to be the leading cause of morbidity and mortality, and a formidable obstacle to the development and well-being of people worldwide. Viruses account for more than half of infectious disease outbreaks that have plagued the world. The past century (1918/19-2019/20) has witnessed some of the worst viral disease outbreaks the world has recorded, with overwhelming impact especially in low- and middle-income countries (LMIC).

Coronavirus Disease 2019 (COVID-19) Reinfection Rates in Malawi: A Possible Tool to Guide Vaccine Prioritisation and Immunisation Policies.

As the fight against the COVID-19 pandemic continues, reports indicate that the global vaccination rate is still far below the target. Understanding the levels of reinfection may help refocus and inform policymakers on vaccination. This retrospective study in Malawi included individuals and patients who tested for COVID-19 infections via reverse transcriptase polymerase chain reaction (rt-PCR) from the data at the Public Health Institute of Malawi (PHIM).

Novel application of multi-facility process map analysis for rapid injury care health system assessment in Northern Malawi.

Objectives: We used the process mapping method and Three Delays framework, to identify and visually represent the relationship between critical actions, decisions and barriers to access to care following injury in the Karonga health system, Northern Malawi.

Design: Facilitated group process mapping workshops with summary process mapping synthesis.

Setting: Process mapping workshops took place in 11 identified health system facilities (one per facility) providing injury care for a population in Karonga, Northern Malawi.

Six months survival and risk factors for attrition for patients detected with cryptococcal antigenemia through screening in Malawi.

Main Objective: A cohort of adult Malawian people living with HIV (PLHIV) testing positive for cryptococcal antigenemia was observed and followed to determine the outcomes and risk factors for attrition.

Methods Concept: Eligible PLHIV were enrolled at 5 health facilities in Malawi, representing different levels of health care. ART naïve patients, ART defaulters returning to care, and patients with suspected or confirmed ART treatment failure with CD4 <200 cells/μL or clinical stage 3 or 4 were enrolled and received CrAg tests on whole blood specimens from August 2018 to August 2019.

The distribution of blinkrate among Malawian young adults: a cross-sectional study.

Blink rate is a critical sign for numerous systemic and ocular conditions in medicine, however, the literature reports varying values for the parameter. Hence, the aim of this study was to establish the cut-off blink rate value among Malawian young adults including the effects of sex and age on the parameter. This was a quantitative descriptive cross-sectional study conducted among students at Mzuzu University in Malawi.

Mobility impairment and life satisfaction in the Northern Region of Malawi.

Background: There exist many psychosocial sequelae associated with mobility impairment, especially in low-resource settings where access to mobility assistive devices is limited.

Objectives: This study aims to (1) define the burden and presenting aetiologies of mobility impairment in the rural Northern Region of Malawi and (2) assess the relationship between physical disability, life satisfaction and access to mobility aids.

Methods: At mobility device donation clinics throughout the Northern Region of Malawi, adults living with mobility impairment were surveyed with a demographic questionnaire and a series of validated surveys to assess their physical activity levels (Global Physical Activity Questionnaire [GPAQ]), degree of mobility impairment (Washington Group Extended Set Questions on Disability) and life satisfaction (patient-reported outcomes measurement information systems satisfaction with participation in social roles and general life satisfaction).

Knowledge, attitude and use of evidence based practice (EBP) among registered nurse-midwives practicing in central hospitals in Malawi: a cross-sectional survey.

Background: Even though evidence based practice (EBP) is being considered as a critical element in improving the quality of health services and achieving excellence in patient care, there is currently little knowledge of how EBP relates to nursing and midwifery in Malawi. This paper is a report of a study describing EBP knowledge, attitudes, and use of registered nurse-midwives practicing in central hospitals across Malawi.

Methods: The descriptive, cross-sectional research design was conducted with a randomly selected sample of 183 nurse-midwives (response rate of 87.

Patient satisfaction with health care at a tertiary hospital in Northern Malawi: results from a triangulated cross-sectional study.

Background: In 2016 the Malawi government embarked on several interrelated health sector reforms aimed at improving the quality of health services at all levels of care and attain Universal Health Coverage by 2030. Patient satisfaction with services is an important proxy measure of quality. We assessed patient satisfaction at a tertiary hospital in Northern Malawi to understand the current state.

Training in Ultrasound to Determine Gestational Age (TUDA): Evaluation of a Novel Education Package to Teach Ultrasound-Naive Midwives Basic Obstetric Ultrasound in Malawi.

Introduction: Although ultrasound to determine gestational age is fundamental to the optimum management of pregnancy and is recommended for all women by the World Health Organisation, it remains unavailable to many women in low-income countries where trained practitioners are scarce. This study aimed to evaluate a novel, context-specific education package to teach midwives basic obstetric ultrasound, including the determination of gestational age by measurement of fetal femur length.

Methods: The study was conducted across six sites in Malawi in January 2021.

Histopathological profile of orbito-ocular cancers at a tertiary hospital in Northern Malawi: a retrospective cross-sectional study.

Objective: Orbito-ocular cancers are a common cause of morbidity and mortality in our population, yet these cancers have not been adequately described in Malawi. This study sought to describe the burden and histopathological profile of orbito-ocular cancers in Northern Malawi.

Methods And Analysis: A retrospective review of pathology reports was done.

Histopathological profile of cervical biopsies in northern Malawi: a retrospective cross-sectional study.

Objectives: According to the WHO (2014), cervical cancer is the second most common cancer in women globally. More than 85% of the global cervical cancer morbidity and mortality occur in low-income and middle-income countries and the highest risk region is in Eastern and Southern Africa. Malawi has the highest age-standardised rate of cervical cancer in the world.

Projecting the cost of introducing typhoid conjugate vaccine (TCV) in the national immunization program in Malawi using a standardized costing framework.

Background: There is a substantial typhoid burden in sub-Saharan Africa, and TCV has been introduced in two African countries to date. Decision-makers in Malawi decided to introduce TCV and applied for financial support from Gavi, the Vaccine Alliance in 2020. The current plan is to introduce TCV as part of the national immunization program in late 2022.

Evaluation of diabetic peer support in Malawi.

Background: Type 2 diabetes is a major health concern worldwide and requires urgent attention from health care providers and policy makers. Due to shortage of health care workers in low-income countries, peer support programs have been viewed as a viable option in management of diabetes and have shown to be effective in sub-Saharan Africa.

Objective: The aim of this study is to assess and evaluate the Kamuzu Central Hospital (KCH) diabetic peer support program's (DPSP) impact 4 years after its establishment by assessing knowledge, self-efficacy and behaviours of DPSP members compared to non-members.

Using EEG in Resource-Limited Areas: Comparing Qualitative and Quantitative Interpretation Methods in Cerebral Malaria.

Background: Our goal was to compare the strength of association and predictive ability of qualitative and quantitative electroencephalographic (EEG) factors with the outcomes of death and neurological disability in pediatric cerebral malaria (CM).

Methods: We enrolled children with a clinical diagnosis of CM admitted to Queen Elizabeth Central Hospital (Blantyre, Malawi) between 2012 and 2017. A routine-length EEG was performed within four hours of admission.

The fight against the COVID-19 pandemic: Vaccination challenges in Sudan.

The first COVID-19 case in Sudan was announced on March 13th, 2020. 1835 deaths were recorded as of February 7th, 2021. 800,000 doses of the Oxford-AstraZeneca vaccine were allocated to Sudan through COVAX in March 2021.