Prevalence and factors associated with malaria parasitaemia in children under the age of five years in Malawi: A comparison study of the 2012 and 2014 Malaria Indicator Surveys (MISs)

© 2017 Zgambo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Malaria is the main cause of morbidity and mortality among children under the age of five years in Malawi. The aim of this study was to compare the prevalence and factors associated with malaria parasitaemia among children under the age of five years in Malawi between the 2014 and 2012 Malaria Indicator Surveys (MISs). Methodology Data on demographic factors, vector control interventions, and blood for malaria test were collected from a representative sample of children under the age of five years in Malawi through multistage cluster sampling method. Data were analysed by chi-square test and logistic regression using complex samples analysis of the Statistical Package for the Social Sciences (SPSS) version 22.Results The prevalence of malaria parasitaemia among children under the age of five years increased from 28% in 2012 to 33% in 2014 (p > 0.05). Likewise, the proportion of children using long-lasting insecticide-treated net (LLIN) increased significantly from 54% in 2012 to 65% in 2014 MIS (p < 0.05). The proportion of households that had used indoor residual spraying (IRS) was 9% for both surveys. In multivariate analysis, use of LLIN significantly predicted for malaria parasitaemia in the 2012 MIS but not in the 2014 MIS. Older children and those coming from the poorest families were significantly associated with having malaria parasites in both surveys. Conclusion The increase in the use of LLIN among children in 2014, did not result in the reduction of malaria parasitaemia in children. The use of LLIN significantly predicted for malaria parasitaemia among children in the 2012 MIS but not in the 2014 MIS. The results of this study underscore the need to increase the coverage of IRS, mosquito repellents and larvicide alongside LLINs in order to reduce the burden of malaria among children in Malawi

Effective Adolescent Sexual and Reproductive Health Education Programs in Sub-Saharan Africa

Background: The objective of this review was to explore and identify feasible, socially acceptable and effective adolescent sexual and reproductive health education (ASRHE) programs in sub-Saharan Africa. Methods: Four databases were searched to identify studies conducted within the past 15 years which evaluate the effectiveness of ASRHE programs in sub-Saharan Africa. The databases searched were Embase, Medline, CINAHL, PyscINFO. A further search for relevant articles was made in the Google scholar website. The title and abstract of each article were analyzed for relevance by applying inclusion and exclusion criteria. Further scrutiny and extraction of the studies was completed by selecting only those studies which met the criteria for inclusion. Results: Fifteen studies were identified. School, peer, mass media, health facility and community based ASRHE programs showed positive impact in one or more of the following outcomes in adolescents in sub-Saharan Africa: ( i) knowledge of HIV transmission; (ii) perceived personal risk of contracting HIV/ AIDS; (iii) self-efficacy to negotiate condom use; (iv) discussion with others about HIV/AIDS or condom use; (v) abstinence from sexual relations; (vi) reduction in high-risk sexual behavior; (vii) condom use (vii) testing for sexually transmitted infection (STI) and (viii) treatment seeking behavior. Conclusion: ASRHE programs of diverse forms can produce positive change in adolescent sexual and reproductive health (ASRH). There is need for rigorous research to assess long term behavioral effects of culturally tailored comprehensive ASRHE programs in sub-Saharan Africa

Challenges experienced by newly qualified nurse-midwives transitioning to practice in selected midwifery settings in northern Malawi

Background: Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from education to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from education to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi. Methodology: A qualitative descriptive approach was used. Data were collected through in-depth interviews using semi-structured interview guides from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). The researchers developed two interview guides; one for the newly qualified nurse-midwives and another one for the key informants. The interview guides had questions related to newly qualified nurse-midwives experiences of transitioning to practice and the support they received. Participants were from three selected hospitals in the Northern part of Malawi that have maternity units. Data were analysed manually using thematic analysis. Findings: Five themes related to challenges faced by newly qualified nurse-midwives during their transition to practice in midwifery units emerged from the thematic analysis of the data. These included (1) Theory—practice gap, (2) Lack of confidence and skills, (3) Inadequate resources, (4) Transition support system, and (5) Workplace conflict. Conclusion: Newly qualified nurse-midwives in Malawi encounter many challenges while transitioning from education to practice. The study findings underscore the need to develop a national framework support system that could not only help newly qualified midwives adjust positively to their new role but also create more opportunities for learning and developing and strengthening a collaborative partnership between colleges and hospitals

Systematic review protocol of the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth globally

INTRODUCTION: Human immunodeficiency virus (HIV) prevention interventions focused at reducing risky sexual behaviours are an important strategy for preventing HIV infection among youth (15-24 years) who continue to be vulnerable to the disease. This systematic review aims to synthesise current global evidence on the effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth in the last decade. METHODS AND ANALYSIS: MEDLINE/PubMed, EMBASE, PsychINFO, ProQuest Central, CINAHL and Web of Science databases, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform and reference lists of included studies and systematic reviews on effectiveness of HIV prevention interventions for reducing risky sexual behaviour among youth will be searched for articles published from August 2011 to August 2021. Eligible studies will be longitudinal studies including randomised controlled trials and quasi-experimental studies that examined the effectiveness of HIV prevention interventions among youth populations (15-24 years) with risky sexual behaviour as a primary or secondary outcome. Study selection and quality assessment will be undertaken independently by three reviewers and disagreements will be resolved through consensus. Data analysis will be undertaken using RevMan software V.5.3.3. A random effects meta-analysis will be conducted to report heterogeneous data where statistical pooling is achievable. We will use I2 statistics to test for heterogeneity. Where appropriate, a funnel plot will be generated to assess publication bias. Where statistical pooling is unachievable, the findings will be reported in a narrative form, together with tables and figures to assist in data presentation if required. Reporting of the systematic review will be informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ETHICS AND DISSEMINATION: Ethical approval is not required. Findings of the systematic review will be published in a peer-reviewed journal. The findings will be of interest to researchers, healthcare practitioners and policymakers. PROSPERO REGISTRATION NUMBER: CRD42021271774

Biopsychosocial risk factors and knowledge of cervical cancer among young women: A case study from Kenya to inform HPV prevention in Sub-Saharan Africa

Background: Cervical cancer is the second most common female reproductive cancer after breast cancer with 84% of the cases in developing countries. A high uptake of human papilloma virus (HPV) vaccination and screening, and early diagnosis leads to a reduction of incidence and mortality rates. Yet uptake of screening is low in Sub-Saharan Africa and there is an increasing number of women presenting for treatment with advanced disease. Nine women in their twenties die from cervical cancer in Kenya every day. This paper presents the biopsychosocial risk factors that impact on cervical cancer knowledge among Kenyan women aged 15 to 24 years. The findings will highlight opportunities for early interventions to prevent the worrying prediction of an exponential increase by 50% of cervical cancer incidences in the younger age group by 2034. Methods: Data from the 2014 Kenya Demographic and Health Survey (KDHS) was analysed using complex sample logistic regression to assess biopsychosocial risk factors of knowledge of cervical cancer among young women aged 15 to 24 years (n = 5398). Findings: Close to one third of the participants were unaware of cervical cancer with no difference between participants aged 15–19 years (n = 2716) and those aged 20–24 years (n = 2691) (OR = 1; CI = 0.69–1.45). Social predisposing factors, such as lack of education; poverty; living further from a health facility; or never having taken a human immunodeficiency virus (HIV) test, were significantly associated with lack of awareness of cervical cancer (p<0.001). Young women who did not know where to obtain condoms had an OR of 2.12 (CI 1.72–2.61) for being unaware of cervical cancer. Psychological risk factors, such as low self-efficacy about seeking medical help, and an inability to refuse unsafe sex with husband or partner, perpetuated the low level of awareness about cervical cancer (p<0.001). Conclusions: A considerable proportion of young women in Kenya are unaware of cervical cancer which is associated with a variety of social and psychological factors. We argue that the high prevalence of cervical cancer and poor screening rates will continue to prevail among older women if issues that affect young women’s awareness of cervical cancer are not addressed. Given that the Kenyan youth are exposed to HPV due to early sexual encounters and a high prevalence of HIV, targeted interventions are urgently needed to increase the uptake of HPV vaccination and screening

The association between levels of alcohol consumption and mental health problems and academic performance among young university students

Purpose: Mental health problems and harmful alcohol consumption have been found to be high among young university students compared to the general population in Australia. This research aimed to investigate the association between levels of drinking and mental health problems and academic performance among university students aged 18 to 24 years. Methods: This study used a quantitative cross-sectional design using data that were collected in 2014 as part of the Youth Alcohol Project (YAP). Participants were randomly drawn from a cross sectional sample of 6000 undergraduate students. Included in the study were only students who were within the age of 18-24, undergraduate, and internally enrolled at the main campus. A total of 2518 undergraduate students aged 18 to 24 years who were enrolled internally at Curtin University Bentley campus were randomly recruited. Data were collected through an online survey. Students were invited to participate in the study through their student email address. The email invitations coincided with the release of semester results to increase the likelihood of students accessing their emails. A further 628 students were randomly recruited through face to face intercept survey during the campus market days. Data were collected by trained research assistants. Validated instruments were used to collected data on levels of alcohol consumption, mental health, and academic performance. Results: A considerable proportion of participants (44%) reported consuming alcohol at hazardous or harmful levels. Multiple logistic regression analysis showed that students who were consuming alcohol at hazardous levels were 1.2 times more likely to report psychological distress than those with lower levels of alcohol consumption (aOR 1.2, 95% CI: 1.1-1.5). In addition, being late for class (aOR 1.7, 95% CI:1.1-2.4), missing classes (aOR = 2.6, 95% CI: 1.9-2.6), inability to concentrate in class (aOR = 2.6, 95% CI: 1.9-3.4), and inability to complete assignments (aOR = 3.5, 95% CI 2.0-6.0) independently predicted for moderate or hazardous alcohol consumption. Conclusion: The study shows that a considerable proportion of undergraduate students at university consume alcohol at hazardous or harmful levels. In addition, high levels of alcohol consumption are associated with poor academic performance and mental health outcomes among students. The results of the study warrant multi-strategy interventions that focus on policy, organisational, educational, environmental and economic strategies that will help to reduce alcohol related harms among university students

Risk Factors for Breast Cancer and Expression of Insulin-Like Growth Factor-2 (IGF-2) in Women with Breast Cancer in Wuhan City, China

PURPOSE: The purpose of this study was to explore the risk factors for breast cancer and establish the expression rate of IGF-2 in female patients. METHODS: A case control study with 500 people in case group and 500 people in control group. A self-administered questionnaire was used to investigate risk factors for breast cancer. All cases were interviewed during a household survey. Immune-histochemical method was used to inspect the expression of IGF-2 in different tissues (benign breast lesions, breast cancer and tumor-adjacent tissue). RESULTS: Multivariate adjusted odds ratios and 95% confidence intervals were calculated using unconditional logistic regression. High body mass index (OR = 1.012,95%CI = 1.008-1.016), working attributes (OR = 1.004, 95%CI = 1.002 = 1.006), long menstrual period (OR = 1.007, 95%CI = 1.005-1.009), high parity OR = 1.003, 95%CI = 1.001-1.005) , frequent artificial abortion (OR = 1.004, 95%CI = 1.001-1.005), family history of cancer (OR = 1.003, 95%CI = 1.000-1.005), period of night shift (OR = 1.003, 95%CI = 1.001-1.006), live in high risk environment (OR = 1.005, 95%CI = 1.002-1.008), and family problems (OR = 1.010, 95%CI = 1.005-1.014) were associated with increased risk for breast cancer. In this study, good sleeping status, positive coping strategies, subjective support, and utility degree of social support were associated with reduced risk for breast cancer (OR = 0.998, 0.997, 0.985, 0.998 respectively; 95%CI = 0.996-1.000, 0.994-1.000, 0.980-0.989, 0.996-1.000, respectively). In benign breast lesions, breast cancer and tumor-adjacent tissue, IGF-2 was mainly expressed in the cytoplasm, but its expression rate was different (p<0.05). CONCLUSIONS: The incidence of breast cancer is a common result of multiple factors. IGF-2 is involved in the development of breast cancer, and its expression varies in different tissues (benign breast lesions, breast cancer and tumor-adjacent tissue)

Healthcare workers' perspectives and practices regarding the disclosure of HIV status to children in Malawi: A cross-sectional study

Background: In 2011 the World Health Organisation recommended that children with a diagnosis of HIV be gradually informed about their HIV status between the ages of 6 and 12 years. However, to date, literature has focused mainly on primary caregiver and child experiences with HIV disclosure, little is known about healthcare workers' perspectives and practices of HIV status disclosure to children. The aim of this study was to assess healthcare workers' perspectives and practices regarding the disclosure of HIV status to children aged between 6 and 12 years in Malawi. Methods: A cross-sectional survey was used to collect data from 168 healthcare providers working in antiretroviral clinics in all government District and Tertiary Hospitals in Malawi. Participants were asked questions regarding their knowledge, practice, and barriers to HIV disclosure. Data were analysed using binary logistic regression. Results: Almost all healthcare workers (98%) reported that it was important to disclose HIV status to children. A significant proportion (37%) reported that they had never disclosed HIV status to a child and about half estimated that the rate of HIV disclosure at their facility was 25% or less. The main barriers to disclosure were lack of training on disclosure (85%) and lack of a standard tool for disclosure (84%). Female healthcare workers (aOR) 2.4; 95% CI: 1.1-5.5) and lack of training on disclosure (aOR 7.7; 95% CI: 3.4-10.7) were independently associated with never having disclosed HIV status to a child. Conclusions: This study highlights the need for providing appropriate training in HIV disclosure for healthcare workers and the provision of standardised disclosure materials

Primary caregivers, healthcare workers, teachers and community leaders' perceptions and experiences of their involvement, practice and challenges of disclosure of HIV status to children living with HIV in Malawi: A qualitative study

Background: The World Health Organisation has recommended that healthcare workers, teachers and community leaders work with parents to support children living with HIV. The aim of this study was to assess the perceptions and experiences of primary caregivers and other care providers such as healthcare workers, teachers, and community leaders regarding their involvement, practice and challenges of HIV disclosure to children aged between 6 and 12 years living with HIV in Malawi. Methods: Twelve focus group discussions and 19 one-on-one interviews involving a total of 106 participants were conducted in all three administrative regions of Malawi. The interviews and focus group discussions explored perceptions and experiences regarding involvement, practice and challenges of disclosure of HIV status to children. Data were analysed using thematic analysis. Results: Primary caregivers, healthcare workers, teachers, and community leaders all reported that the disclosure of HIV status to children was not well coordinated because each of the groups of participants was working in isolation instead of working as a team. A "working together" model emerged from the data analysis where participants expressed the need for them to work as a team in order to promote safe and effective HIV status disclosure through talking about HIV, sharing responsibility and open communication. Participants reported that by working together, the team members would ensure that the prevalence of HIV disclosure to young children increases and that there would be a reduction in any negative impact of disclosure. Conclusion: Global resources are required to better support children living with HIV and their families. Healthcare workers and teachers would benefit greatly from training in working together with families living with HIV and, specifically, training in the disclosure process. Resources, in the form of books and other educational materials, would help them explain HIV and its effective management to children and families

Fatch Kalembo's Quick Files

The Quick Files feature was discontinued and it’s files were migrated into this Project on March 11, 2022. The file URL’s will still resolve properly, and the Quick Files logs are available in the Project’s Recent Activity