An analysis of Malawi\'s publication productivity

Background: Publications productivity, the number of scientific articles published, is a measure of a country's scientific output. If measured carefully it can be a useful indicator that describes a countries' research activity. Our objective was to analyze trends in publications originating from Malawi between 1996 – 2006. Methods: The MEDLINE/PubMed database, a registry of articles from over 5,000 scientific journals was searched for articles originating from Malawi between 1996 – 2006 by typing Malawi in the author affiliation search field. A review of abstracts was performed to determine health field and origin of first author – Malawian vs foreign. Results: 506 articles were retrieved of which 489 were on health. 15.5% on TB, 14.5% on HIV and AIDS, 11.2% on infectious disease, 7.2% on TB and HIV, 7.2% on Malaria. 20.9% of the authors were of Malawian origin and Tropical Doctor was the journal that had the most articles originating from Malawi. The number of articles published from Malawi has grown by 106% in the past ten years. Conclusions: Our results suggest there is growth in scientific publishing in Malawi but the main contribution is from foreign researchers residing in Malawi. More needs to be done to promote publishing by Malawian authors. Malawi Medical Journal Vol. 20 (3) 2008: pp. 90-9

Assessment of nutritional characteristics of products developed using soybean (Glycine max (L.) Merr.) pipeline and improved varieties

Open Access Journal; Published online: 30 Oct 2017 Breeding new varieties can introduce compositional differences in Soybean grains which could be caused by environment and climate factors, among other factors. Thus, there was need to evaluate these differences and also to investigate the applications of these varieties for product development at household level for improve nutrition. This study evaluated the nutritional, functional and pasting properties of pipeline and improved soybean varieties and of soy-based products. A total of six improved/pipeline soybean varieties and nine products were developed, which include six soy-fortified products using 80:20 wheat: soy flour blend and three soy-based products using 100% processed soybean grains, were milled and analysed. The moisture, fat and protein contents ranged from 4.91–6.13/100 g; 13.77–19.82/100 g and 31.78–36.56/100 g fresh weight, respectively. The lowest water absorption capacity (WAC) was observed for D.AL/Z 7 having 180.43% while D.AL/Z 8 had the highest value at 285.94%. Pasting viscosity ranged from 1.65–9.63 RVU. The results also showed that the ash, fiber and fat contents of Soy yoghurt are significantly (p < 0.05) lower compared with Soy tofu and Salad cream. Soy Tofu had a significant (p < 0.05) higher level of protein content (30.7/100 g FW)

Community-linked maternal death review (CLMDR) to measure and prevent maternal mortality: a pilot study in rural Malawi.

In Malawi, maternal mortality remains high. Existing maternal death reviews fail to adequately review most deaths, or capture those that occur outside the health system. We assessed the value of community involvement to improve capture and response to community maternal deaths

Water use practices, water quality, and households\u2019 diarrheal encounters in communities along the Boro-Thamalakane-Boteti river system, Northern Botswana

Background: Some rural African communities residing along rivers use the untreated river water for domestic purposes, making them vulnerable to waterborne diseases such as diarrhea. Methods: We determined water use practices and water quality, relating them to prevalence of diarrhea in communities along the Boro-Thamalakane-Boteti river system, northern Botswana. A total of 452 households were interviewed and 196 water samples collected show during February, May, September, and December 2012 in settlements of Boro, Maun, Xobe, Samedupi, Chanoga, and Motopi. Information was sought on water use practices (collection, storage, and handling) and diarrheal experience using questionnaires. Water quality was assessed for physicochemical and microbiological parameters using portable field meters and laboratory analysis, respectively. Results: All (100 %) of the river water samples collected were fecally contaminated and unsuitable for domestic use without prior treatment. Samples had Escherichia coli ( E. coli) and fecal streptococci levels reaching up to 186 and 140 CFU/100 ml, respectively. Study revealed high dependence on the fecally contaminated river water with low uptake of water treatment techniques. Up to 48 % of households indicated that they experience diarrhea, with most cases occurring during the early flooding season (May). Nonetheless, there was no significant relationship between river water quality and households\u2019 diarrheal experience across studied settlements (p &gt; 0.05). Failure to treat river water before use was a significant predictor of diarrhea (p = 0.028). Conclusions: Even though the river water was unsafe for domestic use, results imply further recontamination of water at household level highlighting the need for simple and affordable household water treatment techniques

Investigation of the sequential validity of quality improvement team self-assessments in a health facility HIV improvement collaborative in Tanzania

Background: Self-assessment is widely used in the health care improvement collaboratives quality improvement (QI) teams’ to assess their own performance. There is mixed evidence on the validity of this approach. This study investigated sequential validity of self-assessments in a QI HIV collaborative in Tanzania.Objectives: Define the separate self-assessment steps in QI process; determine if the validity of self-assessments improved over time; determine if validity improvement is the same for the different self-assessment activities and determine if validity is the same for the different facilities and type of care.Design: Prospective semi-quantitative study.Setting: The study was undertaken over 10 months in nine facilities in Mtwara region of Tanzania following appropriate approvals. Study did not interfere with routine services and processes of continuous quality improvement at the facilities.Subjects:Trained investigators retrieved information from records and the computers using data capture forms. Patients of service providers were not questioned or participate in the study.Conclusion:The validity of self-assessments in the HIV/ART/PMTCT Improvement Collaborative in Mtwara region of Tanzania improved as the collaborative matured. Data from computerised data bases unreliable, calling for more training in the use of computers. The weakness in communication should be addressed by collaborative designers and coaches

Early Childhood Infection of Kaposi’s Sarcoma-associated Herpesvirus in Zambian Households: a Molecular Analysis

Sub-Saharan Africa is endemic for Kaposi’s sarcoma-associated herpesvirus (KSHV) and there is a high rate of early childhood infection; however, the transmission sources are not well characterized. We examined household members as potential KSHV transmission sources to young children in the KSHV-endemic country of Zambia. To this end, we enrolled and followed Zambian households with at least one KSHV-seropositive child and collected longitudinal buccal swab samples. KSHV burden was evaluated and K1 sequences from the children were determined and analyzed for differences to K1 sequences from household members. The K1 sequences were also analyzed for evolution over time. We generated K1 sequences from 31 individuals across 16 households. Nine households contained multiple KSHV-positive members, including at least one child. In 6 of 9 households, the child had 100% sequence identity to all household members. However, in two households the child and mother had distinct K1 sequences. In the remaining household, the children were the only KSHV-infected individuals. Furthermore, we report that 1 of 18 individuals had K1 sequence variation within the timespan analyzed. In the present study, we provide evidence that (1) early childhood KSHV transmission occurs from both within and outside the household, (2) intra-household transmission can occur via non-maternal sources, (3) viral shedding in the buccal cavity is highly variable, and (4) the dominant K1 sequence within an individual did not rapidly evolve over time. These results are important for developing KSHV intervention strategies

Delayed acquisition of Plasmodium falciparum antigen-specific CD4+ T cell responses in HIV-exposed uninfected Malawian children receiving daily cotrimoxazole prophylaxis

BACKGROUND: Cotrimoxazole (CTX) prophylaxis, recommended in HIV-exposed uninfected (HEU) children primarily against HIV-related opportunistic infections, has been shown to have some efficacy against Plasmodium falciparum malaria. The effects of CTX prophylaxis on the acquisition of P. falciparum antigen specific CD4(+) T cells-mediated immunity in HEU children is still not fully understood. METHODS: Peripheral blood was collected from HEU and HIV-unexposed uninfected (HUU) children at 6, 12 and 18 months of age. Proportion of CD4(+) T cells subsets were determined by immunophenotyping. P. falciparum antigen-specific CD4(+) T cells responses were measured by intracellular cytokine staining assay. RESULTS: There were no differences in the proportions of naïve, effector and memory CD4(+) T cell subsets between HEU and HUU children at all ages. There was a trend showing acquisition of P. falciparum-specific IFN-γ and TNF-producing CD4(+) T cells with age in both HUU and HEU children. There was, however, lower frequency of P. falciparum-specific IFN-γ-producing CD4(+) T cells in HEU compared to HUU at 6 and 12 months, which normalized 6 months after stopping CTX prophylaxis. CONCLUSION: The results demonstrate that there is delayed acquisition of P. falciparum-specific IFN-γ-producing CD4(+) T cells in HEU children on daily cotrimoxazole prophylaxis, which is evident at 6 and 12 months of age in comparison to HUU age-matched controls. However, whether this delayed acquisition of P. falciparum-specific IFN-γ-producing CD4(+) T cells leads to higher risk to malaria disease remains unknown and warrants further investigation

Lymphocyte subsets in healthy Malawians: Implications for immunologic assessment of HIV infection in Africa

BackgroundCD4+T lymphocyte measurements are the most important indicator of mortality in HIV-infected individuals in resource-limited settings. There is currently a lack of comprehensive immunophenotyping data from African populations to guide the immunologic assessment of HIV infection.ObjectiveTo quantify variation in absolute and relative lymphocyte subsets with age in healthy Malawians.MethodsLymphocyte subsets in peripheral blood of 539 healthy HIV-uninfected Malawians stratified by age were enumerated by flow cytometry.ResultsB and T–lymphocyte and T-lymphocyte subset absolute concentrations peaked in early childhood then decreased to adult levels, whereas lymphocyte subset proportions demonstrated much less variation with age. Adult lymphocyte subsets were similar to those in developed countries. In contrast, high B-lymphocyte and CD8+T-lymphocyte levels among children under 2 years, relative to those in developed countries, resulted in low CD4+T-lymphocyte percentages that varied little between 0 and 5 years (35% to 39%). The CD4+T-lymphocyte percentages in 35% of healthy children under 1 year and 18% of children age 1 to 3 years were below the World Health Organization threshold defining immunodeficiency in HIV-infected children in resource-limited settings. Thirteen percent of healthy children under 18 months old had a CD4:CD8T-lymphocyte ratio <1.0, which is commonly associated with HIV infection. All immunologic parameters except absolute natural killer lymphocyte concentration varied significantly with age, and percentage and overall absolute CD4+T-lymphocyte counts were higher in females than males.ConclusionAlthough lymphocyte subsets in Malawian adults are similar to those from developed countries, CD4+T-lymphocyte percentages in young children are comparatively low. These findings need to be considered when assessing the severity of HIV-related immunodeficiency in African children under 3 years

Overview of the Malawi energy situation and A PESTLE analysis for sustainable development of renewable energy

This paper presents an overview of the Malawi energy situation and the potential of renewable energy resources including solar, wind, biomass, hydro and geothermal. Despite a range of efforts by local and international stakeholders to increase access to modern energy sources in the country, 89 per cent of Malawi׳s energy is still sourced from traditional biomass mainly fuel wood. Only 8 per cent of the population in Malawi have access to electricity but installed capacity of electricity generation is lower than demand. This leads to load shedding by the electricity supplier; consequently electricity supply in Malawi is unreliable and micro and macroeconomic activities are significantly affected. Solar, non-traditional biomass (crop residues and forest residues not burnt on three stone fireplaces, and biogas), hydro, wind and geothermal are potential energy resources that could enhance Malawi׳s energy security. However, unreliable financing mechanisms for large scale energy projects; shortage of trained human resource; lack of coordination among local institutions; unclear regulation enforcement; and sometimes political governance impede sustainable delivery of energy projects. The Malawi energy policy targets and drivers are also discussed in the paper. Based on the prevailing energy situation, a PESTLE analysis is provided in this paper outlining a novel thinking for addressing the political (P), economic (E), social (S), technological (T), legal (L), and environmental (E) challenges that constrain the development of renewable energy technologies in Malawi