Burden and trends of symptomatic sexually transmitted infections in Malawi from 2000 to 2021: comparative analysis of survey and case report data

Background: In settings without aetiologic testing for sexually transmitted infections (STIs), programmes rely on STI symptom data to inform priorities. To evaluate whether self-reported STI symptoms in household surveys consistently represent the STI burden, we compared symptomatic infection rates between survey self-reporting and health facility case reporting in Malawi. Methods: We analysed self-reported symptoms and treatment seeking in the past year among sexually active adults from four Malawi Demographic and Health Surveys between 2000-2015. Bayesian mixed-effects models were used to estimate temporal trends, spatial variation, and sociodemographic determinants. Survey reporting was compared with health facility syndromic diagnoses between 2014-2021. Results: In surveys, 11.0% (95% CI:10.7-11.4%) of adults reported STI or STI-related symptoms in the last year, of whom 54.2% (52.8-55.7%) sought treatment. In facilities, the mean annual symptomatic case diagnosis rate was 3.3%. Survey-reported treatment in the last year was 3.8% (95% CrI:2.3-6.1%) for genital ulcer, 3.8% (2.0-6.7%) for vaginal discharge, and 2.6% (1.2-4.7%) for urethral discharge. Mean annual diagnosis rates at facilities were 0.5% for genital ulcer, 2.2% for vaginal discharge, and 2.0% for urethral discharge. Both data sources indicated a higher burden of symptoms among women, individuals above 25 years, and in Southern Malawi. Conclusion: Survey and facility case reports indicated similar spatial and demographic patterns of STI symptom burden and care seeking, but implied large differences in the magnitude and relative burden of symptoms, particularly genital ulcer, which could affect programme priorities. Targeted aetiologic surveillance would improve interpretation of these data to enable more comprehensive STI surveillance

Factors that foster and deter STEM professional development among teachers

The present study seeks to identify teachers' perceptions regarding STEM teaching professional development and to identify the factors that facilitate or hinder the success of teachers' professional development. The participants of the study were 35 teachers. A qualitative approach was used for data collection by conducting semistructured interviews with 11 teachers out of 35. All the participants were involved in the three focus group sessions. The findings of the study revealed that teachers have various perceptions toward the STEM professional development based on their experience, knowledge, and skills. Moreover, the study revealed different factors influencing STEM professional development among teachers including personal characteristics and internal factors including attitudes and beliefs toward STEM professional development activities, and teachers' capacity. Also, external factors such as design of the training program, availability of training material, and timing of training. The findings of the study could benefit the decision-makers to be aware about these factors that influence professional development and the teachers' needs

Strategic planning for saving the lives of mothers, newborns and children and preventing stillbirths in KwaZulu-Natal province South Africa: modelling using the Lives Saved Tool (LiST)

BACKGROUND: KwaZulu-Natal province in South Africa has the largest population of children under the age of five and experiences the highest number of child births per annum in the country. Its population has also been ravaged by the dual epidemics of HIV and TB and it has struggled to meet targets for maternal and child mortality. In South Africa’s federal system, provinces have decision-making power on the prioritization and allocation of resources within their jurisdiction. As part of strategic planning for 2015–2019, KwaZulu-Natal provincial authorities requested an assessment of current mortality levels in the province and identification and costing of priority interventions for saving additional maternal, newborn and child lives, as well as preventing stillbirths in the province. METHODS: The Lives Saved Tool (LiST) was used to determine the set of interventions, which could save the most additional maternal and child lives and prevent stillbirths from 2015–2019, and the costs of these. The impact of family planning was assessed using two scenarios by increasing baseline coverage of modern contraception by 0.5 percentage points or 1 percentage point per annum. RESULTS: A total of 7,043 additional child and 297 additional maternal lives could be saved, and 2,000 stillbirths could be prevented over five years. Seventeen interventions account for 75 % of additional lives saved. Increasing family planning contributes to a further reduction of up to 137 maternal and 3,168 child deaths. The set of priority interventions scaled up to achievable levels, with no increase in contraception would require an additional US$91 million over five years or US$1.72 per capita population per year. By increasing contraceptive prevalence by one percentage point per year, overall costs to scale up to achievable coverage package, decrease by US$24 million over five years. CONCLUSION: Focused attention on a set of key interventions could have a significant impact on averting stillbirths and maternal and neonatal mortality in KwaZulu-Natal. Concerted effort to prioritize family planning will save more lives overall and has the potential to decrease costs in other areas of maternal and child care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-2661-x) contains supplementary material, which is available to authorized users