Determinants of vaccination coverage in Malawi: Evidence from the demographic and health surveys

The purpose of this paper is to identify groups of children in Malawi who are less or not reached by vaccination services by using data from the Demographic and Health Surveys conducted in Malawi in 1992, 1996, 2000 and 2004. These surveys have shown that the proportion of children aged 12- 23 months who were fully vaccinated by 12 months of age has been decreasing: it was 67% in 1992, then 55%, 54% and 51% in 1996, 2000 and 2004, respectively. The review has also shown that birth order of the child, residence (rural/ urban) and mother's education are major determinants of the immunization status of the child. Malawi Medical Journal Biology Vol. 19 (2) 2007: pp. 79-8

Staphylococcus aureus bacteraemia Audit - UK experience

Background: Staphylococcus aureus bacteraemia (SAB) causes high morbidity, mortality and healthcare costs. There are national recommendations for minimal 14 days of IV antibiotics, repeat blood cultures and screen for endocarditis. Study was conducted in University Hospital Coventry (UHC). It is a most modern healthcare facility in Europe with 1,005 beds, 26 operating theatres and specialize in cardiology, neurosurgery, stroke, joint replacements, in vitro fertilization and maternal health, diabetes and kidney transplants. Management of SAB is continuously audited in UHC since 2007. The standard treatment pathway for the trust is underway.Objectives: This is to assess the standard of care in management of SAB comparing the results of past 3-years and looking forward for further development.Methods: Retrospective study conducted between June 2016 to December 2018. Electronic patient records were used.Results: Total 153 patients were identified with SAB. Majority were >60 years. There were 25 intravenous drug users in the group and 6 presented with recurrence. There were only 2% MRSAs. In majority (28%), the source of infection was skin and soft tissue infections. Surveillance blood cultures were done in 76% patients. It is improved form 67% in last audit which was conducted betweenJune 2016 and May2018. Fifty one percent had undergone echocardiogram and 8% patients died before blood culture results are available. In 89% of patients appropriate treatment was started. More than 14 days of treatment was completed in 81% patients. Flucloxacillin, meropenem, ertapenem, daptomycin and other antibiotics were used for the completion of 14 days course. From total patients, 16% had complications and endocarditis was the commonest. The 60 days mortality rate was 21%.Conclusions: The mortality rate and complications of SAB is high disregard of the effective antibiotics and further improvement of the clinical management is essential

Phytochemical composition of four selected vegetable spices commonly consumed in Malawi

Spices, regardless of source, play an important role in enhancing or improving flavor of foods or dishes. In this study, determination of phytochemical composition with respect to total phenolic compounds, antioxidant capacity and vitamin C was conducted in four selected vegetable spices consumed in Malawi, namely Allium cepa L, Allium sativum L, green bell pepper (Capsicum annum L.) and Zingiber officinale. Results showed that total phenolic composition, in mg GAE/100 g, was highest in Zingiber officinale rhizomes (326.5±0.39) followed by Allium cepa L. (169.7±0.00), green bell pepper (124.9±0.20) and Allium sativum L. (72.72±0.39), respectively. Results further showed that Zingiber officinale had the highest antioxidant capacity and reducing power and the lowest vitamin C content, in the range of 21.78±0.21 mg AAE/100 g, 24.35±2.24 mg AAE/g and 3.61±0.23 mg AAE/100 g, respectively compared to the other vegetable spices. On the other hand, vitamin C content was highest in Allium sativum L followed by red Allium cepa L registering values of 455.0±2.12 and 443.4±2.50 mg AAE/100 g, respectively. The reducing power (in mg AAE/g) of the vegetable spices was highest in green bell pepper (Capsicum annum L.) with the value of 17.11±1.549 followed by red Allium cepa L. (9.519±0.860) and Allium sativum L. (5.922±0.778), respectively. Total tannins content, in mg TAE/g, was highest in Allium sativum L, which registered the value of 159.56±4.84 followed by Zingiber officinale (91.53±0.33), bell  pepper (79.94±0.21) and Allium cepa L (49.36±1.98). Furthermore, phytic acid and oxalic acid contents were highest in Zingiber officinale registering values of 5.504±0.822 mg/kg and 37.25±2.83 mg/g, respectively. Red Allium cepa L. was found to contain 20.53±0.916 mg/g oxalic acid but had the lowest phytic acid content registering the value of 2.057±0.095 mg/kg. It can be concluded that the high phytochemical composition in the four vegetable spices, with low antinutrients like phytic and oxalic acids, can play an important role in improving human nutrition and health of consumers.&nbsp

Connecting with home, keeping in touch : physical and virtual mobility across stretched families in sub-Saharan Africa.

There is a long history of migration among low-income families in sub-Saharan Africa, in which (usually young, often male) members leave home to seek their fortune in what are perceived to be more favourable locations. While the physical and virtual mobility practices of such stretched families are often complex and contingent, maintaining contact with distantly located close kin is frequently of crucial importance for the maintenance of emotional (and possibly material) well-being, both for those who have left home and for those who remain. This article explores the ways in which these connections are being reshaped by increasing access to mobile phones in three sub-Saharan countries – Ghana, Malawi and South Africa – drawing on interdisciplinary, mixed-methods research from twenty-four sites, ranging from poor urban neighbourhoods to remote rural hamlets. Stories collected from both ends of stretched families present a world in which the connectivities now offered by the mobile phone bring a different kind of closeness and knowing, as instant sociality introduces a potential substitute for letters, cassettes and face-to-face visits, while the rapid resource mobilization opportunities identified by those still at home impose increasing pressures on migrant kin

What happens to ART-eligible patients who do not start ART? Drop out between screening and ART initiation: a cohort study in Karonga, Malawi

BACKGROUND: Routine ART programme statistics generally only provide information about individuals who start treatment. We aimed to investigate the outcome of those who are eligible but do not start ART in the Malawi programme, factors associated with this dropout, and reasons for not starting treatment, in a prospective cohort study.METHODS: Individuals having a first screening visit at the ART clinic at Karonga District Hospital, northern Malawi, between September 2005 and July 2006 were interviewed. Study follow-up to identify treatment outcomes was conducted at the clinic and in the community. Logistic regression models were used to identify factors associated with dropout before ART initiation among participants identified as clinically eligible for ART.RESULTS: 88 participants eligible for ART at their first screening visit (out of 633, 13.9%) defaulted before starting ART. Participants with less education, difficulties in dressing, a more delayed ART initiation appointment, and mid-upper arm circumference (MUAC) < 22 cm were significantly less likely to have visited the clinic subsequently. Thirty-five (58%) of the 60 participants who defaulted and were tracked at home had died, 21 before their ART initiation appointment.CONCLUSIONS: MUAC and reported difficulties in dressing may provide useful screening indicators to identify sicker ART-eligible individuals at high risk of dropping out of the programme who might benefit from being brought back quickly or admitted to hospital for observation. Individuals with less education may need adapted health information at screening. Deaths of ART-eligible individuals occurring prior to ART initiation are not included in routine programme statistics. Considering all those who are eligible for ART as a denominator for programme indicators would help to highlight this vulnerable group, in order to identify new opportunities for further improving ART programmes

Harnessing innovation platforms for sustainable intensification R4D experiences from Kongwa and Kiteto, Tanzania

United States Agency for International Developmen