Ward Round - Crocodile bites in Malawi: microbiology and surgical management

We present a case series of 5 patients admitted over 5 months to Queen Elizabeth Central Hospital who had sustained injuries from a crocodile bite. Three patients required amputation of a limb. The severe soft tissue injury associated with a crocodile bite and the unusual normal oral flora of the crocodile create challenges in treatment. Progressive tissue destruction and haemolysis are complications of such infected wounds. An antibiotic regime is recommended that covers gram negative rods, anaerobes and may include doxycycline, as well as the need to have a low threshold for early amputation. Malawi Medical Journal Vol. 21 (1) 2009: pp. 29-3

Effects of biochar and gypsum soil amendments on groundnut (Arachis hypogaea L.) dry matter yield and selected soil properties under water stress

The effects of amending soil with gypsum and biochar on groundnut chlorophyll concentration, water use efficiency (WUE), biomass yield and selected soil properties were investigated under water stress. Gypsum (CaSO4.2H2O) was applied at 0 and 200 kg/ha, groundnut shell biochar at 1, 2 and 4% w/w of soil, and water at 100, 70 and 40% of daily plant water requirement (PWR) as main, sub and sub-sub plots, respectively, in a split-split-plot design. Biochar neutralized the acid soil, significantly raising soil pH from 5 to 7.15 and increasing cation exchange capacity by 75%. Biochar amended at 1 and 2%, increased groundnut dry matter yield by 28%. The optimum biochar application rate for dry matter yield was 1.4% w/w. Biochar application at 4% and irrigation at 40% of PWR reduced the WUE by 45 and 50%, respectively. Chlorophyll concentration index was highest at 40% of PWR. The results suggest that biochar has potential to raise soil pH, increase moisture retention and improve crop performance. Applying water at 100% PWR can increase groundnut dry matter yields, while higher gypsum application rates may be required to affect crop performance

Gender distribution of adult patients on highly active antiretroviral therapy (HAART) in Southern Africa: a systematic review

Background: HIV and AIDS are significant and growing public health concerns in southern Africa. The majority of countries in the region have national adult HIV prevalence estimates exceeding 10 percent. The increasing availability of highly active antiretroviral therapy (HAART) has potential to mitigate the situation. There is however concern that women may experience more barriers in accessing treatment programs than men. Methods: A systematic review of the literature was carried out to describe the gender distribution of patients accessing highly active antiretroviral therapy (HAART) in Southern Africa. Data on number of patients on treatment, their mean or median age and gender were obtained and compared across studies and reports. Results: The median or mean age of patients in the studies ranged from 33 to 39 years. While female to male HIV infection prevalence ratios in the southern African countries ranged from 1.2:1 to 1.6:1, female to male ratios on HAART ranged from 0.8: 1 to 2.3: 1. The majority of the reports had female: male ratio in treatment exceeding 1.6. Overall, there were more females on HAART than there were males and this was not solely explained by the higher HIV prevalence among females compared to males. Conclusion: In most Southern African countries, proportionally more females are on HIV antiretroviral treatment than men, even when the higher HIV infection prevalence in females is accounted for. There is need to identify the factors that are facilitating women's accessibility to HIV treatment. As more patients access HAART in the region, it will be important to continue assessing the gender distribution of patients on HAART.Peer Reviewe

Applying Bandura's Theory of Self-Efficacy to assess the perceptions of Pre-service Economics teachers concerning teaching using graphs

This qualitative study examined the Self-efficacy perceptions of preservice economics teachers regarding teaching with graphs. Understanding graphs have a major role in future teaching practices however learners find it challenging understanding economics graphs. Using a structured interview of 55 pre-service secondary school teachers, economics self-efficacy items by Bandura self-efficacy framework was used to analyze the data. The study found that student teachers are not confident to teach using graphs but have positive attitude to learn how to plot and interpret graphs. The teaching practices of high school teachers were found to have influenced the low-self-efficacy of most of the participants though they look forward to teaching using graphs. Most participants agreed that plotting, understanding, and interpreting data from graphs as well as presenting information graphically are key skills that all economics teachers and students should master. The research concludes that both high school economics teachers and preservice teachers should be equipped with the necessary skills to understand graph presentation because they both grapple with interpreting and plotting graphs. The research contributes to improving the way graphs are taught because economics teachers must be comfortable with graph presentations. Higher education institutions should increase their effectiveness when teaching introductory economics courses by finding creative ways to help students understand graphical representations of economics content. It is recommended that Teacher Education programs should emphasize the importance of graphs in the teaching of economics and empower student teachers with the necessary skills

Applying Bandura's Theory of Self-Efficacy to assess the perceptions of Pre-service Economics teachers concerning teaching using graphs

This qualitative study examined the Self-efficacy perceptions of preservice economics teachers regarding teaching with graphs. Understanding graphs have a major role in future teaching practices however learners find it challenging understanding economics graphs. Using a structured interview of 55 pre-service secondary school teachers, economics self-efficacy items by Bandura self-efficacy framework was used to analyze the data. The study found that student teachers are not confident to teach using graphs but have positive attitude to learn how to plot and interpret graphs. The teaching practices of high school teachers were found to have influenced the low-self-efficacy of most of the participants though they look forward to teaching using graphs. Most participants agreed that plotting, understanding, and interpreting data from graphs as well as presenting information graphically are key skills that all economics teachers and students should master. The research concludes that both high school economics teachers and preservice teachers should be equipped with the necessary skills to understand graph presentation because they both grapple with interpreting and plotting graphs. The research contributes to improving the way graphs are taught because economics teachers must be comfortable with graph presentations. Higher education institutions should increase their effectiveness when teaching introductory economics courses by finding creative ways to help students understand graphical representations of economics content. It is recommended that Teacher Education programs should emphasize the importance of graphs in the teaching of economics and empower student teachers with the necessary skills

The Relevance of Indigenous Knowledge for Small-Scale Farming in Tanzania

This article is based on a study that sought to explore small-scale farmers’ perceptions and understanding of indigenous farming with an ultimate goal of promoting the use of IK for agricultural development in Tanzania. This study was mainly qualitative, where semistructured interviews were used to collect data from 181 small-scale farmers in six rural districts of Tanzania. Based on the study findings, it was evident that the local communities had an extensive base of IK and understanding of their environment, and they were able to put appropriate managerial skills and adaptive strategies to crop and animal farming. The findings also showed that IK was location specific, and farmers possessed IK on various farm tasks such as evaluation of soil quality, preservation of planting materials and crops, plant diseases and pest control and animal disease control. It is thus important to understand and facilitate the identification, documentation and use of this knowledge as well as integrating it with conventional knowledge for improved agricultural activities. The knowledge intermediaries (research, education, information and knowledge services, and agricultural support services) should thus conduct regular user studies to identify, validate and document IK in order to determine areas that need intervention, and to enable the incorporation of IK into research to enrich the agricultural technology development process and make it relevant for farmers.Keywords: Indigenous knowledge, local knowledge, agricultural indigenous knowledg

The cost-effectiveness of orthopaedic clinical officers in Malawi

Background In Malawi the orthopaedic clinical officer (OCO) training programme trains non-physician clinicians in musculoskeletal care. We studied the cost-effectiveness of this program. Methods Hospital logbooks were reviewed for data pertaining to activity in seven district hospitals over a 6-month period. The total costs were divided by the total effectiveness, calculated as disability adjusted life years (DALYs) averted. Results The total cost-effectiveness of providing orthopaedic care through the OCO training programme was US$92.06 per DALY averted. The mean per hospital was US$138.75 (95% CI: US$69.58–207.91) per DALY averted which is very cost-effective when compared with other health interventions. Of the 837 patients treated 63% were aged &lt;15 years and 36% were in the ‘economically active’ demographic of ages 15–74 years. Conclusion Training of clinical officers in orthopaedic surgery is very cost-effective and allows transfer of skills into rural areas. The demographics suggest that failure to provide such care would have a negative economic impact. </jats:sec