MOESM3 of Analysis of rural health centres preparedness for the management of diabetic patients in Malawi

Additional file 3: Figure S3. Questionnaire for the study

MOESM2 of Analysis of rural health centres preparedness for the management of diabetic patients in Malawi

Additional file 2: Figure S2. Number of health centres with diabetes medicines in the three region

Characteristics of caregivers (N = 37).

The Corona Virus Disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. In Malawi, COVID-19 cases are managed at home, with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. This descriptive qualitative study was conducted from January to June 2021 in Blantyre, Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study and aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases who were purposively sampled. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed it using a thematic approach guided by the theory of caregiving dynamics. Caregivers stated that the economic status of a family largely influenced caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers expressed being committed to their role despite being ill-prepared to manage a COVID-19 patient at home, in addition to fears about the contagious nature of COVID-19. They prioritised their patients’ health by ensuring that they were present to offer nutritional and medical treatment. Caregivers highlighted challenges faced in the implementation of preventive measures because of financial limitations and cultural factors. They further expressed fear resulting from the increase in death rates, and the lack of proper information challenged their expectation of having their patients healed. Caregivers stated that they managed their role by sharing responsibilities, getting better at it with time, and getting support from religious institutions and social networks. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus was minimised. There is a need to support households in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.</div

Interview guide.

The Corona Virus Disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. In Malawi, COVID-19 cases are managed at home, with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. This descriptive qualitative study was conducted from January to June 2021 in Blantyre, Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study and aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases who were purposively sampled. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed it using a thematic approach guided by the theory of caregiving dynamics. Caregivers stated that the economic status of a family largely influenced caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers expressed being committed to their role despite being ill-prepared to manage a COVID-19 patient at home, in addition to fears about the contagious nature of COVID-19. They prioritised their patients’ health by ensuring that they were present to offer nutritional and medical treatment. Caregivers highlighted challenges faced in the implementation of preventive measures because of financial limitations and cultural factors. They further expressed fear resulting from the increase in death rates, and the lack of proper information challenged their expectation of having their patients healed. Caregivers stated that they managed their role by sharing responsibilities, getting better at it with time, and getting support from religious institutions and social networks. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus was minimised. There is a need to support households in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.</div

Associations of antibodies measured with HIV and infant birth weight.

<p>A) Values for both phagocytic antibodies (circles) and total IgG to CS2_VSA (squares) were plotted according to the women's’ HIV status (HIV negative – full symbols; HIV positive – open symbols). Mann-Whitney rank sum tests were performed on HIV positive vs. negative women. *p = 0.010; n.s. ( p = 0.078). Univariate linear regression of total IgG to CS2_VSA (B) and phagocytic antibodies (C) and infant birth weight. Both p-values are plotted. Only phagocytic antibodies correlated with infant birth weight (r² = 0.025, p = 0.034).</p

COREQ checklist.

The Corona Virus Disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. In Malawi, COVID-19 cases are managed at home, with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. This descriptive qualitative study was conducted from January to June 2021 in Blantyre, Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study and aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases who were purposively sampled. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed it using a thematic approach guided by the theory of caregiving dynamics. Caregivers stated that the economic status of a family largely influenced caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers expressed being committed to their role despite being ill-prepared to manage a COVID-19 patient at home, in addition to fears about the contagious nature of COVID-19. They prioritised their patients’ health by ensuring that they were present to offer nutritional and medical treatment. Caregivers highlighted challenges faced in the implementation of preventive measures because of financial limitations and cultural factors. They further expressed fear resulting from the increase in death rates, and the lack of proper information challenged their expectation of having their patients healed. Caregivers stated that they managed their role by sharing responsibilities, getting better at it with time, and getting support from religious institutions and social networks. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus was minimised. There is a need to support households in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.</div

Fig 1 -

The Corona Virus Disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. In Malawi, COVID-19 cases are managed at home, with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. This descriptive qualitative study was conducted from January to June 2021 in Blantyre, Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study and aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases who were purposively sampled. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed it using a thematic approach guided by the theory of caregiving dynamics. Caregivers stated that the economic status of a family largely influenced caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers expressed being committed to their role despite being ill-prepared to manage a COVID-19 patient at home, in addition to fears about the contagious nature of COVID-19. They prioritised their patients’ health by ensuring that they were present to offer nutritional and medical treatment. Caregivers highlighted challenges faced in the implementation of preventive measures because of financial limitations and cultural factors. They further expressed fear resulting from the increase in death rates, and the lack of proper information challenged their expectation of having their patients healed. Caregivers stated that they managed their role by sharing responsibilities, getting better at it with time, and getting support from religious institutions and social networks. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus was minimised. There is a need to support households in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.</div

Effect of HIV on the anti-CS2_VSA antibody levels in the ‘No Malaria’ histopathology group.

<p>In a univariate analysis of women that showed no evidence of either peripheral or placental malaria infection, using Mann-Whitney ranksum tests, phagocytic antibodies (A) are shown to be significantly decreased by HIV infection (z = −2.17, <i>p</i> = 0.03). On the contrary total IgG to CS2_VSA (B) shows a non-significant decrease in the HIV-positive group (z = −1.35, <i>p</i> = 0.179. Box, median and interquartile range; whiskers, lowest and highest values. P values are shown.</p

Fig 2 -

The Corona Virus Disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. In Malawi, COVID-19 cases are managed at home, with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. This descriptive qualitative study was conducted from January to June 2021 in Blantyre, Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study and aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases who were purposively sampled. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed it using a thematic approach guided by the theory of caregiving dynamics. Caregivers stated that the economic status of a family largely influenced caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers expressed being committed to their role despite being ill-prepared to manage a COVID-19 patient at home, in addition to fears about the contagious nature of COVID-19. They prioritised their patients’ health by ensuring that they were present to offer nutritional and medical treatment. Caregivers highlighted challenges faced in the implementation of preventive measures because of financial limitations and cultural factors. They further expressed fear resulting from the increase in death rates, and the lack of proper information challenged their expectation of having their patients healed. Caregivers stated that they managed their role by sharing responsibilities, getting better at it with time, and getting support from religious institutions and social networks. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus was minimised. There is a need to support households in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.</div

Characteristics of the cohort and associations with HIV and placental malaria.

<p>The data represents numbers of patients (percentages of total for each parameter) and means [standard deviations].</p>1<p>Maternal haemoglobin levels.</p>2<p>Birth weight of babies at delivery.</p>3<p>DOUBLE NEGATIVES are women with neither HIV nor malaria.</p>4<p>DOUBLE POSITIVES are women with both HIV and malaria infection. Variables are normally distributed, so Student's t-tests were applied.</p