To screen, or not to screen for SARS-Cov2

One of the trappings, if not a burden, to Editors-in-Chief (EIC) of many medical journals is that one is expected to write editorials. Thus attempting to speak from the Mount, the EIC has the opportunity to identify one or more issues they think is/are important for the readership at that time or had been in the past or for the future

Explaining the gender disparities in SARS-Cov 2 infection and Covid-19 Disease in Malawi

Global Covid-19 data show that there is higher morbidity and mortality among males compared to females1-3. Why, is this the case, and what needs to be done to save lives? Alternatively is this a situation where the observed status is only good for reporting but not worth interventions

Recent changes in the Malawi Health System: A time for reflection

In this editorial I intend to present a summary of the key issues which have happened in the health sector in Malawi up to the end of 2019. I do believe doing so not only preserves the record but also encourages discussion and debate that may impact the health sector

The Kamuzu University of Health Sciences: a “semi” new university is born in Malawi

Community Health Workers (CHWs) have been identified On 4th May 2021, a new university, the Kamuzu University of Health Sciences (KUHeS) started its operations in Malawi following the notice of its commencement by the Ministry of Education. The (semi) new university emerged from the amalgamation of two (former) constituent colleges of the University of Malawi (UNIMA), i.e. the Kamuzu College of Nursing (KCN) and the College of Medicine (CoM)

Decolonising the medical literature: We are not just a low-resource setting

I was appointed the Editor-in-Chief (EIC) of the Malawi Medical Journal (MMJ), a periodical of the Malawi College of Medicine (www.medcol.mw) and the Medical Association of Malawi (MAM) in February 2019. It is a daunting task certainly to be at the helm of such a prestigious medical journal indexed in/by almost all the databases that matter in medical publishing. Our journal has published since the 1970s, first as the Medical Quarterly, and later as the Malawi Medical Journal

Physical trauma experience among school children in periurban Blantyre, Malawi

<p>Abstract</p> <p>Background</p> <p>Physical trauma is an important cause of childhood morbidity and mortality in Africa. There are however, few community-based reports on the subject on the continent. The present study was conducted to explore school children's experience of physical trauma in a disadvantaged periurban area of Blantyre, in Malawi.</p> <p>Methods</p> <p>A cross sectional questionnaire study was carried out among school children in Ndirande-Blantyre, Malawi in 2004. Data were obtained to describe the following aspects of trauma experience: being a victim or observer of motor vehicular accidents involving pedestrians; history of falls from heights; and knowledge about road safety. Sex differences were determined for some of the variables in order to gain insights as to whether there is a difference in trauma experience between boys and girls.</p> <p>Results</p> <p>A total of 217 school children, 99 (45.6%) boys and 118 (54.4%) girls participated in the study. Eight of them reported to have ever been hit by a motor vehicle, 87 (40.1%) had witnessed a road accident where a pedestrian had been hit and 83 (38.2%) had witnessed a pedestrian they knew having been hit by a motor vehicle. Of those that reported to have ever been hit by motor vehicle, 2 (25%) reported that they had been hospitalized as a result of injury. With regard to falling from heights, 86 reported to have ever fallen from tree, 44 of these (51.2%) were injured from the fall and 14 (16.3%) were hospitalized as a result of injury sustained from the fall. Girls were more likely to fall from trees and getting injured as compared to males (p = 0.04 for both situations). Just under half (41.9%) of the study participants were able to report the correct procedure of crossing the road despite the fact that the majority (80%) reported having been taught road safety at home or school.</p> <p>Conclusion</p> <p>Many school children in Blantyre, Malawi have been exposed to trauma either involving themselves or someone they observed. Prevention, including education, supervision and management of trauma must receive the necessary attention they deserve in terms of resources, surveillance and impact mitigation.</p

Serological Survey of Antibodies to Toxoplasma Gondii *

Toxoplasmosis is one of the most prevalent parasitic infections of man and livestock, and its transmission has usually been attributed to ingestion of undercooked or raw meat from infected livestock, with the infection rate in those animals being an important risk predictor of human disease, high in Iran and Ardabil State. During a study on this public health problem, we tested serum samples from cattle, goats, sheep and chicken from the State of Ardabil, Iran, for IgG antibodies to Toxoplasma gondii by enzyme-linked immunosorbent assay (ELISA). Antibodies to Toxoplasma gondii were found in 30% (60/200) of sheep, 15% (30/200) of goats and 9% (18/200) of cattle, and none were found in chicken sera. Despite the differences in feeding habits of each species, the rate of infection of the animals tested could be attributed to livestock management methods, whose improvement could reduce infection

Pain management among medical in-patients in Blantyre, Malawi

<p>Abstract</p> <p>Background</p> <p>Pain is a leading symptom which influences patients to seek medical attention. The management of pain among patients attending in-patient care in southern African countries has been little described. Information regarding the prevalence of pain and the quality of its management may be useful in guiding clinical decisions, training of health workers and health care quality improvements.</p> <p>Methods</p> <p>A hospital-based audit was conducted to estimate the prevalence of pain and examine the quality of its management among patients admitted to adult medical wards at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi in 2004. Data were abstracted from ward charts of consecutive patients' who had been either been discharged or had died within a specified period. Characteristics of interest included; socio-demographic data, presence or absence of pain at admission, characterization or description of pain when present, and drug treatment given. Data were analyzed to obtain frequencies and proportions of the characteristics and assess the prevalence of pain and quality of care.</p> <p>Results</p> <p>A total of 121 patients' case notes were reviewed and the prevalence of pain was recorded for 91 (75.2%) of the patients. Clinicians had recorded pertinent information regarding pain management with the following frequency: pain severity or intensity 5/91 (5.5%), alleviating factors 5 (5.5%), pain radiation 7 (7.7%), exacerbating factors in 9 (9.9%) and periodicity in 43 (47.3%) of the cases. Males with pain were more than 3 times more likely to receive analgesic as compared to females, p < 0.01. Paracetamol was the commonest analgesic prescribed.</p> <p>Conclusion</p> <p>Inadequate management of pain among patients attending medical wards at QECH was found. There is need for prospective studies to further characterize pain management and identify pain management gaps in Malawi. Interviews of clinicians and documentation of observations within clinical practice are likely to be of value.</p

Stillbirths and hospital early neonatal deaths at Queen Elizabeth Central Hospital, Blantyre-Malawi

<p>Abstract</p> <p>Background</p> <p>Much of the data on still births and early neonatal deaths from resource-limited settings are obtained via maternal recall from national or community level surveys. While this approach results in useful information to be obtained, often such data suffer from significant recall bias and misclassification. In order to determine the prevalence of stillbirths (SB), early hospital neonatal death (EHND) and associated factors in Blantyre, Malawi, a prospective study of pregnant and post-natal women was conducted at the Queen Elizabeth Central Hospital (QECH), Malawi.</p> <p>Methods</p> <p>A prospective observational study was conducted between February 1, 2004 and October 30, 2005. Consecutive women attending the hospital for delivery were recruited. Data were collected on the health status of the fetus on admission to labor ward and immediately after delivery, whether alive or dead. Gestational age (GA) and birth weight (BW) and sex of the newborn were also noted. Similar data were also collected on the live births that died in the delivery room or nursery. Data were analyzed using SPSS (Statistical Package for the Social Sciences) statistical package.</p> <p>Results</p> <p>A total of 10,700 deliveries were conducted during the 12 months study period and of these deliveries, 845 (7.9%) were SB and EHND. Stillbirths comprised 3.4% of all deliveries; 20.2% of the ante-partum deaths occurred before the mother was admitted to the labor ward while a slightly higher proportion (22.7%) of fetal loss occurred during the process of labor and delivery. Fifty-sex percent of the perinatal deaths (PD) were EHND. The mean gestational age for the perinatal deaths was 34.7 weeks and mean birth weight was 2,155 g (standard deviation = 938 g). The majority, 468 (57.8%) of the perinatal deaths were males and 350 (43.2%) were females. Many of the perinatal deaths (57.9%) were deliveries between gestational ages of 20 and 37 weeks. Most (62.7%) of the mothers with a perinatal death had experienced a previous similar incident.</p> <p>Conclusion</p> <p>About 3.4% of all pregnant mothers past 20 weeks of gestation ended up in delivering a stillbirth; another 4.4% of the live births died before discharge from hospital, thus, 7.9% of pregnancy loss after 20 weeks (or 500 g estimated weight) of gestation. This is a higher loss when compared to international and regional data. We recommend attention be given to these unfavorable outcomes and preventive measures or intervention for preventable causes be considered seriously. These measures could include the provision of emergency obstetric care, improving access to deliveries by health professionals and resourcing of health facilities such that neonatal viability is promoted.</p

Shortage of Health Workers in the Malawian Public Health Services System: How do Parliamentarians Perceive the Problem?*

The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis. Parliamentarians identified the shortage of health workers as resulting from death, retirement and brain drain to other countries mostly the UK, Saudi Arabia and South Africa. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions and remuneration of health workers are suggested as some of the solutions. Even without the brain drain of health workers to other countries, Malawi's health sector personnel numbers are not adequate to serve the needs of the country. Relying on training more health workers in the numbers normally produced from the prevailing training institutions is unlikely to remove the shortages