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https://www.readbyqxmd.com/read/28110108/boys-are-not-exempt-sexual-exploitation-of-adolescents-in-sub-saharan-africa
#1
Jones K Adjei, Elizabeth M Saewyc
Research on youth sexual exploitation in Africa has largely neglected the experiences of exploited boys. To date, much of the research in sub-Saharan Africa continues to consider boys mainly as exploiters but not as exploited. Using the only publicly available population-based surveys from the National Survey of Adolescents, conducted in four sub-Saharan African countries - Burkina Faso, Ghana, Malawi, and Uganda-we assessed factors associated with transactional sexual behaviour among never-married adolescent boys and girls...
January 18, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28110030/high-morbidity-and-mortality-after-lower-extremity-injuries-in-malawi
#2
Maganizo B Chagomerana, Jared Tomlinson, Sven Young, Mina C Hosseinipour, Leonard Banza, Clara N Lee
INTRODUCTION: A lower extremity injury can be a devastating event in low-income countries due to limited access to surgical care. Its incidence, treatment patterns, and outcomes, however, have not been well-described. METHODS: We prospectively enrolled all patients admitted with lower extremity trauma to a tertiary hospital in Lilongwe, Malawi between October 2010 and September 2011. Patients with a lower extremity injury but primarily admitted for unrelated reasons were excluded...
January 18, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28109188/impoverishing-effects-of-catastrophic-health-expenditures-in-malawi
#3
Martina Mchenga, Gowokani Chijere Chirwa, Levison S Chiwaula
BACKGROUND: Out of pocket (OOP) health spending can potentially expose households to risk of incurring large medical bills, and this may impact on their welfare. This work investigates the effect of catastrophic OOP on the incidence and depth of poverty in Malawi. METHODS: The paper is based on data that was collected from 12,271 households that were interviewed during the third Malawi integrated household survey (IHS-3). The paper considered a household to have incurred a catastrophic health expenditure if the share of health expenditure in the household's non-food expenditure was greater than a given threshold ranging between 10 and 40%...
January 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28099696/reaching-vulnerable-women-through-maternity-waiting-homes-in-malawi
#4
Kavita Singh, Ilene Speizer, Eunsoo Timothy Kim, Clara Lemani, Ann Phoya
OBJECTIVE: To determine whether two maternity waiting homes (MWHs) supported by the Safe Motherhood Initiative are reaching vulnerable women during the early phase of their implementation. METHODS: A cross-sectional interview-based study was conducted among women who attended two centers in Malawi with attached MWHs (Area 25 Health Centre, Lilongwe; and Kasungu District Hospital, Kasungu). Between April and June 2015, exit interviews were conducted among MWH users and non-users...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099438/age-related-patterns-of-disease-and-mortality-in-hospitalised-adults-in-malawi
#5
Theresa J Allain, Stephen Aston, Gugulethu Mapurisa, Thokozani N Ganiza, Ndaziona P Banda, Servace Sakala, Andrew Gonani, Robert S Heyderman, Ingrid Peterson
BACKGROUND: The epidemic of non-communicable diseases (NCDs) in low and middle income countries (LMICs) is widely recognised as the next major challenge to global health. However, in many LMICs, infectious diseases are still prevalent resulting in a "double burden" of disease. With increased life expectancy and longevity with HIV, older adults may particularly be at risk of this double burden. Here we describe the relative contributions of infections and NCDs to hospital admissions and mortality, according to age, in Malawi's largest hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28099432/an-analysis-of-the-last-clinical-encounter-before-outpatient-mortality-among-children-with-hiv-infection-and-exposure-in-lilongwe-malawi
#6
Chris A Rees, Robert J Flick, David Sullivan, Menard Bvumbwe, Joseph Mhango, Mina C Hosseinipour, Peter N Kazembe
BACKGROUND: Human immunodeficiency virus (HIV) contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting. METHODS: This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children's Center of Excellence in Lilongwe, Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/28097471/experiences-and-perceptions-regarding-clinical-breast-exam-screening-by-trained-laywomen-in-malawi
#7
Racquel E Kohler, Anna R Miller, Lily Gutnik, Clara N Lee, Satish Gopal
PURPOSE: Despite the increasing burden, breast cancer control in sub-Saharan Africa is insufficient. Late diagnosis and lack of early detection and screening services contribute to high mortality. Clinical breast exam (CBE) screening can be valuable in low-income countries, including use of community health workers and non-health professionals to conduct exams. We assessed experiences of women who underwent CBE screening by trained laywomen in Lilongwe, Malawi, as part of a pilot program...
January 17, 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/28095916/insecticide-treated-net-effectiveness-at-preventing-plasmodium-falciparum-infection-varies-by-age-and-season
#8
Andrea G Buchwald, Jenna E Coalson, Lauren M Cohee, Jenny A Walldorf, Nelson Chimbiya, Andy Bauleni, Kondwani Nkanaunena, Andrew Ngwira, John D Sorkin, Don P Mathanga, Terrie E Taylor, Miriam K Laufer
BACKGROUND: After increasing coverage of malaria interventions, malaria prevalence remains high in Malawi. Previous studies focus on the impact of malaria interventions among children under 5 years old. However, in Malawi, the prevalence of infection is highest in school-aged children (SAC), ages 5 to 15 years. This study examined the interaction between age group and insecticide-treated net (ITN) use for preventing individual and community-level infection in Malawi. METHODS: Six cross-sectional surveys were conducted in the rainy and dry seasons in southern Malawi from 2012 to 2014...
January 17, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#9
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27(th) April and 17(th) July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28079133/mechanical-transgressive-segregation-and-the-rapid-origin-of-trophic-novelty
#10
Roi Holzman, C Darrin Hulsey
Hybrid phenotypes are often intermediate between those of parental species. However, hybridization can generate novel phenotypes when traits are complex. For instance, even when the morphologies of individual musculo-skeletal components do not segregate outside the parental range in hybrid offspring, complex functional systems can exhibit emergent phenotypes whose mechanics exceed the parental values. To determine if transgression in mechanics could facilitate divergence during an adaptive radiation, we examined three functional systems in the trophic apparatus of Lake Malawi cichlid fishes...
January 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28073361/sustainability-of-health-information-systems-a-three-country-qualitative-study-in-southern-africa
#11
Corrina Moucheraud, Amee Schwitters, Chantelle Boudreaux, Denise Giles, Peter H Kilmarx, Ntolo Ntolo, Zwashe Bangani, Michael E St Louis, Thomas J Bossert
BACKGROUND: Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, and strategic use of information. Many donors have worked to improve health information systems, particularly by supporting the introduction of electronic health information systems (EHIS), which are considered more responsive and more efficient than older, paper-based systems. As many donor-driven programs are increasing their focus on country ownership, sustainability of these investments is a key concern...
January 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28073351/exploring-neurodevelopmental-outcome-measures-used-in-children-with-cerebral-malaria-the-perspectives-of-caregivers-and-health-workers-in-malawi
#12
Emmie W Mbale, Terrie Taylor, Bernard Brabin, Macpherson Mallewa, Melissa Gladstone
BACKGROUND: Progress has been made in tackling malaria however there are still over 207 million cases worldwide, the majority in children. As survival rates improve, numbers of children with long-term neurodisabling sequelae are likely to increase. Most outcome studies in cerebral malaria (CM) have focused only on body function and structure and less on outcomes within the broader framework of the International Classification of Functioning and Disability (ICF). The aim of this study was to utilise qualitative methods to identify relevant clinical outcomes in CM to support formulation of a core outcome set relevant to CM and other acquired brain injuries for use in future clinical trials...
January 10, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28062682/genome-wide-association-study-of-nevirapine-hypersensitivity-in-a-sub-saharan-african-hiv-infected-population
#13
Daniel F Carr, Stephane Bourgeois, Mas Chaponda, Louise Y Takeshita, Andrew P Morris, Elena M Cornejo Castro, Ana Alfirevic, Andrew R Jones, Daniel J Rigden, Sam Haldenby, Saye Khoo, David G Lalloo, Robert S Heyderman, Collet Dandara, Elizabeth Kampira, Joep J van Oosterhout, Francis Ssali, Paula Munderi, Giuseppe Novelli, Paola Borgiani, Matthew R Nelson, Arthur Holden, Panos Deloukas, Munir Pirmohamed
BACKGROUND: The antiretroviral nevirapine is associated with hypersensitivity reactions in 6%-10% of patients, including hepatotoxicity, maculopapular exanthema, Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). OBJECTIVES: To undertake a genome-wide association study (GWAS) to identify genetic predisposing factors for the different clinical phenotypes associated with nevirapine hypersensitivity. METHODS: A GWAS was undertaken in a discovery cohort of 151 nevirapine-hypersensitive and 182 tolerant, HIV-infected Malawian adults...
January 6, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28060518/in-use-emissions-and-estimated-impacts-of-traditional-natural-and-forced-draft-cookstoves-in-rural-malawi
#14
Roshan Wathore, Kevin Mortimer, Andrew P Grieshop
Emissions from traditional cooking practices in low- and middle-income countries have detrimental health and climate effects; cleaner-burning cookstoves may provide "co-benefits". Here we assess this potential via in-home measurements of fuel-use and emissions and real-time optical properties of pollutants from traditional and alternative cookstoves in rural Malawi. Alternative cookstove models were distributed by existing initiatives and include a low-cost ceramic model, two forced-draft cookstoves (FDCS; Philips™ HD4012LS and ACE-1), and several institutional cookstoves...
January 6, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28060044/early-antiretroviral-therapy-initiation-and-mortality-among-infants-diagnosed-with-hiv-in-the-first-12-weeks-of-life-experiences-from-kinshasa-dr-congo-and-blantyre-malawi
#15
Anna Sheahan, Lydia Feinstein, Queen Dube, Andrew Edmonds, Chawanangwa Mahebere Chirambo, Emily Smith, Frieda Behets, Robert Heyderman, Annelies Van Rie
BACKGROUND: Based on clinical trial results, the WHO recommends infant HIV testing at age 4-6 weeks and immediate antiretroviral therapy (ART) initiation in all HIV-infected infants. Little is known about the outcomes of HIV infected infants diagnosed with HIV in the first weeks of life in resource-limited settings. We assessed ART initiation and mortality in the first year of life among infants diagnosed with HIV by 12 weeks of age. METHODS: Cohort of HIV-infected infants in Kinshasa and Blantyre diagnosed before 12 weeks to estimate 12-month cumulative incidences of ART initiation and mortality, accounting for competing risks...
January 3, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28060042/hiv-infected-children-in-malawi-have-decreased-performance-on-the-6-minute-walk-test-with-preserved-cardiac-mechanics-regardless-of-antiretroviral-treatment-status
#16
Amy Sims Sanyahumbi, Mina Hosseinipour, Danielle Guffey, Irving Hoffman, Peter N Kazembe, Madeline McCrary, Charles G Minard, Charles Van der Horst, Craig A Sable
INTRODUCTION: We aimed to (1) determine if cardiac disease can be detected in HIV-infected children by strain imaging, and (2) to evaluate differences in exercise performance between HIVinfected on and not yet on antiretroviral therapy (ART) and in HIV-uninfected children by 6- minute walk tests (6MWT) METHODS:: This cross-sectional study evaluated cardiac function by echocardiogram and exercise performance by 6MWT in HIV-infected and uninfected children ages 4 to 18 years in Lilongwe, Malawi...
January 3, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28052071/impact-of-the-13-valent-pneumococcal-conjugate-vaccine-on-clinical-and-hypoxemic-childhood-pneumonia-over-three-years-in-central-malawi-an-observational-study
#17
Eric D McCollum, Bejoy Nambiar, Rashid Deula, Beatiwel Zadutsa, Austin Bondo, Carina King, James Beard, Harry Liyaya, Limangeni Mankhambo, Marzia Lazzerini, Charles Makwenda, Gibson Masache, Naor Bar-Zeev, Peter N Kazembe, Charles Mwansambo, Norman Lufesi, Anthony Costello, Ben Armstrong, Tim Colbourn
BACKGROUND: The pneumococcal conjugate vaccine's (PCV) impact on childhood pneumonia during programmatic conditions in Africa is poorly understood. Following PCV13 introduction in Malawi in November 2011, we evaluated the case burden and rates of childhood pneumonia. METHODS AND FINDINGS: Between January 1, 2012-June 30, 2014 we conducted active pneumonia surveillance in children <5 years at seven hospitals, 18 health centres, and with 38 community health workers in two districts, central Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/28050117/estimating-demand-for-perennial-pigeon-pea-in-malawi-using-choice-experiments
#18
Kurt B Waldman, David L Ortega, Robert B Richardson, Sieglinde S Snapp
Perennial crops have numerous ecological and agronomic advantages over their annual counterparts. We estimate discrete choice models to evaluate farmers' preferences for perennial attributes of pigeon pea intercropped with maize in central and southern Malawi. Pigeon pea is a nitrogen-fixing leguminous crop, which has the potential to ameliorate soil fertility problems related to continuous maize cultivation, which are common in Southern Africa. Adoption of annual pigeon pea is relatively low but perennial production of pigeon pea may be more appealing to farmers due to some of the ancillary benefits associated with perenniality...
January 2017: Ecological Economics: the Journal of the International Society for Ecological Economics
https://www.readbyqxmd.com/read/28046115/correction-voluntary-medical-male-circumcision-for-hiv-prevention-in-malawi-modeling-the-impact-and-cost-of-focusing-the-program-by-client-age-and-geography
#19
Katharine Kripke, Frank Chimbwandira, Zebedee Mwandi, Faustin Matchere, Melissa Schnure, Jason Reed, Delivette Castor, Sema Sgaier, Emmanuel Njeuhmeli
[This corrects the article DOI: 10.1371/journal.pone.0156521.].
2017: PloS One
https://www.readbyqxmd.com/read/28045712/exploring-the-experiences-of-women-and-health-care-workers-in-the-context-of-pmtct-option-b-plus-in-malawi
#20
Fabian Cataldo, Levison Chiwaula, Misheck Nkhata, Monique van Lettow, Florence Kasende, Nora E Rosenberg, Hannock Tweya, Veena Sampathkumar, Mina Hosseinipour, Erik Schouten, Atupele Kapito-Tembo, Michael Eliya, Frank Chimbwandira, Sam Phiri
INTRODUCTION: Malawi has embarked on a 'test-and-treat' approach to prevent mother-to-child transmission of HIV (PMTCT), known as 'Option B+', offering all HIV-infected pregnant and breastfeeding women lifelong antiretroviral treatment (ART) regardless of CD4-count or clinical stage. We conducted a cross-sectional qualitative study to explore early experiences surrounding 'Option B+' for patients and health care workers (HCWs) in Malawi. METHODS: Study participants were purposively selected across six health facilities in three regional health zones in Malawi...
December 9, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
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