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https://www.readbyqxmd.com/read/28525582/challenges-in-the-estimation-of-the-annual-risk-of-mycobacterium-tuberculosis-infection-in-children-aged-under-5-years
#1
P Y Khan, J R Glynn, T Mzembe, D Mulawa, R Chiumya, A C Crampin, K Kranzer, K L Fielding
Accurate estimates of Mycobacterium tuberculosis (M.tb) infection in young children provide a critical indicator of on-going community M.tb transmission. Cross reactions due to infection with environmental mycobacteria and/or Bacille Calmette-Guérin (BCG) vaccination compromise the estimates derived from population-level tuberculin skin test surveys using traditional cut-off methods. Newer statistical approaches are prone to failure of model convergence, especially in settings where the prevalence of M.tb infection is low and environmental sensitisation is high...
May 19, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28515195/cohort-profile-internal-migration-in-sub-saharan-africa-the-migration-and-health-in-malawi-mhm-study
#2
Philip Anglewicz, Mark VanLandingham, Lucinda Manda-Taylor, Hans-Peter Kohler
PURPOSE: The Migration and Health in Malawi (MHM) study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. The MHM study uses a longitudinal panel premigration and postmigration study design (with a non-migrant comparison group) to measure and/or control for important characteristics that affect both migration and health outcomes...
May 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28515136/loss-of-humoral-and-cellular-immunity-to-invasive-nontyphoidal-salmonella-during-current-or-convalescent-plasmodium-falciparum-infection-in-malawian-children
#3
Tonney S Nyirenda, James T Nyirenda, Dumizulu L Tembo, Janet Storm, Queen Dube, Chisomo L Msefula, Kondwani C Jambo, Henry C Mwandumba, Robert S Heyderman, Melita A Gordon, Wilson L Mandala
Invasive nontyphoidal Salmonella (iNTS) infections are commonly associated with Plasmodium falciparum infections, but the immunologic basis for this linkage is poorly understood. We hypothesized that P. falciparum infection compromises the hosts' humoral and cellular immunity to NTS which increases their susceptibility to iNTS infection. We prospectively recruited children aged between 6 and 60 months at a Community Health Centre in Blantyre, Malawi and allocated them to the following groups; febrile with uncomplicated malaria, febrile malaria-negative, non-febrile malaria-negative...
May 17, 2017: Clinical and Vaccine Immunology: CVI
https://www.readbyqxmd.com/read/28500813/quality-of-case-management-for-pneumonia-and-diarrhea-among-children-seen-at-health-facilities-in-southern-malawi
#4
Miwako Kobayashi, Dyson Mwandama, Humphreys Nsona, Ruth J Namuyinga, Monica P Shah, Andrew Bauleni, Jodi Vanden Eng, Alexander K Rowe, Don P Mathanga, Laura C Steinhardt
AbstractPneumonia and diarrhea are leading causes of child deaths in Malawi. Guidelines to manage childhood illnesses in resource-poor settings exist, but studies have reported low health-care worker (HCW) adherence to guidelines. We conducted a health facility survey from January to March 2015 to assess HCW management of pneumonia and diarrhea in children < 5 years of age in southern Malawi, and to determine factors associated with case management quality. Descriptive statistics and multivariable logistic regression models examined patient, HCW, and health facility factors associated with recommended pneumonia and diarrhea management, using Malawi's national guidelines as the gold standard...
May 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28499423/could-cash-and-good-parenting-affect-child-cognitive-development-a-cross-sectional-study-in-south-africa-and-malawi
#5
Lorraine Sherr, Ana Macedo, Mark Tomlinson, Sarah Skeen, Lucie Dale Cluver
BACKGROUND: Social protection interventions, including cash grants and care provision have been shown to effectively reduce some negative impacts of the HIV epidemic on adolescents and families. Less is known about the role of social protection on younger HIV affected populations. This study explored the impact of cash grants on children's cognitive development. Additionally, we examined whether combined cash and care (operationalised as good parenting) was associated with improved cognitive outcomes...
May 12, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28498989/determination-of-the-genetic-architecture-underlying-short-wavelength-sensitivity-in-lake-malawi-cichlids
#6
Sri Pratima Nandamuri, Brian E Dalton, Karen L Carleton
African cichlids are an exemplary system to study organismal diversity and rapid speciation. Species differ in external morphology including jaw shape and body coloration, but also differ in sensory systems including vision. All cichlids have 7 cone opsin genes with species differing broadly in which opsins are expressed. The differential opsin expression results in closely related species with substantial differences in spectral sensitivity of their photoreceptors. In this work, we take a first step in determining the genetic basis of opsin expression in cichlids...
June 1, 2017: Journal of Heredity
https://www.readbyqxmd.com/read/28498195/building-health-system-capacity-through-implementation-research-experience-of-inspire-a-multi-country-pmtct-implementation-research-project
#7
Morkor Newman Owiredu, Nita B Bellare, Christine C Chakanyuka Musanhu, Taiwo A Oyelade, Ellen M Thom, Francoise Bigirimana, Chukwuma Anyaike, Michael T Eliya, Angela Mushavi, Eugene A Nyarko, David O Okello, Felicitas R Zawaira
BACKGROUND: The INSPIRE-Integrating and Scaling Up PMTCT through Implementation REsearch-initiative was established as a model partnership of national prevention of mother-to-child transmission of HIV (PMTCT) implementation research in 3 high HIV burden countries-Malawi, Nigeria, and Zimbabwe. INSPIRE aimed to link local research groups with Ministries of Health (MOH), build local research capacity, and demonstrate that implementation research may contribute to improving health care delivery and respond to program challenges...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498194/modeling-the-impact-of-retention-interventions-on-mother-to-child-transmission-of-hiv-results-from-inspire-studies-in-malawi-nigeria-and-zimbabwe
#8
Elizabeth McCarthy, Jessica Joseph, Geoff Foster, Alexio-Zambezio Mangwiro, Victor Mwapasa, Bolanle Oyeledun, Sam Phiri, Nadia A Sam-Agudu, Shaffiq Essajee
BACKGROUND: Six implementation research studies in Malawi, Nigeria, and Zimbabwe tested approaches for improving retention in care among women living with HIV. We simulated the impact of their interventions on the probability of HIV transmission during pregnancy and breastfeeding. METHODS: A computer-based state-transition model was developed to estimate the impact of the retention interventions. Patient-level data from the 6 studies were aggregated and analyzed, and weighted averages of mother-to-child transmission (MTCT) of HIV probabilities were presented...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498193/the-roles-of-expert-mothers-engaged-in-prevention-of-mother-to-child-transmission-pmtct-programs-a-commentary-on-the-inspire-studies-in-malawi-nigeria-and-zimbabwe
#9
Fabian Cataldo, Nadia A Sam-Agudu, Sam Phiri, Bridget Shumba, Llewellyn J Cornelius, Geoff Foster
INTRODUCTION: Several initiatives aiming to improve retention and adherence in Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs include "expert mothers" (EMs) as a central tenet of their interventions. This article compares the role of EMs in 3 implementation research studies examining approaches for improving retention in care among mothers living with HIV. METHODS: We compared and synthesized qualitative data and lessons learned from 3 studies (MoMent in Nigeria, PURE in Malawi, and EPAZ in Zimbabwe) with respect to the involvement of EMs in supporting PMTCT clients...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498184/viral-suppression-and-hiv-drug-resistance-at-6-months-among-women-in-malawi-s-option-b-program-results-from-the-pure-malawi-study
#10
Mina Hosseinipour, Julie A E Nelson, Clement Trapence, Sarah E Rutstein, Florence Kasende, Virginia Kayoyo, Blessings Kaunda-Khangamwa, Kara Compliment, Christopher Stanley, Fabian Cataldo, Monique van Lettow, Nora E Rosenberg, Hannock Tweya, Salem Gugsa, Veena Sampathkumar, Erik Schouten, Michael Eliya, Frank Chimbwandira, Levison Chiwaula, Atupele Kapito-Tembo, Sam Phiri
BACKGROUND: In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health and prevent pediatric HIV infection. For optimal outcomes, women need to achieve HIVRNA suppression. We report 6-month HIVRNA suppression and HIV drug resistance in the PURE study. METHODS: PURE study was a cluster-randomized controlled trial evaluating 3 strategies for promoting uptake and retention; arm 1: Standard of Care, arm 2: Facility Peer Support, and arm 3: Community Peer support...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498183/impact-of-facility-and-community-based-peer-support-models-on-maternal-uptake-and-retention-in-malawi-s-option-b-hiv-prevention-of-mother-to-child-transmission-program-a-3-arm-cluster-randomized-controlled-trial-pure-malawi
#11
Sam Phiri, Hannock Tweya, Monique van Lettow, Nora E Rosenberg, Clement Trapence, Atupele Kapito-Tembo, Blessings Kaunda-Khangamwa, Florence Kasende, Virginia Kayoyo, Fabian Cataldo, Christopher Stanley, Salem Gugsa, Veena Sampathkumar, Erik Schouten, Levison Chiwaula, Michael Eliya, Frank Chimbwandira, Mina C Hosseinipour
BACKGROUND: Many sub-Saharan African countries have adopted Option B+, a prevention of mother-to-child transmission approach providing HIV-infected pregnant and lactating women with immediate lifelong antiretroviral therapy. High maternal attrition has been observed in Option B+. Peer-based support may improve retention. METHODS: A 3-arm stratified cluster randomized controlled trial was conducted in Malawi to assess whether facility- and community-based peer support would improve Option B+ uptake and retention compared with standard of care (SOC)...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498182/integrating-hiv-and-maternal-neonatal-and-child-health-services-in-rural-malawi-an-evaluation-of-the-implementation-processes-and-challenges
#12
Andrews Gunda, Aurelie Jousset, Timothy Tchereni, Jessica Joseph, Victor Mwapasa
INTRODUCTION: Introducing Option B+ in Malawi increased antiretroviral therapy coverage among pregnant and breastfeeding women 3 fold. The Promoting Retention among Infants and Mothers Effectively (PRIME) study integrated care of Maternal, Neonatal and Child Health services through a mother-infant pair (MIP) clinic. This article evaluates the implementation processes and challenges health care workers' experienced in implementing these MIP clinics. METHODS: Between May 2013 and August 2016, 20 health facilities implemented MIP clinics...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498181/impact-of-mother-infant-pair-clinics-and-short-text-messaging-service-sms-reminders-on-retention-of-hiv-infected-women-and-hiv-exposed-infants-in-emtct-care-in-malawi-a-cluster-randomized-trial
#13
Victor Mwapasa, Jessica Joseph, Timothy Tchereni, Aurelie Jousset, Andrews Gunda
BACKGROUND: Poor retention of mothers and HIV-exposed infants (HEIs) in HIV care threatens efforts to eliminate pediatric HIV. Novel strategies are required to address this challenge. We compared 12-month maternal and HEI postpartum retention in health facilities implementing the following HIV care delivery models: integrated HIV and maternal, neonatal, and child health services [mother-infant pair (MIP) clinics], MIP clinics plus short-text messaging service (SMS) reminders to prevent default (MIP + SMS), and standard of care (SOC)...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28498179/improving-retention-in-care-among-pregnant-women-and-mothers-living-with-hiv-lessons-from-inspire-and-implications-for-future-who-guidance-and-monitoring
#14
Nigel C Rollins, Shaffiq M Essajee, Nita Bellare, Meg Doherty, Gottfried O Hirnschall
Identifying women living with HIV, initiating them on lifelong antiretroviral treatment (ART), and retaining them in care are among the important challenges facing this generation of health care managers and public health researchers. Implementation research attempts to solve a wide range of implementation problems by trying to understand and work within real-world conditions to find solutions that have a measureable impact on the outcomes of interest. Implementation research is distinct from clinical research in many ways yet demands similar standards of conceptual thinking and discipline to generate robust evidence that can be, to some extent, generalized to inform policy and service delivery...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28494007/child-malnutrition-in-sub-saharan-africa-a-meta-analysis-of-demographic-and-health-surveys-2006-2016
#15
Blessing J Akombi, Kingsley E Agho, Dafna Merom, Andre M Renzaho, John J Hall
BACKGROUND: Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. METHODS: Cross-sectional data from the most recent Demographic and Health Surveys (2006-2016) of 32 countries in sub-Saharan Africa were used...
2017: PloS One
https://www.readbyqxmd.com/read/28493322/three-year-cancer-incidence-in-blantyre-malawi-2008-2010
#16
Steady J D Chasimpha, D Maxwell Parkin, Leo Masamba, Charles P Dzamalala
In this paper we present incidence rates of different cancers calculated for the population of Blantyre, Malawi for the period 2008-2010, using data from the Malawi Cancer Registry. Active methods were used for case finding, with standard checks for accuracy and validity performed in CanReg 4. During this three year period, a total of 3,711 cases were registered comprising 1,643 men (an estimated age-standardized incidence rate (ASR) of 169.8 per 100,000) and 2,068 women (ASR 238.7 per 10(5) ). Kaposi sarcoma (KS) was the most common cancer in men (40...
May 10, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28490345/post-2015-why-delay-to-seek-healthcare-perceptions-and-field-experiences-from-tb-healthcare-providers-in-northern-malawi-a-qualitative-study
#17
Nathan B W Chimbatata, Chang-Ming Zhou, Chikondi M Chimbatata, Biao Xu
BACKGROUND: Malawi is a low-income country with high Tuberculosis (TB) burden. TB diagnosis delay and untimely initiation of treatment is still a major problem in Malawi which could increase the risk of tuberculosis transmission in the communities. This study investigated factors related to the diagnostic delay of tuberculosis from TB healthcare providers in the northern region of Malawi. METHODS: Nine focus group discussions were conducted with 57 participants in total...
May 11, 2017: Infectious Diseases of Poverty
https://www.readbyqxmd.com/read/28488810/one-gene-multiple-alleles-insights-into-the-microevolution-of-pigmentation-polymorphisms
#18
M Emília Santos
Understanding how phenotypic variation is generated and maintained, and the evolutionary forces that shape these processes is the main goal of evolutionary biology. Great progress has been made in uncovering the genetic basis of morphological diversity, yet little is known about both the genetics and developmental basis of discrete polymorphisms segregating in wild populations. Exploring variation in developmental mechanisms at the population level can address the long-standing question of whether the mechanisms of change are the same at the micro- and macroevolutionary scale...
May 2017: Molecular Ecology
https://www.readbyqxmd.com/read/28486980/task-shifting-of-triage-to-peer-expert-informal-care-providers-at-a-tertiary-referral-hiv-clinic-in-malawi-a-cross-sectional-operational-evaluation
#19
Megan Landes, Courtney Thompson, Edson Mwinjiwa, Edith Thaulo, Chrissie Gondwe, Harriet Akello, Adrienne K Chan
BACKGROUND: HIV treatment models in Africa are labour intensive and require a high number of skilled staff. In this context, task-shifting is considered a feasible alternative for ART service delivery. In 2006, a lay health cadre of expert patients (EPs) at a tertiary referral HIV clinic in Zomba, Malawi was capacitated. There are few evaluations of EP program efficacy in this setting. Triage is the process of prioritizing patients in terms of the severity of their condition and ensures that no harmful delays occur to treatment and care...
May 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28482905/availability-of-family-planning-services-and-quality-of-counseling-by-faith-based-organizations-a-three-country-comparative-analysis
#20
Janine Barden-O'Fallon
BACKGROUND: Faith-based organizations (FBOs) have a long history of providing health services in developing countries and are important contributors to healthcare systems. Support for the wellbeing of women, children, and families is evidenced through active participation in the field of family planning (FP). However, there is little quantitative evidence on the availability or quality of FP services by FBOs. METHODS: The descriptive analysis uses facility-level data collected through recent Service Provision Assessments in Malawi (2013-14), Kenya (2010), and Haiti (2012) to examine 11 indicators of FP service and method availability and nine indicators of comprehensive and quality counseling...
May 8, 2017: Reproductive Health
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