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Sarah A MacLean, Kathryn E Lancaster, Thandie Lungu, Pearson Mmodzi, Mina C Hosseinipour, Brian W Pence, Bradley N Gaynes, Irving F Hoffman, William C Miller
Globally, female sex workers (FSW) experience a high prevalence of mental health disorders, but in sub-Saharan Africa these are rarely identified. If left untreated, mental health disorders may place FSW and their partners at risk for HIV/sexually transmitted infections (STIs). We assessed the prevalence and correlates of probable depression, post-traumatic stress disorder (PTSD), and suicidal ideation (SI) in a cohort of 200 FSW in Lilongwe, Malawi. FSW completed the Patient Health Questionnaire-9 and the PTSD Check List-Civilian Version...
February 2018: International Journal of Mental Health and Addiction
Alinane L Nyondo-Mipando, Angela F Chimwaza, Adamson S Muula
BACKGROUND: The perception of male involvement (MI) in maternal child health services is multifaceted and differs among varying programs and populations. In the Prevention of Mother to Child Transmission (PMTCT) context, MI includes men's attendance at antenatal care (ANC) clinics, undertaking an HIV tests within the ANC and financial and psychological support. Contexualising the definition of MI is fundamental in the development of MI in PMTCT policy and interventions. The objective of this study was to explore the perceptions of men, women and health care workers on male partner involvement in PMTCT services in Malawi...
March 20, 2018: BMC Health Services Research
Jeremy Greenwood, Philipp Kircher, Cezar Santos, Michele Tertilt
No abstract text is available yet for this article.
May 2017: American Economic Review
Jeffrey P Wilkinson, Angela M Bengtson, Ennet Chipungu, Rachel J Pope, Bonus Makanani, Margaret Moyo, Mwawi Mwale, Jennifer H Tang
Objective: Obstetric fistula (OF) is a morbid condition caused by prolonged obstructed labor. Women with OF experience profound injury and have high rates of infertility and poor obstetric outcomes. We examined endovaginal ultrasound parameters in women with and without OF. Design/Setting/Sample/Methods: This cross-sectional study enrolled women evaluated at the Fistula Care Centre in Lilongwe, Malawi. Eligibility criteria included age 18-45, prior pregnancy, and a uterus on ultrasound...
2018: Obstetrics and Gynecology International
Hendramoorthy Maheswaran, Stavros Petrou, Danielle Cohen, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Aileen Clarke
INTRODUCTION: Although HIV infection and its associated co-morbidities remain the commonest reason for hospitalisation in Africa, their impact on economic costs and health-related quality of life (HRQoL) are not well understood. This information is essential for decision-makers to make informed choices about how to best scale-up anti-retroviral treatment (ART) programmes. This study aimed to quantify the impact of HIV infection and ART on economic outcomes in a prospective cohort of hospitalised patients with high HIV prevalence...
2018: PloS One
Münevver Demir, Sam Phiri, Eva Heger, Tom Heller, Rolf Kaiser, Thom Chaweza, Gerd Fätkenheuer, Hans-Michael Steffen, Florian Neuhann
No abstract text is available yet for this article.
March 13, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Claire Wendland
Maternal and neonatal mortality statistics foreground some possible causes of death at the expense of others. Political place (nation, state) and place of birth (hospital, home) are integral to these statistics; respect for women as persons is not. Using case examples from Malawi and the United States, I argue that the focus on place embedded in these indicators can legitimate coercive approaches to childbirth. Qualitative assessments in both cases reveal that respectful care, while not represented in current indicators, is critical for the health of women and newborns...
March 1, 2018: AMA Journal of Ethics
T D Reid, P D Strassle, J Gallaher, J Grudziak, C Mabedi, A G Charles
INTRODUCTION: Trauma is a large contributor to morbidity and mortality in developing countries. We sought to determine which anatomic injury locations and mechanisms of injury predispose to prehospital mortality in Malawi to help target preventive and therapeutic interventions. We hypothesized that head injury would result in the highest prehospital mortality. METHODS: This was a retrospective analysis of all trauma patients presenting to Kamuzu Central Hospital in Lilongwe, Malawi, from 2008 to 2015...
March 14, 2018: World Journal of Surgery
Katerini T Storeng, Jennifer Palmer, Judith Daire, Maren O Kloster
Global health donors increasingly embrace international non-governmental organisations (INGOs) as partners, often relying on them to conduct political advocacy in recipient countries, especially in controversial policy domains like reproductive health. Although INGOs are the primary recipients of donor funding, they are expected to work through national affiliates or counterparts to enable 'locally-led' change. Using prospective policy analysis and ethnographic evidence, this paper examines how donor-funded INGOs have influenced the restrictive policy environments for safe abortion and family planning in South Sudan and Malawi...
March 14, 2018: Global Public Health
Kelly Kilburn, Sudhanshu Handa, Gustavo Angeles, Peter Mvula, Maxton Tsoka
This study analyzes the impact of a positive income shock on child schooling outcomes using experimental data from an unconditional cash transfer program in Malawi. Since households receive the cash and parents are responsible for making spending decisions, we also examine the intervening pathways between cash transfers and child schooling. Data comes from a cluster-randomized study of Malawi's Social Cash Transfer Program (SCTP). After a baseline survey, households in village clusters were randomly assigned to treatment and control arms with treatment villages receiving transfers immediately and control villages assigned a later entry...
August 2017: Economics of Education Review
Emma Slaymaker, Estelle McLean, Alison Wringe, Clara Calvert, Milly Marston, Georges Reniers, Chodziwadziwa Whiteson Kabudula, Amelia Crampin, Alison Price, Denna Michael, Mark Urassa, Daniel Kwaro, Maquins Sewe, Jeffrey W Eaton, Rebecca Rhead, Jessica Nakiyingi-Miiro, Tom Lutalo, Dorean Nabukalu, Kobus Herbst, Victoria Hosegood, Basia Zaba
Timely progression of people living with HIV (PLHIV) from the point of infection through the pathway from diagnosis to treatment is important in ensuring effective care and treatment of HIV and preventing HIV-related deaths and onwards transmission of infection.  Reliable, population-based estimates of new infections are difficult to obtain for the generalised epidemics in sub-Saharan Africa.  Mortality data indicate disease burden and, if disaggregated along the continuum from diagnosis to treatment, can also reflect the coverage and quality of different HIV services...
November 6, 2017: Gates Open Res
Holly M Burke, Mario Chen, Mercy Buluzi, Rachael Fuchs, Silver Wevill, Lalitha Venkatasubramanian, Leila Dal Santo, Bagrey Ngwira
BACKGROUND: Injectable contraceptives are popular in sub-Saharan Africa but have high discontinuation rates due partly to the need for provider-administered re-injection. We compared continuation rates of women who self-injected subcutaneous depot medroxyprogesterone acetate (DMPA-SC) and women who received DMPA-SC from a health-care provider, including community health workers (CHWs). METHODS: We did an open-label randomised controlled trial based at six Ministry of Health clinics in rural Mangochi District, Malawi...
March 8, 2018: Lancet Global Health
Jordana L Burdon Bailey, Luke Gamble, Andrew D Gibson, Barend M deC Bronsvoort, Ian G Handel, Richard J Mellanby, Stella Mazeri
Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed...
March 9, 2018: PLoS Neglected Tropical Diseases
Catherine A Grodensky, Carol E Golin, Allison P Pack, Audrey Pettifor, Michele Demers, Cecelia Massa, Gift Kamanga, Kevin McKenna, Amy Corneli
OBJECTIVE: Individuals diagnosed with acute HIV infection (AHI) are highly infectious and require immediate HIV prevention efforts to minimize their likelihood of transmitting HIV to others. We sought to explore the relevance of Motivational Interviewing (MI), an evidence-based counseling method, for Malawians with AHI. METHODS: We designed a MI-based intervention called "Uphungu Wanga" to support risk reduction efforts immediately after AHI diagnosis...
February 7, 2018: Patient Education and Counseling
Margaret E Kruk, Anna D Gage, Godfrey M Mbaruku, Hannah H Leslie
OBJECTIVE: Describe content of clinical care for sick children in low-resource settings. DATA SOURCES: Nationally representative health facility surveys in Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda from 2007 to 2015. STUDY DESIGN: Clinical visits by sick children under 5 years were observed and caregivers interviewed. We describe duration and content of the care in the visit and estimate associations between increased content and caregiver knowledge and satisfaction...
March 7, 2018: Health Services Research
Caroline Crehan, Tim Colbourn, Michelle Heys, Elizabeth Molyneux
BACKGROUND: Non-invasive respiratory support using bubble continuous positive airway pressure (bCPAP) is useful in treating babies with respiratory distress syndrome. Despite its proven clinical and cost-effectiveness, implementation is hampered by the inappropriate administration of bCPAP in low-resource settings. A clinical algorithm-'TRY' (based on Tone: good; Respiratory distress; Yes, heart rate above 100 beats/min)-has been developed to correctly identify which newborns would benefit most from bCPAP in a teaching hospital in Malawi...
March 7, 2018: Archives of Disease in Childhood
Abraham Siika, Leanne McCabe, Mutsa Bwakura-Dangarembizi, Cissy Kityo, Jane Mallewa, Jay Berkley, Kath Maitland, Anna Griffiths, Keith Baleeta, Shepherd Mudzingwa, James Abach, Kusum Nathoo, Margaret J Thomason, Andrew J Prendergast, Ann Sarah Walker, Diana M Gibb
Background: Severely immunocompromised human immunodeficiency virus (HIV)-infected individuals have high mortality shortly after starting antiretroviral therapy (ART). We investigated predictors of early mortality and "late presenter" phenotypes. Methods: The Reduction of EArly MortaLITY (REALITY) trial enrolled ART-naive adults and children ≥5 years of age with CD4 counts <100 cells/µL initiating ART in Uganda, Zimbabwe, Malawi, and Kenya. Baseline predictors of mortality through 48 weeks were identified using Cox regression with backwards elimination (exit P > ...
March 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Pragna Patel, Colin Speight, Alice Maida, Fleetwood Loustalot, Denise Giles, Sam Phiri, Sundeep Gupta, Pratima Raghunathan
Pragna Patel and colleagues describe the implementation of a hypertension management model for HIV-infected people in Malawi.
March 2018: PLoS Medicine
Alinune Nathanael Kabaghe, Michael Give Chipeta, Robert Sean McCann, Dianne Jean Terlouw, Tinashe Tizifa, Zinenani Truwah, Kamija Samuel Phiri, Michèle van Vugt
BACKGROUND: Despite the availability of cost effective malaria control interventions, such as insecticide-treated bed nets (ITN), diagnosis and effective treatment of malaria, and intermittent preventive treatment during pregnancy (IPTp), the lack of equitable access and coverage affect utilization of these interventions in rural communities. Aggregated rates of access and utilization of malaria interventions in national surveys mask substantial variations in intervention coverage. Utilization of interventions and factors affecting utilization need investigation in rural communities...
March 6, 2018: Malaria Journal
Alinune N Kabaghe, Michael G Chipeta, Steve Gowelo, Monicah Mburu, Zinenani Truwah, Robert S McCann, Michèle van Vugt, Martin P Grobusch, Kamija S Phiri
BACKGROUND: Spatio-temporal variations in malaria burden are currently complex and costly to measure, but are important for decision-making. We measured the spatio-temporal variation of clinical malaria incidence at a fine scale in a cohort of children under five in an endemic area in rural Chikhwawa, Malawi, determined associated factors, and monitored adult mosquito abundance. METHODS: We followed-up 285 children aged 6-48 months with recorded geolocations, who were sampled in a rolling malaria indicator survey, for one year (2015-2016)...
March 5, 2018: Parasites & Vectors
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