Malawi Medical Journal最新文献

{"title":"Development of rice farming: a cause of the emergence of multiple insecticide resistance in populations of Anopheles gambiae s.l and its impact on human health in Malanville, Bénin","authors":"YADOULETON Anges, BADOU Yvette, SANOUSSI Falilath, HOUNKANRIN Gildas, TCHIBOZO Carine, ADEWUMI Praise, BABA-MOUSSA Lamine","doi":"10.4314/mmj.v35i3.6","DOIUrl":"https://doi.org/10.4314/mmj.v35i3.6","url":null,"abstract":"AimThe rise in rice production in the district of Malanville, Northen Benin, is a present concern, as it has resulted in the widespread usage of pesticides for crop protection. This could impact human health but also life cycle of Anopheles gambiae, the main vector of malaria.Methods Therefore, insecticide susceptibility bioassays were carried out on populations of An. gambiae s.l aged to 3-5 days old (two from areas where insecticide is highly used and other two areas of low insecticide use) and subjected to insecticide-impregnated papers (Permethrin 0.75%; deltamethrin 0.05%; DDT 4% and bendiocarb 0.1%) following WHO protocol. Polymerase Chain Reactions (PCRs) were used for the detection of Acethlylcholinestrase (Ace-1) and the knock down resistance (kdr) L1014F mutations in An. gambiae populations. Finally, indirect bioassays were conducted for the investigating on the factors affecting the life cycle of An. gambiae due to the use of pesticides.Results An. gambiae from the four sites were resistant to DDT (6 to 8% and 10 to 14% respectively from areas of high and low dose), pyrethroids (22 to 26% and 30 to 36% for permethrin, from areas of high and low dose respectively and 66 to 70% and 72 to 80% for deltamethrin, from high and low dose) but susceptible to carbamate. The kdr L1014F mutation was detected in An. gambiae populations (0.88 to 0.90 and 0.84 to 0.88 from high and low dose, respectively). The ace-1 was detected at low frequencies (<0.002). Bioassays on the impacts of the use of pesticides in the life cycle of An. gambiae showed that soil substrates with pesticides residues have a negative impact on the life cycle eggs of An. gambiae. ConclusionThese findings confirmed the negative impacts of pesticides use in rice farming and its impacts on the life cycle of An. gambiae.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136213927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Socioeconomic consequences of femoral shaft fracture for patients in Malawi","authors":"Kush S. Mody, Hao-Hua Wu, Linda C. Chokotho, Nyengo C. Mkandawire, Sven Young, Brian C. Lau, David Shearer, Kiran J. Agarwal- Harding","doi":"10.4314/mmj.v35i3.2","DOIUrl":"https://doi.org/10.4314/mmj.v35i3.2","url":null,"abstract":"BackgroundFemoral shaft fractures are common in Malawi, with an annual incidence of 44 per 100,000 people. Inadequate treatment and delayed presentation often result in functional, biopsychosocial, and financial challenges for patients. The purpose of this study was to examine the socioeconomic consequences of femoral shaft fractures for patients in Malawi. Methods This study of 42 patients was part of a larger study that prospectively examined quality of life. Questionnaires were distributed to patients at 1-year follow-up following femoral shaft fracture treatment. Patients reported pre- and post-injury standard of living and financial well-being. Results Patients reported relatively high transportation costs to and from the hospital. One year after injury, 17 patients (40%) had not returned to work. Of the 25 (60%) who had returned, 5 (20%) changed jobs due to their injury, all reported decreased productivity. Household income decreased for 29% of patients. 20 (49%) of 41 patients reported food insecurity in the week prior to questionnaire completion. Many patients reported changing their residence, borrowing money, selling personal property, and unenrolling children from school due to financial hardship caused by their injury. Conclusion While the Malawian public healthcare system is free at the point of care, it lacks the financial risk protection that is essential to universal health coverage (UHC). In this study, we found that the indirect costs of care due to femoral shaft fractures had substantial socioeconomic consequences on the majority of patients and their families. Increased investment of financial and human capital should be made into capacity building and preventative measures to decrease the burden of injury, increase access to care, improve care delivery, and provide financial risk protection for patients with traumatic injuries in Malawi.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136213473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year follow-up outcomes of adult patients with Guillain-Barré Syndrome after rehabilitation","authors":"Fatma Ballı Uz, Cuma Uz, Ozgur Zeliha Karaahmet","doi":"10.4314/mmj.v35i3.4","DOIUrl":"https://doi.org/10.4314/mmj.v35i3.4","url":null,"abstract":"Background Guillain-Barré syndrome (GBS), the most common cause of acute paralytic neuropathy, covers a number of recognizably different variants. We aimed to evaluate the clinical characteristics of the patients with GBS and the outcome results of the patients after rehabilitation.Methods We enrolled 24 adult patients with GBS and evaluated their demographic characteristics, signs, complications, functional levels, and residual symptoms at admission, discharge, and during the 1st and 3rd-year follow-up visits. Functional Independence Scale (FIM), Functional Ambulation Scale (FAS), Hughes functional grading scale, Six-Minute Walking Test (6MWT), and Fatigue Severity Scale (FSS) were used for patient evaluation.Results In this study, patients with a mean age of 47.29 ± 16.2 years (40% female) were hospitalized for an average of 28.91 ± 25.6 days. The predominant symptoms experienced by these patients were fatigue (100%), neuropathic pain (70.8%), joint pain (54.2%), and autonomic dysfunction (50%). Significant changes were observed in FIM, Hughes functional grading scale, FAS, 6MWT, and MRC score at admission, discharge, and 1st/3rd-year follow-ups (p=0.000, p=0.000, p=0.000, p=0.001, p=0.000, respectively). Fatigue and Hughes score increased significantly with age (p=0.019, r=0.475; p=0.041, r=0.419, respectively). Negative correlations were found between age and FAS, 6MWT, and MRC score at 1st-year follow-up (p=0.025, r=-0.456; p=0.027, r=-0.450; p=0.008, r=-0.528). FSS was above 4 before admission and in 53.1% at 3rd-year follow-up, correlating negatively with 6MWT and MRC sum score. GBS clinical types showed no significant differences. ConclusionRehabilitation improves functional improvement in GBS patients, with long-term benefits observed. However, residual symptoms such as fatigue and neuropathic pain may persist despite functional improvement. These findings highlight the importance of incorporating rehabilitation into the management of GBS and addressing residual symptoms to improve patient outcomes.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136213785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it possible to predict Surgical Site Infection?","authors":"Sezgi Gullu Erciyestepe, Ahmet Birtan Boran, Merve Sezer Yildirim, Mert Erciyestepe","doi":"10.4314/mmj.v35i3.9","DOIUrl":"https://doi.org/10.4314/mmj.v35i3.9","url":null,"abstract":"IntroductionSurgical site infection (SSI) is a widely seen postoperative complication that causes a decrease in life quality and an economic burden. In this study, we aim to find the predictive values of preoperative and postoperative neutrophile lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) values for SSI.MethodsIn this retrospective study, 698 patients who had total abdominal hysterectomy operations with benign indications and confirmed histopathological results were accessed. In this study, the correlation of preoperative NLR, preoperative PLR, postoperative NLR, and postoperative PLR, with the occurrence of postoperative surgical site infection complications were examined. Results The overall SSI rate was 9.46% (n = 66) with 30 days follow-up postoperatively. Preoperative NLR and PLR values of the patients who had SSIs were significantly lower than the control group (p < 0.05). Postoperative NLR and PLR values of the patients who had SSIs were significantly higher than control group (p < 0.05). In the patients who had postoperative SSIs, the increase of the values of postoperative NLR and PLR were significantly higher than the control group (p < 0.05).ConclusionsIn our study, hematological markers of NLR and PLR were found to be independent and significant predictive markers for SSI.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136212911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Self-efficacy of Malawian Nursing Educators towards the use of Case Study Teaching Method","authors":"Burnett Chila Chiona, Masauko Msiska","doi":"10.4314/mmj.v35i2.3","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.3","url":null,"abstract":"Introduction The case study teaching method is important in imparting critical thinking and clinical reasoning skills in nursing students. The self-efficacy of the nurse educators towards the use of the case study teaching method is a critical aspect of determining the quality of teaching using this method. This study, therefore, aimed at assessing the self-efficacy of the nurse educators towards the use of the case study teaching method in Malawi. MethodA cross-sectional study utilizing a quantitative research design was conducted at eight nursing colleges that are under the Christian Health Association of Malawi. Only nursing colleges offering college diplomas in nursing and midwifery technician were involved. A total of 145 nurse educators completed the Self-Efficacy towards Teaching Inventory. The computer software of Statistical Package for Social Sciences version 23.0 was used to analyze the data.Results The results show that the nurse educators are confident in using the case study teaching method (mean=78.4, SD=11.166). The study results also show that there are differences in mean scores between the nurse educators who attended an education workshop and those who did not (t=5.2334; P<0.001). Conclusion The study indicates that Malawian nurse educators have moderate levels of self-efficacy in using the case study teaching method. This study, therefore, has shown a need for nurse educators to participate in strategies that can increase their level of self-efficacy in using case studies.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of completion of radiology request forms at St. Francis’ Hospital of Katete District: A clinical audit in Zambia","authors":"Mubanga Bwalya, Osward Bwanga, John. Y. Mvula, Foster Munsanje, Bretina Muntanga","doi":"10.4314/mmj.v35i2.7","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.7","url":null,"abstract":"BackgroundMost imaging examinations use ionising radiation which causes biological effects on the body. For this reason, only justified examinations should be requested by adequately completing the radiology request form (RRF) by clinicians. The RRF allows radiographers and radiologists to assess if the benefit outweighs the risk associated with medical radiation exposure. Inadequately or incorrectly filled RRFs leads to unnecessary radiation exposures, imaging errors, and delays in performing the examination. Therefore, this study aimed at auditing the adequacy of completion of general RRFs at St. Francis’ Hospital of Katete District in Zambia.MethodsThis was a quantitative study in which RRFs for general radiography from January to December 2020 were audited. Data were collected retrospectively using a checklist from a total of 974 RRFs. The filled-in forms were assessed for completeness of information related to the patient, examination, and referring clinician. Data were analysed using descriptive statistics. The standard of completeness was based on the Royal College of Radiologists (RCR) guidelines requiring all the designated variables completed on the RRF.ResultsMost N=881(90.5%), RRFs were incompletely filled. With regards to patient’s identification, the findings revealed N=4(0.5%), N=597(61.3%), N=3(0.4%), and N=2(0.3%) RRFs devoid of patient’s name, hospital number, age, and gender, respectively. Regarding the examination, the findings revealed N=3(0.4%), N=68(7%), N=449(46.2%), and N=336 (37%) RRFs devoid of requested examination, indication, clinical history, and level of urgency, respectively. Regarding the referrer, the findings revealed N=135(13.9%), N=173(17.8 %), N=472(48.5%), and N=31(3.2%) RRFs were devoid of information relating to the ward, clinicians’ name, referring department, and signature, respectively.Conclusion This audit reports that most of the RRFs were incompletely filled-in at St. Francis’ Hospital. Furthermore, the hospital number, clinical history and level of urgency were the frequently unfilled variables. Overall, there were gaps in completion of RRFs requiring remedying.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of menopausal symptoms and menopausal quality of life with premenstrual syndrome","authors":"Fatma Tuygar- Okutucu, Gamzenur Cimilli- Senocak, Hacer A. Ceyhun, Halil Ozcan","doi":"10.4314/mmj.v35i2.4","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.4","url":null,"abstract":"BackgroundPremenstrual symptoms at reproductive age resemble menopausal symptoms and have symptomatic commonalities. We hypothesized that women with previous premenstrual syndrome may be more prone to develop menopausal symptoms and aimed to investigate the association of menopausal symptoms and menopausal quality of life with premenstrual symptoms. MethodsThe study included 120 postmenopausal women. We evaluated the current menopausal symptoms with menopause rating scale (MRS) and quality of life with menopause-specific quality of life scale (MSQoL), previous premenstrual symptoms with premenstrual syndrome scale (PMSS) retrospectively and compared the associations statistically. ResultsAccording to retrospective PMSS, participants were divided into two groups; with and without premenstrual syndrome (PMS). PMS group included 29 (24.2%) participants and 91 (75.8%) participants were in group without PMS. Sociodemographic characteristics of groups were similar. Somatic and psychological symptoms were higher in MRS of PMS group. Evaluating the MSQoL; psychosocial and physical symptoms were impaired in the PMS group. Vasomotor, urogenital and sexual symptoms were similar in both groups. ConclusionPremenstrual and menopausal symptoms were related in terms of somatic, and psychosocial symptoms but not in vasomotor, urogenital, and sexual symptoms. It seems that women with previous premenstrual symptoms are more likely to develop menopausal symptoms in some ways. However, a prospective longitudinal study may be needed for more conclusive results.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anopheles funestus sensu stricto Giles (Diptera:Culicidae) bites after sunrise at two rural villages in northern Malawi and its implications for malaria vector control","authors":"Themba Mzilahowa, Steven Gowelo, John Chiphwanya, Andrew Bauleni, Mavuto Mukaka","doi":"10.4314/mmj.v35i2.2","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.2","url":null,"abstract":"Introduction Malawi has scaled up distribution and use of LLINs but their effectiveness depends on vector behaviour. This study reports information on where and when peak biting takes place by Anopheles vectors at two study sites in northern Malawi. MethodsThe study was carried out at a single village each in Nkhata Bay and Karonga districts, northern Malawi. Monthly, three teams of four people each sampled mosquitoes using Human Landing Collections (HLCs) from 6.00 pm to 6.00 am. Mosquitoes were counted and identified by PCR. Plasmodium falciparum sporozoites were detected by ELISA and an entomological inoculation rate was estimated. ResultsA total of 4,668 and 2,079 mosquitoes were sampled in Nkhata Bay and Karonga districts respectively. An. funestus s.s was common (91.3%; n = 2,611) in Nkhata Bay while An. arabiensis was common (96.9%; n = 706) in Karonga. Pf sporozoite rates varied from 0.8% (4/484) to 3.3% (51/1558). Individuals in Nkhata Bay received more bites (approx. 200 bites/ person/ night) compared to Karonga (approx. 50 bites/ person/ night). An. funestus was more likely to bite indoors (p=0.002) while An. arabiensis was (p=0.05) more likely to bite outdoors. Furthermore, An. funestus peak biting was in the early morning hours from 4:00 am (approx. 331 and 177 bites/ person/ night indoors and outdoors respectively) and remained high till 6:00 am. An. arabiensis peak biting (approx. 63 and 62 bites/ person/ night indoors and outdoors respectively) was around mid-night (12:00). An EIR of 108.4 infective bites/ person/ year was estimated for Nkhata Bay compared to 9.1 infective bites/ person/ year for Karonga.Conclusion An. funestus s.s. had a considerable Pf sporozite infection rate and EIR. The shift in biting behaviour shown by this species poses a challenge to malaria control. Further studies are required to understand the biting behaviour of Anopheles vectors in Malawi.&#x0D;","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malawi: What are the implications that aspartame is now a “possible carcinogen”?","authors":"Adamson S. Muula","doi":"10.4314/mmj.v35i2.1","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.1","url":null,"abstract":"Aspartame is an artificial non-saccharide sweetener 200 times sweeter than sucrose. It is commonly used as a sugar substitute in foods and beverages. Aspartame is a methyl ester of the aspartic acid/phenylalanine dipeptide category. It (aspartame) was approved by the United States Food and Drug Administration (FDA) in 1974. Its approval was revoked in 1980 before being re-instated a year later. It is one of the most studied food additives in the human food supply. Because of its low caloric value, it is often a preferred sweetener when there are concerns of weight gain, an attribute glucose and sucrose do not have (it is an ingredient of many diet drinks and chewing gum), the latter being, among other concerns, obesitogenic and diabetogenic.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malawi’s LGBTQI controversy","authors":"Thengo Kavinya","doi":"10.4314/mmj.v35i2.10","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.10","url":null,"abstract":"Same-sex sexual activity is prohibited in Malawi under the Penal Code, which criminalises acts of ‘carnal knowledge against the order of nature’ as well as ‘gross indecency’; proclaiming a maximum penalty of 14 years imprisonment.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}