Malawi Medical Journal最新文献

{"title":"Socio-demographic characteristics of children and young adults with varied asthma control- does it make a difference?","authors":"Eze N Joy,&nbsp;Ayuk C Adaeze,&nbsp;Ughasoro D Maduka,&nbsp;Oguonu Tagbo","doi":"10.4314/mmj.v34i1.6","DOIUrl":"https://doi.org/10.4314/mmj.v34i1.6","url":null,"abstract":"<p><strong>Background: </strong>The socioeconomic status and caregiver perception of asthma as a disease, the availability of specialty care and medication adherence have major influence on outcome of asthma control in children with asthma. The control of asthma therefore depends on the optimizing the interplay of these factors taking into consideration the regional and racial variations.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the association between socio-demographic factors and asthma control outcome in children with asthma.</p><p><strong>Materials and methods: </strong>This was a cross-sectional study involving 66 consecutively enrolled participants with asthma whose economic burden for asthma was assessed in a previous study. Based on the number of registered children attending the clinic, a minimum sample size of 66 calculated for this study was obtained.The participants were consenting children and young adults between the ages of 1 and 20 years. Using standard methods, data on socio-economic status, personal and family demographics, including household number, mothers' educational attainments and employment status; and asthma control were collected and analyzed. Asthma control was assessed using Asthma control test (ACT) and guided by the original developers scoring, participants were grouped into well controlled, partly controlled and uncontrolled. The Chi-square test was used to test for association between participants' socio-demographic characteristics (age, socioeconomic status, mothers' education and employment, and number of children in the household) and asthma control status at 5% level of significance.</p><p><strong>Results: </strong>Of all study participants, 34 (51.55%) were male, with mean age (SD) of 11.6 (4.8) years. The mean (SD) age at initial asthma diagnosis was 6.2 (4.6) years. The majority 49(76.5%) of the mothers had tertiary education. Study participants belonging to the poorest; very poor; poor; and least poor socio-economic cadres were, 16 (24.2%); 17 (25.8%); 17 (25.8%); and 16 (24.2%) respectively. Asthma control classification showed that, 26 (39.4%); 31 (47%) and 9 (13.6%) participants had well controlled asthma, partially controlled asthma and uncontrolled asthma respectively. The factors like age, socioeconomic status, mothers 'educational level, employment status and number of children in the household did not show any statistically significant association with the asthma control status of participants.</p><p><strong>Conclusions: </strong>Asthma control outcome remains multifactorial as participants' socio-demographic characteristics did not impact on the level of control of asthma, among participants in the south eastern parts of Nigeria, despite being in a LMIC. A larger study is recommended to further explore this.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"34 1","pages":"31-36"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/f6/MMJ3401-0031.PMC10230584.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9591621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum antibodies to selected <i>Helicobacter pylori</i> antigens are associated with active gastritis in patients seen at the University Teaching Hospital in Lusaka, Zambia.","authors":"Violet Kayamba,&nbsp;Julia Butt,&nbsp;Matthew Gordon Varga,&nbsp;Aaron Shibemba,&nbsp;Maria Blanca Piazuelo,&nbsp;Keith Tucker Wilson,&nbsp;Kanekwa Zyambo,&nbsp;Simutanyi Mwakamui,&nbsp;Chola Mulenga,&nbsp;Tim Waterboer,&nbsp;Meira Epplein,&nbsp;Douglas Corbett Heimburger,&nbsp;Masharip Atadzhanov,&nbsp;Paul Kelly","doi":"10.4314/mmj.v34i1.4","DOIUrl":"https://doi.org/10.4314/mmj.v34i1.4","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about specific bacterial characteristics of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection influencing gastric carcinogenesis in Zambia. The aim of this study was to evaluate the associations between pre-selected <i>H. pylori</i> antibodies with gastric cancer, premalignant lesions and active gastritis.</p><p><strong>Methods: </strong>This was cross-sectional study with multiple comparisons of patients with gastric cancer (GC), gastric premalignant (GP) lesions and active or chronic gastritis. A fluorescent bead-based antibody multiplex serology assay was used to quantify antibodies to thirteen immunogenic <i>H. pylori</i> antigens. Logistic regression models were used to examine the associations.</p><p><strong>Results: </strong>Included were 295 patients with: 59 GC, 27 GP lesions, 48 active and 161 chronic gastritis. Overall, 257/295 (87%) were <i>H. pylori</i> positive. <i>H. pylori</i> seropositivity was not associated with sex, age, body mass index, socio-economic status, HIV infection, alcohol consumption or cigarette smoking (p-values all above 0.05). When compared to the patients with chronic gastritis, the presence of catalase and cinnamyl alcohol dehydrogenase (Cad) antibodies was positively associated with GP lesions (OR 3.53; 95% CI 1.52-8.17 and OR 2.47; 95% CI 1.08-5.67 respectively). However, seropositivity to Cad antibodies was significantly lower in GC patients (OR 0.28; 95% CI 0.09-0.83). Compared to chronic, active gastritis was significantly associated with (p<0.05) <i>H. pylori</i> sero-positivity (OR 9.46; 95% CI 1.25-71.52) and specific antibodies including cytotoxin-associated gene A, vacuolating cytotoxin A, <i>Helicobacter cysteine</i>-rich protein C, hypothetical protein HP0305 and outer membrane protein HP1564.</p><p><strong>Conclusions: </strong>Among Zambian patients seen at a single center, antibodies to <i>H. pylori</i> (CagA, VacA, Omp, HcpC, HP0305 and HpaA) were associated with active gastritis.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"34 1","pages":"17-24"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/7d/MMJ3401-0017.PMC10230586.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10139921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting the failure of High Flow Nasal Cannula Oxygen therapy in Intensive Care follow-up of COVID-19 Severe Respiratory Failure.","authors":"Çiyiltepe Fulya, Kahraman Ersin, Geçici Mehmet, Bilir Yeliz, Bombacı Elif, Saraçoğlu Kemal","doi":"10.4314/mmj.v34i1.7","DOIUrl":"10.4314/mmj.v34i1.7","url":null,"abstract":"<p><strong>Aim: </strong>Acute respiratory distress syndrome is the primary clinical problem that requires follow-up at the intensive care units. High Flow Nasal Cannula Oxygen Therapy has become an increasingly popular method by reducing the need for intubation but determining which patient will benefit from High Flow Nasal Cannula Oxygen Therapy is an important issue.</p><p><strong>Methods: </strong>Seventy patients who followed up with acute respiratory distress syndrome related COVID-19 treated with High Flow Nasal Cannula Oxygen Systems as initial treatment at the intensive care units were retrospectively review. The primary endpoint of this study is to identify factors correlating with failure (mortality and invasive mechanical ventilator requirement) of High Flow Nasal Cannula Oxygen Therapy in the treatment of COVID-19-related severe ARDS. The secondary aim of this study is to determine the ROX index measured at the 12th hour, which will indicate the need for intubation in critically ill patients followed up with HFNC.</p><p><strong>Results: </strong>Advanced age, male gender, and low ROX index were independent variables affecting High Flow Nasal Cannula Oxygen Therapy failure. While mortality was lowest in patients who completed the process with High Flow Nasal Cannula Oxygen Therapy treatment, patients who were intubated early (12-24h) had lower mortality than those who were intubated later (>24h) (Mortality rates were %4,3 ,%65,6 ,%93,3 respectively). The cut-off value for ROX index, which will indicate the need for intubation, was found to be 2.84.</p><p><strong>Conclusion: </strong>High Flow Nasal Cannula Oxygen Therapy can be an effective treatment method in the follow-up of patients with COVID-19-related severe respiratory failure. Despite this, the requirement for intubation develops in two third of the patients. Early intubation reduces mortality in patients who fail High Flow Nasal Cannula Oxygen Therapy, and the easily calculated ROX index is a useful parameter to determine the need for intubation.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"34 1","pages":"37-42"},"PeriodicalIF":1.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/36/4e/MMJ3401-0037.PMC10230580.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Malawian pharmaceutical response to the COVID-19 Pandemic.","authors":"Baxter Kachingwe,&nbsp;Peter Kumpalume,&nbsp;Felix Khuluza,&nbsp;Kumbukani Nyirenda,&nbsp;Ernest Matambo,&nbsp;John Mponda,&nbsp;Nettie Dzabala,&nbsp;Francis Chiumia,&nbsp;Ibrahim Chikowe,&nbsp;Frider Chimimba,&nbsp;Nelson Nyoloka,&nbsp;Louisa Alfazema,&nbsp;Happy Nyirongo,&nbsp;Dallas Smith","doi":"10.4314/mmj.v34i1.11","DOIUrl":"https://doi.org/10.4314/mmj.v34i1.11","url":null,"abstract":"<p><p>The COVID-19 pandemic has elicited swift and innovative responses due to the severity of the outbreak. Higher education institutions worldwide with pharmacy programs have identified vital gaps in COVID-19 care and has undertaken proactive steps to aid in the fight against the coronavirus. In Malawi, the Kamuzu University of Health Science's Department of Pharmacy initiated the production of a modified formulation of the World Health Organization's (WHO) recommended hand sanitizer. This manufacturing venture involved mobilizing the pharmacy faculty, identifying gaps in supplies and equipment, and utilizing evidenced-based information to create a high-quality sanitation product, which passed the requirements as tested by the Malawi Bureau of Standards. The department of pharmacy is expanding their distribution of the product to meet the needs of frontline healthcare workers and vulnerable populations. With historical issues of accessing care in Malawi and with COVID-19's spread among healthcare workers, this hand sanitizer venture is vital in the public healthcare's system response. The department of pharmacy will continue to lead the pharmacy profession in Malawi to provide targeted interventions in this unprecedented time.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"34 1","pages":"60-62"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/c0/MMJ3401-0060.PMC10230587.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9591618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers' breastfeeding attitudes when lactation overlaps with a new pregnancy.","authors":"Nursan Çınar,&nbsp;Özge Karakaya Suzan,&nbsp;Sümeyra Topal,&nbsp;Sultan Pekşen","doi":"10.4314/mmj.v34i1.10","DOIUrl":"https://doi.org/10.4314/mmj.v34i1.10","url":null,"abstract":"<p><strong>Background and aim: </strong>There is usually a strong cultural taboo when breastfeeding overlaps with pregnancy. A lot of mothers cease breastfeeding their infants when they conceive again due to social pressure, professional advice, or their own beliefs.The present research aimed to reveal the attitudes of mothers who conceived again while breastfeeding their infants and their experiences in this process.</p><p><strong>Methods: </strong>The data of the study, were collected between November 2018 and March 2019 in Sakarya University Education and Research Hospital, Sakarya. The study conducted in 40 women in whom lactation overlapped with pregnancy, and the face-to-face interview technique was employed for data collection. Data were collected using an information form containing information about the participants and a semi-structured interview form. The interviews conducted were then examined using the interpretative phenomenological analysis method, one of the qualitative research methods. The codes and themes were created using the NVIVO 9.0 program. In the report of this study, the Consolidated criteria for reporting qualitative research (COREQ) checklist was utilized as a guide.</p><p><strong>Results: </strong>The mean age of the mothers is 26.70±4.58 (min: 20, max: 36), 62.5% (n=25) of the mothers were in the third trimester. While 5% of the mothers (n=2) continued breastfeeding during pregnancy, 95% (n=38) ceased breastfeeding at certain periods of pregnancy. It was observed that the mothers who conceived again during the lactation period considerably hesitated how to act about breastfeeding, they were significantly influenced by the people in their environment concerning how to overcome this, and they were often misguided.</p><p><strong>Conclusion: </strong>There is obviously an urgent need for evidence-based studies on the subject. Studies to be carried out in this regard will increase the self-confidence of healthcare professionals and will enable them to perform effective training and counseling on the subject.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"34 1","pages":"53-59"},"PeriodicalIF":0.8,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/57/MMJ3401-0053.PMC10230579.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9594204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between intimate partner violence and HIV outcomes among pregnant women living with HIV in Malawi.","authors":"Elizabeth C Wetzel, Tapiwa Tembo, Elaine J Abrams, Alick Mazenga, Mike J Chitani, Saeed Ahmed, Xiaoying Yu, Maria H Kim","doi":"10.4314/mmj.v33i4.4","DOIUrl":"10.4314/mmj.v33i4.4","url":null,"abstract":"<p><strong>Background: </strong>Intimate partner violence (IPV) is a global public health concern particularly in pregnancy where IPV can have negative health implications for the mother and child. Data suggest IPV disproportionately affects pregnant women living with HIV (PWLWH) compared to those without HIV. HIV-related outcomes are worse among women experiencing IPV. Despite this knowledge, there is paucity of data concerning PWLWH and IPV in Malawi, where there is a high HIV prevalence (10.6%).</p><p><strong>Objectives: </strong>We aim to characterize IPV amongst PWLWH in Malawi and describe its relationship to demographic characteristics, psychosocial factors, and HIV-related outcomes.</p><p><strong>Methods: </strong>This analysis used data from the VITAL Start pilot study, which is a video-based intervention targeting retention and ART adherence amongst PWLWH in Malawi. PWLWH not on ART were recruited at antenatal clinic and given study questionnaires to assess demographics, IPV, and psychosocial factors. Questionnaires were also administered at one-month follow-up to assess outcomes related to HIV. Descriptive statistics and logistic regression models were used to explore the risk factors associated with IPV.</p><p><strong>Results: </strong>Thirty-nine percent of participants reported ever experiencing IPV from their current partner. The majority (53%) reporting IPV experienced more than one type of violence. IPV was associated with being married (p=0.04) and depression (p<0.0001) in the univariable analysis. For women retained at one-month, IPV was associated with reporting a missed ART dose in the past month but not with adherence measured by pill count.</p><p><strong>Conclusions: </strong>A large proportion of PWLWH experienced IPV from their current partner and IPV was associated with worse self-reported ART adherence at one-month follow-up. Further evidence is needed to understand how IPV impacts PWLWH throughout postpartum and beyond. Given the detrimental impact on health outcomes among PWLWH in Malawi, additional focus on IPV is essential to identify mechanisms to prevent, screen, and manage IPV among this population.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 4","pages":"242-252"},"PeriodicalIF":1.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/46/MMJ3304-0242.PMC8892998.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10476212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review","authors":"Alice Namanja, Ana Usman, Toyin Odunuga","doi":"10.4314/mmj.v33i4.10","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.10","url":null,"abstract":"Purpose Although Cardiac Rehabilitation (CR) implementation models recommend delivery of any CR treatment component, Sub-Saharan Africa (SSA) constitutes only 17% of globally available CR programs. The aims of this review were to assess the benefits of employing any CR treatment modality in SSA, and evaluate if this approach should be encouraged in this resource-constrained region. Methodology Records were identified electronically via CINAHL, MEDLINE, Cochrane library, African journal online, PubMed, Web of science and google scholar, and grey literature was hand-searched. Articles reporting effectiveness of any CR treatment modality were included if participants had any cardiovascular disease and if the study was conducted in SSA. Quality assessment for each enrolled study was done using Downs and Black (1998) checklist and data was extracted using a modified standard tool. Results Searches identified 1666 records, 24 full text articles were examined and 10 were included for the review; 60%, 30% and 10% of the enrolled studies were done in South Africa, Nigeria and Benin respectively. The studies implemented exercise, psychosocial and education treatment modalities of CR, and the approach of delivery was either comprehensive or modified. Comprehensive CR and delivery of combined aerobic and resistance exercises improved physical (13%, p=0.001), social (40%, p=0.001) and mental aspects of quality of life and reduced anxiety (-12%, p<0.05) and depression (-6%, p<0.001) respectively. Comprehensive CR and aerobic training both reduced systolic blood pressure (range of mean reduction [RMR] -6 to -14mmHg), diastolic blood pressure (RMR -4 to -6mmHg) and resting heart rate (RMR -7 to -17bpm). Overall, all types of exercises showed a 1–5ml.kg-1.min-1 increase in peak oxygen consumption. Conclusion The findings support delivery of exercise treatment modality and comprehensive delivery of CR in SSA. However, efficacy of independent implementation of education and psychosocial therapeutic components of CR remains unclear; hence the need for further investigations.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"287 - 296"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46743593","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":"Histomorphological assessment of non-neoplastic renal diseases at autopsy: an institutional experience in Southwestern Nigeria","authors":"S. Omenai, M. Ajani, J. Nwadiokwu, C. Okolo","doi":"10.4314/mmj.v33i4.9","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.9","url":null,"abstract":"Background Autopsy remains an invaluable resource for medical education and establishing diagnosis of diseases that were missed prior to death. Many patients on admission in hospitals suffer kidney diseases that may contribute to their morbidity and/or mortality. The kidneys from autopsies provide opportunity to diagnose and understand some of these non-neoplastic renal lesions. This study aimed to present the frequency of non-neoplastic renal diseases at autopsy. Methods We conducted a five-year retrospective review of post-mortem records of deceased who had autopsy. Data such as age, sex, cause of death, and kidney lesions were extracted from the post-mortem records and clinical details were gotten from the clinical summaries in the autopsy reports. The kidneys were examined for pathological findings that were then classified into glomerular, tubulointerstitial (tubulointerstitial nephritis and other tubular lesions such as tubular necrosis, casts and fibrosis) and vascular lesions. Results A total of seventy (70) cases met the inclusion criteria with 91.4% having significant non-neoplastic renal lesions. The mean age of the deceased was 57.7years (18years – 91years). Males accounted for 65.7% of the cases. Glomerular lesions were seen in 84.3% of the cases, tubulointerstitial nephritis in 41.6% of cases, vascular lesions were seen in 30% of the cases and other tubular lesions (such as stones, casts and tubular necrosis) were seen in 52.9% of the cases. Cardiovascular diseases and infections were the major causes of death in these patients, accounting for 40% and 27% respectively. Renal diseases were attributed to immediate cause of death in 10% of the cases. Conclusion The kidney at autopsy provides a valuable renal pathology educational tool, as a wide range of medical renal lesions can be seen from kidneys examined at post mortem.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"281 - 286"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47793862","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":"Plasma cytokines quantification among Trypanosoma brucei rhodesiense sleeping sickness cases and controls in Rumphi, Malawi","authors":"K. Kamoto, A. Chiwaya, Peter Nambala, Pricilla Chammudzi, E. Senga, J. Chisi, E. Matovu, J. Musaya","doi":"10.4314/mmj.v33i4.2","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.2","url":null,"abstract":"Introduction Trypanosoma brucei (T.b.) rhodesiense is the cause of the acute form of human African trypanosomiasis (HAT) in eastern and southern African countries, including Malawi. For a long time, untreated HAT infections were believed to be 100% fatal. However, recent studies show that infection by T.b. rhodesiense can result in a wide range of clinical outcomes in its human host. Apart from other factors such as parasite diversity, cytokines have been strongly implicated to play a major role in the outcome of T.b. rhodesiense infections. In this study, we quantify the levels of three cytokines Interleukin-8 (IL-8), Tumor Necrotic Factor alpha (TNF-α) and Interleukin -10 (IL-10) in plasma amongst HAT cases (treated and untreated) and controls recruited during medical survey. Methods Two-hundred and thirty-three plasma samples (HAT cases and controls) from Rumphi, one of the endemic areas in Malawi were used. Blood collected was centrifuged, plasma extracted and stored in cryovials at -80°C until processing. Plasma cytokine concentration was measured using ELISA. Results Plasma samples for 233 individuals, 76 HAT cases and 157 controls were quantified. Among the cases, nine had their plasma collected before treatment (untreated) and the rest were treated before blood for plasma analysis was collected. Controls had significantly higher mean plasmatic levels of TNF-α (94.5 ±474.12 pg/ml) and IL-8 (2258.6 ±5227.4 pg/ml) than cases TNF-α (29.35±181.58 pg/ml) and IL-8 (1191.3±4236.09 pg/ml). Controls and cases had similar mean levels of IL-10 in plasma. Only IL-8 had statistically significant higher median levels in the untreated than treated HAT cases P=0.006. Conclusion Our data suggest that cytokines could be considered as biomarkers of HAT infection and treatment. Further studies with a larger cohort of cases and additional cytokines which are known to be associated with HAT infection outcomes will be required to evaluate these cytokines further.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"230 - 235"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44090412","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":"In memoriam: Professor Malcolm Molyneux (1943–2021)","authors":"A. Muula","doi":"10.4314/mmj.v33i4.1","DOIUrl":"https://doi.org/10.4314/mmj.v33i4.1","url":null,"abstract":"We, at the Malawi Medical Journal (www.medcol.mmj.mw) were saddened by the demise of Professor Malcolm Molyneux, former Editor-in-Chief (EIC) of our journal on 17th November 2021. Malcolm passed away in the UK where he had been since 2015 after almost three decades of service to Malawi and our journal. The Malawi Medical Journal started off as the Medical Quarterly for which Prof Molyneux was its EIC from 1980 to 1984.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"229 - 229"},"PeriodicalIF":0.8,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70575455","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}