{"title":"Pharmacists' Readiness to Receive, Recommend and Administer COVID-19 Vaccines in an African Country: An Online Multiple-Practice Settings Survey in Nigeria.","authors":"Abdulmuminu Isah, Chukwuemeka Michael Ubaka","doi":"10.4314/mmj.v33i3.9","DOIUrl":"10.4314/mmj.v33i3.9","url":null,"abstract":"<p><strong>Background: </strong>Without a cure, vaccination is the most reliable means of combating COVID-19 pandemic, since non-pharmacological measures could not prevent its spread, as evidenced in the emergence of a second wave. This study assessed the readiness of pharmacists to receive, recommend and administer COVID-19 vaccines to clients in Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional study in which responses were collected from pharmacists in Nigeria through Google Form link. A 21-item questionnaire was developed and validated for the study. The link was shared on the WhatsApp groups of eligible respondents. The response was downloaded into Microsoft Excel (2019) and cleared of errors. This was uploaded into KwikTables (Beta Version 2021) for data analysis. Descriptive statistics such as frequencies and percentages were used to describe the data. Chi-squared test was used to determine the relationship between all the responses and the practice areas of the pharmacists.</p><p><strong>Results: </strong>A total of 509 pharmacists responded to the study, but 507 indicated their areas of practice. The highest response of 247(48.7%) was obtained from hospital pharmacists, then community pharmacists; 157(31.0%). Hospital and community pharmacists accounted for 96 and 66 of the 191(37.7%) pharmacists that would probably accept the vaccine (p=0.126). The Pfizer-bioNTech vaccine was the preferred brand for 275(54.2%) respondents. Healthcare Professionals>Elderly>General Populace>Children was the order of roll-out recommended by 317(62.5%). Adverse-effect-following-immunization was the concern of 330(65.1%) pharmacists. Age was a factor in their likelihood of recommending the COVID-19 vaccine to clients (p=0.001).</p><p><strong>Conclusion: </strong>This study established that most pharmacists are willing to accept to be vaccinated against COVID-19, recommend and administer it to other citizens. They were impressed by the effectiveness and cost of some of the vaccines, but were concerned about their possible adverse effects. The pharmacists would want the authorities to consider strategies that will make the vaccines accessible to all citizens.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 3","pages":"210-220"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/1c/MMJ3303-0210.PMC8843180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9591065","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":"Herbal Medicine, Diabetes Care at Primary Care Facilities and Prevention of Vertical HIV Transmission.","authors":"Adamson S Muula","doi":"10.4314/mmj.v33i3.12","DOIUrl":"10.4314/mmj.v33i3.12","url":null,"abstract":"","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"229-230"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42623203","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":"Seroprevalence of hepatitis B and C viral infections in the premarital adult population of Al Majmaah, Saudi Arabia","authors":"S. Mir, B. Alshehri","doi":"10.4314/mmj.v33i3.10","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.10","url":null,"abstract":"Background Viral hepatitis is a major global health problem affecting millions of people worldwide. The main objective of the present study was to estimate the seroprevalence of hepatitis C and hepatitis B in Saudi adults undertaking premarital screening voluntarily. Methodology This observational retrospective study was conducted at King Khaled General Hospital, Al Majmaah, Saudi Arabia, for a period of 3 years (October 1, 2016 to September 30, 2019). The prevalence of hepatitis B and hepatitis C infections was calculated using Microsoft Excel and the hematological data analysis was performed using SPSS software. A total of 3755 premarital Saudi adults who voluntarily participated in the premarital screening were included in this study. Subjects were screened for hepatitis C virus (HCV) and hepatitis B virus (HBV). The demographic and epidemiological parameters included patient age, sex, nationality, and seropositivity for HBV and/or HCV. Results Of the 3755 subjects, eight (0.242%) and 12 (0.364%) subjects were positive for HCV and HBV, respectively. Among the 12 HBV-positive subjects, nine (75%) subjects were men, and three (25%) subjects were women. However, among the eight HCV-positive subjects, five (62.5%) subjects were men, and three (37.5%) subjects were women. Conclusion This study concluded that the prevalence of HBV infection was slightly higher than that of HCV infection among the Saudi adult population of Al Mjamaah. In addition, both HBV and HCV were less prevalent in women than in men in the study population.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"221 - 225"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46575037","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":"Breast metastasis from rectal carcinoma: A case report and review of the literature","authors":"Dan-dan Wang, Su-jin Yang, Wei-xian Chen","doi":"10.4314/MMJ.V33I3.11","DOIUrl":"https://doi.org/10.4314/MMJ.V33I3.11","url":null,"abstract":"Background Metastasis from extramammary primary tumor to breast is extremely rare. Case Summary A 59-year-old woman with 1-year history of rectal cancer presented with asymptomatic breast mass. At 16 months after the diagnosis of rectal mucinous adenocarcinoma, a breast mass was confirmed by ultrasonography and identified by pathology and immunohistochemistry as a metastasis from the rectal cancer. Treatments included chemotherapy (6 cycles: 300 mg irinotecan on day 1, 4.5 mg raltitrexed on day 2, 450 mg bevacizumab on day 3), radiotherapy, and surgical resection. Two years of follow-up examinations (6-months intervals) showed no evidence of recurrence or novel distant metastasis. Conclusion Breast metastasis from rectal carcinoma is a rare secondary malignancy. Final diagnosis can be established by histopathology and immunohistochemistry.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"226 - 228"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49621948","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}
Maybin Kalubula, Heqing Shen, Mpundu Makasa, Longjian Liu
{"title":"Epidemiology of Cancers in Zambia: A significant variation in Cancer incidence and prevalence across the nation.","authors":"Maybin Kalubula, Heqing Shen, Mpundu Makasa, Longjian Liu","doi":"10.4314/mmj.v33i3.6","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.6","url":null,"abstract":"<p><strong>Background: </strong>Cancer is one of the leading causes of death worldwide. More than two-thirds of deaths due to cancers occur in low- and middle-income countries where Zambia belongs. This study, therefore, sought to assess the epidemiology of various types of cancers in Zambia.</p><p><strong>Methods: </strong>We conducted a retrospective observational study using the Zambia National Cancer Registry (ZNCR) population based data from 2007 to 2014. Zambia Central Statistics Office (CSO) demographic data were used to determine catchment area denominator used to calculate prevalence and incidence rates of cancers. Age-adjusted rates and case fatality rates were estimated using standard methods. We used a Poisson Approximation for calculating 95% confidence intervals (CI).</p><p><strong>Results: </strong>The seven most cancer prevalent districts in Zambia were Luangwa, Kabwe, Lusaka, Monze, Mongu, Katete and Chipata. Cervical cancer, prostate cancer, breast cancer and Kaposi's sarcoma were the four most prevalent cancers as well as major causes of cancer related deaths in Zambia. Age adjusted rates and 95% CI for these cancers were: cervix uteri (186.3; CI = 181.77 - 190.83), prostate (60.03; CI = 57.03 - 63.03), breast (38.08; CI = 36.0 - 40.16) and Kaposi's sarcoma (26.18; CI = 25.14 - 27.22). CFR were: Leukaemia (38.1%); pancreatic cancer (36.3%); lung cancer (33.3%); and brain, nervous system (30.2%). The cancer population was associated with HIV with p-value of 0.000 and a Pearson correlation coefficient of 0.818.</p><p><strong>Conclusions: </strong>The widespread distribution of cancers with high prevalence observed in the southern zone may have been perpetrated by lifestyle and sexual culture (traditional male circumcision known to prevent STIs is practiced in the northern belt) as well as geography. Intensifying cancer screening and early detection countrywide as well as changing the lifestyle and sexual culture would greatly help in the reduction of cancer cases in Zambia.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 3","pages":"186-195"},"PeriodicalIF":1.2,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8843183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017928","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":"Assessment of risk factors for Non-Communicable diseases among a cohort of community health workers in Western Cape, South Africa","authors":"L. Johnson, L. Schopp, F. Waggie, J. Frantz","doi":"10.4314/mmj.v33i3.7","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.7","url":null,"abstract":"Community Health Workers (CHWs) have been identified as the key health professionals to drive the agenda of the prevention of health risk behaviours, linked to non-communicable diseases (NCDs) in South Africa. They are regarded as the agents of change, who will provide impetus to the achievement of the health behaviour goals, set out by the South African National Department of Health.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"196 - 203"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44084048","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}
Hawah Mbali, Jessie Jane Khaki Sithole, A. L. Nyondo-Mipando
{"title":"Prevalence and correlates of herbal medicine use among Anti-Retroviral Therapy (ART) clients at Queen Elizabeth Central Hospital (QECH), Blantyre Malawi: a cross-sectional study","authors":"Hawah Mbali, Jessie Jane Khaki Sithole, A. L. Nyondo-Mipando","doi":"10.4314/mmj.v33i3.2","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.2","url":null,"abstract":"Background There has been an unprecedented explosion in the popularity of herbal preparations during the last few decades. Herbal medicines are commonly used by HIV/AIDs clients. There is limited data on the prevalence of herbal medicine and correlating factors of herbal medicine use in Malawi. This study establishes prevalence and factors contributing to the use of herbal medicine among HIV/AIDS clients attending the ART clinic at QECH, Blantyre Malawi. Methods A cross-sectional study design was used to interview 211 conveniently sampled clients at QECH ART clinic. The questionnaire addressed socio-demographic, clinical characteristics, NCD-HIV comorbidity, and herbal medicine utilization. The main outcome of the study was herbal medicine use since the initiation of ART. Logistic regression analysis was done in Stata version 16. Both unadjusted and adjusted models were fitted for potential confounders. Results The prevalence of use of herbal medicine was reported in 17.5% (n=37) of the ART clients. The adjusted logistic regression analysis showed that urban residence was statistically associated with reduced use of herbal medicine (adjusted Odds Ratio – AOR: 0.04, 95% CI: 0.169, 0.976). Conclusion There is a high prevalence of use of herbal medicine among clients taking ART. Herbal Medicine has the potential to cover the gaps in health coverage in rural communities.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"153 - 158"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49652645","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}
U. Nnadozie, C. Maduba, G. Okorie, L. Lawani, Anikwe C Chidebe, O. Asiegbu, Amaechi Ugbala
{"title":"Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria","authors":"U. Nnadozie, C. Maduba, G. Okorie, L. Lawani, Anikwe C Chidebe, O. Asiegbu, Amaechi Ugbala","doi":"10.4314/mmj.v33i3.8","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.8","url":null,"abstract":"Background Burns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA). Methods A five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics. Results A total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25–34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death. Conclusion The good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"204 - 209"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47507820","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}
C. Pfaff, Gift Malamula, Gabriel Kamowatimwa, Joe Theu, T. Allain, A. Amberbir, Sunganani Kwilasi, Saulos Nyirenda, M. Joshua, J. Mallewa, Clement Mandala, J. V. van Oosterhout, M. van Lettow
{"title":"Decentralising diabetes care from hospitals to primary health care centres in Malawi","authors":"C. Pfaff, Gift Malamula, Gabriel Kamowatimwa, Joe Theu, T. Allain, A. Amberbir, Sunganani Kwilasi, Saulos Nyirenda, M. Joshua, J. Mallewa, Clement Mandala, J. V. van Oosterhout, M. van Lettow","doi":"10.4314/mmj.v33i3.3","DOIUrl":"https://doi.org/10.4314/mmj.v33i3.3","url":null,"abstract":"Background Non-communicable diseases (NCDs) such as diabetes and hypertension have become a prominent public health concern in Malawi, where health care services for NCDs are generally restricted to urban centres and district hospitals, while the vast majority of Malawians live in rural settings. Whether similar quality of diabetes care can be delivered at health centres compared to hospitals is not known. Methods We implemented a pilot project of decentralized diabetes care at eight health centres in four districts in Malawi. We described differences between district hospitals and rural health centres in terms of patient characteristics, diabetes complications, cardiovascular risk factors, and aspects of the quality of care and used multivariate logistic regression to explore factors associated with adequate diabetes and blood pressure control. Results By March 2019, 1339 patients with diabetes were registered of whom 286 (21%) received care at peripheral health centres. The median duration of care of patients in the diabetes clinics during the study period was 8.8 months. Overall, HIV testing coverage was 93.6%, blood pressure was recorded in 92.4%; 68.5% underwent foot examination of whom 35.0% had diabetic complications; 30.1% underwent fundoscopy of whom 15.6% had signs of diabetic retinopathy. No significant differences in coverage of testing for diabetes complications were observed between health facility types. Neither did we find significant differences in retention in care (72.1 vs. 77.6%; p=0.06), adequate diabetes control (35.0% vs. 37.8%; p=0.41) and adequate blood pressure control (51.3% vs. 49.8%; p=0.66) between hospitals and health centres. In multivariate analysis, male sex was associated with adequate diabetes control, while lower age and normal body mass index were associated with adequate blood pressure control; health facility type was not associated with either. Conclusion Quality of care did not appear to differ between hospitals and health centres, but was insufficient at both levels.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 1","pages":"159 - 168"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41550512","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":"A multidrug-resistant <i>Stenotrophomonas maltophilia</i> clinical isolate from Kamuzu Central Hospital, Malawi.","authors":"Geoffrey Peterkins Kumwenda, Watipaso Kasambara, Kenneth Chizani, Abel Phiri, Alick Banda, Faheema Choonara, Burnet Lichapa","doi":"10.4314/mmj.v33i2.3","DOIUrl":"https://doi.org/10.4314/mmj.v33i2.3","url":null,"abstract":"<p><strong>Background: </strong><i>Stenotrophomonas maltophilia</i> is a significant opportunistic pathogen that is associated with high mortality in immunocompromised individuals. In this study, we describe a multidrug-resistant (MDR) <i>S. maltophilia</i> clinical isolate from Kamuzu Central Hospital (KCH), Lilongwe, Malawi.</p><p><strong>Methods: </strong>A ceftriaxone and meropenem nonsusceptible isolate (Sm-MW08), recovered in December 2017 at KCH, was referred to the National Microbiology Reference Laboratory for identification. In April 2018, we identified the isolate using MALDI Biotyper mass spectrometry and determined its antimicrobial susceptibility profile using microdilution methods. Sm-MW08 was analysed by S1-PFGE, PCR, and Sanger sequencing, in order to ascertain the genotypes that were responsible for the isolate's multidrug-resistance (MDR) phenotype.</p><p><strong>Results: </strong>Sm-MW08 was identified as <i>S. maltophilia</i> and exhibited resistance to a range of antibiotics, including all β-lactams, aminoglycosides (except arbekacin), chloramphenicol, minocycline, fosfomycin and fluoroquinolones, but remained susceptible to colistin and trimethoprim-sulfamethoxazole. The isolate did not harbour any plasmid but did carry chromosomally-encoded <i>bla</i><sub>L1</sub> metallo-β-lactamase and <i>bla</i><sub>L2</sub> β-lactamase genes; this was consistent with the isolate's resistance profile. No other resistance determinants were detected, suggesting that the MDR phenotype exhibited by Sm-MW08 was innate.</p><p><strong>Conclusion: </strong>Herein, we have described an MDR <i>S. maltophilia</i> from KCH in Malawi, that was resistant to almost all locally available antibiotics. We therefore recommend the practice of effective infection prevention measures to curtail spread of this organism.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"33 2","pages":"82-84"},"PeriodicalIF":0.8,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/19/MMJ3302-0082.PMC8560359.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39732062","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}