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1
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
...
Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
more
Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr
...
ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
more
Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu
...
s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
more
To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness.
Systematic review of published scientific evidence. A search of six bibliographic databases and gre
...
y literature was executed to identify relevant studies conducted in Malawi in the English language, with no time or study design restrictions. Data extraction was conducted in Excel and evidence synthesis followed a thematic analysis approach to identify and compare emerging themes.
more
Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to
...
sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
more
Malawi Internationally recommended key policies uptake
Namibia has, for many years, had a strong legislative and policy framework for the protection of children. These policies and laws have been developed through the combined expertise of those working in the field of child protection who have ensured Namibia has a robust legal framework that is in li
...
ne with international best practices.
more
Cogent Medicine, 7:1, 1794272,
PUBLIC HEALTH & PRIMARY CARE | RESEARCH ARTICLE
Edutainment and infographics for
schistosomiasis health education in Ndumo area,
Kwazulu-Natal, South Africa
Tafadzwa Mindu1*, Muhubiri Kabuyaya1 and Moses J. Chimbari1
Educational interventions targeting communiti
...
es which are at risk of contracting
schistosomiasis infection may empower them to develop capacity to minimize the
spread of the disease. We compared the effectiveness of health education inter-
ventions for schistosomiasis knowledge uptake among school-going children in
Ndumo area, KwaZulu-Natal using a quasi-experimental trial.
more
Infectious Diseases of Poverty (2020) 9:74
To detect acute schistosomiasis, low-intensity infections, or to verify the success of treatment with
praziquantel, highly sensitive test methods are required. The aim of this study was therefore to demonstrate the
performance of Schistosoma mansoni spec
...
ific DNA detection in serum and urine using real-time polymerase chain
reaction (PCR) in an endemic area before and after treatment.
more
Acta Trop. 2020 Mar:203:105289. doi: 10.1016/j.actatropica.2019.105289
The role of malacological surveys to identify potential transmission sites for schistosomiasis control in this era of
mass drug administration have received little attention. In that context, the present study was conducted to
...
determine the abundance, identity and disease transmission potential of intermediate host snails for intestinal
schistosomiasis on Ijinga Island, north-western Tanzania.
more
International Journal of Advances in Medicine. Vol. 7 No. 7 (2020): July 2020 . This study explores the clinical characteristics and outcomes of patients with concurrent malaria and HIV infection, a combination that is relatively understudied in India.
Accessed January 2019, publication date unknown.
Lancet Global Health Volume 7, Issue 1, January 2019, Pages e81-e95
The report studied child poverty in nine dimensions – development/stunting, nutrition, health, water, sanitation, and housing. Other dimensions included education, health related knowledge, and information and participation.
An estimated 36 million of a total population of 41 million children und
...
er the age of 18 in Ethiopia are multi-dimensionally poor, meaning they are deprived of basic goods and services in at least three dimensions
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This manual outlines proposals for the insertion of housing, land and property restitution rights simultaneously within the context of the ongoing peace process and within broader national legal reform efforts, including work towards a national land law. The paper begins by emphasising that many cou
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ntries emerging from both conflict and political reform processes have successfully implemented restitution programmes, and that the current, largely piecemeal, efforts towards restitution in Myanmar under the Central Land Grab Reinvestigation Committee processes are simply inadequate in securing restitution rights for everyone in and from Myanmar with a legitimate restitution claim.
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