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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Ian A Forde; Vrijesh Tripathi;

    This review evaluated the association of place of residence (urban/rural) and under-five mortality in middle- and low-income countries. Both English and Spanish language studies conducted during the Millennium Development Goal (MDG) period (1990 to 2015) were reviewed. Twenty-six cross-sectional studies, all in the English language, were selected for further review. Published data were used for this analysis. A funnel plot was produced to ascertain the presence of publication bias. The combined relative risk for under-five mortality was estimated using a random-effects model and a meta-regression was conducted on 15 of the 26 studies. The studies had a combined effect size of 1.47 (95% confidence interval, 1.27–1.67). The results of the meta-regression showed a positive association between the relative risk and the percentage of the rural population for the various regions/countries. The coefficient for the variable rural population percentage was 0.007, indicating that for every one percent increase in the rural population percentage, there was a 0.007 increase in the relative risk for under-five mortality. However, this was not significant (p-value = 0.3). Rural disadvantage persists in middle- and low-income countries. This is important to evaluate policies and programmes designed to remove the gap in under-five mortality rates between urban and rural areas.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
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    Article . 2018 . Peer-reviewed
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
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      Article . 2018 . Peer-reviewed
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: McCollum, ED; King, C; Deula, R; Zadutsa, B; +8 Authors

    To investigate implementation of outpatient pulse oximetry among children with pneumonia, in Malawi.In 2011, 72 health-care providers at 18 rural health centres and 38 community health workers received training in the use of pulse oximetry to measure haemoglobin oxygen saturations. Data collected, between 1 January 2012 and 30 June 2014 by the trained individuals, on children aged 2-59 months with clinically diagnosed pneumonia were analysed.Of the 14 092 children included in the analysis, 13 266 (94.1%) were successfully checked by oximetry. Among the children with chest indrawing and/or danger signs, those with a measured oxygen saturation below 90% were more than twice as likely to have been referred as those with higher saturations (84.3% [385/457] vs 41.5% [871/2099];Implementation of pulse oximetry by our trainees substantially increased the referrals of Malawian children with severe hypoxaemic pneumonia. When data from oximetry were excluded, retrospective application of the guidelines published by WHO in 2014 failed to identify a considerable proportion of severely hypoxaemic children eligible only via oximetry.Étudier l'utilisation de l'oxymétrie de pouls chez les enfants atteints de pneumonie en traitement ambulatoire au Malawi.En 2011, 72 prestataires de soins de santé de 18 centres de santé ruraux et 38 agents de santé communautaires ont été formés à l'utilisation de l'oxymétrie de pouls pour mesurer la saturation en oxygène de l'hémoglobine. Des données collectées entre le 1er janvier 2012 et le 30 juin 2014 par les individus formés sur des enfants âgés de 2 à 59 mois atteints d'une pneumonie cliniquement diagnostiquée ont été analysées.Sur les 14 092 enfants inclus dans l'analyse, 13 266 (94,1%) ont été examinés avec succès grâce à l'oxymétrie. Parmi les enfants présentant un tirage sous-costal et/ou des signes de danger, ceux dont la saturation en oxygène mesurée était inférieure à 90% avaient plus de deux fois plus de chances d'être orientés vers un spécialiste que ceux présentant une saturation plus importante (84,3% [385/457] contre 41,5% [871/2099]; P 0,001). L'utilisation de l'oxymétrie semble avoir augmenté de 0% à 27,2% (P 0.001) le taux d'orientation vers un spécialiste dans le cas des enfants souffrant d'hypoxémie sévère sans tirage sous-costal ni signes de danger. En l'absence d'oxymétrie, si les directives en la matière publiées par l'Organisation mondiale de la Santé (OMS) en 2014 avaient été appliquées, 390/568 (68,7%) enfants souffrant d'hypoxémie sévère examinés dans les centres de santé considérés et 52/84 (61,9%) enfants souffrant d'hypoxémie sévère examinés par des agents de santé communautaires n'auraient pas pu bénéficier d'une orientation vers un spécialiste.L'utilisation de l'oxymétrie de pouls par les individus formés a considérablement accru l'orientation vers un spécialiste des enfants malawites atteints de pneumonie sévère et ayant développé une hypoxémie. Lorsque les données provenant de l'oxymétrie étaient exclues, l'application rétrospective des directives publiées par l'OMS en 2014 ne permettait pas d'identifier une proportion considérable d'enfants souffrant d'hypoxémie sévère qui remplissaient les conditions requises uniquement au vu de l'oxymétrie.Investigar la implementación de la oximetría de pulso ambulatoria en niños con neumonía en Malawi.En 2011, 72 profesionales de la salud de 18 centros de salud en zonas rurales y 38 trabajadores de la salud comunitarios recibieron formación con respecto al uso de la oximetría de pulso para medir las saturaciones de oxígeno de la hemoglobina. Se analizaron los datos, que las personas formadas recopilaron entre el 1 de enero de 2012 y el 30 de junio de 2014, de niños de 2 a 59 meses de edad con un diagnóstico clínico de neumonía.De los 14 092 niños incluidos en el análisis, se realizaron las pruebas con oximetría de manera satisfactoria a 13 266 (94,1%). Entre los niños con retracción costal y/o signos de peligro, aquellos con una medida de saturación de oxígeno por debajo del 90% tenían más del doble de probabilidades de haber sido derivados que aquellos con saturaciones más elevadas (84,3% [385/457] frente al 41,5% [871/2 099];La implementación de la oximetría de pulso por las personas formadas incrementó de forma sustancial las derivaciones de los niños de Malawi con neumonía hipoxémica grave. Cuando se excluyeron los datos procedentes de la oximetría, la aplicación retrospectiva de las directrices publicadas por la OMS en 2014 no pudo identificar un porcentaje considerable de niños hipoxémicos graves que cumplían los requisitos únicamente a través de la oximetría.الاستقصاء بشأن تنفيذ عمليات قياس التأكسج في العيادات الخارجية للأطفال المصابين بالالتهاب الرئوي في ملاوي.حصل 72 من مقدمي خدمات الرعاية الصحية في 18 مركزًا طبيًا ريفيًا و38 عاملاً في مجال الخدمات الصحية المجتمعية في عام 2011 على تدريبات متعلقة باستخدام تقنية قياس التأكسج بهدف قياس نسب تشبع الأكسجين والهيموجلوبين. وتم تحليل البيانات المجمعة في الفترة بين 1 كانون الثاني/يناير 2012 و 30 حزيران/يونيو 2014 بواسطة الأفراد المدرّبين، وهذه البيانات خاصة بالأطفال البالغ أعمارهم ما بين 2 إلى 59 شهرًا والمصابين بمرض الالتهاب الرئوي الذي تم تشخيصه داخل العيادات.من بين 14092 طفلاً شملهم التحليل، كان 13266 طفلاً منهم (بنسبة ‏94.1‏%) قد تم فحصه بنجاح بواسطة تقنية قياس التأكسج. ومن بين الأطفال الذين يعانون من بروز القفص الصدري أثناء التنفس و/أو علامات الخطر، كان أولئك الذين لديهم نسبة تشبع الأكسجين أقل من 90‏% لديهم أرجحية مضاعفة لإحالتهم للعلاج باعتبارهم من الأطفال الذين لديهم نسبة تشبع أعلى (84.3‏% [385/457] مقابل ‏41.5‏% [871/2099[؛إن تنفيذ عملية قياس التأكسج بواسطة المتدربين لدينا أدى بشكل كبير إلى زيادة حالات الإحالة للعلاج بالنسبة للأطفال المصابين بالالتهاب الرئوي الحاد في ملاوي. وعندما تم استبعاد بيانات قياس التأكسج، فشل التطبيق بأثر رجعي للمبادئ التوجيهية الصادرة من منظمة الصحة العالمية في عام 2014 في تحديد نسبة كبيرة من الأطفال المصابين بخلل الجهاز التنفسي الحاد والذين كانوا مؤهلين للعلاج نتيجة استخدام تقنية قياس التأكسج فقط.旨在调查马拉维肺炎患儿门诊脉搏血氧饱和度检测的实施情况。.2011 年,18 个农村医疗中心的 72 位医疗护理人员和 38 位社区医疗工作者接受了培训,学习使用脉搏血氧饱和度检测法测量血氧饱和度。 我们分析了受训人员于 2012 年 1 月 1 日到 2014 年 6 月 30 日期间采集的年龄在 2-59 个月、临床诊断为肺炎的儿童的数据。.在我们分析的 14 092 位儿童中,13 266 (94.1%) 位已经成功接受血氧饱和度检测。 在出现胸部凹陷和/或危险症状的儿童中,测量的血氧饱和度低于 90% 的儿童转诊的可能性是饱和度更高儿童的两倍以上(分别为 84.3% [385/457] 和 41.5% [871/2099];受训人员对脉搏血氧饱和度检测的实施大幅度提高了马拉维重度低氧性肺炎患儿的转诊率。 但是如果不采用血氧饱和度检测中的数据,而是追溯式采纳 WHO 2014 年发布的指南,则相当大比例的仅通过血氧饱和度检测才能确诊的重度低氧血症儿童无法得到确诊。.Изучить амбулаторное применение пульсоксиметрии у больных пневмонией детей в Малави.В течение 2011 года 72 врача из 18 сельских больниц и 38 местных медицинских работников были обучены использованию пульсоксиметрии для измерения насыщенности гемоглобина кислородом. Были проанализированы данные, собранные обученными лицами на протяжении периода с 1 января 2012 года по 30 июня 2014 года у детей в возрасте от 2 до 59 месяцев, которым был поставлен диагноз «пневмония».Из 14 092 детей, включенных в анализ, у 13 266 (94,1%) удалось успешно провести пульсоксиметрию. Дети со впалой грудью и (или) опасными симптомами, у которых измеренная насыщенность кислородом была менее 90%, более чем в два раза чаще направлялись в больницу, чем дети с высокой оксигенацией (84,3% (385 из 457 детей) против 41,5% (871 ребенок из 2099), р 0,001). Доступность оксиметрии привела к повышению уровня направления в больницу для детей с серьезной гипоксемией без впалой груди или опасных симптомов с 0 до 27,2% (p 0,001). В отсутствие оксиметрии и при использовании соответствующих рекомендаций Всемирной организации здравоохранения (ВОЗ), опубликованных в 2014 году, 390 из 568 детей (68,7%) с серьезной гипоксемией в центрах проведения исследования и 52 из 84 детей (61,9%) с серьезной гипоксемией, которых осматривали местные медицинские работники, не были бы направлены в больницу ввиду отсутствия показаний.Внедрение пульсоксиметрии нашими стажерами значительно повысило частоту направления в больницу малавийских детей с серьезной гипоксемией пневмонийного происхождения. При исключении из анамнеза данных пульсоксиметрии ретроспективное применение рекомендаций ВОЗ от 2014 года не позволяло выявить значительное количество детей с серьезной гипоксемией, необходимость госпитализации которых оказалось возможным определить только с помощью оксиметрии.

    image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
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    UCL Discovery
    Article . 2016
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    Bulletin of the World Health Organization
    Article . 2016 . Peer-reviewed
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      image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/ Europe PubMed Centra...arrow_drop_down
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      UCL Discovery
      Article . 2016
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      Bulletin of the World Health Organization
      Article . 2016 . Peer-reviewed
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  • image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
    Authors: A, Lakos; Z, Igari; N, Solymosi;

    ABSTRACT Purpose The evaluation of the correspondence between positive Borrelia burgdorferi antibody response and the clinical symptoms attributed to Lyme disease is especially important in labour rights-related issues among forestry workers. Material and Methods Between 1992 and 1995, 1670 forestry workers were surveyed and tested serologically for Lyme borreliosis in Hungary. The collected data was analysed retrospectively. Results In the case histories of the forestry employees erythema migrans, polyneuropathy and large joint arthritis were mentioned in 128 (7.7%), 192 (11.5%), and 93 (5.6%) workers, respectively. We found positive Borrelia burgdorferi s.l. antibody reaction in 622 workers out of whom 280 (45%) were free of any signs or symptoms referring to B. burgdorferi s.l. infection in their case histories. The frequency of seropositivity increased with age, number of registered tick bites, and erythema migrans in case history, as well as arthralgia. The frequency of polyneuropathy was somewhat more closely corresponding with age than seropositivity. Women gave account of a smaller number of tick bites, and were less likely seropositive while fewer of them were symptom-free. Since the 45% of seropositive forestry workers were symptom-free and they could not recall any symptoms suggestive for present or past Lyme borreliosis, the positive predictive value of Borrelia antibody testing in this high-risk group is surprisingly low, less than 5%. Conclusion Positive Borrelia antibody test result may be especially misleading in a high-risk population.

    image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Advances in Medical ...arrow_drop_down
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    Advances in Medical Sciences
    Article . 2012 . Peer-reviewed
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      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Advances in Medical ...arrow_drop_down
      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
      Advances in Medical Sciences
      Article . 2012 . Peer-reviewed
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  • image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
    Authors: U. W. U. Ayonoadu; J. Norrington-Davies; O. T. Edje; L. K. Mughogho;

    SummaryA number of herbicide treatments involving the use of trifluralin, preforan and igran were compared together with hand weeding as methods for the control of weeds in a cultivar ofPhaseolus vulgarissown on 19 January 1972.Favourable increases in yield of beans were obtained by combinations of preforan and igran which were associated with an increase in the number of pods produced per plant. Hand weeding failed to give a significant increase in final yield.Within 14 days from sowing there was an appreciable weed cover in the control and hand-weeded plots but little evidence of weeds in the herbicide-treated plots. At 41 days there were still no significant differences between the control and the plots to be hand weeded. There was, however, a considerable reduction in percentage cover of weeds on the herbicide treated plots. Trifluralin and preforan were equally effective in reducing weed cover.

    image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao The Journal of Agric...arrow_drop_down
    image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
    The Journal of Agricultural Science
    Article . 1974 . Peer-reviewed
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      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
      The Journal of Agricultural Science
      Article . 1974 . Peer-reviewed
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    Authors: Bone, Rachel A.; Parks, Kate E.; Hudson, Malcolm D.; Tsirinzeni, Mathews; +1 Authors

    Land cover has changed rapidly across the tropics over the past century; however, detailed historical information describing the extent and possible drivers of such change is widely lacking. Here, we constructed a history of land-cover change at the district level in Malawi over a 37-year period from 1972 to 2009, the immediate post-colonial phase. Overall, there was a loss of 12 760 km2 (36%) of original forested area but also 11 161 km2 of new forest establishment, resulting in a relatively modest overall net loss of 1 599 km2 (5%). We correlated changes in deforestation and forest establishment with changes in socio-economic variables derived from spatially explicit data from the same time period. Deforestation was positively correlated with (in order of influence) changes in male school attendance, sex ratio, population density, hospital bed numbers, protected areas and dependency rate, but negatively correlated with changes in cattle density; forest establishment broadly showed the inverse relationships with the same variables. Although direct drivers of deforestation are well known for Malawi and much of Africa, the significance of socio-economic variables within this study can help to understand the underlying social pressures behind such drivers. In particular, development, population pressure and demographic factors are important predictors of deforestation rate within our study area.Keywords: afforestation, Africa, deforestation, drivers, land-use change, reforestation, rural, urban

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    Southern Forests a Journal of Forest Science
    Article . 2016 . Peer-reviewed
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      Southern Forests a Journal of Forest Science
      Article . 2016 . Peer-reviewed
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  • image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
    Authors: Miriam Kalanda Joshua; Ruth Kalinga Chirwa; Cosmo Ngongondo; Maurice Monjerezi; +2 Authors

    Access to drinking water remains a challenge in many rural areas in Sub-Saharan Africa. This situation is further compounded by frequent disasters such as floods, which affect water supply infrastructure. However, few scholarly works have examined access to drinking water for rural households vulnerable to floods in Southern Africa. This study analysed the extent to which the 2019 flooding induced by Cyclone Idai affected households’ access to water in Magalasi Village in Chikwawa District in Malawi. Data was collected and analysed following the mixed methods research design in which both quantitative and qualitative approaches were used. The results show that during the floods, households relocated to a nearby school which has solar powered tap water. However, the increased numbers at the camp resulted in a decline in the daily minimum water per capita of 20 L/c/d in about 60% of the households as each tap is meant to carter for 250 people only. Furthermore, the use of the taps was restricted to 8 h (6 am–2 pm during weekdays and 8 am–5 pm during weekends), which coincided with times for farming activities. Consequently, households had to fetch water from a village about 3 km away. However, the alternative water sources were also inaccessible during severe flooding conditions, with intermittent and contaminated water. Considering the health challenges associated with consumption of insufficient and contaminated water, this study proposes construction of more resilient deep boreholes for continuous water supply.

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    https://doi.org/10.1007/978-3-...
    Part of book or chapter of book . 2021 . Peer-reviewed
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      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao https://doi.org/10.1...arrow_drop_down
      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
      https://doi.org/10.1007/978-3-...
      Part of book or chapter of book . 2021 . Peer-reviewed
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    Authors: Robert Heyderman; Nicola Desmond; Deborah Nyirenda;

    Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ‘ Umoyo nkukambirana’ was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings.

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    Public Understanding of Science; OpenAPC Global Initiative
    Article . Conference object . 2016 . Peer-reviewed
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    Public Understanding of Science
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      Public Understanding of Science; OpenAPC Global Initiative
      Article . Conference object . 2016 . Peer-reviewed
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      Public Understanding of Science
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Kimberly Baltzell; Teresa Bleakly Kortz; Alden Blair; Ellen Scarr; +4 Authors

    BackgroundWhile health providers consistently use malaria rapid diagnostic tests to rule out malaria, they often lack tools to guide treatment for those febrile patients who test negative. Without the tools to provide an alternative diagnosis, providers may prescribe unnecessary antibiotics or miss a more serious condition, potentially contributing to antibiotic resistance and/or poor patient outcomes. MethodsThis study ascertained which diagnoses and treatments might be associated with poor outcomes in adults who test negative for malaria. Adult patients for rapid diagnostic test of malaria seen in mobile health clinics in Mulanje and Phalombe districts were followed for 14 days. Participants were interviewed on sociodemographic characteristics, health-seeking behaviour, diagnosis, treatment and access to care. Mobile clinic medical charts were reviewed. Two weeks (±2 days) following clinic visit, follow-up interviews were conducted to assess whether symptoms had resolved.ResultsInitially, 115 adult patients were enrolled and 1 (0.88%) was lost to follow-up. Of the 114 adult patients remaining in the study, 55 (48%) were seen during the dry season and 59 (52%) during the wet season. Symptoms resolved in 90 (80%) patients at the 14-day follow-up visit (n=90) with the rest (n=24) reporting no change in symptoms. None of the patients in the study died or were referred for further care. Almost all patients received some type of medication during their clinic visit (98.2%). Antibiotics were given to 38.6% of patients, and virtually all patients received pain or fever relief (96.5%). However, no anti-malarials were prescribed.ConclusionsMobile clinics provide important health care where access to care is limited. Although rapid tests have guided appropriate treatment, challenges remain when a patient’s presenting complaint is less well defined. In rural areas of southern Malawi, simple diagnostics are needed to guide treatment decisions.

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    Malawi Medical Journal
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    Malawi Medical Journal
    Article . 2020 . Peer-reviewed
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      Malawi Medical Journal
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      Malawi Medical Journal
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  • Authors: Gombachika, Belinda C; Fjeld, Heidi;

    In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing among people living with HIV is important. The little that is known originates from either studies conducted before widespread availability of highly active ART or has focused on women’s or men’s reproductive behaviours and experiences. This paper therefore explores factors that influence childbearing decisions of married couples living with HIV in patrilineal and matrilineal kinship communities in rural Malawi. Qualitative exploratory research was conducted in two rural districts in the southern part of Malawi. Data were collected using in-depth interviews from 20 couples purposively sampled in matrilineal (Chiradzulu) and patrilineal (Chikhwawa) communities from July to December 2010 and was analysed using the content analysis method. The research findings show that couples living with HIV continue having children despite knowledge of the risk associated with childbearing and resistance from others in the community. Furthermore, the findings suggest that men are driven to have children by the need to cement relationships (patrilineal and matrilineal communities) and to secure position (matrilineal communities) while women do not want to have children because they are afraid of the risks and a heavier childcare burden. Finally, the findings suggest that outcomes of the decisions are dominated by husbands’ desires in both communities. This paper therefore extends the discourse on the value of childbearing beyond the question of adulthood expressed in varying ways according to gender and kinship organisation. We therefore recommend that intervention strategies for both reproductive health and HIV and AIDS must focus on husbands and be sensitive to local culture. The antiretroviral clinics must integrate family planning services in their routine activities and condom use must be complemented with other effective family planning methods to prevent future pregnancies.Keywords: kinship, matrilineal, patrilineal, reproductive healthAfrican Journal of AIDS Research 2014, 13(1): 21–29

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  • Authors: Rochelle H. Holm; Alinafe Kamangira; Victor Kasulo; Prince Kaponda; +3 Authors

    In sub-Saharan Africa, moving towards the Sustainable Development Goals will require an approach to water and sanitation service delivery for many rural communities where handpumps still dominate infrastructure. This paper reviews a case study of allowing users (local government and communities) in Rumphi District, Malawi, to choose a handpump model based on information about the life-cycle costs. The results indicate that there is some awareness within communities and within the local government of several handpump options for the rural water supply in the study area. Given a choice of different handpump models in the treatment communities, each community chose the rope pump. Allowing communities to choose the type of handpump model, with input from both local government and donors on low cost borehole drilling, should be considered as an innovative approach to rural water service delivery.

    Waterlinesarrow_drop_down
    Waterlines
    Article . 2017 . Peer-reviewed
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      Article . 2017 . Peer-reviewed
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Ian A Forde; Vrijesh Tripathi;

    This review evaluated the association of place of residence (urban/rural) and under-five mortality in middle- and low-income countries. Both English and Spanish language studies conducted during the Millennium Development Goal (MDG) period (1990 to 2015) were reviewed. Twenty-six cross-sectional studies, all in the English language, were selected for further review. Published data were used for this analysis. A funnel plot was produced to ascertain the presence of publication bias. The combined relative risk for under-five mortality was estimated using a random-effects model and a meta-regression was conducted on 15 of the 26 studies. The studies had a combined effect size of 1.47 (95% confidence interval, 1.27–1.67). The results of the meta-regression showed a positive association between the relative risk and the percentage of the rural population for the various regions/countries. The coefficient for the variable rural population percentage was 0.007, indicating that for every one percent increase in the rural population percentage, there was a 0.007 increase in the relative risk for under-five mortality. However, this was not significant (p-value = 0.3). Rural disadvantage persists in middle- and low-income countries. This is important to evaluate policies and programmes designed to remove the gap in under-five mortality rates between urban and rural areas.

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    Children
    Article . 2018 . Peer-reviewed
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    Authors: McCollum, ED; King, C; Deula, R; Zadutsa, B; +8 Authors

    To investigate implementation of outpatient pulse oximetry among children with pneumonia, in Malawi.In 2011, 72 health-care providers at 18 rural health centres and 38 community health workers received training in the use of pulse oximetry to measure haemoglobin oxygen saturations. Data collected, between 1 January 2012 and 30 June 2014 by the trained individuals, on children aged 2-59 months with clinically diagnosed pneumonia were analysed.Of the 14 092 children included in the analysis, 13 266 (94.1%) were successfully checked by oximetry. Among the children with chest indrawing and/or danger signs, those with a measured oxygen saturation below 90% were more than twice as likely to have been referred as those with higher saturations (84.3% [385/457] vs 41.5% [871/2099];Implementation of pulse oximetry by our trainees substantially increased the referrals of Malawian children with severe hypoxaemic pneumonia. When data from oximetry were excluded, retrospective application of the guidelines published by WHO in 2014 failed to identify a considerable proportion of severely hypoxaemic children eligible only via oximetry.Étudier l'utilisation de l'oxymétrie de pouls chez les enfants atteints de pneumonie en traitement ambulatoire au Malawi.En 2011, 72 prestataires de soins de santé de 18 centres de santé ruraux et 38 agents de santé communautaires ont été formés à l'utilisation de l'oxymétrie de pouls pour mesurer la saturation en oxygène de l'hémoglobine. Des données collectées entre le 1er janvier 2012 et le 30 juin 2014 par les individus formés sur des enfants âgés de 2 à 59 mois atteints d'une pneumonie cliniquement diagnostiquée ont été analysées.Sur les 14 092 enfants inclus dans l'analyse, 13 266 (94,1%) ont été examinés avec succès grâce à l'oxymétrie. Parmi les enfants présentant un tirage sous-costal et/ou des signes de danger, ceux dont la saturation en oxygène mesurée était inférieure à 90% avaient plus de deux fois plus de chances d'être orientés vers un spécialiste que ceux présentant une saturation plus importante (84,3% [385/457] contre 41,5% [871/2099]; P 0,001). L'utilisation de l'oxymétrie semble avoir augmenté de 0% à 27,2% (P 0.001) le taux d'orientation vers un spécialiste dans le cas des enfants souffrant d'hypoxémie sévère sans tirage sous-costal ni signes de danger. En l'absence d'oxymétrie, si les directives en la matière publiées par l'Organisation mondiale de la Santé (OMS) en 2014 avaient été appliquées, 390/568 (68,7%) enfants souffrant d'hypoxémie sévère examinés dans les centres de santé considérés et 52/84 (61,9%) enfants souffrant d'hypoxémie sévère examinés par des agents de santé communautaires n'auraient pas pu bénéficier d'une orientation vers un spécialiste.L'utilisation de l'oxymétrie de pouls par les individus formés a considérablement accru l'orientation vers un spécialiste des enfants malawites atteints de pneumonie sévère et ayant développé une hypoxémie. Lorsque les données provenant de l'oxymétrie étaient exclues, l'application rétrospective des directives publiées par l'OMS en 2014 ne permettait pas d'identifier une proportion considérable d'enfants souffrant d'hypoxémie sévère qui remplissaient les conditions requises uniquement au vu de l'oxymétrie.Investigar la implementación de la oximetría de pulso ambulatoria en niños con neumonía en Malawi.En 2011, 72 profesionales de la salud de 18 centros de salud en zonas rurales y 38 trabajadores de la salud comunitarios recibieron formación con respecto al uso de la oximetría de pulso para medir las saturaciones de oxígeno de la hemoglobina. Se analizaron los datos, que las personas formadas recopilaron entre el 1 de enero de 2012 y el 30 de junio de 2014, de niños de 2 a 59 meses de edad con un diagnóstico clínico de neumonía.De los 14 092 niños incluidos en el análisis, se realizaron las pruebas con oximetría de manera satisfactoria a 13 266 (94,1%). Entre los niños con retracción costal y/o signos de peligro, aquellos con una medida de saturación de oxígeno por debajo del 90% tenían más del doble de probabilidades de haber sido derivados que aquellos con saturaciones más elevadas (84,3% [385/457] frente al 41,5% [871/2 099];La implementación de la oximetría de pulso por las personas formadas incrementó de forma sustancial las derivaciones de los niños de Malawi con neumonía hipoxémica grave. Cuando se excluyeron los datos procedentes de la oximetría, la aplicación retrospectiva de las directrices publicadas por la OMS en 2014 no pudo identificar un porcentaje considerable de niños hipoxémicos graves que cumplían los requisitos únicamente a través de la oximetría.الاستقصاء بشأن تنفيذ عمليات قياس التأكسج في العيادات الخارجية للأطفال المصابين بالالتهاب الرئوي في ملاوي.حصل 72 من مقدمي خدمات الرعاية الصحية في 18 مركزًا طبيًا ريفيًا و38 عاملاً في مجال الخدمات الصحية المجتمعية في عام 2011 على تدريبات متعلقة باستخدام تقنية قياس التأكسج بهدف قياس نسب تشبع الأكسجين والهيموجلوبين. وتم تحليل البيانات المجمعة في الفترة بين 1 كانون الثاني/يناير 2012 و 30 حزيران/يونيو 2014 بواسطة الأفراد المدرّبين، وهذه البيانات خاصة بالأطفال البالغ أعمارهم ما بين 2 إلى 59 شهرًا والمصابين بمرض الالتهاب الرئوي الذي تم تشخيصه داخل العيادات.من بين 14092 طفلاً شملهم التحليل، كان 13266 طفلاً منهم (بنسبة ‏94.1‏%) قد تم فحصه بنجاح بواسطة تقنية قياس التأكسج. ومن بين الأطفال الذين يعانون من بروز القفص الصدري أثناء التنفس و/أو علامات الخطر، كان أولئك الذين لديهم نسبة تشبع الأكسجين أقل من 90‏% لديهم أرجحية مضاعفة لإحالتهم للعلاج باعتبارهم من الأطفال الذين لديهم نسبة تشبع أعلى (84.3‏% [385/457] مقابل ‏41.5‏% [871/2099[؛إن تنفيذ عملية قياس التأكسج بواسطة المتدربين لدينا أدى بشكل كبير إلى زيادة حالات الإحالة للعلاج بالنسبة للأطفال المصابين بالالتهاب الرئوي الحاد في ملاوي. وعندما تم استبعاد بيانات قياس التأكسج، فشل التطبيق بأثر رجعي للمبادئ التوجيهية الصادرة من منظمة الصحة العالمية في عام 2014 في تحديد نسبة كبيرة من الأطفال المصابين بخلل الجهاز التنفسي الحاد والذين كانوا مؤهلين للعلاج نتيجة استخدام تقنية قياس التأكسج فقط.旨在调查马拉维肺炎患儿门诊脉搏血氧饱和度检测的实施情况。.2011 年,18 个农村医疗中心的 72 位医疗护理人员和 38 位社区医疗工作者接受了培训,学习使用脉搏血氧饱和度检测法测量血氧饱和度。 我们分析了受训人员于 2012 年 1 月 1 日到 2014 年 6 月 30 日期间采集的年龄在 2-59 个月、临床诊断为肺炎的儿童的数据。.在我们分析的 14 092 位儿童中,13 266 (94.1%) 位已经成功接受血氧饱和度检测。 在出现胸部凹陷和/或危险症状的儿童中,测量的血氧饱和度低于 90% 的儿童转诊的可能性是饱和度更高儿童的两倍以上(分别为 84.3% [385/457] 和 41.5% [871/2099];受训人员对脉搏血氧饱和度检测的实施大幅度提高了马拉维重度低氧性肺炎患儿的转诊率。 但是如果不采用血氧饱和度检测中的数据,而是追溯式采纳 WHO 2014 年发布的指南,则相当大比例的仅通过血氧饱和度检测才能确诊的重度低氧血症儿童无法得到确诊。.Изучить амбулаторное применение пульсоксиметрии у больных пневмонией детей в Малави.В течение 2011 года 72 врача из 18 сельских больниц и 38 местных медицинских работников были обучены использованию пульсоксиметрии для измерения насыщенности гемоглобина кислородом. Были проанализированы данные, собранные обученными лицами на протяжении периода с 1 января 2012 года по 30 июня 2014 года у детей в возрасте от 2 до 59 месяцев, которым был поставлен диагноз «пневмония».Из 14 092 детей, включенных в анализ, у 13 266 (94,1%) удалось успешно провести пульсоксиметрию. Дети со впалой грудью и (или) опасными симптомами, у которых измеренная насыщенность кислородом была менее 90%, более чем в два раза чаще направлялись в больницу, чем дети с высокой оксигенацией (84,3% (385 из 457 детей) против 41,5% (871 ребенок из 2099), р 0,001). Доступность оксиметрии привела к повышению уровня направления в больницу для детей с серьезной гипоксемией без впалой груди или опасных симптомов с 0 до 27,2% (p 0,001). В отсутствие оксиметрии и при использовании соответствующих рекомендаций Всемирной организации здравоохранения (ВОЗ), опубликованных в 2014 году, 390 из 568 детей (68,7%) с серьезной гипоксемией в центрах проведения исследования и 52 из 84 детей (61,9%) с серьезной гипоксемией, которых осматривали местные медицинские работники, не были бы направлены в больницу ввиду отсутствия показаний.Внедрение пульсоксиметрии нашими стажерами значительно повысило частоту направления в больницу малавийских детей с серьезной гипоксемией пневмонийного происхождения. При исключении из анамнеза данных пульсоксиметрии ретроспективное применение рекомендаций ВОЗ от 2014 года не позволяло выявить значительное количество детей с серьезной гипоксемией, необходимость госпитализации которых оказалось возможным определить только с помощью оксиметрии.

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    Bulletin of the World Health Organization
    Article . 2016 . Peer-reviewed
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    Authors: A, Lakos; Z, Igari; N, Solymosi;

    ABSTRACT Purpose The evaluation of the correspondence between positive Borrelia burgdorferi antibody response and the clinical symptoms attributed to Lyme disease is especially important in labour rights-related issues among forestry workers. Material and Methods Between 1992 and 1995, 1670 forestry workers were surveyed and tested serologically for Lyme borreliosis in Hungary. The collected data was analysed retrospectively. Results In the case histories of the forestry employees erythema migrans, polyneuropathy and large joint arthritis were mentioned in 128 (7.7%), 192 (11.5%), and 93 (5.6%) workers, respectively. We found positive Borrelia burgdorferi s.l. antibody reaction in 622 workers out of whom 280 (45%) were free of any signs or symptoms referring to B. burgdorferi s.l. infection in their case histories. The frequency of seropositivity increased with age, number of registered tick bites, and erythema migrans in case history, as well as arthralgia. The frequency of polyneuropathy was somewhat more closely corresponding with age than seropositivity. Women gave account of a smaller number of tick bites, and were less likely seropositive while fewer of them were symptom-free. Since the 45% of seropositive forestry workers were symptom-free and they could not recall any symptoms suggestive for present or past Lyme borreliosis, the positive predictive value of Borrelia antibody testing in this high-risk group is surprisingly low, less than 5%. Conclusion Positive Borrelia antibody test result may be especially misleading in a high-risk population.

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    Advances in Medical Sciences
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      Advances in Medical Sciences
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    Authors: U. W. U. Ayonoadu; J. Norrington-Davies; O. T. Edje; L. K. Mughogho;

    SummaryA number of herbicide treatments involving the use of trifluralin, preforan and igran were compared together with hand weeding as methods for the control of weeds in a cultivar ofPhaseolus vulgarissown on 19 January 1972.Favourable increases in yield of beans were obtained by combinations of preforan and igran which were associated with an increase in the number of pods produced per plant. Hand weeding failed to give a significant increase in final yield.Within 14 days from sowing there was an appreciable weed cover in the control and hand-weeded plots but little evidence of weeds in the herbicide-treated plots. At 41 days there were still no significant differences between the control and the plots to be hand weeded. There was, however, a considerable reduction in percentage cover of weeds on the herbicide treated plots. Trifluralin and preforan were equally effective in reducing weed cover.

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    The Journal of Agricultural Science
    Article . 1974 . Peer-reviewed
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      The Journal of Agricultural Science
      Article . 1974 . Peer-reviewed
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    Authors: Bone, Rachel A.; Parks, Kate E.; Hudson, Malcolm D.; Tsirinzeni, Mathews; +1 Authors

    Land cover has changed rapidly across the tropics over the past century; however, detailed historical information describing the extent and possible drivers of such change is widely lacking. Here, we constructed a history of land-cover change at the district level in Malawi over a 37-year period from 1972 to 2009, the immediate post-colonial phase. Overall, there was a loss of 12 760 km2 (36%) of original forested area but also 11 161 km2 of new forest establishment, resulting in a relatively modest overall net loss of 1 599 km2 (5%). We correlated changes in deforestation and forest establishment with changes in socio-economic variables derived from spatially explicit data from the same time period. Deforestation was positively correlated with (in order of influence) changes in male school attendance, sex ratio, population density, hospital bed numbers, protected areas and dependency rate, but negatively correlated with changes in cattle density; forest establishment broadly showed the inverse relationships with the same variables. Although direct drivers of deforestation are well known for Malawi and much of Africa, the significance of socio-economic variables within this study can help to understand the underlying social pressures behind such drivers. In particular, development, population pressure and demographic factors are important predictors of deforestation rate within our study area.Keywords: afforestation, Africa, deforestation, drivers, land-use change, reforestation, rural, urban

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    Southern Forests a Journal of Forest Science
    Article . 2016 . Peer-reviewed
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      Southern Forests a Journal of Forest Science
      Article . 2016 . Peer-reviewed
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  • image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
    Authors: Miriam Kalanda Joshua; Ruth Kalinga Chirwa; Cosmo Ngongondo; Maurice Monjerezi; +2 Authors

    Access to drinking water remains a challenge in many rural areas in Sub-Saharan Africa. This situation is further compounded by frequent disasters such as floods, which affect water supply infrastructure. However, few scholarly works have examined access to drinking water for rural households vulnerable to floods in Southern Africa. This study analysed the extent to which the 2019 flooding induced by Cyclone Idai affected households’ access to water in Magalasi Village in Chikwawa District in Malawi. Data was collected and analysed following the mixed methods research design in which both quantitative and qualitative approaches were used. The results show that during the floods, households relocated to a nearby school which has solar powered tap water. However, the increased numbers at the camp resulted in a decline in the daily minimum water per capita of 20 L/c/d in about 60% of the households as each tap is meant to carter for 250 people only. Furthermore, the use of the taps was restricted to 8 h (6 am–2 pm during weekdays and 8 am–5 pm during weekends), which coincided with times for farming activities. Consequently, households had to fetch water from a village about 3 km away. However, the alternative water sources were also inaccessible during severe flooding conditions, with intermittent and contaminated water. Considering the health challenges associated with consumption of insufficient and contaminated water, this study proposes construction of more resilient deep boreholes for continuous water supply.

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    https://doi.org/10.1007/978-3-...
    Part of book or chapter of book . 2021 . Peer-reviewed
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      image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao https://doi.org/10.1...arrow_drop_down
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      https://doi.org/10.1007/978-3-...
      Part of book or chapter of book . 2021 . Peer-reviewed
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Robert Heyderman; Nicola Desmond; Deborah Nyirenda;

    Radio is an effective source of health information in many resource poor countries. In Malawi, 53% of households own radios however few radio programmes in Malawi focus on health issues in the context of medical research. An interactive health-talk radio programme ‘ Umoyo nkukambirana’ was introduced by Malawi-Liverpool-Wellcome Trust Clinical Research Programme on a national radio station. The aim was to increase awareness of health and medical research, and improve engagement between researchers, healthcare workers and the public. The content and presentation were developed through participatory community consultations. Focus Group Discussions were conducted with established Radio Listening Clubs whilst quantitative data was collected using toll free FrontlineSMS to explore national response. A total of 277 to 695 SMS (Median: 477) were received per theme. The majority of SMS were received from men (64%) and mainly from rural areas (54%). The programme improved knowledge of medical research, health and dispelled misconceptions. This study suggests that the radio may be an effective means of increasing the exposure of men to health information in resource poor settings.

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    Public Understanding of Science; OpenAPC Global Initiative
    Article . Conference object . 2016 . Peer-reviewed
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    Public Understanding of Science
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      Public Understanding of Science; OpenAPC Global Initiative
      Article . Conference object . 2016 . Peer-reviewed
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      Public Understanding of Science
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  • image/svg+xml art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos Open Access logo, converted into svg, designed by PLoS. This version with transparent background. http://commons.wikimedia.org/wiki/File:Open_Access_logo_PLoS_white.svg art designer at PLoS, modified by Wikipedia users Nina, Beao, JakobVoss, and AnonMoos http://www.plos.org/
    Authors: Kimberly Baltzell; Teresa Bleakly Kortz; Alden Blair; Ellen Scarr; +4 Authors

    BackgroundWhile health providers consistently use malaria rapid diagnostic tests to rule out malaria, they often lack tools to guide treatment for those febrile patients who test negative. Without the tools to provide an alternative diagnosis, providers may prescribe unnecessary antibiotics or miss a more serious condition, potentially contributing to antibiotic resistance and/or poor patient outcomes. MethodsThis study ascertained which diagnoses and treatments might be associated with poor outcomes in adults who test negative for malaria. Adult patients for rapid diagnostic test of malaria seen in mobile health clinics in Mulanje and Phalombe districts were followed for 14 days. Participants were interviewed on sociodemographic characteristics, health-seeking behaviour, diagnosis, treatment and access to care. Mobile clinic medical charts were reviewed. Two weeks (±2 days) following clinic visit, follow-up interviews were conducted to assess whether symptoms had resolved.ResultsInitially, 115 adult patients were enrolled and 1 (0.88%) was lost to follow-up. Of the 114 adult patients remaining in the study, 55 (48%) were seen during the dry season and 59 (52%) during the wet season. Symptoms resolved in 90 (80%) patients at the 14-day follow-up visit (n=90) with the rest (n=24) reporting no change in symptoms. None of the patients in the study died or were referred for further care. Almost all patients received some type of medication during their clinic visit (98.2%). Antibiotics were given to 38.6% of patients, and virtually all patients received pain or fever relief (96.5%). However, no anti-malarials were prescribed.ConclusionsMobile clinics provide important health care where access to care is limited. Although rapid tests have guided appropriate treatment, challenges remain when a patient’s presenting complaint is less well defined. In rural areas of southern Malawi, simple diagnostics are needed to guide treatment decisions.

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    Malawi Medical Journal
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    Malawi Medical Journal
    Article . 2020 . Peer-reviewed
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      Malawi Medical Journal
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      Malawi Medical Journal
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  • Authors: Gombachika, Belinda C; Fjeld, Heidi;

    In the context of increasing access to antiretroviral therapy (ART), the issue of childbearing among people living with HIV is important. The little that is known originates from either studies conducted before widespread availability of highly active ART or has focused on women’s or men’s reproductive behaviours and experiences. This paper therefore explores factors that influence childbearing decisions of married couples living with HIV in patrilineal and matrilineal kinship communities in rural Malawi. Qualitative exploratory research was conducted in two rural districts in the southern part of Malawi. Data were collected using in-depth interviews from 20 couples purposively sampled in matrilineal (Chiradzulu) and patrilineal (Chikhwawa) communities from July to December 2010 and was analysed using the content analysis method. The research findings show that couples living with HIV continue having children despite knowledge of the risk associated with childbearing and resistance from others in the community. Furthermore, the findings suggest that men are driven to have children by the need to cement relationships (patrilineal and matrilineal communities) and to secure position (matrilineal communities) while women do not want to have children because they are afraid of the risks and a heavier childcare burden. Finally, the findings suggest that outcomes of the decisions are dominated by husbands’ desires in both communities. This paper therefore extends the discourse on the value of childbearing beyond the question of adulthood expressed in varying ways according to gender and kinship organisation. We therefore recommend that intervention strategies for both reproductive health and HIV and AIDS must focus on husbands and be sensitive to local culture. The antiretroviral clinics must integrate family planning services in their routine activities and condom use must be complemented with other effective family planning methods to prevent future pregnancies.Keywords: kinship, matrilineal, patrilineal, reproductive healthAfrican Journal of AIDS Research 2014, 13(1): 21–29

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  • Authors: Rochelle H. Holm; Alinafe Kamangira; Victor Kasulo; Prince Kaponda; +3 Authors

    In sub-Saharan Africa, moving towards the Sustainable Development Goals will require an approach to water and sanitation service delivery for many rural communities where handpumps still dominate infrastructure. This paper reviews a case study of allowing users (local government and communities) in Rumphi District, Malawi, to choose a handpump model based on information about the life-cycle costs. The results indicate that there is some awareness within communities and within the local government of several handpump options for the rural water supply in the study area. Given a choice of different handpump models in the treatment communities, each community chose the rope pump. Allowing communities to choose the type of handpump model, with input from both local government and donors on low cost borehole drilling, should be considered as an innovative approach to rural water service delivery.

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    Waterlines
    Article . 2017 . Peer-reviewed
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      Waterlines
      Article . 2017 . Peer-reviewed
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