Sedimentation in reservoirs is a significant challenge that affects water storage capacity and operational efficiency.This study establishes a baseline sedimentation status for Mwimba Reservoir in Kasungu,Malawi,five ...Sedimentation in reservoirs is a significant challenge that affects water storage capacity and operational efficiency.This study establishes a baseline sedimentation status for Mwimba Reservoir in Kasungu,Malawi,five years after its commissioning in 2017,using an integrated bathymetric survey and Geographic Information System(GIS)analysis.A bathymetric survey conducted in March 2022 collected depth measurements at 507 points along 23 transects,which were used to construct a Triangulated Irregular Network(TIN)model in ArcGIS for accurate volume calculations.Sediment concentration was determined from seven water samples using the filtration method.The original design volume of 89,200 m^(3)was compared to the current volume of 72,966 m^(3),indicating an 18.2% loss in capacity over the five-year period.Statistical analysis using a one-sample T-test confirmed that this reduction is significant(p=0.013).The annual sedimentation rate was estimated at 1.25 tonnes per year,and the reservoir’s projected operational life is 27.5 years if no intervention is undertaken.Despite a relatively low sedimentation rate compared to other regional reservoirs,targeted sediment management and further catchment analysis are essential.This study provides critical baseline data for future sediment monitoring,management,and conservation planning for Mwimba Reservoir and similar small water bodies in Sub-Saharan Africa.展开更多
Objectives:This study aimed to explore childbirth fear and childbirth preparation among primigravid women in the late pregnancy from 36 to 40 weeks gestation.Methods:We purposively recruited 18 primigravid women into ...Objectives:This study aimed to explore childbirth fear and childbirth preparation among primigravid women in the late pregnancy from 36 to 40 weeks gestation.Methods:We purposively recruited 18 primigravid women into in-depth interviews,21 birth companions,and 13 health workers into focus group discussions.Participants were recruited from two community hospitals'maternity waiting homes in Lilongwe,Malawi.Semi-structured interview guides were used to collect data that were analyzed using content analysis.NVivo11 computer software was used to organize the data.Results:The four categories developed were:"ambivalent pregnancy feelings","dependence on traditional childbirth counseling","inadequate prenatal childbirth instruction"and"inconsistent roles of a birth companion".The findings suggest that primigravid women who were mainly exposed to traditional childbirth mentoring rather than professional care providers,experienced childbirth fear,and lacked proper psychosocial childbirth preparation.Conclusions:Childbirth fear among primigravid women emanate from personal;family;ineffective traditional counseling;and inadequate antenatal childbirth instruction.Birth companions may increase childbirth stress.However,our findings highlight birth companions as readily available psychosocial support resources among primigravid women.We recommend that professional childbirth instruction during antenatal care should be strengthened to surpass traditional childbirth counseling.Appropriateness and effectiveness of birth companions need to be carefully assessed.展开更多
Rates of exclusive breastfeeding in Malawi remain low despite the acknowledged benefits of exclusive breastfeeding for the infant’s wellbeing and the prevention of mother-to-child transmission of HIV. Creating an env...Rates of exclusive breastfeeding in Malawi remain low despite the acknowledged benefits of exclusive breastfeeding for the infant’s wellbeing and the prevention of mother-to-child transmission of HIV. Creating an environment supportive of exclusive breastfeeding is critical to increase the rate of exclusive breastfeeding among HIV-positive mothers. However, little is known on factors that influence the environment within which HIV-positive mothers in Malawi practise exclusive breastfeeding. Therefore, the exploratory qualitative study on which this article is based was conducted at the Chatinkha maternity unit of Queen Elizabeth Central Hospital in Malawi from April 16, 2009 to May 8, 2009 to explore perceived practice environment related barriers to exclusive breastfeeding among HIV-positive mothers. Data were obtained through indepth interviews with 16 purposively selected breastfeeding HIV-positive mothers between 18 and 35 years old and two focus group discussions with women of unknown HIV status. Semi-structured interview and focus group guides were utilised. Content analysis of data was done. Five main themes emerged regarding factors that may influence the environment within which exclusive breastfeeding was practised: 1) availability of resources;2) societal norms and cultural practices;3) mother-baby proximity;4) health workers’ attitudes and 5) disclosure of the mothers’ HIV status. A multi-sectoral approach to promote exclusive breastfeeding is suggested. This?should include community involvement because it is in the community where breastfeeding norms and cultural practices associated with breast-feeding are propagated.展开更多
Objective: To estimate risk factors of urban malaria in Blantyre, Malawi, with the goal of understanding the epidemiology and ecology of the disease, and informing malaria elimination policies for African urban cities...Objective: To estimate risk factors of urban malaria in Blantyre, Malawi, with the goal of understanding the epidemiology and ecology of the disease, and informing malaria elimination policies for African urban cities that have markedly low prevalence of malaria.Methods: We used a case-control study design, with cases being children under the age of five years diagnosed with malaria, and matched controls obtained at hospital and communities. The data were obtained from Ndirande health facility catchment area. We then fitted a multivariate spatial logistic model of malaria risk. Covariate and risk factors in the model included child-specific, household and environmental risk factor(nearness to garden, standing water, river and swamps). The spatial component was assumed to follow a Gaussian process and model fitted using Bayesian inference.Results: Our findings showed that children who visited rural areas were 6 times more likely to have malaria than those who did not [odds ratio(OR) = 6.66, 95% confidence interval(CI): 4.79–9.61]. The risk of malaria increased with age of the child(OR = 1.01,95% CI: 1.003–1.020), but reduced with high socio-economic status compared to lower status(OR = 0.39, 95% CI: 0.25–0.54 for the highest level and OR = 0.67, 95% CI: 0.47–0.94 for the medium level). Although nearness to a garden, river and standing water showed increased risk, these effects were not significant. Furthermore, significant spatial clusters of risk emerged, which does suggest other factors do explain malaria risk variability apart from those established above.Conclusions: As malaria in urban areas is highly fuelled by rural-urban migration,emphasis should be to optimize information, education and communication prevention strategies, particularly targeting children from lower socio-economic position.展开更多
Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with c...Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents;21 in-depth interviews of children;15 focus group discussions with community members;62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.展开更多
Aim:The study aimed to explore factors related to the initiation and utilization of focused antenatal care(FANC)in the Southern District of Mzimba,Malawi.Methods:This study used an exploratory qualitative design.Total...Aim:The study aimed to explore factors related to the initiation and utilization of focused antenatal care(FANC)in the Southern District of Mzimba,Malawi.Methods:This study used an exploratory qualitative design.Total of 22 in-depth interviews with pregnant women and community midwife assistants were conducted from December 2015 to January 2016 in Mzimba.Thematic analysis approach was adopted to identify the facilitator and harriers of the FANC initiation and utilization.Results:Facilitator of FANC initiation and utilization included seeking pregnancy confirmation,medical treatment for an existing health problem and the support by community health extension workers.Barriers included the additional cost to free FANC service,lack of essential equipment,unfriendly adolescent reproductive health service,and HIV stigma.Conclusion:Early initiation of FANC relies on both woman’s awareness and community support.Promoting the use of FANC should focus on creating an enabling environment,e.g.,increasing investment of essential medical equipment,reducing additional costs of FANC services,eliminating the discrimination against adolescent pregnancy and people living with HIV,and strengthening health personnel’s training.展开更多
Background: A number of suspected endemic districts with Trachoma have not been mapped in Malawi, and this contributes to delays for scaling up trachoma control activities. Objectives: To determine the prevalence of t...Background: A number of suspected endemic districts with Trachoma have not been mapped in Malawi, and this contributes to delays for scaling up trachoma control activities. Objectives: To determine the prevalence of trachoma and associated risk factors in one of the suspected endemic districts (Salima District) in central Malawi and to generate information to guide policy decisions. Methods: A population-based survey conducted in randomly selected clusters in Salima District (population 418,672), centralMalawi. Children aged 1-9 years and adults aged 15 and above were assessed for clinical signs of trachoma. Results: In total, 884 households were enumerated within 36 clusters. A total of 2765 persons were examined for ocular signs of trachoma. The prevalence of trachomatous inflammation, follicular (TF) among children aged 1-9 years was 17.1% (95% CI 14.9-19.4). The prevalence of trachoma trichiasis (TT) in women aged 15 years and above was 1.3% (CI 0.7-2.3), while the prevalence in men was zero. The presence of a dirty face and lack of sanitation were significantly associated with trachoma follicular (P < 0.001). Conclusion: Prevalence rate of trachoma follicles (TF) in Central Malawi exceeds the WHO guidelines for the intervention with mass antibiotic distribution (TF > 10%), and warrants the trachoma SAFE (Surgery, Antibiotics, Face washing and Environmental hygiene) control strategy to be undertaken in Salima District.展开更多
Introduction: Voluntary medical male circumcision (VMMC) reduces chances of contracting HIV during heterosexual intercourse in males, and risk of cervical cancer in their female sexual partners. However, its uptake am...Introduction: Voluntary medical male circumcision (VMMC) reduces chances of contracting HIV during heterosexual intercourse in males, and risk of cervical cancer in their female sexual partners. However, its uptake among traditionally circumcising communities, where male circumcision carries a cultural significance, has not been studied. Previous research has focused on barriers to uptake of VMMC in non-circumcising communities. This study was conducted to determine socio-cultural barriers to VMMC uptake in order to identify culture-sensitive and evidence-based interventions to increase its uptake. Methodology: This exploratory mixed methods cross-sectional study generated quantitative data from 262 randomly sampled sexually active men;and qualitative data through four focus-group discussions with 58 purposely selected male participants and 10 key informants. Results: The study established that only 6.3% (n = 15) of those circumcised (90.8%, n = 238) were circumcised in clinical setting. Limited access to VMMC services, cost, pain, being attended to by female providers and cultural influences were the major hindrances to uptake of VMMC. Conclusion: Although there is a paradigm shift of preference from traditional male circumcision to VMMC in this community, its uptake is low. The study recommends that besides introducing mobile VMMC services, the Ministry of Health should collaborate with traditional circumcisers and local leaders to provide gender-and-culture-sensitive safer medical male circumcision services.展开更多
Background: Postoperative nausea and vomiting are common complications of anaesthesia and surgery. Known risk factors include motion sickness, migraine, gender and types of surgery. Other possible risk factors for pos...Background: Postoperative nausea and vomiting are common complications of anaesthesia and surgery. Known risk factors include motion sickness, migraine, gender and types of surgery. Other possible risk factors for postoperative nausea and vomiting are ethnicity and genetics surgery. Objective: The main objective of the study was to describe factors associated with postoperative nausea and vomiting among adult Malawians. Methods: This was a prospective observational study. 138 adult patients were recruited into the study. Data were collected using a predesigned questionnaire. Patients were followed up to 18 hours postoperatively and any episodes of postoperative nausea and vomiting were noted. Results: A total of 138 patients were enrolled in the study. 78 were female (56.5%) and 60 were males (43.5%). The ages ranged from 18 to 87 years. The mean age was 36.9 years. The overall incidence of postoperative nausea and vomiting was 29.6%. It was higher among women than men. Patients with motion sickness had the highest incidence of postoperative nausea and vomiting (78.6%) followed by those with migraine (73.3%). Patients whose intraoperative systolic blood pressure fell <80 mmHg had an incidence of 71.4% and those who received postoperative opioids had an incidence of 37.7%. Conclusions: Patients with a history of migraine, motion sickness, whose intraoperative blood pressures fall below a systolic of 80 mmHg and who receive postoperative opioids are at an increased risk for postoperative nausea and vomiting.展开更多
Vegetables are key to nutrition and economic security, especially for developing societies. Research in vegetables has been historically key. From early domestication efforts to modern-day breeding and value addition,...Vegetables are key to nutrition and economic security, especially for developing societies. Research in vegetables has been historically key. From early domestication efforts to modern-day breeding and value addition, research has enabled vegetable productivity to support the nutritional and economic needs of societies. Impactful research, however, requires competent research capacity and a guiding framework, in a continuously changing socio-climatic world. Vegetable research appraisal in Malawi, especially regarding capacity, focus, and a guiding framework, is lacking. By using 5 search engines and 506 analyzed publications, this review sought to first examine the existing research capacity in Malawi and assess the vegetable research focus in terms of both value chain analysis themes and specific vegetable tax. This approach allowed for the isolation and flagging out of key emerging issues from existing research that positively contextualize future vegetable research direction in Malawi. It has been found that Malawi has adequate institutional and expertise capacity to further vegetable research. The identified challenges include local funding and infrastructural capacity to leverage donor funding. Three key emerging issues of climate change, modeling, and biofortification in vegetable crops have been identified. It is suggested that, with Malawi facing the climate change challenge, research focus in these areas, will enhance not only nutritional and economic security, but also overall climate change readiness. Key to climate change readiness is the involvement of indigenous vegetable production. As a package, vegetable cultivation can play a critical role in contributing to the achievement of pillar 1 of the Malawi vision 2063, which seeks to leverage agricultural productivity and commercialization with a focus on climate change resilience.展开更多
Availability of antiretroviral therapy and prevention of mother to child transmission of HIV programmes have increased childbearing decisions in people living with HIV. However, pregnancy decisions of married women li...Availability of antiretroviral therapy and prevention of mother to child transmission of HIV programmes have increased childbearing decisions in people living with HIV. However, pregnancy decisions of married women living with HIV have not been adequately reported in Malawi. In order to provide information to inform the development of antiretroviral and family planning services targeted to the unique needs of women living with HIV, this study explored pregnancy decisions of women living with HIV in rural southern Malawi. Twenty in-depth interviews on married women living with HIV selected purposively were conducted in two antiretroviral clinics of patrilineal Chikhwawa and matrilineal Chiradzulu districts in 2010. With their pregnancy and child rearing experiences, the women who got pregnant after a positive HIV diagnosis decided to never get pregnant again. Their lived experiences of motherhood when living with HIV play a major role in their pregnancy decisions despite free access to antiretroviral therapy, which has improved the quality of their life’s and survival. Societies in Malawi must accept this behavioural change by married women living with HIV and their needs for family planning. Health care workers must be knowledgeable and sensitive about it and assist women living with HIV who are willing to adapt their pregnant decisions based on living experiences.展开更多
In the past two to three years, the world has been heavily affected by the infectious coronavirus disease and Malawi has not been spared due to its interconnection with neighboring countries. There is no management to...In the past two to three years, the world has been heavily affected by the infectious coronavirus disease and Malawi has not been spared due to its interconnection with neighboring countries. There is no management tool to identify and model the vulnerabilities of Malawi’s districts in prioritizing health services as far as coronavirus prevalence and other infectious diseases are concerned. The aim of this study was to model coronavirus vulnerability in all districts in Malawi using Geographic Information System (GIS) to monitor the disease’s cumulative prevalence over the severely affected period between 2020 and 2021. To achieve this, four parameters associated with coronavirus prevalence, including population density, percentage of older people, temperature, and humidity, were prepared in a GIS environment and used in the modelling process. A multiscale geographically weighted regression (MGWR) model was used to model and determine the vulnerability of coronavirus in Malawi. In the MGWR modelling, the Fixed Spatial Kernel was used following a Gaussian distribution model type. The Results indicated that population density and older people (age greater than 60 years) have a more significant impact on coronavirus prevalence in Malawi. The modelling further shows that Malawi, between April 2020 and May 2021, Lilongwe, Blantyre and Thyolo were more vulnerable to coronavirus than other districts. This research has shown that spatial variability of Covid-19 cases using MGWR has the potential of providing useful insights to policymakers for targeted interventions that could otherwise not be possible to detect using non-geovisualization techniques.展开更多
Cholera remains a public health threat in most developing countries in Asia and Africa including Malawi with seasonal recurrent outbreaks. Malawi’s recent Cholera outbreak in 2022 and 2023, exhibited higher morbidity...Cholera remains a public health threat in most developing countries in Asia and Africa including Malawi with seasonal recurrent outbreaks. Malawi’s recent Cholera outbreak in 2022 and 2023, exhibited higher morbidity and mortality rates than the past two decades. Lack of spatiotemporal-based technology and variability assessment tools in Malawi’s Cholera monitoring and management, limit our understanding of the disease’s epidemiology. The present work developed a spatiotemporal variability model for Cholera disease at district level and its relationship to socioeconomic and climatic factors based on cumulative confirmed Cholera cases in Malawi from March 2022 to July 2023 using Z-score statistic and multiscale geographically weighted regression (MGWR) in a Geographical Information System (GIS). We found out that socioeconomic factors such as access to safe drinking water, population density and poverty level, and climatic factors including temperature and rainfall strongly influenced Cholera prevalence in a complex and multifaceted manner. The model shows that Lilongwe, Mangochi, Blantyre and Balaka districts were highly vulnerable to Cholera disease followed by lakeshore districts of Salima, Nkhotakota, Nkhata-Bay and Karonga than other districts. We recommend strategic measures such as Water, Sanitation, and Hygiene (WASH) interventions, community awareness on proper water storage, Cholera case management, vaccination campaigns and spatial-based surveillance systems in the most affected districts. This research has shown that MGWR, as a surveillance system, has the potential of providing insights on the disease’s spatial patterns for public health authorities to identify high-risk districts and implement early response interventions to reduce the spread of the disease.展开更多
To determine commonly used methods of contraception at Monkey Bay Community hospital, to compare different methods of contraception used by people of various age groups, parity, Human Immunodeficiency Virus (HIV) and ...To determine commonly used methods of contraception at Monkey Bay Community hospital, to compare different methods of contraception used by people of various age groups, parity, Human Immunodeficiency Virus (HIV) and Marital status, a clinical audit of family planning methods used by clients at Monkey Community hospital from January 2018 to June 2019 was done. Data was collected from the registers. A total number of 1734 clients reported at family planning clinic of Monkey-Bay Community Hospital between January 2018 and June 2019. All the clients were females. Most of these clients were in the age range of 15 - 34 years (83.33%). There were 1,486 (87%) HIV negative clients, 208 (12%) HIV positive clients and 24 (1%) had unknown HIV status. Most clients had a parity of 1 - 2 (905, 52.71%) followed by 3 - 4 (540, 31.45%) and 5 or plus (272, 15.84%). There were more married people (1641, 97.23%) than unmarried ones (46, 2.73%). There was only one person who was divorced (1, 0.05%). Education status was not recorded. The five commonly used contraceptive methods were: Intramuscular (IM) injectable Depo-IM (1366, 79.51%), Jadelle (122, 7.10%), Subcutaneous (SC) injectable Depo-SC (65, 3.78%), Combined Oral Contraceptives (COC) (60, 3.49%) and Implanon (40, 2.33%). None of the clients was used female condoms as a method of contraception. The contraceptive use was common between the age group of 15 - 24 (707, 44.92%) and 25 - 34 (709, 45%). Depo-IM was most used in age group 25 - 34 (44.5%) while Jadelle was mostly used by 15 - 24 years old (48%). 1181 clients (79.5%) of HIV negative clients used Depo-IM as the contraceptive method while 164 clients (78.8%) of HIV positive clients used Depo IM as a method of contraception. More HIV negative clients used Jadelle and COC as compared to HIV positive clients. The choice of a particular method of contraception was influenced by many factors. Parity, marital status, age as well as HIV status did have some association with the preferred method of contraception. Our study shows that there could be varied reason for women chose types of contraception in this part of Malawi. Interventions that aim to increase access to family planning methods, should consider exploring the reasons why clients use some methods more than the other for better planning of these services. Absence of male clients accessing vasectomy at the hospital raises concern and more studies will be needed to determine the reason why men do not come forward for family planning services at Monkey Community Hospital.展开更多
Malawi has one of the highest rates of HIV prevalence in the world, and accounts for 4% of the total number of people living in sub-Saharan Africa with HIV. Approximately one million people in Malawi were living with ...Malawi has one of the highest rates of HIV prevalence in the world, and accounts for 4% of the total number of people living in sub-Saharan Africa with HIV. Approximately one million people in Malawi were living with HIV in 2016, with 24,000 HIV-related deaths. The Option B+ program, first implemented in Malawi, aimed to initiate ART for all pregnant women, regardless of their CD4 cell count or disease stage. This study serves to analyze and assess the effectiveness of Option B+ retention, in relation to the facilitation of how various social and cultural barriers were handled. A literature review of 29 publications was conducted. Careful evaluation of various studies indicates that although there is a myriad of reasons explaining low levels of retention, the women who were at the highest risk for low retention were young pregnant women who were treated on the same day of HIV-diagnosis. Solutions focused around women and their partners or communities showed promising evidence of success in increasing adherence, as these strategies likely provided women reliable social and emotional support to address major barriers to retention such as a lack of support from male partners, ineffective education from healthcare workers, or stigma towards their HIV disclosure statue.展开更多
Air pollution in Malawi is recognized as one of the key environmental issues. Out of nine key issues it is ranked eighth on priority issues. This has led to lagging behind in terms of research and reporting on the iss...Air pollution in Malawi is recognized as one of the key environmental issues. Out of nine key issues it is ranked eighth on priority issues. This has led to lagging behind in terms of research and reporting on the issue. However, the Malawi Government has made strides in implementing policies, acts and programs that are directly or indirectly concerned with the improvement and abatement of air quality to meet the millennium development goals (MDGs) especially goal number 7. The inventories and studies show that air quality in Malawi is still good, but future anticipated air quality problems are cause for worry such as impact on human health, global climate change and ozone depletion. Trends in consumption of ozone depleting substances (ODS) show a remarkable drive towards total reduction. Emissions standards are in place in line with World Health Organization (WHO) guidelines. Recommendations on how to deal with air quality issues have been proposed in the national state of environmental report (NSOER) in that: 1) there is a need for an operational framework for climate change programs in Malawi and;2) there is a need to unify climate change policies dealing with enforcement of ODS phasing out, alternative energy sources, emissions from vehicles and industries, and institutional and human resource capacity.展开更多
lntra-regional fish trade has potential in addressing the region＇s food and nutrition insecurity, as well as poverty reduction, by enabling movement of fish from countries of surplus to those with deficit. However, i...lntra-regional fish trade has potential in addressing the region＇s food and nutrition insecurity, as well as poverty reduction, by enabling movement of fish from countries of surplus to those with deficit. However, informal fish trade, just like all informal economic activities, has been overlooked and neglected in many national and regional policies, leading to obscurity of such an important part of the fisheries sector. This study examined the situation in the cross-border informal fish trade in order to deepen our understanding about the traders, the factors influencing the traders to use informal trade channels, the structure of the products traded and the challenges traders face, as well as propose policy direction to enhance the cross-border fish trade in the Southern Africa region. The study revealed that female traders dominated informal fish trade. In both Malawi and Zambia, an estimated 45,285.52 metric tonnes of fish valued at 82.14 million dollars and 102,263.9 metric tolmes of fish valued at 3.3 million dollars were informally traded. The key species involved in informal cross-border trade in Malawi and Zambia were the small pelagics, usipa （Engraulicypris sardella） from Lake Malawi and dagaa （Rastrineobola argentea） from Lake Tanganyika, respectively. It emerged from focus group discussions with informal fish traders and key informants＇ interviews with border post fish inspection and revenue collection officials that traders are put off by the cross-border regulations. Therefore, it is important for countries in the Southern African Development Community （SADC） region to regularize and formalize cross-border trade, particularly in small pelagic fish species, since this species plays a great role in the livelihoods, food and nutrition security of many people in the region, especially the rural and urban poor. It is also important for governments to support processors and traders to improve the quality of fish being traded, and decentralize issuing of the import/export certificates and other cross-border support documents. Lastly, there is a need to establish informal fish trade monitoring systems to adequately quantify the volumes traded.展开更多
We present the characteristics of the commonly diagnosed sexually transmitted infections (STI) at a clinic of Monkey Bay community hospital by a retrospective study. We conducted an audit of patients’ hospital record...We present the characteristics of the commonly diagnosed sexually transmitted infections (STI) at a clinic of Monkey Bay community hospital by a retrospective study. We conducted an audit of patients’ hospital records from a STIs clinic at Monkey Bay community hospital in Mangochi District (Malawi) covering a period from January 2019 to June 2019 (18 months). Data was tabulated in excel and analyses were made based on sex, age, male circumcision status, pregnancy and the pattern of STIs diagnosed within the chosen study period. A total number of 659 clients presented at STI clinic of Monkey Bay community hospital between January 2018 and June 2019. Out these clients, 409 (62%) were females and 250 (38%) were males. Most of the patients were in the age range of 25 years or above (447, 68%). Majority of the patients were HIV negative (523, 79%). Out of the 250 males, 113 (45%) were circumcised. Among female patients 56 of the 409 (14%) were pregnant. The most common presentations for all cases put together were lower abdominal pain (253, 38%), then urethral discharge (189, 29%), abnormal vaginal discharge (141, 21%), genital ulcer disease (64, 10%), in that order. Syphilis, genital warts, inguinal bubo and scrotal swelling were less common. The most common presentation in males was urethral discharge (178, 71%), while in females it was lower abdominal pain (214, 52%). Our audit showed that in Mangochi (Malawi) sexually transmitted diseases of various types are more common among young adults, females and uncircumcised men. There was no much difference in the percentage of STI’s between HIV positive and HIV negative people. These results point to an alarmingly high level of risky sexual behaviors among sexually active age groups in this part of Malawi, a country which still has one of the highest HIV prevalence in sub-Saharan Africa. This calls for continued and better research and control for transmission of STIs in the district.展开更多
This article analyses vulnerability to climate related shocks across five districts in the shire river basin of Malawi. The analysis employs an indicator approach that integrates biophysical and socio-economic indices...This article analyses vulnerability to climate related shocks across five districts in the shire river basin of Malawi. The analysis employs an indicator approach that integrates biophysical and socio-economic indices. Principal component statistical analysis was used to calculate an index for adaptive capacity, sensitivity and exposure to climate impact for each of the five districts. These indices were aggregated to develop a vulnerability index differentiated also by gender for the surveyed districts. The results showed that Chikwawa, Machinga and Blantyre appear to be more vulnerable to climate related shocks compared with Mwanza and Zomba. Women in Chikwawa are also found to be the most susceptible to the climate hazards impacts. To reduce vulnerability to climate impact, the study suggests that the national adaptation strategies adopted by the government should be mainstreamed into specific local adaptation actions that can be accessible and adopted by the community. Specific emphasis should be given to the improvement of women’s welfare through better access to productive assets and resources.展开更多
Battery based standalone SHS （solar home systems） are installed in Malawi to expedite rural electrification. A study was conducted to analyze the performance of SHS in low and high insolation areas of Malawi. It is ...Battery based standalone SHS （solar home systems） are installed in Malawi to expedite rural electrification. A study was conducted to analyze the performance of SHS in low and high insolation areas of Malawi. It is found that if the system is designed in accordance to procedures stipulated in Malawi standards, then it is capable of operating annually with mean performance ratio of 0.68, PV array production factor of 0.88 and system efficiency of 78% indicating a good system performance. The system is more reliable in high insulation areas （loss of load probability = 0.09） and when the battery charging is given priority during daytime, the overall system＇s reliability is improved by 40%. However, if the system is under-designed its performance ratio is reduced considerably and the system becomes less reliable. In overall, SHS in Malawi perform reliably if the system is well designed and maintained.展开更多
基金the Agricultural Research and Extension Trust of Malawi and the Centre of Excellence of Transformative Agriculture Commercialisation at Lilongwe University of Agriculture and Natural Resources for supporting this study.
文摘Sedimentation in reservoirs is a significant challenge that affects water storage capacity and operational efficiency.This study establishes a baseline sedimentation status for Mwimba Reservoir in Kasungu,Malawi,five years after its commissioning in 2017,using an integrated bathymetric survey and Geographic Information System(GIS)analysis.A bathymetric survey conducted in March 2022 collected depth measurements at 507 points along 23 transects,which were used to construct a Triangulated Irregular Network(TIN)model in ArcGIS for accurate volume calculations.Sediment concentration was determined from seven water samples using the filtration method.The original design volume of 89,200 m^(3)was compared to the current volume of 72,966 m^(3),indicating an 18.2% loss in capacity over the five-year period.Statistical analysis using a one-sample T-test confirmed that this reduction is significant(p=0.013).The annual sedimentation rate was estimated at 1.25 tonnes per year,and the reservoir’s projected operational life is 27.5 years if no intervention is undertaken.Despite a relatively low sedimentation rate compared to other regional reservoirs,targeted sediment management and further catchment analysis are essential.This study provides critical baseline data for future sediment monitoring,management,and conservation planning for Mwimba Reservoir and similar small water bodies in Sub-Saharan Africa.
文摘Objectives:This study aimed to explore childbirth fear and childbirth preparation among primigravid women in the late pregnancy from 36 to 40 weeks gestation.Methods:We purposively recruited 18 primigravid women into in-depth interviews,21 birth companions,and 13 health workers into focus group discussions.Participants were recruited from two community hospitals'maternity waiting homes in Lilongwe,Malawi.Semi-structured interview guides were used to collect data that were analyzed using content analysis.NVivo11 computer software was used to organize the data.Results:The four categories developed were:"ambivalent pregnancy feelings","dependence on traditional childbirth counseling","inadequate prenatal childbirth instruction"and"inconsistent roles of a birth companion".The findings suggest that primigravid women who were mainly exposed to traditional childbirth mentoring rather than professional care providers,experienced childbirth fear,and lacked proper psychosocial childbirth preparation.Conclusions:Childbirth fear among primigravid women emanate from personal;family;ineffective traditional counseling;and inadequate antenatal childbirth instruction.Birth companions may increase childbirth stress.However,our findings highlight birth companions as readily available psychosocial support resources among primigravid women.We recommend that professional childbirth instruction during antenatal care should be strengthened to surpass traditional childbirth counseling.Appropriateness and effectiveness of birth companions need to be carefully assessed.
文摘Rates of exclusive breastfeeding in Malawi remain low despite the acknowledged benefits of exclusive breastfeeding for the infant’s wellbeing and the prevention of mother-to-child transmission of HIV. Creating an environment supportive of exclusive breastfeeding is critical to increase the rate of exclusive breastfeeding among HIV-positive mothers. However, little is known on factors that influence the environment within which HIV-positive mothers in Malawi practise exclusive breastfeeding. Therefore, the exploratory qualitative study on which this article is based was conducted at the Chatinkha maternity unit of Queen Elizabeth Central Hospital in Malawi from April 16, 2009 to May 8, 2009 to explore perceived practice environment related barriers to exclusive breastfeeding among HIV-positive mothers. Data were obtained through indepth interviews with 16 purposively selected breastfeeding HIV-positive mothers between 18 and 35 years old and two focus group discussions with women of unknown HIV status. Semi-structured interview and focus group guides were utilised. Content analysis of data was done. Five main themes emerged regarding factors that may influence the environment within which exclusive breastfeeding was practised: 1) availability of resources;2) societal norms and cultural practices;3) mother-baby proximity;4) health workers’ attitudes and 5) disclosure of the mothers’ HIV status. A multi-sectoral approach to promote exclusive breastfeeding is suggested. This?should include community involvement because it is in the community where breastfeeding norms and cultural practices associated with breast-feeding are propagated.
基金Supported by National Institutes of Health(Grant No.5R01TW7599)
文摘Objective: To estimate risk factors of urban malaria in Blantyre, Malawi, with the goal of understanding the epidemiology and ecology of the disease, and informing malaria elimination policies for African urban cities that have markedly low prevalence of malaria.Methods: We used a case-control study design, with cases being children under the age of five years diagnosed with malaria, and matched controls obtained at hospital and communities. The data were obtained from Ndirande health facility catchment area. We then fitted a multivariate spatial logistic model of malaria risk. Covariate and risk factors in the model included child-specific, household and environmental risk factor(nearness to garden, standing water, river and swamps). The spatial component was assumed to follow a Gaussian process and model fitted using Bayesian inference.Results: Our findings showed that children who visited rural areas were 6 times more likely to have malaria than those who did not [odds ratio(OR) = 6.66, 95% confidence interval(CI): 4.79–9.61]. The risk of malaria increased with age of the child(OR = 1.01,95% CI: 1.003–1.020), but reduced with high socio-economic status compared to lower status(OR = 0.39, 95% CI: 0.25–0.54 for the highest level and OR = 0.67, 95% CI: 0.47–0.94 for the medium level). Although nearness to a garden, river and standing water showed increased risk, these effects were not significant. Furthermore, significant spatial clusters of risk emerged, which does suggest other factors do explain malaria risk variability apart from those established above.Conclusions: As malaria in urban areas is highly fuelled by rural-urban migration,emphasis should be to optimize information, education and communication prevention strategies, particularly targeting children from lower socio-economic position.
文摘Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents;21 in-depth interviews of children;15 focus group discussions with community members;62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.
基金supported by“Fudan Global Health Seed Grant(Grant No CMB13-131)of China”.
文摘Aim:The study aimed to explore factors related to the initiation and utilization of focused antenatal care(FANC)in the Southern District of Mzimba,Malawi.Methods:This study used an exploratory qualitative design.Total of 22 in-depth interviews with pregnant women and community midwife assistants were conducted from December 2015 to January 2016 in Mzimba.Thematic analysis approach was adopted to identify the facilitator and harriers of the FANC initiation and utilization.Results:Facilitator of FANC initiation and utilization included seeking pregnancy confirmation,medical treatment for an existing health problem and the support by community health extension workers.Barriers included the additional cost to free FANC service,lack of essential equipment,unfriendly adolescent reproductive health service,and HIV stigma.Conclusion:Early initiation of FANC relies on both woman’s awareness and community support.Promoting the use of FANC should focus on creating an enabling environment,e.g.,increasing investment of essential medical equipment,reducing additional costs of FANC services,eliminating the discrimination against adolescent pregnancy and people living with HIV,and strengthening health personnel’s training.
文摘Background: A number of suspected endemic districts with Trachoma have not been mapped in Malawi, and this contributes to delays for scaling up trachoma control activities. Objectives: To determine the prevalence of trachoma and associated risk factors in one of the suspected endemic districts (Salima District) in central Malawi and to generate information to guide policy decisions. Methods: A population-based survey conducted in randomly selected clusters in Salima District (population 418,672), centralMalawi. Children aged 1-9 years and adults aged 15 and above were assessed for clinical signs of trachoma. Results: In total, 884 households were enumerated within 36 clusters. A total of 2765 persons were examined for ocular signs of trachoma. The prevalence of trachomatous inflammation, follicular (TF) among children aged 1-9 years was 17.1% (95% CI 14.9-19.4). The prevalence of trachoma trichiasis (TT) in women aged 15 years and above was 1.3% (CI 0.7-2.3), while the prevalence in men was zero. The presence of a dirty face and lack of sanitation were significantly associated with trachoma follicular (P < 0.001). Conclusion: Prevalence rate of trachoma follicles (TF) in Central Malawi exceeds the WHO guidelines for the intervention with mass antibiotic distribution (TF > 10%), and warrants the trachoma SAFE (Surgery, Antibiotics, Face washing and Environmental hygiene) control strategy to be undertaken in Salima District.
文摘Introduction: Voluntary medical male circumcision (VMMC) reduces chances of contracting HIV during heterosexual intercourse in males, and risk of cervical cancer in their female sexual partners. However, its uptake among traditionally circumcising communities, where male circumcision carries a cultural significance, has not been studied. Previous research has focused on barriers to uptake of VMMC in non-circumcising communities. This study was conducted to determine socio-cultural barriers to VMMC uptake in order to identify culture-sensitive and evidence-based interventions to increase its uptake. Methodology: This exploratory mixed methods cross-sectional study generated quantitative data from 262 randomly sampled sexually active men;and qualitative data through four focus-group discussions with 58 purposely selected male participants and 10 key informants. Results: The study established that only 6.3% (n = 15) of those circumcised (90.8%, n = 238) were circumcised in clinical setting. Limited access to VMMC services, cost, pain, being attended to by female providers and cultural influences were the major hindrances to uptake of VMMC. Conclusion: Although there is a paradigm shift of preference from traditional male circumcision to VMMC in this community, its uptake is low. The study recommends that besides introducing mobile VMMC services, the Ministry of Health should collaborate with traditional circumcisers and local leaders to provide gender-and-culture-sensitive safer medical male circumcision services.
文摘Background: Postoperative nausea and vomiting are common complications of anaesthesia and surgery. Known risk factors include motion sickness, migraine, gender and types of surgery. Other possible risk factors for postoperative nausea and vomiting are ethnicity and genetics surgery. Objective: The main objective of the study was to describe factors associated with postoperative nausea and vomiting among adult Malawians. Methods: This was a prospective observational study. 138 adult patients were recruited into the study. Data were collected using a predesigned questionnaire. Patients were followed up to 18 hours postoperatively and any episodes of postoperative nausea and vomiting were noted. Results: A total of 138 patients were enrolled in the study. 78 were female (56.5%) and 60 were males (43.5%). The ages ranged from 18 to 87 years. The mean age was 36.9 years. The overall incidence of postoperative nausea and vomiting was 29.6%. It was higher among women than men. Patients with motion sickness had the highest incidence of postoperative nausea and vomiting (78.6%) followed by those with migraine (73.3%). Patients whose intraoperative systolic blood pressure fell <80 mmHg had an incidence of 71.4% and those who received postoperative opioids had an incidence of 37.7%. Conclusions: Patients with a history of migraine, motion sickness, whose intraoperative blood pressures fall below a systolic of 80 mmHg and who receive postoperative opioids are at an increased risk for postoperative nausea and vomiting.
文摘Vegetables are key to nutrition and economic security, especially for developing societies. Research in vegetables has been historically key. From early domestication efforts to modern-day breeding and value addition, research has enabled vegetable productivity to support the nutritional and economic needs of societies. Impactful research, however, requires competent research capacity and a guiding framework, in a continuously changing socio-climatic world. Vegetable research appraisal in Malawi, especially regarding capacity, focus, and a guiding framework, is lacking. By using 5 search engines and 506 analyzed publications, this review sought to first examine the existing research capacity in Malawi and assess the vegetable research focus in terms of both value chain analysis themes and specific vegetable tax. This approach allowed for the isolation and flagging out of key emerging issues from existing research that positively contextualize future vegetable research direction in Malawi. It has been found that Malawi has adequate institutional and expertise capacity to further vegetable research. The identified challenges include local funding and infrastructural capacity to leverage donor funding. Three key emerging issues of climate change, modeling, and biofortification in vegetable crops have been identified. It is suggested that, with Malawi facing the climate change challenge, research focus in these areas, will enhance not only nutritional and economic security, but also overall climate change readiness. Key to climate change readiness is the involvement of indigenous vegetable production. As a package, vegetable cultivation can play a critical role in contributing to the achievement of pillar 1 of the Malawi vision 2063, which seeks to leverage agricultural productivity and commercialization with a focus on climate change resilience.
文摘Availability of antiretroviral therapy and prevention of mother to child transmission of HIV programmes have increased childbearing decisions in people living with HIV. However, pregnancy decisions of married women living with HIV have not been adequately reported in Malawi. In order to provide information to inform the development of antiretroviral and family planning services targeted to the unique needs of women living with HIV, this study explored pregnancy decisions of women living with HIV in rural southern Malawi. Twenty in-depth interviews on married women living with HIV selected purposively were conducted in two antiretroviral clinics of patrilineal Chikhwawa and matrilineal Chiradzulu districts in 2010. With their pregnancy and child rearing experiences, the women who got pregnant after a positive HIV diagnosis decided to never get pregnant again. Their lived experiences of motherhood when living with HIV play a major role in their pregnancy decisions despite free access to antiretroviral therapy, which has improved the quality of their life’s and survival. Societies in Malawi must accept this behavioural change by married women living with HIV and their needs for family planning. Health care workers must be knowledgeable and sensitive about it and assist women living with HIV who are willing to adapt their pregnant decisions based on living experiences.
文摘In the past two to three years, the world has been heavily affected by the infectious coronavirus disease and Malawi has not been spared due to its interconnection with neighboring countries. There is no management tool to identify and model the vulnerabilities of Malawi’s districts in prioritizing health services as far as coronavirus prevalence and other infectious diseases are concerned. The aim of this study was to model coronavirus vulnerability in all districts in Malawi using Geographic Information System (GIS) to monitor the disease’s cumulative prevalence over the severely affected period between 2020 and 2021. To achieve this, four parameters associated with coronavirus prevalence, including population density, percentage of older people, temperature, and humidity, were prepared in a GIS environment and used in the modelling process. A multiscale geographically weighted regression (MGWR) model was used to model and determine the vulnerability of coronavirus in Malawi. In the MGWR modelling, the Fixed Spatial Kernel was used following a Gaussian distribution model type. The Results indicated that population density and older people (age greater than 60 years) have a more significant impact on coronavirus prevalence in Malawi. The modelling further shows that Malawi, between April 2020 and May 2021, Lilongwe, Blantyre and Thyolo were more vulnerable to coronavirus than other districts. This research has shown that spatial variability of Covid-19 cases using MGWR has the potential of providing useful insights to policymakers for targeted interventions that could otherwise not be possible to detect using non-geovisualization techniques.
文摘Cholera remains a public health threat in most developing countries in Asia and Africa including Malawi with seasonal recurrent outbreaks. Malawi’s recent Cholera outbreak in 2022 and 2023, exhibited higher morbidity and mortality rates than the past two decades. Lack of spatiotemporal-based technology and variability assessment tools in Malawi’s Cholera monitoring and management, limit our understanding of the disease’s epidemiology. The present work developed a spatiotemporal variability model for Cholera disease at district level and its relationship to socioeconomic and climatic factors based on cumulative confirmed Cholera cases in Malawi from March 2022 to July 2023 using Z-score statistic and multiscale geographically weighted regression (MGWR) in a Geographical Information System (GIS). We found out that socioeconomic factors such as access to safe drinking water, population density and poverty level, and climatic factors including temperature and rainfall strongly influenced Cholera prevalence in a complex and multifaceted manner. The model shows that Lilongwe, Mangochi, Blantyre and Balaka districts were highly vulnerable to Cholera disease followed by lakeshore districts of Salima, Nkhotakota, Nkhata-Bay and Karonga than other districts. We recommend strategic measures such as Water, Sanitation, and Hygiene (WASH) interventions, community awareness on proper water storage, Cholera case management, vaccination campaigns and spatial-based surveillance systems in the most affected districts. This research has shown that MGWR, as a surveillance system, has the potential of providing insights on the disease’s spatial patterns for public health authorities to identify high-risk districts and implement early response interventions to reduce the spread of the disease.
文摘To determine commonly used methods of contraception at Monkey Bay Community hospital, to compare different methods of contraception used by people of various age groups, parity, Human Immunodeficiency Virus (HIV) and Marital status, a clinical audit of family planning methods used by clients at Monkey Community hospital from January 2018 to June 2019 was done. Data was collected from the registers. A total number of 1734 clients reported at family planning clinic of Monkey-Bay Community Hospital between January 2018 and June 2019. All the clients were females. Most of these clients were in the age range of 15 - 34 years (83.33%). There were 1,486 (87%) HIV negative clients, 208 (12%) HIV positive clients and 24 (1%) had unknown HIV status. Most clients had a parity of 1 - 2 (905, 52.71%) followed by 3 - 4 (540, 31.45%) and 5 or plus (272, 15.84%). There were more married people (1641, 97.23%) than unmarried ones (46, 2.73%). There was only one person who was divorced (1, 0.05%). Education status was not recorded. The five commonly used contraceptive methods were: Intramuscular (IM) injectable Depo-IM (1366, 79.51%), Jadelle (122, 7.10%), Subcutaneous (SC) injectable Depo-SC (65, 3.78%), Combined Oral Contraceptives (COC) (60, 3.49%) and Implanon (40, 2.33%). None of the clients was used female condoms as a method of contraception. The contraceptive use was common between the age group of 15 - 24 (707, 44.92%) and 25 - 34 (709, 45%). Depo-IM was most used in age group 25 - 34 (44.5%) while Jadelle was mostly used by 15 - 24 years old (48%). 1181 clients (79.5%) of HIV negative clients used Depo-IM as the contraceptive method while 164 clients (78.8%) of HIV positive clients used Depo IM as a method of contraception. More HIV negative clients used Jadelle and COC as compared to HIV positive clients. The choice of a particular method of contraception was influenced by many factors. Parity, marital status, age as well as HIV status did have some association with the preferred method of contraception. Our study shows that there could be varied reason for women chose types of contraception in this part of Malawi. Interventions that aim to increase access to family planning methods, should consider exploring the reasons why clients use some methods more than the other for better planning of these services. Absence of male clients accessing vasectomy at the hospital raises concern and more studies will be needed to determine the reason why men do not come forward for family planning services at Monkey Community Hospital.
文摘Malawi has one of the highest rates of HIV prevalence in the world, and accounts for 4% of the total number of people living in sub-Saharan Africa with HIV. Approximately one million people in Malawi were living with HIV in 2016, with 24,000 HIV-related deaths. The Option B+ program, first implemented in Malawi, aimed to initiate ART for all pregnant women, regardless of their CD4 cell count or disease stage. This study serves to analyze and assess the effectiveness of Option B+ retention, in relation to the facilitation of how various social and cultural barriers were handled. A literature review of 29 publications was conducted. Careful evaluation of various studies indicates that although there is a myriad of reasons explaining low levels of retention, the women who were at the highest risk for low retention were young pregnant women who were treated on the same day of HIV-diagnosis. Solutions focused around women and their partners or communities showed promising evidence of success in increasing adherence, as these strategies likely provided women reliable social and emotional support to address major barriers to retention such as a lack of support from male partners, ineffective education from healthcare workers, or stigma towards their HIV disclosure statue.
文摘Air pollution in Malawi is recognized as one of the key environmental issues. Out of nine key issues it is ranked eighth on priority issues. This has led to lagging behind in terms of research and reporting on the issue. However, the Malawi Government has made strides in implementing policies, acts and programs that are directly or indirectly concerned with the improvement and abatement of air quality to meet the millennium development goals (MDGs) especially goal number 7. The inventories and studies show that air quality in Malawi is still good, but future anticipated air quality problems are cause for worry such as impact on human health, global climate change and ozone depletion. Trends in consumption of ozone depleting substances (ODS) show a remarkable drive towards total reduction. Emissions standards are in place in line with World Health Organization (WHO) guidelines. Recommendations on how to deal with air quality issues have been proposed in the national state of environmental report (NSOER) in that: 1) there is a need for an operational framework for climate change programs in Malawi and;2) there is a need to unify climate change policies dealing with enforcement of ODS phasing out, alternative energy sources, emissions from vehicles and industries, and institutional and human resource capacity.
文摘lntra-regional fish trade has potential in addressing the region＇s food and nutrition insecurity, as well as poverty reduction, by enabling movement of fish from countries of surplus to those with deficit. However, informal fish trade, just like all informal economic activities, has been overlooked and neglected in many national and regional policies, leading to obscurity of such an important part of the fisheries sector. This study examined the situation in the cross-border informal fish trade in order to deepen our understanding about the traders, the factors influencing the traders to use informal trade channels, the structure of the products traded and the challenges traders face, as well as propose policy direction to enhance the cross-border fish trade in the Southern Africa region. The study revealed that female traders dominated informal fish trade. In both Malawi and Zambia, an estimated 45,285.52 metric tonnes of fish valued at 82.14 million dollars and 102,263.9 metric tolmes of fish valued at 3.3 million dollars were informally traded. The key species involved in informal cross-border trade in Malawi and Zambia were the small pelagics, usipa （Engraulicypris sardella） from Lake Malawi and dagaa （Rastrineobola argentea） from Lake Tanganyika, respectively. It emerged from focus group discussions with informal fish traders and key informants＇ interviews with border post fish inspection and revenue collection officials that traders are put off by the cross-border regulations. Therefore, it is important for countries in the Southern African Development Community （SADC） region to regularize and formalize cross-border trade, particularly in small pelagic fish species, since this species plays a great role in the livelihoods, food and nutrition security of many people in the region, especially the rural and urban poor. It is also important for governments to support processors and traders to improve the quality of fish being traded, and decentralize issuing of the import/export certificates and other cross-border support documents. Lastly, there is a need to establish informal fish trade monitoring systems to adequately quantify the volumes traded.
文摘We present the characteristics of the commonly diagnosed sexually transmitted infections (STI) at a clinic of Monkey Bay community hospital by a retrospective study. We conducted an audit of patients’ hospital records from a STIs clinic at Monkey Bay community hospital in Mangochi District (Malawi) covering a period from January 2019 to June 2019 (18 months). Data was tabulated in excel and analyses were made based on sex, age, male circumcision status, pregnancy and the pattern of STIs diagnosed within the chosen study period. A total number of 659 clients presented at STI clinic of Monkey Bay community hospital between January 2018 and June 2019. Out these clients, 409 (62%) were females and 250 (38%) were males. Most of the patients were in the age range of 25 years or above (447, 68%). Majority of the patients were HIV negative (523, 79%). Out of the 250 males, 113 (45%) were circumcised. Among female patients 56 of the 409 (14%) were pregnant. The most common presentations for all cases put together were lower abdominal pain (253, 38%), then urethral discharge (189, 29%), abnormal vaginal discharge (141, 21%), genital ulcer disease (64, 10%), in that order. Syphilis, genital warts, inguinal bubo and scrotal swelling were less common. The most common presentation in males was urethral discharge (178, 71%), while in females it was lower abdominal pain (214, 52%). Our audit showed that in Mangochi (Malawi) sexually transmitted diseases of various types are more common among young adults, females and uncircumcised men. There was no much difference in the percentage of STI’s between HIV positive and HIV negative people. These results point to an alarmingly high level of risky sexual behaviors among sexually active age groups in this part of Malawi, a country which still has one of the highest HIV prevalence in sub-Saharan Africa. This calls for continued and better research and control for transmission of STIs in the district.
文摘This article analyses vulnerability to climate related shocks across five districts in the shire river basin of Malawi. The analysis employs an indicator approach that integrates biophysical and socio-economic indices. Principal component statistical analysis was used to calculate an index for adaptive capacity, sensitivity and exposure to climate impact for each of the five districts. These indices were aggregated to develop a vulnerability index differentiated also by gender for the surveyed districts. The results showed that Chikwawa, Machinga and Blantyre appear to be more vulnerable to climate related shocks compared with Mwanza and Zomba. Women in Chikwawa are also found to be the most susceptible to the climate hazards impacts. To reduce vulnerability to climate impact, the study suggests that the national adaptation strategies adopted by the government should be mainstreamed into specific local adaptation actions that can be accessible and adopted by the community. Specific emphasis should be given to the improvement of women’s welfare through better access to productive assets and resources.
文摘Battery based standalone SHS （solar home systems） are installed in Malawi to expedite rural electrification. A study was conducted to analyze the performance of SHS in low and high insolation areas of Malawi. It is found that if the system is designed in accordance to procedures stipulated in Malawi standards, then it is capable of operating annually with mean performance ratio of 0.68, PV array production factor of 0.88 and system efficiency of 78% indicating a good system performance. The system is more reliable in high insulation areas （loss of load probability = 0.09） and when the battery charging is given priority during daytime, the overall system＇s reliability is improved by 40%. However, if the system is under-designed its performance ratio is reduced considerably and the system becomes less reliable. In overall, SHS in Malawi perform reliably if the system is well designed and maintained.
