Background Guillain-Barré syndrome (GBS), the most common cause of acute paralytic neuropathy, covers a number of recognizably different variants. We aimed to evaluate the clinical characteristics of the patients with GBS and the outcome results of the patients after rehabilitation.Methods We enrolled 24 adult patients with GBS and evaluated their demographic characteristics, signs, complications, functional levels, and residual symptoms at admission, discharge, and during the 1st and 3rd-year follow-up visits. Functional Independence Scale (FIM), Functional Ambulation Scale (FAS), Hughes functional grading scale, Six-Minute Walking Test (6MWT), and Fatigue Severity Scale (FSS) were used for patient evaluation.Results In this study, patients with a mean age of 47.29 ± 16.2 years (40% female) were hospitalized for an average of 28.91 ± 25.6 days. The predominant symptoms experienced by these patients were fatigue (100%), neuropathic pain (70.8%), joint pain (54.2%), and autonomic dysfunction (50%). Significant changes were observed in FIM, Hughes functional grading scale, FAS, 6MWT, and MRC score at admission, discharge, and 1st/3rd-year follow-ups (p=0.000, p=0.000, p=0.000, p=0.001, p=0.000, respectively). Fatigue and Hughes score increased significantly with age (p=0.019, r=0.475; p=0.041, r=0.419, respectively). Negative correlations were found between age and FAS, 6MWT, and MRC score at 1st-year follow-up (p=0.025, r=-0.456; p=0.027, r=-0.450; p=0.008, r=-0.528). FSS was above 4 before admission and in 53.1% at 3rd-year follow-up, correlating negatively with 6MWT and MRC sum score. GBS clinical types showed no significant differences. ConclusionRehabilitation improves functional improvement in GBS patients, with long-term benefits observed. However, residual symptoms such as fatigue and neuropathic pain may persist despite functional improvement. These findings highlight the importance of incorporating rehabilitation into the management of GBS and addressing residual symptoms to improve patient outcomes.
吉兰-巴罗综合征(GBS)是急性麻痹性神经病变最常见的病因，涵盖了许多可识别的不同变体。我们的目的是评估GBS患者的临床特征和患者康复后的结果。方法:我们招募了24例成年GBS患者，并在入院、出院、1年和3年随访期间评估他们的人口统计学特征、体征、并发症、功能水平和残留症状。采用功能独立量表(FIM)、功能步行量表(FAS)、Hughes功能分级量表、6分钟步行测试(6MWT)和疲劳严重程度量表(FSS)对患者进行评估。结果本组患者平均年龄47.29±16.2岁，其中女性占40%，平均住院时间28.91±25.6天。这些患者的主要症状是疲劳(100%)、神经性疼痛(70.8%)、关节疼痛(54.2%)和自主神经功能障碍(50%)。入院、出院和1 /3年随访时，FIM、Hughes功能分级量表、FAS、6MWT和MRC评分均发生显著变化(p=0.000, p=0.000, p=0.000, p=0.001, p=0.000)。随着年龄的增长，疲劳和休斯评分显著增加(p=0.019, r=0.475;P =0.041, r=0.419)。1年随访时，年龄与FAS、6MWT、MRC评分呈负相关(p=0.025, r=-0.456;p = 0.027, r = -0.450;p = 0.008, r = -0.528)。入院前FSS≥4分，随访3年时FSS≥53.1%，与6MWT、MRC总分呈负相关。GBS临床分型差异无统计学意义。结论康复治疗可改善GBS患者的功能，并可观察到远期疗效。然而，尽管功能改善，残余症状如疲劳和神经性疼痛可能持续存在。这些发现强调了将康复纳入GBS管理和解决残留症状以改善患者预后的重要性。
{"title":"Three-year follow-up outcomes of adult patients with Guillain-Barré Syndrome after rehabilitation","authors":"Fatma Ballı Uz, Cuma Uz, Ozgur Zeliha Karaahmet","doi":"10.4314/mmj.v35i3.4","DOIUrl":"https://doi.org/10.4314/mmj.v35i3.4","url":null,"abstract":"Background Guillain-Barré syndrome (GBS), the most common cause of acute paralytic neuropathy, covers a number of recognizably different variants. We aimed to evaluate the clinical characteristics of the patients with GBS and the outcome results of the patients after rehabilitation.Methods We enrolled 24 adult patients with GBS and evaluated their demographic characteristics, signs, complications, functional levels, and residual symptoms at admission, discharge, and during the 1st and 3rd-year follow-up visits. Functional Independence Scale (FIM), Functional Ambulation Scale (FAS), Hughes functional grading scale, Six-Minute Walking Test (6MWT), and Fatigue Severity Scale (FSS) were used for patient evaluation.Results In this study, patients with a mean age of 47.29 ± 16.2 years (40% female) were hospitalized for an average of 28.91 ± 25.6 days. The predominant symptoms experienced by these patients were fatigue (100%), neuropathic pain (70.8%), joint pain (54.2%), and autonomic dysfunction (50%). Significant changes were observed in FIM, Hughes functional grading scale, FAS, 6MWT, and MRC score at admission, discharge, and 1st/3rd-year follow-ups (p=0.000, p=0.000, p=0.000, p=0.001, p=0.000, respectively). Fatigue and Hughes score increased significantly with age (p=0.019, r=0.475; p=0.041, r=0.419, respectively). Negative correlations were found between age and FAS, 6MWT, and MRC score at 1st-year follow-up (p=0.025, r=-0.456; p=0.027, r=-0.450; p=0.008, r=-0.528). FSS was above 4 before admission and in 53.1% at 3rd-year follow-up, correlating negatively with 6MWT and MRC sum score. GBS clinical types showed no significant differences. ConclusionRehabilitation improves functional improvement in GBS patients, with long-term benefits observed. However, residual symptoms such as fatigue and neuropathic pain may persist despite functional improvement. These findings highlight the importance of incorporating rehabilitation into the management of GBS and addressing residual symptoms to improve patient outcomes.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136213785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sezgi Gullu Erciyestepe, Ahmet Birtan Boran, Merve Sezer Yildirim, Mert Erciyestepe
IntroductionSurgical site infection (SSI) is a widely seen postoperative complication that causes a decrease in life quality and an economic burden. In this study, we aim to find the predictive values of preoperative and postoperative neutrophile lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) values for SSI.MethodsIn this retrospective study, 698 patients who had total abdominal hysterectomy operations with benign indications and confirmed histopathological results were accessed. In this study, the correlation of preoperative NLR, preoperative PLR, postoperative NLR, and postoperative PLR, with the occurrence of postoperative surgical site infection complications were examined. Results The overall SSI rate was 9.46% (n = 66) with 30 days follow-up postoperatively. Preoperative NLR and PLR values of the patients who had SSIs were significantly lower than the control group (p < 0.05). Postoperative NLR and PLR values of the patients who had SSIs were significantly higher than control group (p < 0.05). In the patients who had postoperative SSIs, the increase of the values of postoperative NLR and PLR were significantly higher than the control group (p < 0.05).ConclusionsIn our study, hematological markers of NLR and PLR were found to be independent and significant predictive markers for SSI.
{"title":"Is it possible to predict Surgical Site Infection?","authors":"Sezgi Gullu Erciyestepe, Ahmet Birtan Boran, Merve Sezer Yildirim, Mert Erciyestepe","doi":"10.4314/mmj.v35i3.9","DOIUrl":"https://doi.org/10.4314/mmj.v35i3.9","url":null,"abstract":"IntroductionSurgical site infection (SSI) is a widely seen postoperative complication that causes a decrease in life quality and an economic burden. In this study, we aim to find the predictive values of preoperative and postoperative neutrophile lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) values for SSI.MethodsIn this retrospective study, 698 patients who had total abdominal hysterectomy operations with benign indications and confirmed histopathological results were accessed. In this study, the correlation of preoperative NLR, preoperative PLR, postoperative NLR, and postoperative PLR, with the occurrence of postoperative surgical site infection complications were examined. Results The overall SSI rate was 9.46% (n = 66) with 30 days follow-up postoperatively. Preoperative NLR and PLR values of the patients who had SSIs were significantly lower than the control group (p < 0.05). Postoperative NLR and PLR values of the patients who had SSIs were significantly higher than control group (p < 0.05). In the patients who had postoperative SSIs, the increase of the values of postoperative NLR and PLR were significantly higher than the control group (p < 0.05).ConclusionsIn our study, hematological markers of NLR and PLR were found to be independent and significant predictive markers for SSI.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136212911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The case study teaching method is important in imparting critical thinking and clinical reasoning skills in nursing students. The self-efficacy of the nurse educators towards the use of the case study teaching method is a critical aspect of determining the quality of teaching using this method. This study, therefore, aimed at assessing the self-efficacy of the nurse educators towards the use of the case study teaching method in Malawi. MethodA cross-sectional study utilizing a quantitative research design was conducted at eight nursing colleges that are under the Christian Health Association of Malawi. Only nursing colleges offering college diplomas in nursing and midwifery technician were involved. A total of 145 nurse educators completed the Self-Efficacy towards Teaching Inventory. The computer software of Statistical Package for Social Sciences version 23.0 was used to analyze the data.Results The results show that the nurse educators are confident in using the case study teaching method (mean=78.4, SD=11.166). The study results also show that there are differences in mean scores between the nurse educators who attended an education workshop and those who did not (t=5.2334; P<0.001). Conclusion The study indicates that Malawian nurse educators have moderate levels of self-efficacy in using the case study teaching method. This study, therefore, has shown a need for nurse educators to participate in strategies that can increase their level of self-efficacy in using case studies.
{"title":"The Self-efficacy of Malawian Nursing Educators towards the use of Case Study Teaching Method","authors":"Burnett Chila Chiona, Masauko Msiska","doi":"10.4314/mmj.v35i2.3","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.3","url":null,"abstract":"Introduction The case study teaching method is important in imparting critical thinking and clinical reasoning skills in nursing students. The self-efficacy of the nurse educators towards the use of the case study teaching method is a critical aspect of determining the quality of teaching using this method. This study, therefore, aimed at assessing the self-efficacy of the nurse educators towards the use of the case study teaching method in Malawi. MethodA cross-sectional study utilizing a quantitative research design was conducted at eight nursing colleges that are under the Christian Health Association of Malawi. Only nursing colleges offering college diplomas in nursing and midwifery technician were involved. A total of 145 nurse educators completed the Self-Efficacy towards Teaching Inventory. The computer software of Statistical Package for Social Sciences version 23.0 was used to analyze the data.Results The results show that the nurse educators are confident in using the case study teaching method (mean=78.4, SD=11.166). The study results also show that there are differences in mean scores between the nurse educators who attended an education workshop and those who did not (t=5.2334; P<0.001). Conclusion The study indicates that Malawian nurse educators have moderate levels of self-efficacy in using the case study teaching method. This study, therefore, has shown a need for nurse educators to participate in strategies that can increase their level of self-efficacy in using case studies.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundMost imaging examinations use ionising radiation which causes biological effects on the body. For this reason, only justified examinations should be requested by adequately completing the radiology request form (RRF) by clinicians. The RRF allows radiographers and radiologists to assess if the benefit outweighs the risk associated with medical radiation exposure. Inadequately or incorrectly filled RRFs leads to unnecessary radiation exposures, imaging errors, and delays in performing the examination. Therefore, this study aimed at auditing the adequacy of completion of general RRFs at St. Francis’ Hospital of Katete District in Zambia.MethodsThis was a quantitative study in which RRFs for general radiography from January to December 2020 were audited. Data were collected retrospectively using a checklist from a total of 974 RRFs. The filled-in forms were assessed for completeness of information related to the patient, examination, and referring clinician. Data were analysed using descriptive statistics. The standard of completeness was based on the Royal College of Radiologists (RCR) guidelines requiring all the designated variables completed on the RRF.ResultsMost N=881(90.5%), RRFs were incompletely filled. With regards to patient’s identification, the findings revealed N=4(0.5%), N=597(61.3%), N=3(0.4%), and N=2(0.3%) RRFs devoid of patient’s name, hospital number, age, and gender, respectively. Regarding the examination, the findings revealed N=3(0.4%), N=68(7%), N=449(46.2%), and N=336 (37%) RRFs devoid of requested examination, indication, clinical history, and level of urgency, respectively. Regarding the referrer, the findings revealed N=135(13.9%), N=173(17.8 %), N=472(48.5%), and N=31(3.2%) RRFs were devoid of information relating to the ward, clinicians’ name, referring department, and signature, respectively.Conclusion This audit reports that most of the RRFs were incompletely filled-in at St. Francis’ Hospital. Furthermore, the hospital number, clinical history and level of urgency were the frequently unfilled variables. Overall, there were gaps in completion of RRFs requiring remedying.
{"title":"Adequacy of completion of radiology request forms at St. Francis’ Hospital of Katete District: A clinical audit in Zambia","authors":"Mubanga Bwalya, Osward Bwanga, John. Y. Mvula, Foster Munsanje, Bretina Muntanga","doi":"10.4314/mmj.v35i2.7","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.7","url":null,"abstract":"BackgroundMost imaging examinations use ionising radiation which causes biological effects on the body. For this reason, only justified examinations should be requested by adequately completing the radiology request form (RRF) by clinicians. The RRF allows radiographers and radiologists to assess if the benefit outweighs the risk associated with medical radiation exposure. Inadequately or incorrectly filled RRFs leads to unnecessary radiation exposures, imaging errors, and delays in performing the examination. Therefore, this study aimed at auditing the adequacy of completion of general RRFs at St. Francis’ Hospital of Katete District in Zambia.MethodsThis was a quantitative study in which RRFs for general radiography from January to December 2020 were audited. Data were collected retrospectively using a checklist from a total of 974 RRFs. The filled-in forms were assessed for completeness of information related to the patient, examination, and referring clinician. Data were analysed using descriptive statistics. The standard of completeness was based on the Royal College of Radiologists (RCR) guidelines requiring all the designated variables completed on the RRF.ResultsMost N=881(90.5%), RRFs were incompletely filled. With regards to patient’s identification, the findings revealed N=4(0.5%), N=597(61.3%), N=3(0.4%), and N=2(0.3%) RRFs devoid of patient’s name, hospital number, age, and gender, respectively. Regarding the examination, the findings revealed N=3(0.4%), N=68(7%), N=449(46.2%), and N=336 (37%) RRFs devoid of requested examination, indication, clinical history, and level of urgency, respectively. Regarding the referrer, the findings revealed N=135(13.9%), N=173(17.8 %), N=472(48.5%), and N=31(3.2%) RRFs were devoid of information relating to the ward, clinicians’ name, referring department, and signature, respectively.Conclusion This audit reports that most of the RRFs were incompletely filled-in at St. Francis’ Hospital. Furthermore, the hospital number, clinical history and level of urgency were the frequently unfilled variables. Overall, there were gaps in completion of RRFs requiring remedying.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatma Tuygar- Okutucu, Gamzenur Cimilli- Senocak, Hacer A. Ceyhun, Halil Ozcan
BackgroundPremenstrual symptoms at reproductive age resemble menopausal symptoms and have symptomatic commonalities. We hypothesized that women with previous premenstrual syndrome may be more prone to develop menopausal symptoms and aimed to investigate the association of menopausal symptoms and menopausal quality of life with premenstrual symptoms. MethodsThe study included 120 postmenopausal women. We evaluated the current menopausal symptoms with menopause rating scale (MRS) and quality of life with menopause-specific quality of life scale (MSQoL), previous premenstrual symptoms with premenstrual syndrome scale (PMSS) retrospectively and compared the associations statistically. ResultsAccording to retrospective PMSS, participants were divided into two groups; with and without premenstrual syndrome (PMS). PMS group included 29 (24.2%) participants and 91 (75.8%) participants were in group without PMS. Sociodemographic characteristics of groups were similar. Somatic and psychological symptoms were higher in MRS of PMS group. Evaluating the MSQoL; psychosocial and physical symptoms were impaired in the PMS group. Vasomotor, urogenital and sexual symptoms were similar in both groups. ConclusionPremenstrual and menopausal symptoms were related in terms of somatic, and psychosocial symptoms but not in vasomotor, urogenital, and sexual symptoms. It seems that women with previous premenstrual symptoms are more likely to develop menopausal symptoms in some ways. However, a prospective longitudinal study may be needed for more conclusive results.
{"title":"Association of menopausal symptoms and menopausal quality of life with premenstrual syndrome","authors":"Fatma Tuygar- Okutucu, Gamzenur Cimilli- Senocak, Hacer A. Ceyhun, Halil Ozcan","doi":"10.4314/mmj.v35i2.4","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.4","url":null,"abstract":"BackgroundPremenstrual symptoms at reproductive age resemble menopausal symptoms and have symptomatic commonalities. We hypothesized that women with previous premenstrual syndrome may be more prone to develop menopausal symptoms and aimed to investigate the association of menopausal symptoms and menopausal quality of life with premenstrual symptoms. MethodsThe study included 120 postmenopausal women. We evaluated the current menopausal symptoms with menopause rating scale (MRS) and quality of life with menopause-specific quality of life scale (MSQoL), previous premenstrual symptoms with premenstrual syndrome scale (PMSS) retrospectively and compared the associations statistically. ResultsAccording to retrospective PMSS, participants were divided into two groups; with and without premenstrual syndrome (PMS). PMS group included 29 (24.2%) participants and 91 (75.8%) participants were in group without PMS. Sociodemographic characteristics of groups were similar. Somatic and psychological symptoms were higher in MRS of PMS group. Evaluating the MSQoL; psychosocial and physical symptoms were impaired in the PMS group. Vasomotor, urogenital and sexual symptoms were similar in both groups. ConclusionPremenstrual and menopausal symptoms were related in terms of somatic, and psychosocial symptoms but not in vasomotor, urogenital, and sexual symptoms. It seems that women with previous premenstrual symptoms are more likely to develop menopausal symptoms in some ways. However, a prospective longitudinal study may be needed for more conclusive results.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Themba Mzilahowa, Steven Gowelo, John Chiphwanya, Andrew Bauleni, Mavuto Mukaka
Introduction Malawi has scaled up distribution and use of LLINs but their effectiveness depends on vector behaviour. This study reports information on where and when peak biting takes place by Anopheles vectors at two study sites in northern Malawi. MethodsThe study was carried out at a single village each in Nkhata Bay and Karonga districts, northern Malawi. Monthly, three teams of four people each sampled mosquitoes using Human Landing Collections (HLCs) from 6.00 pm to 6.00 am. Mosquitoes were counted and identified by PCR. Plasmodium falciparum sporozoites were detected by ELISA and an entomological inoculation rate was estimated. ResultsA total of 4,668 and 2,079 mosquitoes were sampled in Nkhata Bay and Karonga districts respectively. An. funestus s.s was common (91.3%; n = 2,611) in Nkhata Bay while An. arabiensis was common (96.9%; n = 706) in Karonga. Pf sporozoite rates varied from 0.8% (4/484) to 3.3% (51/1558). Individuals in Nkhata Bay received more bites (approx. 200 bites/ person/ night) compared to Karonga (approx. 50 bites/ person/ night). An. funestus was more likely to bite indoors (p=0.002) while An. arabiensis was (p=0.05) more likely to bite outdoors. Furthermore, An. funestus peak biting was in the early morning hours from 4:00 am (approx. 331 and 177 bites/ person/ night indoors and outdoors respectively) and remained high till 6:00 am. An. arabiensis peak biting (approx. 63 and 62 bites/ person/ night indoors and outdoors respectively) was around mid-night (12:00). An EIR of 108.4 infective bites/ person/ year was estimated for Nkhata Bay compared to 9.1 infective bites/ person/ year for Karonga.Conclusion An. funestus s.s. had a considerable Pf sporozite infection rate and EIR. The shift in biting behaviour shown by this species poses a challenge to malaria control. Further studies are required to understand the biting behaviour of Anopheles vectors in Malawi.
{"title":"Anopheles funestus sensu stricto Giles (Diptera:Culicidae) bites after sunrise at two rural villages in northern Malawi and its implications for malaria vector control","authors":"Themba Mzilahowa, Steven Gowelo, John Chiphwanya, Andrew Bauleni, Mavuto Mukaka","doi":"10.4314/mmj.v35i2.2","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.2","url":null,"abstract":"Introduction Malawi has scaled up distribution and use of LLINs but their effectiveness depends on vector behaviour. This study reports information on where and when peak biting takes place by Anopheles vectors at two study sites in northern Malawi. MethodsThe study was carried out at a single village each in Nkhata Bay and Karonga districts, northern Malawi. Monthly, three teams of four people each sampled mosquitoes using Human Landing Collections (HLCs) from 6.00 pm to 6.00 am. Mosquitoes were counted and identified by PCR. Plasmodium falciparum sporozoites were detected by ELISA and an entomological inoculation rate was estimated. ResultsA total of 4,668 and 2,079 mosquitoes were sampled in Nkhata Bay and Karonga districts respectively. An. funestus s.s was common (91.3%; n = 2,611) in Nkhata Bay while An. arabiensis was common (96.9%; n = 706) in Karonga. Pf sporozoite rates varied from 0.8% (4/484) to 3.3% (51/1558). Individuals in Nkhata Bay received more bites (approx. 200 bites/ person/ night) compared to Karonga (approx. 50 bites/ person/ night). An. funestus was more likely to bite indoors (p=0.002) while An. arabiensis was (p=0.05) more likely to bite outdoors. Furthermore, An. funestus peak biting was in the early morning hours from 4:00 am (approx. 331 and 177 bites/ person/ night indoors and outdoors respectively) and remained high till 6:00 am. An. arabiensis peak biting (approx. 63 and 62 bites/ person/ night indoors and outdoors respectively) was around mid-night (12:00). An EIR of 108.4 infective bites/ person/ year was estimated for Nkhata Bay compared to 9.1 infective bites/ person/ year for Karonga.Conclusion An. funestus s.s. had a considerable Pf sporozite infection rate and EIR. The shift in biting behaviour shown by this species poses a challenge to malaria control. Further studies are required to understand the biting behaviour of Anopheles vectors in Malawi.
","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aspartame is an artificial non-saccharide sweetener 200 times sweeter than sucrose. It is commonly used as a sugar substitute in foods and beverages. Aspartame is a methyl ester of the aspartic acid/phenylalanine dipeptide category. It (aspartame) was approved by the United States Food and Drug Administration (FDA) in 1974. Its approval was revoked in 1980 before being re-instated a year later. It is one of the most studied food additives in the human food supply. Because of its low caloric value, it is often a preferred sweetener when there are concerns of weight gain, an attribute glucose and sucrose do not have (it is an ingredient of many diet drinks and chewing gum), the latter being, among other concerns, obesitogenic and diabetogenic.
{"title":"Malawi: What are the implications that aspartame is now a “possible carcinogen”?","authors":"Adamson S. Muula","doi":"10.4314/mmj.v35i2.1","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.1","url":null,"abstract":"Aspartame is an artificial non-saccharide sweetener 200 times sweeter than sucrose. It is commonly used as a sugar substitute in foods and beverages. Aspartame is a methyl ester of the aspartic acid/phenylalanine dipeptide category. It (aspartame) was approved by the United States Food and Drug Administration (FDA) in 1974. Its approval was revoked in 1980 before being re-instated a year later. It is one of the most studied food additives in the human food supply. Because of its low caloric value, it is often a preferred sweetener when there are concerns of weight gain, an attribute glucose and sucrose do not have (it is an ingredient of many diet drinks and chewing gum), the latter being, among other concerns, obesitogenic and diabetogenic.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Same-sex sexual activity is prohibited in Malawi under the Penal Code, which criminalises acts of ‘carnal knowledge against the order of nature’ as well as ‘gross indecency’; proclaiming a maximum penalty of 14 years imprisonment.
{"title":"Malawi’s LGBTQI controversy","authors":"Thengo Kavinya","doi":"10.4314/mmj.v35i2.10","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.10","url":null,"abstract":"Same-sex sexual activity is prohibited in Malawi under the Penal Code, which criminalises acts of ‘carnal knowledge against the order of nature’ as well as ‘gross indecency’; proclaiming a maximum penalty of 14 years imprisonment.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
IntroductionSuccess in the nursing and midwifery licensure examination is the only legal prerequisite to practice as a nurse and midwife in Malawi. However, the past decade has registered poor performance of students in Nursing and Midwifery Technician (NMT) licensure examinations for candidates who failed on the first attempt. The study sought to unravel whether students’ socio-demographic and academic characteristics could predict NMT licensure examination performance on the first attempt.Methods We conducted a quantitative ex post facto using stratified random sampling. We reviewed 280 former NMT licensure exam candidate records from 2013 to 2017 with a study population of 2,668 NMTs. We reported descriptive statistics and used Chi-square / Fisher’s exact test and logistic regression to determine the significance of associations and predictors respectively. ResultsWe found that the NMT licensure examination could be predicted by students’ academic characteristics, especially entry Malawi School Certificate of Education (MSCE) point scores [p < 0.001, OR 0.830, 95% CI (0.771-0.892)], and exit college final scores [p < 0.001, OR 1.214, 95% CI (1.131-1.303)]. We established that students’ socio-demographic characteristics like age [χ2 (2, N =280) =13.143, p < 0.001], and marital status [χ2 (1, N = 280) = 5.645, p = 0.018] were significantly associated with NMT licensure examination performance but were not predictors of NMT licensure examination outcome. Furthermore, we did not find any association between NMT licensure examination performance and the sex of the students [χ2 (1, N = 280) = 0.523, p = 0.470]. ConclusionNMT licensure examinations performance predictors are academic variables like entry MSCE and exit college final scores. Consequently, teaching institutions should frame relevant admission criteria, and timely support the students at risk of failure in licensure exams.
在马拉维，成功通过护理和助产执照考试是成为护士和助产士的唯一法律先决条件。然而，在过去的十年中，在护理和助产技术员(NMT)执照考试中，有一些考生在第一次考试中失败，表现不佳。该研究试图揭示学生的社会人口统计学和学术特征是否可以预测NMT执照考试在第一次尝试中的表现。方法采用分层随机抽样的方法进行定量事后调查。我们回顾了2013年至2017年280名前NMT执照考试候选人的记录，研究人群为2668名NMT。我们报告了描述性统计，并分别使用卡方/费雪精确检验和逻辑回归来确定关联和预测因子的显著性。结果我们发现NMT执照考试可以通过学生的学业特征来预测，特别是马拉维学校教育证书(MSCE)的入学分数[p <0.001, OR 0.830, 95% CI(0.771-0.892)]，和毕业后的大学期末成绩[p <0.001，或1.214,95% ci(1.131-1.303)]。我们确定学生年龄等社会人口学特征[χ2 (2, N =280) =13.143, p <婚姻状况与NMT执照考试成绩显著相关[χ2 (1, N = 280) = 5.645, p = 0.018]，但不是NMT执照考试结果的预测因素。此外，我们没有发现NMT执照考试成绩与学生性别之间存在任何关联[χ2 (1, N = 280) = 0.523, p = 0.470]。结论nmt执照考试成绩的预测因子是入学mce和毕业大学期末成绩等学术变量。因此，教学机构应该制定相应的录取标准，并及时支持有可能在执照考试中失败的学生。
{"title":"Predictors of Students’ Performance in Nursing and Midwifery Technician Licensure Examination in Southern Malawi","authors":"Mc Geofrey Mvula, Annie Msosa","doi":"10.4314/mmj.v35i2.6","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.6","url":null,"abstract":"IntroductionSuccess in the nursing and midwifery licensure examination is the only legal prerequisite to practice as a nurse and midwife in Malawi. However, the past decade has registered poor performance of students in Nursing and Midwifery Technician (NMT) licensure examinations for candidates who failed on the first attempt. The study sought to unravel whether students’ socio-demographic and academic characteristics could predict NMT licensure examination performance on the first attempt.Methods We conducted a quantitative ex post facto using stratified random sampling. We reviewed 280 former NMT licensure exam candidate records from 2013 to 2017 with a study population of 2,668 NMTs. We reported descriptive statistics and used Chi-square / Fisher’s exact test and logistic regression to determine the significance of associations and predictors respectively. ResultsWe found that the NMT licensure examination could be predicted by students’ academic characteristics, especially entry Malawi School Certificate of Education (MSCE) point scores [p < 0.001, OR 0.830, 95% CI (0.771-0.892)], and exit college final scores [p < 0.001, OR 1.214, 95% CI (1.131-1.303)]. We established that students’ socio-demographic characteristics like age [χ2 (2, N =280) =13.143, p < 0.001], and marital status [χ2 (1, N = 280) = 5.645, p = 0.018] were significantly associated with NMT licensure examination performance but were not predictors of NMT licensure examination outcome. Furthermore, we did not find any association between NMT licensure examination performance and the sex of the students [χ2 (1, N = 280) = 0.523, p = 0.470]. ConclusionNMT licensure examinations performance predictors are academic variables like entry MSCE and exit college final scores. Consequently, teaching institutions should frame relevant admission criteria, and timely support the students at risk of failure in licensure exams.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135066073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundWhile the amount of information on many issues related to COVID-19 has increased, the long-term consequences of illness and disability remain largely unclear. In previous studies on COVID-19 infections, long-lasting functional and symptomatic abnormalities have also been shown. It is predicted that survivors of COVID-19 may have to deal with physical or psychological problems later.Aim We aimed to evaluate long-lasting symptoms including fatigue and investigate the associated risk factors.Methods In this prospective cohort study, 132 consecutive COVID-19 patients who were previously diagnosed and admitted 13±1 weeks after diagnosis were included. The Functional Assessment of Chronic Illness Therapy (FACIT) – Fatigue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Lawton Instrumental Activities of Daily Living (IADL) Scale were applied in the follow-up visit.ResultsThe median age of the patients (76 male, 56 female) was 52. Eighty (61%) of the patients were hospitalized, while 52 (39%) of them were not hospitalized. At least one symptom persisted in 103 (78%) patients, with fatigue (n=48, 36%) being the most common symptom. Both dyspnea and fatigue were more prominent in women than in men (34% vs. 11%, p=0.001 and 46% vs 29%, p=0.03; respectively). Persisted symptoms including fatigue were not significantly associated with hospitalization status. The FACIT scores of the patients at 12 weeks were positively associated with their depression and anxiety levels (R: 0.55, p=0.0001 and R: 0.42, p=0.0001), while they were negatively associated with their IADL scores (R: -0.25, p=0.004).Conclusions Fatigue was the most frequent persistent symptom. The initial fatigue scores were higher in the severely ill patients. Persistent fatigue was not associated with disease severity but was closely associated with anxiety and depression.
{"title":"Fatigue has a prominent impact on health lasting 12-weeks after COVID-19 infection","authors":"Birsen Pınar Yıldız, Didem Görgün Hattatoğlu, Cihan Aydin, Gülnihal Darçın","doi":"10.4314/mmj.v35i2.9","DOIUrl":"https://doi.org/10.4314/mmj.v35i2.9","url":null,"abstract":"BackgroundWhile the amount of information on many issues related to COVID-19 has increased, the long-term consequences of illness and disability remain largely unclear. In previous studies on COVID-19 infections, long-lasting functional and symptomatic abnormalities have also been shown. It is predicted that survivors of COVID-19 may have to deal with physical or psychological problems later.Aim We aimed to evaluate long-lasting symptoms including fatigue and investigate the associated risk factors.Methods In this prospective cohort study, 132 consecutive COVID-19 patients who were previously diagnosed and admitted 13±1 weeks after diagnosis were included. The Functional Assessment of Chronic Illness Therapy (FACIT) – Fatigue Scale, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Lawton Instrumental Activities of Daily Living (IADL) Scale were applied in the follow-up visit.ResultsThe median age of the patients (76 male, 56 female) was 52. Eighty (61%) of the patients were hospitalized, while 52 (39%) of them were not hospitalized. At least one symptom persisted in 103 (78%) patients, with fatigue (n=48, 36%) being the most common symptom. Both dyspnea and fatigue were more prominent in women than in men (34% vs. 11%, p=0.001 and 46% vs 29%, p=0.03; respectively). Persisted symptoms including fatigue were not significantly associated with hospitalization status. The FACIT scores of the patients at 12 weeks were positively associated with their depression and anxiety levels (R: 0.55, p=0.0001 and R: 0.42, p=0.0001), while they were negatively associated with their IADL scores (R: -0.25, p=0.004).Conclusions Fatigue was the most frequent persistent symptom. The initial fatigue scores were higher in the severely ill patients. Persistent fatigue was not associated with disease severity but was closely associated with anxiety and depression.","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136368990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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