A5002249741- Pneumonia and Respiratory Infections
- Global Maternal and Child Health
- Bacterial Infections and Vaccines
- Child Nutrition and Water Access
- Respiratory viral infections research
- Emergency and Acute Care Studies
- Child and Adolescent Health
- Neonatal Respiratory Health Research
- Pneumocystis jirovecii pneumonia detection and treatment
- Hemoglobinopathies and Related Disorders
- Tuberculosis Research and Epidemiology
- Neonatal and Maternal Infections
- Respiratory Support and Mechanisms
- Iron Metabolism and Disorders
- Salmonella and Campylobacter epidemiology
- Global Health and Surgery
- Family and Patient Care in Intensive Care Units
- Cardiac Arrest and Resuscitation
- Viral gastroenteritis research and epidemiology
- Malaria Research and Control
- Sepsis Diagnosis and Treatment
- HIV/AIDS Research and Interventions
- Mosquito-borne diseases and control
- Healthcare Policy and Management
- Infectious Diseases and Tuberculosis
Kamuzu Central Hospital
2014-2024
Kamuzu University of Health Sciences
2023-2024
University of Malawi
2010-2022
Ministry of Health
2021-2022
Blantyre Institute for Community Ophthalmology
2003-2017
University of Liverpool
2004-2012
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
2004-2012
Copperbelt University
1995
Background. There are no published data for the incidence or etiology of childhood bacteremia in Malawi. We describe clinical and microbiologic features children admitted to hospital from whom blood cultures yielded bacterial pathogens. Methods. Any neonate child pediatric wards Queen Elizabeth Central Hospital had a culture taken event fever without obvious explanation. Clinical were prospectively collected with significant positive culture. Results. Between September, 1996, August, 1997,...
Evidence regarding the appropriate duration of treatment with antibiotic agents in children pneumonia low-resource settings Africa is lacking.We conducted a double-blind, randomized, controlled, noninferiority trial Lilongwe, Malawi, to determine whether amoxicillin for 3 days less effective than 5 chest-indrawing (cough lasting <14 or difficulty breathing, along visible indrawing chest wall without fast breathing age). Children not infected human immunodeficiency virus (HIV) who were 2 59...
<h3>Importance</h3> Pneumonia is the leading infectious killer of children. Rigorous evidence supporting antibiotic treatment children with nonsevere fast-breathing pneumonia in low-resource African settings lacking. <h3>Objective</h3> To assess whether placebo for substantively less effective than 3 days amoxicillin. <h3>Design, Setting, and Participants</h3> This double-blind, 2-arm, randomized clinical noninferiority trial follow-up 14 screened 1343 HIV-uninfected aged 2 to 59 months at...
The aim of this retrospective study was to report causes, antibiotic resistance and outcome neonatal sepsis (often fatal in developing countries) Malawi.All blood cerebrospinal fluid isolates collected between January 1996 December 2001 from inpatients aged 0-30 days with suspected at Queen Elizabeth Central Hospital, Blantyre, Malawi were reviewed. In vitro antibiotics commonly used assessed. Case fatality rate analysed respect age, bacterial pathogen infection site.A total 801 bacteria...
Infection with HIV, and oftentimes coinfection TB, complicates the care of severely malnourished children in sub-Saharan Africa. These superimposed infections challenge clinicians faced a population for whose evidence-based guidelines have not kept up. Even as HIV-uninfected has improved dramatically advent community-based even there are hopeful signs that HIV epidemic may be stabilizing or ameliorating, significant gaps remain HIV. Here we summarize what is currently known, remains unknown,...
The clinical course and outcome of non-typhoidal salmonella (NTS) meningitis in Malawian children over a 10-year period (1997-2006) is described.Demographic, laboratory data were collected for all 2 months age admitted with to Queen Elizabeth Central Hospital from 1997 2006. In the 1st year, salmonellae susceptible chloramphenicol, received weeks chloramphenicol treatment. When NTS resistance started appear 1998, treatment was changed ceftriaxone. From 2002, duration antibiotic therapy...
Acute bacterial meningitis (ABM) causes significant death and disability in children worldwide, with HIV recognized as an established risk factor for infection negative outcomes. However, additional major factors pediatric ABM remain unclear.
Background:In low-income countries and those with a high prevalence of HIV, respiratory failure is common cause death in children. However, the role non-invasive ventilation bubble continuous positive airway pressure (bCPAP) these patients not well established.Methods:A prospective observational study bCPAP was undertaken between July September 2012 77 Malawian children aged 1 week to 14 years progressive acute despite oxygen antimicrobial therapy.Results:Forty-one (53%) survived following...
Severe anemia is a major cause of sickness and death in African children, yet the causes this population have been inadequately studied.We conducted case-control study 381 preschool children with severe (hemoglobin concentration, <5.0 g per deciliter) 757 without urban rural settings Malawi. Causal factors previously associated were studied. The data examined by multivariate analysis structural equation modeling.Bacteremia (adjusted odds ratio, 5.3; 95% confidence interval [CI], 2.6 to...
HIV infection is a major risk factor for death in childhood pneumonia HIV-endemic regions. Improved case management and preventive strategies require better understanding of the impact on causes, clinical presentation, outcome.A prospective, descriptive study Malawian infants children with severe included blood culture nasopharyngeal aspiration diagnosis pneumocystis (PcP). A select group consolidation chest radiograph, without hypoxia or hyperinflation, also had lung aspirate taken...
We investigated the benefit of 2 candidate adjunctive therapies in bacterial meningitis: glycerol, which has shown promise earlier studies, and acetaminophen, is reportedly beneficial adult septicemia. In a hospital Blantyre, Malawi, we enrolled 360 children aged ≥ months with proven meningitis (36% HIV infected) double-blind, randomized, placebo-controlled trial glycerol acetaminophen × factorial design. Of 4 groups, first group received oral second rectal third both fourth placebos only....
<h3>Objectives</h3> To determine whether blood lactate measured at the time of presentation to hospital predicted outcome in children with pneumonia Malawi, and understand factors associated high concentrations pneumonia. <h3>Design</h3> Analysis data from a prospective study presenting Queen Elizabeth Central Hospital, Blantyre, WHO-defined severe or very <h3>Results</h3> Among 233 pneumonia, median serum concentration was 2.7 mmol/l (IQR 1.8–4.4 mmol/l). 77 (33%) had 2.1–4.0 mmol/l, 72...
Eighty per cent of Malawi's 8 million children live in rural areas, and there is an extensive tiered health system infrastructure from village clinics to district hospitals which refers patients one the four central hospitals. The are staffed by nurses, non-physician clinicians recently qualified doctors. There 16 paediatric specialists working two serve urban population as well accepting referrals In order provide expert care close home possible, we describe our plan task share within a...
The case fatality rate of severely malnourished children during inpatient treatment is high and mortality often associated with diarrhea. As intestinal carbohydrate absorption impaired in severe acute malnutrition (SAM), differences dietary formulations nutritional rehabilitation could lead to the development osmotic diarrhea subsequently hypovolemia death. We compared three strategies commonly used transition higher caloric feeds, i.e., F100 milk (F100), Ready-to-Use Therapeutic Food (RUTF)...
Background: There are scarce data on outcomes of in-hospital paediatric cardiac arrest (CA) in resource-poor settings and none for World Bank-defined low-income countries.Aim: To report the CA from a university-affiliated referral hospital Malawi.Methods: Data were collected prospectively patients aged 30 days to 13 years who experienced underwent cardiopulmonary resuscitation (CPR) at Kamuzu Central Hospital Lilongwe, Malawi January through June 2017. Utstein-style reporting guidelines CAs...
Introduction In low-resource countries, respiratory failure is associated with a high mortality risk among critically ill children. We evaluated the role of bubble continuous positive airway pressure (bCPAP) in routine care children Lilongwe, Malawi. Methods conducted an observational study between 26 February and 15 April 2014, urban paediatric unit approximately 20 000 admissions/year (in-hospital <5% during this time period). Modified oxygen concentrators or cylinders provided...
Introduction To achieve sustained reductions in child mortality low- and middle-income countries, increased local capacity is necessary. One approach to capacity-building support offered via partnerships with institutions high-income countries. However, lack of cooperation between can create barriers successful implementation programs may inadvertently weaken the health system they are striving improve. A coordinated Background Three U.S.-based have separately supported various aspects...
Objective: To compare the growth of HIV-exposed children receiving 1 2 complementary foods after prevention mother-to-child HIV transmission through maternal lifelong antiretroviral therapy (ART). Methods: In rural Malawi, 280 HIV-infected pregnant women were consecutively identified and offered ART, without consideration their CD4 counts. Mothers supported to exclusively breast-feed tested for status at 1.5 5.5 months age. From this group, 248 enrolled randomized receive micronutrients with...
Abstract Background Nearly all countries have ratified the United Nations Convention on Rights of Child and, therefore, support children having access to their rights. However, only a small minority worldwide environmental, economic, and social The most recent global effort address these deficits came in 2015, when General Assembly agreed plan for fairer more sustainable future by 2030 outlined Sustainable Development Goals (SDGs). One remediable cause is lack revenue many countries, which...
Pneumonia is the leading infectious cause of death in children under 5 years age around globe. In addition to preventing pneumonia, there a critical need provide greater access appropriate and effective treatment. Studies Asia have evaluated effectiveness 3 days oral amoxicillin for treatment fast-breathing pneumonia; however, further evidence needed determine if also chest indrawing pneumonia.This double-blind, randomized, non-inferiority trial with objective assess shorter duration...
Background: HIV protease (PR) is a virus-encoded aspartic that essential for viral replication and infectivity.The fully active mature dimeric released from the Gag-Pol polyprotein as result of precursor autoprocessing. Results:We here describe simple model system to directly examine autoprocessing in transfected mammalian cells.A fusion was engineered encoding GST fused well-characterized miniprecursor, consisting along with its upstream transframe region (TFR), small peptide epitopes...
Neonatal sepsis is common and often fatal in Malawi. The aim of this retrospective study was to report causes, antibiotic resistance outcome Malawian neonates. We reviewed all blood cerebrospinal fluid isolates collected between January, 1996, December, 2001, from inpatients aged 0-30 days with suspected at the Queen Elizabeth Central Hospital, Blantyre. In vitro antibiotics commonly used Malawi assessed. Case-fatality rate analysed respect age, bacterial pathogen infection site. A total 801...