A5041029221- Pneumonia and Respiratory Infections
- Respiratory viral infections research
- Pneumocystis jirovecii pneumonia detection and treatment
- Energy and Environment Impacts
- Global Public Health Policies and Epidemiology
- Parasitic Diseases Research and Treatment
- Health disparities and outcomes
- Air Quality and Health Impacts
- Parasites and Host Interactions
- Obesity, Physical Activity, Diet
- HIV/AIDS Impact and Responses
- Global Health and Epidemiology
- Cardiovascular Health and Risk Factors
- Injury Epidemiology and Prevention
- HIV Research and Treatment
- Child Nutrition and Water Access
- Influenza Virus Research Studies
- COVID-19 Digital Contact Tracing
- Viral Infections and Immunology Research
- Insect symbiosis and bacterial influences
- Parasite Biology and Host Interactions
- Global Health Care Issues
- HIV/AIDS Research and Interventions
- COVID-19 epidemiological studies
- COVID-19 impact on air quality
Malawi Epidemiology and Intervention Research Unit
2015-2021
Liverpool School of Tropical Medicine
2015
University of Liverpool
2015
Sub-Saharan Africa is in rapid demographic transition, and non-communicable diseases are increasingly important causes of morbidity mortality. We investigated the burden diabetes, overweight obesity, hypertension, multimorbidity, their treatment, associations with lifestyle other factors Malawi, a very poor country predominantly rural-but rapidly growing urban-population, to identify high-risk populations inform appropriate interventions.
Thirteen-valent pneumococcal conjugate vaccine (PCV13) was introduced in Malawi November 2011 and is offered to infants at 6, 10 14 weeks of age as part routine immunisation. PCV13 expected reduce type (VT) nasopharyngeal carriage, leading reduced transmission herd protection.We compared carriage rural Karonga District, Malawi, pre-vaccine 2009-2011 post-vaccine 2014 using a combination cross-sectional longitudinal analyses. Nasopharyngeal swabs were collected from cohort mother-infant pairs...
The emerging burden of cardiovascular disease and diabetes in sub-Saharan Africa threatens the gains made health by major international effort to combat infectious diseases. There are few data on distribution risk factors outcomes region inform an effective public response. A comprehensive research programme is being developed aimed at accurately documenting drivers NCDs urban rural Malawi; design test intervention strategies. includes population surveys all people aged 18 years above,...
HIV-infected adults have high rates of pneumococcal carriage and invasive disease. We investigated the effect antiretroviral therapy (ART) on in prior to infant conjugate vaccine (PCV) rollout.Observational cohort study.We recruited newly attending a rural HIV clinic northern Malawi between 2008 2010. Nasopharyngeal samples were taken at baseline after 6, 12, 18 24 months. compared by ART status using generalized estimated equation models adjusted for CD4 cell count, sex, seasonality, other...
The prevalence of Streptococcus pneumoniae (pneumococcus) carriage is higher in adults who are infected with human immunodeficiency virus (HIV) than not. We hypothesized that infants exposed to HIV become carriers nasopharyngeal pneumococcus earlier and more frequently not HIV. compared infant pneumococcal acquisition by maternal status household exposure Karonga District, Malawi, 2009–2011, before the introduction conjugate vaccine. Nasopharyngeal swabs were collected every 4–6 weeks first...
Little is known about the pattern or risk factors for deaths from external causes in sub-Saharan Africa: there a lack of reliable data, and public health priorities have been focussed on other causes. This study assessed prevalence factor rural Malawi. We analysed data 2002–2012 Karonga demographic surveillance site which covers ~35,000 people northern Verbal autopsies with clinician coding are used to assign cause death. Repeated annual surveys capture socio-economic factors. Using Poisson...
Household air pollution (HAP) emitted from solid fuel combustion for cooking and heating is responsible 4.3 million premature deaths annually. Those most affected include women young children in resource-limited countries. The current standard practice reducing HAP exposure to replace traditional cookstoves with more efficient improved stoves. However, the relationship between reduction potential health benefits has been quantified at limited levels. Accurate personal data have not available...
Abstract Background The extent to which rural-to-urban migration affects risk for cardiometabolic diseases (CMD) in Africa is not well understood. We investigated prevalence and obesity, diabetes, hypertension precursor conditions by status. Methods In a cross-sectional survey Malawi (February 2013–March 2017), 13 903 rural, 9929 migrant 6741 urban residents (≥18 years old) participated. interviewed participants, measured blood pressure collected anthropometric data fasting samples estimate...
In Africa, albendazole and ivermectin are currently used in combination for annual mass drug administration (MDA) lymphatic filariasis (LF) elimination. Rapid sustained clearance is desirable public health impact elimination of LF. Increasing the dose and/or frequency treatment may be more effective clearing microfilariae than standard MDA. We conducted a randomised controlled open label trial northern Malawi comparing three modified groups to dosage adults with confirmed circulating LF...
Abstract Background Pneumococcal conjugate vaccines (PCVs) have reduced pneumococcal diseases globally. genomic surveys elucidate PCV effects on population structure but are rarely conducted in low-income settings despite the high disease burden. Methods We undertook whole-genome sequencing (WGS) of 660 isolates collected through from healthy carriers 2 years 13-valent (PCV13) introduction and 1 year after rollout northern Malawi. investigated changes structure, within-lineage serotype...
Background Lymphatic filariasis (LF) and human immunodeficiency virus (HIV) are major public health problems. Individuals may be co-infected, raising the possibility of important interactions between these two pathogens with consequences for LF elimination through annual mass drug administration (MDA). Methodology Principal Findings We analysed circulating filarial antigenaemia (CFA) by HIV infection status among adults in sites northern Malawi, a region endemic both HIV. Stored blood...
To optimise care HIV patients need to be promptly initiated on antiretroviral therapy (ART) and subsequently retained treatment. In this study we report the interval between enrolment treatment initiation, investigate subsequent attrition mortality of ART at a rural clinic in Malawi. HIV-positive individuals were recruited cohort January 2008 August 2011 Chilumba Rural Hospital (CRH). Outcomes ascertained, up 7 years after enrolment, through follow-up by linkage registers Karonga Health...
In high-income settings, body mass index (BMI) and measures of central adiposity, such as waist-to-hip ratio (WHR) are associated with cardiometabolic risk, but evidence from low-income particularly sub-Saharan Africa (SSA), is limited. We assessed whether there differences between general adiposity in their associations fasting glucose, diabetes, systolic diastolic blood pressures hypertension, these differ gender or rural/urban setting Malawi. used data a population-based study 27 880...
Abstract The routine COVID-19 surveillance in Malawi that relied on retrospective reporting could not efficiently steer timely measures to the rapidly evolving pandemic. To monitor real-time changes infections and inform response, we implemented an active sentinel system from July December 2022. SARS-CoV-2 symptomatic asymptomatic patients selected health facilities (HFs) anyone aged ≥5 years entering at Point of Entry (PoEs) sites were eligible participate. Self-reported epidemiological...
Background/Aim: Around 3 billion people globally rely on solid fuels for their everyday household cooking. The resultant air pollution (HAP) causes childhood pneumonia. Streptococcus pneumoniae (SP) is the most important causative organism, and naso-pharyngeal carriage (NPC) considered as a key step in acquiring Very little known about association of HAP with NPC. This study aims to investigate effect reduction Methods: was carried out at Karonga Prevention Study, Malawi, where children born...
Abstract Background After 30 years without a poliovirus case, wild type 1 outbreak was declared in Malawi on 16th February 2022. To improve detection of transmission, the country implemented enhanced AFP surveillance by deploying Frontline Field Epidemiology Training Program (FETP) graduates who had received three-month general epidemiology training. We describe results from October 2022 to March 2023. Methods Ten districts with increased risk polio transmission and suboptimal performance...
Abstract Pneumococcal conjugate vaccines (PCV) have reduced pneumococcal diseases globally. Despite this, much remains to be learned about their effect on pathogen population structure. Here we undertook whole genome sequencing of 660 strains from asymptomatic carriers investigate restructuring in sampled before and after PCV13 introduction a previously vaccine-naïve setting. We show substantial decreasing frequency vaccine-type (VT) strain diversity post-vaccination the vaccinated but not...
Background: Household air pollution (HAP) from solid cooking fuels is a risk factor for childhood pneumonia. Nasopharyngeal carriage of Streptococcus pneumoniae necessary step in development pneumococcal We hypothesised that HAP influences S. carriage. MSCAPE assesses the relationship between and prevalence/density among children.Methods: prospective study children participating trial cleaner burning cookstove to reduce pneumonia incidence Malawi (CAPS). assessed impact exposure on...