A5039797186- Pneumonia and Respiratory Infections
- Respiratory viral infections research
- Bacterial Infections and Vaccines
- Chronic Disease Management Strategies
- Tuberculosis Research and Epidemiology
- Diabetes Management and Education
- Chronic Obstructive Pulmonary Disease (COPD) Research
- COVID-19 epidemiological studies
- SARS-CoV-2 and COVID-19 Research
- COVID-19 Clinical Research Studies
- Disaster Response and Management
- Pneumocystis jirovecii pneumonia detection and treatment
- Global Health and Epidemiology
- HIV/AIDS Impact and Responses
- Immunodeficiency and Autoimmune Disorders
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Global Public Health Policies and Epidemiology
- Global Maternal and Child Health
- Respiratory Support and Mechanisms
- Primary Care and Health Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Antibiotic Use and Resistance
- Inhalation and Respiratory Drug Delivery
- Heart Failure Treatment and Management
- Family and Patient Care in Intensive Care Units
Kamuzu University of Health Sciences
2022-2024
Queen Elizabeth Central Hospital
2020-2024
Kamuzu Central Hospital
2022-2024
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
2024
University of Liverpool
2011-2024
University of Malawi
2010-2023
University of Health Science
2022
Queen Elizabeth Hospital
2020
Chris Hani Baragwanath Hospital
2015
University of the Witwatersrand
2015
Abstract Background Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity data low-income countries. Our aim was explore relationship between viral lineage patient outcome. Methods We enrolled prospective observational cohort adult PCR-confirmed July 2020 March 2022 Blantyre, Malawi, covering four waves SARS-CoV-2 infections. Clinical diagnostic were collected using an adapted...
Introduction Despite growing evidence of the long-term impact tuberculosis (TB) on quality life, Global Burden Disease (GBD) estimates TB-related disability-adjusted life years (DALYs) do not include post-TB morbidity, and evaluations TB interventions typically assume treated patients return to pre-TB health. Using primary data, we estimate lost due disability (YLDs), premature mortality (YLL) DALYs associated with cardiorespiratory morbidity in a low-income country. Methods Adults aged ≥15...
Rationale Pulmonary tuberculosis (PTB) can cause post-TB lung disease (PTLD) associated with respiratory symptoms, spirometric and radiological abnormalities. Understanding of the predictors natural history PTLD is limited. Objectives To describe symptoms function Malawian adults up to 3 years following PTB-treatment completion, determine evolution over this period. Methods Adults successfully completing PTB treatment in Blantyre, Malawi were followed for assessed using questionnaires,...
Although the COVID-19 pandemic has left no country untouched there been limited research to understand clinical and immunological responses in African populations. Here we characterise patients hospitalised with suspected (PCR-negative/IgG-positive) or confirmed (PCR-positive) COVID-19, healthy community controls (PCR-negative/IgG-negative). PCR-positive participants were more likely receive dexamethasone a beta-lactam antibiotic, survive hospital discharge than PCR-negative/IgG-positive...
BackgroundThe effect of childhood pneumococcal conjugate vaccine implementation in Malawi is threatened by absence herd effect. There persistent vaccine-type carriage both vaccinated children and the wider community. We aimed to use a human infection study measure 13-valent (PCV13) efficacy against carriage.MethodsWe did double-blind, parallel-arm, randomised controlled trial investigating PCV13 or placebo experimental Streptococcus pneumoniae serotype 6B (strain BHN418) among healthy adults...
The aim of this study was to describe the current status diabetes care in an urban clinic Malawi and prevalence human immunodeficiency virus (HIV) population, investigating possible associations between HIV diabetes. A systematic prospective survey patients attending at a teaching hospital Blantyre, conducted. Six hundred twenty were assessed. Seventy-four percent had glycosylated hemoglobin (HbA1C) > 7.5%. Systolic blood pressure 140 mm Hg 52% patients. Hypertension more common with raised...
Pulmonary TB survivors face a high burden of post-TB lung disease (PTLD) after treatment completion. In this secondary data analysis we investigate the performance parameters measured at completion in predicting morbidity over subsequent year, to inform programmatic approaches PTLD screening low-resource settings. Cohort from urban Blantyre, Malawi were used construct regression models for five outcomes (chronic respiratory symptoms or functional limitation, ongoing health seeking,...
Introduction: Chronic obstructive pulmonary disease (COPD) continues to pose a global public health challenge. However, literature is scarce on the burden of COPD in Malawi. We assessed prevalence and risk factors for among adults Neno, Methodology: conducted population-based analytical cross-sectional study Neno District between December 2021 November 2022. Using multi-stage sampling technique, we included 525 aged≥ 40 years. All participants underwent spirometry according American Thoracic...
Up to 14% of Malawian adults die during the intensive phase tuberculosis treatment. In a prospective cohort 199 with microbiologically confirmed pulmonary tuberculosis, clinical and laboratory parameters were compared between those who died or deteriorated had an uneventful recovery. Baseline tumor necrosis factor alpha responses stimulation heat-killed Mycobacterium lipopolysaccharide reduced among 22 patients poor outcome (P = .017). Low body mass index .002) elevated respiratory rate .01)...
Persistent carriage of pneumococcal vaccine serotypes has occurred after introduction PCV13 vaccination in Africa but the mechanisms are unclear. We tested feasibility using a human challenge model Malawi to understand immune correlates protection against and trial alternative candidates. aimed identify dose Streptococcus pneumoniae serotype 6B sufficient establish nasopharyngeal 40% those nasally inoculated evaluate nasal mucosal immunity before experimental inoculation.Healthy student...
Background The epidemic of non-communicable diseases (NCDs) in low and middle income countries (LMICs) is widely recognised as the next major challenge to global health. However, many LMICs, infectious are still prevalent resulting a “double burden” disease. With increased life expectancy longevity with HIV, older adults may particularly be at risk this double burden. Here we describe relative contributions infections NCDs hospital admissions mortality, according age, Malawi’s largest...
<ns3:p><ns3:italic>Streptococcus pneumoniae</ns3:italic> is the leading cause of morbidity and mortality due to community acquired pneumonia, bacterial meningitis bacteraemia worldwide. Pneumococcal conjugate vaccines protect against invasive disease, but are expensive manufacture, limited in serotype coverage, associated with replacement demonstrate reduced effectiveness mucosal colonisation. As asymptomatic colonisation human nasopharynx a prerequisite for pneumococcal this proposed as...
Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity data low-income countries. Our aim was explore relationship between viral lineage patient outcome.
Cardiovascular disease (CVD) is a major cause of death in Malawi. In rural districts, heart failure (HF) care limited and provided by non-physicians. The causes patient outcomes HF Africa are largely unknown. our study, non-physician providers performed focused cardiac ultrasound (FOCUS) for diagnosis longitudinal clinical follow-up Neno,
Type II diabetes mellitus (T2DM) significantly impacts quality of life (QoL) yet data among these patients in Malawi are lacking. This study was conducted to assess QoL with T2DM. A mixed-method cross-section at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Data collection done using a modified (MDQoL)-17 questionnaire for quantitative while in-depth interviews and diary methods were used qualitative data. Demographic summarized descriptive statistics inferential t-tests ANOVA. Thematic...
Streptococcus pneumoniae is the leading cause of morbidity and mortality due to community acquired pneumonia, bacterial meningitis bacteraemia worldwide. Pneumococcal conjugate vaccines protect against invasive disease, but are expensive manufacture, limited in serotype coverage, associated with replacement demonstrate reduced effectiveness mucosal colonisation. As asymptomatic colonisation human nasopharynx a prerequisite for pneumococcal this proposed as marker novel vaccine efficacy. Our...
Streptococcus pneumoniae is the leading cause of morbidity and mortality due to community acquired pneumonia, bacterial meningitis bacteraemia worldwide. Pneumococcal conjugate vaccines protect against invasive disease, but are expensive manufacture, limited in serotype coverage, associated with replacement, demonstrate reduced effectiveness mucosal colonisation. For Malawi, nasopharyngeal carriage vaccine-type pneumococci common vaccinated children despite national roll-out 13-valent...
The coronavirus disease 2019 (COVID-19) pandemic is now established on the African continent, with cases rapidly increasing in Malawi (1742 confirmed and 19 deaths as of 5 July 20201). Clinicians require guidelines, deliverable context, to effectively safely treat patients for best possible outcome. In Malawi, key public messages around social distancing, hand washing shielding at-risk individuals have been widely distributed by Ministry Health. However, it has not implement strict lockdown...
<p>Background. ere is a sense among respiratory physicians that asthma poorly controlled in public sector hospitals, possibly due to poor<br />adherence and lack of knowledge regarding inhaler technique.<br />Objective. To describe the status control patients attending Respiratory Outpatient Department at Chris Hani Baragwanath<br />Academic Hospital.<br />Methods. A retrospective record review was conducted on outpatient les asthmatics known Department....
<ns3:p><ns3:italic>Streptococcus pneumoniae</ns3:italic> is the leading cause of morbidity and mortality due to community acquired pneumonia, bacterial meningitis bacteraemia worldwide. Pneumococcal conjugate vaccines protect against invasive disease, but are expensive manufacture, limited in serotype coverage, associated with replacement, demonstrate reduced effectiveness mucosal colonisation. For Malawi, nasopharyngeal carriage vaccine-type pneumococci common vaccinated children despite...
The Malawian health sector has a strong tradition of systematic data collection for monitoring and evaluation large-scale services. A highly successful adapted Directly Observed Treatment, Short course “DOTS” framework, based on patient registers paperbased mastercards was introduced to facilitate the management scale up antiretroviral therapy. Subsequently, simple, touch-screen electronic medical record system (EMRs) effectively at high burden ART sites. Based this model, in 2010, diabetes...
Antimicrobial resistance (AMR) is a major concern in health care worldwide. In Malawi rates of AMR, particular third-generation cephalosporin-resistant (3GC-R) Enterobacterales have rapidly increased since 2003. Antibiotic guidelines are key component antimicrobial stewardship (AMS). As part stewardship, Queen Elizabeth Central Hospital (QECH) Blantyre, developed an antibiotic guideline the form smart phone application June 2016.We conducted study to assess clinicians adherence local on...