A5085742202- Emergency and Acute Care Studies
- Global Maternal and Child Health
- Pneumonia and Respiratory Infections
- Neonatal Respiratory Health Research
- Respiratory viral infections research
- Infant Development and Preterm Care
- Child Nutrition and Water Access
- Sepsis Diagnosis and Treatment
- Respiratory Support and Mechanisms
- Neonatal and Maternal Infections
- Vaccine Coverage and Hesitancy
- Cystic Fibrosis Research Advances
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Disaster Response and Management
- Trauma and Emergency Care Studies
- Ultrasound in Clinical Applications
- Viral Infections and Outbreaks Research
- Healthcare Policy and Management
- Mobile Health and mHealth Applications
- SARS-CoV-2 and COVID-19 Research
- Simulation-Based Education in Healthcare
- Child and Adolescent Health
- Family and Patient Care in Intensive Care Units
- Energy and Environment Impacts
- Antibiotic Use and Resistance
Malawi Government
2018-2025
Ministry of Health
2015-2024
World Health Organization - Pakistan
2022
World Health Organization
2022
Public Health Institute of Malawi
2013-2020
Christian Health Association of Malawi
2018-2019
Uppsala University
2019
Research for Equity And Community Health Trust
2019
University College London
2018
Great Ormond Street Hospital
2018
To investigate implementation of outpatient pulse oximetry among children with pneumonia, in Malawi.In 2011, 72 health-care providers at 18 rural health centres and 38 community workers received training the use to measure haemoglobin oxygen saturations. Data collected, between 1 January 2012 30 June 2014 by trained individuals, on aged 2-59 months clinically diagnosed pneumonia were analysed.Of 14 092 included analysis, 13 266 (94.1%) successfully checked oximetry. Among chest indrawing...
Background Pneumonia is the leading infectious cause of under-5 mortality in sub-Saharan Africa. Clinical prediction tools may aide case classification, triage, and allocation hospital resources. We performed an external validation two published compared this to a locally developed tool identify children admitted with pneumonia at increased risk for in-hospital Malawi. Methods retrospectively analyzed performance Respiratory Index Severity Children (RISC) modified RISC (mRISC) scores child...
Few studies have reported long-term data on mortality rates for children admitted to hospital with pneumonia in Africa. We examined trends case fatality all-cause clinical and its risk factors Malawian between 2001 2012.Individual patient (<5 years) who were hospitals participating Malawi's Child Lung Health Programme 2012 recorded prospectively a standardised medical form. analysed children's characteristics, we estimated the association of younger than 2 months, 2-11 months age, 12-59 age...
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...
Pneumonia is the leading cause of death among children globally. Most pneumonia deaths in low-income and middle-income countries (LMICs) occur with HIV infection or exposure, severe malnutrition, hypoxaemia despite antibiotics oxygen. Non-invasive bubble continuous positive airway pressure (bCPAP) considered a safe ventilation modality that might improve child survival. bCPAP outcomes for high-risk African are unknown. Since most hospitalisations Africa non-tertiary district hospitals...
Background The pneumococcal conjugate vaccine's (PCV) impact on childhood pneumonia during programmatic conditions in Africa is poorly understood. Following PCV13 introduction Malawi November 2011, we evaluated the case burden and rates of pneumonia. Methods Findings Between January 1, 2012-June 30, 2014 conducted active surveillance children <5 years at seven hospitals, 18 health centres, with 38 community workers two districts, central Malawi. Eligible had clinical per guidelines, defined...
More than two-thirds of newborn lives could be saved worldwide if evidence-based interventions were successfully implemented. We developed the NeoTree application to improve quality care in resource-poor countries. The is a fully integrated digital health intervention that combines immediate data capture, entered by healthcare workers (HCW) on admission, while simultaneously providing them with clinical decision support and education. conducted mixed-methods development study, codeveloping...
Background The mortality impact of pulse oximetry use during infant and childhood pneumonia management at the primary healthcare level in low-income countries is unknown. We sought to determine outcomes infants children diagnosed referred using clinical guidelines with or without Malawi. Methods findings conducted a data linkage study prospective health facility community case data. matched prospectively collected worker (CHW) centre (HC) outpatient hospital community-based surveillance...
Abstract Background Each year an estimated 2.3 million newborns die in the first 28 days of life. Most these deaths are preventable, and high-quality neonatal care is fundamental for surviving thriving. Service readiness used to assess capacity hospitals provide care, but current health facility assessment (HFA) tools do not fully evaluate inpatient small sick newborn (SSNC). Methods Health systems ingredients SSNC were identified from international guidelines, notably World Organization...
In Malawi essential drugs are provided free of charge to patients at all public health facilities in order ensure equitable access care. The country thereby spends about 30% the national budget on drugs. investigate level drug shortages and eventually find reasons for Malawi, we studied management supplies common life threatening diseases such as pneumonia malaria a random selection centres.In July August 2005 visited eight out total 37 centres chosen Lilongwe District, Malawi. We recorded...
Abstract Objective To develop a new paediatric illness severity score, called inpatient triage, assessment and treatment ( ITAT ), for resource‐limited settings to identify hospitalised patients at highest risk of death facilitate urgent clinical re‐evaluation. Methods We performed nested case–control study Malawian referral hospital. The score was derived from four equally weighted variables, yielding cumulative between 0 8. Variables included oxygen saturation, temperature, age‐adjusted...
Abstract Objective We aimed to improve paediatric inpatient surveillance at a busy referral hospital in Malawi with two new programmes: (i) the provision of vital sign equipment and implementation an triage programme ( ITAT ) that includes simplified severity‐of‐illness score, (ii) task shifting cadre healthcare workers called ‘vital assistants’ VSA s). Methods This study, conducted on ward large Malawi, was divided into three phases, each lasting 4 weeks. In Phase A, we collected baseline...
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...
Introduction Existing risk assessment tools to identify children at of hospitalised pneumonia-related mortality have shown suboptimal discriminatory value during external validation. Our objective was derive and validate a novel tool aged 2–59 months across various settings. Methods We used primary, baseline, patient-level data from 11 studies, including evaluated for pneumonia in 20 low-income middle-income countries. Patients with complete were included logistic regression model assess the...
ObjectivesWe determined the pulse oximetry benefit in pediatric pneumonia mortality risk stratification and chest-indrawing in-hospital factors.MethodsWe report characteristics pneumonia-related of children aged 2-59 months who were included Pneumonia Research Partnership to Assess WHO Recommendations dataset. We developed multivariable logistic regression models identify factors.ResultsAmong 285,839 children, 164,244 (57.5%) from hospital-based studies included. case fatality (CFR) without...
Although pneumonia is the leading cause of child mortality worldwide, little known about quality routine care in high burden settings like Malawi that utilize World Health Organization's Integrated Management Childhood Illnesses (IMCI) guidelines. Due to severe human resource constraints, majority clinical delivered by non-physician clinicians called Clinical Officers (COs).
OBJECTIVES: Our aim in this observational study was to monitor continuous positive airway pressure (CPAP) usage and outcomes newborn wards at 26 government hospitals Malawi after the introduction of CPAP as part a quality-improvement initiative. implemented 3 phases from 2013 through 2015. METHODS: Survival discharge analyzed for neonates treated with nasal oxygen and/or admission weights 1 2.49 kg 24 transfer rates &lt;15%. This analysis includes admitted respiratory illness 5.5 months...
The Cooking and Pneumonia Study (CAPS) is a pragmatic cluster-level randomized controlled trial of the effect an advanced cookstove intervention on pneumonia in children under age 5 years (under 5s) Malawi (www.capstudy.org). primary outcome incidence during two-year follow-up period, as diagnosed by healthcare providers who are using World Health Organization (WHO) integrated management childhood illnesses (IMCI) assessment protocol blinded to arms. We evaluated quality 5s this setting via...
We describe hypoxemic pneumonia prevalence in outpatient and inpatient settings, in-hospital mortality, clinical guideline performance for identifying hypoxemia young infants Malawi. In this retrospective analysis of a prospective cohort study, we investigate younger than 2 months participating surveillance at seven hospitals 18 health centers Malawi between 2011 2014. Logistic regression, multiple imputation with chained equations, pattern mixture modeling were used to determine the...
Introduction: Access to oral antivirals like nirmatrelvir/ritonavir treat COVID-19 remains largely unavailable across Africa. Ghana, Malawi, Rwanda and Zambia, all members of the COVID Treatment QuickStart Consortium, leveraged existing infrastructure rapidly commence test-and-treat programs. We describe individual-level impact within cascade care.Methods: A retrospective cohort study was conducted in 36 facilities four countries that captured data on SARS-CoV-2 positive individuals who were...