Malawi

Publication Title: 
African Journal of Reproductive Health

This paper explores how young people in Malawi conceptualize sex and sexual relations through an analysis of their personal narratives about these phenomena. Eleven focus group discussions were conducted with 114 youth aged 14-19 years. Participants were asked to describe behaviors, attitudes, and motivations to reduce unplanned pregnancies and the spread of HIV/AIDS, with appropriate probes to illuminate their sexual world-views.

Author(s): 
Undie, Chi-Chi
Crichton, Joanna
Zulu, Eliya
Publication Title: 
Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing

PURPOSE: The purpose of this study was to examine women's evaluation of postpartum care services (postpartum clinical assessments, health education, and midwife kindness) received from midwives prior to discharge in rural health facilities, and to examine husband-and-wife-farmer dyads' reasons for their decisions to return or not return for 1-week postpartum care visits in rural central Malawi. DESIGN: Cross-sectional matched-pairs survey design.

Author(s): 
Adams, Yenupini Joyce
Stommel, Manfred
Ayoola, Adejoke
Horodynski, Mildred
Malata, Address
Smith, Barbara
Publication Title: 
African Journal of Health Sciences

The main objective was to determine motivating factors for community care givers (CCGs), the services they provided to the community, and to identify sources of CCGs' material supplies. A cross sectional qualitative study was done using in-depth key informant interviews with community cares givers and traditional leaders. Analysis was based on themes utilizing content analysis. Most of the CCGs were housewives. Intrinsic motivating factors included feelings of empathy, altruism and religious convictions.

Author(s): 
Mkandawire, Wanangwa C.
Muula, Adamson S.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

We measured in vitro antimalarial drug susceptibility of 84 Plasmodium falciparum field isolates from Blantyre, Southern Malawi, using the WHO microtest and the lactate dehydrogenase assay. We also genotyped these isolates to investigate whether variation in their absolute drug sensitivity is associated with specific sets of pfcrt and pfmdr-1 mutations harbored by parasites.

Author(s): 
Nkhoma, Standwell
Molyneux, Malcolm
Ward, Stephen
Publication Title: 
Malaria Journal

BACKGROUND: Having reliable forecasts is critical now for producers, malaria-endemic countries and agencies in order to adapt production and procurement of the artemisinin-based combination treatments (ACTs), the new first-line treatments of malaria. There is no ideal method to quantify drug requirements for malaria. Morbidity data give uncertain estimations. This study uses drug consumption to provide elements to help estimate quantities and financial requirements of ACTs.

Author(s): 
Kindermans, Jean-Marie
Vandenbergh, Daniel
Vreeke, Ed
Olliaro, Piero
D'Altilia, Jean-Pierre
Publication Title: 
PloS One

The objective of this study was to determine the appropriate dose of artesunate for use in a fixed dose combination therapy with chlorproguanil-dapsone (CPG-DDS) for the treatment of uncomplicated falciparum malaria. METHODS: Open-label clinical trial comparing CPG-DDS alone or with artesunate 4, 2, or 1 mg/kg at medical centers in Blantyre, Malawi and Farafenni, The Gambia. The trial was conducted between June 2002 and February 2005, including 116 adults (median age 27 years) and 107 children (median age 38 months) with acute uncomplicated Plasmodium falciparum malaria.

Author(s): 
Wootton, Daniel G.
Opara, Hyginus
Biagini, Giancarlo A.
Kanjala, Maxwell K.
Duparc, Stephan
Kirby, Paula L.
Woessner, Mary
Neate, Colin
Nyirenda, Maggie
Blencowe, Hannah
Dube-Mbeye, Queen
Kanyok, Thomas
Ward, Stephen
Molyneux, Malcolm
Dunyo, Sam
Winstanley, Peter A.
Publication Title: 
Antimicrobial Agents and Chemotherapy

The Plasmodium falciparum dihydrofolate reductase (PfDHFR) enzyme is the target of pyrimethamine, a component of the antimalarial pyrimethamine-sulfadoxine. Resistance to this drug is associated primarily with mutations in the Pfdhfr gene. The I164L mutant allele is of particular interest, because strains possessing this mutation are highly resistant to pyrimethamine and to chlorproguanil, a component of chlorproguanil-dapsone.

Author(s): 
Ochong, Edwin
Bell, David J.
Johnson, David J.
D'Alessandro, Umberto
Mulenga, Modest
Muangnoicharoen, Sant
Van Geertruyden, Jean-Pierre
Winstanley, Peter A.
Bray, Patrick G.
Ward, Stephen A.
Owen, Andrew
Publication Title: 
Acta Tropica

We genotyped 160 P. falciparum infections from Malawi for pfmdr-1 copy number changes and SNPs associated with in vivo tolerance and poor in vitro sensitivity to the component drugs of Coartem. We also measured in vitro susceptibility of 49 of these isolates to a variety of drugs in clinical use or with a potential for use in Africa. All 160 infections carried a single copy of pfmdr-1 but 34% exhibited sequence variation at 4 of the 5 polymorphic sites in pfmdr-1.

Author(s): 
Nkhoma, Standwell
Nair, Shalini
Mukaka, Mavuto
Molyneux, Malcolm E.
Ward, Stephen A.
Anderson, Timothy J. C.
Publication Title: 
Malaria Journal

BACKGROUND: Sulphadoxine-pyrimethamine (SP) is the only single dose therapy for uncomplicated malaria, but there is widespread resistance. At the time of this study, artemether-lumefantrine (AL) and chlorproguanil-dapsone (CPD), both multi-dose regimes, were considered possible alternatives to SP in Malawi. The aim of this study was to investigate the impact of poor adherence on the effectiveness of AL and CPD. METHODS: Children > or =12 months and adults with uncomplicated malaria were randomized to receive AL, CPD or SP.

Author(s): 
Bell, David J.
Wootton, Dan
Mukaka, Mavuto
Montgomery, Jacqui
Kayange, Noel
Chimpeni, Phillips
Hughes, Dyfrig A.
Molyneux, Malcolm E.
Ward, Steve A.
Winstanley, Peter A.
Lalloo, David G.
Publication Title: 
Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America

BACKGROUND: In 2007, Malawi replaced the first-line medication for uncomplicated malaria, sulfadoxine-pyrimethamine-a single-dose regimen-with artemether-lumefantrine (AL)-a 6-dose, 3-day regimen. Because of concerns about the complex dosing schedule, we assessed patient adherence to AL 2 years after routine implementation. METHODS: Adults and children with uncomplicated malaria were recruited at 3 health centers. We conducted both pill counts and in-home interviews on medication consumption 72 hours after patients received AL.

Author(s): 
Mace, Kimberly E.
Mwandama, Dyson
Jafali, James
Luka, Madalitso
Filler, Scott J.
Sande, John
Ali, Doreen
Kachur, S. Patrick
Mathanga, Don P.
Skarbinski, Jacek

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