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A series of half-day meetings were held between the Malawi National TB Control Programme and the other seven disease control programmes housed in the Community Health Science Unit (CHSU) to look at the structure and function of these programmes. Data were collected into a structured proforma on human resources, sources of international funding, policies and disease control activities, supportive activities, management organization, monitoring and evaluation and operational research. A number ofpmid:27528976 pmcid:PMC3346034 fatcat:5jkijtttbjco3nxionmjkjkb2a
more »... constraints were identified, particularly in the areas of technical supervision, monitoring and evaluation and operational research. Serious consideration should be given to allow CHSU to have a more centralised and unifying role, with the aim of creating a more efficient and better-funded national communicable disease control service.
BMJ Global Health
Adults admitted to hospital with critical illness are vulnerable and at high risk of morbidity and mortality, especially in sub-Saharan African settings where resources are severely limited. As life expectancy increases, patient demographics and healthcare needs are increasingly complex and require integrated approaches. Patient outcomes could be improved by increased critical care provision that standardises healthcare delivery, provides specialist staff and enhanced patient monitoring anddoi:10.1136/bmjgh-2020-004041 pmid:33214176 pmcid:PMC7678231 fatcat:p7mlrnmg2rfmrlmmnw6svwzkda
more »... litates some treatment modalities for organ support. In Malawi, we established a new high-dependency unit within Queen Elizabeth Central Hospital, a tertiary referral centre serving the country's Southern region. This unit was designed in partnership with managers, clinicians, nurses and patients to address their needs. In this practice piece, we describe a participatory approach to design and implement a sustainable high-dependency unit for a low-income sub-Saharan African setting. This included: prospective agreement on remit, alignment with existing services, refurbishment of a dedicated physical space, recruitment and training of specialist nurses, development of context-sensitive clinical standard operating procedures, purchase of appropriate and durable equipment and creation of digital clinical information systems. As the global COVID-19 pandemic unfolded, we accelerated unit opening in anticipation of increased clinical requirement and describe how the high-dependency unit responded to this demand.
Plasma selenium (Se) concentration is an established population level biomarker of Se status, especially in Se-deficient populations. Previously observed correlations between dietary Se intake and urinary Se excretion suggest that urine Se concentration is also a potentially viable biomarker of Se status. However, there are only limited data on urine Se concentration among Se-deficient populations. Here, we test if urine is a viable biomarker for assessing Se status among a large sample ofdoi:10.1016/j.envint.2019.105218 pmid:31715489 fatcat:qgihhgr65jbifhbsv3lboj2kqe
more »... and children in Malawi, most of whom are likely to be Se-deficient based on plasma Se status. Casual (spot) urine samples (n = 1406) were collected from a nationally representative sample of women of reproductive age (WRA, n =741) and school aged children (SAC, n=665) across Malawi as part of the 2015/16 Demographic and Health Survey. Selenium concentration in urine was determined using inductively coupled plasma mass spectrometry (ICP-MS). Urinary dilution corrections for specific gravity, osmolality, and creatinine were applied to adjust for hydration status. Plasma Se status had been measured for the same survey participants. There was between-cluster variation in urine Se concentration that corresponded with variation in plasma Se concentration, but not between households within a cluster, or between individuals within a household. Corrected urine Se concentrations explained more of the between-cluster variation in plasma Se concentration than uncorrected data. These results provide new evidence that urine may be used in the surveillance of Se status at the population level in some groups. This could be a cost-effective option if urine samples are already being collected for other assessments, such as for iodine status analysis as in the Malawi and other national Demographic and Health Surveys.
Zinc (Zn) is an essential micronutrient, and Zn deficiency remains a major global public health challenge. Recognised biomarkers of population Zn status include blood plasma or serum Zn concentration and proxy data such as dietary Zn intake and prevalence of stunting. Urine Zn concentration is rarely used to assess population Zn status. This study assessed the value of urine Zn concentration as a biomarker of population Zn status using a nationally representative sample of non-pregnant women ofdoi:10.1007/s10653-020-00700-5 pmid:32862269 pmcid:PMC7847879 fatcat:bixbbisvp5hdpn3rejkeuja364
more »... reproductive age (WRA) and school-aged children (SAC) in Malawi. Spot (casual) urine samples were collected from 741 WRA and 665 SAC. Urine Zn concentration was measured by inductively coupled plasma mass spectrometry with specific gravity adjustment for hydration status. Data were analysed using a linear mixed model with a spatially correlated random effect for between-cluster variation. The effect of time of sample collection (morning or afternoon), and gender (for SAC), on urine Zn concentration were examined. There was spatial dependence in urine Zn concentration between clusters among SAC but not WRA, which indicates that food system or environmental factors can influence urine Zn concentration. Mapping urine Zn concentration could potentially identify areas where the prevalence of Zn deficiency is greater and thus where further sampling or interventions might be targeted. There was no evidence for differences in urine Zn concentration between gender (P = 0.69) or time of sample collection (P = 0.85) in SAC. Urine Zn concentration was greater in afternoon samples for WRA (P = 0.003). Relationships between urine Zn concentration, serum Zn concentration, dietary Zn intake, and potential food systems covariates warrant further study.
Selenium (Se) is an essential human micronutrient. Deficiency of Se decreases the activity of selenoproteins and can compromise immune and thyroid function and cognitive development, and increase risks from non-communicable diseases. The prevalence of Se deficiency is unknown in many countries, especially in sub-Saharan Africa (SSA). Here we report that the risk of Se deficiency in Malawi is large among a nationally representative population of 2,761 people. For example, 62.5% and 29.6% ofdoi:10.1038/s41598-019-43013-z pmid:31024041 pmcid:PMC6484074 fatcat:wn5ajne2lrax3f7wpjf623n2ii
more »... of reproductive age (WRA, n = 802) had plasma Se concentrations below the thresholds for the optimal activity of the selenoproteins glutathione peroxidase 3 (GPx3; <86.9 ng mL-1) and iodothyronine deiodinase (IDI; <64.8 ng mL-1), respectively. This is the first nationally representative evidence of widespread Se deficiency in SSA. Geostatistical modelling shows that Se deficiency risks are influenced by soil type, and also by proximity to Lake Malawi where more fish is likely to be consumed. Selenium deficiency should be quantified more widely in existing national micronutrient surveillance programmes in SSA given the marginal additional cost this would incur.
Micronutrient deficiencies including selenium (Se) are widespread in Malawi and potentially underlie a substantial disease burden, particularly among poorer and marginalised populations. Concentrations of Se in staple cereal crops can be increased through application of Se fertilisers - a process known as agronomic biofortification (agro-biofortification) - and this may contribute to alleviating deficiencies. The Addressing Hidden Hunger with Agronomy (AHHA) trial aims to establish the efficacydoi:10.1186/s13063-019-3894-2 pmid:31888766 pmcid:PMC6937860 fatcat:zmn2w7swgbewpj2gpat7h4bhoe
more »... of this approach for improving Se status in rural Malawi. A double-blind, randomised, controlled trial will be conducted in a rural community in Kasungu District, Central Region, Malawi. The hypothesis is that consumption of maize flour agro-biofortified with Se will increase serum Se concentration. We will recruit 180 women of reproductive age (WRA) (20-45 years) and 180 school-age children (SAC) (5-10 years) randomly assigned in a 1:1 ratio to receive either maize flour enriched through agro-biofortification with Se or a control flour not enriched with Se. Households will receive flour (330 g per capita per day) for 12 weeks. The primary outcome is Se concentration in serum (μg/L). Serum will be extracted from venous blood samples drawn at baseline (prior to flour distribution) and end-line. Selenium concentration will be measured by using inductively coupled plasma mass spectrometry. Findings will be communicated to policy stakeholders and participating communities and reported in peer-reviewed journals. The Addressing Hidden Hunger with Agronomy (Malawi) trial is registered (5th March 2019; ISCRTN85899451).
Phiri FP, Ander EL, Bailey EH, Chilima B, Chilimba ADC, Gondwe J, et al. The risk of selenium deficiency in Malawi is large and varies over multiple spatial scales. Sci Rep. ... Phiri FP, Ander EL, Lark RM, Bailey EH, Chilima B, Gondwe J, et al. Urine selenium concentration is a useful biomarker for assessing population level selenium status. Environ Int. ...doi:10.3389/fnut.2021.788096 pmid:35071297 pmcid:PMC8770811 fatcat:i2yq4qt6ufhbvkebibuyoztdia
Background Since their domestication 10,500 years ago, goat populations with distinctive genetic backgrounds have adapted to a broad variety of environments and breeding conditions. The VarGoats project is an international 1000-genome resequencing program designed to understand the consequences of domestication and breeding on the genetic diversity of domestic goats and to elucidate how speciation and hybridization have modeled the genomes of a set of species representative of the genus Capra.doi:10.1186/s12711-021-00659-6 pmid:34749642 pmcid:PMC8573910 fatcat:33wrbi7hmvde7bcnkcojianbpq
more »... indings A dataset comprising 652 sequenced goats and 507 public goat sequences, including 35 animals representing eight wild species, has been collected worldwide. We identified 74,274,427 single nucleotide polymorphisms (SNPs) and 13,607,850 insertion-deletions (InDels) by aligning these sequences to the latest version of the goat reference genome (ARS1). A Neighbor-joining tree based on Reynolds genetic distances showed that goats from Africa, Asia and Europe tend to group into independent clusters. Because goat breeds from Oceania and Caribbean (Creole) all derive from imported animals, they are distributed along the tree according to their ancestral geographic origin. Conclusions We report on an unprecedented international effort to characterize the genome-wide diversity of domestic goats. This large range of sequenced individuals represents a unique opportunity to ascertain how the demographic and selection processes associated with post-domestication history have shaped the diversity of this species. Data generated for the project will also be extremely useful to identify deleterious mutations and polymorphisms with causal effects on complex traits, and thus will contribute to new knowledge that could be used in genomic prediction and genome-wide association studies.
Literature search shows that there are very limited papers on museums in Malawi (Baker, 2011; Gondwe, 2009 Gondwe, , 2011 Gondwe, , 2012 Maluwa, 2006; Mtonga, 2006 and Newlands, 1984) . ... Gondwe (2011 Gondwe ( , 2012 narrated how the Museums of Malawi is addressing the current wide range of issues of health, poverty, food security and civic education through outreach education programs ...doaj:bd0611880c6e428d92cabb45fb6a943b fatcat:k4xk7wj475hvzptnitn4cfkqjm
Felix, ' Untersueh. iiber d. inneren Bau Westt~dlischer Carbon-Pflanzen,' Abh. k. Preuss. Geol. Landesanst. vol. vii. (1886) pt. iii. pl. ii. ... from different horizons in the Gondw~Ina Series of India have in several instances formed the types of new species founded on quite inadequate grounds. ...doi:10.1144/gsl.jgs.1897.053.01-04.25 fatcat:46tkhyfqlzerrccamizpmdyfga
Evangelos (2001) and Gondwe (2001) stated that although globalization is a powerful engine of the world economy, its benefits have not been evenly distributed. ... state owned industry in order to qualify for IMF and World Bank loans and the increasing dominance of Western corporate culture across the globe has come to symbolize globalization for its critics (Felix ...doi:10.4314/ijah.v7i2.12 fatcat:xlxbvbvw5zf73ma3rmed22affy
Globalizations as documented by Gondwe (2011) have enriched the world scientifically, culturally and to have benefited a large number of people economically. ... industrial inputs, dwindling capacity utilization, high cost of production, low value added, declining output growth, low employment generation and inadequate linkages with other sectors of the economy (Felix ...doi:10.37745/ijdes.13/vol10n3pp118 fatcat:plctnnocx5bh7irjjuagitflcy
Similar to its precursor DMSP the main production time for MS À in the Southern Hemisphere is the austral summer [Gondwe et al., 2003] , when the algae bloom approaches its end. ... and especially methane sulfonate (MS À ), which is solely of marine biogenic origin, have attracted increasing attention as potential records of marine productivity and radiative forcing in the past [Gondwe ...doi:10.1029/2005jd005872 fatcat:vbhifga6tjaz5oa2itedjnjp4i
African Journal of Agricultural Research
., 1996a, b; Gondwe, 1998; Chataika et al., 2011; Duncan et al., 2014) . Halo blight is difficult to control. ... significance differences of disease incidence and severity among bean varieties tested which is in agreement with previous studies which report different races of halo blight affecting common bean (Félix-Gastélum ...doi:10.5897/ajar2018.13254 fatcat:tytgnqni2jacrc34pznxvqoe3m
Dr Felix Chingota (Blantyre Synod) who was the moderator of the General Assembly at the time and Rev. Y.A. ... See: Joyce Dainess Mlenga, Women in Holy Ministry in the Church of Central Africa Presbyterian Synod of Livingstonia: A study of perceptions, TRS PhD Module, Mzuzu University, 2008. 27 See: Esela Gondwe ...doi:10.17159/2412-4265/2016/1243 fatcat:g7q3yhv24jb3pjo75sgqabztrm
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