Browsing by Author "Katundu, Kondwani"

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    Barriers and facilitators to screening for dyslipidaemia, hypertension and diabetes among people living with HIV aged 40 years and above at ART clinics in district hospitals in Southern Malawi
    (2021-11-18) Katundu, Kondwani
    Study Type: The study will utilise a mixed-methods (convergent) approach. Background: Malawi is ranked among the countries in the world with the highest burden of atherosclerotic cardiovascular diseases (ASCD) among people living with HIV (PLWH). Dyslipidaemia, Hypertension, and diabetes mellitus (DM) are major risk factors for ASCD and lead to debilitating consequences such as stroke. There is a gap in the effectiveness in identifying and managing hypertension dyslipidaemia and DM among PLWH in many public health facilities across Malawi. Investigating the local barriers and facilitators in the Malawian setting is critical to creating better implementation strategies for the effective screening and management of these cardiovascular risk factors in district hospitals of the country. Study Objectives: The objectives of this study are: (a) to determine the proportion of PLWH aged 40 years and older who are evaluated for dyslipidaemia, hypertension and DM in routine care at district hospital ART clinics in Southern Malawi (b) to identify the barriers and facilitators to screening for dyslipidaemia, hypertension and DM among PLWH) aged 40 years and older at ART clinics in district hospitals in Southern Malawi. Methods: A mixed-methods (convergence) approach will be used to collect the study data. Firstly, we will quantitatively collect retrospective data on the performance of five randomly selected district hospital ART clinics in Southern Malawi to screen for hypertension, dyslipidaemia and DM in routine care. From these clinics, we will purposefully select three clinics rated as highest, intermediate and low on the screening performance for hypertension, which is the expected standard routine assessment in these clinics, according to Malawi standard clinical guidelines for the management of PLWH. In the three clinics we will collect qualitative data guided by the Consolidated Framework for Implementation Research (CFIR), and we will assess for three major domains namely the intervention, the inner setting and the characteristics of individuals. Expected findings and dissemination: We expect to find a relatively high prevalence of screening for hypertension since it is in the national management guidelines. However, we hypothesize that the prevalence for screening for DM and dyslipidaemia will be lower due to the lack of inclusion in the national guidelines and screening resources in district hospitals. We expect to identify the barriers and facilitators to the integration of screening of hypertension, DM and dyslipidaemia in the ART clinics. The results once analysed will be published in an international scientific journal and will be presented both at local and regional or international conferences. Published results will also be submitted to the district hospitals engaged, the HIV and non-communicable diseases units of the MalawiMinistry of Health, the College of Medicine Research and Ethics Committee (COMREC) and the Kamuzu University of Health Sciences Library.
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    Barriers and facilitators to screening for dyslipidaemia, hypertension and diabetes among people living with HIV aged 40 years and above at ART clinics in district hospitals in Southern Malawi
    (Kamuzu University of Health Sciences, 2021-11-18) Katundu, Kondwani
    Study Type: The study will utilise a mixed-methods (convergent) approach. Background: Malawi is ranked among the countries in the world with the highest burden of atherosclerotic cardiovascular diseases (ASCD) among people living with HIV (PLWH). Dyslipidaemia, Hypertension, and diabetes mellitus (DM) are major risk factors for ASCD and lead to debilitating consequences such as stroke. There is a gap in the effectiveness in identifying and managing hypertension dyslipidaemia and DM among PLWH in many public health facilities across Malawi. Investigating the local barriers and facilitators in the Malawian setting is critical to creating better implementation strategies for the effective screening and management of these cardiovascular risk factors in district hospitals of the country. Study Objectives: The objectives of this study are: (a) to determine the proportion of PLWH aged 40 years and older who are evaluated for dyslipidaemia, hypertension and DM in routine care at district hospital ART clinics in Southern Malawi (b) to identify the barriers and facilitators to screening for dyslipidaemia, hypertension and DM among PLWH) aged 40 years and older at ART clinics in district hospitals in Southern Malawi. Methods: A mixed-methods (convergence) approach will be used to collect the study data. Firstly, we will quantitatively collect retrospective data on the performance of five randomly selected district hospital ART clinics in Southern Malawi to screen for hypertension, dyslipidaemia and DM in routine care. From these clinics, we will purposefully select three clinics rated as highest, intermediate and low on the screening performance for hypertension, which is the expected standard routine assessment in these clinics, according to Malawi standard clinical guidelines for the management of PLWH. In the three clinics we will collect qualitative data guided by the Consolidated Framework for Implementation Research (CFIR), and we will assess for three major domains namely the intervention, the inner setting and the characteristics of individuals. Expected findings and dissemination: We expect to find a relatively high prevalence of screening for hypertension since it is in the national management guidelines. However, we hypothesize that the prevalence for screening for DM and dyslipidaemia will be lower due to the lack of inclusion in the national guidelines and screening resources in district hospitals. We expect to identify the barriers and facilitators to the integration of screening of hypertension, DM and dyslipidaemia in the ART clinics. The results once analysed will be published in an international scientific journal and will be presented both at local and regional or international conferences. Published results will also be submitted to the district hospitals engaged, the HIV and non-communicable diseases units of the Malawi Ministry of Health, the College of Medicine Research and Ethics Committee (COMREC) and the Kamuzu University of Health Sciences Library.
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    Serum levels of vitamin C and D in adult individuals with diabetes and hypertension compared to healthy controls, and the supplementation tendencies of the vitamins among non-severe COVID-19 patients in Blantyre, Malawi by Dr Kondwani Katundu
    (Kamuzu University of Health Sciencies, 18-10-21) Katundu, Kondwani
    Executive Summary Study Title: Serum levels of vitamin C and D in adult individuals with diabetes and hypertension compared to healthy controls in Blantyre, Malawi. Study Type: Cross-sectional Background: Vitamin C and D mitigate the progression of atherosclerosis in individuals with Diabetes mellitus (DM) and hypertension. DM and hypertension are risks for worse outcome in COVID-19, and low blood Vitamin C and D associate with the severity of COVID-19 disease. Vitamin C and D status in healthy controls compared with DM and hypertension has not been well described in Malawi. Study Objectives: This study aims to determine the prevalence of serum vitamin C and D deficiency in adult individuals with diabetes and hypertension in Blantyre, Malawi. Methods: This will be a cross-sectional where we will analyse serum samples for vitamin C and D from a cross-sectional study in adult individuals with DM (n=75) and hypertension (n=75) at QECH and age-matched healthy controls (n=75). Sample-size: The sample size for the determination of serum vitamin C and D study of 75 participants in each of the three groups (total 225) was calculated to detect at least 15% prevalence of hypovitaminosis in the healthy individuals compared to the individuals with DM and hypertension, respectively, at a power of 80% and 95% confidence interval. Outcomes and definitions: The primary outcomes of the study will be the prevalence of vitamin C and D deficiency and insufficiency in the study population groups. Vitamin C deficiency and insufficiency will be defined as serum vitamin C concentration of ≤11.4 μmol/L and ≤23.0 - 28 μmol/L respectively. Vitamin D deficiency and insufficiency will be defined as 25(OH)D of ≤20 ng/ml (50 nmol/L) and ≤21–29 ng/ml respectively. Expected findings and dissemination: Vitamin C deficiency and insufficiency is prevalent (up 56%) in low-income countries, and the low fruit intake in most Malawian households likely predispose individuals to low vitamin C status. We expect low vitamin C status of at least 20% in the study populations. Low vitamin D status of up to 60% has also been reported in a recent African review, which did not include data from Malawian adults. We also expect a positive association between the low vitamin C status with HBA1C, dyslipidaemia and poorly controlled hypertension. The results once analysed will be published in an international scientific journal and will be presented both at local and regional or international conferences. Published results will also be submitted to the Malawi Liverpool Welcome Trust Clinical Research Programme, College of Medicine Research and Ethics Committee (COMREC), Kamuzu University of Health Sciences Library, Blantyre District Health and Social Services Office and Queen Elizabeth Central Hospital.
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    Supplementation tendencies of vitamin C and D among non-severe COVID-19 patients in Blantyre, Malawi
    (2021-11-18) Katundu, Kondwani
    Study Type: Retrospective cross-sectional quantitative study. Background: Low blood Vitamin C and D have been associated with the severity of Coronavirus disease 2019 (COVID-19). The practice of vitamin supplementation among individuals with non-severe COVID- 19 disease appears to be common, but the frequency and dose of these vitamins among this population group has not been well evaluated in Malawi. Study Objectives: This study aims to determine prevalence and dose of supplementation of the vitamin C and D among non-severe COVID-19 patients in Blantyre, Malawi. Methods: We will conduct a retrospective study in randomly selected recovered non-severe COVID-19 adults (n=150) in Blantyre, Malawi who had a COVID-19 infection between January and September 2021. We will acquire information on the frequency, dose and duration of vitamin C and D supplementation during an episode of the non-severe COVID-19. Sample-size: The sample size for the study will be 150 participants was calculated to detect at least 40% frequency use of vitamin C and D supplementation at a power of 80% and 95% confidence interval. Outcomes and definitions: Vitamin C and D supplementation will be considered as any pharmacological form of the vitamins taken orally or parenterally at least at one point during the sickness episode of nonsevere COVID-19 infection. The prevalence of supplementation, the mean dose and the duration of supplementation will be calculated. Expected findings and dissemination: We expect at least 50% use of vitamin C and D supplementation in individuals with non-severe COVID-19. The results once analysed will be published in an international scientific journal and will be presented both at local and regional or international conferences. Published results will also be submitted to the Malawi Liverpool Welcome Trust Clinical Research Programme, College of Medicine Research and Ethics Committee (COMREC), Kamuzu University of Health Sciences Library, Blantyre District Health and Social Services Office and Queen Elizabeth Central Hospital
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    Supplementation tendencies of vitamin C and D among non-severe COVID-19 patients in Blantyre, Malawi
    (Kamuzu University of Health Sciences, 2021-11-21) Katundu, Kondwani
    Study Type: Retrospective cross-sectional quantitative study. Background: Low blood Vitamin C and D have been associated with the severity of Coronavirus disease 2019 (COVID-19). The practice of vitamin supplementation among individuals with non-severe COVID- 19 disease appears to be common, but the frequency and dose of these vitamins among this population group has not been well evaluated in Malawi. Study Objectives: This study aims to determine prevalence and dose of supplementation of the vitamin C and D among non-severe COVID-19 patients in Blantyre, Malawi. Methods: We will conduct a retrospective study in randomly selected recovered non-severe COVID-19 adults (n=150) in Blantyre, Malawi who had a COVID-19 infection between January and September 2021. We will acquire information on the frequency, dose and duration of vitamin C and D supplementation during an episode of the non-severe COVID-19. Sample-size: The sample size for the study will be 150 participants was calculated to detect at least 40% frequency use of vitamin C and D supplementation at a power of 80% and 95% confidence interval. Outcomes and definitions: Vitamin C and D supplementation will be considered as any pharmacological form of the vitamins taken orally or parenterally at least at one point during the sickness episode of nonsevere COVID-19 infection. The prevalence of supplementation, the mean dose and the duration of supplementation will be calculated. Expected findings and dissemination: We expect at least 50% use of vitamin C and D supplementation in individuals with non-severe COVID-19. The results once analysed will be published in an international scientific journal and will be presented both at local and regional or international conferences. Published results will also be submitted to the Malawi Liverpool Welcome Trust Clinical Research Programme, College of Medicine Research and Ethics Committee (COMREC), Kamuzu University of Health Sciences Library, Blantyre District Health and Social Services Office and Queen Elizabeth Central Hospital.