Browsing by Author "Laher, Beverly"

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    The feasibility and acceptability of asthma self-management delivered through a mobile phone application. A pilot study (Asthma m-health)
    (Kamuzu University of Health Sciences, 2020-11-11) Laher, Beverly
    Type of study: Mixed methods pilot study Problem: Despite the high rates of mortality and morbidity due chronic respiratory diseases (CRDs), attention to this group of diseases is arguably insufficient both at global, regional and country level. Globally asthma is a significant cause of reduced quality of life and death in all age groups across the life span. Asthma ranks number 28 on the global burden of disease list and contributes substantially to years lived with disability. In children is it the most common NCD and has devastating socioeconomic consequences. Asthma management requires a long-term approach due its chronic nature and the variability of asthma symptoms, triggers and exacerbations. Current guidelines advocate for self-management as part of standard care. However low-income countries like Malawi struggle to accommodate this practice due to shortage of resources. Emerging literature suggest that LMICs particularly in Africa are experiencing an increase in the burden of disease which hinders delivery of self-management services. Malawi is no exception to the escalating burden of asthma amidst insufficient resources. Mobile phone health application (MHealth) have been reported to be an effective and cost-effective tool in the monitoring and management of chronic disease like asthma. This study therefore aims to determine the feasibility and acceptability of an asthma selfmanagement mobile phone application in a resource-limited environment. Methodology: This will be a mixed methods pilot study assessing the feasibility and acceptability of using a mobile phone application (AsthMWa) for asthma self-management. The study will recruit a sample of 20 asthma patient aged 10-years and above, from the paediatric general clinic at Queen Elizabeth Central Hospital. Participants will be issued a phone with a pre-installed application (AsthMWa) which will collect information on medication use, self-assessment of symptoms and a personal asthma action plan. Participants will also participate in semi structured interviews, collecting data on acceptability, barriers to using the app and suggestions for modifications. We will take informed consent and assent and adhere to strict data protection procedures. Expected findings and dissemination: The study will determine the feasibility and acceptability of the asthma mobile health in the self-management of asthma in a low resource setting. The qualitative and quantitative results from this study will explore the ability of the application to collect the intended information and the patients capability to use the app to manage their Asthma. These results will also for a probable baseline for future research. The findings will be presented to COMREC and the College of Medicine Research Dissemination Conference. In addition, findings will also be presented at Malawi Liverpool Welcome Trust and published in a peer-reviewed journal.
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    Socio-economic factors associated with hypertension in adults aged 45 and below in Malawi- a cross sectional study
    (Kamuzu University of Health Sciences, 2020-11-11) Laher, Beverly
    Type of study: Quantitative cross-sectional Study Problem: Despite the high rates of mortality and morbidity due to NCDs, attention to this group of diseases is arguably insufficient both at global, regional and country level. Hypertension is the leading cause of cardiovascular disease and its prevalence continue to escalate in the least developed parts. Hypertension is responsible for at least 45% of deaths due to heart disease and 51% of deaths due to stroke. The highest prevalence of hypertension is documented in the African region at an estimated 46% in 2013. Studies initially identified hypertension to be a disease of the affluent. However emerging evidence suggests that the condition also affects those from underserved and socially disadvantaged communities like Malawi, where 65% of the population is reported to be poor and resides in rural areas. Most studies establishing this association used income and expenditure as economic indicators. These indicators may not depict the economic status of rural Malawians as most are not formally employed nor do they document household expenditure. In addition, globally reported hypertension risk factors such as obesity and physical inactivity in Malawi are uncommon. It is reported that most hypertensives in Malawian are lean, young and highly physically active. Establishing context specific factors associated with hypertension, may improve its management and assist in the attainment of the WHO target to reduce hypertension by 25%. This study therefore aims to determine the socioeconomic factors associated with hypertension in rural Malawi using the wealth index as an economic indicator. This study also aims at determining the mechanism through which low socioeconomic status leads to hypertension. Methodology: This will be a population-based study using secondary data from the Malawi Longitudinal Study of Families and Health (MLSFH), a long-standing publicly-available longitudinal cohort study that documents more than two decades of demographic, socioeconomic and health conditions in three districts in Malawi.In particular, this analysis will focus on cross-sectional survey data for 2019; focusing on Education levels, stress and household wealth as potential socioeconomic correlates for hypertension. This study aims to determine the association of household wealth, stress and hypertension. Ethical issues including seeking permission to access, use and protect the data will be followed. Expected findings and dissemination: The investigator will determine the socioeconomic factors associated with hypertension in a low socioeconomic setting, in rural Malawi. The findings will be presented to COMREC and the research dissemination organized by the college, the department for viva and publishing findings in a recognized health peer-reviewed journal once accepted