Anaemia

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    Experiences of caregivers of children living with sickle cell disease in Blantyre, Malawi
    (Kamuzu University of Health Sciences, 2020-11-11) Ngutwa, Nellie
    Type of study This is a descriptive qualitative study that will explore experiences of caregivers of children living with sickle cell disease. Problem statement In Malawi it has been reported that confirmed cases of Sickle cell disease in children have reported increased number of admissions, pain episodes and anaemia (Heimlich et al., 2016).To improve outcomes, early therapeutic interventions are recommended, however trends have shown poor attendance of children at the QECH sickle cell clinic. There is need to explore issues surrounding the poor turnover. These can be solicited where the experiences of the caregivers are known. There are no published studies on experiences of caregivers living with sickle cell children in Malawi. As such it is important to explore experiences of these caregivers. Study objective Broad objective To explore experiences of caregivers of children living with sickle cell disease. Specific objective 5. To describe the emotional impact of learning SCD diagnosis in their children 6. To describe the caregiver’s role in the care of their Sickle cell Children 7. To identify challenges experienced and coping strategies used in the care of their Sickle Cell children 8. To identify the forms of support caregivers, receive when caring for their Sickle Cell children Methodology The study will be conducted in Blantyre, Malawi under QECH 15 participants who are caregivers to children with sickle cell will be included. The study will utilize qualitative data collection and analysis method Expected findings The study is expected to report experiences of caregivers living with sickle cell children specifically challenges relating to their psychosocial aspect of life. Dissemination The results will be disseminated through meetings at institutions departmental level and Continuous Professional Development session. Written reports will be sent to the Hospital Director, the unit Matron, head of Sickle cell clinic and College of Medicine Research Committee. A manuscript will be submitted to a peer reviewed journal for publication. The results will also be shared at conferences both national and international.
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    Prevalence of Thalassemia in anaemic pregnant women at Kamuzu Central Hospital and Bwaila Hospital In Lilongwe, Malawi
    (2022-01-19) Mbewe, Folias
    Despite pregnant women being on ferrous sulphate, some are still present with clinical anaemia (haemoglobin less than 10.5g/dL) Basing on the finding of Malawi Macronutrient Survey that 33% of Pre – School Children (PSC) are carriers for alpha – thalassemia. This anaemia in pregnant women despite on ferrous sulphate for iron deficiency could be due to alpha – thalassemia. Patients with alpha – thalassemia are not supposed to get ferrous sulphate due to iron overload. This iron overload has negative impact towards pregnancy.(10) Hemoglobin concentrations higher than normal have been associated with higher rates of preeclampsia, prematurity, and fetal growth restriction(11)(12)
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    Magnitude of depression and associated factors among primary school teachers in Blantyre city, southern region of Malawi
    (2022-01-19) Mhango, Pluto; Simoko, Anthony; Nyoso, Edwin; Mlenga, Paul
    Type of study: Cross-sectional study design will be used in this study. Problem: this study aims to assess the magnitude of depression and associated factors among the primary school teachers in Blantyre city, southern region of Malawi. Objectives: We aim at assessing magnitude of depression and associated factors among primary school teachers in Blantyre city, Malawi. Methodology: The project will be a cross sectional study and will use PHQ-9 to assess the severity of depression. A minimum calculated sample size of 384 participants will be used from 15 randomly selected primary schools in Blantyre city. Expected results: This study might uncover the magnitude and associated factor among primary school teachers
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    Evaluation of intergrating intravenous iron therapyfor treatment of anaemia in pregnant women in Malawi
    (2022-06-06) Mategula, Elizabeth
    Executive Summary Type of Research Study: This is a cross-section study. We will use a mixed-methods approach. We are using a combination of qualitative and quantitative approaches. The problem: Anaemia has significant consequences on both the mother and child's health as it results in maternal haemorrhage, low birth weight, premature delivery, poor organ development, and infections at birth and hence the need for treatment. World Health Organisation defines anaemia in pregnancy as having low haemoglobin of less than 11.0 g/dl. In Malawi, 38% of pregnant women have anaemia. In low-middle income countries, anaemic pregnant women are recommended to take 30 mg to 60 mg of elemental iron daily throughout pregnancy. However, oral iron tablets are often poorly tolerated. A potential alternative to oral iron is intravenous (IV) iron which allows the saturation of the body iron stores quickly Currently, a randomised controlled trial on the Effect of intravenous iron on Anaemia in Malawian Pregnant women (REVAMP) is underway that aims to assess whether pregnant women in Malawi have a single dose of IV ferric carboxymaltose (FCM) iron is safe, efficacious and improves maternal and neonatal health outcomes. Suppose the use of IV iron during pregnancy would be effective in Malawi. In that case, it could change how we treat and manage pregnant women with anaemia and be scaled up throughout Malawi to improve maternal and child health. However, the feasibility and acceptability of implementing IV iron into routine antenatal care in low-income, low resource settings are unknown. Objectives: This research project's broader goal is to determine the acceptability and feasibility of implementing intravenous iron among pregnant Malawian women with moderate to severe anaemia in their third trimester. Specifically, we will i) explore the perceptions of different stakeholder on the use of IV iron. ii) identify factors (behaviour and socio-cultural norms) that impact pregnant women's ability to seek IV iron intervention. iii) to estimate the direct and indirect cost incurred by the pregnant women in accessing IV iron intervention or oral iron. Iv) estimate the cost of delivering IV iron or oral iron to pregnant women at the health facility level. v) examine the relationship of the appropriateness of care to pregnant women’s experiences, preferences, satisfaction, and caregiver support in engaging with health care services in accessing IV iron intervention. Methodology: This is a crosscutting study where we will recruit both providers and end-users to participate. We will do in-depth-interviews policymakers, health managers, health workers, pregnant 06-Jun-2022 REVASMP-IS-4As version1 14/02/2022 VI women, and community members a maximum of 12 participants each category. Data will be recorded, transcribed and imported to NVivo. We will employ thematic analysis to answer the ability of pregnant women to seek and engage with the IV iron intervention. Health economics analysis will explore the health systems/ service delivery costs including costs associated with care seeking and receipt of treatment. Data on cost will be collected from the 8 health facilities of zomba and entered into Microsoft excel for the calculations of averages, proportions and applying test of significance using STATA software Constraints Covid 19: Understanding that the Covid-19 situation has now improved in Malawi so that there are currently few cases in a day, all activities concerning this project will be done physically. However, it will be a must that all personnel working on this project are vaccinated and that all covid 19 measures are followed. Expected findings and dissemination: We expect to find that pregnant women can seek, reach, and engage with IV iron intervention. The health facility system can cover the cost of IV iron intervention delivery. These results will help inform decisions to introduce and implement the intervention of IV iron in Malawi to improve maternal and child health outcomes. The dissemination of our findings will promote evidence-based decision-making on the barriers and facilitators to implementing and upscaling the intervention into routine practice and care. Results will be shared through annual meetings with the District Health Office and collaborators and national research meetings, such as the College of Medicine's yearly research dissemination conference (COMREC) and presented at international research conferences. Results will be prepared for publication in international peer-reviewed scientific journals and shared with COMREC. The significant outcome of this research will be a PhD thesis. 06-Jun-202
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    Assessing the change in bleeding rates and related clinical outcomes in haemophilia patients before and after introducing Humanitarian Aid factor concentrates in Malawi
    (Kamuzu University of Health Sciences, 2022-08-05) Mkwenembere, Francis
    Type of study This study will be a retrospective cohort that will use existing de-identified data from the WBDR to be obtained from an observational study of a larger COMREC approved haemophilia cohort study titled “Health-related quality of life in haemophilia patients in Malawi” (P.02/19/2612) which is being conducted by the Society of Haemophilia and Allied Disorders (SHAD). Study problem There is data paucity on haemophilia in Malawi. Literature review showed that many research studies were done in high income countries that mostly focused on comparison of treatment modalities of prophylaxis and on demand. The Malawi NCDI Commission 2018 Report lacked representation of haemophilia disease suggesting limited data of haemophilia research in Malawi. Objectives This study aims at assessing the change in bleeding rates and related clinical outcomes in haemophilia patients before and after introducing clotting factor concentrates in Malawi. Specifically, it will assess the change of annual bleeding rates before and after clotting factor concentrates, compare the quality of life before and after exposure of factor clotting factor concentrates and estimate the difference regarding days lost to work or school before and after clotting concentrates Methodology Data will be analysed using Stata 15 and continuous variables will be summarised either using Mean/Standard deviation or median/interquartile range depending on the normality. Wilcoxon Rank Sum Test will be used for comparison with a p-value of <0.05 considered statistically significant. Expected findings The study is expected to reveal any difference in bleeding rates, quality of life and improved clinical outcomes between the time prior and after the introduction of use of factor concentrates in Malawi. Dissemination Results will be shared with COMREC, Kamuzu University of Health Sciences, WFH, SHAD, and Ministry of Health through the Department of Non-Communicable Diseases. The results will also be disseminated through various symposia and will be submitted for publication in peer-reviewed journals.