Maternal & Child Health

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    Sustainable scale-up of “Best Practice” for the diagnostic evaluation and clinical management maternal infections and sepsis in Malawi
    (Kamuzu University of Health Sciences, 2021-11-19) Twabi, Hussein Hassan
    The type of research study We will conduct a cross-sectional survey using retrospective and prospective routine data on maternal infections and sepsis from the Kamuzu University of Health Sciences Microbiology laboratory and the Queen Elizabeth Central Hospital (QECH). 2.2 The problem to be studied Most of the maternal deaths in the world occur in sub-Saharan Africa and are predominantly caused by maternal infections and sepsis. However, there is a paucity of data to inform the organismspecific therapy of maternal infections. Coupled with the narrow range of available antimicrobials, there is an imminent threat of an outbreak of drug-resistant bugs in our maternal units. This study aims to describe the aetiological landscape of maternal infections and sepsis in secondary and tertiary care facilities in the Southern Region of Malawi, while profiling the antimicrobial resistance patterns in this setting. 2.3 The Research objectives 2.3.1 Broad objective • To describe the aetiological landscape of maternal infections and sepsis in secondary and tertiary care facilities. in the Southern Region of Malawi. 2.3.2 Specific objectives • To determine the prevalence of maternal infections and sepsis in secondary and tertiary care facilities in the Southern Region. • To describe the factors associated with maternal sepsis • To describe the antimicrobial resistance profile of maternal infections • To determine the immediate maternal and foetal outcomes of maternal sepsis • To describe the factors associated with poor maternal and foetal outcomes due to maternal infections and sepsis 2.4 Methodology We conduct a survey of the existing data storage and management systems at QECH OBGYN department, which will involve an electronic self-administered questionnaire that are to be filled by facility staff to investigate the existing record keeping facilities at the department. We will then conduct a retrospective review of case files from records at QECH OBGYN department as well as a review of microbiological reports of samples analysed by the microbiology lab at the Kamuzu University of Health Sciences Microbiology lab with a case file analysis of positive microbiology samples for outcome data. 2.5 Expected findings and their dissemination. We hypothesize that there is increasing prevalence of maternal infections and sepsis in Blantyre, especially with the more inclusive definition of maternal infection and sepsis that the WHO has recommended. The results of this study will be submitted to College of Medicine Research and Ethics Committee (COMREC) and to journals for peer-reviewed publication. The results of the trial will also be shared with policy makers at the Ministry of Health in Malawi and the World Health Organization (WHO).