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- ItemRestrictedPrevalence of Sexually Transimitted Infections and Predisposing Factors Among the Youths in Ndirande(Kamuzu University of Health Sciences, 2022-07-11) Magaso, Justice; Kondowe, John; Mteya, Jefter; Takadi, IrvineEXECUTIVE SUMMARY Ndirande Township is one of the largest townships in Malawi. With an approximate population of over 130,000, Ndirande is a bustling township where everything and anything gets traded. Being one of the most highly populated areas in Blantyre, Ndirande is faced with different development issues such as poverty, poor housing, and inadequate farming land. It is a vibrant community from which many young people reside and are vulnerable to risky behaviours such as unsafe sex, which exposes them to different STIs. The prevalence of STIs is increasing among youths in many countries including Malawi, however little is known about the extent of the spread as well as the predisposing factors to this in Malawi. A mixed method study involving participants will be conducted to assess the prevalence of STIs among the youths of Ndirande. The main objective will be to determine the prevalence of STIs among the youths. The other objectives include; to compare the association of gender and STIs; to explore the factors that predisposes the youths to contract STIs and to assess the health seeking behaviours of the youths affected as well as their barriers. The study will be conducted at Ndirande Health Centre in Blantyre. It will include boys and girls of ages ranging from 18 to 24 years. The information will be disseminated to the Kamuzu University of Health Sciences academic staff and students during the dissemination day in 2021/2022. The final report of the study findings will be submitted to our research supervisor and College of medicine Research Committee. JUSIFICATION OF THE STUDY In 2012, 286 million people age 12-24 lived in Africa, accounting for 18% of the global youth population (7). By 2040, the number of young people in Africa is projected to increase by 60% to 466 million (7). Young people aged 15-24 make up the largest and fastest growing proportion of the general population in Malawi. The 2018 Malawi population and housing census shows 51% of the population is below 18 years (8). It has been estimated that 25% of STIs cases nationwide occur among young people aged 15-24 years (8) Blantyre city has a bigger population of young people who live and work there. One of the most youthful population areas in Blantyre is Ndirande. Most young people live and work there. According to the report from Ndirande health centre, in 2020, one thousand fifty-three persons (from the director of Ndirande Health Centre) visited the health centre for screening and treatment of STIs. The health centre records suggest that STI prevalence among youths in Ndirande might be higher than that of the nationwide hence need to do more research on the prevalence of the STIs, factors that predisposes and the health seeking behaviour of youths in Ndirande. OBJECTIVES OF THE STUDY BROAD OBJECTIVE To determine the prevalence of STIs among youths in Ndirande SPECIFIC OBJECTIVES ❖ To quantify the prevalence of STIs among youths in Ndirande. ❖ To compare the association of gender and STIs ❖ To explore factors that predisposes the youths to contracting STIs ❖ To assess the health seeking behaviour of the youths affected by the STIs and their barriers. METHODOLOGY RESEARCH STUDY DESIGN We will use cross sectional study design where we will adopt a mixed methods approach. STUDY PLACE The study will be conducted both in Ndirande area and at Ndirande health centre. STUDY POPULATION Young people both males and females aged 18 to 24 in Ndirande. INCLUSION CRITERIA Study eligibility will require young people with ages from 18 to 24 years old living in Ndirande EXCLUSION CRITERIA All young people below 18 years and above 24 years and those who don’t stay in Ndirande STUDY PERIOD The study will be carried out during the MBBS 4 research block. The first 2 to 3 weeks will involve data collection. The fourth week will involve data management and analysis. The fifth week will involve writing a final report and also starting writing a presentation for dissemination. SAMPLE SIZE A sample of 288 has been calculated with a confidence interval of 95% and an error margin of 5% using the formula: n = [(Zɑ/2)2PQ]/D2 (S.K.Lwanga, S.Lemeshow, 1991) P = Population with STI Q = population without STI (1-P) D = margin of an error Zɑ/2=coefficient at a given level of confidence, at 95% Confidence interval, Z=1.96 n = [(1.96)2 0.25x 0.75]/(0.05)2 = 288 288 people is calculated working sample that we are going to use. we are to get second data of 288 youths who visited Ndirande Health Centre for STI screening and treatment. We agreed that we are going to interview 28 youths from different areas within Ndirande. DATA COLLECTION Primary data will be collected using semi-structured interview guide which will be in Chichewa. The secondary data will be collected from Health Management Information Systems (HMIS) e.g., health registers from Ndirande Health Centre. The information collected will be categorized in the following: ✓ Gender ✓ Predisposing factors to STIs ✓ Age range at risk ✓ Health seeking behaviour We will obtain the information about the last specific objective ‘To assess the health seeking behaviour of the youths affected by the STIs and their barriers’ through our interviews with the study participants. We anticipate that our interviews in the sample population during primary data collection, will give us people within Ndirande who have STIs or at some point had STIs. We will then enquire about how they sought the treatment and what were the obstacles they encountered during their treatment seeking from the hospital. DATA MANAGEMENT AND ANALYSIS Data will be sorted and quality checks will be done. Quantitative analysis of data will be done using Microsoft Excel. The recorded qualitative data will be transcribed and coded. RESULTS PRESENTATION After analysis of the data, the results will be presented in different formats. Tables, histograms and pie charts are the formats in which the data will be presented. DISSEMINATION OF THE RESULTS The study findings will be disseminated to the KUHeS academic staff and students. The final report of the study findings will be submitted to our research supervisor. A copy of the final report of results will be submitted to COMREC and KUHeS Library. Other institutions and researchers can use the research findings to identify the gap when they want to conduct their research or carry out some interventions.
- ItemRestrictedPrevelance of vaginal candidiasis in women with cervical cancer at QECH(Kamuzu University of Health Sciences, 2022-02-09) Agness Banda Mphatso, KamingaHuman papillomavirus (HPV) is the necessary cause of cervical cancer. Vulvovaginal infection with pathogens like Candida Albicans is a likely cofactor. The interactions between HPV and Candida albicans are less understood, although inflammation induced by these pathogens has been demonstrated to facilitate oncogenesis. 1.2 Objectives Our study is aimed to evaluate the association between C. Albicans with HPV in cervical oncogenesis at QECH. 1.3 Methodology It is a quantitative cross sectional study. 65 participates will be recruited from the wards in the Gynecology Department at Queen Elizabeth Central Hospital. Their age, cervical cancer diagnosis and use of antifungal medication will be assessed using questionnaires. High vaginal swabs will then be collected from the participants to test for the presence of C. Albicans. The collected data will be summarized in terms of graphs and tables. SPSS will be used to analyse the data and come up with an estimation of the association between cervical cancer and vaginal candidiasis. 1.4 Expected findings A higher prevalence of vaginal candidiasis is an expected to be found in women with cervical cancer. 2 Introduction and literature review 2.1 Introduction Vaginal candidiasis is a yeast infection of the vagina and vulva caused by genus candida. Among the 5 species of candida yeast associated with candidiasis, C. Albicans is the most prevalent (1). C. Albicans is a commensal of the skin, mouth, throat, gastrointestinal tract and vagina. However, it can cause vaginal candidiasis if it grows out of control. This can occur can occur with taking broad-spectrum antibiotics,hormonal fluctuations and during chemotherapy. In vaginal candidiasis, candida adheres to the vaginal epithelial cells .This interaction disrupts the vaginal epithelium causing inflammation, lesions and changes in the cervical cells(2). Cervical cancer is a malignant tumor that occurs in the cells of the cervix — the lower part of the uterus that connects to the vagina. Various strains of the human papillomavirus (HPV), a sexually transmitted virus, play a role in causing most cervical cancer. The common HPV serotypes that cause cervical cancer are 16 and 18(3). When exposed to HPV, the body's immune system typically prevents the virus from doing harm. However, literature suggests that 10% of women with HPV infection on their cervix will develop long-lasting infections that contribute to the progression of cervical cancer(4).
- ItemRestrictedPrevalence of STI’s among pregnant women who visit antenatal care clinic in peri-urban health centers in Blantyre(Kamuzu University of Health Sciences, 2022-02-09) Kawonga, Nathan; Machilika, Innocent; Glory, KaundaPregnant women are at an increased risk of being infected with STIs which has a potential to cause undesirable effects to the mothers themselves as well as the unborn child. Therefore estimating the prevalence of the STIs would raise an alarm and possibly timely interventions and management of the conditions before it causes complications. The broad objective of this study is to determine the prevalence of STIs among pregnant women who attend antenatal care clinic in the peri-urban health centers of Blantyre city. The second objective is to ascertain factors that contribute to higher prevalence of STIs. This is both quantitative and qualitative research which is anticipated to be carried out in the selected periurban health centers of Blantyre city. In the study, quantitative method will be used to collect secondary data of number of women who were diagnosed with STIs in the past 6 months among all pregnant women who attended the clinic. Qualitative primary data will be obtained from the pregnant women themselves who will happen to be convenient at the time of the study. Questionnaires will be used in collection of primary data. The study is expected to take place within the period of 6 weeks, next academic year, 2022. After analysis of the data, we expect the results of this study to have similar trend as other studies which were conducted in other countries like Nepal and Gambia which showed that the prevalence of STIs is high during gestational period. The results of the research will be disseminated to various protocols, that is, to the COMREC, KUHES library and also to our supervisor. These results will also be presented during the Student’s dissemination session at the end of the Research Rotation in fourth year of the MBBS program.
- ItemRestrictedExploring factors influencing access to sexual and reproductive health services for learners in primary and secondary schools in Malawi(Kamuzu University of Health Sciences, 2020-10-08) Mwalabu, GertrudeFamily Planning Association of Malawi (FPAM) is an indigenous, non-profit making and nonpolitical local NGO established in 1999 registered under the Trustees Incorporation Act. FPAM is affiliated to International Planned Parenthood Federation (IPPF) as a Member Association. It exists to provide comprehensive youth friendly sexual and reproductive health services to young people aged between 10 and 24. FPAM targets young people in the rural underserved communities in the provision of integrated youth friendly Sexual Reproductive Health and Rights (SRHR) information and services using static and community-based approaches. However, 29% of women aged 15-19 have begun childbearing; 22% have had a live birth and 7% are pregnant with first child. At this age, net school attendance ratio falls from 94% in primary school to 17% in secondary school (NSO and ICF 2017). Young people often receive conflicting, inaccurate and incomplete sexuality information and education which exposes them to sexual abuse, coercion, exploitation, and sexually transmitted infections (STI) including learners in primary and secondary schools and has led to. This often leads to high school drop rates and poor SRH outcomes including unwanted pregnancies and early childbearing among learners. It is from this perspective that FPAM with funding from Human Sciences Research Council, proposes to conduct a study with learners from standard five to form four, parents/guardians and key informants to explore factors that influence access to SRHR services by learners in Primary and secondary schools in Malawi. The aim of the study therefore is to explore the factors that influence access to SRH service among learners in primary and secondary schools in order to inform policy and health practice. This cross- sectional study will utilize both quantitative and qualitative methods. The literature review and qualitative data will be used to supplement the baseline survey to provide the contextual understanding of the factors influencing access to SRHR information and services by learners. Data will be collected through analysis of relevant policy documents and studies, survey, focus group discussions and in-depth interviews in three districts of Mzimba, Dedza and Machinga. In these districts, FPAM has established structures at both district and community levels. Questionnaires will be administered to learners. Focus group discussions will be conducted with learners (separate groups for primary and secondary school learners), parents/guardians and teachers. In-depth interviews will be conducted with key stakeholders. Key players at national, district and community levels will participate as sources of information to support the process of documenting strategies that will support linking schools to SRHR services. The study further seeks to identify the perspectives of the learners, parents/guardians, teachers and key stakeholders on linking schools to SRHR in order to share this information with the line ministries of Education, Health and Youth for the purpose of developing harmonized guidelines that supports access to SRH services by school going youths. The study also intends to establish the presence of documents in support of linking schools to SRHR which includes provision of comprehensive sexual education in schools. FPAM has therefore engaged services of a consultant, an expert in Sexual and Reproductive Health and Rights, Dr Gertrude Grey Tiwonge Mwalabu (See Appendix 11), to conduct the study. The results will reveal the SRH needs and experiences of learners, factors influencing the SRH services in primary and secondary schools and improve quality of sexual and reproductive health outcomes of these learners. The results will further provide evidence-based data to inform policy makers and health practices about comprehensive and developmentally-appropriate strategies that will be realistic in primary and secondary schools, in facilitating optimal SRH outcomes among learners in Malawi. The results will be disseminated at national and district levels as advocacy tool for policy makers. Copies of the same report will also be sent to the relevant academic institutions, COMREC, and selected relevant organizations in SRHR. The results will further bu published and shared widely both locally and internationally through the Human Sciences Research Council.
- ItemRestrictedFactors associated with bacterial and viral infections amongst inmates at Maula Prison(Kamuzu University of Health Sciences, 2021-03-04) Muwalo, SamanthaType of study: This will be a cross-sectional study using a mixed methods approach with a QUAN-QUAL design. Problem to be studied: Prisons in most sub-Saharan African countries are extremely overcrowded. Normally prisons were constructed to maximize public safety, not to minimize the transmission of disease or to efficiently deliver health care. Maula prison is no stranger to harsh conditions and overcrowding with an excess of about 1,500 prisoners from its intended holding capacity. In prisons, health services are generally poor, ill equipped and understaffed or non-existent usually with poor or no access to prevention or treatment services. Left untreated in prison, the risk of disease transmission to family, friends, intimate partners and other community members is likely high on leaving prison and returning to general society. Despite the fact that prisons are acknowledged as institutions with a high burden of infectious diseases, data on the extent and magnitude of these infections is to a large extent unavailable and often incomplete. And Malawi, there are very limited representative data on the burden of bacterial and viral infections in prisons. This study aims to look at factors that are associated with Syphilis related infections at Maula amongst the prison inmates. Main objective: To investigate factors associated with Syphilis related infections amongst Maula prison inmates. Specific Objectives: 1. To estimate the prevalence of bacterial and viral infections including skin infections and STIs (syphilis, Chlamydia, Gonorrhea) among prison inmates. 2. To characterize the infections based on prison inmates demographic details. 3. To explore risk factors associated with the infection transmission among prison inmates. Study design: This study will use quantitative and qualitative methods, using structured questionnaires and focus group discussion. Study Place: This study will be conducted at Maula maximum prison situated in Lilongwe. Study population: The study population is inmate’s aged 18-49 from clinic register at Maula Prison between the years 2018 to 2020 and some key Stuff members who have been working at Maula Prison for more than 5 years. Study period: The study duration will be from April 2019 – January 2021, this period includes the preparation of the proposal, data collection, data analysis and dissemination. Data collection: Secondary data will be used to collect quantitative data extracted from the clinic register concerning all Syphilis related infections and interviews will be used to collect qualitative data from key informants who work with the prison. Data management and analysis: Quantitative Data shall be analyzed using SPSS and various measures of association each objective shall be used during data analysis and these will include prevalence ratios and prevalence odds ratios for the qualitative aspects thematic analysis will be applied. Possible Constraints: There may be missing information from the prison clinic register which may hinder data collection. Dissemination plans: A copy of the results will be submitted at the department and another copy will be handed over to the prison medical facility where they will help identify certain characters of infections and how best they can be treated to minimize their occurrences.