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- ItemRestrictedAcceptability of new Orange Fleshed Sweet Potato varieties among children and caregivers in Nsanje, Malawi, version 1.0(Kamuzu University of Health Sciences, 2022-08-04) Manda, RobertType of Study: A cross-sectional study will be conducted in Nsanje among children and their caregivers to determine their sensory acceptability and consumer preference for new orange fleshed sweet potato (OFSP) varieties bred in Malawi. Problem Statement: OFSP are some of the bio-fortified crops bred in Malawi. However, bio-fortification results into different visual phenotypes and taste changes than pre-existing varieties of the crops. Due to these changes, sensory attributes are also affected and acceptability of these newly introduced varieties is a challenge. Main Objective: To assess consumer preference and sensory acceptability of new biofortified orange fleshed sweet potato varieties bred in Malawi by International Potato Centre (CIP) among children aged 12-59 months and their caregivers in Nsanje Malawi. Specific Objectives: i) To assess sensory acceptability of new OFSP varieties among children aged 12-59 months. ii) To determine consumer preference for new OFSP varieties among caregivers of children aged 12-59 months. iii) To assess sensory acceptability of new OFSP varieties among caregivers of children aged 12–59 months. Methodology: New OFSP varieties that will be assessed in this study are Anaakwanire, Kaphulira, Mathuthu, Royal Choice, Mthetsanjala and Msungabanja. These varieties will be assessed against local sweet potato varieties grown in Malawi. Plate waste and hedonic Likert scale sensory techniques will be used to assess acceptability of the sweet potatoes among children aged 12-59 years. Paired preference test and preference ranking sensory procedures will be used to assess consumer preference for the sweet potatoes among caregivers of children aged 12–59 months. Pearson correlation co-efficient will be used to measure likeness, preference and levels of satisfaction of the sweet potatoes among children and caregivers. Expected results: The study expects to find acceptability of new OFSP among children and caregivers to reduce Vitamin A Deficiency which is a public health concern in Malawi and drivers of consumers preference for new OFSP varieties. Dissemination: The findings will be disseminated through conference presentation to KUHEs-COM, CIP, UNICEF, DNHA, The Hunger Project, Nsanje District Council, others nutritional stakeholders and journal publication for utilization. For academic purpose, a copy of the dissertation will be sent to Kamuzu University of Health Sciences, COMREC and KUHES libraries for reference.
- ItemRestrictedDeterminants of non-compliance to iron and folic acid supplementation among adolescent girls in schools of Salima district(Kamuzu University of Health Sciences, 2022-09-09) Mhango, MemoryExecutive Summary Type of the study This will be a school-based quantitative cross-sectional study aiming at assessing the determinants of non-compliance to iron and folic acid supplementation among adolescent girls in selected schools in Salima district. Problem In Malawi, the prevalence of anaemia among adolescent girls is unacceptably high. The Malawi demographic health survey (MDHS) 2015-2016 indicated the anaemia prevalence of 35.3% among adolescent girls. World health organization (WHO) recommends iron and folic acid supplementation to adolescent girls in a country with prevalence of more than 20%. The recommendation is based on evidence that Iron and Folic Acid Supplementation (IFAS) has been proved cost effective way of improving iron status especially in developing countries. Considering this, the ministry of health, in collaboration with the ministry of education and other partners in 2019 launched the weekly IFAS program for adolescent girls aged 10 to 19 years to mitigate the 35.3% prevalence of anemia among adolescent girls in the country. The program was piloted in six districts of Mangochi, Dedza, Salima Lilongwe, Dowa, and Machinga, and later rolled out to other districts. However, since the implementation started in Salima district, compliance rates have been disappointingly low below the national requirement of 100% for the past 3 years of implementation. According to Salima Health Information and Management System (HMIS) data for school platform, from July to December 2019, the program had a coverage of 79% with a compliance rate of 61%. In 2020, the same duration, 69% IFAS coverage was achieved with a compliance rate of 14%, and from July to December 2021, 82% IFAS coverage was achieved with a 21% compliance rate. Yet, the reasons behind the low compliance remain unknown due to limited literature and being a new intervention among adolescent girls in Malawi. Hence the need for this study. Broad Objective The aim of the study is to assess determinants of non-compliance to Iron and Folic Acid supplementation among adolescent girls enrolled in selected schools in Salima district. Specific Objectives (1) To determine the adolescent girls‘ level of knowledge of Iron deficiency anaemia and IFAS program in selected schools in Salima district. (2) To identify individual factors affecting compliance with IFAS among adolescent girls enrolled in selected schools in Salima district. (3) To examine modifying factors affecting compliance to IFAS among adolescent girls enrolled in selected schools in Salima district. Methodology The study will be conducted in randomly selected primary schools and is targeting adolescent girls (10 to 19 years) with a sample size of 106 calculated using Cochran's formula. Sampling will be done in stages (multi stage sampling) to select the health facilities, schools, and adolescent girls (responded). The data will be collected through face to face interviews using a structured questionnaire and analyzed using SPSS version 22. Descriptive statistics will be used to present the data in figures and tables. And then, logistic regression analysis will be carried out to identify determinants of IFAS non-compliance. The ethical approval to conduct this study will be sort from college of medicine research and ethics committee (COMREC) and institution clearance was obtained from Salima district council, education department. Expected findings The study findings will document determinants of non-compliance to IFAS among adolescent girls. This will give evidence that will serve as a basis for recommendation to policymakers, program managers, advocators and service providers to formulate policies and improve IFAS program strategies by including interventions that will promote compliance among the girls hence reducing the prevalence of iron deficiency anemia. Dissemination of the results The findings will be presented to schools and district nutrition coordinating committee (DNCC) in Salima, COMREC, and ministry of health, department of nutrition and HIV Aids (DNHA). The study findings will be published in a reputable peer review journals and presentedat a conference. A copy of thesis will be in Kamuzu University of health sciences (KUHES) library.
- ItemRestrictedIdentification of malnutrition in infants using ultrasound – a proof-ofconcept(Kamuzu University of Health Sciences, 2022-09-01) Iroh Tam, Pui-YingStudy Type: Cross-sectional case-control: The problem: Early identification of at-risk infants for severe malnutrition (SM) has been highlighted as a top research priority. However, few easy and reliable diagnostics are available and predictive for infants and children. Current anthropometric measures (such as weight-forlength/ height z scores, WLZ), have <50% sensitivity for predicting mortality, and poor correlation with mid-upper arm circumference (MUAC). Other, more sensitive measures of growth and nutritional status may be body composition (fat mass and fat-free mass), thymus gland, and other organs, however current approaches are time- and labour-intensive and require specialized equipment such as CT, MRI or air displacement plethysmography. A noninvasive test that can measure correlates of nutrition and be done at the bedside, such as a ultrasound, may, if shown to be sensitive and a good predictor of morbidity and mortality, support screening for therapeutic feeding programmes in low resource settings. Broad objective: To assess utility of ultrasound in identification of malnutrition. Specific objectives: 1. To document feasibility of conducting ultrasound measurements in infants. 2. To determine inter-user reliability and reproducibility in ultrasound measurements. 3. To evaluate whether there are differences in measurements between malnourished v. nonmalnourished infants. Place of study: Queen Elizabeth Central Hospital, Paediatric wards. Study population: Children <6 months of age. Study methods: • 10 infants <6 months hospitalized with malnutrition will be age- and sex-matched with 10 non-malnourished hospitalized children. • For each enrolled infant, sociodemographic data (clinical diagnosis, birthweight), anthropometry (weight, length, MUAC) and ultrasound measurements (biceps, quadriceps, rectus abdominis, thymus, etc) will be collected, measured and documented. Expected findings and their dissemination: We expect that ultrasound measurements in infants will be feasible, and have reasonable inter-user reliability and reproducibility between examiners. We expect to identify differences in measurements between infants with and without malnutrition. Study findings will be presented to MLW, QECH, and COMREC Research Dissemination Conference, and may be published in a peer-reviewed journal.
- ItemRestrictedDeterminants of Under-5 Malnutrition in Dedza District, Malawi(2022-07-13) Kulemero, FleraType of Study This study will use a quantitative approach to analyze the determinants of under-5 malnutrition in Dedza district, Malawi using the Malawi Demographic and Health Survey (MDHS) 2015 – 16 data. Problem Statement Dedza district in Malawi is among the districts with high rates of under-5 malnutrition as per the MDHS of 2015 – 16. This is worrisome considering that Dedza is among the districts that is known to produce a variety of crops for consumption and commercial purposes. There is need, therefore, to understand district specific determinants of malnutrition in children 5 years and below. This will pave way for public health interventions to reduce childhood malnutrition rates in the district. Objectives Broad Objectives The aim of this study is to describe the distribution, household and parental socio-demographic characteristics, vaccine status in under-5 children and their association with malnutrition in children 5 years and below in Dedza district, Malawi. Specific Objectives • To determine household and parental socio-demographic characteristics and their association with malnutrition in Under-5 children in Dedza district, Malawi • To determine the distribution of malnutrition among Under-5 children that are fully vaccinated, partially vaccinated, and unvaccinated in Dedza district, Malawi. Methodology This will be a cross-sectional quantitative study that will analyze secondary MDHS 15 - 16 data to assess the determinants of under-5 malnutrition in Dedza district. Expected Findings and Dissemination of the Results This study is expected to find the distribution of under-5 malnutrition in the district. In addition, it is likely to show the relationship of maternal and household characteristics and their influence on under-5 malnutrition in Dedza. A close-up report of the study and the findings will be shared with13-Jul-2022 xiv Determinants of Under-5 Malnutrition in Dedza, Malawi; Version 3 – June, 2022 COMREC and thereafter, a written report of the findings of this study will be shared with the DHSS in Dedza. Furthermore, a manuscript will be published in peer reviewed journal and other copies distributed to the KUHeS library, the DHS program and to PACHA
- ItemRestrictedAssessment of antibiotic resistance in humans and in food animals in Blantyre in Malawi(Kamuzu University of Health Sciences, 2022-05-12) Mbamira, SimeonoeStudytype:thisisadescriptiveandretrospectivestudy.Problem:antibiotic resistanceisagrowingpublichealththreatofamajorconcerntocountriesand multiplesectors.Thisthreatensone-healththatisbothpublichealthandveterinary. Dataisavailableonantibioticresistanceinhumans.However,dataonthetrendof thisantibioticresistanceinbothhumanandveterinarymedicineisscantyhencethis study.Objectives:toassessantibioticresistanceinhumansandinfoodanimals (cattle,goats,pigs,chickens)inBlantyre,Malawi.Methodology:qualitativedata collectionmethodwillbeemployed.Datawillbecollectedfromtherecordson antibioticresistanceforthepast6yearsthatisfrom2021downto2015fromQECH andBlantyreveterinaryandthisdatawillbeanalyzed.Expectedresults:itis expectedthattherewillbeanincreasingtrendofantibioticresistanceinbothhuman medicineandfoodanimals.Disseminationofresults:theresultswillbe disseminatedthroughconductionofpresentationsandthroughattendanceoflocal conferences.AcopyofthefinalreportwillbesenttoQECH,Blantyreveterinary, CollegeofMedicineResearchEthicsCommitteeandothers.