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- ItemRestrictedDesign and testing of a MEML online adverse drug reactions management system(Kamuzu University of Health Sciences, 2022-03-10) Maida, Kondwani; Chagwa, PreciousThis is an experimental study that is aimed at designing and testing the mobile application that would be used by health care providers (HCPs) in recalling ADRs and drug interactions as well as their influencing factors during the diagnosis and treatment of diseases. This is going to be achieved through the following specific objectives; to create the database of ADRs and drug interactions of drugs in Malawi Essential Medicines List(MEML), to create the interface of the mobile application used to check possible ADRs, to create a link between the interface and the database of the mobile application of ADRs and to test the developed mobile application in a stimulated clinical setting. The database of ADRs and drug interactions will be created after through research into the selected medicines ADRs reported in literature and various online databases. The database will contain a list of each drug and its associated ADRs, drug interactions, influencing factors (patient, medicine and formulation related). An interface will be developed on an Android platform from scratch using Google and third party developers’ libraries as outlined by Farao Jaydon et al (2020) the interface and database linage will be done as outlined by Malila Bessie et al (2020). The developed application will be evaluated by the potential users. Volunteers will be selected from the student population for a start and in future actual HCPs will be involved. A written questionnaire containing attitude and practice questions will be used to evaluate the users’ experiences after testing its use in a simulated clinical setting. It is expected that this study will produce a mobile app that would be used to detect the ADRs and drug interactions easily with certainty by HCPs, hence reduce their occurrence or severity if inevitable, which would also reinforce the significance of using mheath in clinical settings. These results will be reported in peer reviewed journals as well as international and national research conferences. Hard copies will also be kept in the library and the department
- ItemRestrictedAntibiotic prescription audit at QECH and KCH(Kamuzu University of Health Sciences, 2022-03-10) Unyolo, Takondwa; Mwambene, GraceThere is an increase in antibiotic resistance by bacteria to most of the available antibiotics and it is an issue of great public health concern. Antibiotic resistance is mostly brought about by inappropriate and unnecessary prescribing of antibiotics despite the availability of prescribing guidelines. Antibiotic stewardship involves appropriate selection, dose, route and duration of antibiotic therapy, and has been shown to minimize emergence of resistance. Auditing antibiotic use is essential in monitoring appropriate use within an institution. This cross sectional and retrospective study aims to conduct an audit on antibiotic prescription at QECH and KCH in Malawi to appreciate the extent of antibiotic prescription between these two referral hospitals. The objectives of this study include, assessing if prescription is based on proper diagnosis, evaluating if antibiotic prescriptions are based on prescribed guidelines and identifying the most commonly prescribed antibiotics at QECH and KCH in the medical wards We are going to audit antibiotic prescription at the two referral hospitals in the medical wards using questionnaires. This process will involve prescribers who are authorized to prescribe antibiotics in the medical department of the hospitals and the use of patient files of those prescribed antibiotics. It is expected that they will be minimal adherence to the prescribing guidelines in the Malawi Standard Treatment Guidelines by the prescribers and that most prescription of antibiotics will be done without appropriate diagnosis. The results of this study will be submitted to KUHES library, they will also be presented to the academic staff and students.
- ItemRestrictedCross section study on knoweledge about Malawi’s poisonous plants among traditional medicine practitioners and users(Kamuzu University of Health Sciences, 2020-06-10) Kandodo, Chifundo; Tembo, Yohane; Dambuleni, JeremiahIt is undeniable that plants have an important role in the development of modern medicine. But use of traditional medicine from plants is associated with devastating side effects. Specific plants or combination of plants used as medicine are associated with these effects hence this study will assess if traditional practitioners and users have knowledge about these plants. The main objective is to explore knowledge among traditional practitioners and users on poisonous plants that are used as traditional medicine. This study is a cross sectional qualitative study exploring the knowledge about poisonous plants in Blantyre urban and rural. This study will therefore involve qualitative study method. The participants will be traditional practitioners and users of traditional medicine both above 18 years old. These participants will be those living or doing their business in Blantyre. The sampling method will be purposive and convenient sampling method for the traditional practitioners, but for the users will use convenient method. It is expected that by the end of this research, we will identify the poisonous plants which people know and use. The results of this study will be presented at College of Medicine (CoM) research dissemination presentations which are held for students to present their research findings.
- ItemRestrictedKnowledge and perspectives of nurses and clinical officers on morphine use at Chiradzulu District Hospital(Kamuzu University of Health Sciences, 2020-11-16) Mbewe, Emily; Misenje, Thomas; Chitani, Enoch; Uladi, AllanThis is a qualitative interview study that aims to explore perspectives of nurses and clinical officers on use of morphine in palliative care patients. The broad objective is to explore perception of nurses and clinical officers on clinical use of morphine. This study will be conducted at Chiradzulu District Hospital. A sample size of 10 participants disaggregated into categories of 5 Nurses and 5 Clinical officers will be selected using convenient sampling technique. Data collection will employ semi-structured in-depth interviews. Some patients do not get complete relief from pain owing to unfounded fears regarding use of morphine despite that it is the drug of choice in Malawi for management of severe pain. This study expects to understand challenges around morphine use in palliative care by service providers. Conversely, these results will significantly contribute towards planning for in-service training aimed at addressing the identified bottlenecks in morphine use thereby making the service accessible to those in need at Chiradzulu District Hospital. Study findings will be disseminated through a variety of channels including College of Medicine Research Dissemination Conference, Chiradzulu District Hospital research committee, COMREC and College of Medicine Library. 3.0 Background Morphine is one of the strong analgesics in a group of opioids. It is primarily used for pain relief. Morphine is a gold standard in palliative care because it is the baseline by which other opioids are measured. Morphine is a potent opioid analgesic widely used for the treatment of acute pain and for long‐term treatment of severe pain. World Health Organization (WHO) rates morphine on level three of the analgesic ladder, it is given to patients who present with severe pain that might be acute or chronic [1]. Morphine is widely being used for almost any condition that causes physical pain for example; active cancer treatment and vaso-occlusive pain during sickle cell [2]. A study done in Kenya revealed that Nurses and clinical officers have had unfounded fears surrounding morphine use, due to inadequate knowledge [3]. This study further revealed that such fears were linked to concerns about addiction, respiratory depression and sedation. Nurses and Clinicians had myths which include morphine will shorten life, morphine use will make my patient an addict, morphine is offered to patient only when death is eminent and it has worse side effect than other drugs [4]. Nurses and clinical officers play an important role in pain management and lack of knowledge creates barriers for them to be able to provide optimal pain management [3]. Nurses and clinical officers who are giving morphine to patients should follow the precaution measures. Some of the precautions include monitoring of mental status, blood pressure, respiratory drive, abuse/overuse and monitoring of other medications the patient is taking. The medications include other opioids that could lead to respiratory depression, alcohol, benzodiazepines and barbiturates [5]. Patients can become apneic study design will be qualitative using phenomenological approach. This analysis is based on discussion and reflection of direct sense perception and experience of the researched phenomenon [9]. The researcher will explore the perception of Nurses and Clinical officers on clinical use of morphine in palliative care patient at Chiradzulu District Hospital. The approach will use semi-structured In-depth interviews with prospective participants. This approach uses open- ended question and probing that give participants the opportunity to respond in their own words rather than forcing them to choose from fixed response [10]. This will help investigators understand perspectives of nurses and clinical officers on the clinical use of morphine in palliative care patients. 7.2 Study place This study will be conducted at Chiradzulu District Hospital. This site was chosen because Chiradzulu is one of the districts that used less amount of morphine as compared to other districts according to Malawi Health Management Information System data of July 2019 to June 2020 [11]. This can be due to several factors, for example, poor perception of nurses and clinical officer on morphine use, poor supply of morphine at the district hospital, lack of knowledge on morphine use among health workers, lack of knowledge on palliative care by the community that led to poor access to palliative care services, 7.3 Study population The study population are nurses and clinical officers because they are the core and frontline providers of palliative care services in Malawi. 7.4 Study period The estimated period for the whole study is 12 months which runs between March 2020 and May 2021. Activities within this period include; proposal development, data collection and analysis and presentation and dissemination of results. 7.5 Sample size We will have a sample size of 10 participants spread out into groups of 5 nurses and 5 clinical officers respectively using non probability convenient sampling technique. This sampling technique is applicable to our study because it will enable us to gather information from people that can be easily accessed. This sample size is ideal as it will help us uncover a variety of views and perspectives from the two cadres in question.
- ItemRestrictedEffects of pharmacy assistant training on medicine stock management in health centres in northern region of Malawi(Kamuzu University of Health Sciences, 2020-10-20) Mwale, JeremiahThe frequent drug shortages in the country’s hospitals is evidently becoming a growing concern and a common in most public health facilities. The persistent medicine shortage at health centre level is largely blamed on unqualified pharmacy personnel managing medicine and supply chain. Evidence generated from research studies has shown that use of unqualified staff in managing medicine at health centre impacts negatively on patient’s outcome. The Millennium Development Goal number 8 calls for universal access to quality health care services. It is our considered view that universal access can only be achieved with adequate qualified staff available to offer health services. There is a growing concern globally and more especially in low- and middle-income countries for shortage of qualified pharmacy personnel. Human resource shortage for pharmacy personnel has resulted into poor quality of health care services offered by unqualified personnel. Historically pharmacy assistant training program was the only pharmacy cadre trained in Malawi in 1977 before changing it to diploma program of pharmacy technician. The main purpose of the pharmacy assistant training program is to improve management and availability of medicine, improve dispensing practices and reporting at health centre level among other things. Currently there are about 630 health centres across the country that form about 85% of the health care system for the country. Although health centres constitute 85% of health care delivery system, it was sad to note that majority of pharmacies were not managed by qualified pharmacy personnel hence reintroduction of the pharmacy assistant training program. There is hope and growing consensus that the introduction of pharmacy assistants training program will improve general pharmacy management and eventually medicine availability. Preliminary results of Pharmacy Assistant training program evaluation show that was improvement in management of medicine as envisaged during program conceptualization process, there is however not enough evidence to show that there indeed that improvement in medicine availability, quality of reported data and timely reporting of logistics management information systems (LMIS). The study will be analyzing whether setbacks in the supply chain have any relationship with pharmacy training. The main objective will be to analyze effectiveness in the aftermath of undergoing training on managing medicine in health centres the Northern Region of Malawi. The specific objectives will be to; determine factors that affect pharmacy management in health centres in the northern region of Malawi, to establish the relationship between training and stock levels of traceable medicines in the health centres in northern region in Malawi and to determine data accuracies and completeness on LMIS report in relation to levels of training. This is a cross sectional study, which will employ quantitative methods in order to establish extent of effectiveness of pharmacy assistant training in management of medicine in their health facilities. It is expected that general pharmacy management in general particularly centering on stock availability, reporting and LMIS data accuracy should be improved in health facilities where pharmacy assistants work. Results of research findings will be disseminated in three fold as follows 1) the respondents, health centre in-charges and District Health officers 2) College of Medicine research dissemination seminar/Conference and College of Medicine Research Committee and 3) Results will be published for public usage. Three hard copies will be produced and one of these will be placed in the university library for public scrutiny, one copy for the research supervisor and final copy will be for the researcher.