Region Of Malawi Research Articles

Powerful Sounds of Prayer. Christianity and Electricity in Northern Malawi

ABSTRACTThe Christianity in Northern Region of Malawi serves as an illustrative case study where technological objects affect religious practices. To elucidate the role of material objects in the constitution of the religious world, the article discusses the example of electricity as a key infrastructure and its role in bridging the modern material world with the colonization of religious practices. Within this analyze, religiosity is conceived not merely as a system of symbols but rather in terms of holistic, embodied, yet institutionalized practices. The pivotal role played by electric musical instruments concerns the establishment of a centralized public sphere closely intertwined with a Christianization project and technological advancements. Electronic keyboards operate within a religiously significant electrical infrastructure, which is intricately interwoven with political and religious ideologies, embodiment, and subjectivity. The electronic sound becomes agents of profound influence, imbuing religious musical experience with the affect of civilization. This transformative impact, however, also underscores the historical marginalization and suppression of indigenous drumming traditions, initially by early missionaries, and later by institutionalized Christian churches. The historical relation between electricity, embodied affect, and religion are exemplified by two case studies: the history of the industrial Presbyterian mission of Livingstonia and the adoption of electric instruments by Katawa Singers and other local gospel choirs. Paradoxically, the development of electrical infrastructures obscures significant asymmetries within the religious socio‐spiritual world. In the Northern Region, other spiritual practices rooted in ancestral reverence and traditional healing modalities construct an antagonistic yet interconnected network that is overshadowed by the mediated public sphere shaped by technical developments.

Socioeconomic disparities in Plasmodium falciparum infection risk in Southern Malawi: mediation analyses

This study investigated the mediators of the association between socioeconomic position (SEP) and Plasmodium falciparum (Pf) infection in Southern region of Malawi. We utilized data from the 2014 International Center of Excellence for Malaria Research (ICEMR) surveys from Malawi in which blood samples of all individuals from selected households in Blantyre, Thyolo and Chikhwawa were tested for Pf parasitemia. We assessed household SEP and potential mediators – housing quality, food security, education status of household heads, and use of long-lasting Insecticide-treated nets (LLINs) and nutritional status. We conducted causal mediation analyses to assess the proportion of SEP effect that is attributed to each mediator and combination of mediators. The mediation analysis shows that during the rainy season, improved housing and educational attainment explained 39.4% and 17.0% of the SEP effect on Pf infection, respectively, and collectively 66.4%. In the dry season, housing, educational attainment, and LLIN usage collectively mediated 33.4% of SEP’s effect with individual contributions of 15.6%, 11.2%, and 3.8%, respectively. Nutrition also played a role, particularly for children, mediating 9.2% of SEP’s effect in the rainy season and 3.7% in the dry season. The study concluded that multifaceted interventions targeting housing, education, LLIN usage, and nutrition are vital to reducing socioeconomic disparities in Pf infection risk in the Southern region of Malawi.

Childbearing after treatment for obstetric fistula: perspectives from survivors in Malawi

Women who suffer from an obstetric fistula endure more than just physical pain. Their ability or desire to bear children may also be affected due to physical damage to their reproductive organs. In addition, they may suffer from emotional trauma which is likely to affect their decision to have children. The aim of this study therefore was to explore in more detail the perspectives of obstetric fistula survivors about childbearing after treatment for their condition. This qualitative study was conducted at a non-governmental organisation in the Central Region of Malawi. Data was collected using in-depth interviews from 18 women who had suffered from an obstetric fistula. The study revealed that many women either had no further desire for children or were unable to bear children. Fear of dying and resulting pain from the fistula surgery deter women from wanting further pregnancies. However, there was still strong emphasis placed on childbearing, especially for the younger women who desired children as a means of maintaining their marriages. The risk of further pregnancies and mitigation strategies for reducing obstetric fistulas, should be fully communicated to women. Those who become infertile as a result of obstetric fistula may also require appropriate counselling.

Factors influencing adoption and use of Tephrosia vogelii in Malawi: Role of by-laws and other drivers

Soil nutrient deficiency poses great challenge to efforts aimed at improving agricultural productivity in Southern Africa. Agroforestry fertilizer tree technologies have potential to improve soil productivity in cropping systems. As such understanding the socio-economic and biophysical drivers in promoting adoption, and use of Tephrosia vogelii (T. vogelii) would provide requisite knowledge to stakeholders who promote integration of fertilizer tree technologies. This study conducted an analysis of effectiveness of by-laws, other socio-economic drivers, and biophysical factors in promoting the adoption and use of T. vogelii in Kasungu district in the central region of Malawi. The study used multistage sampling technique and data from 432 farmers. A Double Hurdle model was used where Probit regression and Truncated regression models were incorporated in the first and second hurdle, respectively. The study found that by-laws, seed availability, frequency of extension officer's visits before planting, technology provider and field characteristics influenced adoption and utilization intensity of T. vogelii in Kasungu district, Malawi. Awareness creation on developed by-laws and enforcement, promoted the adoption of intercropping of T. vogelii in the maize-based cropping system.

Cyclone Freddy and its impact on maternal health service utilisation: Cross-sectional analysis of data from a national maternal surveillance platform in Malawi.

Climate change poses a significant threat to women's health in sub-Saharan Africa, yet the impact of climate change on maternal health is rarely reported in the region. Using an existing Maternal Surveillance Platform (MATSurvey), we estimated the immediate impact of Cyclone Freddy on maternal health care service indicators in Malawi. We analysed facility-level data for pregnant women up to 42 weeks post-partum using the national MATSurvey database. We compared incidences of service utilisation before (1 January to 19 February 2023) and after (20 February to 30 March 2023) the cyclone using a negative binomial regression approach. Between 1 January and 30 March 2023, a total of 37,445 live births, 50,048 antenatal clinic attendances, 23,250 postnatal clinic attendances, 84 maternal deaths, and 1,166 neonatal deaths were recorded by 33 facilities in the MatSurvey database. There was an immediate reduction in service utilisation in the post-cyclone period, including the postnatal attendance per week (pre-cyclone median: 355.0 [IQR 279.0-552.0], post-cyclone median: 261.0 [IQR 154.3-305.5], RR 0.56 [95% CI 0.44-0.71, p <0.001]) and the antenatal attendance per week (pre-cyclone median: 860.0 [IQR 756.5-1060.0], post-cyclone median: 656.5 [IQR 486.5-803.3], RR 0.66 [95% CI 0.55-0.78, p <0.001]). Stratified analyses by geographical zones revealed a stronger reduction in postnatal clinic attendance in the Southwest (RR 0.50 [95% CI 0.29-0.85, p = 0.010]) and the North (RR 0.29 [95% CI 0.15-0.56, p <0.001]). Cyclone Freddy resulted in an immediate decline in utilisation of maternal health services in cyclone-affected regions in Malawi. We observe evidence of catastrophic climate events impacting on the healthcare of women and their babies. Policymakers, researchers, and health systems need to ensure that essential women's health services are maintained during these events and improve measures to support service resilience in the face of climate change.

Assessment of infrastructure, behaviours, and user satisfaction of guardian waiting shelters for secondary level hospitals in southern Malawi.

Guardian Waiting Shelters (GWSs) are an essential component of the Malawi's health care system as they serve as a temporary home for patient guardians while taking care of their relatives admitted to the hospital, and expectant mothers. Although GWSs play a crucial role in Malawi's healthcare system, past studies have primarily concentrated on maternity waiting homes, neglecting the role and importance of GWSs. The study examines GWS management structures and conditions, as well as guardian satisfaction and perception of health risks related to GWS use. In this explanatory sequential mixed methods design, we assessed 12 GWSs from southern region of Malawi. Qualitative data included interviews (n = 149) and focus group discussions with patient guardians (n = 72), interviews with GWS caretakers (n = 5), representatives from Hospital Management (n = 12) and Hospital Advisory Committees (n = 11). Lack of guidelines and standards for GWSs resulted in creating a customized facility checklist to quantitatively assess infrastructure present at GWSs (n = 12). Descriptive statistics and qualitative thematic analysis were utilized for data analysis, and a problem tree analysis was used to triangulate and summarize the findings. A total of 249 participants participated in the study. Each GWS had an average of 100 users daily, primarily adult females (71%). No one was accountable for GWS operation and maintenance due to the lack of a management hierarchy. GWS infrastructure conditions were poor, with inadequate functional sleeping rooms, insufficient access to water, sanitation and hygiene facilities. Notably, 50% of the GWSs lacked water access, and a quarter had non-functional toilets. Guardians felt unsafe and at risk of disease transmission when staying within GWS. Study findings highlight lack of clear, consistent GWS ownership as a root cause of challenges in GWSs. Clear policy and operational standards must be established for effective management and smooth functioning of GWSs.

Tragia grandistipularis (Euphorbiaceae), a new species from Malawi

SummaryWe describe and illustrate Tragia grandistipularis (Euphorbiaceae), a new species from the Southern Region of Malawi, which is easily distinguished by its large stipules. We amend the key to the genus in Flora Zambesiaca to accommodate the new species. The new species is only known from a single population in a threatened habitat. Based on its limited known distribution and the threats to this habitat, we provisionally assess it as Critically Endangered (CR) with criteria B2ab(i,ii,iii,v) following the IUCN Red List categories and guidelines. We recommend further surveys to better understand the ecology and distribution of this new species.

Improving person-centred care for older persons with serious multimorbidity in LMICs.

Few interventions are documented to meet person-centred needs of older people with serious multimorbidity in low- and middle-income countries where access to palliative care is limited. Most of the care in these settings is delivered by primary care health workers. This study reports the development and acceptability testing of a communication skills training and mentorship intervention for primary health care workers in Malawi. This study was conducted at Mangochi District Hospital in the south-eastern region of Malawi. Twelve primary health care workers (four clinical officers and eight nurses) working in the primary care clinics received the intervention. The intervention was designed using modified nominal group technique, informed by stakeholder interviews and a theory of change workshop. Acceptability is reported from thematic analysis of a focus group discussion with primary health care workers who received the intervention using NVivo version 14. Older persons with serious multi-morbidity and their caregivers identified a need for enhanced communication with their healthcare providers. This helped to inform the development of a communication training skills and mentorship intervention package based on the local best practice six-step Ask-Ask-Tell-Ask-Ask-Plan framework. Primary health care workers reported that the intervention supported person-centred communication and improved the quality of holistic assessments, although space, workload and availability of medication limited the implementation of person-centred communication. The Ask-Ask-Tell-Ask-Ask-Plan framework, supported person-centered communication and improved the quality of holistic assessment.Contribution:This intervention offers an affordable, local model for integrating person-centered palliative care in resource-limited primary healthcare settings.

Teacher Preparedness and Strategies Used in Teaching of Climate Change Education in the Southern Region of Malawi

This study examined the preparedness of teachers and the strategies used in the teaching of Climate Change Education (CCE) in senior secondary schools in the Southern Region of Malawi. The mixed method convergent parallel design was employed as a scientific research methodology of examining this phenomenon. Data was collected from 422 participants consisting of 416 senior secondary school teachers in 52 schools, three inspectors of schools and three officers responsible for curriculum development. A statistical formula n = was used to arrive at the total sample in the study. Questionnaires, semi-structured interviews and lesson observations were used to collect field data. Quantitative data was analyzed using SPSS which helped to generate descriptive statistics of frequencies and percentages while qualitative data was analyzed thematically. The results indicated that most teachers are not well prepared in the teaching of CCE content in senior secondary schools as 93.2% of teachers responded that they never attended any training for CCE. It was also revealed that most teachers did not use transformative teaching strategies such as projects, fieldtrips and case studies in the teaching of CCE content in senior secondary schools. It was therefore recommended that the Ministry of Education, Science and Technology (MoEST) should prepare teachers by training them on how they can teach CCE content. There is thus a need to have Continuing Professional Development Programs (CPDs) so that teachers can share knowledge and skills on the teaching of CCE content. Teachers’ colleges and Universities should offer CCE courses to student teachers.

Analysis of factors influencing market participation among orange‐fleshed sweet potato smallholder farmers in southern region of Malawi: A case of RTC project

AbstractAgricultural markets remain major issue downgrading root and tuber crop farmers who form the mainstream of the agricultural producers in Malawi. Recent evidence however reveals that orange‐fleshed sweet potato (OFSP) (Ipomea batatas) is currently being sold in produce markets along with the non‐orange varieties, sometimes in differentiated form in Malawi. The main objective of this study was to examine factors affecting market participation of sweet potato farmers in southern region of Malawi. Using a double‐hurdle model, this paper analyzed both the factors affecting farmer decision to participate and the extent/intensity of participation in market. The first tier of the double hurdle focused on decision to participate in the market using probit model and the second tier addressed factors affecting intensity of participation using truncated normal regression model. The paper used data collected from 360 farmers in southern districts of Malawi. Out of 360, 146 farmers had grown OFSP in the season preceding the survey. Double hurdle results indicate that farm size, output, age of a farmer (household head), and early maturing trait significantly determined decision to participate in the market. Further, results on intensity of participation indicate that access to market training, farm size, asset value, and output positively determined the intensity and negatively determined by distance to main market and gender of a farmer (household head). Based on the research findings, higher output levels and early maturing trait were found to increase smallholder farmer market participation. It is therefore recommended that strategies aimed at increasing household capacity to produce surplus produce through market tailored extension messages and productivity enhancement technologies could be highly effective in fostering smallholders' participation in commercial markets. Again, enhanced capacity building of research institutions to breed sweet potato varieties based on market demand is pivotal for increased market participation. Furthermore, research suggests that improving smallholder farmers' access to market price information, asset value, and farm size can help increase their intensity in the market. Therefore, it is critical for policymakers to holistically comprehend these socioeconomic factors in order to address the issue of smallholder farm households' decisions about market participation and the degree to which they participate.

Availability, pricing, and affordability of essential medicines for pediatric population in Malawi.

Lack of access to essential medicines negatively impacts on the quality of healthcare delivery and increases morbidity and mortality, especially to the vulnerable pediatric population. We assessed the availability, pricing, and affordability of pediatric formulations in Malawi. The study was conducted in 76 health facilities (public, faith-based and private pharmacies, and clinics) from the northern and southern regions of Malawi from March to May 2023. We adapted the WHO/HAI method for the assessment of both availability and pricing of medicines. Data on availability were collected from stock card records using a WHO/HAI template and medicine prices were provided by the pharmacy personnel who were managing the facilities. Availability of medicines was calculated as the percentage of facilities which had a stock of the respective medicine at the time of data collection while medicine prices was assessed by calculating the median prices of each medicine. To assess the affordability of the medicines, we calculated the number of days it takes for a person who is receiving the government-set minimum wage to work to pay for a treatment course of common indications. The study was approved by the KUHES ethics committee under the numbers U.12/22/3900 and U.12/22/3903. The overall availability of pediatric medicines was 38.1% for public health facilities, 53.7% for private retail pharmacies and drug stores, 49.5% for private clinics and 48.3% for Christian Health Association of Malawi (CHAM) facilities. We found the illegal availability of prescription-only medicines of up to 54% in medicine stores. Medicine median prices were higher in the private clinics followed by retail pharmacies and drugs stores. CHAM had the lowest median prices for medicines of all the sectors. More than 50% of medicines were found to be affordable as less than a day's wage was required to purchase the treatment. We found poor availability of pediatric formulation among public, CHAM, and private sectors in Malawi. This may affect the quality of care among pediatric patients and therefore contribute to morbidity and mortality in Malawi. The supply of medicines and health commodities needs to consider needs of special populations such as children to achieve universal health coverage.

Prevalence and risk factors associated with under-five years children diarrhea in Malawi: Application of survey logistic regression

BackgroundDiarrhea is a leading cause of illness and mortality among children under five, posing a significant public health challenge in Malawi. The current study assesses the prevalence and risk factors linked to diarrhea among under-five children in Malawi. MethodThe researcher used the Malawi Multiple Indicator Cluster Survey (MICS) 2019-20 as the dataset for this study. Due to the complex sampling design, survey logistic regression was used to accomplish the study objectives. The sample size was 15569 children who were aged under five. ResultsThe study found that the prevalence of diarrhea was 24.9%, with a higher percentage observed among children aged 12–23 months (38.5%) compared to other age groups. Additionally, children from the southern region had a higher prevalence of diarrhea at 27% compared to those from the northern region at 19.3%. Children from the poorest households also had a higher prevalence of diarrhea at 28.9% compared to those from the richest households at 22.6%. Furthermore, children with fever had a higher prevalence of diarrhea at 33.3% compared to those who did not have fever at 19.4%. ConclusionThe current study concluded that the prevalence of diarrhea was higher among children aged 12–23 months. Subsequently, policymakers should apply policies to reduce this high prevalence among this age group of children. In addition, the government needs special consideration in diarrhea control for children from the southern region because of the high prevalence of the disease compared to the other regions in Malawi. My study can help policymakers understand the scope and nature of the problem, which can notify the development of policies and programs intended to decrease the prevalence of risk factors and enhance child health outcomes.

Innovative Extension Services for Technology Transfer: The Case of Aquaculture in Northern Malawi

Aquaculture started a long time ago in Africa, but only in recent years did visible production systems emerge that are sustainable for rural areas. Such systems demonstrate increased fish production and higher incomes as shown by examples from Egypt, Nigeria, Zambia and 33Uganda. In Malawi, aquaculture growth has been slow and positive impacts recorded from past efforts were short-lived. This presentation outlines an innovative extension approach that gained national visibility. Examples were drawn from three districts of the Northern Region of Malawi, where per unit fish production from ponds doubled, incomes rose while the recruitment of fish farmers overshot targets. Participation by men and women, and youth indicated that the technology reached across the whole society. The GIZ Aquaculture Value Chain Project (2018-2022) implemented an approach that followed a sequence of activities that emphasised participation at all farming levels that was cupped by coaching loops. From sensitization workshops of stakeholders arranged in collaboration with the District Executive Committees of Council, to Training of Trainers {ToTs) followed by technical trainings of fish farmers arranged in groups, field activities were consolidated by coaching loops which were reflectively anchored on fish farmers providing solutions to problems they encountered. From an initial target of 400 fish farmers, which was adjusted to 700 half-way into the implementation period, the project recorded assistance to 853 by year 2022, who established farm business units. Through the project cycle of 2019-2023, there was a suite of key must-do activities which were diligently conducted with the assistance of a local NGO. During coaching purposeful questioning, mirroring and feedback were spiced by a visioning exercise. Coaching was mostly facilitated by the local NGO employing services of mostly graduate interns. The number of trained fish farmers eventually reached 1,121. The current average fish productivity of 2,090-3,800 kg/ha is the highest ever increase ever reported by fish farmers in Malawi from a baseline of 500-1,000kg/ha recorded by IMANI (2018). By establishing quality feed suppliers, teaching and demonstrating hatchery operations, and providing marketing support, the project established modern fish farm units that can be replicated in other countries. There was an offshoot of Peri-Urban fish farmers around Mzuzu City under Lusangazi Conservation Trust. Hatchery operations were anchored by pilot operators, who incidentally realised higher income from sales of fingerlings than from on-growing market units. To gain more control over the breeding process, some of the farmers adopted the hapa-in-pond system. Several innovations have emerged such as fish-banana and fish-sweet potato integrations; other integrations are possible as with pig or poultry. We believe that this approach could be replicated in other countries like Namibia where fish farming and related technologies have yet to be firmly established. For sustainability, the “Follow-up and Coaching Loop” and what is dubbed the “Light House Approaches” are the critical highlights. Since then, Fish Farmers’ groups in Rumphi district have formed a Fish Farmers Association to work with the District Development Committee while in Mzimba district, fish farming has been adopted by District Development Committee for annual internal budgetary support. With large numbers of farmers, extension support through private sector suppliers of fingerlings and feeds can eventually emerge for a win-win situation, overcoming the limited effectiveness of government extension support. The cooler climatic similarities between Malawi and Namibia offer interesting parallels for slowness of rural fish farming development, but the approach in the northern region of Malawi demonstrates an effective approach to assisting rural farmers.

Factors associated with stunting among children aged below 60 months from rural Malawi: a matched case-control study

Stunting currently affects 37% (1.1 million) of Malawian children and causing unfavorable impact for both children and their households. Identifying risk factors to stunting would go a long way in developing appropriate interventions. The objective of this study was to identify the risk factors of stunting among children aged below 60 months from Balaka, Dedza and Mzimba districts in Malawi. A matched cross-sectional case-control study was conducted among 913 (446 controls; 467 cases) children aged below 60 months from three regions of Malawi. Household demographic, anthropometric measurements, dietary intake, food security, and morbidity information were collected. Case-Control Stepwise multiple logistic regression models are used to determine risk factors of stunting. The following were identified as risk factors for stunting including; age of child (AOR= 6.3; 95% CI: 2.9, 8.9), polygamy (AOR= 8.9; 95%, CI: 3.3, 13.03), maternal education (AOR= 9.9; 95%, CI: 2.8, 20.1), access to markets (AOR= 1.3; 95%, CI: 0.2, 2.4), childhood infections (AOR= 2.11; 95%, CI: 1.4, 4.2) and presence of oedema (AOR= 2.5; 95%, CI: 1.3, 4.1). Also, lack of food any month (AOR= 1.31; 95%, CI: 1.01, 4.9), purchasing food on credit (AOR= 1.48; 95%, CI: 1.4, 1.7), begging for food (AOR= 1.55; 95%, CI: 1.2, 2.1), mothers or caregivers consuming less than 5 food groups (MDD-W) (AOR = 4.83; 95% CI: 1.9, 16.4), exclusive breastfeeding (AOR= 5.45; 95%, CI: 4.33, 7.61) children weaned on plain water (AOR= 1.6; 95%, CI: 1.6, 2.41), powdered milk (AOR= 0.63; 95%, CI: 0.4, 1.32), juices (AOR= 0.44; 95%, CI: 0.12, 0.96) and children fed on sugary food (AOR= 0.66; 95%, CI: 0.4, 0.99) were significantly related to stunting. Stunting is associated with increasing age of children, boys, polygamous households, lack of education by mothers or caregivers, inaccessible markets, childhood infections and presence of oedema, food insecurity, breastfeeding and complementary feeding among children and dietary diversity of mothers or caregivers. These results suggest that interventions against childhood stunting should be designed according to the factors that significantly affect stunting. Key words: child growth, Malawi, stunting and complementary feeding, Regression, Food Security and Health

Cytolytic circumsporozoite-specific memory CD4+ T cell clones are expanded during Plasmodium falciparum infection

Clinical immunity against Plasmodium falciparum infection develops in residents of malaria endemic regions, manifesting in reduced clinical symptoms during infection and in protection against severe disease but the mechanisms are not fully understood. Here, we compare the cellular and humoral immune response of clinically immune (0-1 episode over 18 months) and susceptible (at least 3 episodes) during a mild episode of Pf malaria infection in a malaria endemic region of Malawi, by analysing peripheral blood samples using high dimensional mass cytometry (CyTOF), spectral flow cytometry and single-cell transcriptomic analyses. In the clinically immune, we find increased proportions of circulating follicular helper T cells and classical monocytes, while the humoral immune response shows characteristic age-related differences in the protected. Presence of memory CD4+ T cell clones with a strong cytolytic ZEB2+ T helper 1 effector signature, sharing identical T cell receptor clonotypes and recognizing the Pf-derived circumsporozoite protein (CSP) antigen are found in the blood of the Pf-infected participants gaining protection. Moreover, in clinically protected participants, ZEB2+ memory CD4+ T cells express lower level of inhibitory and chemotactic receptors. We thus propose that clonally expanded ZEB2+ CSP-specific cytolytic memory CD4+ Th1 cells may contribute to clinical immunity against the sporozoite and liver-stage Pf malaria.

Ethnobotanical survey of medicinal plants claimed by traditional herbal practitioners to manage cancers in Malawi

IntroductionThis study documented medicinal plants that are claimed by traditional herbal practitioners (THPs) to manage specific types of cancers in Mzimba and Nkhata Bay districts of the northern region of Malawi. MethodsA semi-structured questionnaire and purposive sampling technique were used in the survey to obtain data regarding the THPs and the herbal plants that are used to manage different types of cancers. Data was analysed using descriptive statistical methods. ResultsTwenty-five THPs were identified and sixty-three plant species from 37 families were used by THPs to treat various cancers in the studied areas. Forty-one percent of the cited plants were used in wound healing, 17%, 16%, 11%, 9%, 3%, 2% and were used to treat prostate, oesophageal, cervical and stomach cancers, ulcers, tumours, and internal wounds, respectively. Roots (47%) were the mostly used plant parts followed by stems (27.7%), leaves (9.2%), fruits (4.6%) and the remaining 10.8% included climbers, shrubs and whole plants. Most prepared recipes were uncarbonised powders (45%) followed by aqueous decoctions (32%), and the remaining 23% were distributed amongst maceration, carbonised powders and infusions. Topical (48%) was the most frequently used mode of administration followed by oral (39%), through porridge (10%) while incisions and bandaging were 2% and 1%, respectively. Some recipes were polyherbal mixtures which utilised the synergy amongst phytochemicals. ConclusionThe study has provided indigenous knowledge of herbal plants available in Mzimba and Nkhata Bay districts which can serve as a baseline for the identification and isolation of bioactive compounds with subsequent use of herbal medicines in clinical trials.

Examining the Impact of Interactive Multimedia Instruction on the Performance of Secondary School Students in Biology in Dedza District, Malawi

&lt;p style="text-align: justify;"&gt;This study examined the impact of teaching biology using interactive multimedia on the students’ academic performance in biology at Community Day Secondary Schools (CDSS). This study was conducted in three secondary schools in the Dedza district, in the central region of Malawi. A pretest-posttest quasi-experimental approach was used in this investigation. A total number of 189 Form Four students were selected from the three schools. The schools were categorized into three groups, namely: (a) urban, (b) rural, and (c) control. The control group received instruction using a teacher-centered approach, while the experimental groups received instruction using interactive multimedia resources. The pretest was conducted for three weeks, after which the posttest was administered. One-way ANOVA in IBM-SPSS software was used to analyse the data. Our findings showed that multimedia instruction packages had a significant impact on student performance (F (2, 188) = 126.557, p &lt; .001). Furthermore, after the intervention, the scores of the rural group and the urban group significantly varied (p &lt; .001). Gender had a significant influence on the performance of students in biology (F (1, 188) = 8.78, p = .003). Therefore, the study concludes that the use of multimedia instructional packages helps learners understand abstract concepts in biology, and the study further recommends that multimedia instructional packages be used to teach hard-to-grasp concepts in biology in CDSS.&lt;/p&gt;

Insight into the genetic diversity of Mycobacterium bovis isolated from cattle in Malawi

We describe the genetic diversity and phylogenetic relationships of Mycobacterium bovis, isolated from cattle in Malawi. Deletion analysis, spoligotyping, and MIRU-VNTR typing were used to genotype the isolates. Combined with a larger dataset from neighboring countries, the overall M. bovis diversity in Southern Africa was contextualized. From the southern and northern regions of Malawi, 24 isolates were confirmed as M. bovis. We pooled data for the central region (60 isolates) from our recent publication to conceptualize the genetic and phylogenetic relationships of M. bovis in Malawi. European 1 was the dominant M. bovis clonal complex, with 10 unique spoligotype patterns, and SB0131 was ubiquitous. High genetic diversity, a low clustering rate, and many singletons, coupled with a low mutation transmission index, infer a low level of recent transmission, and suggest an endemic status of bovine tuberculosis (bTB) in Malawi. M. bovis isolates from Zambia, Mozambique, and South Africa were genetically related to Malawian isolates, whereas Tanzanian isolates were distantly related. The diversity and phylogenetic analysis suggest earlier introductions and maintenance of M. bovis by constant reinfection from reservoir animals. These findings are fundamental to understanding the source and route of infection in order to establish alternative management strategies for bTB.

A comparison of clinical outcomes among people living with HIV of different age groups attending queen Elizabeth central hospital outpatient ART Clinic in Malawi.

Adherence to Antiretroviral Treatment (ART) in children and adolescents living with HIV in low-resource settings is not extensively studied in large cohort studies including both adults and pediatric patients. We compared rates of virological suppression, adherence and defaulting among children, adolescents and adults attending a family ART clinic at Queen Elizabeth Central Hospital; a tertiary hospital situated in the southern region of Malawi. The study was longitudinal and made use of routinely collected data for all 27,229 clinic attendees. Clinical information obtained at routine clinical visits entered electronically since 2008 was extracted in February 2017. This data was used to ascertain differences across the different age groups. Logistic regression and Cox regression models were fitted to compare rates of Virological Suppression (VS), adherence, and defaulting, respectively. Younger and older adolescents (ages 10-14 years and 15-19 years respectively) were less likely to achieve VS compared to adults in the final model AOR 0.4 (0.2-0.9, 95% CI) and AOR 0.2 (0.1-0.4, 95% CI) respectively. Young children (ages 0-4 years), older children (ages 5-9 years) and younger adolescents were less adherent to ART compared to adults AOR 0.1 (0.1-0.2, 95% CI), AOR 0.2 (0.1-0.3, 95% CI), and AOR 0.4 (0.3-0.5, 95% CI) respectively. Young adults and younger children had an increased likelihood of defaulting compared to adults. Poor performance on ART of children and adolescents highlights unaddressed challenges to adherence. Ongoing research to explore these potential barriers and possible interventions needs to be carried out. The adherence assessment methods used and strategies for improving it among children and adolescents need to be revised at the clinic.

Socio-Ecological Associations of the Development of Sexual Behavior in Young Adolescent Girls in the Rural Southern Region of Malawi

Adolescent girls are more likely to experience early sexual debut than boys. However, the developmental context of their sexual behaviors is under-investigated. Using the socio-ecological model and Malawi Schooling and Adolescent Survey, we investigated factors crucial in determining the development of sexual behaviors of 416, 14-year-old girls in rural southern Malawi. We applied Bivariate Logistic Regression analysis to determine associations. Results showed that 353 (84.9%) experienced sexual intercourse, 60 (18.4%) had multiple sexual partners, and 32 (9.1%) used condoms or hormonal contraceptives. Participants’ educational background, desire for higher education, reproductive health knowledge, and being monitored by teachers in school were positively associated with healthy sexual behaviors. Having a boyfriend, lack of schooling support, and being invited to teachers’ homes were positively associated with risky sexual behaviors. Therefore, promoting adolescents’ formal education, sexual health literacy, and safety in schools should be essential components of research and biobehavioral interventions targeting young adolescents in Malawi.