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Zomba, Malawi

The University of Malawi is an educational institution established in 1964 and composed of five constituent colleges located in Zomba, Blantyre, and Lilongwe. Of the five colleges, the largest is Chancellor College in Zomba. The name of the school is abbreviated to UNIMA. It is part of the Malawian government educational system. The present Vice Chancellor is Professor John Kalenga Saka. Wikipedia.

Brain histology and ophthalmoscopy suggest that approximately 25% of children with World Health Organization-defined cerebral malaria (CM) have a nonmalarial cause of death. Misclassification complicates clinical care, confounds studies of association, and may obfuscate successes in malaria control. Retinopathy predicts intracerebral parasite sequestration with >90% sensitivity and specificity, but detecting retinopathy requires well-trained personnel and expensive equipment. We investigated the utility of plasma concentrations of parasite histidine-rich protein 2 (pHRP2), a Plasmodium-specific protein, as a predictor of intracerebral parasite sequestration at autopsy and of malaria retinopathy on clinical examination in patients with clinically defined CM. In 64 autopsy cases, 47 of whom had histological evidence of sequestration, the sensitivity and specificity of a plasma pHRP2 level of >1700 ng/mL were 98% and 94%, respectively, and the area under the receiver operating characteristic (AUROC) curve was 0.98. In a separate, prospectively studied group of 101 children with clinically defined CM, of whom 71 had retinopathy, the same pHRP2 cutoff predicted retinopathy-positivity with a sensitivity of 90% and specificity of 87% (AUROC, 0.90). Elevated plasma pHRP2 concentrations can identify Malawian children with histologically confirmed or retinopathy-positive CM and is a more field-friendly approach to confirming the diagnosis than post mortem sampling or ophthalmoscopy. Source

In 2011, Joint United Nations Programme on HIV/AIDS announced a plan to eliminate new HIV infections among children by 2015. This increased focus on the elimination of maternal to child transmission (MTCT) is most welcome but is insufficient, as access to prevention of MTCT (PMTCT) programming is neither uniform nor universal. A new and more expansive agenda must be articulated to ensure that those infants and children who will never feel the impact of the current elimination agenda are reached and linked to appropriate care and treatment. This agenda must addresses challenges around both reducing vertical transmission through PMTCT and ensuring access to appropriate HIV testing, care, and treatment for all affected children who were never able to access PMTCT programming. Option B+, or universal test and treat for HIV-infected pregnant women is an excellent start, but it may be time to rethink our current approaches to delivering PMTCT services. New strategies will reduce vertical transmission to less than 1% for those mother-infant pairs who can access them allowing for the contemplation of not just PMTCT, but actual elimination of MTCT. But expanded thinking is needed to ensure elimination of pediatric HIV. Source

Kaunda C.S.,University of Malawi
Renewable and Sustainable Energy Reviews | Year: 2013

Sustainable energy is required for any national development. This paper has reviewed and documented energy situation and small-scale hydropower potential and application status in Malawi. The country's energy sector is dominated by traditional forms of biomass. Level of modern forms of energy supply is low. In particular, electricity supply is unreliable and small in capacity. Decentralised energy supply systems like small-scale hydropower are some of the recommended energy projects for developing countries. The paper adds knowledge on small-scale hydropower in Malawi. The study has reviewed Government reports and other documents. Informants were also consulted. Information from documents and informants was confirmed through site visits. The analysis of the small-scale hydropower potential sites indicates that the country has considerable potential for decentralised hydropower generation, which if fully exploited, can contribute to the country's electricity and power supply especially for rural electrification. Most of the identified potential sites are located in the northern parts of the country. From the information on the assessed sites, a proven potential of 7.6 MW can be harnessed. An inventory of small-scale hydropower systems shows there is an installed capacity of 5.8 MW with most of the plants not functioning due to various reasons. Challenges and opportunities towards popularisation of the technology have been identified and discussed. © 2013 Elsevier Ltd. Source

Macdonald A.J.D.,Institute of Psychiatry | Elphick M.,University of Malawi
British Journal of Psychiatry | Year: 2011

The Department of Health in England has long encouraged the routine measurement of clinical outcomes in mental health services but has now decided to use outcome measures as part of a new payments system - Payment by Results. We examine how these two policies should or might interact. Source

Boele van Hensbroek M.,University of Malawi
PloS one | Year: 2010

Severe anaemia is a major cause of morbidity and mortality in African children. The aetiology is multi-factorial, but interventions have often targeted only one or a few causal factors, with limited success. We assessed the contribution of different pathophysiological mechanisms (red cell production failure [RCPF], haemolysis and blood loss) to severe anaemia in Malawian children in whom etiological factors have been described previously. More complex associations between etiological factors and the mechanisms were explored using structural equation modelling. In 235 children with severe anaemia (haemoglobin<3.2 mMol/L [5.0 g/dl]) studied, RCPF, haemolysis and blood loss were found in 48.1%, 21.7% and 6.9%, respectively. The RCPF figure increased to 86% when a less stringent definition of RCPF was applied. RCPF was the most common mechanism in each of the major etiological subgroups (39.7-59.7%). Multiple aetiologies were common in children with severe anaemia. In the final model, nutritional and infectious factors, including malaria, were directly or indirectly associated with RCPF, but not with haemolysis. RCPF was the most common pathway leading to severe anaemia, from a variety of etiological factors, often found in combination. Unlike haemolysis or blood loss, RCPF is a defect that is likely to persist to a significant degree unless all of its contributing aetiologies are corrected. This provides a further explanation for the limited success of the single factor interventions that have commonly been applied to the prevention or treatment of severe anaemia. Our findings underline the need for a package of measures directed against all of the local aetiologies of this often fatal paediatric syndrome. Source

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