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Adamson S Muula

Publications and source records attributed to Adamson S Muula.

50 records · Page 3Linked to original sources
PubMed2004

HIV/AIDS in Sub-Saharan Africa.

Sub-Saharan Africa is the region most severely affected by the HIV/AIDS pandemic. Of the 40 million HIV infected individuals at the end of 2003, 26 million (65%) were living in the area. Reasons for the high infection rate include historical, political, economic, and cultural factors. The diversity of populations, combined with destitution, political and economic instability and hunger, has led to a number of strategies for combating the disease in Sub-Saharan Africa. These include voluntary counseling and testing, community involvement, facilitating behavior modifications, which include consistent and correct use of condoms, reduction in the number of sexual partners, increasing antiretroviral availability, and the involvement of non-governmental organizations in prevention, treatment, care, and support of the infected population. While Uganda has accomplished significant success through these mechanisms, other countries have not yet been able to control the disease. The populations requiring special attention include women of child-bearing age, who make 55% of the Sub-Saharan Africa's HIV infected population, children and the elderly. In this review, the current state of HIV/AIDS in Sub-Saharan Africa will be explored, in many cases referring to the situation in the southern African country of Malawi. Lessons will be highlighted and hopefully will contribute to the debate on HIV/AIDS and success of current and future prevention and control efforts.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Ethical and programmatic challenges in antiretroviral scaling-up in Malawi: challenges in meeting the World Health Organization's "Treating 3 million by 2005" initiative goals.

The Fifty-seventh World Health Assembly's (WHA's) resolution on the "scaling up of treatment and care within a coordinated and comprehensive response to HIV/AIDS' is welcomed globally, and even more so in Sub-Saharan Africa, where the majority of the people currently in need of antiretroviral therapy do not have access to it. The WHA identified, among others, the following areas which should be pursued by member states and the World Health Organization (WHO): trained human resources, equity in access to treatment, development of health systems, and the integration of nutrition into the comprehensive response to HIV/AIDS. The WHO Director-General was requested to "provide a progress report on the implementation of this resolution to the Fifty-eighth World Health Assembly.' Much of what happens between now and that time depends on the actions of the WHO and the member states and also on the contribution of the international community to the fight against HIV/AIDS. Much of what is to be done will be based on what is available now in terms of practice, human resources, and programs. This paper explores the WHA's resolution, especially regarding the scaling up of antiretroviral therapy, taking Malawi as the case study, to identify the challenges that a Southern African country may be facing which will eventually influence whether the initiative to "Treat 3 Million by 2005' ("3 by 5') will be achieved or not. The challenges southern countries may be facing are presented in this paper not in order to undermine the initiative but to create an awareness of these factors and initiate the appropriate action which would surmount the challenges and achieve the goals set.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Academic medicine in a southern African country of Malawi.

Academic medicine is usually considered to be a tripartite composition of teaching, research, and health care services delivery or patient care. The meaning of each component varies with interpretation. Developing countries such as Malawi face particular challenges in the field of academic medicine, including research resources, financing, and the brain drain of health human resources. Such constraints contribute to reduced numbers of faculty members, poor remuneration and diminished capabilities for career advancement. Addressing the issues currently plaguing academic medicine will enable this essential and multi-faceted discipline to flourish.

Academic Medical Centers↗
PubMed2004

Are public antenatal clinics in Blantyre, Malawi, ready to offer services for the prevention of vertical transmission of HIV?

At least 100% of the adult population in Malawi is infected with HIV and vertical transmission is a major mode of transmission. Currently, there are plans to provide widespread antiretroviral therapy to prevent mother to child transmission of HIV. This study was conducted to describe the perceptions of midwives towards selected issues regarding prevention of mother to child transmission of HIV in eleven public health centres in Blantyre, Malawi. A cross-sectional study using a self-administered questionnaire incorporating both open-ended and closed-ended questions was used. Twenty seven midwives participated in the study. Less than half (40.7%), of them reported working at a baby friendly hospital initiative health facility, while 96.3% reported that they would advise an HIV infected woman to breastfeed her infant. HIV prevention messages were reportedly offered routinely by 77.8% of the respondents, but only 22.2% reported that their clinics offered condoms to pregnant women. Also, only 37.0% reported offering routine STI screening, while 37.0% of the midwives would support antenatal women being accompanied by their male partners Majority (81.2%) said that women who know they are HIV infected should not become pregnant, while 37.0% reported that they would be uncomfortable to assist in the delivery of an HIV infected woman. There was lack of appropriate clinic space and sterile gloves for the proper delivery of maternity services. Midwives in Malawi need training, supervision and other support to provide adequate health care services to antenatal women.

Anti-HIV Agents↗
PubMed2004

Likely stakeholders in the prevention of mother to child transmission of HIV/AIDS in Blantyre, Malawi.

OBJECTIVES: To determine potential partners for pregnant women in the prevention of mother to child transmission of HIV and to determine pregnant women's perceptions towards selected potential HIV prevention efforts. DESIGN: Cross sectional, questionnaire-administered study. SETTING: Ante-natal clinics of eleven public health centers and the major referral and university teaching hospital of Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi. SUBJECTS: A total of 321 pregnant women attending ante-natal clinics. RESULTS: Antenatal women in Blantyre, Malawi obtain health information on HIV/AIDS from the radio (96.3%), health workers (82.2%), religious gatherings (66.7%), friends (54.8%) and newspapers (39.3%). The majority intend to be accompanied by own mother and sister for delivery (52.4% and 15.4% respectively). Almost all (99%) planned to breast feed with 91.8% reporting an intended breastfeeding period of at least 6 months. About 97% of married women reported desire to tell spouse in case of HIV sero-positive results while only 65.1% had ever discussed about HIV with spouse, and only 5.2% had ever attended antenatal clinic with spouse. Whether woman had ever discussed about HIV/AIDS with spouse or not did not influence desire to disclose HIV status to spouse. CONCLUSION: Close relatives, spouse and the media are important stakeholders in the health of pregnant women. Programs aimed at prevention of mother to child transmission of HIV should give serious consideration to these partners.

Breast Feeding↗
PubMed2004

Access to continued professional education among health workers in Blantyre, Malawi.

OBJECTIVE: To describe the current status of continued professional development (CPD) of healthcare personnel within the Ministry of Health (MoH) health centres in Blantyre, Malawi. DESIGN: A cross-sectional descriptive study utilizing an interviewer-administered questionnaire. SUBJECTS: Healthcare workers in public health centers in Blantyre District, Malawi. RESULTS: Fifty-seven healthcare workers participated of whom 47 (82.5%) were nurses, 8 (14.0%) were either medical assistants or clinical officers, and one laboratory technician and a dental therapist. At the time of the study, 50(87.7%) were prescribers and 54 (94.7%) had ever issued a prescription for medications. Participation in workshops and seminars within the past 12 months was reported by 54 (94.7%) of the participants and 49 (86.0%) reported that their health facilities had clinical hand-over meetings. All participants indicated desire to receive professional journals for free while only 35 (61.4%) were willing to pay for a journal subscription. Current personal and institutional subscription to a journal was low, at 2 (3.5%) each. About 30% had been trained to conduct research and 23 (40.1%) had ever conducted research with only 3 (5.3%) ever written a journal or newsletter article. 47.4% had access to a working phone at work and only 3 (5.3%) had access to internet facilities at all. Only 21% were satisfied with their own knowledge on health matters. CONCLUSIONS: Healthcare professionals in Blantyre's DHO zone are using mostly clinical hand-over meetings, seminars and workshops for their CPD. There is need to improve access to relevant professional journals. The regulatory or licensing boards for healthcare professional in Malawi should seriously consider mandatory CPD credits for re-registration.

Adult↗
PubMed2003

The ethics of developed nations recruiting nurses from developing countries: the case of Malawi.

There is currently a global shortage of nurses. Developing countries such as Malawiare among those hardest hit by this shortage. The demands on available nurses have increased and at the same time there is a lack of interest in becoming a nurse owing to the poor working conditions among those still employed in the service. It is questionable if developed nations should recruit nurses from countries such as Malawi, where severe human resource constraints are being experienced. We argue in this article that the current phenomenon of nurses leaving developing nations for western countries is complex. Human rights issues of individual autonomy and public interest are at stake.

Conflict, Psychological↗
PubMed2003

Risks and benefits of genetically modified maize donations to southern Africa: views from Malawi.

In 2001 and 2002, many countries in the Southern African Development Community (SADC) have suffered from severe food shortages resulting in an estimated 14 million people facing starvation due to inadequate quantities of the staple maize. The international community's response has been the donation of foodstuffs, including genetically modified maize. Reactions of the recipient countries of Zambia, Zimbabwe, and Malawi have been different. Zambia appealed to the donors not to send genetically modified maize, whereas Malawi accepted the maize donations. Malawi is currently facing many public health challenges because 10% of its 10-million population is HIV-positive, maternal mortality rate has almost doubled between 1992 and 2000, and there are also an estimated 1 million orphans due to HIV/AIDS. In the European Union, genetically modified maize falls under "Novel Foods" and its marketing and distribution are strictly regulated by law. This has never been the case in the southern African countries. In this article, we discuss the ethical challenges associated with genetically modified maize donations to southern Africa. Although genetically modified food offers a way to avoid many adverse effects of food shortages, we believe that some of the ethical questions of genetically modified food donations should be solved first, under the leadership of the donor countries and partnership of the developing countries. There are fears that consummation of genetically modified maize could have adverse health effects. These fears must be addressed if the confidence of developing countries in the donor community is to be maintained.

Bioethical Issues↗