Introduction chronic disease comorbidities are common among cancer patients in most parts of the world, however; there are limited data on the same for Malawi. Comorbidities worsen clinical outcomes and are associated with lower quality of life among cancer patients. We aimed at estimating chronic disease comorbidities and associated factors among cancer patients attending oncology services at the Queen Elizabeth Hospital (QECH) and Kamuzu Central Hospital (KCH) in Blantyre and Lilongwe respectively. Methods we conducted a cross-sectional study at QECH and KCH in Malawi from January to March 2021. Participants were recruited using simple random sampling technique at the oncology clinics and were interviewed using structured questionnaires. The College of Medicine Research and Ethics Committee (COMREC) approved the study and informed consent was obtained with each participant. Data were analyzed in Stata version 14 and summary statistics were presented as frequencies and proportions. Results we interviewed 398 cancer patients and the mean age was 45.4years (SD± 12.77). The common cancers were cervical (30%), Kaposi´s sarcoma (24%), breast (11%), esophageal (4%) and leukemia (4%). The prevalence of chronic disease comorbidities was 61.56% (n=398) and common conditions included: HIV and AIDS (43%), depression (9%) hypertension (8%) and anemia (9%). Chronic disease comorbidities were significantly associated with formal employment (p<0.01) and obesity (p<0.02). Conclusion chronic disease comorbidities were prevalent among cancer patients in the study settings in Malawi. There is a need to develop a multidisciplinary approach when managing cancer patients with emphasis on active screening for the common conditions as reported by this study.

The CanScreen5 project is a global cancer screening data repository that aims to report the status and performance of breast, cervical and colorectal cancer screening programs using a harmonized set of criteria and indicators. Data collected mainly from the Ministry of Health in each country underwent quality validation and ultimately became publicly available through a Web-based portal. Until September 2022, 84 participating countries reported data for breast (n = 57), cervical (n = 75) or colorectal (n = 51) cancer screening programs in the repository. Substantial heterogeneity was observed regarding program organization and performance. Reported screening coverage ranged from 1.7% (Bangladesh) to 85.5% (England, United Kingdom) for breast cancer, from 2.1% (Côte d’Ivoire) to 86.3% (Sweden) for cervical cancer, and from 0.6% (Hungary) to 64.5% (the Netherlands) for colorectal cancer screening programs. Large variability was observed regarding compliance to further assessment of screening programs and detection rates reported for precancers and cancers. A concern is lack of data to estimate performance indicators across the screening continuum. This underscores the need for programs to incorporate quality assurance protocols supported by robust information systems. Program organization requires improvement in resource-limited settings, where screening is likely to be resource-stratified and tailored to country-specific situations.

Introduction: By 2030, the non-communicable diseases (NCDs) are expected to overtake communicable, maternal, neonatal, and nutritional (CMNN) diseases combined as the leading cause of mortality in sub-Saharan Africa (SSA). With the increasing trend in NCDs, the NCD risk factors (NCDRF) need to be understood at local level in order to guide NCD risk mitigation efforts. Therefore, we provide a detailed analysis of some modifiable NCDRF and their determinants in Malawi using the 2017 Stepwise survey (STEPS). Methods: This is a secondary analysis of the Malawi 2017 STEPS. Data was analysed using frequencies, proportions, odds ratios (OR) and their associated 95% confidence intervals (95%CI). We fitted multiple logistic regression of the NCD risk factors on the explanatory variables using likelihood ratio test. The level of statistical significance was set at P< 0.05. Results: Of the 4187 persons, 9% were current smokers, 1% were taking alcohol, 16% had high salt intake, 64% had insufficient fruit intake, 21% had low physical activity, 25% had high blood sugar, and 11% had high blood pressure. Smoking odds increased with age but decreased with level of education. Females had lower odds of engaging in harmful alcohol use than males (AOR=0.04, 95%CI: 0.01-0.17, P<0.001). Females had lower odds of high salt uptake than the males (AOR=0.70, 95%CI: 0.58-0.84, P=0.0001). Persons in non-paid jobs had higher odds of salt uptake than those employed (AOR=1.70, 95%CI: 1.03-2.79, P=0.04). Females were 22% more likely to have insufficient fruit uptake compared to males (AOR=1.22, 95%CI: 1.06-1.41, P=0.007). Conclusion: The high prevalence of physical inactivity, high salt consumption, insufficient fruit intake, raised blood glucose and high relatively blood pressure calls for a sound public health approach. The Malawi Ministry of Health should devise multi-sectoral approaches that minimize exposure to modifiable NCD risk factors at population and individual levels.

Background Depressive disorders, with prevalence varying widely by setting, are among the common debilitating mental health disorders in patients with cancer worldwide. An understanding of the prevalence of depressive disorders among a specific patient population group should inform both their prevention and management. We conducted this study to estimate the prevalence and correlates of depressive disorders among patients living with cancer at Kamuzu Central Hospital (KCH), Lilongwe in Malawi. Methods We conducted a cross-sectional study nested in another larger quasi-experimental study evaluating the effect of integrating depression screening and management on clinical outcomes among cancer patients attending oncology services at a Cancer Unit based at Kamuzu Central Hospital in Lilongwe. A validated PHQ-9 tool was used to estimate prevalence of major depressive disorders. A total of 399 consented participants were enrolled from August to December, 2021. We estimated the prevalence and associated factors to depression among this patient group. Results The study comprised more females (64%) than males. Cervical cancer (33%), Kaposi’s Sarcoma (16%), breast cancer (9%) and esophageal cancer (4%) were the top four common malignancies in the study. The prevalence of major depressive disorders was 11.5%; most (52%) of whom had moderate depressive symptoms on PHQ-9 scale. Patients receiving palliative care were associated with reduced odds of major depressive disorders [Odds ratio: 0.36 (95% CI: 0.14–0.94)]. Conclusion A high proportion of patients with cancer had major depressive disorders. Patients on palliative care were protected from having major depressive disorders. There is a need for integrating screening and treatment of depressive disorders among patients living with cancer to improve cancer care in Malawi.

Introduction: Many cancer patients experience psychosocial challenges that affect quality of life during the trajectory of their disease process. We aimed at estimating quality of life among cancer patients at two major tertiary hospitals in Malawi. Methods: The study was conducted among 398 cancer patients using semi-structured questionnaire. Quality of life was measured using EQ-5D-3L instrument. Results: Mean age was 45 years ± 12.77. Pain (44%) was the most prevalent problem experienced by cancer patients. About 23% had worst imaginable health status on the subjective visual analogues scale. Attending cancer services at QECH (AOR=0.29, 95% CI: 0.17-0.54, p<0.001) and having normal weight (AOR=0.25, 95% CI: 0.08-0.74, p = 0.012), were associated with improved quality of life. A history of ever taken alcohol (AOR= 2.36, 95% CI: 1.02-5.44, p = 0.045) and multiple disease comorbidities (AOR= 3.78, 95% CI: 1.08-13.12, p = 0.037) were associated with poor quality of life. Conclusion: Loss of earning, pain, marital strife, sexual dysfunction, were among the common psychosocial challenges experienced. History of ever taken alcohol and multiple comorbidities were associated with poor quality of life. There is need to integrate psychosocial solutions for cancer patients to improve their quality of life and outcomes. Keywords: Cancer patients; quality of life.

Patients living with cancer and their families experience several challenges that affect their health-related quality of life (HRQOL). Perceived factors affecting quality of life (QOL) among people living with cancer have rarely been studied. We aimed at exploring the factors perceived to be associated with health-related quality of life among people living with cancer attending to a National Cancer Centre at Kamuzu Central Hospital in Malawi. Between May and June 2022, we conducted a qualitative study to assess perceptions and the in-depth lived experiences for people living with cancer, caregivers and healthcare workers at the cancer center on health-related quality of life. We purposively selected and interviewed thirteen participants. Interviews were transcribed, coded using NVivo 12 and analyzed using thematic analysis. Two broad categories of emerging themes of quality of life were identified. These included: (a) individual level factors such as experiences with diagnosis and treatment, changes on physical, psychological and social health, support received, benefits and challenges, (b) facility level factors such as availability of resources, relationship with providers, satisfaction with cancer care, facility organization, facilitators and barriers to improved quality of life. This study has highlighted the importance of physical, psychological, and social factors as key determinants perceived to be affecting health-related quality of life among patients living with cancer and their caregivers at the National Cancer Centre, Kamuzu Central Hospital in Malawi. The QOL challenges experienced by patients and their caregivers, implied that cancer care interventions should consider a holistic approach to cover for all dimensions of life in order to improve health-related quality of life among patients living with cancer.