Introduction Low back pain (LBP) is a significant musculoskeletal problem during pregnancy with potential to negatively affect the woman's quality of life. Data on LBP among pregnant women in Malawi is almost non-existent. We investigated the prevalence and risk factors of LBP and its association with functional activities in pregnant women in Malawi. Methods We conducted a cross-sectional study in Blantyre, Malawi, from December 2017 to January 2018. Participants were drawn from low-risk antenatal clinics in selected local health facilities. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages. The association between occurrence of LBP and selected factors was assessed using the Chi-Square test (X 2 ) (α=5%) followed by a multiple logistic regression. Odds ratios (OR) and their 95% confidence intervals were calculated. Results We interviewed 404 pregnant women; the mean age of respondents was 25.83 years old ( SD: ±5.91 ). Prevalence of LBP in pregnancy was 62% ( n=249 ); 172 (69%) of these reported LBP for the first time during the current pregnancy. Gestational age was significantly associated with presence of LBP ( P= 0.03 ). LBP was associated with the women's sleep patterns, mobility, lifting techniques and sexual activities. However, a reasonable high proportion of those with LBP (34%) did not seek care for their low back pain. Conclusion LBP is highly prevalent and an important clinical condition among pregnant women in Blantyre, Malawi. Given the significant effect of LBP on quality of life, health workers need to be proactive in identifying LBP and provide the appropriate management.

BackgroundLow back pain (LBP) affects many people globally. Its aetiology is not clear. Patients lack knowledge of its contributing factors and have negative perception about their LBP. This study aimed to identify knowledge, attitudes and beliefs regarding the perceived contributing factors to LBP among patients attending physiotherapy outpatient departments in Malawi. This information can possibly facilitate planning of a LBP education programme in Malawi.MethodsA quantitative cross-sectional survey was conducted, using a six-part self-administered questionnaire with questions on demographic information, participants’ attitudes and beliefs regarding their LBP, knowledge about the course and causes of LBP, beliefs regarding nine contributing factors to LBP (identified in a Delphi study) and the sources of the participants’ knowledge. Data were analysed descriptively using the Statistical Package for Social Sciences (version 19.0). A Chi-square test was used to determine any association between variables (alpha 0.05). All ethical procedures were strictly followed.ResultsMost participants (186, 91.2 %) did not manage to answer all six questions regarding knowledge correctly and were regarded as ‘partially knowledgeable’ about the course and causes of LBP. More than half (67%) portrayed negative attitudes and beliefs about LBP in general. The findings also showed a statistically significant relationship between knowledge, attitudes and beliefs (p = 0.04).ConclusionThis study highlighted that many patients with LBP in Malawi are not adequately knowledgeable about LBP and hold negative attitudes and beliefs regarding their LBP. Therefore, LBP management programmes in Malawi should include education programmes aimed at empowering patients with knowledge regarding LBP, as well as changing their negative attitudes and beliefs about their pain. Patients’ understanding of the cause and nature of their pain may enhance the achievement of treatment goals.

Low back pain (LBP) is a musculoskeletal disorder, affecting humans from adolescent to adult age. It is a health and socioeconomic problem worldwide. The cause and contributing factors to LBP are multifactorial resulting in different approaches for its management. The attitudes and beliefs of patient with LBP, play an important role in the whole process of pain management. Negative attitudes and beliefs may lead to fear-avoidance behaviour, resulting into pain chronicity and disability. Thus, this study aimed to identify the attitudes and beliefs among patients with LBP, attending physiotherapy treatment in Malawi. Queen Elizabeth and Kamuzu Central hospitals were selected as study settings. A quantitative cross-sectional survey was done, using a self-administered questionnaire, employing a convenience sampling method. Twelve statements about attitudes and beliefs on LBP were adopted from the Back Beliefs Questionnaire (BBQ) and from the Survey of Pain Attitudes (SOPA). The SPSS (version 19.0) was used for data capturing and analysis. Descriptive and inferential statistics were used to summarize data. The Chi-square test was used to determine any association between variables and the Alpha level of significance was set at 0.05. All ethical issues were sought and adhered to throughout the study period. The results showed that out of 205 participants, with mean age of 47.74 years, (SD=13.29), female constituted 53.2% of the sample. More than half (67%) of all participants portrayed negative attitudes and beliefs about their LBP. We concluded that, majority of patients with LBP in Malawi hold negative attitudes and beliefs about their pain. Therefore, patient health education is needed to change these attitudes and beliefs if recovery and treatment goal are to be achieved.

Background Type II diabetes mellitus (T2DM) significantly impacts quality of life (QoL) yet data on quality of life among these patients in Malawi are lacking. This study was conducted to assess QoL among patients with T2DM. Methods A mixed-method cross-section study was conducted at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. A systematic sampling method was used for quantitative data and purposive sampling was used for qualitative data. A modified diabetes quality of life (MDQoL)-17 questionnaire was used for quantitative data while in-depth interviews and diary methods were used for qualitative data. Demographic data were summarized using descriptive statistics and inferential statistics using t-test and ANOVA. Thematic analysis was utilized to analyze qualitative data. Ethical approval was obtained from the College of Medicine Research and Ethics Committee (CoMREC) reference number P.09.20.3122. Results A sample of 339 participants (mean age 50.3 ± 15.5) was recruited. Overall, the mean QoL score was moderate (63.91 ± 19.54). Those with tertiary education and those on health insurance had better QoL (QoL 73.8, C.I. 68.56–79.04, p-value 0.005), (QoL 76.71, C.I. 69.22–84.19, p-value 0.005) respectively compared to those with lower education and those without health insurance. Furthermore, absence of comorbidities was associated with having better QoL (QoL 71.18, C.I. 66.69–75.67, p-value < 0.0001). Qualitatively, participants referred to QoL as an absence of disease and leading an independent life. T2DM was associated with patients’ health status, increased stress levels and loss of independence. There were QoL-promoting factors among T2DM patients such as diabetes health talks, having a supportive family and following hospital advice. Inhibiting factors include drug shortages, societal perceptions, sedentary lifestyle, stress, and despising hospital advice. Conclusions Overall QoL in patients with T2DM receiving treatment at KCH is moderate. QoL of patients with T2DM is influenced by interrelated factors which requires multidisciplinary team care to optimize the QoL among these patients. Health workers need to adopt a holistic approach when treating patients with T2DM, such as managing comorbidities and including assessment of QoL, behavioral change measures like physical exercises, and a healthy diet. The government and various stakeholders need to promote mandatory national health insurance which improve health status.

Background: Type II diabetes mellitus (T2DM) significantly impacts the quality of life (QoL) yet data on quality of life among these patients in Malawi are lacking. This study was conducted to assess QoL among patients with T2DM. Methods: A mixed-method cross-section study was carried out at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. A systematic sampling method was used for quantitative data and purposive sampling was used for qualitative data. A modified diabetes quality of life (MDQoL)-17 questionnaire was used for quantitative data while in-depth interviews and diary methods were used for qualitative data. Demographic data were summarized using descriptive statistics and inferential statistics using t-test and ANOVA. Thematic content analysis guided by Braun and Clark (2006) was utilized to analyze qualitative data. Ethical approval was obtained from the College of Medicine Research and Ethics Committee (CoMREC) reference number P.09.20.3122.Results: A sample of 339 participants with a mean age of 50.3±15.5 was recruited. Overall, the mean QoL score was moderate (63.91±19.54). Those with tertiary education and those on health insurance had better QoL (QoL 73.8, C.I. 68.56-79.04, p-value 0.005), (QoL 76.71, C.I. 69.22-84.19, p-value 0.005) respectively compared to those with lower education and those without health insurance. Furthermore, the absence of comorbidities was associated with having better QoL (QoL 71.18, C.I. 66.69-75.67, p-value < 0.0001). Qualitatively, the participants referred to QoL as an absence of disease and leading an independent life. T2DM was associated with patients’ health status, increased stress levels, loss of independence as well as lifestyle changes. There were QoL-promoting factors among T2DM patients such as diabetes health talks, having a supportive family, accepting one’s condition positively, and following hospital advice such as doing physical exercises and following a prescribed diet. Inhibiting factors include drug shortages, societal perceptions, sedentary lifestyle, stress, and despising hospital advice.Conclusion: Overall the QoL in patients with T2DM receiving treatment at KCH is moderate. The QoL of patients with T2DM is influenced by interrelated factors and this requires multidisciplinary team care to optimize the QoL among these patients. Health workers need to adopt a holistic approach when treating patients with T2DM, such as managing comorbidities and including assessment of QoL, behavioral change measures like physical exercises, and a healthy diet. The government and various stakeholders need to promote education and mandatory national health insurance which improve health status.

Introduction Despite improvements in survival, reports indicate that people living with HIV are experiencing a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging recently termed ‘disability’. Among adult persons living with HIV in Malawi, the prevalence of disability and associated risk factors are not known. This study was designed to assess the prevalence of impairments, activity limitations and associated risk factors among adults living with HIV in Blantyre urban, Malawi. Methods We conducted a quantitative cross sectional study among adult persons living with HIV in Blantyre urban from March to August 2018. Participants were recruited consecutively from 5 health centers. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. Written informed consent was sourced from study participants, permission was granted at each study site and the study received ethics approval from the College of Medicine Research Ethics Committee (COMREC). Descriptive statistics were used to summarize the data. Categorical variables were summarized as frequencies and percentages and continuous variables were summarized using means and standard deviation. Univariable and multivariable logistic regression were used to assess association between presence of disability and selected factors. Odds ratios (OR) and their 95% confidence intervals were calculated. Results Of the 277 participants enrolled in the study, 225 (81%) were female and 52 (19%) were male. The mean age of participants was 37 years ( std. dev 9.5 ). Impairments in mental functions were the most prevalent affecting 118 (43%) study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Impairments in the mental functions, genital urinary, reproductive, digestive, metabolic and endocrine systems were associated with higher odds of disability among the participants. Conclusions Our results indicate a high prevalence of impairments among persons living with HIV. Clinicians and rehabilitation personnel need to be proactive in identifying and managing impairments to promote health among HIV patients.