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.

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Background Despite improvements in survival, persons living with HIV experience a range of physical, cognitive, mental and social health-related challenges. 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. MethodsWe conducted a quantitative cross-sectional study among adult persons aged 18 years and older living with HIV and on ART receiving their care at five government run health facilities in Blantyre urban. We used the WHO’s International Classification of Functioning, Disability and Health (ICF) for data collection. The ICF provides a unified, standard language and framework for the description of health and health-related states. The College of Medicine Research Ethics Committee (COMREC) approved the study and written informed consent was obtained from study participants. Descriptive statistics were used to summarize the data. 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, 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 (43%) and sensory functions and pain (40%) were the most prevalent among the study participants. Energy and drive (18%), memory (14%) and sleep (13%) were the most affected mental functions. Socio-demographic characteristics were not significantly associated with occurrence of the mental function impairments. Conclusions Our study highlights the level of impairments among person living with HIV especially mental health impairments, sensory functions and pain. Integrated health services including mental health screening and care, physical rehabilitation into all HIV testing and treatment settings are very critical to improve service delivery but also general access to rehabilitation by persons living with HIV.

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.

Background Road trauma represents a major but neglected public health challenge in Malawi that requires concerted efforts for effective and sustainable prevention. In order to make the road traffic system safer, it is important to develop an understanding of the whole system and its elements including vehicles, roads and road-users along with their physical, social and environmental circumstances. In this study, we measured data quality in terms of database and variable completeness of road trauma case reports to determine if the data are sufficient for informing, monitoring and evaluating road safety interventions. Methods This was a quantitative retrospective study based in Ntcheu district, Malawi. Data were collected for year 2018 from both police and hospital sources. Categorical data exploration from these two sources was done using frequency distribution tables. Continuous data were summarized using means and standard deviation. Data source completeness was assessed using the capture–recapture methodology, while variable completeness was assessed using a checklist developed from the World Health Organization’s minimum injury surveillance core data set. Results The hospital data source was incomplete in areas of road user type, time of injury, mechanism of injury and place of injury. Thirteen case matches were identified between the two databases. Using the capture-recapture methods, the estimated road trauma events in Ntcheu district for the year 2018 is 954 (95% CI: 457, 1451) and an estimated 173 deaths (95% CI: 89, 257) in the same year. These estimates indicate 11% and 14% ascertainment of fatalities for the police and hospital data sources respectively.Discussion and conclusion There is significant underreporting for road deaths and injuries in Ntcheu district, which means there are critical data quality challenges in the respective data sources. It is therefore imperative for the road safety agencies and partners to resolve these data reporting and acquisition challenges.

Background: Road trauma represents a significant yet neglected public health challenge in Zambia leading to loss of lives, severe disabilities and hampering development. It disproportionately affects low and middle income countries (LMIC) with 90%  of all road deaths occurring there. Zambia, like many other LMIC lacks robust evidence to guide road safety initiatives and program planning due to limited research, poor quality data and competing health priorities. Objectives: We aimed to investigate the epidemiology of road trauma cases seen at a general hospital in Monze district from 2013 to 2017. We further assessed the road trauma data quality as captured by the hospital registry. Methods: We reviewed records for all road trauma cases seen at Monze Mission Hospital from 2013 to 2017. Descriptive statistics  were used to summarised using means and proportion. We further assess the variables captured for each case that  presented at the hospital including socio-demographic and trauma-related details. Depending on the quality of data obtained, statistical methods were applied to explain the epidemiology including Chi-square, t-tests and proportional  tests were used to assess the differences in means and proportions, respectively. Results: The road trauma data at MMH are very poor evidenced by a lot of missing variables for road trauma cases that would aid  understanding of the epidemiology of road trauma cases seen at the facility. However, of the 449 road trauma cases reviewed, 62.4% of these were males. The highest road trauma burden was recorded among those aged 15-44. Time trend analysis shows a decreasing pattern in road deaths in Monze district. The case-fatality rates were very high with more than 90% the of deaths occurring before arrival at the hospital. However, many case files lacked data on occupation, education level, type of road user, type of vehicles involved and time of collision. Conclusion: The available data at MMH suggested that young and active people aged 15-44 years were the most affected of road  trauma in Monze district, with males experiencing a higher burden than females. The data also showed a decreasing  trend in the road trauma burden in Monze district. However, these results should be interpreted with great caution as the data are highly unreliable due to suspected very high levels of underreporting.