Background and Purpose— The incidence of stroke in Malawi is unknown but major risk factors, including hypertension, obesity, and diabetes mellitus, are highly prevalent. We sought to understand community-level knowledge about stroke. Methods— A population-based cross-sectional study was conducted in rural Malawi (2016–2017). Adults aged ≥15 years were randomly selected and interviewed about their knowledge and perceptions of stroke symptoms, risk factors, and prevention. Logistic regression was used to investigate sociodemographic factors associated with stroke knowledge. Results— Of 812 selected, 739 (91% response rate) were seen and consented; 57% were female, and the median age was 52.0 years. Knowledge of stroke was poor: 71% knew no (correct) risk factors. Witchcraft (20.6%) was mentioned as frequently as hypertension (19.8%) as a cause. Knowledge of stroke was greatest in the most educated and wealthy and lowest in men, the never married, and the youngest age group. HIV-positive individuals had higher knowledge of prevention (odds ratio, 2.91; 95% CI, 1.21–7.03) than HIV negative individuals. Conclusions— Knowledge about stroke is very low in this community, particularly among the least educated and poor. Programs to support prevention, early recognition, and timely hospital presentation after a stroke are needed.
Conclusions Due to HIV+ people enjoying a longer life expectancy, and an insufficient drop in incidence, HIV prevalence will rise as a result of ART. Modelling suggests that even small increases in risky sexual behaviour will lead to further substantial increases in HIV prevalence. Policy makers are urged to continue promoting sex education, and be prepared for a higher than previously suggested number of HIV+ people in need of treatment. Background Post-exposure prophylaxis (PEP) is a short-term antiretroviral (ARV) treatment that reduces the likelihood of HIV infection after exposure to HIV-infected blood or sexual contact with an HIV-positive person. We are able to offer PEP mediations in our SWOP clinics to clients reporting high risk exposure. Normally ARVs for PEP are given within 72 h of exposure for a period of 4 weeks. Our objective was to assess whether the clients had already established STIs prior administration of PEP. The clients were aged between 19 and 49 years with each having an average of 9 men clients per day. Methods A cross sectional study was conducted on 91 female sex workers who came to the clinic for PEP in the period September 2009 to July 2010. The female sex workers were first given counselling, completed a standard questionnaire before having PEP administered. The samples taken included blood for HIV Elisa, high vaginal swab for Gonorrhoea Culture on Thayer martin media and Gram stain smear for Bacteria vaginosis, presence of spermatozoa and white blood cells. Results The clients were all HIV seronegative. 76% of the women had come for PEP for the first time, 21% for the second time and 3% for the third time. 80% of the patients reported condom burst, 8.6% were as a result of rape or coerced sex, while 3.2% reported client refused condom use. However 73% smears of the women did not have spermatozoa. Overall 9% of the patients were GC positive but 3.2% had GC and spermatozoa while 6.6% had GC without spermatozoa. Trichomonas prevalence was 4.3% but all these patients did not have spermatozoa. 38% had a WBC count of over 6e30 field on gram stain Conclusion: The presence of high white cell count at the time of seeking PEP may indicate a pre-existing infection, hence presence of underlying high risk behaviour. Moreover presence of GC and TV without spermatozoa may also indicate exposure longer reported. There is need to educate sex workers on proper use of PEP and to maintain low risk behaviour. We also need to understand the decision making process of sex workers in choosing post-exposure prophylaxis and any barriers that may contribute to delays in seeking PEP. P1-
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