Community prevalence of chronic respiratory symptoms in rural Malawi: Implications for policy

Banda, Hastings; Thomson, Rachael; Mortimer, Kevin; Bello, George; Mbera, Grace B.; Malmborg, Rasmus; Faragher, Brian; Squire, S. Bertel

doi:10.1371/journal.pone.0188437

Cited by 32 publications

(38 citation statements)

References 20 publications

(25 reference statements)

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“…As already mentioned in our study, women using solid fuel for cooking in the living house showed 1.89 times higher odds of having at least one respiratory symptom compared with cleaner energy users, which is consistent with previous studies [26,27,31,33,37]. Meanwhile, the distribution of at least one of the respiratory symptoms was nearly equal among those having a window in the cooking area and those having only the door as a means of ventilation.…”

Section: Discussionsupporting

confidence: 92%

“…Both the prevalence of the respiratory symptoms and the exposure to the solid fuels were high compared with another study from Rwanda [31]. Except for breathlessness, which was found to be higher in that study, the prevalence of other respiratory symptoms among never-smokers were nearly doubled in this study when compared with other Sub-Saharans studies [31][32][33]. Not only did all rural women in the present study use solid fuel as the only energy source, most of them also had a larger family size, poor ventilation, animals in the same house and performed cooking in the main living room.…”

Section: Discussioncontrasting

confidence: 58%

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Respiratory Symptoms and Lung Function among Ethiopian Women in Relation to Household Fuel Use

Tamire

Addissie

Kumie

et al. 2019

IJERPH

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Exposure to household air pollution has been linked to chronic obstructive pulmonary disease, respiratory symptoms and reduced lung function. This study aims to assess respiratory symptoms and lung function among Ethiopian women in relation to exposure to HAP. We conducted a cross-sectional study among non-smoking women responsible for household cooking. Data was collected on socio-demographic characteristics, respiratory symptoms and risk factors using a validated questionnaire. Spirometry with reversibility testing was performed according to American Thoracic Society/European Respiratory Society guidelines. We used independent t-test and multivariable logistic regression to compare the means and measure association respectively. A total of 545 women participated in the study out of which 231 (42.3%) performed spirometry with at least three acceptable manoeuvres. Everyone in the rural group and 43% of the urban group were exposed to HAP from solid fuels during cooking. The odds of developing at least one respiratory symptom when compared with those using cleaner fuels are twice as high for women cooking within the living house. We also found significantly lower forced expiratory volume in the first second (FEV1) (L) among solid fuels users compared with cleaner energy users. Given the larger population settlement in the rural areas and the use of solid fuel as the only energy source, there is a higher risk of developing chronic respiratory health problems for those women in Ethiopia.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 58%

Respiratory Symptoms and Lung Function among Ethiopian Women in Relation to Household Fuel Use

Tamire

Addissie

Kumie

et al. 2019

IJERPH

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“…Another study by Banda reported that 22.5% of the study population of Malawi had at-least one respiratory symptoms and chronic cough was the most commonest symptom. 10 Both these studies reported higher prevalence of chronic respiratory symptoms compared to the present study.…”

Section: Discussioncontrasting

confidence: 53%

Prevalence of chronic respiratory symptoms in an urban population of North Kerala

Vasudevan

Silpa

2019

Int J Community Med Public Health

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INTRODUCTIONWith the advent of antibiotics in 1940s, the importance of acute respiratory tract infection as a cause of high mortality and morbidity, declined rapidly in developed countries and also it is decreasing in developing countries. However the burden of chronic diseases of respiratory system is increasing day by day. Tobacco smoking, socio economic development, urbanization, associated life style changes and resulting increase in air pollution are undoubtedly the underlying causative factors. Apart from the discomfort of the symptoms and the prolonged treatment, chronic respiratory diseases are associated with a variety of serious complications, which result in high treatment costs, reduced quality of life, reduced productivity, and shortened life expectancy. ABSTRACTBackground: Chronic respiratory diseases are becoming a challenge to public health due to its high morbidity and mortality. Most of these diseases are preceded by variable periods of chronic respiratory symptoms. If chronic respiratory symptoms can be diagnosed and managed properly and timely, we can reduce the incidence and complication of chronic respiratory diseases. Methods: A community based cross sectional survey was conducted in 20 electoral wards of Calicut corporation of Northern Kerala among the adult resident population of 20-70 years to assess the prevalence of chronic respiratory symptoms such as chronic cough, phlegm, wheezing, breathlessness and nasal allergy and the factors associated with these chronic symptoms. The information was collected from 1384 eligible subjects selected by cluster sampling using British research council respiratory questionnaire. Results: About 9.2% (n=95) of study population had at-least one of the chronic respiratory symptoms. 1.8% (n=19) had all the chronic respiratory symptoms. Prevalence of various chronic respiratory symptoms was chronic cough (8.7%), Phlegm (14.3%), wheezing (8.5%), breathlessness (2.2%) and nasal allergy (14.5%). Advancing age, current smoking, family history and past history of various respiratory diseases are significantly associated with the development of chronic respiratory symptoms. Female gender, longer duration of stay in Calicut corporation and regular alcoholism were significantly associated with chronic phlegm in the study population. Wheezing, breathlessness and chronic nasal allergy was significantly higher among lower socio economic status. Conclusions: Prevalence of chronic respiratory symptoms is high among the urban population of Northern Kerala. Older age group, smoking, past and family history of respiratory diseases are the major risk factors associated with these respiratory symptoms.

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“…The findings from this qualitative study are being used to complement the data obtained in the Triage II Plus project (Trial Registration Number: NCT02127983) [13] in which it is nested. Triage II Plus, which is being carried out by the Research for Equity And Community Health (REACH) Trust in Malawi, is a trial investigating the approaches to improve detection and management of chronic airways disease.…”

Section: Research Objectivesmentioning

confidence: 99%

“…The fieldwork for this study was carried out in April 2018 alongside the Triage II Plus Endline Survey [13] which provided the data for selection and recruitment of participants. In order to coordinate with local research assistants, and because the data collection for the current study was conducted at the same time as that of the Triage II Plus project, the first 12 survey respondents who were considered to meet our inclusion criteria and could be located using the household GPS coordinates provided, were recruited.…”

Section: Recruitmentmentioning

confidence: 99%

Access to health care for people with disabilities in rural Malawi: what are the barriers?

Harrison

Thomson

Banda

et al. 2020

Preprint

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Background People with disabilities experience significant health inequalities. In Malawi, where most individuals live in low-income rural settings, many of these inequalities are exacerbated by restricted access to health care services. This qualitative study explores the barriers to health care access experienced by individuals with a mobility or sensory impairment, or both, living in rural villages in Dowa district, central Malawi. In addition, the impact of a chronic lung condition, alongside a mobility or sensory impairment, on health care accessibility is explored. Methods Using data from survey responses obtained through the Research for Equity And Community Health (REACH) Trust’s randomised control trial in Malawi, 12 adult participants, with scores of either 3 or 4 in the Washington Group Short Set (WGSS) questions, were recruited. The WGSS questions concern a person’s ability in core functional domains (including seeing, hearing and moving), and a score of 3 indicates ‘a lot of difficulty’ whilst 4 means ‘cannot do at all’. People with cognitive impairments were not included in this study. All who were selected for the study participated in an individual in-depth interview and full recordings of these were then transcribed and translated. Results Through thematic analysis of the transcripts, three main barriers to timely and adequate health care were identified: 1) Cost of transport, drugs and services, 2) Insufficient health care resources, and 3) Dependence on others. Attitudinal factors were explored and, whilst unfavourable health seeking behaviour was found to act as an access barrier for some participants, community and health care workers’ attitudes towards disability were not reported to influence health care accessibility in this study. Conclusions This study finds that health care access for people with disabilities in rural Malawi is hindered by closely interconnected financial, practical and social barriers. There is a clear requirement for policy makers to consider the challenges identified here, and in similar studies, and to address them through improved social security systems and health system infrastructure, including outreach services, in a drive for equitable health care access and provision. Key words Health care access, barriers, disability, impairment, Malawi, rural, in-depth interviews

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Community prevalence of chronic respiratory symptoms in rural Malawi: Implications for policy

Cited by 32 publications

References 20 publications

Respiratory Symptoms and Lung Function among Ethiopian Women in Relation to Household Fuel Use

Respiratory Symptoms and Lung Function among Ethiopian Women in Relation to Household Fuel Use

Prevalence of chronic respiratory symptoms in an urban population of North Kerala

Access to health care for people with disabilities in rural Malawi: what are the barriers?

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