ABSTRACT
Geographical Information Systems (GIS) is becoming a useful tool in disease control by health planners. However little is known about its potential in tuberculosis (TB) control. In 2000 the National TB Programme (NTP) in Malawi assessed its usefulness. Routinely collected case-finding data from the 3 previous years (1997 to 1999) were entered into a system containing a digital map of Malawi. District performance was mapped. We concluded that GIS may be complementary in monitoring TB programme performance; and may be useful for target setting; advocacy; and research. World Health Organisation (WHO) now provides free GIS software (Health Mapper) and training. However; the use of GIS in TB control still needs further piloting and expansion without constraining the locally available resources or disrupting the present TB data management system
Subject(s)
Geographic Information Systems , TuberculosisABSTRACT
Setting: 6 outpatient departments (OPD) of 3 hospitals and 2 health centres in Lilongwe. Objective: To assess the existing health worker practice in providing care to patients with respiratory symptoms in the OPD. Methods:Between 1 and 31 July 2002 exit interviews were conducted with patients from OPD consultation rooms and possessing a prescription for respiratory diseases. Verbal confirmation of the patients' complaints was done; patients' OPD notes were reviewed and a questionnaire was completed. Data was collected for patients aged 5 and above. Results: 3001 patients with median age of 27 years were enrolled in the study. 1203 (40) were male. 80 had made several visits to the OPD with the same symptom. In some cases verbal reports of main symptoms did not match with those recorded on OPD notes. 511 (17 ) patients reported that a clinician listened to their chest. Antibiotics were prescribed to 2501 (83.3 ) patients for various respiratory complaints. Similarly analgesics were prescribed to 2671 (89) patients. Steroids were prescribed to 32 (1.2) patients and a bronchodilator was prescribed to 185 (6.2) patients. Only 56 (2) patients were referred to another level of care. Conclusion: Management of patients with respiratory symptoms in Lilongwe is characterised by increased usage of antibiotics; analgesics and inability of health workers to examine the patients' chests. Referral to other care facilities is also uncommon. More investigations are required to understand the causes of this practice so that corrective measures are designed and implemented
Subject(s)
TuberculosisABSTRACT
Data from 252 deliveries at a rural hospital during 1988 and 1989 showed that infants born to adolescent mothers had the lowest mean birth wieght and highest incidence of low birth weight. Adolescent mothers were; in general; mothers of low parity level; and highest incidence of low birth weight was observed in mothers of parity 0 or 1. Average virth weights were higher at parity levels of 4 and 5. Although almost every woman attended the antenatal clinic; women who attended the clinic more than 3 times during pregnancy tended to have higher birth weight infants. More detailed data from 40 of these deliveries suggested that low socioeconomic status and household food insecurity during pregnancy are also associated with lower birth weight infants