Incidence of cryptosporidiosis species in paediatric patients in Malawi.

We determined the incidence of cryptosporidiosis in children aged <5 years presenting with diarrhoea in an urban and rural hospital-based setting in Malawi. Stools were collected over a 22-month period during both rainy and dry seasons. A range of microscopic methods were used to determine the presence of Cryptosporidium spp. oocysts. Species determination was by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of oocyst-extracted DNA using 18S rRNA and COWP gene loci. Cryptosporidium spp. oocysts were seen in 5.9% (50/848) of samples, of which 43 amplified by PCR-RFLP indicated the following species: C. hominis, C. parvum, C. hominis/C. parvum, C. meleagridis and C. andersoni. Seven samples could not be amplified by PCR. Wider species diversity was found in the rural setting, and may be a result of increased malnutrition and zoonotic exposure in this area. Improvements in water, sanitation, household hygiene and animal control are required to reduce the incidence of infection in this population.

Problems associated with the use of pit latrines in Blantyre, Republic of Malawi.

A questionnaire and observational study was conducted to determine the problems associated with construction, design and hygiene methods used to maintain pit latrines in a high-density urban township in Malawi. The survey comprised 100 randomly selected households and the person responsible for the latrine maintenance was interviewed. Eighty-seven percent of householders used traditional latrines, 67% with earthen and 20% with concrete (i.e. sanitation platform, also known as San-plats) floors. A variety of makeshift squat-hole covers (e.g. iron sheets, rocks, cardboard) are used by those who cannot afford San-plats to reduce fly and odour problems. Most squat-hole covers were fouled with faecal matter and some presented risk of invasive injury due to sharp edges. Five households used ventilated improved latrines whilst the remaining eight per cent made use of their neighbour's latrine. Ownership of property, poverty and theft in the area significantly influenced the type and structural condition of the latrine. Walls, ceilings and doors of the superstructure comprised a mixture of miscellaneous materials (i.e. cardboard, paper, cloth, brick) making the hygienic upkeep of the latrine difficult. Cloth doors were often used for hand drying. Geographical location, such as rocky terrain with inadequate soil consolidation, and environmental conditions, such as heavy rains and floods, exacerbate structural defects. Coupled with the lack of attention afforded to the disposal of young children's faeces, wash-water and pit surcharging, the potential exists for widespread contamination of the surrounding environment and transmission of faecal-oral disease. More than half of the respondents stressed that they had not received any information regarding health education and hygienic maintenance of the latrine. As such, there is need for a hygiene education programme to promote awareness of appropriate sanitation and behavioural change. Cultural and religious factors were found not to influence latrine use.

Grass-root health education strategies in Malawi.

PIP: Various health education strategies have been observed to be practiced at the grassroots level in Malawi. One approach to communicate health knowledge and information in health education is by teaching people directly by a lecture that may be delivered at prearranged meetings. Generally, lectures stress the value of: good housing, good sanitation practice, personal hygiene, food and nutrition, child care, use of potable water, communicable disease control, and use of available health services in their communities. Another approach to health education is through the use of mass media (radio and newspapers and leaflets). There are articles on health issues in local newspapers. Their disadvantage is that there is delayed feedback with room for misunderstanding the messages; Malawi has a literacy rate of only 30% for women and 60% for men. Health education messages are further disseminated by using visual aids: posters, films, models, flip charts, and photographs. The Ministry of Health and many nongovernmental organizations (NGOs) produce very good visual aids for teaching. Posters on AIDS are displayed in schools and colleges. Other widely practiced methods of communicating health messages to people include role playing through drama and singing health songs in promoting maternal and child health, nutrition, sanitation, and hygiene at clinics. Primary health care started in Malawi in 1979 by embracing both curative, preventive, and promotive aspects of health. Primary health workers (PHWs) in the villages are trained in basic curative medicine, public health work, and health education methods. Village health committees (VHCs) conduct health education. Women's groups, chiefs, church leaders, schools, farmers' clubs, and business associations publicize proposed health education programs in rural and urban communities.^ieng

Evaluation of source of messages on AIDS by college students

A survey was carried out to assess the degree of credibility and trustworthiness of eight selected sources of communications on AIDS as perceived by students. Results showed that the medical doctor and nurse are perceived as the most credible and trustworthy sources of messages; while friends and Traditional Healers are perceived as being the least credible and trustworthy. Although it could be said that because of the moral implications of AIDS; the priest (minister of religion) might have a major role to play in disseminating AIDS messages; the priest is not percieved as being particulary credible nor trustworthy in this area

Theoretical and practical capabilities of health inspectors

A look at the Public Health Programme at the Polytechnic of the University of Malawi

Job satisfaction among health inspectors survey

Self administered questionnaires were sent to 96 Health Inspectors of which 85 replied. Results indicated that the majority of Junior Health Inspectors are motivated by job security while Senior Health Inspectors are more motivated by the work itself