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Weaving a Malawi sunrise : a woman, a school, a people
\"\"When you educate a girl, you educate a nation. --Malawian saying. The women of Malawi, like many other women in developing countries, struggle to find their way out of poverty and build a better life for themselves and their families. Weaving a Malawi Sunrise tells the story of Memory Chazeza's quest to get an education and to build a school for young women. Roberta Laurie was one of many who helped Memory realize her vision of seeing young girls become strong and independent women who could care for themselves and their future families. During her time in Malawi, Laurie met several other women, each of whom had a story of her own. Laurie interweaves these accounts with well-researched information about the country's underlying social and political context. Readers interested in Africa, global affairs, women's studies, development, and international education will give high marks to Weaving a Malawi Sunrise.\"-- Provided by publisher.
Book
The Politics and Economics of Decolonization in Africa
The slow collapse of the European colonial empires after 1945 provides one of the great turning points of twentieth century history. With the loss of India however, the British under Harold Macmillan attempted to enforce a 'second' colonial occupation - supporting the efforts of Sir Andrew Cohen of the Colonial Office to create a Central African Federation. Drawing on newly released archival material, The Politics and Economics of Decolonization offers a fresh examination of Britain's central African territories in the late colonial period and provides a detailed assessment of how events in Britain, Africa and the UN shaped the process of decolonization. The author situates the Central African Federation - which consisted of modern day Zambia, Zimbabwe and Malawi - in its wider international context, shedding light on the Federation's complex relationships with South Africa, with US Presidents Dwight Eisenhower and John F. Kennedy and with the expanding United Nations. The result is an important history of the last days of the British Empire and the beginnings of a more independent African continent.
eBook
Effects of Coronavirus Disease Pandemic on Tuberculosis Notifications, Malawi
The coronavirus disease (COVID-19) pandemic might affect tuberculosis (TB) diagnosis and patient care. We analyzed a citywide electronic TB register in Blantyre, Malawi and interviewed TB officers. Malawi did not have an official COVID-19 lockdown but closed schools and borders on March 23, 2020. In an interrupted time series analysis, we noted an immediate 35.9% reduction in TB notifications in April 2020; notifications recovered to near prepandemic numbers by December 2020. However, 333 fewer cumulative TB notifications were received than anticipated. Women and girls were affected more (30.7% fewer cases) than men and boys (20.9% fewer cases). Fear of COVID-19 infection, temporary facility closures, inadequate personal protective equipment, and COVID-19 stigma because of similar symptoms to TB were mentioned as reasons for fewer people being diagnosed with TB. Public health measures could benefit control of both TB and COVID-19, but only if TB diagnostic services remain accessible and are considered safe to attend.
Journal Article
Azithromycin to Reduce Childhood Mortality in Sub-Saharan Africa
Childhood mortality remains high in sub-Saharan Africa. In this cluster-randomized, placebo-controlled trial, mortality among children younger than 5 years of age was lower among those who received azithromycin than among those who received placebo.
Journal Article
A cleaner burning biomass-fuelled cookstove intervention to prevent pneumonia in children under 5 years old in rural Malawi (the Cooking and Pneumonia Study): a cluster randomised controlled trial
WHO estimates exposure to air pollution from cooking with solid fuels is associated with over 4 million premature deaths worldwide every year including half a million children under the age of 5 years from pneumonia. We hypothesised that replacing open fires with cleaner burning biomass-fuelled cookstoves would reduce pneumonia incidence in young children.
We did a community-level open cluster randomised controlled trial to compare the effects of a cleaner burning biomass-fuelled cookstove intervention to continuation of open fire cooking on pneumonia in children living in two rural districts, Chikhwawa and Karonga, of Malawi. Clusters were randomly allocated to intervention and control groups using a computer-generated randomisation schedule with stratification by site, distance from health centre, and size of cluster. Within clusters, households with a child under the age of 4·5 years were eligible. Intervention households received two biomass-fuelled cookstoves and a solar panel. The primary outcome was WHO Integrated Management of Childhood Illness (IMCI)-defined pneumonia episodes in children under 5 years of age. Efficacy and safety analyses were by intention to treat. The trial is registered with ISRCTN, number ISRCTN59448623.
We enrolled 10 750 children from 8626 households across 150 clusters between Dec 9, 2013, and Feb 28, 2016. 10 543 children from 8470 households contributed 15 991 child-years of follow-up data to the intention-to-treat analysis. The IMCI pneumonia incidence rate in the intervention group was 15·76 (95% CI 14·89–16·63) per 100 child-years and in the control group 15·58 (95% CI 14·72–16·45) per 100 child-years, with an intervention versus control incidence rate ratio (IRR) of 1·01 (95% CI 0·91–1·13; p=0·80). Cooking-related serious adverse events (burns) were seen in 19 children; nine in the intervention and ten (one death) in the control group (IRR 0·91 [95% CI 0·37–2·23]; p=0·83).
We found no evidence that an intervention comprising cleaner burning biomass-fuelled cookstoves reduced the risk of pneumonia in young children in rural Malawi. Effective strategies to reduce the adverse health effects of household air pollution are needed.
Medical Research Council, UK Department for International Development, and Wellcome Trust.
Journal Article
William Kamkwamba : powering his village
\"Imagine your family had to choose between sending you to school or having enough food to eat. This book tells how William Kamkwamba was forced to drop out of his school in Wimbe, Malawi, when a famine struck his village and his family, who relied on farming, could no longer afford his tuition fee. Instead of giving up on his education, William visited his local library often. It was here that he read a book about wind power. At the age of 14, William used what he learned from the book to build a windmill that brought power to his family's home. He has since built his village's first drinking water pump. William's ingenuity, perseverance, and initiative are an inspiration to many people around the world.\"-- Provided by publisher.
BOOK
Ferric carboxymaltose versus standard-of-care oral iron to treat second-trimester anaemia in Malawian pregnant women: a randomised controlled trial
Anaemia affects 46% of pregnancies in Africa; oral iron is recommended by WHO but uptake and adherence are suboptimal. We tested a single dose of a modern intravenous iron formulation, ferric carboxymaltose, for anaemia treatment in Malawian pregnant women.
In this open-label, individually randomised controlled trial, we enrolled women with a singleton pregnancy of 13–26 weeks' gestation in primary care and outpatient settings across two regions in southern Malawi. Women were eligible if they had capillary haemoglobin of less than 10·0 g/dL and negative malaria rapid diagnostic test. Participants were randomised by sealed envelope 1:1. Assessors for efficacy outcomes (laboratory parameters and birthweight) were masked to intervention; participants and study nurses were not masked. Participants were given ferric carboxymaltose up to 1000 mg (given once at enrolment in an outpatient primary care setting), or standard of care (60 mg elemental iron twice daily for 90 days), along with intermittent preventive malaria treatment. The primary maternal outcome was anaemia at 36 weeks' gestation. The primary neonatal outcome was birthweight. Analyses were performed in the intention-to-treat population for mothers and liveborn neonates, according to their randomisation group. Safety outcomes included incidence of adverse events during infusion and all adverse events from randomisation to 4 weeks' post partum. The trial is registered with ANZCTR, ACTRN12618001268235. The trial has completed follow-up.
Between Nov 12, 2018, and March 2, 2021, 21 258 women were screened, and 862 randomly assigned to ferric carboxymaltose (n=430) or standard of care (n=432). Ferric carboxymaltose did not reduce anaemia prevalence at 36 weeks' gestation compared with standard of care (179 [52%] of 341 in the ferric carboxymaltose group vs 189 [57%] of 333 in the standard of care group; prevalence ratio [PR] 0·92, 95% CI 0·81 to 1·06; p=0·27). Anaemia prevalence was numerically lower in mothers randomly assigned to ferric carboxymaltose compared with standard of care at all timepoints, although significance was only observed at 4 weeks' post-treatment (PR 0·91 [0·85 to 0·97]). Birthweight did not differ between groups (mean difference –3·1 g [–75·0 to 68·9, p=0·93). There were no infusion-related serious adverse events or differences in adverse events by any organ class (including malaria; ≥1 adverse event: ferric carboxymaltose 183 [43%] of 430 vs standard of care 170 [39%] of 432; risk ratio 1·08 [0·92 to 1·27]; p=0·34).
In this malaria-endemic sub-Saharan African setting, treatment of anaemic pregnant women with ferric carboxymaltose was safe but did not reduce anaemia prevalence at 36 weeks' gestation or increase birthweight.
Bill & Melinda Gates Foundation (INV-010612).
Journal Article