Pharmacy
Permanent URI for this community
Browse
Browsing Pharmacy by Title
Now showing 1 - 10 of 10
Results Per Page
Sort Options
- ItemRestrictedAntibiotic prescription audit at QECH and KCH(Kamuzu University of Health Sciences, 2022-03-10) Unyolo, Takondwa; Mwambene, GraceThere is an increase in antibiotic resistance by bacteria to most of the available antibiotics and it is an issue of great public health concern. Antibiotic resistance is mostly brought about by inappropriate and unnecessary prescribing of antibiotics despite the availability of prescribing guidelines. Antibiotic stewardship involves appropriate selection, dose, route and duration of antibiotic therapy, and has been shown to minimize emergence of resistance. Auditing antibiotic use is essential in monitoring appropriate use within an institution. This cross sectional and retrospective study aims to conduct an audit on antibiotic prescription at QECH and KCH in Malawi to appreciate the extent of antibiotic prescription between these two referral hospitals. The objectives of this study include, assessing if prescription is based on proper diagnosis, evaluating if antibiotic prescriptions are based on prescribed guidelines and identifying the most commonly prescribed antibiotics at QECH and KCH in the medical wards We are going to audit antibiotic prescription at the two referral hospitals in the medical wards using questionnaires. This process will involve prescribers who are authorized to prescribe antibiotics in the medical department of the hospitals and the use of patient files of those prescribed antibiotics. It is expected that they will be minimal adherence to the prescribing guidelines in the Malawi Standard Treatment Guidelines by the prescribers and that most prescription of antibiotics will be done without appropriate diagnosis. The results of this study will be submitted to KUHES library, they will also be presented to the academic staff and students.
- ItemRestrictedAssessing the impact of training and remodeling of adverse drug reaction reporting systems on the practice of pharmacovigilance in Malawi(Kamuzu University of Health Sciences, 2021-06-16) Chimimba, FriderPharmacovigilance (PV) system is essential in every country to ensure patient safety and public health in relation to medication. Strong and effective PV is achievable if there are collective efforts from well trained and informed health care professionals who are able to monitor, detect and report suspected adverse drug reactions (ADRs) using convenient and effective reporting tools. Type of the study This is a cross sectional survey that will use quantitative approach to assess the ADR reporting rates, knowledge, attitudes and practices and qualitative approach to seek opinions of healthcare workers on pharmacovigilance. Problem In Malawi and other low- and middle-income counties (LMICs), PV systems are weak and reporting of adverse drug reactions is still low. Furthermore, the currently used traditional paper-based ADR reporting tools face logistical challenges which result in delays in transmission of information and compromise confidentiality. As a way of continued efforts to counter these challenges, the Malawi Pharmacy and Medicines Regulatory Authority (PMRA) with support from the World Health Organization (WHO) have been conducting PV training among Health Care Professionals (HCPs) on basic principles of PV. They are also in the process of establishing Unstructured Supplementary Service Data (USSD) system for reporting of adverse drug reactions and other medicine related problems. However, the impact of the training and use of USSD reporting system on PV in Malawi is not known. Objectives Our main objective of this study is therefore to assess the impact of the training on knowledge, attitudes and practices (KAP) of Pharmacovigilance and use of USSD reporting system on the ADRs reporting rate. The specific objectives are to: To assess the KAP of healthcare professionals on Pharmacovigilance after undergoing PV training To investigate the preferences of healthcare professionals on the reporting tools for ADRs To evaluate the improvement on ADR reporting rate after introducing USSD system training HCP on PV Methodology We will recruit HCPs who participated in PV trainings conducted by PMRA, from randomly selected districts in Malawi. Quantitative data will be collected using a structured questionnaire from all participants who participated and responded to a similar questionnaire before the training to assess the KAP after the training. Face-to-face interviews will be conducted to conveniently sampled participants using a semi-structured questionnaire to collect qualitative data on the usability of USSD system and preferences of HCPs on ADR reporting tools. Quantitative data will be analyzed using both descriptive and analytical statistics in Statistical Package for Social Sciences (SPSS) while qualitative data will be analyzed manually or using NVivo by content thematic analysis. Expected findings We hope that there will be improved level of knowledge, attitudes and practices among healthcare workers after undergoing training and also an improved rate of ADR reporting after launching USSD system as compared to the paper-based reports. In addition, the opinions and preferences of healthcare workers on PV tools will also be known from the study. Dissemination of results The results of this study will be shared with stakeholders such as WHO, Ministry of Health, Pharmacy and Medicines Regulatory authority, members of the academia and COMREC through conferences, meetings and publications. Key words: Adverse drug reactions, drug safety monitoring, Pharmacovigilance
- ItemRestrictedAssessing the quality and use of antibiotics and associated clinical outcomes in southern Malawi(Kamuzu University of Health Sciences, 2021-12-10) Chiumia, FrancisType of study This study will be a quantitative cohort study which will use both prospective and retrospective approaches. Problem Inappropriate medication and use of poor-quality antibiotic medicines have the potential to cause poor outcomes such as occurrence of adverse drug reactions, treatment failure and antimicrobial resistance. Substandard and falsified medicines is a global problem which disproportionally affects LMICs such as Malawi but its clinical impact has been poorly assessed and documented. Moreover, it has been known that high disease incidence is associated with a high prevalence of substandard and falsified (SF) medicines, suggesting that the risk of SF antibiotics is high in Malawi as antibiotics are one of the most prescribed class of medicines in low-middle income countries (LMICs). In addition, the appropriateness of the use antibiotics and clinical outcomes is still not investigated. Objectives The goal or purpose of this study is to assess the quality and use of antibiotic medicines and the associated clinical outcomes in southern Malawi. The specific objectives are to: 1. To assess the availability of antibiotics in public and private health sectors 2. To determine the prevalence of substandard and falsified antibiotics in public and private health sectors 3. To assess the storage factors that affect quality of antibiotics 4. To evaluate appropriateness of the use of antibiotics Methodology We will focus on a list of 15 selected antibiotics (sample size of 553) that are prescribed to treat common infections according to the Malawi standard treatment guidelines and the essential medicine list and recruit a sample size of 398 in-patients who are exposed to these antibiotics. Firstly, we will collect data from stock cards on the availability of our selected antibiotics in government, CHAM and private sector using a form. We will also collect data from clinical records such as patient files to assess the appropriateness of the use of these antibiotic medicines according to local and international guidelines. A global trigger tool will be used to detect any occurrence of adverse drug events or failure of treatment and the patient outcomes will be assessed for each patient. Medicine quality analysis will be done for the batches of the antibiotic medicines administered to the study participants. This will involve inspection of visual defects, labelling and registration status of the medicine, followed up by dissolution tests and chemical analysis for the presence and quantity of the active ingredients according to official pharmacopeial specifications. The analytical assays will apply different techniques such as thin layer chromatography, high performance liquid chromatography and ultra-violet visible spectrophotometry and titration. Furthermore, storage conditions will be longitudinally recorded for these antibiotic conditions to determine the effect of storage on the quality of the antibiotic formulations. Data will be entered in Microsoft excel and analyzed in SPSS or STATA. We will use descriptive statistics to describe the baseline characteristics of our variables and apply analytical statistics to determine associations among quality of antibiotic medicines, factors that influence the quality of medicines, appropriateness of antibiotic use and the patient outcomes. These results will be presented in appropriate tables, graphs and charts. Expected finding and their dissemination By the end of this study, we expect to describe the prevalence of SF antibiotic medicines and establish the pattern for the use of antibiotics and characteristics of associated outcomes such as any adverse drug reactions including failure of treatment. The study will be done in a period of three years and the results will finally be disseminated to College of Medicine Research and Ethics Committee (COMREC), local and international stakeholders in the medical or pharmaceutical field and the academia through conference presentations and scientific publications in peer reviewed journals.
- ItemRestrictedCross section study on knoweledge about Malawi’s poisonous plants among traditional medicine practitioners and users(Kamuzu University of Health Sciences, 2020-06-10) Kandodo, Chifundo; Tembo, Yohane; Dambuleni, JeremiahIt is undeniable that plants have an important role in the development of modern medicine. But use of traditional medicine from plants is associated with devastating side effects. Specific plants or combination of plants used as medicine are associated with these effects hence this study will assess if traditional practitioners and users have knowledge about these plants. The main objective is to explore knowledge among traditional practitioners and users on poisonous plants that are used as traditional medicine. This study is a cross sectional qualitative study exploring the knowledge about poisonous plants in Blantyre urban and rural. This study will therefore involve qualitative study method. The participants will be traditional practitioners and users of traditional medicine both above 18 years old. These participants will be those living or doing their business in Blantyre. The sampling method will be purposive and convenient sampling method for the traditional practitioners, but for the users will use convenient method. It is expected that by the end of this research, we will identify the poisonous plants which people know and use. The results of this study will be presented at College of Medicine (CoM) research dissemination presentations which are held for students to present their research findings.
- ItemRestrictedDesign and testing of a MEML online adverse drug reactions management system(Kamuzu University of Health Sciences, 2022-03-10) Maida, Kondwani; Chagwa, PreciousThis is an experimental study that is aimed at designing and testing the mobile application that would be used by health care providers (HCPs) in recalling ADRs and drug interactions as well as their influencing factors during the diagnosis and treatment of diseases. This is going to be achieved through the following specific objectives; to create the database of ADRs and drug interactions of drugs in Malawi Essential Medicines List(MEML), to create the interface of the mobile application used to check possible ADRs, to create a link between the interface and the database of the mobile application of ADRs and to test the developed mobile application in a stimulated clinical setting. The database of ADRs and drug interactions will be created after through research into the selected medicines ADRs reported in literature and various online databases. The database will contain a list of each drug and its associated ADRs, drug interactions, influencing factors (patient, medicine and formulation related). An interface will be developed on an Android platform from scratch using Google and third party developers’ libraries as outlined by Farao Jaydon et al (2020) the interface and database linage will be done as outlined by Malila Bessie et al (2020). The developed application will be evaluated by the potential users. Volunteers will be selected from the student population for a start and in future actual HCPs will be involved. A written questionnaire containing attitude and practice questions will be used to evaluate the users’ experiences after testing its use in a simulated clinical setting. It is expected that this study will produce a mobile app that would be used to detect the ADRs and drug interactions easily with certainty by HCPs, hence reduce their occurrence or severity if inevitable, which would also reinforce the significance of using mheath in clinical settings. These results will be reported in peer reviewed journals as well as international and national research conferences. Hard copies will also be kept in the library and the department
- ItemRestrictedEffects of pharmacy assistant training on medicine stock management in health centres in northern region of Malawi(Kamuzu University of Health Sciences, 2020-10-20) Mwale, JeremiahThe frequent drug shortages in the country’s hospitals is evidently becoming a growing concern and a common in most public health facilities. The persistent medicine shortage at health centre level is largely blamed on unqualified pharmacy personnel managing medicine and supply chain. Evidence generated from research studies has shown that use of unqualified staff in managing medicine at health centre impacts negatively on patient’s outcome. The Millennium Development Goal number 8 calls for universal access to quality health care services. It is our considered view that universal access can only be achieved with adequate qualified staff available to offer health services. There is a growing concern globally and more especially in low- and middle-income countries for shortage of qualified pharmacy personnel. Human resource shortage for pharmacy personnel has resulted into poor quality of health care services offered by unqualified personnel. Historically pharmacy assistant training program was the only pharmacy cadre trained in Malawi in 1977 before changing it to diploma program of pharmacy technician. The main purpose of the pharmacy assistant training program is to improve management and availability of medicine, improve dispensing practices and reporting at health centre level among other things. Currently there are about 630 health centres across the country that form about 85% of the health care system for the country. Although health centres constitute 85% of health care delivery system, it was sad to note that majority of pharmacies were not managed by qualified pharmacy personnel hence reintroduction of the pharmacy assistant training program. There is hope and growing consensus that the introduction of pharmacy assistants training program will improve general pharmacy management and eventually medicine availability. Preliminary results of Pharmacy Assistant training program evaluation show that was improvement in management of medicine as envisaged during program conceptualization process, there is however not enough evidence to show that there indeed that improvement in medicine availability, quality of reported data and timely reporting of logistics management information systems (LMIS). The study will be analyzing whether setbacks in the supply chain have any relationship with pharmacy training. The main objective will be to analyze effectiveness in the aftermath of undergoing training on managing medicine in health centres the Northern Region of Malawi. The specific objectives will be to; determine factors that affect pharmacy management in health centres in the northern region of Malawi, to establish the relationship between training and stock levels of traceable medicines in the health centres in northern region in Malawi and to determine data accuracies and completeness on LMIS report in relation to levels of training. This is a cross sectional study, which will employ quantitative methods in order to establish extent of effectiveness of pharmacy assistant training in management of medicine in their health facilities. It is expected that general pharmacy management in general particularly centering on stock availability, reporting and LMIS data accuracy should be improved in health facilities where pharmacy assistants work. Results of research findings will be disseminated in three fold as follows 1) the respondents, health centre in-charges and District Health officers 2) College of Medicine research dissemination seminar/Conference and College of Medicine Research Committee and 3) Results will be published for public usage. Three hard copies will be produced and one of these will be placed in the university library for public scrutiny, one copy for the research supervisor and final copy will be for the researcher.
- ItemRestrictedAn exploration of the utilization of transparency and accountability mechanisms for pharmaceutical products in Malawi public hospitals(Kamuzu University of Health Sciences, 2021-10-18) Matope, DeborahThe study will be qualitative which will include, in-depth interviews with section heads and health workers who are responsible for ordering drug and pharmaceutical supplies. Broad objective: To explore the utilization of accountability and transparency mechanism available in the Malawi health system in relation to pharmaceutical disbursement. Specific objectives: The specific objectives of the study are to: 1. To explore the strategies and protocols available for transparency and accountability in the Malawi health system 2. To establish how the transparency and accountability protocols and strategies are applied in operations with regard to drugs and other pharmaceuticals 3. To explore how best transparency and accountability mechanisms could be utilized in the Malawi health system in order to reduce the risk of corruption in drug and pharmaceutical disbursement processes
- ItemRestrictedKnowledge and perspectives of nurses and clinical officers on morphine use at Chiradzulu District Hospital(Kamuzu University of Health Sciences, 2020-11-16) Mbewe, Emily; Misenje, Thomas; Chitani, Enoch; Uladi, AllanThis is a qualitative interview study that aims to explore perspectives of nurses and clinical officers on use of morphine in palliative care patients. The broad objective is to explore perception of nurses and clinical officers on clinical use of morphine. This study will be conducted at Chiradzulu District Hospital. A sample size of 10 participants disaggregated into categories of 5 Nurses and 5 Clinical officers will be selected using convenient sampling technique. Data collection will employ semi-structured in-depth interviews. Some patients do not get complete relief from pain owing to unfounded fears regarding use of morphine despite that it is the drug of choice in Malawi for management of severe pain. This study expects to understand challenges around morphine use in palliative care by service providers. Conversely, these results will significantly contribute towards planning for in-service training aimed at addressing the identified bottlenecks in morphine use thereby making the service accessible to those in need at Chiradzulu District Hospital. Study findings will be disseminated through a variety of channels including College of Medicine Research Dissemination Conference, Chiradzulu District Hospital research committee, COMREC and College of Medicine Library. 3.0 Background Morphine is one of the strong analgesics in a group of opioids. It is primarily used for pain relief. Morphine is a gold standard in palliative care because it is the baseline by which other opioids are measured. Morphine is a potent opioid analgesic widely used for the treatment of acute pain and for long‐term treatment of severe pain. World Health Organization (WHO) rates morphine on level three of the analgesic ladder, it is given to patients who present with severe pain that might be acute or chronic [1]. Morphine is widely being used for almost any condition that causes physical pain for example; active cancer treatment and vaso-occlusive pain during sickle cell [2]. A study done in Kenya revealed that Nurses and clinical officers have had unfounded fears surrounding morphine use, due to inadequate knowledge [3]. This study further revealed that such fears were linked to concerns about addiction, respiratory depression and sedation. Nurses and Clinicians had myths which include morphine will shorten life, morphine use will make my patient an addict, morphine is offered to patient only when death is eminent and it has worse side effect than other drugs [4]. Nurses and clinical officers play an important role in pain management and lack of knowledge creates barriers for them to be able to provide optimal pain management [3]. Nurses and clinical officers who are giving morphine to patients should follow the precaution measures. Some of the precautions include monitoring of mental status, blood pressure, respiratory drive, abuse/overuse and monitoring of other medications the patient is taking. The medications include other opioids that could lead to respiratory depression, alcohol, benzodiazepines and barbiturates [5]. Patients can become apneic study design will be qualitative using phenomenological approach. This analysis is based on discussion and reflection of direct sense perception and experience of the researched phenomenon [9]. The researcher will explore the perception of Nurses and Clinical officers on clinical use of morphine in palliative care patient at Chiradzulu District Hospital. The approach will use semi-structured In-depth interviews with prospective participants. This approach uses open- ended question and probing that give participants the opportunity to respond in their own words rather than forcing them to choose from fixed response [10]. This will help investigators understand perspectives of nurses and clinical officers on the clinical use of morphine in palliative care patients. 7.2 Study place This study will be conducted at Chiradzulu District Hospital. This site was chosen because Chiradzulu is one of the districts that used less amount of morphine as compared to other districts according to Malawi Health Management Information System data of July 2019 to June 2020 [11]. This can be due to several factors, for example, poor perception of nurses and clinical officer on morphine use, poor supply of morphine at the district hospital, lack of knowledge on morphine use among health workers, lack of knowledge on palliative care by the community that led to poor access to palliative care services, 7.3 Study population The study population are nurses and clinical officers because they are the core and frontline providers of palliative care services in Malawi. 7.4 Study period The estimated period for the whole study is 12 months which runs between March 2020 and May 2021. Activities within this period include; proposal development, data collection and analysis and presentation and dissemination of results. 7.5 Sample size We will have a sample size of 10 participants spread out into groups of 5 nurses and 5 clinical officers respectively using non probability convenient sampling technique. This sampling technique is applicable to our study because it will enable us to gather information from people that can be easily accessed. This sample size is ideal as it will help us uncover a variety of views and perspectives from the two cadres in question.
- ItemRestrictedThe prevalence of drug resistant tuberculosis in clinical isolates in Blantyre and Lilongwe, Malawi(Kamuzu University of Health Sciences, 2021-11-11) Sikwese Daston, TiongeThe type of research study: We will conduct a cross-sectional study on Mycobacterium Tuberculosis (MTB) Positive isolates from the EXACT study (Utility of the Xpert® MTB/RIF Ultra assay with the GeneXpert®Omni System and digital chest radiography for diagnosis of tuberculosis in high HIV prevalence settings) which was conducted at Kamuzu University of Health Sciences in 2020 to 2021 and Isolates from National Tuberculosis Reference Laboratory in Lilongwe. 1.2. The problem to be studied Patients infected with Multidrug Resistance Tuberculosis (MDR –TB) strains are difficult to cure and are more likely to remain sources of infection for a longer period of time than are patients with drug-susceptible strains, as a result it necessary to conduct a prevalence survey on MDR-TB in order to assess the emerging cases of MDR-TB. 1.3. The Research objectives 1.3.1. Broad objective To investigate the prevalence of drug resistant tuberculosis in clinical isolates existing framework for drug resistance in Blantyre and Lilongwe 1.3.2. Specific objectives • To determine the number of patients presenting with investigate the prevalence of drug resistance TB among patients registering for TB treatment in Blantyre and Lilongwe • To find out the number of patients presenting with investigate the prevalence of Extremely Drug resistance (XDR) TB in Blantyre and Lilongwe using sample pooling method • To describe the association between MDR-TB and Age, Sex and HIV status characteristics of patients with MDR-TB using the following parameter (Age, Sex and HIV) To describe pathways of care for patients with MDR-TB in Blantyre and Lilongwe 1.4. Methodology We will conduct Line Probe Assay test using GenoType MTBDRplus (version 2.0) on 400 culture isolates for Mycobacterium Tuberculosis which were archived from January 2019 active in COM/MLW TB laboratory in Blantyre and Isolates from National TB reference Laboratory in Lilongwe. From the identified MDR-TB we are going to investigate the prevalence of XDR-TB using the pooling method. 1.5. Expected findings and their dissemination. We hypothesize that there is increasing prevalence of MDR-TB among TB patients registering for treatment in Blantyre and Lilongwe. The results of this trial will also be submitted to College of Medicine Research and Ethics Committee (COMREC) and for publication in open access and medical journals. The results of the trial will also be shared with policy makers at the Ministry of Health in Malawi and the World Health Organization (WHO).
- ItemRestrictedRisk assessment of different drugs on the Malawi essential medicine list for drug induced dental caries(Kamuzu University of Health Sciences, 2021-06-16) Piliminta, Richard; Kamanga, MercyThis is a laboratory based experimental study that is aimed at assessing risks of different drugs from the Malawi Essential Medicines List on drug induced dental caries which is a public concern. This will be achieved through the following specific objectives; to measure the pH and corrosion capability of the orally taken drugs; to quantify the amount of sugars in the widely used oral medicines labelled with sugar materials and to assess the risk of developing dental caries on the patients taking vulnerable medicines. Qualitative and quantitative measures of acidity will be measured using the pH parameter of the medicines in aqueous solutions using pH meter. A qualitative measure of the presence of sugars will also be measured.in-vitro tests will also be measured following incubation of the removed teeth to determine if the acidic and basic or neutral medicines indeed translate to tooth corrosion. This will be followed by risk assessment using appropriate risk assessment models in the literature. It is expected that some drugs will be found to be at risk of causing dental caries due to the presence of high sugar levels, low pH and corrosion of incubated tooth. The results will contribute to the general body of knowledge in the scientific world as well as informing Malawians on the risks of drugs they take on dental caries. These results will therefore be reported in peer reviewed journals as well as in international and national research dissemination conferences. 2.0 INTRODUCTION 2.1 BACKGROUND Dental caries is the most prevalent chronic disease worldwide (1). The Global Burden of Disease Study 2016 estimated that oral diseases affected at least 3.58 billion people worldwide, with caries of the permanent teeth being the most prevalent of all conditions assessed. Globally, it is estimated that 2.4 billion people suffer from caries of permanent teeth and 486 million children suffer from caries of primary teeth (2). There is no clear statistics on dental caries in Africa as their published articles were limited. The prevalence of dental caries in Africa is rather low compared to its existence in developed countries (3). This may be due to the low sugar intake in African diet and the inability to access sugary snacks and confectioneries because most Africans live below poverty line. However, an increase in urbanization in African cities and a global escalation in sugar intake has caused sugar-rich diets to be more common, and there is a fear that the frequency of dental caries is likely to rise, especially among children in Africa (3). A national Dental & Oral Health Survey conducted in 2014 showed that 50% of school going children (6-9 years) had tooth decay the sugar into acid which destroys the enamel hence causing dental caries. This study will assess the different drugs for drug induced dental caries. In this study the potential of drugs to induce dental caries depends on the pH of the drug. Drugs that are more acidic are more likely to induce dental caries. Therefore, the longer the drugs stay in contact with the teeth the more the enamel dissolves. Drugs that are sugary also have a high potential to induce dental caries because the sugars present will be converted to acid by the bacteria therefore dissolve the teeth enamel. Drugs that are formulated in solution form are more likely to induce dental caries than drugs formulated in tablets and capsules. This is because drugs in solution form are more likely to make contact and stick to the teeth. Drugs that are in capsule and traditional tablets are less likely to induce dental caries because they do not stay in contact with teeth for a long time. However chewable tablets show a high risk of inducing dental caries because they get stuck between the teeth enamel.