The State of Stroke Research in Malawi: Results from a Mapping Review Study.

Introduction: Stroke is one of the leading causes of death and disability globally, and low-income countries such as Malawi bear a heavy burden. Tailored, high-quality research is essential for bridging existing gaps and improving the healthcare provided in low-resource settings while maximizing available resources. Aim: This mapping study aimed to synthesize the current state of stroke research in Malawi. Methods: Six databases were thoroughly searched: CINAHL complete, Ovid MEDLINE and EMBASE, Web of Science Core Collection, PubMed, and Google Scholar. Results: The search retrieved 598 references and identified 20 studies published between 2005 and 2023. Of these, 70% were conducted at Queen Elizabeth Central Hospital only; open-access journals published 95% of the studies. Cross-sectional studies were the most common (50%), followed by case-control studies (20%). The Malawi-Liverpool-Wellcome Trust Clinical Research Program authors contributed the most articles as main authors (25%). The number of citations per article ranged from 0 to 168 on Google Scholar, and the number of authors per article ranged from 1 to 15. Authors from thirty-five different institutions from 11 other countries partnered with Malawi on stroke articles, and England contributed 45.7% of the institutions. Most articles focused on pathophysiology (30%), followed by diagnosis (20%) and stroke management (15%). The highest number of participants included in the analysis was 739 and the highest number of stroke participants was 222. The identified challenges included the need for more infrastructure and under-utilization of available services. The Wellcome Trust has emerged as the primary funding agency for stroke research in Malawi. Conclusion: The study found limited collaboration among local institutions in Malawi, with most research focused in Blantyre District. There is a critical need for increased interdisciplinary teamwork to boost nationwide research.

Seroprevalence of anti-SARS-CoV-2 antibodies in Africa: A systematic review and meta-analysis.

We estimated the seroprevalence of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in residents of African countries and explored its associated factors. We searched PubMed, EMBASE, PsycINFO, AMED, CINAHL, DOAJ and Google Scholar databases for peer reviewed articles and pre-prints that reported anti-SARS-CoV-2 antibody seroprevalence of general or specific human populations resident in Africa. The eligible studies were evaluated using Joana Briggs Institute prevalence critical appraisal tool. Twenty-three studies involving 27,735 individuals were included in our paper. The pooled seroprevalence of anti-SARS-CoV-2 antibodies in Africa was 22% (95%CI: 14-31) with very high heterogeneity (I2  = 100%, p < 0.001). Seroprevalence was highest in studies conducted in Central Africa compared to Southern Africa, West Africa, North Africa and East Africa respectively. The number of days between the first reported coronavirus disease 2019 case in each country and when a seroprevalence study was conducted was a significant moderator of seroprevalence. Seropositivity was numerically influenced by gender and age of the participants with males and those aged below 50 years being most affected with SARS-CoV-2 infection. The highest pooled seroprevalence in Africa reported in this review should be interpreted cautiously due to high heterogeneity between studies. Continued seroprevalence surveillance is warranted to establish Africa's transition towards herd immunity.

Coping with Fears of Covid-19 Pandemic Among Nursing Students During Clinical Practice: Malawi's Perspective.

PURPOSE: Fears of the Covid-19 pandemic have brought additional psychological pressure among nursing students. Nursing students at Mzuzu University in Malawi resumed clinical practice amidst the first wave of the pandemic and completed their rotation from September to December 2020. However, it was not known how they were coping with fears of the Covid-19 pandemic during clinical practice and this had set the impetus for conducting this study. METHODS: The study used qualitative approach employing a descriptive phenomenological design. Four focus group discussions (FGDs) were conducted on students who had completed a clinical rotation during the first wave of the Covid-19 pandemic. RESULTS: Four themes emerged from the data analysis, and these were staying positive amidst the Covid-19 pandemic; applying the Covid-19 preventive measures; the role of religion and use of avoidance strategies. CONCLUSION: Students should be encouraged to use coping strategies that have been proven to promote psychological well-being in times of crisis such as the Covid-19 pandemic.

Using preceptors to improve nursing students' clinical learning outcomes: A Malawian students' perspective.

OBJECTIVE: Clinical environment remains an important aspect in the development of student's competence, confidence and fulfillment of their expected learning outcomes. Preceptors and clinical teachers play a significant role in preparing students to achieve their professional goals through continuous support and resource provision. This study explored the students' perception of using clinical preceptors to improve their clinical learning outcomes. METHODS: The researchers used semi structured interviews to collect qualitative data. A total of 48 students were purposively and conveniently sampled from 8 hospitals to participate in the study. Content analysis was used to analyse the data. FINDINGS: Two themes emerged from the study findings namely: creating a positive clinical learning environment and facilitating academic clinical collaboration. CONCLUSIONS: The findings of the study revealed that students gained more confidence and competence in clinical practice when supported by preceptors as well as achieved clinical learning outcomes. These findings suggest the need to train more clinical preceptors for improvement of students' clinical learning outcomes.