IntroductionLimited data exists on histologically confirmed cancers and tuberculosis in rural Malawi, despite the high burden of both conditions. One of the main reasons for the limited data is the lack of access to pathology services for diagnosis. We reviewed histopathology results of patients in Neno District, one of the poorest rural districts in Malawi, from May 2011 to July 2017, with an emphasis on cancers and tuberculosis.MethodsThis is a retrospective descriptive study reviewing pathology results of samples collected at Neno health facilities and processed at Kamiza Pathology Laboratory. Data was entered into Microsoft Excel and cleaned and analysed using Stata 14.ResultsA total of 532 specimens were collected, of which 87% (465) were tissue biopsies (incision or core biopsies), and 13% (67) were cytology samples. Of all specimens, 7% (n=40) of the samples had non-diagnostic results. Among the results that were diagnostic (n=492), 37% (183) were malignancies, 33% (112) were infections and inflammatory conditions other than tuberculosis, 20% (97) were benign tumours, 7% (34) were tuberculosis, 4% (21) were pre-malignant lesions, 5% (23) were normal samples, and 4% (22) were other miscellaneous conditions. Among the malignancies (n=183), 62% (114) were from females and 38% (69) from males. Among females, almost half of the cancers were cervical (43%, n= 49), followed by Kaposi sarcoma (14%, n=16), skin cancers (9%, n=10), and breast cancer (8%, n=9). In males, Kaposi sarcoma was the most common cancer (35%, n=24), followed by skin cancers (17%, n=12). About 75% (n=137) of the cancers occurred in persons aged 15 to 60 years.ConclusionHistopathology services at a rural hospital in Malawi provides useful diagnostic information on malignancies, tuberculosis and other diagnoses, and can inform management at the district level.
To determine commonly used methods of contraception at Monkey Bay Community hospital, to compare different methods of contraception used by people of various age groups, parity, Human Immunodeficiency Virus (HIV) and Marital status, a clinical audit of family planning methods used by clients at Monkey Community hospital from January 2018 to June 2019 was done. Data was collected from the registers. A total number of 1734 clients reported at family planning clinic of Monkey-Bay Community Hospital between January 2018 and June 2019. All the clients were females. Most of these clients were in the age range of 15 -34 years (83.33%). There were 1,486 (87%) HIV negative clients, 208 (12%) HIV positive clients and 24 (1%) had unknown HIV status. Most clients had a parity of 1 -2 (905, 52.71%) followed by 3 -4 (540, 31.45%) and 5 or plus (272, 15.84%). There were more married people (1641, 97.23%) than unmarried ones (46, 2.73%). There was only one person who was divorced (1, 0.05%). Education status was not recorded. The five commonly used contraceptive methods were: Intramuscular (IM) injectable Depo-IM (1366, 79.51%), Jadelle (122, 7.10%), Subcutaneous (SC) injectable Depo-SC (65, 3.78%), Combined Oral Contraceptives (COC) (60, 3.49%) and Implanon (40, 2.33%). None of the clients was used female condoms as a method of contraception. The contraceptive use was common between the age group of 15 -24 (707, 44.92%) and 25 -34 (709, 45%). Depo-IM was most used in age group 25 -34 (44.5%) while Jadelle was mostly used by 15 -24 years old (48%). 1181 clients (79.5%) of HIV negative clients used Depo-IM as the contraceptive method while 164 clients (78.
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