Trends in Invasive Pneumococcal Disease in Malawi
Author Information
Author(s): Everett Dean B., Mukaka Mavuto, Denis Brigitte, Gordon Stephen B., Carrol Enitan D., van Oosterhout Joep J., Molyneux Elizabeth M., Molyneux Malcolm, French Neil, Heyderman Robert S.
Primary Institution: Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, Blantyre, Malawi
Hypothesis
Has the scale-up of antiretroviral therapy and cotrimoxazole prophylaxis in Malawi affected the trends in invasive pneumococcal disease?
Conclusion
The scale-up of antiretroviral therapy in Malawi was associated with a decrease in invasive pneumococcal disease.
Supporting Evidence
- There was a decline in invasive pneumococcal infections from 2005 onwards.
- Cotrimoxazole resistance increased from 73.8% to 92.6% over the study period.
- Multidrug resistance was constant at almost one third of isolates.
Takeaway
This study looked at how many people got sick from a type of bacteria in Malawi over ten years, and found that more people got better when they started getting free medicine for HIV.
Methodology
The study analyzed blood and cerebrospinal fluid cultures from patients at a central hospital in Malawi over a ten-year period.
Potential Biases
Potential bias due to changes in healthcare access and clinician turnover over the study period.
Limitations
The study may not be representative of the entire country and lacks individual data on HIV status and treatment.
Participant Demographics
Included both adults and children with suspected severe bacterial infections.
Statistical Information
P-Value
<0.001
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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