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      Ophthalmological conditions among elderly patients attending a private eye care facility in Malawi: A retrospective study

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          Abstract

          Background

          The elderly comprises the fastest‐expanding age group globally, with the greatest increase occurring in developing countries. The elderly populace is prone to develop various ocular morbidities.

          Purpose

          To determine the distribution of ocular morbidities among the elderly population visiting a private eye care facility in Malawi.

          Methods

          This was a retrospective cross‐sectional study conducted at St. John's Hospital in Mzuzu, Malawi. We retrieved data from the hospital's ophthalmic outpatient registry from January, 2021 to December, 2021. A nonprobability census sampling technique was used to retrieve 52 elderly patients. Data analysis were done employing SPSS (v.26).

          Results

          This study found according to gender a larger proportion were females 27 (51.9%) compared males, who accounted for 25 (48.1%). Refractive error 21 (40.4%) was the most prevalent ocular morbidity followed by cataract 13 (25.0%), pinguecula 6 (11.5%), and glaucoma 4 (7.7%). Although clear differences exist in the distribution of ocular morbidities according to sex ( p = 0.529) and age ( p = 0.328), the differences are not statistically significant.

          Conclusion

          The pattern of eye diseases is typical to the country. More resources should be targeting main causes of preventable blindness including refractive error and cataracts at the facility.

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          Most cited references24

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          Women's (health) work: A population-based, cross-sectional study of gender differences in time spent seeking health care in Malawi

          Background There has been a notable expansion in routine health care in sub-Saharan Africa. While heath care is nominally free in many contexts, the time required to access services reflects an opportunity cost that may be substantial and highly gendered, reflecting the gendered nature of health care guidelines and patterns of use. The time costs of health care use, however, have rarely been systematically assessed at the population-level. Methods Data come from the 2015 wave of a population-based cohort study of young adults in southern Malawi during which 1,453 women and 407 men between the ages of 21 and 31 were interviewed. We calculated the time spent seeking health care over a two-month period, disaggregating findings by men, recently-pregnant women, mothers with children under two years old, and “other women”. We then extrapolated the time required for specific services to estimate the time that would be needed for each subpopulation to meet government recommendations for routine health services over the course of a year. Results Approximately 60% of women and 22% of men attended at least one health care visit during the preceding two months. Women spent six times as long seeking care as did men (t = -4.414, p<0.001), with an average 6.4 hours seeking care over a two-month period compared to 1 hour for men. In order to meet government recommendations for routine health services, HIV-negative women would need to spend between 19 and 63 hours annually seeking health care compared to only three hours for men. An additional 40 hours would be required of HIV-positive individuals initiating antiretroviral care. Conclusions Women in Malawi spend a considerable amount of time seeking routine health care services, while men spend almost none. The substantial time women spend seeking health care exacerbates their time poverty and constrains opportunities for other meaningful activities. At the same time, few health care guidelines pertain to men who thus have little interaction with the health care system. Additional public health strategies such as integration of services for those services frequently used by women and specific guidelines and outreach for men are urgently needed.
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            The availability, prices and affordability of essential medicines in Malawi: A cross-sectional study

            Introduction The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi. Methods Data on availability and prices of 50 essential medicines were collected in 44 health facilities in two major cities and two districts. These included 12 public facilities, 11 facilities of the Christian Health Association of Malawi (CHAM), nine retail pharmacies, eight wholesalers and four private clinics/hospitals. Price, availability and affordability were assessed based on the methodology developed by the World Health Organization and Health Action International, which compares local prices to international reference prices. Results and discussion The overall availability of medicines was 48.5% in public facilities, 71.1% in retail pharmacies, 62.9% in CHAM facilities and 57.5% in private clinics. The availability of essential medicines varied from 0% for ethosuximide to 100% for amoxicillin and cotrimoxazole tablets. Antibiotic formulations for adults were widely available, in contrast to the low availability of pediatric formulations. Several medicines for non-communicable diseases like sodium valproate, phenytoin, paraldehyde, captopril and simvastatin showed poor availability and affordability. The overall median price ratio compared to the international reference price was 1.11 for wholesalers, 2.54 in CHAM facilities, 2.70 in retail pharmacies, and 4.01 in private clinics, which is low compared to other countries. But nevertheless, for 18 out of 32 medicines assessed, the cost of one course exceeded the statutory minimum daily wage, making them unaffordable to a majority of the population. Therefore, continued provision of free public health care is still of critical importance for the foreseeable future until other financing mechanisms have been explored.
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              Falls and other geriatric syndromes in Blantyre, Malawi: a community survey of older adults.

              The prevalence of geriatric syndromes (falls, immobility, intellectual or memory impairment, and incontinence) is unknown in many resource-poor countries. With an aging population such knowledge is essential to develop national policies on the health and social needs of older people. The aim of this study was to provide a preliminary survey to explore the prevalence of falls and other geriatric syndromes and their association with known risk factors in people aged > 60 years in urban Blantyre, Malawi.
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                Author and article information

                Contributors
                mzumarathokozani@gmail.com
                Journal
                Health Sci Rep
                Health Sci Rep
                10.1002/(ISSN)2398-8835
                HSR2
                Health Science Reports
                John Wiley and Sons Inc. (Hoboken )
                2398-8835
                22 May 2024
                May 2024
                : 7
                : 5 ( doiID: 10.1002/hsr2.v7.5 )
                : e2112
                Affiliations
                [ 1 ] Department of Optometry Mzuzu University Mzuzu Malawi
                [ 2 ] Department of Ophthalmology, Mzuzu Health Centre Mzimba North District Health Office Mzuzu Malawi
                Author notes
                [*] [* ] Correspondence Thokozani Mzumara, Department of Ophthalmology, Mzuzu Health Centre, Mzimba North District Health Office, Mzuzu, Malawi.

                Email: mzumarathokozani@ 123456gmail.com

                Author information
                http://orcid.org/0009-0001-1159-6634
                http://orcid.org/0000-0002-0011-269X
                Article
                HSR22112
                10.1002/hsr2.2112
                11111601
                38784254
                b95acfe8-655d-4a9a-9899-9318ba292313
                © 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 21 April 2024
                : 06 October 2023
                : 23 April 2024
                Page count
                Figures: 3, Tables: 0, Pages: 5, Words: 2804
                Categories
                Original Research
                Original Research
                Custom metadata
                2.0
                May 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.3 mode:remove_FC converted:22.05.2024

                access,cataract,geriatric eye care,ocular morbidity,private not‐for‐profit hospital,refractive error

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