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1.  Anthropometric measurements and prevalence of underweight, overweight and obesity in adult Malawians: nationwide population based NCD STEPS survey 
Overweight and obesity are significant causes of increased morbidity and premature mortality from non-communicable diseases, particularly in sub-Saharan Africa, although local high quality population-based data to inform policies and strategies are lacking.
Using the WHO STEPwise approach to chronic disease risk factor surveillance, population-based nationwide survey was conducted on participants aged 25-64 years in Malawi. A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range.
A total of 4845 participants (65.7% females, 87.6% from rural areas) had complete anthropometric data and included in this analysis. Overall (both sexes) population-based mean body weight, height, systolic blood pressure, diastolic blood pressure, blood glucose and cholesterol were estimated at 58.7 kg, 159.9 cm, 133.4 mmHg, 79.5 mmHg, 4.3 mmol/L, 4.4 mmol/L respectively. Prevalence of underweight, overweight, obesity, overweight and/ or obesity and central adiposity were 6.5%, 17.3%, 4.6%, 21.9% and 28.8% respectively. Overweight, obesity, overweight and/ or obesity and central adiposity were more frequent in females than males (20.7% vs 14.1%, 7.4% vs 2.0%, 28.1% vs 16.1% and 52.8% vs 5.6%), in urban than rural areas (23.2% vs 16.6%, 12.0% vs 3.7%, 35.2% vs 20.2%) respectively.
This study demonstrated that overweight and/ or obesity is the major public health problem affecting at least one in five adults in Malawi. The problem is more frequent in females than males and urban than rural. Implementation of primary health care approaches such as WHO package for essential non-communicable diseases could reduce the problem.
PMCID: PMC3828071  PMID: 24244794
Anthropometric measurements; overweight; obesity; sub-Saharan Africa; Malawi
2.  Burden of leprosy in Malawi: community camp-based cross-sectional study 
Although leprosy was eliminated globally in 2000, the disease continues to be the significant cause of peripheral neuropathy, disability and disfigurement in some developing countries. However, recent population-based prevalence data are lacking to inform evidence-based renewed commitment for the final push for leprosy elimination at national and sub-national levels.
Community camp-based cross-sectional descriptive study was conducted in four selected districts. World Health Organisation guidelines and tools for leprosy elimination monitoring were used to evaluate the Malawi National Leprosy Programme.
A total of 6,338 people (60% females, 35% children aged less than 15 years) were examined for leprosy and other skin diseases. Prevalence of skin diseases was 18%, the commonest being fungal (9%), eczema/dermatitis (3%) and leprosy (1%). Of the fungal skin conditions, pityriasis versicolor and Tinea capatis were the commonest (22% and 21% respectively) then Tinea corporis (9%), Tinea cruris (6%) and Tinea pedis (2%). A total of 66 leprosy cases were detected out of 6,338 people screened giving a prevalence of 104.1 per 10,000 population (range by district 67.1 to 194.1). Of the leprosy cases, 37 were new, 6 were defaulters and 23 were on treatment, 30 were females and 9 were children aged less than 15 years old. Of the 37 new leprosy cases, 9 (24.3%) were children, 25 (67.6%) had 1–5 leprosy lesions and 8 (21.6%) had grade 2 disability. The most frequent location of leprosy lesions was the head and neck (24.1%), arms (24.1%), chest (17.2%), legs (13.8%), back (13.8%) and abdomen (7.0%). Between 2006 and 2011, trends of leprosy prevalence and detection increased, prevalence/detection ratios were over 1 and cure rates by cohort analysis of 2009 multibacillary and 2010 paucibacillary cases were 33% and 63% respectively far below the expected 80% although the national prevalence remained at less than 1 case per 10,000 population.
Leprosy was still an important public health problem in Malawi. Improving knowledge and skills of health workers, registration and recording of data, contact tracing, decentralisation and integration of treatment to health centres and introduction of leprosy awareness days and community-based surveillance could help to improve early detection, treatment, case holding and prevention of disabilities.
PMCID: PMC3492035  PMID: 22867526
Leprosy; Skin diseases; Sub-Saharan Africa; Malawi
3.  The Burden of Selected Chronic Non-Communicable Diseases and Their Risk Factors in Malawi: Nationwide STEPS Survey 
PLoS ONE  2011;6(5):e20316.
Chronic non-communicable diseases (NCDs) are becoming significant causes of morbidity and mortality, particularly in sub-Saharan African countries, although local, high-quality data to inform evidence-based policies are lacking.
To determine the magnitude of NCDs and their risk factors in Malawi.
Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25–64 years. Socio-demographic and behaviour risk factors were collected in Step 1. Physical anthropometric measurements and blood pressure were documented in Step 2. Blood cholesterol and fasting blood glucose were measured in Step 3.
Results and Conclusion
A total of 5,206 adults (67% females) were surveyed. Tobacco smoking, alcohol drinking and raised blood pressure (BP) were more frequent in males than females, 25% vs 3%, 30% vs 4% and 37% vs 29%. Overweight, physical inactivity and raised cholesterol were more common in females than males, 28% vs 16%, 13% vs 6% and 11% vs 6%. Tobacco smoking was more common in rural than urban areas 11% vs 7%, and overweight and physical inactivity more common in urban than rural areas 39% vs 22% and 24% vs 9%, all with p<0.05. Overall (both sexes) prevalence of tobacco smoking, alcohol consumption, overweight and physical inactivity was 14%, 17%, 22%, 10% and prevalence of raised BP, fasting blood sugar and cholesterol was 33%, 6% and 9% respectively. These data could be useful in the formulation and advocacy of NCD policy and action plan in Malawi.
PMCID: PMC3100352  PMID: 21629735

Results 1-3 (3)