LETTERTO THE EDTTOR
Diagnosecancers early
Thble: major topics of presentations,1998-2001 SubiectArea Numberof Presentations
Jrr We have reviewed patients diagnosedto have bladder cancer in the Lilongwe CentralHospital. In 1993therewere 32 cases,and in the 2000 there were 28 cases (the latter period included November 1999). Every one ofthese 60 caseswas too advanced to be curable.In the same hospital in the 13-monthperiod 26 October 1999to I Jan 2001 there were 58 patientsdiagnosedto havecarcinomaofthe oesophagus,and between I Jan 1999 and 16 Oct 2000 there were 3l diagnosesof breastcarcinoma.All the oesophagealand many of the breastcancerswere inoperable. Carcinoma of the cervix is very common and is frequently beyond the reach of surgery by the time it is identified. What can be done to improve this unforlunate situation? The only way forward is to improve the training of health staff at all levels, so that the danger signs are recognizedand acted upon promptly. Not all haematuriais due to bilharzia. Dysphagia (food sticking at a particular level) always needs urgentinvestigation. Breastlumps shouldbe investigatedwhen still small. Irregular vaginal bleedingrequiresexamination. Our medical, nursing, and auxiliary training colleges arewhere this training processmust start,but all who have clinical responsibility need reminding regularly throughout their clinical careers.
CommunicableDiseases MaternalHealth B a s i cM e d i c a lS c i e n c eIsB M S ; Child Health HIV/AIDS/STD Surgery Health,rMedicalEducation Psychiatry
NicholasF Viek MD, EssamEl din Abdel Dalam Ismael MD Li longwe Central Hospital.
Research interests at the Universitv of Malawi College of Medicine, 1998-2001 J14
47 24 24 15 I2 6 5 1
Note: Somepresentations had more than one domain of interest.
The most common topic of presentationsat the College's Annual Research Dissemination Day is communicable diseases.As communicable diseasesare the major causesof both adult and paediatric morbidity and mortality in Malawi oo,this would suggest that researchersat the College of Medicine are engagedin 'things that matter' for Malawi. Maternal health issues also assumepafticular interest among researchersat the College. The country's matemal mortality ratio had been estimated at 620 deathsper 100,000live births in the 1990sLe.The Demographic Health Survey 2000 and a study by Kalumbi and Tadessea"' at the Queen Elizabeth Hospital in 2000 report higher levels in the maternal mortality ratio than had been previously reported. Malawi's MMR now standsat 1,120 per 100,000 live birlhs. The bulk of these deaths result from preventable causes. Malawi's infant and under-five mortality, estimated at lO4 deathsper 1,000live births and 189 deathsper 1,000live births are among the highest in the world'. It is therefore in keeping that the College also emphasizes research on this aspect of human health. Meanwhile there were virtually no presentations on non-communicable diseases such as hypertension, malignancies, trauma and diabetes mellitus, although these diseasesare increasingly becoming major causesof morbidity and mortality in the country 1''l': I recognize the fact that not all researchcarried out at the College of Medicine and its collaborating research institutions is reported at the Dissemination Day. However, it is reasonableto say the presentationsmade are of topics that are considered of importance to Malawi.
The College of Medicine' 3 openedin 1991 as a community-orientedmedical school. It aims to conductresearchthat is relevant to Malawi and the southemAfrican region. Since 1997the Collegeof Medicine has been hosting annualresearch dissemination days at the end of each academic year. Ministry of Health policy makers,other University of Malawi Collegesand international research institutions in the country are invited to participate.The researchdisseminationconferenceis a forum *'here researchconductedat and by the Collegeof Medicine and Adamson S Muula its research affiliated institutions are presented to other researchers,goverarmentpolicy makers and other stakeholders. Department of Community Health, University of Malawi College of Medicine, Private Bag (265) 674700 EmarL [email protected] I have analysedthe researchtopics that have beenpre- 360, Chichiri, Blantyre 3, Malawi. Fax: sented at the annual dissemination days of the College of References \Iedicine, 1998-2001. Copies of abstractsfor the College of l. Muula AS, Broadhead RL. The First Decade of the Malawi College of Medicine: a critical appraisal.Trop Med Int Health 200 l;6(2):155-9 \Iedicine ResearchDisseminationDays between1998and 2001 2. Muula AS, Muula RL. The Australian contdbution towards medical training in Malawi. '.r'ereidentified and reviewed. I recorded the total number of Med J Aust 2001. 175:42-7 paperspresented,the distribution between oral and poster pre- 3. Mulwafu W, Muula A. The First Medical School in Malawr. Sunrise Publications, Lilongwe, Malawi :entations and the domain or field(s) that best describes the 4. Ministry of Health and Population. Malawi National Health Plan 1999-2004. Ministry of Health and Population, Lilongwe, Malawi, 1999 researchwork. I classifiedeachpresentationas closely as possiMolyneux E, WalshA, Molyneux M. Acute bacterial meningitis in children admitted to ble into one of the following subject areas: Child Health, 5. the Queen Elizabeth Central Blantyre, Maalwi in 1996-97. Malawi Med J 1998 ;ll(2): \laternal Health; HIV/AIDS/STDs, Communicable Diseases, 64-9 BasicMedical Sciences,Health and Medical Education,Surgery 6. The World Health Report 1998. World Health Organisation, Geneva, 1998 7. Demographic and Health Suney 2000. National Statistical Office, Zomba, Malawi, 2001 lnd Psychiatry. 8. Demographic and Health Suney 1992. National Statistical Office, Zomba, Malawi, 1992 '7'7 There were a total of 117 presentations, (667o) made 9. Malawi Social Indicators Survey 1996. Ministry of Economic Planning and Development, National Statistical Office, Centre for Social Reserch, 1996 rally and 40 (3480)ls posters.29 (258Eo)were singleauthored, 10. Kalumbi C, TadesseE. An audit ofdeliveries and outcome at Queen Elizabeth Cenffal )z (247a)had two authors,13 (11Eo)three authorsand47(407o) Hospital, Blantyre, Malawi in 1999. Malawi Med J 2001;13(3):34-5 ::ore than 3 authors. The table depicts the distribution of 1l. Muula AS. Chtracteristics of individuals interested to fom a diabetes association in Malawi. Diabetes Intemational 2001,11(3):91-2 :rpics. Out of the24 presentationsin the BMS domain, Il(467o) 12. Muula AS. Preventing diabetes-associatedmorbidity md mortality in resource poor ,'"ere in Anatomy. countries. Diabetes Intemational 2000110(2):47-8 \lalawi Medical Jomal
33
Diagnosecancers early
Thble: major topics of presentations,1998-2001 SubiectArea Numberof Presentations
Jrr We have reviewed patients diagnosedto have bladder cancer in the Lilongwe CentralHospital. In 1993therewere 32 cases,and in the 2000 there were 28 cases (the latter period included November 1999). Every one ofthese 60 caseswas too advanced to be curable.In the same hospital in the 13-monthperiod 26 October 1999to I Jan 2001 there were 58 patientsdiagnosedto havecarcinomaofthe oesophagus,and between I Jan 1999 and 16 Oct 2000 there were 3l diagnosesof breastcarcinoma.All the oesophagealand many of the breastcancerswere inoperable. Carcinoma of the cervix is very common and is frequently beyond the reach of surgery by the time it is identified. What can be done to improve this unforlunate situation? The only way forward is to improve the training of health staff at all levels, so that the danger signs are recognizedand acted upon promptly. Not all haematuriais due to bilharzia. Dysphagia (food sticking at a particular level) always needs urgentinvestigation. Breastlumps shouldbe investigatedwhen still small. Irregular vaginal bleedingrequiresexamination. Our medical, nursing, and auxiliary training colleges arewhere this training processmust start,but all who have clinical responsibility need reminding regularly throughout their clinical careers.
CommunicableDiseases MaternalHealth B a s i cM e d i c a lS c i e n c eIsB M S ; Child Health HIV/AIDS/STD Surgery Health,rMedicalEducation Psychiatry
NicholasF Viek MD, EssamEl din Abdel Dalam Ismael MD Li longwe Central Hospital.
Research interests at the Universitv of Malawi College of Medicine, 1998-2001 J14
47 24 24 15 I2 6 5 1
Note: Somepresentations had more than one domain of interest.
The most common topic of presentationsat the College's Annual Research Dissemination Day is communicable diseases.As communicable diseasesare the major causesof both adult and paediatric morbidity and mortality in Malawi oo,this would suggest that researchersat the College of Medicine are engagedin 'things that matter' for Malawi. Maternal health issues also assumepafticular interest among researchersat the College. The country's matemal mortality ratio had been estimated at 620 deathsper 100,000live births in the 1990sLe.The Demographic Health Survey 2000 and a study by Kalumbi and Tadessea"' at the Queen Elizabeth Hospital in 2000 report higher levels in the maternal mortality ratio than had been previously reported. Malawi's MMR now standsat 1,120 per 100,000 live birlhs. The bulk of these deaths result from preventable causes. Malawi's infant and under-five mortality, estimated at lO4 deathsper 1,000live births and 189 deathsper 1,000live births are among the highest in the world'. It is therefore in keeping that the College also emphasizes research on this aspect of human health. Meanwhile there were virtually no presentations on non-communicable diseases such as hypertension, malignancies, trauma and diabetes mellitus, although these diseasesare increasingly becoming major causesof morbidity and mortality in the country 1''l': I recognize the fact that not all researchcarried out at the College of Medicine and its collaborating research institutions is reported at the Dissemination Day. However, it is reasonableto say the presentationsmade are of topics that are considered of importance to Malawi.
The College of Medicine' 3 openedin 1991 as a community-orientedmedical school. It aims to conductresearchthat is relevant to Malawi and the southemAfrican region. Since 1997the Collegeof Medicine has been hosting annualresearch dissemination days at the end of each academic year. Ministry of Health policy makers,other University of Malawi Collegesand international research institutions in the country are invited to participate.The researchdisseminationconferenceis a forum *'here researchconductedat and by the Collegeof Medicine and Adamson S Muula its research affiliated institutions are presented to other researchers,goverarmentpolicy makers and other stakeholders. Department of Community Health, University of Malawi College of Medicine, Private Bag (265) 674700 EmarL [email protected] I have analysedthe researchtopics that have beenpre- 360, Chichiri, Blantyre 3, Malawi. Fax: sented at the annual dissemination days of the College of References \Iedicine, 1998-2001. Copies of abstractsfor the College of l. Muula AS, Broadhead RL. The First Decade of the Malawi College of Medicine: a critical appraisal.Trop Med Int Health 200 l;6(2):155-9 \Iedicine ResearchDisseminationDays between1998and 2001 2. Muula AS, Muula RL. The Australian contdbution towards medical training in Malawi. '.r'ereidentified and reviewed. I recorded the total number of Med J Aust 2001. 175:42-7 paperspresented,the distribution between oral and poster pre- 3. Mulwafu W, Muula A. The First Medical School in Malawr. Sunrise Publications, Lilongwe, Malawi :entations and the domain or field(s) that best describes the 4. Ministry of Health and Population. Malawi National Health Plan 1999-2004. Ministry of Health and Population, Lilongwe, Malawi, 1999 researchwork. I classifiedeachpresentationas closely as possiMolyneux E, WalshA, Molyneux M. Acute bacterial meningitis in children admitted to ble into one of the following subject areas: Child Health, 5. the Queen Elizabeth Central Blantyre, Maalwi in 1996-97. Malawi Med J 1998 ;ll(2): \laternal Health; HIV/AIDS/STDs, Communicable Diseases, 64-9 BasicMedical Sciences,Health and Medical Education,Surgery 6. The World Health Report 1998. World Health Organisation, Geneva, 1998 7. Demographic and Health Suney 2000. National Statistical Office, Zomba, Malawi, 2001 lnd Psychiatry. 8. Demographic and Health Suney 1992. National Statistical Office, Zomba, Malawi, 1992 '7'7 There were a total of 117 presentations, (667o) made 9. Malawi Social Indicators Survey 1996. Ministry of Economic Planning and Development, National Statistical Office, Centre for Social Reserch, 1996 rally and 40 (3480)ls posters.29 (258Eo)were singleauthored, 10. Kalumbi C, TadesseE. An audit ofdeliveries and outcome at Queen Elizabeth Cenffal )z (247a)had two authors,13 (11Eo)three authorsand47(407o) Hospital, Blantyre, Malawi in 1999. Malawi Med J 2001;13(3):34-5 ::ore than 3 authors. The table depicts the distribution of 1l. Muula AS. Chtracteristics of individuals interested to fom a diabetes association in Malawi. Diabetes Intemational 2001,11(3):91-2 :rpics. Out of the24 presentationsin the BMS domain, Il(467o) 12. Muula AS. Preventing diabetes-associatedmorbidity md mortality in resource poor ,'"ere in Anatomy. countries. Diabetes Intemational 2000110(2):47-8 \lalawi Medical Jomal
33
