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Community prevalence of chronic respiratory symptoms in rural Malawi: Implications for policy

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Banda, Hastings T., Thomson, Rachael, Mortimer, Kevin ORCID: https://orcid.org/0000-0002-8118-8871, Bello, George A. F., Mbera, Grace B., Malmborg, Rasmus, Faragher, Brian and Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 (2017) 'Community prevalence of chronic respiratory symptoms in rural Malawi: Implications for policy'. PLoS ONE, Vol 12, Issue 12, e0188437.

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Abstract

Background
No community prevalence studies have been done on chronic respiratory symptoms of cough, wheezing and shortness of breath in adult rural populations in Malawi. Case detection rates of tuberculosis (TB) and chronic airways disease are low in resource-poor primary health care facilities.

Objective
To understand the prevalence of chronic respiratory symptoms and recorded diagnoses of TB in rural Malawian adults in order to improve case detection and management of these diseases.

Methods
A population proportional, cross-sectional study was conducted to determine the proportion of the population with chronic respiratory symptoms that had a diagnosis of tuberculosis or chronic airways disease in two rural communities in Malawi. Households were randomly selected using Google Earth Pro software. Smart phones loaded with Open Data Kit Essential software were used for data collection. Interviews were conducted with 15795 people aged 15 years and above to enquire about symptoms of chronic cough, wheeze and shortness of breath.

Results
Overall 3554 (22.5%) participants reported at least one of these respiratory symptoms. Cough was reported by 2933, of whom 1623 (55.3%) reported cough only and 1310 (44.7%) combined with wheeze and/or shortness of breath. Only 4.6% (164/3554) of participants with chronic respiratory symptoms had one or more of the following diagnoses in their health passports (patient held medical records): TB, asthma, bronchitis and chronic obstructive pulmonary disease)

Conclusions
The high prevalence of chronic respiratory symptoms coupled with limited recorded diagnoses in patient-held medical records in these rural communities suggests a high chronic respiratory disease burden and unmet health need.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Administration and Organization > WA 525 General works
WF Respiratory System > WF 20 Research (General)
WF Respiratory System > Tuberculosis > WF 205 Epidemiology
WF Respiratory System > Lungs > WF 600 Lungs
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pone.0188437
SWORD Depositor: JISC Pubrouter
Depositing User: Lynn Roberts-Maloney
Date Deposited: 08 Dec 2017 10:47
Last Modified: 08 Dec 2017 10:47
URI: http://archive.lstmed.ac.uk/id/eprint/7938

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