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4 results on '"Paul Chidothi"'

1. Epidemiology of fractures and their treatment in Malawi: Results of a multicentre prospective registry study to guide orthopaedic care planning

Author

Alexander Thomas Schade, Foster Mbowuwa, Paul Chidothi, Peter MacPherson, Simon Matthew Graham, Claude Martin, William James Harrison, and Linda Chokotho

Subjects
Medicine, Science
Abstract

Importance Injuries cause 30% more deaths than HIV, TB and malaria combined, and a prospective fracture care registry was established to investigate the fracture burden and treatment in Malawi to inform evidence-based improvements. Objective To use the analysis of prospectively-collected fracture data to develop evidence-based strategies to improve fracture care in Malawi and other similar settings. Design Multicentre prospective registry study. Setting Two large referral centres and two district hospitals in Malawi. Participants All patients with a fracture (confirmed by radiographs)—including patients with multiple fractures—were eligible to be included in the registry. Exposure All fractures that presented to two urban central and two rural district hospitals in Malawi over a 3.5-year period (September 2016 to March 2020). Main outcome(s) and measure(s) Demographics, characteristics of injuries, and treatment outcomes were collected on all eligible participants. Results Between September 2016 and March 2020, 23,734 patients were enrolled with a median age of 15 years (interquartile range: 10–35 years); 68.7% were male. The most common injuries were radius/ulna fractures (n = 8,682, 36.8%), tibia/fibula fractures (n = 4,036, 17.0%), humerus fractures (n = 3,527, 14.9%) and femoral fractures (n = 2,355, 9.9%). The majority of fractures (n = 21,729, 91.6%) were treated by orthopaedic clinical officers; 88% (20,885/2,849) of fractures were treated non-operatively, and 62.7% were treated and sent home on the same day. Open fractures (OR:53.19, CI:39.68–72.09), distal femoral fractures (OR:2.59, CI:1.78–3.78), patella (OR:10.31, CI:7.04–15.07), supracondylar humeral fractures (OR:3.10, CI:2.38–4.05), ankle fractures (OR:2.97, CI:2.26–3.92) and tibial plateau fractures (OR:2.08, CI:1.47–2.95) were more likely to be treated operatively compared to distal radius fractures. Conclusions and relevance The current model of fracture care in Malawi is such that trained orthopaedic surgeons manage fractures operatively in urban referral centres whereas orthopaedic clinical officers mainly manage fractures non-operatively in both district and referral centres. We recommend that orthopaedic surgeons should supervise orthopaedic clinical officers to manage non operative injuries in central and district hospitals. There is need for further studies to assess the clinical and patient reported outcomes of these fracture cases, managed both operatively and non-operatively.

Published
2021

2. Decolonizing Global Surgery: Bethune Round Table, 2022 Conference on Global Surgery (virtual), June 16-18, 2022

Author

Fabio, Botelho, Karen, Gripp, Natalie, Yanchar, Abbie, Naus, Dan, Poenaru, Robert, Baird, Eliane, Reis, Leonildo, Farias, Ana Gabriely, Silva, Francisco, Viana, José Armando Pessoa, Neto, Sidney, Silva, Karen, Ribeiro, Luana, Gatto, Matheus Daniel, Faleiro, Miguel Godeiro, Fernandez, Lucas Sousa, Salgado, Natália Zaneti, Sampaio, Anna Luiza, Mendes, Rodrigo Vaz, Ferreira, Luiz, Marcião, Gabriel, Canto, José, Borges, Victor, Araújo, Gabrielly, Andrade, Joyce, Braga, Lívia, Bentes, Luís, Pinto, Henry T, Ndasi, Lahin M, Amlani, Ghislain, Aminake, Xavier, Penda, Serge, Tima, Aron, Lechtig, Kiran J, Agarwal-Harding, Marta, Whyte, Melinda, Fowler-Woods, Amanda, Fowler-Woods, Geraldine, Shingoose, Andrew, Hatala, Felicia, Daeninck, Ashley, Vergis, Kathleen, Clouston, Krista, Hardy, Laure, Djadje, Olga Mbougo, Djoutsop, Adrien Tangmi, Djabo, Ulrick Sidney, Kanmounye, Vanessa Nono, Youmbi, Patricia, Kakobo, Surafeal, Tafesse, Bisrat, Tamene, Zelalem, Chimdesa, Eden, Alemayehu, Birhanu, Abera, Dawit, Yifru, Fitsum Kifle, Belachew, Abenezer, Tirsit, Negussie, Deyassa, Bente E, Moen, Terje, Sundstrøm, Morten, Lund-Johansen, Mersha, Abebe, Rabia, Khan, Amha, Mekasha, Sophie, Soklaridis, Faizal, Haji, Juventine, Asingei, Eric P, O'Flynn, Diarmuid T, O'Donovan, Sophia C, Masuka, Doreen, Mashava, Faith V, Akello, Mpoki M, Ulisubisya, Helena, Franco, Abdoulie, Njai, Samuel, Simister, Micelle, Joseph, Pierre, Woolley, Deeptiman, James, Faye M, Evans, Ekta, Rai, Nobhojit, Roy, Varun, Bansal, Jyoti, Kamble, Anna, Aroke, Siddarth, David, Deepa, Veetil, Kapil Dev, Soni, Martin Gerdin, Wärnberg, Siddhesh, Zadey, João Ricardo Nickenig, Vissoci, Himanshu, Iyer, Ritika, Shetty, Anushka, Jindal, Gabriel, Ouma, Sayed Shah Nur Hussein, Shah, Carrie, Hinchman, Isaiah Michael, Rayel, Myles, Dworkin, Elijah, Mlinde, Collin J, May, Leonard N, Banza, Linda, Chokotho, Foster, Mbomuwa, Paul, Chidothi, Claude, Martin, William James, Harrison, Samuel, Paek, Lahin, Amlani, Togo, Adégné, Poudiougo, Abdoulmouinou, Traoré, Amadou, Traoré, Youssouf, Konaté, Madiassa, Dicko Moussa, Younoussa, Samaké, Moussa, Bah, Amadou, Touré, Hawa, Abramowitz, Laurent, Damilola Alexander, Jesuyajolu, Charles Arinze, Okeke, Otomi, Obuh, Damilola A, Jesuyajolu, Peace E, Ehizibue, Nnamdi E, Ikemefula, Jamike O, Ekennia-Ebeh, Abdulqudus A, Ibraham, Obinna E, Ikegwuonu, Thomas M, Diehl, Gisèle Juru, Bunogerane, Dan, Neal, Alain Jules, Ndibanje, Robin T, Petroze, Edmond, Ntaganda, Laurie, Milligan, Lydia, Cairncross, Francois, Malherbe, Liana, Roodt, Daniel K, Kyengera, Nathan N, O'Hara, David, Stockton, Alemayehu, Bedada, Marvin, Hsiao, Unami, Chilisa, Brianne, Yarranton, Nkhabe, Chinyepi, Georges, Azzie, Jeongyoon, Moon, Zachary, Rehany, Mehrshad, Bakhshi, Amy, Bergeron, Nathalie, Boulanger, Larry, Watt, Evan G, Wong, Natalie, Pawlak, Christine, Bierema, Emmanuel, Ameh, Abebe, Bekele, Maria F, Jimenez, Kokila, Lakhoo, Hernan, Sacato, Girma, Tefera, Doruk, Ozgediz, Sudha, Jayaraman, Ines, Peric, George, Youngson, Eric, Borgstein, Eric, O'Flynn, Joana, Simoes, Pamela A, Kingsley, Lior, Sasson, Hagi, Dekel, Alona Raucher, Sternfeld, Sagi, Assa, Racheli Sion, Sarid, Naizihijwa Joel, Mnong'one, Godwin Godfrey, Sharau, Stella Mihayo, Mongella, William Goldstein, Caryl, Bernard, Goldman, Rajan, Bola, Joseph, Ngonzi, Fanan, Ujoh, Raymond Bernard, Kihumuro, Ronald, Lett, Amanda, Torquato, Clara, Tavares, Gabriele, Lech, Anja, Džunic, Victoria, Gusa, Rosemary, Apeaii, Rafat, Noor, Isaac Ohene, Guyan, Jan, Christilaw, Stephen, Hodgins, Catherine, Binda, Kayoung, Heo, Samuel, Cheng, Hannah, Foggin, Grace, Hu, Sheila, Lam, Lydia, Feng, Alisha, Labinaz, Jayd, Adams, Rachel, Livergant, Sacha, Williams, Tamilarasy, Vasanthakumaran, Youcef, Lounes, Juan, Mata, Philip, Hache, Christian, Schamberg-Bahadori, Adaw, Monytuil, Emmanuel, Mayom, Shahrzad, Joharifard, Émilie, Joos, Amy, Paterson, Salome, Maswime, Anneli, Hardy, Rupert M, Pearse, Bruce M, Biccard, Mina, Salehi, Irena, Zivkovic, Sukhdeep, Jatana, Michael J, Flores, Kelsey E, Brown, Heather J, Roberts, Claire A, Donnelley, Ericka P, von Kaeppler, Edmund, Eliezer, Billy, Haonga, Saam, Morshed, and David W, Shearer

Published
2022

3. Clubfoot in Malawi: treatment-seeking behaviour

Author

K. Juliet A. Bedford, Harris Sakala, Paul Chidothi, Chris Lavy, and John Cashman

Subjects
Adult, Parents, Malawi, medicine.medical_specialty, Clubfoot, Critical medical anthropology, MEDLINE, Resistance (psychoanalysis), Positive action, Interviews as Topic, Health care, Humans, Medicine, Qualitative Research, Treatment seeking, business.industry, Public Health, Environmental and Occupational Health, Patient Acceptance of Health Care, medicine.disease, Infectious Diseases, Socioeconomic Factors, Child, Preschool, Family medicine, business, Qualitative research
Abstract

We explore the treatment-seeking behaviour of guardians of patients undergoing treatment for clubfoot at clinics run by the Malawi National Clubfoot Programme (MNCP). Core data was collected and analysed using qualitative methodologies of critical medical anthropology. Sixty detailed case studies were completed, each based on an extended open-ended interview with patient guardians. Two positive drivers in seeking treatment for clubfoot were identified: a desire to correct the impairment; and a direct instruction to do so, usually from a health-care professional. Four main barriers prevented treatment seeking: lack of knowledge about the condition and its treatment; familial resistance; logistical obstacles; and socio-economic pressures. In delivering effective health care, organizations should seek to minimize barriers and their impact, whilst maximizing drivers that lead to positive action.

Published
2016

4. Clubfoot in Malawi: local theories of causation

Author

K. Juliet A. Bedford, Paul Chidothi, Harris Sakala, John Cashman, and Chris Lavy

Subjects
Health Knowledge, Attitudes, Practice, Malawi, Clubfoot, Critical medical anthropology, business.industry, Service provision, Culture, Public Health, Environmental and Occupational Health, Context (language use), medicine.disease, Variety (cybernetics), Infectious Diseases, Knowledge base, medicine, Humans, Social science, Causation, business, Qualitative Research, Qualitative research
Abstract

This paper examines local theories of the causation of clubfoot expressed by the guardians of children undergoing treatment at clinics run by the Malawi National Clubfoot Programme (MNCP). Core data was collected and analysed using qualitative methodologies of critical medical anthropology. Sixty detailed case studies were completed, each based on an extended open-ended interview with patient guardians. Five main theories of causation were put forward: God; the devil; witchcraft or curses; biological reasons; and inherited condition. Each was elaborated in a variety of ways. There is growing international recognition of the importance of examining the relationship between culture and disability. This study is the first attempt to do so for clubfoot in Malawi. It provides a platform on which to build future qualitative research that can be harnessed by the MNCP and similar initiatives to develop their knowledge base and service provision, both in Malawi and the wider African context.

Published
2016
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