ReviewBMJ global health2020
Establishment of a high-dependency unit in Malawi.
Review in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed.
- Effect of 13-valent pneumococcal conjugate vaccine on experimental carriage of Streptococcus pneumoniae serotype 6B in Blantyre, Malawi: a randomised controlled trial and controlled human infection study.The Lancet. Microbe · 2023Trial
- Hospital burden of critical illness across global settings: a point prevalence and cohort study in Malawi, Sri Lanka and Sweden.BMJ global health · 2025Observational
- Optimising Clinical Epidemiology in Disease Outbreaks: Analysis of ISARIC-WHO COVID-19 Case Report Form Utilisation.Epidemiologia (Basel, Switzerland) · 2024Article
- The role of healthcare providers and caregivers in monitoring critically ill children: a qualitative study in a tertiary hospital, southern Malawi.BMC health services research · 2024Article
- Improving the management of open tibia fractures, Malawi.Bulletin of the World Health Organization · 2024Article
- EPidemiology, clinical characteristics and Outcomes of 4546 adult admissions to high-dependency and intensive care units in Kenya (EPOK): a multicentre registry-based observational study.Critical care explorations · 2024Article
- Critical care capacity and care bundles on medical wards in Malawi: a cross-sectional study.BMC health services research · 2023Article
- A health systems approach to critical care delivery in low-resource settings: a narrative review.Intensive care medicine · 2023Review
- Critical Care Units in Malawi: A Cross-Sectional Study.Annals of global health · 2023Article
- Impact of establishing a respiratory high dependency unit for SCAP patients on the therapeutic effect, prognosis, and expenditure: a retrospective case-control study.Scientific reports · 2022Article
- "An increase in COVID-19 patients would be overwhelming": A qualitative description of healthcare workers' experiences during the first wave of COVID-19 (March 2020 to October 2020) at Malawi's largest referral hospital.Wellcome open research · 2022Article
- Improving competencies and skills across clinical contexts of care: a qualitative study on Malawian nurses' experiences in an institutional health and training programme.Nursing open · 2021Article
- Distinct clinical and immunological profiles of patients with evidence of SARS-CoV-2 infection in sub-Saharan Africa.Nature communications · 2021Article
- Acute physiology and chronic health evaluation score and mortality of patients admitted to intermediate care units of a hospital in a low- and middle-income country: A cross-sectional study from Pakistan.International journal of critical illness and injury scienceArticle
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
Adults admitted to hospital with critical illness are vulnerable and at high risk of morbidity and mortality, especially in sub-Saharan African settings where resources are severely limited. As life expectancy increases, patient demographics and healthcare needs are increasingly complex and require integrated approaches. Patient outcomes could be improved by increased critical care provision that standardises healthcare delivery, provides specialist staff and enhanced patient monitoring and facilitates some treatment modalities for organ support. In Malawi, we established a new high-dependency unit within Queen Elizabeth Central Hospital, a tertiary referral centre serving the country's Southern region. This unit was designed in partnership with managers, clinicians, nurses and patients to address their needs. In this practice piece, we describe a participatory approach to design and implement a sustainable high-dependency unit for a low-income sub-Saharan African setting. This included: prospective agreement on remit, alignment with existing services, refurbishment of a dedicated physical space, recruitment and training of specialist nurses, development of context-sensitive clinical standard operating procedures, purchase of appropriate and durable equipment and creation of digital clinical information systems. As the global COVID-19 pandemic unfolded, we accelerated unit opening in anticipation of increased clinical requirement and describe how the high-dependency unit responded to this demand.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.