Evidence map›Paper›PMID 36810123›Full record

ArticleGlobal health research and policy2023

Non-communicable disease burden among inpatients at a rural district hospital in Malawi.

Peter Olds, Chiyembekezo Kachimanga, George Talama, Bright Mailosi, Enoch Ndarama, Jodie Totten, Nicholas Musinguzi, Dickson Hangiwa, Gene Bukhman, Emily B Wroe

Open access · diamondAbstract read
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In one paragraph

Article in Global health research and policy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Peter OldsMassachusetts General Hospital, Boston, MA, USA. polds@mgh.harvard.edu.ORCID 0000-0003-0373-2349
Chiyembekezo KachimangaPartners in Health, Neno, Malawi.
George TalamaPartners in Health, Neno, Malawi.
Bright MailosiPartners in Health, Neno, Malawi.
Enoch NdaramaMinistry of Health and Population, Lilongwe, Malawi.
Jodie TottenDepartment of Emergency Medicine, University of Washington, Seattle, WA, USA.
Nicholas MusinguziGlobal Health Collaborative, Mbarara University of Science and Technology, Mbarara, Uganda.
Dickson HangiwaPartners in Health, Neno, Malawi.
Gene BukhmanHarvard Medical School, Boston, MA, USA.
Emily B WroeHarvard Medical School, Boston, MA, USA.
Brigham and Women's Hospital · USHarvard University · USMbarara University of Science and Technology · UGMinistry of Health · MWUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe burden of non-communicable diseases (NCDs) is high in Malawi. However, resources and training for NCD care remain scarce, especially in rural hospitals. Current care for NCDs in the developing world focuses on the WHO's traditional 4 × 4 set. However, we do not know the full burden of NCDs outside of that scope, like neurological disease, psychiatric illness, sickle cell disease, and trauma. The goal of this study was to understand the burden of NCDs among inpatients in a rural district hospital in Malawi. We broadened our definition of NCDs beyond the traditional 4 × 4 set of NCDs, and included neurological disease, psychiatric illness, sickle cell disease, and trauma.

methodsWe conducted a retrospective chart review of all inpatients who were admitted to the Neno District Hospital between January 2017 and October 2018. We broke patients down by age, date of admission, type, and number of NCD diagnoses, and HIV status, and constructed multivariate regression models for length of stay and in-hospital mortality.

resultsOf 2239 total visits, 27.5% were patients with NCDs. Patients with NCDs were older (37.6 vs 19.7 years, p < 0.001) and made up 40.2% of total hospital time. We also found two distinct populations of NCD patients. The first were patients 40 years and older with primary diagnoses of hypertension, heart failure, cancer, and stroke. The second were patients under 40 years old with primary diagnoses of mental health conditions, burns, epilepsy, and asthma. We also found significant trauma burden, accounting for 40% of all NCD visits. In multivariate analysis, carrying a medical NCD diagnosis was associated with longer length of stay (coefficient 5.2, p < 0.001) and a higher risk of in-hospital mortality (OR 1.9, p = 0.03). Burn patients also had significantly longer length of stay (coefficient 11.6, p < 0.001).

conclusionsThere is a significant burden of NCDs in a rural hospital in Malawi, including those outside of the traditional 4 × 4 set. We also found high rates of NCDs in the younger population (under 40 years of age). Hospitals must be equipped with adequate resources and training to meet this burden of disease.

Indexed as

Hospitals, RuralNoncommunicable DiseasesAdultHumansInpatientsMalawiRetrospective StudiesBurden of diseaseHospitalInpatientMalawiNon-communicable diseaseRural

Identifiers

PMID36810123
PMCPMC9945353
OpenAlexW4321433885

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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.