Elias Phiri - Academia.edu (original) (raw)
Papers by Elias Phiri
![Research paper thumbnail of In association with SOUTH LUANGWA AREA MANAGEMENT UNIT [Formerly the Luangwa Integrated Resource Development Project] Zambia Lessons from Luangwa The Story of the Luangwa Integrated Resource Development Project, Zambia](https://attachments.academia-assets.com/83168738/thumbnails/1.jpg)
](Readers are encouraged to quote or reproduce material from this book for non-commercial purposes ... more Readers are encouraged to quote or reproduce material from this book for non-commercial purposes but, as copyright holder, IIED requests due acknowledgement, with full reference to the publication, and a copy of the publication.
Precis chimie analytique , Precis chimie analytique , مرکز فناوری اطلاعات و اطلاع رسانی کشاورزی
Journal of Virus Eradication
Malawi Medical Journal, Jun 30, 2018
International Journal of STD & AIDS
The use of digital vending machines (VMs) to delivery HIV self-testing (HIVST) could expand HIV t... more The use of digital vending machines (VMs) to delivery HIV self-testing (HIVST) could expand HIV testing in priority populations. We surveyed primarily Black African (BA) participants and other minority ethnicities, to identify acceptability, preferences, and concerns of using VMs for HIVST dispensing. A structured survey was developed with Black African and Caribbean, Latin American and other Minorities (BLAM) communities, and distributed between September 2018 and January 2019. Participants were recruited using mobile tablet surveys distributed by outreach volunteers, and online through BLAM communities’ websites, workshops, and language-specific messages on social media. Descriptive analyses were undertaken stratified by ethnic groups. One hundred and twenty-eight (67.0%) participants identified as BAs, 31 (16.2%) Black Caribbeans (BCs), 22 (11.5%) Latin Americans (LAs), and 10 (5.2%) other non-white ethnicities (ONWEs). Rates of willingness to use the HIVST were high in all group...
British Journal of Hospital Medicine, 2015
INTRODUCTION Routine HIV testing in areas of high HIV prevalence has been shown to be both cost e... more INTRODUCTION Routine HIV testing in areas of high HIV prevalence has been shown to be both cost effective and to avert downstream morbidity and mortality from 'late' HIV diagnosis (defined as CD4 cell count<350 cells/ml). In the London borough of Waltham Forest in 2010, late HIV diagnoses were resulting in high morbidity with associated lengthy and costly hospital admissions. METHODS A retrospective analysis of all new HIV diagnoses was undertaken within a two-phased quality improvement project 2010-13. Newly diagnosed patients in 2010 were characterized, including immunological state, presence of HIV-related illness and department where they presented. After an intervention to set up an opt-out, walk-in rapid HIV testing service in outpatients, an analysis was conducted of numbers of tests, prevalence and immunological state of newly diagnosed patients in 2013. RESULTS A total of 91 patients were diagnosed with HIV, January-December 2010, 70% of which were a late diagnosis, including 48% defined as 'very immunosuppressed' (CD4 count<100 cells/ml). Of these, 51 out of 91 patients (56%) had attended hospital services in the 5 years before diagnosis, including 204 outpatient department attendances. After the intervention, rates of late diagnosis in 2013 had reduced to 46%, and rates of those diagnosed 'very immunosuppressed' had reduced from 48% to 8%. CONCLUSIONS HIV testing in outpatients is feasible and acceptable to patients and can be offered alongside routine outpatient care. The rate of positive HIV tests in this group of patients in the authors' setting has been much higher than the HIV positivity rate of larger scale HIV testing interventions in other hospital settings. This approach also provides a model for more integrated care of HIV-positive patients.
BMJ Global Health
Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and ... more Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and registered its first confirmed coronavirus case on the 2 April 2020. The aim of this paper was to document policy decisions made in response to the COVID-19 pandemic from January to August 2020. We reviewed policy documents from the Public Health Institute of Malawi, the Malawi Gazette, the Malawi Ministry of Health and Population and the University of Oxford Coronavirus Government Response Tracker. We found that the Malawi response to the COVID-19 pandemic was multisectoral and implemented through 15 focused working groups termed clusters. Each cluster was charged with providing policy direction in their own area of focus. All clusters then fed into one central committee for major decisions and reporting to head of state. Key policies identified during the review include international travel ban, school closures at all levels, cancellation of public events, decongesting workplaces and p...
Journal of AIDS and HIV Research, Feb 28, 2014
In Sub Saharan Africa, human immunodeficiency virus (HIV) and tuberculosis (TB) co-infections are... more In Sub Saharan Africa, human immunodeficiency virus (HIV) and tuberculosis (TB) co-infections are common, and patients often find out about their HIV positive status during consultation for pulmonary tuberculosis. Reports from the HIV and TB hospital unit in Swaziland indicate that many deaths are related to low uptake of antiretroviral therapy among patients co-infected with TB, and anecdotal evidence suggests reluctance and refusal by some TB/HIV co-infected patients to initiate antiretroviral therapy (ART) before completing TB treatment, and this phenomenon is not well understood. The aim of this study was to explore the reasons for refusing antiretroviral therapy among HIV co-infected tuberculosis patients, prior to the completion of tuberculosis treatment, at a regional hospital in Swaziland. A qualitative descriptive study was conducted to understand patients' views and concerns, which results in their refusing to initiate ART before completing tuberculosis treatment. A sample of convenience, consisting of nineteen HIV/TB co-infected patients was selected to answer the research question. Reasons given were the clients' un-readiness for ART, the perception that one was still in good health, the fear of adverse outcomes being precipitated by combining ART with TB medicines, preference for traditional medicines, and health systems-related problems.
Readers are encouraged to quote or reproduce material from this book for non-commercial purposes ... more Readers are encouraged to quote or reproduce material from this book for non-commercial purposes but, as copyright holder, IIED requests due acknowledgement, with full reference to the publication, and a copy of the publication.
Precis chimie analytique , Precis chimie analytique , مرکز فناوری اطلاعات و اطلاع رسانی کشاورزی
Journal of Virus Eradication
Malawi Medical Journal, Jun 30, 2018
International Journal of STD & AIDS
The use of digital vending machines (VMs) to delivery HIV self-testing (HIVST) could expand HIV t... more The use of digital vending machines (VMs) to delivery HIV self-testing (HIVST) could expand HIV testing in priority populations. We surveyed primarily Black African (BA) participants and other minority ethnicities, to identify acceptability, preferences, and concerns of using VMs for HIVST dispensing. A structured survey was developed with Black African and Caribbean, Latin American and other Minorities (BLAM) communities, and distributed between September 2018 and January 2019. Participants were recruited using mobile tablet surveys distributed by outreach volunteers, and online through BLAM communities’ websites, workshops, and language-specific messages on social media. Descriptive analyses were undertaken stratified by ethnic groups. One hundred and twenty-eight (67.0%) participants identified as BAs, 31 (16.2%) Black Caribbeans (BCs), 22 (11.5%) Latin Americans (LAs), and 10 (5.2%) other non-white ethnicities (ONWEs). Rates of willingness to use the HIVST were high in all group...
British Journal of Hospital Medicine, 2015
INTRODUCTION Routine HIV testing in areas of high HIV prevalence has been shown to be both cost e... more INTRODUCTION Routine HIV testing in areas of high HIV prevalence has been shown to be both cost effective and to avert downstream morbidity and mortality from 'late' HIV diagnosis (defined as CD4 cell count<350 cells/ml). In the London borough of Waltham Forest in 2010, late HIV diagnoses were resulting in high morbidity with associated lengthy and costly hospital admissions. METHODS A retrospective analysis of all new HIV diagnoses was undertaken within a two-phased quality improvement project 2010-13. Newly diagnosed patients in 2010 were characterized, including immunological state, presence of HIV-related illness and department where they presented. After an intervention to set up an opt-out, walk-in rapid HIV testing service in outpatients, an analysis was conducted of numbers of tests, prevalence and immunological state of newly diagnosed patients in 2013. RESULTS A total of 91 patients were diagnosed with HIV, January-December 2010, 70% of which were a late diagnosis, including 48% defined as 'very immunosuppressed' (CD4 count<100 cells/ml). Of these, 51 out of 91 patients (56%) had attended hospital services in the 5 years before diagnosis, including 204 outpatient department attendances. After the intervention, rates of late diagnosis in 2013 had reduced to 46%, and rates of those diagnosed 'very immunosuppressed' had reduced from 48% to 8%. CONCLUSIONS HIV testing in outpatients is feasible and acceptable to patients and can be offered alongside routine outpatient care. The rate of positive HIV tests in this group of patients in the authors' setting has been much higher than the HIV positivity rate of larger scale HIV testing interventions in other hospital settings. This approach also provides a model for more integrated care of HIV-positive patients.
BMJ Global Health
Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and ... more Malawi declared a state of national disaster due to the COVID-19 pandemic on 20th March 2020 and registered its first confirmed coronavirus case on the 2 April 2020. The aim of this paper was to document policy decisions made in response to the COVID-19 pandemic from January to August 2020. We reviewed policy documents from the Public Health Institute of Malawi, the Malawi Gazette, the Malawi Ministry of Health and Population and the University of Oxford Coronavirus Government Response Tracker. We found that the Malawi response to the COVID-19 pandemic was multisectoral and implemented through 15 focused working groups termed clusters. Each cluster was charged with providing policy direction in their own area of focus. All clusters then fed into one central committee for major decisions and reporting to head of state. Key policies identified during the review include international travel ban, school closures at all levels, cancellation of public events, decongesting workplaces and p...
Journal of AIDS and HIV Research, Feb 28, 2014
In Sub Saharan Africa, human immunodeficiency virus (HIV) and tuberculosis (TB) co-infections are... more In Sub Saharan Africa, human immunodeficiency virus (HIV) and tuberculosis (TB) co-infections are common, and patients often find out about their HIV positive status during consultation for pulmonary tuberculosis. Reports from the HIV and TB hospital unit in Swaziland indicate that many deaths are related to low uptake of antiretroviral therapy among patients co-infected with TB, and anecdotal evidence suggests reluctance and refusal by some TB/HIV co-infected patients to initiate antiretroviral therapy (ART) before completing TB treatment, and this phenomenon is not well understood. The aim of this study was to explore the reasons for refusing antiretroviral therapy among HIV co-infected tuberculosis patients, prior to the completion of tuberculosis treatment, at a regional hospital in Swaziland. A qualitative descriptive study was conducted to understand patients' views and concerns, which results in their refusing to initiate ART before completing tuberculosis treatment. A sample of convenience, consisting of nineteen HIV/TB co-infected patients was selected to answer the research question. Reasons given were the clients' un-readiness for ART, the perception that one was still in good health, the fear of adverse outcomes being precipitated by combining ART with TB medicines, preference for traditional medicines, and health systems-related problems.