Malawi Medical Journal
College of Medicine, University of Malawi and Medical Association of Malawi
Vol. 32, No. 2, 2020, pp. 64-73
Bioline Code: mm20011
Full paper language: English
Document type: Research Article
Document available free of charge
Malawi Medical Journal, Vol. 32, No. 2, 2020, pp. 64-73
© Copyright 2020 - The College of Medicine and the Medical Association of Malawi
Non-communicable respiratory disease in Malawi: a systematic review and meta-analysis|
Nightingale, Rebecca; Jary, Hannah; Meghji, Jamilah; Rylance, Sarah; Masiye, Jones; Chiumia, Hastings; Rylance, Jamie; Mortimer, Kevin & Lesoky, Maia
Non-communicable respiratory diseases are important contributors to morbidity and mortality in sub-Saharan African countries such
To conduct a systematic review of the available literature relating to chronic respiratory disease in Malawi.
We conducted a systematic protocol-driven literature search of key scientific databases including Scopus and Medline. Papers were
independently assessed for eligibility by two authors and included if they reported objective measures (including self-reported standard
symptoms) of chronic respiratory disease and were conducted in Malawi. A meta-analysis of available estimates was then conducted.
We re-analysed data from three of these studies in a secondary data analysis to allow for between-study comparisons.
Our search identified 393 papers of which 17 (5 involving children and 12 involving adults) met the inclusion criteria. Wheeze was the
symptom most frequently reported in children in the community (12.1%), hospital (11.2%) and HIV clinic (8.1%) settings. Cough was
the symptom most frequently reported by adults in the community (3–18%). Spirometric abnormalities varied substantially between
studies. For example, in adults, airflow obstruction varied between 2.3% and 20% and low forced vital capacity (FVC) varied between
2.7% and 52.8%.
We identified a high burden of chronic respiratory symptoms and abnormal spirometry (particularly low FVC) within paediatric and
adult populations in Malawi. The estimates for country-wide burden related to this disease were limited by the heterogeneity of the
methods used to assess symptoms and spirometry. There is an urgent need to develop a better understanding of the determinants and
natural history of non-communicable respiratory disease across the life-course in Malawi.
COPD; asthma; chronic lung disease; cough; non-communicable disease; Malawi
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