Justin Moher, MD
Justin Moher, MD
Pediatric Emergency Medicine · Houston, TX

Anemia and Heart Function in Children in Malawi

February 1st
Lilongwe, Malawi

Project Description

This project aims to improve understanding of cardiac function in children with severe anemia in Malawi both with and without the complications of malnutrition and malaria, to create a protocol for the use of point-of-care ultrasound to evaluate children with severe anemia, and to improve overall care of children in a pediatric emergency care at Kamuzu Central Hospital (KCH) in Malawi.

This project will study the cardiac function using point-of-care ultrasound for children presenting to the Emergency Zone (EZ) at KCH with anemia to gain an understanding of underlying function in children with varying severity of anemia and those with concomitant co-morbidities including malaria and malnutrition. There is minimal data currently on cardiac function as assessed on ultrasound for children with malaria, malnutrition or anemia in the international setting. A general understanding of cardiac function with these common complaints can help in improving care as use of blood or fluids or rates of infusion may be better tailored based on cardiac function. This work will also help further the training of a clinical officer who is engaged in a POCUS training curriculum. Ultimately, data from this project and changes in management could be further studied at this and other global health sites that we practice at in order to further expand its impact.

In addition to the above project and in partnership with the local physicians and clinicians, I will be aiding in clinical, educational and other research efforts to aid the care of acutely ill children at KCH.

Population Served

Malawi is a landlocked country located in southeastern Africa with a significant health burden with a high under 5 mortality rate and a large prevalence of HIV/AIDS, tuberculosis, and malaria. Kamuzu Central Hospital is the national referral hospital in the capital city of Lilongwe serving the central region of Malawi. The pediatric ward admits more than 27,000 patients per year and manages all medical emergencies. In the emergency zone, a small staff of nurses and clinicians will care for often over 100 acutely and critically ill children each day.

My project will serve to benefit this especially vulnerable population of sick children and the dedicated local clinicians who care for them.

Expected Impact

This project will provide important knowledge that could affect the care of critically ill children local. It will additionally help in the training of a local clinical officer. A prior project developed an educational program in point-of-care ultrasound and we have had one graduate thus far. This project will be spearheaded by this clinical officer advancing his clinical and research skills.

Trip Photos & Recap

Through this trip, we were able to complete our point-of-care ultrasound education curriculum and graduate our first clinical officer. We were also able to take the initial steps in a new research project. I also had the opportunity to work clinically, helping to care for critically ill children along with teaching medical students, medical officers and clinical officers at the bedside.