Stephen Spencer
@sspencer.bsky.social
780 followers 250 following 9 posts
@WellcomeTrust Clinical PhD Fellow in global health research @MLWTrust & @LSTMnews. Intensive care & acute medicine registrar
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sspencer.bsky.social
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Thrilled to share our latest paper @lancetgh.bsky.social on multimorbidity-related hospital admissions in Malawi & Tanzania.

Increased medical complexity in sub–Saharan African hospitals requires urgent interventions to address population needs.

www.thelancet.com/journals/lan...
Reposted by Stephen Spencer
benmorton.bsky.social
Congratulations to @sspencer.bsky.social for publishing the final paper of his PhD! This describes the complexity of patients with breathlessness in Malawi. Whilst vertical programmes are important for individual diseases like TB, more integrated approaches are urgently required

🧪🩺 #ansky #idsky
https://thorax.bmj.com/content/early/2025/09/09/thorax-2025-223623
Reposted by Stephen Spencer
benmorton.bsky.social
And now, after 7 months of baking, the shiny @lancetgh.bsky.social manuscript has emerged!

Very excited to share this as the culmination of a huge amount of work and fantastic/constructive peer review process.

www.thelancet.com/journals/lan...

🧪🩺 #IDsky #icusky
Reposted by Stephen Spencer
sspencer.bsky.social
Many many people and institutions involved:
@benmorton.bsky.social @darknatter.bsky.social +others not on bluesky

@lstmnews.bsky.social; Malawi Liverpool Wellcome; Muhimbili National Hospital; KCMC @dukepress.bsky.social @manchester.ac.uk

🙏Funded by @nihr.bsky.social @wellcometrust.bsky.social
sspencer.bsky.social
What’s next:
We've incorporated these findings into a cluster RCT across Malawi and Tanzania to evaluate a complex intervention to:
- Improve recognition and control of chronic disease
- Reduce readmission
- Improve survival

More info: multilinknihr.com
Home - Multilink Consortium
multilinknihr.com
sspencer.bsky.social
This work builds on our earlier systematic review @whobulletin.bsky.social:
- We found lots of data on individual diseases in SSA hospitals (and estimated their prevalence and disease control)
- But evidence on multimorbidity in this context was sparse

pmc.ncbi.nlm.nih.gov/articles/PMC...
sspencer.bsky.social
Most common long-term conditions were:
• Hypertension (44%)
• HIV (31%)
• Diabetes (27%)

📉 Disease control was poor, particularly for NCDs
• Across both countries, participants had low baseline HRQoL, high disability & frailty.
sspencer.bsky.social
Our adapted UpSet plot presents a rich description of multimorbidity patterns:
- Combinations and prevalence of HIV, diabetes, hypertension, CKD, etc.
- We also found a correlation between the number of conditions and 90-day mortality.
sspencer.bsky.social
Key findings:
- 47% of adults admitted acutely to medical wards had multimorbidity (≥2 long-term conditions).
- This was linked to higher mortality, poorer health-related quality of life, and greater financial burden.

#Multimorbidity #NCDs
sspencer.bsky.social
This work represents the culmination of 3+ years of collaborative work by the NIHR Multilink Consortium: multilinknihr.com.

We assessed health and economic outcomes of multimorbidity across 4 hospitals in Malawi and Tanzania
Home - Multilink Consortium
multilinknihr.com
sspencer.bsky.social
🧵
Thrilled to share our latest paper @lancetgh.bsky.social on multimorbidity-related hospital admissions in Malawi & Tanzania.

Increased medical complexity in sub–Saharan African hospitals requires urgent interventions to address population needs.

www.thelancet.com/journals/lan...
Reposted by Stephen Spencer
benmorton.bsky.social
🧪🩺 What causes breathlessness in patients who require acute hospital admission in Malawi? This protocol paper by @sspencer.bsky.social sets out a systematised approach to address this question: wellcomeopenresearch.org/articles/9-2....
wellcomeopenresearch.org