Info for Authors

INFORMATION FOR CONTRIBUTORS

The Malawi Medical Journal is a peer-reviewed journal which publishes original articles, reviews, case studies and correspondence about all aspects of practice, education, policy and research in medicine. The Journal hopes to encourage the study of medicine in Malawi and the southern African region but also globally. These guidelines are based on those of a number of international medical journals, including JAMA and the Croatian Medical Journal, and comply with the International Committee of Medical Journal Editor’s “Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication” ( www.icmje.org).”

Manuscripts
Manuscript are accepted for consideration with the understanding that they have been submitted solely to the Malawi Medical Journal and that they have not been previously published, either whole or in part elsewhere. This does not refer to abstracts presented in the Proceedings of Societies or Conferences/Symposia. All original contributions are reviewed by the editors, and when appropriate, sent to one or more editorial consultants. The editors reserve the right to make editorial changes in all matter published in the Journal. Manuscripts should whenever possible be submitted through the online manuscript submission and review system at http://mc.manuscriptcentral.com/mmj; only submit manuscripts via email, to mmj@medcol.mw, if you have difficulties with the Manuscript Central site.

Authorship Criteria
Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content. One or more authors should take responsibility for the integrity of the work as a whole, from inception to published article. Authorship credit should be based only on
(1) substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; and
(2) drafting the article or revising it critically for important intellectual content; and
(3) final approval of the version to be published.
Conditions 1, 2, and 3 must all be met.1,2 Acquisition of funding, the collection of data, or general supervision of the research group, by themselves, do not justify authorship. The order of authorship on the byline should be a joint decision of the coauthors. Authors should be prepared to explain the order in which authors are listed.

Role of the Corresponding Author
The corresponding author (or coauthor designee) will serve on behalf of all coauthors as the primary correspondent with the editorial office during the submission and review process.

Group Authorship
If authorship is attributed to a group (either solely or in addition to 1 or more individual authors), all members of the group must meet the full criteria and requirements for authorship as described above. 3 If that is not the case, a group must designate 1 or more individuals as authors or members of a writing group who meet full authorship criteria and requirements. Other group members who are not authors may be listed in an Acknowledgment.

Duplicate/Previous Publication or Submission
Manuscripts are normally considered with the understanding that they have not been published previously in print or electronic format and are not under consideration by another publication or electronic medium. In exceptional circumstances where the manuscript is of scientific relevance to the Malawian community, the MMJ will permit a publication of an already published article if all the following conditions are met
(a) the Authors have received approval from the editors of both journals;
(b) the paper for secondary publication is intended for a different group of readers; in this case, an abbreviated version is sufficient; and
(c) a footnote on the title page of the secondary version acknowledges the primary reference. Copies of related or possibly duplicative materials (ie, those containing substantially similar content or using the same or similar data) that have been previously published or are under consideration elsewhere must be provided at the time of manuscript submission.1

Timeliness of Data
Data included in research reports submitted to MMJ should be as timely and current as possible.4 Manuscripts based on data from randomized controlled trials should be reported as soon as possible after the trial has ended, ideally within 1 year after follow-up has been completed. For cohort studies, the date of final follow-up should be no more than 3 to 4 years before manuscript submission. Likewise, data used in case-control or crosssectional studies should have been collected as recently as possible, but certainly less than 3 to 4 years ago. Authors of manuscripts that report data that have been collected more than 3 to 4 years ago should provide an explanation regarding the relevance of the information in light of current knowledge and medical practice.

Survey Research
Manuscripts reporting survey data, such as studies involving patients, clinicians, the public, or others, should report data collected as recently as possible, ideally within the past 2 years.3 Survey studies should have sufficient response rates (generally at least 60%) and appropriate characterization of nonresponders to ensure that nonresponse bias does not threaten the validity of the findings. For most surveys, such as those conducted by telephone, personal interviews (eg, drawn from a sample of households), mail, email, or via the Web, authors are encouraged to report the survey outcome rates using standard definitions and metrics.

Ethical Approval of Studies and Informed Consent
For human or animal experimental investigations, formal review and approval, or review and waiver, by an appropriate institutional review board or ethics committee is required and should be described in the Methods section.1 For those investigators who do not have formal ethics review committees, the principles outlined in the Declaration of Helsinki should be followed.4 For investigations of human subjects, state in the Methods section the manner in which informed consent was obtained from the study participants (ie, oral or written).

Identification of Patients in Descriptions, Photographs, and Pedigrees
A signed statement of informed consent to publish (in print and online) patient descriptions, photographs, and pedigrees should be obtained from all persons (parents or legal guardians for minors) who can be identified (including by the patients themselves) in such written descriptions, photographs, or pedigrees should be submitted with the manuscript and indicated in the Acknowledgment section of the manuscript. Such persons should be shown the manuscript before its submission.3 Omitting data or making data less specific to deidentify patients is acceptable, but changing any such data is not acceptable.

Patient Permission Form
Please contact MMJ Editorial office on mmj@medcol.mw

Previous Presentation or Release of Information
A complete report following presentation at a meeting or publication of preliminary findings elsewhere (eg, an abstract) is eligible for consideration for publication.

Unauthorized Use
Published manuscripts become the permanent property of the Malawi Medical Journal (MMJ) and may not be published elsewhere without written permission. Unauthorized use of the MMJ name, logo, or any content for commercial purposes or to promote commercial goods and services (in any format, including print, video, audio, and digital) is not permitted by the MMJ.

Editorial Review and Publication
Authors will be sent notifications of the receipt of manuscripts and editorial decisions by e-mail. During the review process, authors can check the status of their submitted manuscript via the online manuscript submission and review system http://mc.manuscriptcentral.com/mmj

Editorial and Peer Review Process
All submitted manuscripts are reviewed initially by a MMJ editor. Manuscripts are evaluated according to the following criteria: material is original and timely, writing is clear, study methods are appropriate, data are valid, conclusions are reasonable and supported by the data, information is important, and topic has general medical interest. From these basic criteria, the editors assess a paper’s eligibility for publication.

Manuscripts with insufficient priority for publication are rejected promptly. Manuscript that are received and assigned either of three general priority levels:
(a) manuscripts sent to reviewers immediately;
(b) manuscripts returned to authors with suggestions for the improvement of data presentation; and
(c) rejected manuscripts.
This editorial procedure reinforces our author-helpful policy because all manuscripts undergo editorial scrutiny and advice. Peer reviewer and author identities are kept confidential. The reviewers are asked to treat the manuscript with confidentiality, and reveal any research conflict of interest with the reviewed manuscript. Reviewers do not have to sign the review forms with suggestions to the authors, but may do so if they wish. The existence of a manuscript under review is not revealed to anyone other than peer reviewers and editorial staff. Information from submitted manuscripts may be systematically collected and analyzed as part of research to improve the quality of the editorial or peer review process. Identifying information remains confidential.

One to three months after submission of the manuscript, the authors will receive the reviews. The comments and suggestions made by the reviewers should be addressed and closely followed. In this respect, the Editor’s accompanying letter will give clear general instructions for further work on the manuscript.

Author’s cover letter accompanying the revised version of the paper
The authors should state clearly and precisely every step taken in accordance with the reviewers’ requests. The description should be listed on a numbered basis, in the order of reviewers’ comments.
Altered paragraphs in the new version of the manuscript should be specified using page and paragraph numbers. Paragraph on top of a page is considered No. 1, even if it does not begin on that page.

Scientific integrity
The Editorial Board of the MMJ is devoted to the promotion of scientific integrity as a vital component of the research process.7 MMJ Editorial Office will deal with all issues related to possible scientific misconduct in manuscripts submitted to or published in the MMJ.8 The following guidelines are aimed to increase awareness of our authors and decrease misunderstandings.

Corrections
Requests to publish corrections should be sent to the editorial office. Corrections are reviewed by editors and authors, published promptly, and linked online to the original article.

Categories of Articles
MMJ publishes original contributions, reviews, brief reports, special communications, commentaries, and many other categories of articles. Topics of interest include all subjects that relate to the practice of medicine and the betterment of public health in Malawi. The most frequently published types of articles are described herein.

Original Contribution
These reports include randomized trials (see Clinical Trial Section below), intervention studies, cohort studies, case-control studies, epidemiologic assessments, other observational studies, surveys with high response rates (see Survey Research Section), cost-effectiveness analyses and decision analyses (see Reports of Costeffectiveness Analyses and Decision Analyses Section), and studies of screening and diagnostic tests (see also Reports of Diagnostic Tests Section). Each manuscript should clearly state an objective or hypothesis; the design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria and/or participation or response rates, or data sources, and how these were selected for the study); the essential features of any interventions; the main outcome measures; the main results of the study; a comment section placing the results in context with the published literature and addressing study limitations; and the conclusions. Data included in research reports should be as timely and current as possible (see Timeliness of Data Section). A structured abstract is required; for more information, see instructions for preparing structured Abstracts. Recommended length: 3000-3500 words (not including abstract, tables, figures, and references).

Clinical Trial
In these studies, individuals are randomly allocated to receive or not receive a preventive, therapeutic, or diagnostic intervention and then followed up to determine the effect of the intervention. All randomized clinical trials should include a flow diagram, and authors should provide a completed randomized trial checklist and a trial protocol. All clinical trials must be registered at an appropriate online public registry before submitting a manuscript based on the trial. These and other requirements are detailed below. Each manuscript should clearly state an objective or hypothesis; the design and methods (including the study setting and dates, patients or participants with inclusion and exclusion criteria, or data sources, and how these were selected for the study); the essential features of any interventions; the main outcome measures; the main results of the study; a comment section placing the results in context with the published literature and addressing study limitations; and the conclusions. A structured abstract is required, and trial registration information (name, number, and URL) should be listed at the end of the abstract; for more information, see instructions for preparing structured Abstracts. Recommended length: 3000-3500 words (not including abstract, tables, figures, and references).

Trial Registration
Acceptable trial registries include the following:
http://www.actr.org.au
http://www.clinicaltrials.gov
http://www.isrctn.com
http://www.trialregister.nl/trialreg/index.asp
http://www.umin.ac.jp/ctr

For this purpose, a clinical trial is any study that prospectively assigns human subjects to intervention or comparison groups to evaluate the cause-and-effect relationship between a medical intervention and a health outcome. All clinical trials, regardless of when they were completed, and secondary analyses of original clinical trials must be registered before submission of a manuscript based on the trial. For clinical trials starting patient enrollment after July 2005, trials must be registered before onset of enrollment. Studies designed for other purposes, such as to study pharmacokinetics or major toxicity (eg, phase 1 trials), are exempt. Trial registry name, registration identification number, and the URL for the registry should be included at the end of abstract and also in the space provided on the online manuscript submission form.

CONSORT Flow Diagram and Checklist
Manuscripts reporting the results of RCTs should include the CONSORT flow diagram showing the progress of patients throughout the trial.6 The CONSORT checklist also should be completed and submitted with the manuscript. The CONSORT checklist is available at www.consort-statement.org/Checklist.doc

Reports of Diagnostic Tests
These manuscripts may be classified as Original Contributions, Brief Reports, or Research Letters. Authors of reports of diagnostic tests are encouraged to submit the STARD flow diagram and checklist (for more information, see http://www.consort-statement.org/Initiatives/complements.htm).

Reports of Cost-effectiveness Analyses and Decision Analyses
These manuscripts may be classified as Original Contributions, Brief Reports, or Research Letters. Authors of reports of cost-effectiveness analyses and decision analyses must submit a copy of the decision tree comprising their model. This is for editorial evaluation and review, not for publication, unless it is included in the body of the manuscript itself.

Systematic Review (Including Metaanalysis).
These manuscripts are systematic, critical assessments of literature and data sources pertaining to clinical topics, emphasizing factors such as cause, diagnosis, prognosis, therapy, or prevention. All articles or data sources should be searched for and selected systematically for inclusion and critically evaluated, and the search and selection process should be described in the paper. The specific type of study or analysis, population, intervention, exposure, and tests or outcomes should be described for each article or data source. The data sources should be as current as possible, ideally with the search having been conducted within several months of manuscript submission. A structured abstract is required; for more information, see instructions for preparing structured Abstracts. Recommended length: 3000-4000 words (not including abstract, tables, figures, and references).

Short Report: These manuscripts are short reports of original studies or evaluations or unique, first-time reports of clinical case series.A concise report of a research study or audit, without Summary. For a short report, there is a maximum of two tables/figures in total and a maximum of five references. Recommended length: 400-800 words (not including abstract, tables, figures, and references).

Case Report: MMJ welcomes well-described reports of cases that can be used for educational purposes or that describe unusual features of the disease, its treatment, transmission or control. When describing clinical cases, the authors are requested to provide written and signed consent [click here for the patient consent form.] to publish the information from the patients or their guardians; case reports may include clinical pictures.

Case Reports no more than 1000 words and should be organized in two separate sections Section 1: Presentation of the Case, Section 2: Discussion of this case (i.e. diagnosis, relevant positive and negative findings from history, examination and investigation), References and Tables/Figures.

Special Communication
These manuscripts describe an important issue in clinical medicine, public health, health policy, or medical research in a scholarly, thorough, well-referenced, systematic or evidence- based manner. Recommended length: up to 3000 words (not including tables, figures, or references).

Commentary
These papers may address virtually any important topic in medicine, public health, research, or health policy and generally are not linked to a specific article. Commentaries should be well focused, scholarly, and clearly presented and generally should have no more than 3 authors. Recommended length: 1500-2000 words, with 1 table or figure, approximately 25 references.

Personal View:
Personal essays, views, reflections, opinions on a wide-range of experiences in medicine that occasional maybe controversial; 200-800 words.

Letter to the Editor.
Letters discussing a recent MMJ article will have the best chance of acceptance. They should not exceed 400 words of text and 5 references. They should be double-spaced and a word count should be provided. The text of letters should include the names, academic degrees, and primary institutional affiliations for all authors, and the e-mail address for the corresponding author.

Interview
A conversation between the writer(s) and a person whose work or view may be of interest to Malawi Medical Journal readers.

Poetry , Short stories, Photographs
Poems, short stories, and photographs may be submitted by e-mail or as attachments to mmj@medcol.mw

Teaching Corner
Teaching Corner is devoted to postgraduate medical education and training. It provides an ongoing forum for discourse on educational, professional, and scientific topics. Manuscripts should be limited to fewer than 2000 words. Manuscripts undergo internal review by the editor. Authors interested in submitting in the Teaching Corner should contact the editorial office prior to manuscript preparation and submission by sending an e-mail to mmj@medcol.mw

Book and Media Reviews.
Reviews of books and new media are invited by the editor and may be submitted by e-mail or as attachments to e-mail to mmj@medcol.mw

Questions about any other categories of articles should be directed to the editorial office.

Manuscript Preparation and Submission Requirements Manuscript Submission
Manuscripts should be submitted online via the MMJ online manuscript submission and review system at http://mc.manuscriptcentral.com/mmj in exceptional circumstances you can submit to mmj@medcol.mw and the Editorial Office will register your manuscript into the system. At the time of submission, complete contact information (postal/mail address, e-mail address, telephone and fax numbers) for the corresponding author is required. First and last names, e-mail addresses, and institutional affiliations of all coauthors are also required.

Cover Letter
Include a cover letter and complete contact information for the corresponding author (postal/mail address, e-mail address, and telephone and fax numbers) and whether the authors have published or submitted any related papers from the same study (see Duplicate/Previous Publication or Submission).

Manuscript Style
Manuscripts should be prepared in accordance with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals.2

Manuscript Components.
Include a title page, abstract, text, references, and as appropriate, figure legends, tables, and figures. Start each of these sections on a new page, numbered consecutively, beginning with the title page.

Recommended File Sizes
We recommend individual file sizes of no more than 500 kB and not exceeding 1 MB, with the total size for all files not exceeding 5 MB (not including any video files).

Manuscript File Formats
For submission and review, acceptable manuscript file formats include Word, WordPerfect, PDF, EPS, Text, Postscript, or RTF format. Use 12-point font size, double-space text, and leave right margins unjustified (ragged).

Title Page
The Title Page should include a word count for text only, the title (concise and informative, not to exceed 80 characters in length); the first and last name(s) of author(s) and appointments; and a short running head of not more than 40 characters (count letters and spaces) placed at the foot of the page and identified. If authors belong to several different institutions, superscript digits should be used to relate the authors’ names to respective institutions. The present address of any author, if different from the place work was done, should be shown. The name, address (including e-mail), telephone and fax numbers of the author to whom correspondence should be addressed must be provided.

Second page
The second page should contain the Abstract and six to ten key words. In selecting key words, the authors should strictly refer to the Medical Subject Headings (MeSH) list of the Index Medicus. In the case of reports on clinical trials, the abstract should also include the information on the identifying number of the trial and the name of the registration database. Any potential conflict of interest should also be disclosed on this page. Authors should disclose any commercial affiliations as well as consultancies, stock or equity interests, and patent-licensing arrangements which could be considered a conflict of interest. The details of such disclosures will be kept confidential but MMJ urges the authors to make general statements in the Acknowledgment section of the manuscript.

Other pages
Each manuscript should follow this sequence: title page; abstract, key words, trial identification number for registered trials; text (Introduction, Methods, Results, Discussion); acknowledgments; references; tables (each table complete with title and footnotes on a separate page), figure legends, and the last page.

Text organization and style
Title
The title is the most important summary of a scientific article. The title should also include information on the scope of investigation,eg, the type of study (clinical, experimental, epidemiological) average follow-up time, etc. If animal or cadaver experiments are reported, the title should carry this information.

Abstract
MMJ requires that the authors prepare a structured abstract of not more than 300 words. Abstracts re not required for editorials, commentaries, and some special features. The abstract should include (at least) four headings:Aim. State explicitly and specifically the purpose of the study. Formulations such as “The purpose of this study was to gain a better insight into the influence of several growth factors on the differentiation of bone marrow cells in the in vitro culture” should be replaced by “Analysis of in vitro differentiation of human bone marrow stem cells in the presence of INF-γ or TNF-α.” Methods. Concisely and systematically list the basic procedures, selection of study subjects or laboratory animals, methods of observation and analysis. Avoid listing of common or irrelevant methods; enable the reader to fathom the essence of your procedure(s) and methods. The essential data on patient characteristics belong here, not in the Results section. Results. List your basic results without any introduction. Only essential statistical significances should be added in brackets. Draw no conclusions as yet: they belong into the next section. Conclusion. List your conclusions in a short, clear and simple manner. State only those conclusions that stem directly from the results shown in the paper. Rather than summarizing the data, conclude from them. Do not forget to include the identifying number of the trial and registration database for reports on clinical trials.

Introduction
The Introduction section should include the hypothesis and specific protocol objectives. The author should briefly introduce the problem, particularly emphasizing the level of knowledge about the problem at the beginning of the investigation. Continue logically, and finish the section with a short description of the aim of the study. Introduction section should generally not exceed one typewritten page. This is no place to write a review of the field or to mention textbooks commonplaces: you are addressing an educated reader, and this section should introduce him/ her to the specific problem investigated.

Patients/material and methods
This section need not be brief. Use of subheadings is advised. For clinical trials define: (a) planned study population, including controls;
(b) inclusion and exclusion criteria;
(c) planned subgroup analyses;
(d) prognostic factors that may affect study results;
(e) outcome measures and minimum difference(s) to be considered clinically important;
(f) planned treatment interventions;
(g) method of assignment of subjects to treatments (eg, randomization method, blinding or masking procedure, matching criteria);
(h) planned sample size and power calculations;
(i) rules for stopping the study; and
(j) methods of statistical analysis in sufficient detail to permit replication. It is important to specify exactly how the patients were selected. The patients should be characterized in detail, so as to avoid confusion about uncontrolled variables.

Give the reasons for a given patient’s exclusion from the follow-up, and analyze whether or not he/she was a representative of the primary series. A follow- up close to 100 percent is required in most studies. Follow-up time should generally not be less than 2 years. Give the exact dates of the study. Control group(s) should be described as precisely as experimental groups. For animals, the species, sex, age, breed, and physiologic condition should be given. Names of chemicals and devices used should be followed by the information on the manufacturer (name, city, and country) set in parentheses. Give generic names for the drugs and chemicals, followed by their commercial names in brackets. In reports on the experiments on human subjects, it should be indicated whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) or with the Helsinki Declaration (3), as revised in 1975 and 1983. Do not use patients’ names, initials, or hospital numbers, especially in illustrative material. Permission to use patient’s pictures and their informed consent must accompany such material. All human and animal studies must have been approved by the authors’ Institutional Review Board.

Statistics
List the tests used. Relate each test to a particular data analysis. This should be repeated in the Results section. Tables should not contain only statistical test results. Statistics is a tool, not the purpose of analysis; it serves to corroborate the specific data. Statistical significances should be shown along with the data in the text, as well as in tables and figures. Provide exact p-values, with three decimal places.

Results
A clinical study as conducted should include:
(a) inclusive dates of accrual of study population;
(b) sample size achieved;
(c) how many subjects were excluded or withdrew, and the reasons;
(d) demographic and clinical characteristics of the study population, including controls; and
(e) how the study as conducted deviated from the study as planned, and the reasons (eg, compliance).

Study findings should include:
(a) estimates of treatment effects, stated as comparisons among treatment groups (eg, differences in risks, rates or means of outcome measures, as well as exact p-values;
(b) measures of precision for outcome measures and for estimates of treatment effects (confidence intervals, standard errors);
(c) summary data and appropriate descriptive statistics;
(d) complications of treatment; and
(e) repository where original data can be obtained (eg, principal investigator).

Key rules for writing the Results section are:
(a) the text should be understandable without referring to the respective tables and figures, and vice versa;
(b) however, the text should not simply repeat the data contained in the tables and figures; and
(c) the text and data in tables and figures should be related to the statements in the text by means of reference marks.

Thus, it is best to describe the main findings in the text, and refer the reader to the tables and figures, implying that details are shown there. Information on significance and other statistical data should preferably be given in the tables and figures. The formulations such as “It is shown in Table 1 that the outcome of Group A was better than that of Group B” should be replaced by “The outcome of Group A was better than that of Group B (Table 1).” Call experimental groups by their real (albeit maybe more descriptive/longer) names, rather than assigning them numbers or letters. The need for brevity should not clash with the requirement that all results be presented.
Discussion
The discussion section should include interpretation of study findings, and results considered in the context of results in other trials reported in the literature. This section has three main functions:
(a) assessment of the results for their validity with respect to the hypothesis, relevance of methods, and significance of differences observed;
(b) discussion of relevant literature providing evidence or counterevidence for your findings; and
(c) assessment of the significance of the conclusions for the application in further research. Do not recapitulate your results, discuss them!

Abbreviations
Do not use abbreviations in the title or abstract and limit their use in the text. Expand all abbreviations at first mention in the text.

Units of Measure
Conventional units of measure are preferred, with Système International (SI) units expressed secondarily (in parentheses). In tables and figures, a conversion factor to SI may be presented in the footnote or legend to economize space. Exceptions to this policy include calories, hematocrit, glycosylated hemoglobin, blood cell counts, and ejection fraction, for which conventional units alone should be expressed. The metric system is preferred for the expression of length, area, mass, and volume. For more details, see the SI unit conversion table.

Names of Drugs, Devices, and Other Products
Use nonproprietary names of drugs, devices, and other products, unless the specific trade name of a drug is essential to the discussion.1(pp355-356)

Gene Names and Symbols
Consult the Human Genome Organisation Gene Nomenclature Committee site for gene names and symbols (http://www.gene.ucl.ac.uk/nomenclature).

Reproduced Material
MMJ does not republish text, tables, figures, or other material from other publishers, except under rare circumstances. Please delete any such material and replace with originals.

Acknowledgment Section
The “Acknowledgment section” is the general term for the list of contributions, credits, and other information included at the end of the text of a manuscript but before the references. The Acknowledgment section includes authors’ contributions; information on author access to data; disclosure of potential conflicts of interests, including financial interests and relationships; sources of funding and support; an explanation of the role of sponsor(s); information on independent statistical analysis (if required); names, degrees, and affiliations of members of a participants in a large study or other group; any important disclaimers; information on previous presentation of the information reported in the manuscript; and the names, degrees, affiliations, and indication if compensation has been received for all persons who have made substantial contributions to the work but who are not authors.

References
In style, references and abbreviations should follow the guidelines of the International Committee of Medical Journal Editors. The references should be typed entirely double-spaced, numbered consecutively and presented in superscript within the text. References that apply to tables or figures should be numbered in sequence where the text first refers to the table or figure concerned. Each numbered references should give the last names, initials, without punctuation, of all six if six or fewer. If there are more than six authors, provide the first three authors and et al. The titles of journals should be abbreviated according to the style used in Index Medicus. Do not use boldface or underlining when typing references.

Avoid using abstracts, “unpublished observations” and “personal communication” as references. References to written, not verbal, communications may be inserted as parentheses, identified by year in the text e.g. (Harries AD, 1998, personal communication). Manuscripts accepted but not yet published may be used only if designated followed by “in press”. Information submitted but not yet accepted should be cited in the text as “unpublished observations” (in parentheses). While all necessary references should be cited, it is preferable not to use an excessively large number. The references used must be verified by the author(s) against the original documents. Examples of correct forms of references are provided below.

Standard Journal Article
Audu R, Omilabu SA, Peenze I, Steele D. Viral diarrhoea in young children in two districts in Nigeria. Cent Afr J Med 2002; 48(5/6): 59-63

Book
Cooper RS, Ghali JK. Coronary heart disease: black-white differences. In: Saunders E, ed. Cardiovascular diseases in blacks. Philadelphia: F.A Davis Company; 1999: 205-25

Published Proceedings Paper
Tembo K, Magai D, Nyasulu YMZ. Proceedings of the Sixth College of Medicine Research Dissemination Conference, University of Malawi College of Medicine, 2002: 24

Tables
Tables should bear Arabic numerals. Each table should be put on a separate sheet of paper (using page break function). Each table should be self-explanatory, with an adequate title (clearly suggesting the contents), and logical presentation of data. The title should not repeat the information given in the headings. Use tables in order to present the exact values of the data that cannot be summarized in a few sentences in the text. Use tables instead of case reports unless a very small number of cases are presented. Avoid repetitive words in the columns: these should be coded, and their explanations given in the footnotes. Never present the same data in more than one way: present them in a table OR a figure. Data should be organized so that related elements read downward, not across. The data arranged in columns should correspond to the time sequence of their collection when read from left to right:
Age→ Sex→Symptoms→ Physical findings →Radiographs →Treatment →Outcome. Each column heading for numerical data should include the unit of measurement applied to all the data under the heading. Choose suitable SI units, so that the values given in the table should fall within the range 0-999. Large numbers can be expressed in smaller units with appropriate column headings (or footnotes). Headings such as ×103 for thousands should be avoided, as it is not clear whether the data given are to be or have already been multiplied by that factor. The precision of biological measurements seldom allows for more than 2 decimal digits. Tabular footnotes should be indicated with superscript lowercase letters. Use table grid option in MS Word for table lines (both vertical and horizontal). Place explanatory matter in footnotes, not in the heading. Explain in footnotes all nonstandard abbreviations that are used in each table.

Number all tables in the order of their citation in the text. Include a title for each table (a brief phrase, preferably no longer than 10 to 15 words). Include all tables in a single file following the manuscript. Refer to Categories of Articles because there may be a limit on the number of tables for the type of manuscript. If a table must be continued, repeat the title on a second sheet, followed by “(cont).”

Instructions for Table
Creation Contact the MMJ Editorial office for more information on this. Figures Diagrams, line drawings and photographs should be referred to as figures. They should be numbered in sequence with Arabic numerals. Legends to figures should be listed on a separate page, in the consecutive order. The legend of a figure should contain the following information:
(a) the word “Figure”, followed by its respective number;
(b) figure title;
(c) all the necessary explanations of symbols and findings, written continuously;
(d) statistics. Do not put the title of the figure on the figure! Several figures related to the same patient, eg, radiographs taken at different times, should be labeled Figure 1 A, B, C, etc. rather than Figures 1, 2, 3. Symbols should be consistent throughout a series of figures. Use simple symbols, like closed and open circles, triangles and squares. Different types of connecting lines can be used. The meanings of symbols and lines should be defined in the legend. The axes should be equal in length so as to make the diagrams square. They should normally be thinner than curve lines. Each axis should be labeled with a description of the variable it represents. Only the first letter of the first word should be capitalized. The labeling should be parallel with the respective axis.

All units should be expressed in SI units and parenthesized. Make liberal use of scale markings, directed outwards. Axes should not extend beyond the last numeral, and should never be terminated by arrows. Choose units so that the values expressed may fall within the between 0 and 999. All the values on a given axis should have the same number of decimals. If an axis is labeled in percentages, this should be indicated. If an axis is not continuous, this must be indicated by a clearly marked interruption.
Figures should be drawn professionally. Photographs must be sharp and glossy or delivered in high-quality electronic format. All micrographs must include a bar to indicate the scale. Graphs or charts must be provided as complete MS Excel files. Do not draw three-dimensional graphs if not absolutely necessary. Do not shade the background. Do not use grids. Most figures are properly presentable in column width, ie, 7.9 cm. Suitable line thickness for this format is 0.17-0.35 mm, and suitable type size for capital letters is 10 points. Radiographs should be cropped so as to present only what is essential. It is rarely necessary to show normal radiographs, even for the purpose of comparison. Frontal and lateral projections should be of the same scale and density, and corresponding details (eg, joint space) should be at the same level.

Number all figures (graphs, charts, photographs, and illustrations) in the order of their citation in the text. Include a title for each figure (a brief phrase, preferably no longer than 10 to 15 words). For initial manuscript submissions, figures must be of sufficient quality for editorial assessment and peer review. All graphs, charts, illustrations, titles, and legends of accepted manuscripts will be re-created or edited according to MMJ style and standards prior to publication. Digital images in accepted manuscripts will be reviewed to determine whether they have undergone improper modification .

Advice on preparing digital images
File names should be alphanumeric. Do not include any spaces or special characters.
The best file format is TIFF. We cannot accept PowerPoint files; also, files saved in TIF format from Power Point application are not at sufficiently high resolution to meet our formatting requirements. Submitted digital halftones of black and white photographic images must have an image resolution of at least 300 dpi at publication size. To check the size and resolution of the image in Adobe Photoshop, select “Image Size” in the “Image” menu. Make sure the “Resample Image” box in “Image Size” dialog window is not checked and the “Width,” “Height,” and “Resolution” boxes are linked by the graphic chain. (It may be necessary to click twice on the “Resample Image” box to establish this link.) This will mean that no resolution (ie dots or data) is lost when reducing the dimensions of an image and that the machine does not add dots to an image when increasing its dimensions. Set the print size to the desired size of the image in the printed journal and make sure that the resolution at this size is equal to or above 300 dpi. Please submit in the TIF format by selecting this choice in the format box of the “Save” dialog window. The resolution for color images should also be at least 300 dpi. Please submit files in RGB format. For published manuscripts, image files will be posted online in their original RGB format, maintaining the full color of your original files. When saving, always embed any ICC profile you have worked with. All profiles will be accurately converted to Adobe RGB. If possible, we recommend that authors use Adobe RGB when preparing files. Note that we will still need to convert all RGB files to CMYK for printing on paper and color shifts may occur in conversion.

You can view an approximation of print results by converting to CMYK in Photoshop or Illustrator. For line art, vector files should be created in an illustration program such as Adobe Illustrator and should be saved and submitted as EPS (Encapsulated PostScript). Only Times, Helvetica, Arial, or Symbol fonts should be used. Using other fonts may result in lost or improperly converted characters. All color art should be in RGB format. For figures with a combination of photographs and line art, prepare photographic image files in Photoshop as above at 300 dpi as described above. Prepare line art in Illustrator as above (if you will be importing color images, be sure to create an RGB Illustrator file). Image files should be placed into the file containing the line art. Always embed images, never link. In Illustrator, copying and pasting or dragging directly from Photoshop will embed the image. If you use the “Place” command, be sure to uncheck “Link” in the dialogue box. If you use another illustration program, please refer to the specific documentation for that application (generally there will be a “link,” “proxy” or “OPI” option on import which should be unchecked). Save as EPS, always embedding any color profile used. We recommend Adobe RGB.

Common mistakes in presenting Data
Averages (means) should be followed by ±SD, and medians by ranges (in parentheses). Percentages should not be given when the total sample number is less than 100. Otherwise, use absolute numbers, decimal fractions or “one third,” “three quarters,” etc. Percentages above 10 usually do not need decimals. Details on the style of scientific writing can be found in several excellent books.8

Acceptable Figure File Size
To reduce the time that it takes to upload files to the MMJ submission site and for reviewers to download files from the site, we recommend that the file size of figures be compressed before uploading them. This can be done by using compression software or by decreasing the resolution of individual files.

Acceptable Figure File Formats
At submission, the following file formats are acceptable: AI, BMP, DOC, EMF, EPS, JPG, PDF, PPT, PSD, TIF, WMF, or XLS. Figures may be embedded at the end of the manuscript text file or loaded as separate files for submission purposes.

Figure Legends (Captions)
Include a legend for each photograph, graph, and illustration at the end of the manuscript (maximum length, 40 words). For photomicrographs, include the type of specimen, original magnification or a scale bar, and stain. For gross pathology specimens, label any rulers with unit of measure

Number of Figures
Refer to Categories of Articles as there may be a limit on the number of figures for the type of manuscript.

Video
Video file formats acceptable at submission are MOV, AVI, MPEG, RM, and WM, and the file size should not exceed 5 MB with a maximum dimension of 800 pixels wide and/or 600 pixels deep.

Language
The language of the MMJ is UK English. The Editors retain the customary right to style and, if necessary, shorten texts accepted for publication. This does not mean that we prefer short articles –actually, we do not limit their size – but rather a resection of the obviously redundant material. The past tense is recommended in the Results Section. Avoid using Latin terms; if necessary, they should be added in parentheses after the English terms. Real names rather than “levels” or “values” should refer to parameters with concrete units (eg, concentration). Above all, the author should have in mind that his/her article is intended for a general medical journal and a general reader.

Copyright
Papers accepted remain the copyright of the Malawi Medical Journal. This ensures that requests from third parties to reproduce articles are handled efficiently and consistently and will also allow the article to be distributed as widely as possible. In assigning copyright, authors may use their own material in other publications provided that the journal is acknowledged as the original place of publication, and the Malawi Medical Journal notified in writing and in advance.

Editorial research
We are keen to better understand and improve editorial conduct, decision making, issues related to peer review and communication of science in general. Therefore, we occasionally take part in or conduct editorial research and your submitted manuscript might be used in such research. If you do not want your manuscript entered into such a study please let us know in your submission letter. Your decision to take part or not will have no effect on the editorial decision on your manuscript.

Communicating with the Editorial Office
We encourage contributors to communicate with the editorial office using e-mail. Other forms of communications are also acceptable.mmj@medcol.mw

Manuscript Checklist

    ϥ Review manuscript submission requirements in these instructions.
    ϥ Include a cover letter as an attachment.
    ϥ Designate a corresponding author and provide a complete postal/mail address, telephone and fax numbers, and e-mail address.
    ϥ Provide first (given) and last (family) names, e-mail addresses, and institutional affiliations for any coauthors.
    ϥ On the title page, include a word count for text only, exclusive of title, abstract, references, tables, and figure legends.
    ϥ Provide an abstract that conforms to the required abstract format.
    ϥ Double-space manuscript and leave right margins unjustified (ragged).
    ϥ Check all references for accuracy and completeness. Put references in proper format in numerical order, making sure each is cited in sequence in the text.
    ϥ Include a title for each table and figure (a brief, succinct phrase, preferably no longer than 10 to 15 words) and explanatory legend as needed.
    ϥ In the Acknowledgment section of the manuscript, include the names, academic degrees, affiliations, and specific contributions of all persons who have contributed to the work reported in the manuscript (eg, data collection, analysis, writing or editing assistance, review of manuscript) but who do not fulfill authorship criteria.
    ϥ If appropriate, include information on institutional review board/ethics committee approval or waiver and informed consent.
    ϥ The reproduction of material (including tables and figures) that was previously published are discouraged. Original material should be provided, except under extraordinary circumstances.
    ϥ Include informed consent forms for identifiable patient descriptions, photographs, and pedigrees.

References

  1. Iverson C, Flanagin A, Fontanarosa PB, et al. American Medical Association Manual of Style: A Guide fo Authors and Editors. 9th ed. Baltimore, Md: Williams & Wilkins; 1998.
  2. International Committee of Medical Journal Editors Uniform requirements for manuscripts submitted to biomedical journals. Available at: http://www.icmje.org.
  3. Flanagin A, Fontanarosa PB, DeAngelis CD. Authorship for research groups. JAMA. 2002;288:3166-3168.
  4. Fontanarosa PB, DeAngelis CD. Information for authors—2004. JAMA. 2004;291:107-108.
  5. World Medical Association Declaration of Helsinki: ethical principles for medical research involvinghuman subjects. Available at: http://www.wma.net/e/policy/pdf/17c.pdf.
  6. Moher D, Schulz KF, Altman D. CONSORT Group. The CONSORT statement: revised recommendations for improving the quality of reports of parallelgroup randomized trials. JAMA. 2001;285:1987-1991.
  7. World Medical Association. Helsinkiv Declaration. JAMA. 1964;190:175
  8. Huth EJ. Writing and publishing invmedicine. 3rd ed. Baltimore (MD):Williams & Wilkins; 1999.