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Aguolu OG, Kiti MC, Nelson K, Liu CY, Sundaram M, Gramacho S, Jenness S, Melegaro A, Sacoor C, Bardaji A, Macicame I, Jose A, Cavele N, Amosse F, Uamba M, Jamisse E, Tchavana C, Briones HGM, Jarquín C, Ajsivinac M, Pischel L, Ahmed N, Mohan VR, Srinivasan R, Samuel P, John G, Ellington K, Joaquim OA, Zelaya A, Kim S, Chen H, Kazi M, Malik F, Yildirim I, Lopman B, Omer SB. Comprehensive profiling of social mixing patterns in resource poor countries: a mixed methods research protocol. medRxiv 2023:2023.12.05.23299472. [PMID: 38105989 PMCID: PMC10723497 DOI: 10.1101/2023.12.05.23299472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Low-and-middle-income countries (LMICs) bear a disproportionate burden of communicable diseases. Social interaction data inform infectious disease models and disease prevention strategies. The variations in demographics and contact patterns across ages, cultures, and locations significantly impact infectious disease dynamics and pathogen transmission. LMICs lack sufficient social interaction data for infectious disease modeling. Methods To address this gap, we will collect qualitative and quantitative data from eight study sites (encompassing both rural and urban settings) across Guatemala, India, Pakistan, and Mozambique. We will conduct focus group discussions and cognitive interviews to assess the feasibility and acceptability of our data collection tools at each site. Thematic and rapid analyses will help to identify key themes and categories through coding, guiding the design of quantitative data collection tools (enrollment survey, contact diaries, exit survey, and wearable proximity sensors) and the implementation of study procedures.We will create three age-specific contact matrices (physical, nonphysical, and both) at each study site using data from standardized contact diaries to characterize the patterns of social mixing. Regression analysis will be conducted to identify key drivers of contacts. We will comprehensively profile the frequency, duration, and intensity of infants' interactions with household members using high resolution data from the proximity sensors and calculating infants' proximity score (fraction of time spent by each household member in proximity with the infant, over the total infant contact time) for each household member. Discussion Our qualitative data yielded insights into the perceptions and acceptability of contact diaries and wearable proximity sensors for collecting social mixing data in LMICs. The quantitative data will allow a more accurate representation of human interactions that lead to the transmission of pathogens through close contact in LMICs. Our findings will provide more appropriate social mixing data for parameterizing mathematical models of LMIC populations. Our study tools could be adapted for other studies.
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Affiliation(s)
| | | | - Kristin Nelson
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Carol Y. Liu
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Maria Sundaram
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | - Sergio Gramacho
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Samuel Jenness
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Alessia Melegaro
- DONDENA Centre for Research in Social Dynamics and Public Policy, Bocconi University, Italy
| | | | - Azucena Bardaji
- Manhiça Health Research Centre, Manhica, Mozambique
- ISGlobal, Hospital Clinic – Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ivalda Macicame
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | - Americo Jose
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | - Nilzio Cavele
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | | | - Migdalia Uamba
- Polana Caniço Health Research and Training Centre, CISPOC, Mozambique
| | | | | | | | - Claudia Jarquín
- Centro de Estudios en Salud (CES), Universidad del Valle de Guatemala
| | - María Ajsivinac
- Centro de Estudios en Salud (CES), Universidad del Valle de Guatemala
| | - Lauren Pischel
- Yale School of Medicine, Yale University, Connecticut, USA
| | - Noureen Ahmed
- Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center, Dallas, Texas
| | | | | | | | - Gifta John
- Christian Medical College Vellore, India
| | - Kye Ellington
- Rollins School of Public Health, Emory University, Georgia, USA
| | | | - Alana Zelaya
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Sara Kim
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Holin Chen
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Momin Kazi
- The Aga Khan University, Karachi, Pakistán
| | - Fauzia Malik
- Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center, Dallas, Texas
| | - Inci Yildirim
- Yale School of Medicine, Yale University, Connecticut, USA
| | - Benjamin Lopman
- Rollins School of Public Health, Emory University, Georgia, USA
| | - Saad B. Omer
- Peter O’Donnell Jr. School of Public Health at UT Southwestern Medical Center, Dallas, Texas
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Nhacolo A, Madewell ZJ, Muir JA, Sacoor C, Xerinda E, Matsena T, Jamisse E, Bassat Q, Whitney CG, Mandomando I, Cunningham SA. Knowledge of COVID-19 symptoms, transmission, and prevention: Evidence from health and demographic surveillance in Southern Mozambique. PLOS Glob Public Health 2023; 3:e0002532. [PMID: 37910574 PMCID: PMC10619866 DOI: 10.1371/journal.pgph.0002532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/02/2023] [Indexed: 11/03/2023]
Abstract
Understanding community members' knowledge of SARS-CoV-2 transmission and prevention is essential for directing public health interventions to reduce disease spread and improve vaccination coverage. Here, we describe knowledge of COVID-19 transmission, prevention, and symptoms among community residents in Mozambique. We conducted a cross-sectional survey among 33,087 households in a Health and Demographic Surveillance System in Manhiça, Mozambique. Participants were recruited in April 2021 before the Delta variant wave to the peak of Omicron cases in February 2022. Principal components analysis was used to create scores representing knowledge of COVID-19 symptoms, transmission, and prevention. Multiple imputation and quasi-Poisson regression were used to examine associations between demographic characteristics and sources of COVID-19 information, and knowledge of COVID-19 symptoms, transmission, and prevention. We examined whether sources of COVID-19 information mediated the relationship between educational attainment and knowledge of symptoms, transmission, and prevention. Across this rural community, 98.2%, 97.0%, and 85.1% of respondents reported knowing how COVID-19 could be prevented, that SARS-CoV-2 can cause disease, and how SARS-CoV-2 is transmitted, respectively. The most recognized COVID-19 symptoms were cough (51.2%), headaches (44.9%), and fever (44.5%); transmission mechanisms were saliva droplets (50.5%) or aerosol (46.9%) from an infected person; and prevention measures were handwashing (91.9%) and mask-wearing (91.8%). Characteristics associated with greater knowledge of symptoms, transmission, and prevention included having at least primary education, older age, employment, higher wealth, and Christian religion. Respondents who had experienced COVID-19 symptoms were also more likely to possess knowledge of symptoms, transmission, and prevention. Receiving information from television, WhatsApp, radio, and hospital, mediated the relationship between educational attainment and knowledge scores. These findings support the need for outreach and for community-engaged messaging to promote prevention measures, particularly among people with low education.
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Affiliation(s)
- Ariel Nhacolo
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Zachary J. Madewell
- Global Health Center, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | | | | | - Elisio Xerinda
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | - Edgar Jamisse
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Quique Bassat
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- ISGlobal—Hospital Clínic, Unversitat de Barcelona, Barcelona, Spain
- Institutó Catalana de Recerca I Estudis Avançats, Barcelona, Spain
- Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública, Madrid, Spain
| | | | - Inacio Mandomando
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
- ISGlobal—Hospital Clínic, Unversitat de Barcelona, Barcelona, Spain
- Instituto Nacional de Saúde, Maputo, Mozambique
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O’Bryan E, Imputiua S, Elobolobo E, Nicolas P, Montana J, Jamisse E, Munguambe H, Casellas A, Ruiz-Castillo P, Rabinovich R, Saute F, Sacoor C, Chaccour C. Burden and risk factors of snakebite in Mopeia, Mozambique: Leveraging larger malaria trials to generate data of this neglected tropical disease. PLoS Negl Trop Dis 2023; 17:e0011551. [PMID: 37590272 PMCID: PMC10464960 DOI: 10.1371/journal.pntd.0011551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/29/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Snakebite is a neglected disease that disproportionally affects the rural poor. There is a dearth of evidence regarding incidence and risk factors in snakebite-endemic countries. Without this basic data, it will be impossible to achieve the target of a 50% reduction of snakebite morbidity and mortality by 2030 as set by the World Health Organization. METHODS This was a descriptive analysis nested in a 2021 community-based demographic survey of over 70,000 individuals conducted in Mopeia, Mozambique, in preparation for a cluster randomized trial to test an intervention for malaria. We describe the incidence rate, demographics, socioeconomic indicators and outcomes of snakebite in this population. FINDINGS We found the incidence of self-reported snakebite in Mopeia to be 393 bites per 100,000 person-years at risk, with 2% of households affected in the preceding 12 months. Whilst no fatalities were recorded, over 3,000 days of work or school days were lost with an individual household economic impact higher than that of uncomplicated malaria. 1 in 6 of those affected did not fully recover at the time of the study. We found significant relationships between age older than 15, use of firewood for household fuel, and animal possession with snakebite. CONCLUSIONS This study exposes higher than expected incidence and burden of snakebite in rural Mozambique. Whilst snakebite elimination in Mozambique seems unattainable today, it remains a preventable disease with manageable sequelae. We have shown that snakebite research is particularly easy to nest in larger studies, making this a practical and cost-effective way of estimating its incidence.
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Affiliation(s)
- Emma O’Bryan
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | | | - Eldo Elobolobo
- Centro de Investigação em Saúde de Manhiça, Mopeia, Mozambique
| | - Patricia Nicolas
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Mopeia, Mozambique
| | - Julia Montana
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Mopeia, Mozambique
| | - Edgar Jamisse
- Centro de Investigação em Saúde de Manhiça, Mopeia, Mozambique
| | | | - Aina Casellas
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | | | - Regina Rabinovich
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Francisco Saute
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Charfudin Sacoor
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Carlos Chaccour
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
- Clinica Universidad de Navarra, Pamplona, Spain
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Xie K, Marathe A, Deng X, Ruiz-Castillo P, Imputiua S, Elobolobo E, Mutepa V, Sale M, Nicolas P, Montana J, Jamisse E, Munguambe H, Materrula F, Casellas A, Rabinovich R, Saute F, Chaccour CJ, Sacoor C, Rist C. Alternative approaches for creating a wealth index: the case of Mozambique. BMJ Glob Health 2023; 8:e012639. [PMID: 37643807 PMCID: PMC10465889 DOI: 10.1136/bmjgh-2023-012639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION The wealth index is widely used as a proxy for a household's socioeconomic position (SEP) and living standard. This work constructs a wealth index for the Mopeia district in Mozambique using data collected in year 2021 under the BOHEMIA (Broad One Health Endectocide-based Malaria Intervention in Africa) project. METHODS We evaluate the performance of three alternative approaches against the Demographic and Health Survey (DHS) method based wealth index: feature selection principal components analysis (PCA), sparse PCA and robust PCA. The internal coherence between four wealth indices is investigated through statistical testing. Validation and an evaluation of the stability of the wealth index are performed with additional household income data from the BOHEMIA Health Economics Survey and the 2018 Malaria Indicator Survey data in Mozambique. RESULTS The Spearman's rank correlation between wealth index ventiles from four methods is over 0.98, indicating a high consistency in results across methods. Wealth rankings and households' income show a strong concordance with the area under the curve value of ~0.7 in the receiver operating characteristic analysis. The agreement between the alternative wealth indices and the DHS wealth index demonstrates the stability in rankings from the alternative methods. CONCLUSIONS This study creates a wealth index for Mopeia, Mozambique, and shows that DHS method based wealth index is an appropriate proxy for the SEP in low-income regions. However, this research recommends feature selection PCA over the DHS method since it uses fewer asset indicators and constructs a high-quality wealth index.
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Affiliation(s)
- Kexin Xie
- Department of Statistics, Virginia Tech, Blacksburg, Virginia, USA
| | - Achla Marathe
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, Virginia, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Xinwei Deng
- Department of Statistics, Virginia Tech, Blacksburg, Virginia, USA
| | - Paula Ruiz-Castillo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | | | - Eldo Elobolobo
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Victor Mutepa
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Mussa Sale
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Patricia Nicolas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Julia Montana
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Edgar Jamisse
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | | | - Aina Casellas
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Regina Rabinovich
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Francisco Saute
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Carlos J Chaccour
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Madrid, Spain
- Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
| | | | - Cassidy Rist
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, USA
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Ruiz-Castillo P, Imputiua S, Xie K, Elobolobo E, Nicolas P, Montaña J, Jamisse E, Munguambe H, Materrula F, Casellas A, Deng X, Marathe A, Rabinovich R, Saute F, Chaccour C, Sacoor C. BOHEMIA a cluster randomized trial to assess the impact of an endectocide-based one health approach to malaria in Mozambique: baseline demographics and key malaria indicators. Malar J 2023; 22:172. [PMID: 37271818 DOI: 10.1186/s12936-023-04605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Many geographical areas of sub-Saharan Africa, especially in rural settings, lack complete and up-to-date demographic data, posing a challenge for implementation and evaluation of public health interventions and carrying out large-scale health research. A demographic survey was completed in Mopeia district, located in the Zambezia province in Mozambique, to inform the Broad One Health Endectocide-based Malaria Intervention in Africa (BOHEMIA) cluster randomized clinical trial, which tested ivermectin mass drug administration to humans and/or livestock as a potential novel strategy to decrease malaria transmission. METHODS The demographic survey was a prospective descriptive study, which collected data of all the households in the district that accepted to participate. Households were mapped through geolocation and identified with a unique identification number. Basic demographic data of the household members was collected and each person received a permanent identification number for the study. RESULTS 25,550 households were mapped and underwent the demographic survey, and 131,818 individuals were registered in the district. The average household size was 5 members and 76.9% of households identified a male household head. Housing conditions are often substandard with low access to improved water systems and electricity. The reported coverage of malaria interventions was 71.1% for indoor residual spraying and 54.1% for universal coverage of long-lasting insecticidal nets. The median age of the population was 15 years old. There were 910 deaths in the previous 12 months reported, and 43.9% were of children less than 5 years of age. CONCLUSIONS The study showed that the district had good coverage of vector control tools against malaria but sub-optimal living conditions and poor access to basic services. The majority of households are led by males and Mopeia Sede/Cuacua is the most populated locality in the district. The population of Mopeia is young (< 15 years) and there is a high childhood mortality. The results of this survey were crucial as they provided the household and population profiles and allowed the design and implementation of the cluster randomized clinical trial. Trial registration NCT04966702.
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Affiliation(s)
| | | | - Kexin Xie
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Eldo Elobolobo
- Centro de Investigaçao em Saúde de Manhiça, Manhiça, Mozambique
| | - Patricia Nicolas
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaçao em Saúde de Manhiça, Manhiça, Mozambique
| | - Julia Montaña
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigaçao em Saúde de Manhiça, Manhiça, Mozambique
| | - Edgar Jamisse
- Centro de Investigaçao em Saúde de Manhiça, Manhiça, Mozambique
| | | | | | - Aina Casellas
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Xinwei Deng
- Department of Statistics, Virginia Tech, Blacksburg, VA, USA
| | - Achla Marathe
- Network Systems Science and Advanced Computing Division, Biocomplexity Institute, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Regina Rabinovich
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Harvard T.H. Chan School of Public Health, Boston, USA
| | - Francisco Saute
- Centro de Investigaçao em Saúde de Manhiça, Manhiça, Mozambique
| | - Carlos Chaccour
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Ciberinfec, Madrid, Spain
- Universidad de Navarra, Pamplona, Spain
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Sacoor C, Vitorino P, Nhacolo A, Munguambe K, Mabunda R, Garrine M, Jamisse E, Magaço A, Xerinda E, Sitoe A, Fernandes F, Carrilho C, Maixenchs M, Chirinda P, Nhampossa T, Nhancale B, Rakislova N, Bramugy J, Nhacolo A, Ajanovic S, Valente M, Massinga A, Varo R, Menéndez C, Ordi J, Mandomando I, Bassat Q. Child Health and Mortality Prevention Surveillance (CHAMPS): Manhiça site description, Mozambique. Gates Open Res 2023. [DOI: 10.12688/gatesopenres.13931.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The Manhiça Health Research Centre (Manhiça HDSS) was established in 1996 in Manhiça, a rural district at Maputo Province in the southern part of Mozambique with approximately 49,000 inhabited households, a total population of 209.000 individuals, and an annual estimated birth cohort of about 5000 babies. Since 2016, Manhiça HDSS is implementing the Child Health and Mortality Prevention Surveillance (CHAMPS) program aiming to investigate causes of death (CoD) in stillbirths and children under the age of 5 years using, among other tools, the innovative post-mortem technique known as Minimally Invasive Tissue sampling (MITS). Both in-hospital and community pediatric deaths are investigated using MITS. For this, community-wide socio-demographic approaches (notification of community deaths by key informants, formative research involving several segments of the community, availability of free phone lines for notification of medical emergencies and deaths, etc.) are conducted alongside to foster community awareness, involvement and adherence as well as to compute mortality estimates and collect relevant information of health and mortality determinants. The main objective of this paper is to describe the Manhiça Health and Demographic Surveillance System (HDSS) site and the CHAMPS research environment in place including the local capacities among its reference hospital, laboratories, data center and other relevant areas involved in this ambitious surveillance and research project, whose ultimate aim is to improve child survival through public health actions derived from credible estimates and understanding of the major causes of childhood mortality in Mozambique.
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Nhacolo A, Jamisse E, Augusto O, Matsena T, Hunguana A, Mandomando I, Arnaldo C, Munguambe K, Macete E, Alonso P, Saúte F, Sacoor C. Cohort Profile Update: Manhiça Health and Demographic Surveillance System (HDSS) of the Manhiça Health Research Centre (CISM). Int J Epidemiol 2021; 50:395. [PMID: 33452521 PMCID: PMC8128467 DOI: 10.1093/ije/dyaa218] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Ariel Nhacolo
- Manhiça Health Research Center, Manhiça District, Mozambique
| | - Edgar Jamisse
- Manhiça Health Research Center, Manhiça District, Mozambique
| | - Orvalho Augusto
- Manhiça Health Research Center, Manhiça District, Mozambique
| | | | - Aura Hunguana
- Manhiça Health Research Center, Manhiça District, Mozambique
| | - Inácio Mandomando
- Manhiça Health Research Center, Manhiça District, Mozambique.,National Institute of Health, Ministry of Health, Maputo, Mozambique
| | - Carlos Arnaldo
- Eduardo Mondlane University, Mozambique, Maputo, Mozambique
| | - Khátia Munguambe
- Manhiça Health Research Center, Manhiça District, Mozambique.,Eduardo Mondlane University, Mozambique, Maputo, Mozambique
| | - Eusébio Macete
- Manhiça Health Research Center, Manhiça District, Mozambique.,National Directorate of Health, Ministry of Health, Maputo, Mozambique
| | - Pedro Alonso
- Manhiça Health Research Center, Manhiça District, Mozambique.,Barcelona Institute for Global Health, Barcelona, Spain
| | - Francisco Saúte
- Manhiça Health Research Center, Manhiça District, Mozambique
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Marbán-Castro E, Sacoor C, Nhacolo A, Augusto O, Jamisse E, López-Varela E, Casellas A, Aponte JJ, Bassat Q, Sigauque B, Macete E, Garcia-Basteiro AL. BCG vaccination in southern rural Mozambique: an overview of coverage and its determinants based on data from the demographic and health surveillance system in the district of Manhiça. BMC Pediatr 2018; 18:56. [PMID: 29439702 PMCID: PMC5811981 DOI: 10.1186/s12887-018-1003-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 01/23/2018] [Indexed: 12/29/2022] Open
Abstract
Background Over the past four decades, the World Health Organization established the Expanded Programme on Immunization (EPI) to foster universal access to all relevant vaccines for all children at risk. The success of this program has been undeniable, but requires periodic monitoring to ensure that coverage rates remain high. The aim of this study was to measure the BCG vaccination coverage in Manhiça district, a high TB burden rural area of Southern Mozambique and to investigate factors that may be associated with BCG vaccination. Methods We used data from the Health and Demographic Surveillance System (HDSS) run by the Manhiça Health Research Centre (CISM) in the district of Manhiça. A questionnaire was added in the annual HDSS round visits to retrospectively collect the vaccination history of children under the age of 3 years. Vaccinations are registered in the National Health Cards which are universally distributed at birth. This information was collected for children born from 2011 to 2014. Data on whether a child was vaccinated for BCG were collected from these National Health Cards and/or BCG scar assessment. Results A total of 10,875 number of children were eligible for the study and 7903 presented the health card. BCG coverage was 97.4% for children holding a health card. A BCG-compatible scar was observed in 99.0% of all children and in 99.6% of children with recorded BCG in the card. A total of 93.4% of children had been vaccinated with BCG within their first 28 days of life. None of the factors analysed were found to be associated with lack of BCG vaccination except for living in the municipality of Maluana compared to living in the municipality of Manhiça; (OR = 1.89, 95% CI: 1.18-3.00). Coverage for other EPI vaccines during the first year of life was similarly high, but decreased for subsequent doses. Conclusions BCG coverage is high and timely administered. Almost all vaccinated infants develop scar, which is a useful proxy for monitoring BCG vaccine implementation. Electronic supplementary material The online version of this article (10.1186/s12887-018-1003-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elena Marbán-Castro
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, C/Rosselló 132, 08036, Barcelona, Spain
| | - Charfudin Sacoor
- Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Ariel Nhacolo
- Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Orvalho Augusto
- Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Edgar Jamisse
- Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Elisa López-Varela
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, C/Rosselló 132, 08036, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Aina Casellas
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, C/Rosselló 132, 08036, Barcelona, Spain
| | - John J Aponte
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, C/Rosselló 132, 08036, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Quique Bassat
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, C/Rosselló 132, 08036, Barcelona, Spain.,Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique.,ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - Betuel Sigauque
- Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Eusebio Macete
- Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique
| | - Alberto L Garcia-Basteiro
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, C/Rosselló 132, 08036, Barcelona, Spain. .,Centro de Investigação em Saúde da Manhiça (CISM), Rua 12, Vila de Manhiça, CP 1929, Maputo, Mozambique. .,Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands.
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