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Cambaco O, Cossa H, Farnham A, Macete E, Winkler MS, Gross K, Munguambe K. Applying the photovoice method with adolescents in mining areas in rural Mozambique: critical reflections and lessons learned. Glob Health Action 2024; 17:2305506. [PMID: 38323354 PMCID: PMC10851835 DOI: 10.1080/16549716.2024.2305506] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
There is a recognised need for innovative methods to elicit the perspective of adolescents on public health issues, particularly when addressing sensitive topics such as the impact of mining projects on their health. Participatory approaches such as "photovoice" allow for deep engagement of vulnerable and marginalised populations, including adolescents. However, few existing studies have used the photovoice method to reflect on issues related to the environment and its impact on public health. To date, no studies have been found that have used photovoice to gain insight into adolescents' perspectives in mining areas. In this paper, we discuss the application of the photovoice method to understand adolescents' perceptions about the impact of mining on their health and well-being in rural areas in Mozambique. The study was conducted in northern and central Mozambique. Photovoice was successfully integrated into eight focus group discussions with adolescent girls and boys aged 15 to 17 years. Several lessons for guiding future research were learned. First, it provided an understanding of the perceived impacts of mining on their health and well-being. Second, photovoice promoted active engagement and interest in the study by the adolescents. Finally, compared to its ability to capture perceptions of physical and environmental aspects affecting adolescents' well-being, the method was less straightforward in revealing their concerns regarding social, relational and community aspects that are less tangible. Programs can make use of photovoice to address health issues without setting adolescents' views and priorities aside, allowing them to influence health decisions on issues that are meaningful to them. Future studies should explore strategies to minimise the role of the power dynamics that affect the engagement and contribution of adolescents in advocating for necessary and meaningful changes. Additionally, it is important to investigate how health programs and policies can help to reduce the impact of existing inequalities.
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Affiliation(s)
- Olga Cambaco
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
- Population Studies Unit, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Hermínio Cossa
- Population Studies Unit, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Andrea Farnham
- Department of Public Health & Global Health, Division of Infectious Diseases, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Eusébio Macete
- Population Studies Unit, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Mirko S. Winkler
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Karin Gross
- Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute (Swiss TPH), Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Khátia Munguambe
- Population Studies Unit, Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Community Health Department, Faculty of Medicine, University Eduardo Mondlane (UEM), Maputo, Mozambique
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Shannon J, Kagone M, Candrinho B, Otikwu S, Ingabire C, Gansane A, Pooda S, Aboubacar F, Ouattara F, Savaio B, Joanguete C, Sixpence L, Koenker H, Uhomoibhi P, Okoko OO, Ali O, Babarinde D, Ogundairo J, Lemah AS, Mbituyumuremyi A, Singirankabo JH, Kawakyu N, Guglielmo F, Fornadel C, Arnett K, Wagman J, Gogue C, Tynuv K, Digre P, Mwesigwa J, Robertson M. A qualitative look at bed net access and use in Burkina Faso, Mozambique, Nigeria, and Rwanda following piloted distributions of dual-active ingredient insecticide-treated nets. Malar J 2024; 23:137. [PMID: 38715035 PMCID: PMC11077758 DOI: 10.1186/s12936-024-04868-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Universal coverage with insecticide-treated nets (ITNs) is important for malaria control and elimination. The emergence and intensification of insecticide resistance threatens progress made through the deployment of these interventions and has required the development of newer, more expensive ITN types. Understanding malaria prevention behaviour, including barriers and facilitators to net access and use, can support effective decision-making for the promotion and distribution of ITNs. METHODS In-depth interviews and focus group discussions were conducted in 3 to 4 villages per district, in 13 districts across Burkina Faso, Mozambique, Nigeria and Rwanda from 2019 to 2022. Interviews were conducted in the local language, translated and transcribed in English, French or Portuguese. Transcripts were coded and analysed using Nvivo and ATLAS.ti. RESULTS ITNs were obtained from mass distribution campaigns, antenatal care and immunization visits, and purchased on the private market in some locations. While there were divergent perspectives in whether the number of distributed nets were adequate, participants consistently expressed concerns of bias, discrimination, and a lack of transparency with the distribution process. ITNs were frequently used alongside other malaria prevention methods. The primary motivation for use was malaria prevention. While some participants reported using nets nightly throughout the year, other participants reported seasonal use, both due to the perceived higher density of mosquitoes and discomfort of sleeping under a net in the increased heat. Other barriers to consistent net use included activities that take place away from the home, sleeping patterns and arrangements, and sensitivity to the insecticides on the nets. CONCLUSIONS ITNs remain an important malaria control intervention. To ensure adequate and increased net access, distribution campaigns should consider family structures, available sleeping spaces, and other bed sharing preferences when identifying the number of nets needed for distribution. In addition, campaigns should allow for multiple options for net distribution points and timing to accommodate households remote to health services. Continuous distribution channels and complimentary distribution through the private sector could help fill gaps in coverage. Solutions are needed for outdoor malaria transmission, including alternative designs for ITNs, and improving access to complementary personal protective measures.
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Affiliation(s)
| | - Moubassira Kagone
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Baltazar Candrinho
- National Malaria Control Programme, Ministry of Health, Maputo, Mozambique
| | | | | | - Adama Gansane
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Samy Pooda
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Fofana Aboubacar
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Fatou Ouattara
- Centre National de Recherche et de Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | | | | | | | | | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Okefu Oyale Okoko
- National Malaria Elimination Programme, Federal Ministry of Health, Abuja, Nigeria
| | - Onoja Ali
- Ibolda Health International, Abuja, Nigeria
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Bai L, Zhu G, Huang H, Zhang L, LÜ H, Zhang Y. Characteristics of mesoscale eddies in the Mozambique Channel. PLoS One 2024; 19:e0302367. [PMID: 38683798 PMCID: PMC11057766 DOI: 10.1371/journal.pone.0302367] [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: 10/27/2023] [Accepted: 04/02/2024] [Indexed: 05/02/2024] Open
Abstract
The mesoscale eddy characteristics of the Mozambique Warm Current were investigated by detecting and tracking satellite altimetry data from 2010 to 2019. A total of 1,086 eddies were identified in the Mozambique Channel, comprising 509 cyclonic eddies and 577 anticyclonic eddies. The results revealed that the bay area on the northwest coast of Madagascar was the main hotspot of eddy generation, and the mean amplitude and radius of the anticyclonic eddies in the Mozambique Channel were 24.23 cm and 82.7 km, respectively, which are larger than those of the cyclonic eddies. Local wind forcing had a significant impact on the formation of mesoscale eddies in the Mozambique Channel. In winter, the wind stress in the northern and southern areas of the Mozambique Channel exhibited a strong correlation with the distribution of eddy kinetic energy (EKE), where both monsoonal winds in the north and trade winds in the south could facilitate mesoscale anticyclonic eddy formation. In addition, the variability in the number of anticyclonic and cyclonic eddies in the Mozambique Channel may have exerted a significant influence on the seasonal anomalous fluctuations in local sea surface temperatures (SSTs). This study presented a novel analysis of the mesoscale eddy characteristics in the Mozambique Channel.
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Affiliation(s)
- Linfei Bai
- Jiangsu Key Laboratory of Marine Bioresources and Environment /Jiangsu Key Laboratory of Marine Bio-technology, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
- Lianyungang Meteorological Bureau, Lianyungang, Lianyungang, Jiangsu Province, China
| | - Guohao Zhu
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
| | - Haojie Huang
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
| | - Liqiong Zhang
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
| | - Haibin LÜ
- Jiangsu Key Laboratory of Marine Bioresources and Environment /Jiangsu Key Laboratory of Marine Bio-technology, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang, Jiangsu Province, China
| | - Yinyi Zhang
- Lianyungang Meteorological Bureau, Lianyungang, Lianyungang, Jiangsu Province, China
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Janmohamed A, Doledec D, Dissieka R, Jalloh UH, Juneja S, Beye M, Ndiaye F, Jumbe T, Baker MM. Vitamin A supplementation coverage and associated factors for children aged 6 to 59 months in integrated and campaign-based delivery systems in four sub-Saharan African countries. BMC Public Health 2024; 24:1189. [PMID: 38678255 PMCID: PMC11055222 DOI: 10.1186/s12889-024-18707-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/24/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Vitamin A deficiency (VAD) is a leading contributor to the poor health and nutrition of young children in sub-Saharan Africa. Funding constraints are compelling many countries to shift from longstanding campaigns to integrating vitamin A supplementation (VAS) into routine health services. We assessed child VAS coverage and associated factors for integrated delivery systems in Mozambique, Senegal, and Sierra Leone and for a campaign-based delivery strategy in Tanzania. METHODS Data were obtained using representative household surveys administered to primary caregivers of N = 16,343 children aged 6-59 months (Mozambique: N = 1,659; Senegal: N = 7,254; Sierra Leone: N = 4,149; Tanzania: N = 3,281). Single-dose VAS coverage was assessed and bivariate and multivariable associations were examined for child VAS receipt with respect to rural or urban residence; child age and sex; maternal age, education, and VAS program knowledge; and household wealth. RESULTS VAS coverage for children aged 6-59 months was 42.8% (95% CI: 40.2, 45.6) in Mozambique, 46.1% (95% CI: 44.9, 47.4) in Senegal, 86.9% (95% CI: 85.8, 87.9) in Sierra Leone, and 42.4% (95% CI: 40.2, 44.6) in Tanzania and was significantly higher for children 6-11 vs. 24-59 months in Mozambique, Senegal, and Tanzania. In Sierra Leone, children aged 12-23 months (aOR = 1.86; 95% CI: 1.20, 2.86) and 24-59 months (aOR = 1.55; 95% CI: 1.07, 2.25) were more likely to receive VAS, compared to those 6-11 months. Maternal awareness of VAS programs was associated with higher uptake in Mozambique (aOR = 4.00; 95% CI: 2.81, 5.68), Senegal (aOR = 2.72; 95% CI: 2.35, 3.15), and Tanzania (aOR = 14.50; 95% CI: 10.98, 19.17). Increased household wealth was associated with a higher likelihood of child VAS in Senegal and Tanzania. CONCLUSIONS Our findings indicate routine delivery approaches for VAS are not achieving the level of coverage needed for public health impact in these settings. Intensive outreach efforts contributed to the higher coverage in Sierra Leone and highlight the importance of reducing the burdens associated with seeking supplementation at health facilities. As countries move towards incorporating VAS into routine health services, the essentiality of informed communities and potential losses for older children and socio-economically disadvantaged populations are key considerations in the sub-Saharan African context.
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Affiliation(s)
- Amynah Janmohamed
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - David Doledec
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - Romance Dissieka
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya
| | - Umu H Jalloh
- Helen Keller International, Freetown, Sierra Leone
| | | | | | | | | | - Melissa M Baker
- Helen Keller International Vitamin A Supplementation Africa Regional Office, Nairobi, Kenya.
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Harris E. WHO Documents Rising Resistance to First-Line HIV Drug. JAMA 2024; 331:1355. [PMID: 38578630 DOI: 10.1001/jama.2024.4497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
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De Schacht C, Amorim G, Calvo L, Ntasis E, Van Rompaey S, Matsimbe J, Martinho S, Graves E, Sardella Alvim MF, Green A, Kassim H, Carlos IC, Wester CW, Audet CM. Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique. PLoS One 2024; 19:e0299282. [PMID: 38635537 PMCID: PMC11025808 DOI: 10.1371/journal.pone.0299282] [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: 05/03/2023] [Accepted: 02/07/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Patient satisfaction with clinical services can have an effect on retention in HIV care and adherence to antiretroviral therapy. This study assessed patient satisfaction and its association with retention and viral suppression in Zambézia Province, Mozambique. METHODS Monthly exit interviews with persons living with HIV were completed from August 2017-January 2019 in 20 health facilities; clinical data were extracted from medical records. Regression analyses assessed the effect of satisfaction scores on retention and viral suppression, adjusting for age, sex, education, civil status, time on treatment, and site. Satisfaction scores were correlated with time spent at health facilities using generalized linear regression models. RESULTS Data from 4388 patients were analyzed. Overall median satisfaction score was 75% (IQR 53%-84%); median time spent at facilities (from arrival until completion of clinical services) was 2h54min (IQR 1h48min-4h). Overall satisfaction score was not associated with higher odds of retention or viral suppression, but association was seen between satisfaction regarding attention given to patient and respect and higher odds of viral suppression. Patient satisfaction was negatively associated with time spent in facility (Spearman's correlation -0.63). Increased time spent at facility (from 1 to 3 hours) was not associated with lower retention in care (OR 0.72 [95%CI:0.52-1.01] and 0.83 [95%CI: 0.63-1.09] at 6- and 12-months, respectively), nor with a lower odds of viral suppression (OR 0.96 [95%CI: 0.71-1.32]). CONCLUSIONS Strategies to reduce patient wait times at the health facility warrant continued prioritization. Differentiated models of care have helped considerably, but novel approaches are still needed to further decongest crowded health facilities. In addition, a good client-provider communication and positive attitude can improve patient satisfaction with health services, with an overall improved retention.
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Affiliation(s)
| | - Gustavo Amorim
- Department of Biostatistics, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
| | - Lázaro Calvo
- Friends in Global Health (FGH), Quelimane, Mozambique
| | | | | | | | | | - Erin Graves
- Vanderbilt Institute for Global Health (VIGH), Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
| | | | - Ann Green
- Vanderbilt Institute for Global Health (VIGH), Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
| | - Hidayat Kassim
- Provincial Health Directorate of Zambézia, Quelimane, Mozambique
- United Nations Funds for Development (UNFDP), Beira, Mozambique
| | - Inoque Carlos Carlos
- Operations Research Unit, Provincial Health Directorate of Zambézia, Quelimane, Mozambique
| | - C. William Wester
- Vanderbilt Institute for Global Health (VIGH), Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
- Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
| | - Carolyn M. Audet
- Vanderbilt Institute for Global Health (VIGH), Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
- Department of Health Policy, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, United States of America
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Nguenha N, Rodriguez C, Drope J, Bialous SA, Cunguara B, Lencucha R. Tobacco policy (in)coherence in Mozambique: an examination of national and subnational stakeholder perspectives. Health Policy Plan 2024; 39:333-343. [PMID: 38459919 PMCID: PMC11005848 DOI: 10.1093/heapol/czae010] [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: 06/28/2023] [Revised: 01/18/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024] Open
Abstract
Mozambique ranks fifth on the list of tobacco producing countries in Africa, while also being a Party to the WHO Framework Convention on Tobacco Control (FCTC). Tobacco farming is regarded by some governments as a strategic economic commodity for export and remains deeply entrenched within Mozambique's political and economic landscape. This study uses a qualitative description methodology to identify tensions, conflicts and alignment or misalignment in policy on tobacco across government sectors and levels in Mozambique. We conducted semi-structured qualitative interviews with 33 key informants from sectors across national and subnational levels including health, agriculture, economic and commercial sectors, as well as non-state actors from civil society organizations, the tobacco industry, farmers unions and associations and individual farmers. Incoherence was present across sectoral mandates, perspectives on industry's presence in the country and regions and between FCTC provisions and informant perceptions of tobacco production as a development strategy. Despite tobacco being viewed as an important economic commodity by many informants, there was also widespread dissatisfaction with tobacco from both farmers and some government officials. There were indications of an openness to shifting to a policy that emphasizes alternatives to tobacco growing. The findings also illustrate where points of convergence exist across sectors and where opportunities for aligning tobacco policy with the provisions of the FCTC can occur.
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Affiliation(s)
- Nicole Nguenha
- Global Alliance for Tobacco Control, 1 Nicholas St, Suite 1004, Ottawa, Ontario K1N 7B7, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, Montreal, Quebec H3S 1Z1, Canada
| | - Jeffrey Drope
- Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, Maryland 21205, USA
| | - Stella Aguinaga Bialous
- School of Nursing and Center for Tobacco Control Research and Education, University of California San Francisco, 2 Koret Way, San Francisco, California 94143, USA
| | - Benedito Cunguara
- Ministry of Economy and Finance, Gabinete de Desenvolvimento do Compacto II, Avenida 10 de Novembro, Praça da Marinha, Nº 929, Maputo 929, Mozambique
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 Promenade Sir William Osler, Montreal, Quebec H3G 1Y5, Canada
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Mariner-Llicer C, Saavedra Cervera B, Mambuque E, Gomes N, Munguambe S, Villamayor L, Cancino-Muñoz I, Torres-Puente M, Nguenha D, Respeito D, Tembe G, López MG, Comas I, García-Basteiro AL. Monitoring of First-line Drug Resistance Mutations Outside the Scope of Xpert MTB/RIF Ultra is Needed for Successful Control of DR-TB in Southern Mozambique. Clin Infect Dis 2024; 78:842-845. [PMID: 38048599 PMCID: PMC11006097 DOI: 10.1093/cid/ciad684] [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: 08/02/2023] [Indexed: 12/06/2023] Open
Abstract
Multidrug-resistant(MDR) tuberculosis in Southern Africa is of great concern, exacerbated by the spread of a clone harboring a mutation missed by Xpert Ultra. In Southern Mozambique, the presence of such mutation and rising cases of non-MDR isoniazid resistance highlights the need to ensure accurate detection of antimicrobial-resistance in the country.
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Affiliation(s)
- Carla Mariner-Llicer
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain
| | - Belén Saavedra Cervera
- ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Edson Mambuque
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Neide Gomes
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Shilzia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | | | - Irving Cancino-Muñoz
- FISABIO Public Health, Valencia, Spain
- I2SysBio, Universitat de València CSIC, Valencia, Spain
| | - Manuela Torres-Puente
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain
| | - Dinis Nguenha
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Amsterdam Institute for Global Health & Development (AIGHD), Amsterdam, The Netherlands
| | - Durval Respeito
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Gustavo Tembe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Mariana G López
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain
| | - Iñaki Comas
- Tuberculosis Genomics Unit, Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain
- CIBER in Epidemiology and Public Health, Madrid, Spain
| | - Alberto L García-Basteiro
- ISGlobal, Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
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Alafo C, Montoya LF, Martí-Soler H, Máquina M, Malheia A, Sacoor C, Abílio AP, Marrenjo D, Cuamba N, Galatas B, Aide P, Saúte F, Paaijmans KP. An evaluation of LLIN physical integrity and population attitudes towards net use, care and handling during the Magude project in southern Mozambique. Malar J 2024; 23:87. [PMID: 38532416 PMCID: PMC10967156 DOI: 10.1186/s12936-024-04910-5] [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: 12/20/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND The Magude Project assessed the feasibility of eliminating malaria in Magude district, a low transmission setting in southern Mozambique, using a package of interventions, including long-lasting insecticidal nets (LLINs). As the efficacy of LLINs depends in part on their physical integrity, this metric was quantified for Olyset® Nets post mass-distribution, in addition to net use, care and handling practices and other risk factors associated with net physical integrity. METHODS Nets were collected during a cross-sectional net evaluation, nine months after the Magude project commenced, which was 2 years after the nets were distributed by the National Malaria Control Programme (NMCP). The physical integrity of the nets was assessed by counting and sizing the holes at different positions on each net. A structured questionnaire was administered to assess how the selected net was used and treated (care, wash and repair). Net bio-efficacy was assessed following the standard World Health Organization (WHO) cone bioassay procedures. RESULTS Out of the 170 Olyset® Nets included in the analysis, 63.5% had been used the night before. The main reason for not using a net was the notion that there were no mosquitoes present. The average number of people using each net was 1.79. Two thirds of the nets had only been washed once or twice since distribution. Most nets (80.9%) were holed and 18% were torn, but none of the risk factors were significantly associated with net integrity, except for presence of mice in the household. Less than half of the participants noticed holes in holed nets, and of those only 38.6% attempted to repair those. None of the six nets that were tested for bio-efficacy passed the WHO threshold of 80% mosquito mortality. CONCLUSION Overall the majority of Olyset® Nets were in serviceable condition two years post-distribution, but their insecticidal effect may have been lost. This study-together with previous evidence on suboptimal access to and use of LLINs in Magude district-highlights that LLINs as an intervention could have been optimized during the Magude project to achieve maximum intervention impact.
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Affiliation(s)
- Celso Alafo
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
| | - Lucia Fernandez Montoya
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
- ISGlobal, Barcelona, Spain
| | | | - Mara Máquina
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
| | - Arlindo Malheia
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
| | - Ana Paula Abílio
- Instituto Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Dulcisaria Marrenjo
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
| | - Nelson Cuamba
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
- PMI VectorLink Project, Abt Associates Inc., Maputo, Mozambique
| | - Beatriz Galatas
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
- ISGlobal, Barcelona, Spain
- Global Malaria Program, World Health Organization, Geneva, Switzerland
| | - Pedro Aide
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
- Instituto Nacional da Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique
| | - Krijn P Paaijmans
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Maputo, Mozambique.
- ISGlobal, Barcelona, Spain.
- Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, AZ, USA.
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, USA.
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Uwamahoro NS, Forsyth J, Andre F, Mandlate DA, Gilmore B, Muhajarine N. Realist evaluation of maternity waiting home intervention models in Inhambane, Mozambique: protocol for a comparative embedded case study, the Mozambique-Canada Maternal Health Project. BMJ Open 2024; 14:e075681. [PMID: 38521527 PMCID: PMC10961506 DOI: 10.1136/bmjopen-2023-075681] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/28/2024] [Indexed: 03/25/2024] Open
Abstract
INTRODUCTION This is a study protocol that tests and refines realist theories regarding the uptake and scale-up of the linked maternity waiting home (hereafter MWH) and facility birth intervention in the Mozambican context. The theories were developed through a realist review of MWH-facility birth literature from low-income and middle-income countries. The aim of the proposed study is to contribute to a contextually refined understanding of the causal chains underlying MWH-facility birth adoption by pregnant women and their families, communities, the health system and donors. METHODS AND ANALYSIS The overarching methodology is mixed-methods realist evaluation. The study will adopt a comparative embedded case study design comparing three new masonry MWHs built by the Mozambique-Canada Maternal Health Project in Inhambane province with three older MWHs selected based on variation in the built environment. Baseline data on participating MWH-facility birth interventions will be collected through observations, reviews of routine data and analysis of statistics and reports from provincial and district health authorities and the Mozambique-Canada Maternal Health project. Realist interviews will be conducted with MWH users and non-users, companions of MWH users and non-users, partners of MWH users and non-users, and stakeholders within the health system and the non-governmental organisation sector. Realist focus groups will be used to collect data from community-level implementers. The analysis will be retroductive and use the context-mechanism-outcome configuration heuristic tool to represent generative causation. We will analyse data from intervention and comparator MWHs independently and compare the resulting refined programme theories. Data analysis will be done in NVivo 12. ETHICS AND DISSEMINATION Ethics approval for the project has been obtained from the Mozambique National Bioethics Committee (CNBS-Comité Nacional de Bioética para a Saúde) and the University of Saskatchewan Bioethical Research Ethics Board. The evaluation will adhere to the International Ethical Guidelines for Biomedical Research Involving Human Subjects and the African adaptation of evaluation ethics and principles. Evaluation results will be disseminated to stakeholders' practice audiences through peer-reviewed publications, plain-language briefs, theory validation/feedback meetings and conference presentations.
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Affiliation(s)
- Nadege Sandrine Uwamahoro
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Mozambique-Canada Maternal Health Project, Inhambane, Mozambique
| | - Jessie Forsyth
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Mozambique-Canada Maternal Health Project, Inhambane, Mozambique
| | - Fernanda Andre
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Mozambique-Canada Maternal Health Project, Inhambane, Mozambique
| | | | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, University College Dublin, Dublin, Ireland
| | - Nazeem Muhajarine
- Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- Mozambique-Canada Maternal Health Project, Inhambane, Mozambique
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11
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Colangelo P, Di Civita M, Bento CM, Franchini P, Meyer A, Orel N, das Neves LCBG, Mulandane FC, Almeida JS, Senczuk G, Pilla F, Sabatelli S. Genome-wide diversity, population structure and signatures of inbreeding in the African buffalo in Mozambique. BMC Ecol Evol 2024; 24:29. [PMID: 38433185 PMCID: PMC10910738 DOI: 10.1186/s12862-024-02209-2] [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: 10/30/2023] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
The African buffalo, Syncerus caffer, is a key species in African ecosystems. Like other large herbivores, it plays a fundamental role in its habitat acting as an ecosystem engineer. Over the last few centuries, African buffalo populations have declined because of range contraction and demographic decline caused by direct or indirect human activities. In Mozambique, historically home to large buffalo herds, the combined effect of colonialism and subsequent civil wars has created a critical situation that urgently needs to be addressed. In this study, we focused on the analysis of genetic diversity of Syncerus caffer caffer populations from six areas of Mozambique. Using genome-wide SNPs obtained from ddRAD sequencing, we examined the population structure across the country, estimated gene flow between areas under conservation management, including national reserves, and assessed the inbreeding coefficients. Our results indicate that all studied populations of Syncerus caffer caffer are genetically depauperate, with a high level of inbreeding. Moreover, buffaloes in Mozambique present a significant population differentiation between southern and central areas. We found an unexpected genotype in the Gorongosa National Park, where buffaloes experienced a dramatic population size reduction, that shares a common ancestry with southern populations of Catuane and Namaacha. This could suggest the past occurrence of a connection between southern and central Mozambique and that the observed population structuring could reflect recent events of anthropogenic origin. All the populations analysed showed high levels of homozygosity, likely due to extensive inbreeding over the last few decades, which could have increased the frequency of recessive deleterious alleles. Improving the resilience of Syncerus caffer caffer in Mozambique is essential for preserving the ecosystem integrity. The most viable approach appears to be facilitating translocations and re-establishing connectivity between isolated herds. However, our results also highlight the importance of assessing intraspecific genetic diversity when considering interventions aimed at enhancing population viability such as selecting suitable source populations.
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Affiliation(s)
- Paolo Colangelo
- National Research Council, Research Institute on Terrestrial Ecosystems, Via Salaria km 29.300, 00015, Montelibretti (Roma), Italy
| | - Marika Di Civita
- Department of Agricultural, Environmental and Food Sciences, University of Molise, 86100, Campobasso, Italy
- Department of Biology and Biotechnologies "Charles Darwin", Sapienza University, Viale dell'Università 32, 00185, Roma, Italy
| | - Carlos M Bento
- Natural History Museum, Eduardo Mondlane University, Travessia do Zambeze 104, 1100, Maputo, Mozambique
| | - Paolo Franchini
- Department of Biology, University of Konstanz, Konstanz, Germany.
- Department of Ecological and Biological Sciences, University of Tuscia, Viale dell'Università s.n.c, 01100, Viterbo, Italy.
| | - Axel Meyer
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Nadiya Orel
- Department of Biology, University of Konstanz, Konstanz, Germany
| | - Luis C B G das Neves
- Biotechnology Centre of Eduardo Mondlane University, Maputo, Mozambique
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Sciences, University of Pretoria, Pretoria, South Africa
| | | | | | - Gabriele Senczuk
- Department of Agricultural, Environmental and Food Sciences, University of Molise, 86100, Campobasso, Italy
| | - Fabio Pilla
- Department of Agricultural, Environmental and Food Sciences, University of Molise, 86100, Campobasso, Italy
| | - Simone Sabatelli
- Department of Biology and Biotechnologies "Charles Darwin", Sapienza University, Viale dell'Università 32, 00185, Roma, Italy
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12
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Matute DR, Cooper BS. Aedes albopictus is present in the lowlands of southern Zambia. Acta Trop 2024; 251:107115. [PMID: 38184292 DOI: 10.1016/j.actatropica.2023.107115] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/12/2023] [Accepted: 12/27/2023] [Indexed: 01/08/2024]
Abstract
Identifying the current geographic range of disease vectors is a critical first step towards determining effective mechanisms for controlling and potentially eradicating them. This is particularly true given that historical vector ranges may expand due to changing climates and human activity. The Aedes subgenus Stegomyia contains over 100 species, and among them, Ae. aegypti and Ae. albopictus mosquitoes represent the largest concern for public health, spreading dengue, chikungunya, and zika viruses. While Ae. aegypti has been observed in the country of Zambia for decades, Ae. albopictus has not. In 2015 we sampled four urban and three rural areas in Zambia for Aedes species. Using DNA barcoding, we confirmed the presence of immature and adult Ae. albopictus at two sites: Siavonga and Livingstone. These genotypes seem most closely related to specimens previously collected in Mozambique based on mtDNA barcoding. We resampled Siavonga and Livingstone sites in 2019, again observing immature and adult Ae. albopictus at both sites. Relative Ae. albopictus frequencies were similar between sites, with the exception of immature life stages, which were higher in Siavonga than in Livingstone in 2019. While Ae. albopictus frequencies did not vary through time in Livingstone, both immature and adult frequencies increased through time in Siavonga. This report serves to document the presence of Ae. albopictus in Zambia, which will contribute to understanding the potential public health implications of this disease vector in southern Africa.
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Affiliation(s)
- Daniel R Matute
- Biology Department, University of North Carolina, 250 Bell Tower Drive, Genome Sciences Building, Chapel Hill, NC 27510, United States.
| | - Brandon S Cooper
- Division of Biological Sciences, University of Montana, 32 Campus Dr., Missoula, MT 59812, United States
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13
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Pedroso R, Quive S, Cumbana I, Mutisse L, Machava A. Food Insecurity Classification in Rural Areas of Mozambique: An Integrated Analysis of Survey-Based Indicators. Ecol Food Nutr 2024; 63:135-159. [PMID: 38349779 DOI: 10.1080/03670244.2024.2316590] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
National food insecurity early warning systems and food policy interventions need reliable information concerning the classification of food insecurity. The aim of this paper was to produce an acute food insecurity classification in Mozambique, by: i) analyzing food insecurity indicators individually; ii) comparing it with a new integrated analysis of survey-based indicators called the "Matrix Analysis." The Matrix results show more severe classifications than the single indicators for the analyzed districts. The matrix novelty consists on a cross-tabulation of all indicators, allowing a less subjective analysis. Further research is needed on how the Matrix approach could complement national classification systems.
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Affiliation(s)
- Rui Pedroso
- Faculty of Spatial Development and Infrastructure Systems, TH Köln/University of Applied Sciences, Institute for Technology and Resources Management in the Tropics and Subtropics (ITT), Cologne, Germany
| | - Samuel Quive
- Faculty of Arts and Social Sciences (FLCS), University Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Ivo Cumbana
- Faculty of Arts and Social Sciences (FLCS), University Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Luísa Mutisse
- Faculty of Arts and Social Sciences (FLCS), University Eduardo Mondlane (UEM), Maputo, Mozambique
| | - Adérito Machava
- Faculty of Arts and Social Sciences (FLCS), University Eduardo Mondlane (UEM), Maputo, Mozambique
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14
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Krajewski T, Hudgens M. The augmented synthetic control method in public health and biomedical research. Stat Methods Med Res 2024; 33:376-391. [PMID: 38320801 PMCID: PMC10981189 DOI: 10.1177/09622802231224638] [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] [Indexed: 03/28/2024]
Abstract
Estimating treatment (or policy or intervention) effects on a single individual or unit has become increasingly important in health and biomedical sciences. One method to estimate these effects is the synthetic control method, which constructs a synthetic control, a weighted average of control units that best matches the treated unit's pre-treatment outcomes and other relevant covariates. The intervention's impact is then estimated by comparing the post-intervention outcomes of the treated unit and its synthetic control, which serves as a proxy for the counterfactual outcome had the treated unit not experienced the intervention. The augmented synthetic control method, a recent adaptation of the synthetic control method, relaxes some of the synthetic control method's assumptions for broader applicability. While synthetic controls have been used in a variety of fields, their use in public health and biomedical research is more recent, and newer methods such as the augmented synthetic control method are underutilized. This paper briefly describes the synthetic control method and its application, explains the augmented synthetic control method and its differences from the synthetic control method, and estimates the effects of an antimalarial initiative in Mozambique using both the synthetic control method and the augmented synthetic control method to highlight the advantages of using the augmented synthetic control method to analyze the impact of interventions implemented in a single region.
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Affiliation(s)
- Taylor Krajewski
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
| | - Michael Hudgens
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
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15
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Dulá J, Chicumbe S, Martins MDRO. Determinants of pregnant women's satisfaction with interactions with health providers at antenatal consultation in primary health care in Southern Mozambique in 2021: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:165. [PMID: 38408915 PMCID: PMC10895729 DOI: 10.1186/s12884-024-06346-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The Ministry of Health of Mozambique (MISAU) and the World Health Organization (WHO) recommend enhancing pregnant women's satisfaction with health care services in order to advance maternal and child health. This study aims to assess the levels and determinants of pregnant women's satisfaction regarding their interactions with antenatal care (ANC) providers, the services of which were provided at the primary health care level in southern Mozambique. METHODOLOGY We conducted an observational, quantitative, and cross-sectional study from November 4 to December 10, 2021. A structured questionnaire was administered to pregnant women who attended ANC during that period. The characteristics of the participants were illustrated using descriptive statistics; to analyse pregnant women's satisfaction determinants, we estimated crude and adjusted odds ratios (AOR) and 95% confidence intervals (95% CI) using logistic regression models. All analyses were performed in SPSS version 24 using a 5% significance level. RESULTS We selected 951 pregnant women with a mean age of 25 years old; 14% attained a secondary educational level, 36% were married or living in a marital relationship, and 85.9% reported being satisfied with their current ANC. Factors that reduced the odds of being satisfied were the following: an "insufficient" ANC duration (AOR = 0.173; 95% CI: 0.079, 0.381); inadequate ANC waiting area (AOR = 0.479; 95% CI: 0.265, 0.863); women's perception about the existing norm of nonattendance in case of late arrival to the ANC (AOR = 0.528; 95% CI 0.292, 0.954); the perception of the existing norm that women are obliged to give birth in same health facility where ANC occurred (AOR = 0.481; 95% CI: 0.273, 0.846); and the perception that delivered ANC is not important for foetal health (AOR = 0.030; 95% CI:0.014, 0.066). CONCLUSIONS Most of the pregnant women mentioned being satisfied with the ANC they received. The perception of short consultation duration, inadequate waiting spaces, strict linkage rules to specific health facilities and ANC norms, the perception that the received ANC is not relevant for foetal well-being are determinants of not being satisfied with ANC, and these determinants can be addressed by reorganizing ANC and, indeed, are modifiable by the improved paced implementation of the MISAU strategies for quality maternal and child health care.
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Affiliation(s)
- Janeth Dulá
- Health Systems Program, Instituto Nacional de Saúde, estrada nacional n 0 1, vila de Marracuene, parcela 3943 CEP 0205-02, Marracuene district, Maputo Province, Mozambique.
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisbon, 1349-008, Portugal.
| | - Sérgio Chicumbe
- Health Systems Program, Instituto Nacional de Saúde, estrada nacional n 0 1, vila de Marracuene, parcela 3943 CEP 0205-02, Marracuene district, Maputo Province, Mozambique
| | - Maria do Rosário O Martins
- Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisbon, 1349-008, Portugal
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16
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Carratala-Castro L, Ssengooba W, Kay A, Acácio S, Ehrlich J, DiNardo AR, Shiba N, Nsubuga JK, Munguambe S, Saavedra-Cervera B, Manjate P, Mulengwa D, Sibandze B, Ziyane M, Kasule G, Mambuque E, Sekadde MP, Wobudeya E, Joloba ML, Heyckendorf J, Lange C, Hermans S, Mandalakas A, García-Basteiro AL, Lopez-Varela E. A stool based qPCR for the diagnosis of TB in children and people living with HIV in Uganda, Eswatini and Mozambique (Stool4TB): a protocol for a multicenter diagnostic evaluation. BMC Infect Dis 2024; 24:233. [PMID: 38383310 PMCID: PMC10880221 DOI: 10.1186/s12879-023-08708-9] [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: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) is a major cause of mortality worldwide. Children and people living with HIV (PLHIV) have an increased risk of mortality, particularly in the absence of rapid diagnosis. The main challenges of diagnosing TB in these populations are due to the unspecific and paucibacillary disease presentation and the difficulty of obtaining respiratory samples. Thus, novel diagnostic strategies, based on non-respiratory specimens could improve clinical decision making and TB outcomes in high burden TB settings. We propose a multi-country, prospective diagnostic evaluation study with a nested longitudinal cohort evaluation to assess the performance of a new stool-based qPCR, developed by researchers at Baylor College of Medicine (Houston, Texas, USA) for TB bacteriological confirmation with promising results in pilot studies. METHODS The study will take place in high TB/HIV burden countries (Mozambique, Eswatini and Uganda) where we will enroll, over a period of 30 months, 650 PLHIV (> 15) and 1295 children under 8 years of age (irrespective of HIV status) presenting pressumptive TB. At baseline, all participants will provide clinical history, complete a physical assessment, and undergo thoracic chest X-ray imaging. To obtain bacteriological confirmation, participants will provide respiratory samples (1 for adults, 2 in children) and 1 stool sample for Xpert Ultra MTB/RIF (Cepheid, Sunnyvale, CA, USA). Mycobacterium tuberculosis (M.tb) liquid culture will only be performed in respiratory samples and lateral flow lipoarabinomannan (LF-LAM) in urine following WHO recommendations. Participants will complete 2 months follow-up if they are not diagnosed with TB, and 6 months if they are. For analytical purposes, the participants in the pediatric cohort will be classified into "confirmed tuberculosis", "unconfirmed tuberculosis" and "unlikely tuberculosis". Participants of the adult cohort will be classified as "bacteriologically confirmed TB", "clinically diagnosed TB" or "not TB". We will assess accuracy of the novel qPCR test compared to bacteriological confirmation and Tb diagnosis irrespective of laboratory results. Longitudinal qPCR results will be analyzed to assess its use as treatment response monitoring. DISCUSSION The proposed stool-based qPCR is an innovation because both the strategy of using a non-sputum based sample and a technique specially designed to detect M.tb DNA in stool. PROTOCOL REGISTRATION DETAILS ClinicalTrials.gov Identifier: NCT05047315.
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Affiliation(s)
- Lucia Carratala-Castro
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo.
- Fundación Privada Instituto de Salud Global Barcelona (ISGlobal), Spain, Barcelona.
| | | | - Alex Kay
- Baylor College of Medicine (BCM), Houston, TX, USA
- Baylor College of Medicine -Children's Foundation Eswatini, Mbabane, Eswatini, Swaziland
| | - Sozinho Acácio
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
- Instituto Nacional de Saúde (INS), Ministério da Saúde de Moçambique, Mozambique, Maputo
| | - Joanna Ehrlich
- Fundación Privada Instituto de Salud Global Barcelona (ISGlobal), Spain, Barcelona
| | - Andrew R DiNardo
- Baylor College of Medicine (BCM), Houston, TX, USA
- Radboud UMC, Nijmegen, Netherlands
| | - Nosisa Shiba
- Baylor College of Medicine -Children's Foundation Eswatini, Mbabane, Eswatini, Swaziland
| | | | - Shilzia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
| | - Belén Saavedra-Cervera
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
- Fundación Privada Instituto de Salud Global Barcelona (ISGlobal), Spain, Barcelona
| | - Patricia Manjate
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
| | - Durbbin Mulengwa
- Baylor College of Medicine -Children's Foundation Eswatini, Mbabane, Eswatini, Swaziland
| | - Busizwe Sibandze
- Baylor College of Medicine -Children's Foundation Eswatini, Mbabane, Eswatini, Swaziland
- Amsterdam UMC, location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
- National Tuberculosis Reference Laboratory, Mbabane, Eswatini, Swaziland
| | - Mangaliso Ziyane
- Amsterdam UMC, location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
- National Tuberculosis Reference Laboratory, Mbabane, Eswatini, Swaziland
| | | | - Edson Mambuque
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
| | | | | | | | - Jan Heyckendorf
- Department of Internal Medicine I, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany
- Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany
- Baylor College of Medicine and Texas Children Hospital, Global TB Program, Houston, TX, USA
| | - Sabine Hermans
- Amsterdam UMC, location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
- Amsterdam UMC, location University of Amsterdam, Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam, the Netherlands
| | - Anna Mandalakas
- Baylor College of Medicine (BCM), Houston, TX, USA
- Research Center Borstel, Borstel, Germany
| | - Alberto L García-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
- Fundación Privada Instituto de Salud Global Barcelona (ISGlobal), Spain, Barcelona
| | - Elisa Lopez-Varela
- Centro de Investigação em Saúde de Manhiça (CISM), Mozambique, Maputo
- Fundación Privada Instituto de Salud Global Barcelona (ISGlobal), Spain, Barcelona
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Niehaus L, Sheffel A, Kalter HD, Amouzou A, Koffi AK, Munos MK. Delays in accessing high-quality care for newborns in East Africa: An analysis of survey data in Malawi, Mozambique, and Tanzania. J Glob Health 2024; 14:04022. [PMID: 38334468 PMCID: PMC10854463 DOI: 10.7189/jogh.14.04022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background Despite the existence of evidence-based interventions, substantial progress in reducing neonatal mortality is lagging, indicating that small and sick newborns (SSNs) are likely not receiving the care they require to survive and thrive. The 'three delays model' provides a framework for understanding the challenges in accessing care for SSNs. However, the extent to which each delay impacts access to care for SSNs is not well understood. To fill this evidence gap, we explored the impact of each of the three delays on access to care for SSNs in Malawi, Mozambique, and Tanzania. Methods Secondary analyses of data from three different surveys served as the foundation of this study. To understand the impact of delays in the decision to seek care (delay 1) and the ability to reach an appropriate point of care (delay 2), we investigated time trends in place of birth disaggregated by facility type. We also explored care-seeking behaviours for newborns who died. To understand the impact of delays in accessing high-quality care after reaching a facility (delay 3), we measured facility readiness to manage care for SSNs. We used this measure to adjust institutional delivery coverage for SSN care readiness. Results Coverage of institutional deliveries was substantially lower after adjusting for facility readiness to manage SSN care, with decreases of 30 percentage points (pp) in Malawi, 14 pp in Mozambique, and 24 pp in Tanzania. While trends suggest more SSNs are born in facilities, substantial gaps remain in facilities' capacities to provide lifesaving interventions. In addition, exploration of care-seeking pathways revealed that a substantial proportion of newborn deaths occurred outside of health facilities, indicating barriers in the decision to seek care or the ability to reach an appropriate source of care may also prevent SSNs from receiving these interventions. Conclusions Investments are needed to overcome delays in accessing high-quality care for the most vulnerable newborns, those who are born small or sick. As more mothers and newborns access health services in low- and middle-income countries, ensuring that life-saving interventions for SSNs are available at the locations where newborns are born and seek care after birth is critical.
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Muhala V, Guimarães-Costa A, Macate IE, Rabelo LP, Bessa-Silva AR, Watanabe L, dos Santos GD, Sambora L, Vallinoto M, Sampaio I. DNA barcoding for the assessment of marine and coastal fish diversity from the Coast of Mozambique. PLoS One 2024; 19:e0293345. [PMID: 38319915 PMCID: PMC10846724 DOI: 10.1371/journal.pone.0293345] [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: 05/01/2023] [Accepted: 10/10/2023] [Indexed: 02/08/2024] Open
Abstract
The ichthyological provinces of Mozambique are understudied hotspots of global fish diversity. In this study, we applied DNA barcoding to identify the composition of the fish fauna from the coast of Mozambique. A total of 143 species belonging to 104 genera, 59 families, and 30 orders were identified. The overall K2P distance of the COI sequences within species ranged from 0.00% to 1.51%, while interspecific distances ranged from 3.64% to 24.49%. Moreover, the study revealed 15 threatened species according to the IUCN Red List of Threatened Species, with elasmobranchs being the most represented group. Additionally, the study also uncovered four new species that were not previously recorded in this geographic area, including Boleophthalmus dussumieri, Maculabatis gerrardi, Hippocampus kelloggi, and Lethrinus miniatus. This study represents the first instance of utilizing molecular references to explore the fish fauna along the Mozambican coast. Our results indicate that DNA barcoding is a dependable technique for the identification and delineation of fish species in the waters of Mozambique. The DNA barcoding library established in this research will be an invaluable asset for advancing the understanding of fish diversity and guiding future conservation initiatives.
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Affiliation(s)
- Valdemiro Muhala
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
- Divisão de Agricultura, Instituto Superior Politécnico de Gaza, Chókwè, Mozambique
| | - Aurycéia Guimarães-Costa
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
| | - Isadola Eusébio Macate
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
- Departamento de Ciências Agrárias e Ambientais, Universidade Estadual de Santa Cruz, Ilheus, BA, Brazil
| | - Luan Pinto Rabelo
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
| | - Adam Rick Bessa-Silva
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
| | - Luciana Watanabe
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
| | - Gisele Damasceno dos Santos
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
| | - Luísa Sambora
- Departamento de Produção Agrária, Escola Superior de Desenvolvimento Rural, Universidade Eduardo Mondlane, Vilankulos, Moçambique
| | - Marcelo Vallinoto
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
| | - Iracilda Sampaio
- Laboratório de Evolução, Universidade Federal do Pará, Alameda Leandro Ribeiro, Aldeia, Bragança, Pará, Brazil
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19
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Castro Lopes S, Constant D, Fraga S, Harries J. Women's voices and meanings of empowerment for reproductive decisions: a qualitative study in Mozambique. Reprod Health 2024; 21:16. [PMID: 38308322 PMCID: PMC10837942 DOI: 10.1186/s12978-024-01748-7] [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: 09/15/2023] [Accepted: 01/24/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Women in Mozambique are often disempowered when it comes to making decisions concerning their lives, including their bodies and reproductive options. This study aimed to explore the views of women in Mozambique about key elements of empowerment for reproductive decisions and the meanings they attach to these elements. METHODS Qualitative in-depth interviews were undertaken with 64 women of reproductive age (18-49 years) in two provinces in Mozambique. Participants were recruited through convenience sampling. Data collection took place between February and March 2020 in Maputo city and Province, and during August 2020 in Nampula Province. A thematic analysis was performed. RESULTS Women described crucial elements of how power is exerted for reproductive choices. These choices include the ability to plan the number and timing of pregnancies and the ability either to negotiate with sexual partners by voicing choice and influencing decisions, or to exercise their right to make decisions independently. They considered that women with empowerment had characteristics such as independence, active participation and being free. These characteristics are recognized key enablers for the process of women's empowerment. CONCLUSIONS This study's findings contribute to an expanded conceptualization and operationalization of women's sexual and reproductive empowerment by unveiling key elements that need to be considered in future research and approaches to women's empowerment. Furthermore, it gave women the central role and voice in the research of empowerment's conceptualization and measurement where women's views and meanings are seldom considered.
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Affiliation(s)
- Sofia Castro Lopes
- Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town, South Africa.
| | - Deborah Constant
- Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Sílvia Fraga
- EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal
| | - Jane Harries
- Division of Social and Behavioural Sciences, School of Public Health, University of Cape Town, Cape Town, South Africa
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20
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Varo R, Crowley VM, Mucasse H, Sitoe A, Bramugy J, Serghides L, Weckman AM, Erice C, Bila R, Vitorino P, Mucasse C, Valente M, Ajanovic S, Balanza N, Zhong K, Derpsch Y, Gladstone M, Mayor A, Bassat Q, Kain KC. Adjunctive rosiglitazone treatment for severe pediatric malaria: A randomized placebo-controlled trial in Mozambican children. Int J Infect Dis 2024; 139:34-40. [PMID: 38013152 DOI: 10.1016/j.ijid.2023.11.031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 11/29/2023] Open
Abstract
OBJECTIVES We tested the hypothesis that adjunctive rosiglitazone treatment would reduce levels of circulating angiopoietin-2 (Angpt-2) and improve outcomes of Mozambican children with severe malaria. METHODS A randomized, double-blind, placebo-controlled trial of rosiglitazone vs placebo as adjunctive treatment to artesunate in children with severe malaria was conducted. A 0.045 mg/kg/dose of rosiglitazone or matching placebo were administered, in addition to standard of malaria care, twice a day for 4 days. The primary endpoint was the rate of decline of Angpt-2 over 96 hours. Secondary outcomes included the longitudinal dynamics of angiopoietin-1 (Angpt-1) and the Angpt-2/Angpt-1 ratio over 96 hours, parasite clearance kinetics, clinical outcomes, and safety metrics. RESULTS Overall, 180 children were enrolled; 91 were assigned to rosiglitazone and 89 to placebo. Children who received rosiglitazone had a steeper rate of decline of Angpt-2 over the first 96 hours of hospitalization compared to children who received placebo; however, the trend was not significant (P = 0.28). A similar non-significant trend was observed for Angpt-1 (P = 0.65) and the Angpt-2/Angpt-1 ratio (P = 0.34). All other secondary and safety outcomes were similar between groups (P >0.05). CONCLUSION Adjunctive rosiglitazone at this dosage was safe and well tolerated but did not significantly affect the longitudinal kinetics of circulating Angpt-2.
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Affiliation(s)
- Rosauro Varo
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
| | - Valerie M Crowley
- S. A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Canada
| | - Humberto Mucasse
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Antonio Sitoe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Justina Bramugy
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Lena Serghides
- Toronto General Research Institute (TGRI), University Health Network, Toronto, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Canada; Department of Immunology and Institute of Medical Sciences University of Toronto, Toronto, Canada
| | - Andrea M Weckman
- S. A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Canada
| | - Clara Erice
- S. A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Canada
| | - Rubao Bila
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Pio Vitorino
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Campos Mucasse
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Marta Valente
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Sara Ajanovic
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Núria Balanza
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Kathleen Zhong
- S. A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Canada
| | - Yiovanna Derpsch
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom; School of Psychology, University of East Anglia, Norwich, United Kingdom
| | - Melissa Gladstone
- Department of Women's and Children's Health, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Alfredo Mayor
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Department of Physiologic Sciences, Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique; Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Toronto, Toronto, Canada
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Spanish Consortium for Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, University of Toronto, Toronto, Canada; ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain; Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
| | - Kevin C Kain
- S. A. Rotman Laboratories, Sandra Rotman Centre for Global Health, University Health Network-Toronto General Hospital, Toronto, Canada; Toronto General Research Institute (TGRI), University Health Network, Toronto, Canada; Tropical Diseases Unit, Division of Infectious Diseases, Department of Medicine, UHN-Toronto General Hospital, Toronto, Canada
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21
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Mepatia AI, Myburgh N, Barrie R, Kimmie-Dhansay F. Self-assessment of dental health status, behaviours and oral health risk factors among adolescents from public schools in Maputo City- Mozambique. BMC Oral Health 2024; 24:145. [PMID: 38297254 PMCID: PMC10832200 DOI: 10.1186/s12903-023-03742-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/06/2023] [Indexed: 02/02/2024] Open
Abstract
Self-assessment of dental health status may have an impact on the oral health behaviour of adolescents which could impact their oral health. Oral health has been linked to various medical health conditions, thus eliminating oral health diseases can improve general health. The present study aimed to assess the association between behaviours and risk factors (oral hygiene habits, sugar intake, urban/rural status) and negative self-perception of dental health status among adolescents attending public schools in Maputo City.Method An analytic cross-sectional study, conducted in three Primary public schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location was included. The size of the sample was 236 12-year-olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO). Chi-square tests or Fishers' Exact tests were used for associations. A simple and multiple logistic regression was used to determine the strength of these associations using backward elimination (p < 0.05). Results: The sample consisted of 221 adolescents, with 114 (51.6%) residing in urban areas and 107 (48.4%) in peri-urban areas. More than half of the participants (111 individuals) reported having a negative perception of their dental health. In the urban location, a higher percentage of participants had a "negative" perception of dental health (57.9%, n = 66), while in the peri-urban location, more participants perceived their dental health as "positive" (57.9%, n = 62). Participants residing in an urban setting were 82% more likely to have a negative perception of dental health (AOR = 1.82 [95% C.I.: 1.05 to 3.14]). Those who had experienced dental pain tended to report a higher proportion of negative dental perception (57.2%, n = 91), with 2.7 times more likely to report a negative perception of dental health (AOR = 2.72 [95% C.I.: 1.46 to 5.08]). The majority (n = 139; 63.2%) claimed to clean their teeth twice a day.Conclusion There was a higher negative perception of dental health in urban areas. The need to strengthen oral health promotion in urban schools is high since schools play such a significant role in oral health promotion.
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Affiliation(s)
- Amália Issufo Mepatia
- Department of Community Oral Health, Faculty of Dentistry, University of the Western Cape, Maputo, South Africa.
| | - Neil Myburgh
- Department of Community Oral Health, Faculty of Dentistry, University of the Western Cape, Maputo, South Africa
| | - Robert Barrie
- Department of Community Oral Health, Faculty of Dentistry, University of the Western Cape, Maputo, South Africa
| | - Faheema Kimmie-Dhansay
- Department of Community Oral Health, Faculty of Dentistry, University of the Western Cape, Maputo, South Africa
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22
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Sitoe E, Van Wyk BE. An inventory and analysis of the medicinal plants of Mozambique. J Ethnopharmacol 2024; 319:117137. [PMID: 37783405 DOI: 10.1016/j.jep.2023.117137] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/29/2023] [Accepted: 09/06/2023] [Indexed: 10/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE A comprehensive checklist and analysis of medicinal plant species and their uses in Mozambique, and a comparison with South Africa provided a more profound understanding of the broad concept of Traditional African Medicine as a healing culture and the need for a more informative classification system. AIMS OF THE STUDY This study was aimed at recording all medicinal plants reported in Mozambique according to literature and answer four main questions. 1. How many medicinal plant species have been recorded for Mozambique? Of those, how many are indigenous to Mozambique, and how many are introduced or cultivated exotics? 2. What are the main medicinal uses in Mozambique and which species are used for which ailments? 3. What are the similarities and differences between the medicinal floras of Mozambique and South Africa - are the same species used for the same ailments and is there evidence of cultural exchange? 4. Do the data provide new insights into Traditional African Medicine as one of the oldest medicine systems in the world? MATERIALS AND METHODS A literature survey was done to compile the medicinal checklist of Mozambique using 29 available literature sources, which were found from published books, journal articles, reports, unpublished theses, dissertations, and online databases. RESULTS A total of 731 medicinal plant species and infraspecific taxa from 447 genera and 120 families was recorded for Mozambique. Of these, 590 (81%) are indigenous, and 87 are non-indigenous (50 naturalised and 37 cultivated exotics). Of the 731 medicinal plant species, 494 (68%) are also used medicinally in South Africa and 148 (30%) are used for the same or similar ailments. Many of the shared taxa and uses have been recorded in the adjoining KwaZulu-Natal Province of South Africa, which has similar vegetation types. CONCLUSION The similarity between Mozambique and South Africa (and especially the KwaZulu-Natal Province) not only suggest an exchange of traditional knowledge but also indicates the existence of a hitherto unnamed medicinal system of the southern and eastern African Bantu-speaking cultures that is in need of detailed comparative studies.
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Affiliation(s)
- E Sitoe
- Department of Botany and Plant Biotechnology, University of Johannesburg, P.O. Box 524, 2006 Auckland Park, Johannesburg, South Africa.
| | - B-E Van Wyk
- Department of Botany and Plant Biotechnology, University of Johannesburg, P.O. Box 524, 2006 Auckland Park, Johannesburg, South Africa.
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Leukes VN, Hella J, Sabi I, Cossa M, Khosa C, Erkosar B, Mangu C, Siyame E, Mtafya B, Lwilla A, Viegas S, Madeira C, Machiana A, Ribeiro J, Garcia-Basteiro AL, Riess F, Elísio D, Sasamalo M, Mhalu G, Denkinger CM, Castro MDM, Bashir S, Schumacher SG, Tagliani E, Malhotra A, Dowdy D, Schacht C, Buech J, Nguenha D, Ntinginya N, Ruhwald M, Penn-Nicholson A, Kranzer K. Study protocol: a pragmatic, cluster-randomized controlled trial to evaluate the effect of implementation of the Truenat platform/MTB assays at primary health care clinics in Mozambique and Tanzania (TB-CAPT CORE). BMC Infect Dis 2024; 24:107. [PMID: 38243223 PMCID: PMC10797907 DOI: 10.1186/s12879-023-08876-8] [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: 09/12/2023] [Accepted: 12/05/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND In 2020, the WHO-approved Molbio Truenat platform and MTB assays to detect Mycobacterium tuberculosis complex (MTB) and resistance to rifampicin directly on sputum specimens. This primary health care center-based trial in Mozambique and Tanzania investigates the effect of Truenat platform/MTB assays (intervention arm) combined with rapid communication of results compared to standard of care on TB diagnosis and treatment initiation for microbiologically confirmed TB at 7 days from enrolment. METHODS The Tuberculosis Close the Gap, Increase Access, and Provide Adequate Therapy (TB-CAPT) CORE trial employs a pragmatic cluster randomized controlled design to evaluate the impact of a streamlined strategy for delivery of Truenat platform/MTB assays testing at primary health centers. Twenty-nine centers equipped with TB microscopy units were selected to participate in the trial. Among them, fifteen health centers were randomized to the intervention arm (which involves onsite molecular testing using Truenat platform/MTB assays, process process optimization to enable same-day TB diagnosis and treatment initiation, and feedback on Molbio platform performance) or the control arm (which follows routine care, including on-site sputum smear microscopy and the referral of sputum samples to off-site Xpert testing sites). The primary outcome of the study is the absolute number and proportion of participants with TB microbiological confirmation starting TB treatment within 7 days of their first visit. Secondary outcomes include time to bacteriological confirmation, health outcomes up to 60 days from first visit, as well as user preferences, direct cost, and productivity analyses. ETHICS AND DISSEMINATION TB-CAPT CORE trial has been approved by regulatory and ethical committees in Mozambique and Tanzania, as well as by each partner organization. Consent is informed and voluntary, and confidentiality of participants is maintained throughout. Study findings will be presented at scientific conferences and published in peer-reviewed international journals. TRIAL REGISTRATION US National Institutes of Health's ClinicalTrials.gov, NCT04568954. Registered 23 September 2020.
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Affiliation(s)
| | - J Hella
- Ifakara Health Institute, Dar Es Salaam, Tanzania
| | - I Sabi
- Mbeya Medical Research Centre, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - M Cossa
- Centro de Investigação Em Saúde de Manhiça (CISM), Manhica, Mozambique
| | - C Khosa
- Instituto Nacional de Saúde (INS), Marracuene, Mozambique
| | | | - C Mangu
- Mbeya Medical Research Centre, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - E Siyame
- Mbeya Medical Research Centre, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - B Mtafya
- Mbeya Medical Research Centre, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - A Lwilla
- Mbeya Medical Research Centre, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | - S Viegas
- Instituto Nacional de Saúde (INS), Marracuene, Mozambique
| | - C Madeira
- Instituto Nacional de Saúde (INS), Marracuene, Mozambique
| | - A Machiana
- Instituto Nacional de Saúde (INS), Marracuene, Mozambique
| | - J Ribeiro
- Instituto Nacional de Saúde (INS), Marracuene, Mozambique
| | - A L Garcia-Basteiro
- Centro de Investigação Em Saúde de Manhiça (CISM), Manhica, Mozambique
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - F Riess
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University Hospital, Munich, Germany
| | - D Elísio
- Centro de Investigação Em Saúde de Manhiça (CISM), Manhica, Mozambique
| | - M Sasamalo
- Ifakara Health Institute, Dar Es Salaam, Tanzania
| | - G Mhalu
- Ifakara Health Institute, Dar Es Salaam, Tanzania
| | - C M Denkinger
- Division of Infectious Disease and Tropical Medicine and German Centre for Infection Research, Heidelberg University Hospital, Heidelberg, Germany
| | - M D M Castro
- Division of Infectious Disease and Tropical Medicine and German Centre for Infection Research, Heidelberg University Hospital, Heidelberg, Germany
| | - S Bashir
- Division of Infectious Disease and Tropical Medicine and German Centre for Infection Research, Heidelberg University Hospital, Heidelberg, Germany
| | | | - E Tagliani
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - A Malhotra
- Johns Hopkins University (JHU), Baltimore, MD, USA
| | - D Dowdy
- Johns Hopkins University (JHU), Baltimore, MD, USA
| | | | - J Buech
- LINQ Management, Berlin, Germany
| | - D Nguenha
- Centro de Investigação Em Saúde de Manhiça (CISM), Manhica, Mozambique
| | - N Ntinginya
- Mbeya Medical Research Centre, National Institute for Medical Research (NIMR), Mbeya, Tanzania
| | | | | | - K Kranzer
- Division of Infectious Diseases and Tropical Medicine, Ludwig Maximilian University Hospital, Munich, Germany.
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
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24
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Máquina M, Opiyo MA, Cuamba N, Marrenjo D, Rodrigues M, Armando S, Nhate S, Luis F, Saúte F, Candrinho B, Lobo NF, Paaijmans KP. Multiple Anopheles species complicate downstream analysis and decision-making in a malaria pre-elimination area in southern Mozambique. Malar J 2024; 23:23. [PMID: 38238774 PMCID: PMC10797956 DOI: 10.1186/s12936-024-04842-0] [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: 10/12/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Different anopheline species (even within a species group/complex) can differ in their feeding and resting behaviours, which impact both malaria transmission patterns as well as the efficacy of vector control interventions. While morphological identification of sampled specimens is an important first step towards understanding species diversity and abundance, misidentification can result in the implementation of less effective vector control measures, and consequently smaller reductions in the number of local malaria cases. Focusing on southern Mozambique, a malaria pre-elimination area where malaria remains persistent, the aims of this preliminary study were to use molecular identification (CO1 and ITS2 barcoding) to (1) validate the results from the morphological identification (with a particular focus on Anopheles pharoensis and Anopheles squamosus), and (2) have a closer look at the Anopheles coustani group (which includes Anopheles tenebrosus and Anopheles ziemanni). METHODS Female anopheline mosquitoes (n = 81) were identified morphologically and subsequently sequenced at the ribosomal DNA internal transcribed spacer region 2 (ITS2) and/or cytochrome oxidase subunit 1 (CO1) loci towards species determination. RESULTS Out of the 62 specimens that were identified morphologically to species, 4 (6.5%) were misidentified. Regarding the An. coustani group, morphological identification showed that several members are present in southern Mozambique, including An. coustani sensu lato (s.l.), An. ziemanni and An. tenebrosus. However, based on both ITS2 and CO1 sequences, the exact species remains unknown for the latter two members until voucher sequences are available for comparison. CONCLUSION The reason(s) for morphological misidentification of anopheline mosquitoes need to be mitigated. This is usually related to both the capacity (i.e. training) of the microscopist to identify anopheline species, and the information provided in the dichotomous identification key. As the An. coustani complex contributes to (residual) malaria transmission in sub-Saharan Africa, it may play a role in the observed persistent malaria in southern Mozambique. A better baseline characterizing of the local anophelines species diversity and behaviours will allow us to improve entomological surveillance strategies, better understand the impact of vector control on each local vector species, and identify new approaches to target those vector species.
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Affiliation(s)
- Mara Máquina
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Manhica, Mozambique
| | - Mercy A Opiyo
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Manhica, Mozambique
- ISGlobal, Barcelona, Spain
- Malaria Elimination Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Nelson Cuamba
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
- PMI VectorLink Project, Abt Associates Inc., Maputo, Mozambique
| | - Dulcisária Marrenjo
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
| | | | | | - Sheila Nhate
- Maputo Provincial Health Service, Matola, Mozambique
| | - Fabião Luis
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Manhica, Mozambique
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Manhica, Mozambique
| | - Baltazar Candrinho
- Programa Nacional de Controlo da Malária, Ministério da Saúde, Maputo, Mozambique
| | - Neil F Lobo
- Malaria Elimination Initiative, University of California San Francisco, San Francisco, CA, USA
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA
| | - Krijn P Paaijmans
- Centro de Investigação em Saúde de Manhiça (CISM), Fundação Manhiça, Manhica, Mozambique.
- ISGlobal, Barcelona, Spain.
- Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, AZ, USA.
- Simon A. Levin Mathematical, Computational and Modeling Sciences Center, Arizona State University, Tempe, AZ, USA.
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Zhang K, Liu H. Digital Technology: Opportunity or Challenge? Am J Trop Med Hyg 2024; 110:412. [PMID: 38227971 PMCID: PMC10859793 DOI: 10.4269/ajtmh.23-0804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Affiliation(s)
- Kaiwen Zhang
- Beijing Institute of Ophthalmology Beijing Tongren Eye Center Beijing Tongren Hospital Capital Medical University Beijing, China E-mail:
| | - Hanruo Liu
- Beijing Institute of Ophthalmology Beijing Tongren Eye Center Beijing Tongren Hospital Capital Medical University Beijing, China
- School of Medical Technology Beijing Institute of Technology Beijing, China
- National Institutes of Health Data Science at Peking University Beijing, China E-mail:
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26
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Zango AB, Stutterheim SE, de Vries N, Crutzen R. Determinants of preventive sexual behaviours among first year university students in Beira city, central Mozambique: a cross-sectional study. Reprod Health 2024; 21:3. [PMID: 38191405 PMCID: PMC10773135 DOI: 10.1186/s12978-023-01733-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Understanding determinants of preventive sexual behaviours is important for intervention efforts to support these behaviours and, thereby, reduce STIs and HIV burden. In general, there is limited insight into determinants of preventive behaviours among university students in Mozambique. Therefore, this study set out to assess both the prevalence and the determinants of condom use and voluntary counselling and testing (VCT) service use in first year university students. METHODS We conducted a cross-sectional study in May-September 2021, at the Universidade Católica de Moçambique and the Universidade Licungo, in Beira central Mozambique. We collected data on sociodemographic characteristics, heterosexual relationship experiences and personal determinants posited to be associated with condom use and VCT service use. We included 819 participants, who were selected using a clustered and random sampling design. We used Pearson's chi-square test to compare proportion and estimate the crude odd ratio as the effect size measure at 95% confidence interval, and Confidence Interval-Based Estimation of Relevance to determine correlation coefficients of means and the behaviours of interest at 95% confidence interval. RESULTS Condoms were used by 96.1% of male participants and 95.0% of female participants. Additionally, 55.1% of male participants and 57.5% of female participants had previously used VCT services. Condom use was associated with discussing sexuality with mother, and self-efficacy for condom use negotiation, and negatively associated with attitudes that condoms reduce pleasure. VCT service use was associated with discussing sexuality with mother, sexual debut, having a sexual partner, and being in what they consider an important heterosexual relationship. Knowledge, attitude, self-efficacy and subjective norms were weakly associated with VCT service use. CONCLUSION In first year university students in Mozambique, reported condom use was high but VCT services were only used by about half of the participants. Interventions aiming to increase VCT service use should focus on improving communication between parents and their adolescent or young adult children, providing personalized risk information, demonstrating that VCT service use is pleasant and non-judgmental, improving users' confidence to schedule a visit, and preparing users for possible positive testing results.
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Affiliation(s)
- Arlinda Basílio Zango
- Departamento de Investigação, Faculdade de Ciências de Saúde, Universidade Católica de Moçambique, Beira, Mozambique.
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
| | - Sarah E Stutterheim
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Nanne de Vries
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Rik Crutzen
- Department of Health Promotion, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Semá Baltazar C, Ribeiro Banze A, Seleme J, Boothe M. People Who Inject Drugs in Mozambique: We need to normalize HIV treatment and care services in specialized community centers for people who inject drugs! Harm Reduct J 2024; 21:6. [PMID: 38184600 PMCID: PMC10771667 DOI: 10.1186/s12954-023-00910-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 11/28/2023] [Indexed: 01/08/2024] Open
Abstract
Globally, People Who Inject Drugs (PWID) have limited healthcare, treatment, and prevention services, and they frequently experience stigma and negative attitudes toward healthcare providers when accessing services. Mozambique, with a general population HIV prevalence of 12.5%, has one of the highest rates in the world, and the PWID population has the highest HIV prevalence among key populations, estimated at nearly 50%. Less than half of HIV positives who inject drugs are linked to HIV treatment and are retained in care. One of the main reasons is that HIV treatment is mainly provided in a public health facility and PWID delayed accessing healthcare since they anticipated mistreatment from multiple levels of healthcare providers. To improve the health outcomes in this group, we need to treat them where they feel comfortable and respected. In this commentary, we outline the importance of innovative approaches to enhance the management of HIV-positive PWID. As a country gets close to controlling the HIV epidemic, refocusing and targeting responses to the highest-risk groups becomes even more essential for shaping more effective HIV interventions and achieving epidemic control.
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Affiliation(s)
| | | | - Jessica Seleme
- Mozambique National Program for STI, HIV and AIDS Control, Ministry Oh Health, Maputo, Mozambique
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Patrão AL, McIntyre TM, Costa ECV, Matediane E, Azevedo V. Testing the effectiveness of two psychosocial interventions - ACCENT and Didactic - to prevent HIV/AIDS behavioral risk factors in Mozambican women: a randomized controlled study. AIDS Care 2024; 36:122-129. [PMID: 37490699 DOI: 10.1080/13548506.2023.2229236] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 06/20/2023] [Indexed: 07/27/2023]
Abstract
In Mozambique, women are the most affected by HIV/AIDS and heterosexual encounters remain the main route for HIV/AIDS. Condom use is the most effective method of HIV/AIDS prevention, and the intention to use and buy/get condoms has a significant role in safe sex behavior. This study aimed to evaluate the efficacy of two psychosocial interventions - the Didactic and ACCENT Interventions - to prevent HIV/AIDS among Mozambican Women. Participants were Mozambican women (n = 150), users of the gynecology clinic of the Central Hospital of Beira. The study design was a randomized controlled trial (RCT) with assignment to three groups: Didactic intervention, ACCENT intervention, and Control group. Measures were from an adaption of the Women's Health Questionnaire, which includes questions about sociodemographic, clinical, and behavioral variables related to HIV prevention/risk. There was a significant group effect on condom use and safer sex preparatory behaviors, F(2, 146) = 6.45, p = .002, with Bonferroni post-hoc tests showing differences between the ACCENT vs. Control groups and ACCENT vs. Didactic groups (all p = .022). There were no statistically significant time effects on both condom use and safer sex preparatory behaviors. Results are promising for HIV/AIDS prevention in Mozambican women at sexual risk, but replication is needed for generalizability of findings.
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Affiliation(s)
- Ana Luísa Patrão
- Center for Psychology at University of Porto (CPUP), Faculty of Psychology and Educational Sciences of the University of Porto, University of Porto, Porto, Portugal
- Institute of Collective Health, Federal University of Bahia, Salvador - BA, Brazil
| | - Teresa M McIntyre
- Andy and Barbara Gessner College of Nursing and Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - Eleonora C V Costa
- Department of Psychology, Portuguese Catholic University, Braga, Portugal
| | - Eduardo Matediane
- Department of Gynaecology, Central Hospital of Beira, Beira, Mozambique
| | - Vanessa Azevedo
- Center for Psychology at University of Porto (CPUP), Faculty of Psychology and Educational Sciences of the University of Porto, University of Porto, Porto, Portugal
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Armand A, Fracchia M, Vicente PC. Let's call! Using the phone to increase vaccine acceptance. Health Econ 2024; 33:82-106. [PMID: 37792290 DOI: 10.1002/hec.4760] [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] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
In the context of the COVID-19 pandemic, we develop and test experimentally three phone-based interventions to increase vaccine acceptance in Mozambique. The first endorses the vaccine with a simple positive message. The second adds the activation of social memory on the country's success in eradicating wild polio with vaccination campaigns. The third further adds a structured interaction with the participant to develop a critical view toward misleading information and minimize the sharing of fake news. We find that combining the endorsement with the stimulation of social memory and the structured interaction increases vaccine acceptance and trust in institutions.
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Affiliation(s)
- Alex Armand
- Nova School of Business and Economics, Universidade Nova de Lisboa, NOVAFRICA, CEPR, and Institute for Fiscal Studies, Carcavelos, Portugal
| | - Mattia Fracchia
- Nova School of Business and Economics, Universidade Nova de Lisboa, NOVAFRICA, Carcavelos, Portugal
| | - Pedro C Vicente
- Nova School of Business and Economics, Universidade Nova de Lisboa, NOVAFRICA, BREAD, and CEPR, Carcavelos, Portugal
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30
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Doménech E, Simó-Alfonso EA, Barragán-Huerta BE, Escriche I. A probabilistic approach to compare the risk associated with heavy metals and bromine in honey from Dominican Republic, Mexico, Mozambique and Spain. Food Chem Toxicol 2024; 183:114306. [PMID: 38052406 DOI: 10.1016/j.fct.2023.114306] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/30/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
This study aims to analyse the risk to consumers given the presence of heavy metals and bromine in honey from different countries. A probabilistic approach was applied to assess carcinogenic risk. Concerning exposure, Al in Spain (3.3E-04 mg/kgBw/day), B in Dominican Republic and Mexico (2E-04 mg/kgBw/day in both cases) and Fe in Mexico and Mozambique had the highest values (5E-05 and 4.8E-05 mg/kgBw/day). In risk characterisation, the values were less than 1 for hazard index (HI), meaning that the consumption of honey represents a low level of concern for non-genotoxic effects. A combination of margin of exposure and probability of exceedance results that exposure to Pb pose no threat. The probability of suffering cancer for Br, Cd, Ni and Pb was lower than 1.0E-06 and, therefore, considered safe. However, the risk at the 95th percentile of Br in Dominican Republic was 1.18E-04 in adults and 2.45E-04 in children, exceeding 1.0E-04, and therefore, considered intolerable. Finally, the sensitivity analysis indicated that the most influential factor in the HI was the consumption in adults and the concentration of Ni in children, whereas for cancer risk, were the concentrations of Ni, Cd, Br and Pb, in both cases.
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Affiliation(s)
- Eva Doménech
- Instituto de Ingeniería de Alimentos FoodUPV, Food Technology Department, Universitat Politècnica de València, Camino de Vera, s/n. 46022, Valencia, Spain.
| | - Ernesto A Simó-Alfonso
- Department of Analytical Chemistry, University of Valencia, C. Doctor Moliner 50, 46100, Burjassot, Valencia, Spain.
| | - Blanca E Barragán-Huerta
- Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Av. Wilfrido Massieu, Unidad Profesional Adolfo López Mateos, Mexico City, 07738, Mexico.
| | - Isabel Escriche
- Instituto de Ingeniería de Alimentos FoodUPV, Food Technology Department, Universitat Politècnica de València, Camino de Vera, s/n. 46022, Valencia, Spain.
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Nhassengo P, Yoshino C, Zandamela A, De Carmo V, Burström B, Lönnroth K, Wingfield T, Khosa C, Atkins S. 'They didn't look at me with good eyes' - experiences of the socioeconomic impact of tuberculosis and support needs among adults in a semi-rural area in Mozambique: A Qualitative Study. Glob Public Health 2024; 19:2311682. [PMID: 38325424 DOI: 10.1080/17441692.2024.2311682] [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: 05/24/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
Tuberculosis is recognised as a disease of the economically disadvantaged people due to its association with financial vulnerability. Mozambique still faces the challenge of the high burden of TB and associated costs. We aimed to understand the social and economic impacts of TB and the need for social support among people with TB in Mozambique. We conducted a qualitative study using a phenomenological approach focusing on the lived experiences and perceptions of people with TB. A total of 52 semi-structured one-to-one in-depth interviews were conducted and data were analysed using a reflexive thematic analysis. Three themes were drawn from the analysis: (i) TB has a social and economic impact that requires adaptation and resourcefulness amongst those affected; (ii) People with TB have different preferences and needs for social support, and (iii) People with TB have different knowledge of, and experiences with, formal social support. TB affects family and community relationships mainly due to impacts on the household's finances. People with TB in Mozambique are not entitled to any form of social support, and they need to rely on help from family and the community which is often insufficient. Further investigation is needed on how social support schemes can be developed in Mozambique.
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Affiliation(s)
- Pedroso Nhassengo
- WHO Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Instituto Nacional de Saúde, Marracuene, Mozambique
- Health and Social Protection Action Research and Knowledge Sharing Network (www.sparksnetwork.ki.se), Stockholm, Sweden
| | - Clara Yoshino
- WHO Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Health and Social Protection Action Research and Knowledge Sharing Network (www.sparksnetwork.ki.se), Stockholm, Sweden
| | | | | | - Bo Burström
- WHO Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Health and Social Protection Action Research and Knowledge Sharing Network (www.sparksnetwork.ki.se), Stockholm, Sweden
| | - Knut Lönnroth
- WHO Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Health and Social Protection Action Research and Knowledge Sharing Network (www.sparksnetwork.ki.se), Stockholm, Sweden
| | - Tom Wingfield
- WHO Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Health and Social Protection Action Research and Knowledge Sharing Network (www.sparksnetwork.ki.se), Stockholm, Sweden
- Departments of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
- Tropical Infectious Diseases Unit, Liverpool University Hospital NHS, Foundation Trust, Liverpool, UK
| | - Celso Khosa
- Instituto Nacional de Saúde, Marracuene, Mozambique
| | - Salla Atkins
- WHO Collaborating Centre in Tuberculosis and Social Medicine, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Health and Social Protection Action Research and Knowledge Sharing Network (www.sparksnetwork.ki.se), Stockholm, Sweden
- Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
- WHO Collaborating Centre on Health in All Policies and Social Determinants of Health, Tampere University, Tampere, Finland
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Casanova D, Baptista V, Costa M, Freitas B, Pereira MDNI, Calçada C, Mota P, Kythrich O, Pereira MHJS, Osório NS, Veiga MI. Artemisinin resistance-associated gene mutations in Plasmodium falciparum: A case study of severe malaria from Mozambique. Travel Med Infect Dis 2024; 57:102684. [PMID: 38159875 DOI: 10.1016/j.tmaid.2023.102684] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/06/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The effectiveness of artemisinin-based combination therapies (ACT) in treating Plasmodium falciparum, is vital for global malaria control efforts, particularly in sub-Saharan Africa. The examination of imported cases from endemic areas holds implications for malaria chemotherapy on a global scale. METHOD A 45-year-old male presented with high fever, dry cough, diarrhoea and generalized muscle pain, following a two-week trip to Mozambique. P. falciparum infection with hiperparasitemia was confirmed and the patient was treated initially with quinine and doxycycline, then intravenous artesunate. To assess drug susceptibility, ex vivo half-maximal inhibitory concentration assays were conducted, and the isolated P. falciparum genome was deep sequenced. RESULTS The clinical isolate exhibited elevated ex vivo half-maximal inhibitory concentration values to dihydroartemisinin, lumefantrine, mefloquine and piperaquine. Genomic analysis identified a I416V mutation in the P. falciparum Kelch13 (PF3D7_1343700) gene, and several mutations at the Kelch13 interaction candidate genes, pfkics (PF3D7_0813000, PF3D7_1138700, PF3D7_1246300), including the ubiquitin carboxyl-terminal hydrolase 1, pfubp1 (PF3D7_0104300). Mutations at the drug transporters and genes linked to next-generation antimalarial drug resistance were also present. CONCLUSIONS This case highlights the emergence of P. falciparum strains carrying mutations in artemisinin resistance-associated genes in Mozambique, couple with a reduction in ex vivo susceptibility to ACT drugs. Continuous surveillance of mutations linked to drug resistance and regular monitoring of drug susceptibility are imperative to anticipate the spread of potential resistant strains emerging in Mozambique and to maintain effective malaria control strategies.
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Affiliation(s)
- Daniela Casanova
- Internal Medicine Department, Hospital Senhora da Oliveira, 4835-044, Guimarães, Portugal
| | - Vitória Baptista
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's─PT Government Associate Laboratory, 4806-909, Guimarães/ Braga, Portugal; Microelectromechanical Systems Research Unit (CMEMS-UMinho), School of Engineering, University of Minho, Campus de Azurém, 4800-058, Guimarães, Portugal
| | - Magda Costa
- Internal Medicine Department, Hospital Senhora da Oliveira, 4835-044, Guimarães, Portugal
| | - Bruno Freitas
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's─PT Government Associate Laboratory, 4806-909, Guimarães/ Braga, Portugal
| | - Maria das Neves Imaculada Pereira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's─PT Government Associate Laboratory, 4806-909, Guimarães/ Braga, Portugal
| | - Carla Calçada
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's─PT Government Associate Laboratory, 4806-909, Guimarães/ Braga, Portugal
| | - Paula Mota
- Clinical Pathology Department, Hospital Senhora da Oliveira, 4835-044, Guimarães, Portugal
| | - Olena Kythrich
- Clinical Pathology Department, Hospital Senhora da Oliveira, 4835-044, Guimarães, Portugal
| | | | - Nuno S Osório
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's─PT Government Associate Laboratory, 4806-909, Guimarães/ Braga, Portugal
| | - Maria Isabel Veiga
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; ICVS/3B's─PT Government Associate Laboratory, 4806-909, Guimarães/ Braga, Portugal; Clinical Academic Center-Braga (2CA-Braga), 4710-243, Braga, Portugal.
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Daca T, Prista A, Farinatti P, Maia Pacheco M, Drews R, Manyanga T, Damasceno A, Tani G. Biopsychosocial Effects of a Conventional Exercise Program and Culturally Relevant Activities in Older Women From Mozambique. J Phys Act Health 2024; 21:51-58. [PMID: 37883628 DOI: 10.1123/jpah.2022-0601] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 08/03/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023]
Abstract
AIM This randomized controlled trial compared the effects of a Conventional Exercise Program (CEP) and Culturally Relevant Activities (CRA) on body mass, cardiovascular risk, functional fitness (strength, flexibility, cardiorespiratory fitness, and agility), self-efficacy, and self-esteem in older women dwelling in Mozambique. METHODS Fifty-seven women (67 [7] y) underwent 60-minute sessions of CEP (n = 28) or CRA (n = 29) performed 3 days per week for 12 weeks. CRA included Mozambican traditional dances and games (intensity corresponding to scores 3-4 of BORG-CR10 scale), and CEP included 20-minute stationary cycling (65%-75% heart rate reserve) and a resistance training circuit (8 exercises, 15-repetition maximum). RESULTS CEP and CRA (P < .05) showed increased percent fat (3.4% and 5.3%), waist circumference (3.3% and 5.8%), and cardiorespiratory fitness (14.4% and 9.4%), and decreased triglycerides (-20.0% and -77.8%). In CEP (P < .05), body mass (2.9%), body mass index (3.2%), and high-density lipoprotein (10.0%) increased, while glycemia (-4.8%) and total cholesterol (-9.8%) decreased. Blood pressure slightly increased in CEP (6.2%, P > .05) and CRA (4.3%, P < .05). Self-efficacy and self-esteem increased to similar levels in both groups (15%, P < .05). CONCLUSIONS CEP and CRA were capable to improve biopsychosocial health-related variables in Mozambican older women. Culturally referenced PA interventions should be considered as an alternative in African countries.
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Affiliation(s)
- Timóteo Daca
- Research Group of Physical Activity and Health, Faculty of Physical Education and Sport, Pedagogical University of Maputo, Maputo, Mozambique
| | - Antônio Prista
- Research Group of Physical Activity and Health, Faculty of Physical Education and Sport, Pedagogical University of Maputo, Maputo, Mozambique
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sport, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | | | - Ricardo Drews
- Faculty of Physical Education and Physiotherapy, Federal University of Uberlândia, Uberlandia, Brazil
| | - Taru Manyanga
- Division of Medical Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Albertino Damasceno
- Faculty of Medicine, Eduardo Mondlane University of Mozambique, Maputo, Mozambique
| | - Go Tani
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Mootz JJ, Chantre C, Sikkema K, Greene MC, Lovero KL, Gouveia L, Santos P, Suleman A, Comé AS, Feliciano P, Uribe-Restrepo JM, Sweetland AC, Shelton RC, Kane J, Mello M, Fumo W, Cadena-Camargo Y, Weissman M, Wainberg ML. Leveraging a Digitized Mental Wellness (DIGImw) Program to Provide Mental Health Care for Internally Displaced People. Psychiatr Serv 2024; 75:98-101. [PMID: 37461818 PMCID: PMC10794516 DOI: 10.1176/appi.ps.202100552] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2024]
Abstract
A local insurgency has displaced many people in the northern Mozambican province of Cabo Delgado. The authors' global team (comprising members from Brazil, Mozambique, South Africa, and the United States) has been scaling up mental health services across the neighboring province of Nampula, Mozambique, now host to >200,000 displaced people. The authors describe how mental health services can be expanded by leveraging digital technology and task-shifting (i.e., having nonspecialists deliver mental health care) to address the mental health needs of displaced people. These methods can serve as a model for other researchers and clinicians aiming to address mental health needs arising from humanitarian disasters in low-resource settings.
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Affiliation(s)
- Jennifer J Mootz
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Catherine Chantre
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Kathleen Sikkema
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - M Claire Greene
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Kathryn L Lovero
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Lidia Gouveia
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Palmira Santos
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Antonio Suleman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Andrea Simone Comé
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Paulino Feliciano
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - José Miguel Uribe-Restrepo
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Annika C Sweetland
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Rachel C Shelton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Jeremy Kane
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Milena Mello
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Wilza Fumo
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Yazmin Cadena-Camargo
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Myrna Weissman
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
| | - Milton L Wainberg
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York City (Mootz, Sweetland, Mello, Weissman, Wainberg) Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven (Chantre, Sweetland); Departments of Sociomedical Sciences (Sikkema, Lovero, Shelton) and Epidemiology (Kane, Weissman), Mailman School of Public Health, Columbia University, New York City; Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City (Greene); Department of Mental Health, Ministry of Health, Maputo, Mozambique (Gouveia, Santos, Suleman, Comé, Feliciano, Fumo); Social and Preventive Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia (Uribe-Restrepo, Cadena-Camargo)
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35
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Moçambique D, Schindele A, Loquiha O, Martins S, Sequene M, Seni A, Macassa E, Samuel L, Mondlane C, Vilanculo A, Epifanio M, Buck WC. Strengthening the Diagnosis and Treatment of Malnutrition Through Increased Nurse Involvement: A Quality Improvement Project From Pediatric Wards in Mozambique. Glob Health Sci Pract 2023; 11:e2300094. [PMID: 38135520 PMCID: PMC10749644 DOI: 10.9745/ghsp-d-23-00094] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/21/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Childhood acute malnutrition continues to be a serious health problem in many low-resource settings in Africa. On pediatric wards in Mozambique, missed opportunities for timely diagnosis and treatment of malnutrition may lead to poor health outcomes. To improve inpatient nutritional care, a quality improvement (QI) project was implemented that aimed to engage pediatric nurses in inpatient malnutrition diagnosis and treatment. METHODS In 2 Mozambican referral hospitals, for 6 months, the Plan-Do-Study-Act framework for QI was implemented to identify key drivers of the following measures: having complete anthropometric evaluation documented at admission, 3 or more weight measurements per hospitalization week, documentation of nutritional therapy for eligible patients, and documentation of referral for outpatient nutritional rehabilitation after discharge. Clinical data were abstracted from hospital charts and entered into an EpiInfo database, including a 3-month observation period after the project, and analyzed retrospectively. RESULTS A total of 2,208 children from wards other than malnutrition were included in the analysis. Complete anthropometric evaluation at admission improved from 24.4% 2 months before the QI project to 80.1% during and 75.2% in the 3 months after the project (P<.001). The percentage of patients with 3 or more weight measurements per hospitalization week rose from 22.3% to 82.8% during and 75.0% after the project (P<.001). Documentation of nutritional therapy increased from 58.8% before to 67.1% during and 70.6% after the project (P=.54), and documentation of referral for outpatient nutritional rehabilitation after discharge decreased from 55.9% to 54.9% during and increased to 70.6% after the project, (P<.001). CONCLUSION Nurse engagement may lead to important advancements in the diagnosis and treatment of acute malnutrition in pediatric wards other than malnutrition in Mozambique. Task-sharing, particularly nurse engagement, in combination with QI methodology, may be considered for wards in similar settings with a high burden of malnutrition.
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Affiliation(s)
| | | | | | | | | | - Amir Seni
- Hospital Central da Beira, Beira, Mozambique
| | | | - Lara Samuel
- Clinton Health Access Initiative, Maputo, Mozambique
| | | | | | - Matias Epifanio
- Pontifícia Universidade Católica Rio Grande do Sul, Porto Alegre, Brazil
| | - W Chris Buck
- Hospital Central de Maputo, Maputo, Mozambique
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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36
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Nguenha N, Bialous S, Matavel J, Lencucha R. Tobacco industry presence and practices in Mozambique: a 'chaotic' but worthy market. Tob Control 2023; 33:86-92. [PMID: 35768213 DOI: 10.1136/tc-2022-057390] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Mozambique has experienced a series of tobacco industry consolidations both in tobacco leaf buying and processing, and in cigarette manufacturing and marketing. The growth of the tobacco industry presence in Mozambique was followed by an increase in tobacco industry's Corporate Social Responsibility (CSR) activities. This is the first paper to describe the history of tobacco industry activities in Mozambique, a party to the WHO Framework Convention on Tobacco Control (FCTC). METHODS We reviewed industry documents and associated web-based information. Industry documents (1990-2021) were identified through University of California San Francisco's Truth Tobacco Industry Documents Library. We followed with a search of web-based sources pertaining to the tobacco industry in Mozambique. We complemented our analysis with select media sources to identify statements by government officials in relation to the tobacco industry. We mapped major tobacco industry players, industry partnerships and corresponding CSR activities. RESULTS Tobacco production increased substantially in Mozambique in the 1990s when tobacco companies began targeting African countries. The increased attention to tobacco production, trade and sales in Mozambique was coupled with greater industry involvement in CSR activities. We identified 10 tobacco industry CSR programmes in Mozambique. Most of the CSR programmes focus on health including HIV/AIDS, social issues and environmental issues. CONCLUSIONS Similar to other tobacco-growing countries, the industry facilitated an increase in tobacco production and continues efforts to increase the tobacco consumption market while engaging in CSR activities focused on social and environmental issues. As in other countries, CSR initiatives in Mozambique enhance industry's reputation. Importantly, these CSR programmes and partnerships breach national laws and the provisions of the FCTC. The continuation of these programmes suggests limited attention within government to protect public policy from industry interference in compliance with Article 5.3 of the FCTC.
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Affiliation(s)
- Nicole Nguenha
- Family Medicine, McGill University, Montreal, Québec, Canada
| | - Stella Bialous
- Center for Tobacco Control, UCSF, San Francisco, California, USA
| | - Joaquim Matavel
- Mental Health Department, Ministry of Health, Maputo, Mozambique
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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Sengo DB, da Deolinda Bernardo Pica A, Dos Santos IIDB, Mate LM, Mazuze AN, Caballero P, López-Izquierdo I. Computer vision syndrome and associated factors in university students and teachers in Nampula, Mozambique. BMC Ophthalmol 2023; 23:508. [PMID: 38093208 PMCID: PMC10720210 DOI: 10.1186/s12886-023-03253-0] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/01/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Computer Vision Syndrome (CVS) is a complex of eye and visual problems that arise while using a computer or other Video Display Terminal (DVT). With the advent of the COVID-19 pandemic, the use of these DVTs has become indispensable in the lives of students and teachers. This study aims to identify the prevalence of CVS and associated factors in students and teachers at Lúrio University, in Nampula, during the pandemic period. METHODS This is a cross-sectional study, carried out between November 2020 and March 2021. The validated CVS questionnaire (CVS-Q) and another semi-structured questionnaire on ergonomic risk factors were applied. Odds ratios (OR) and adjusted odds ratios (aOR) were calculated to measure the association between CVS and computer use conditions. RESULTS The prevalence of CVS was 76.6%, and the female gender, age ≤ 20 years, levels I, II, III of course, lack of knowledge about ergonomics, use the computer to study, use more than 6 hours daily, absence of anti-reflex treatment, use of other devices and sitting in an inappropriate chair were risk factors for the occurrence of CVS, while being a teacher was a protective factor. CONCLUSION The prevalence of CVS found in this study was high, due to several factors, especially not using ergonomic principles when using computers and other DVTs. There is a need to adopt intervention strategies focused on the most vulnerable groups such as women, age group ≤20 years and students, especially at the first year level, right after entering the University.
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Affiliation(s)
- Dulnério Barbosa Sengo
- Instituto Superior de Ciências da Saúde, Av. Tomás Nduda, nr. 977 RC, Cidade de Maputo, Mozambique.
| | | | | | - Laura Mavota Mate
- Ministério dos Combatentes, Av Mártires Machava, nr. 307, Cidade de Maputo, Moçambique
| | - Avelino Nelson Mazuze
- Universidade Lúrio, faculdade Ciências de Saúde, Bairro de Marrere, R. nr, 4250, Nampula, Mozambique
| | - Pablo Caballero
- Universitat d'Alacant, Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Carretera Sant Vicent del Raspeig s/n, 03690, Sant Vicent del Raspeig, Alacant, Spain
| | - Inmaculada López-Izquierdo
- Universidad de Sevilla, Departamento de Física de la Materia Condensada, Av. Reina Mercedes s/n, 41012, Sevilla, Spain
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38
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Oludele J, Alho P, Chongo I, Maholela P, Magaia V, Muianga A, Melchior B, Isaías T, Gatambire A, Zimba E, Nhavoto E, Notiço P, Inguana P, Cantoria J, António V, Monteiro V, Ali S, Inlamea O, Samo Gudo E. Emerging Zoonotic Diseases among Pastoral Communities of Caia and Búzi Districts, Sofala, Mozambique: Evidence of Antibodies against Brucella, Leptospira, Rickettsia, and Crimean-Congo Hemorrhagic Fever Virus. Viruses 2023; 15:2379. [PMID: 38140620 PMCID: PMC10748219 DOI: 10.3390/v15122379] [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: 08/01/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Emerging zoonotic diseases are an increasing threat to public health. There is little data on the seroprevalence of zoonotic diseases among pastoralists in the country. We aim to carry out a cross-sectional study on the prevalence of major zoonotic diseases among pastoral communities in the Caia and Búzi districts. METHODS Between January and December 2018, a questionnaire was used to solicit socio-demographic data from consenting pastoralists with the collection of blood samples in the Caia and Búzi districts of the Sofala province. All samples were tested using ELISA commercial reagents for the detection of IgM antibodies against Brucella and Leptospira. Likewise, IgM and IgG antibodies against Rickettsia and CCHFV were determined using ELISA kits. RESULTS A total of 218 samples were tested, of which 43.5% (95/218) were from the district of Caia and 56.4% (123/218) from the Búzi district. Results from both districts showed that the seroprevalence of IgM antibodies against Brucella and Leptospira was 2.7% (6/218) and 30.3% (67/218), respectively. Positivity rates for IgM and IgG anti-Rickettsia and CCHFV were 8.7% (19/218), 2.7% (6/218), 4.1% (9/218), and 0.9% (2/218), respectively. CONCLUSIONS Results from our study showed evidence of antibodies due to exposure to Brucella, Leptospira, Rickettsia, and CCHFV with antibodies against Leptospira and Rickettsia being the most prevalent. Hence, laboratory diagnosis of zoonotic diseases is essential in the early detection of outbreaks, the identification of silent transmission, and the etiology of non-febrile illness in a pastoral community. There is a need to develop public health interventions that will reduce the risk of transmission.
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Affiliation(s)
- John Oludele
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Pascoal Alho
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Inocêncio Chongo
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Plácida Maholela
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Vlademiro Magaia
- Centro de Biotecnologia, Universidade Eduardo Mondlane, Maputo CP 257, Mozambique;
| | - Argentina Muianga
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Bibiana Melchior
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Telma Isaías
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Aline Gatambire
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Edna Zimba
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Emídio Nhavoto
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Paulo Notiço
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Pedro Inguana
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Juma Cantoria
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Virgílio António
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Vanessa Monteiro
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Sádia Ali
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
- Center for International Health, Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, Ludwig Maximilian University of Munich, 80802 München, Germany
| | - Osvaldo Inlamea
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
| | - Eduardo Samo Gudo
- Instituto Nacional de Saúde, Marracuene 3943, Mozambique; (P.A.); (I.C.); (P.M.); (A.M.); (B.M.); (T.I.); (A.G.); (E.Z.); (E.N.); (P.N.); (P.I.); (J.C.); (V.A.); (V.M.); (S.A.); (O.I.); (E.S.G.)
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Tallman S, Sungo MDD, Saranga S, Beleza S. Whole genomes from Angola and Mozambique inform about the origins and dispersals of major African migrations. Nat Commun 2023; 14:7967. [PMID: 38042927 PMCID: PMC10693643 DOI: 10.1038/s41467-023-43717-x] [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: 03/10/2022] [Accepted: 11/17/2023] [Indexed: 12/04/2023] Open
Abstract
As the continent of origin for our species, Africa harbours the highest levels of diversity anywhere on Earth. However, many regions of Africa remain under-sampled genetically. Here we present 350 whole genomes from Angola and Mozambique belonging to ten Bantu ethnolinguistic groups, enabling the construction of a reference variation catalogue including 2.9 million novel SNPs. We investigate the emergence of Bantu speaker population structure, admixture involving migrations across sub-Saharan Africa and model the demographic histories of Angolan and Mozambican Bantu speakers. Our results bring together concordant views from genomics, archaeology, and linguistics to paint an updated view of the complexity of the Bantu Expansion. Moreover, we generate reference panels that better represents the diversity of African populations involved in the trans-Atlantic slave trade, improving imputation accuracy in African Americans and Brazilians. We anticipate that our collection of genomes will form the foundation for future African genomic healthcare initiatives.
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Affiliation(s)
- Sam Tallman
- University of Leicester, Department of Genetics & Genome Biology, University Road, Leicester, LE1 7RH, UK
- Genomics England, 1 Canada Square, London, E14 5AB, UK
| | | | - Sílvio Saranga
- Universidade Pedagógica, Avenida Eduardo Mondlane, CP 2107, Maputo, Mozambique
| | - Sandra Beleza
- University of Leicester, Department of Genetics & Genome Biology, University Road, Leicester, LE1 7RH, UK.
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40
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Korkalo L, Alfthan G, Fidalgo L, Freese RI. Prevalence of vitamin E inadequacy, dietary intake and sources of alpha-tocopherol, and predictors of alpha- and gamma-tocopherol status in adolescent girls in Central Mozambique. J Nutr Sci 2023; 12:e121. [PMID: 38155808 PMCID: PMC10753459 DOI: 10.1017/jns.2023.103] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/20/2023] [Accepted: 10/27/2023] [Indexed: 12/30/2023] Open
Abstract
An adequate alpha-tocopherol status is important for females at reproductive age. We studied the dietary intake and sources of alpha-tocopherol and alpha- and gamma-tocopherol status indicators in 14-19-year-old girls in Central Mozambique. We also explored factors associated with alpha- and gamma-tocopherol status. The participants (n 508) were from the cross-sectional ZANE Study that was conducted in 2010. We recruited two separate samples, one in January-February and the other in May-June. We collected venous blood samples and conducted 24 h dietary recall interviews. At the time of blood sampling, 11 % of participants were pregnant and 10 % were lactating. In the total sample, both seasons combined, the median intake of alpha-tocopherol was 6⋅7 mg/d, the mean plasma alpha- and gamma-tocopherol concentrations were 13⋅5 and 0⋅75 μmol/l, respectively, and the prevalence of vitamin E inadequacy (alpha-tocopherol <12 μmol/l) was 36⋅7 % (95 % CI: 31⋅9-42⋅0 %). Season and lactation status were significant predictors of alpha-tocopherol status regardless of which the three indicators (plasma concentration, alpha-tocopherol:total cholesterol ratio, gamma-tocopherol:alpha-tocopherol ratio) were used. Being a lactating mother was negatively associated and having a blood sample taken in January-February, when the main sources of alpha-tocopherol were mango and dark green leafy vegetables, was positively associated with alpha-tocopherol status. In conclusion, vitamin E inadequacy was common in Central Mozambique, and the status may fluctuate due to seasonal changes in the diet. We suggest that lactating mothers are specifically at risk of poor alpha-tocopherol status in resource-poor settings.
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Affiliation(s)
- Liisa Korkalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Georg Alfthan
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lourdes Fidalgo
- Food Security and Nutrition Association (ANSA), Maputo, Mozambique
| | - Riitta I. Freese
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Schmidt S. When WASHing Is Not Enough: Food Hygiene and Chicken Production in Mozambique. Environ Health Perspect 2023; 131:124002. [PMID: 38153554 PMCID: PMC10754252 DOI: 10.1289/ehp14175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023]
Abstract
From egg to market, contamination of poultry products with Campylobacter and Salmonella increases along the "value chain," suggesting opportunities to reduce infection with these enteropathogens and complement WASH approaches to sanitation.
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Lszl GM, Volynkin AV. A new species of Karschiola Gaede from Mozambique and Zimbabwe (Lepidoptera: Erebidae: Arctiinae) with updated information on the distribution of the genus. Zootaxa 2023; 5375:214-226. [PMID: 38220826 DOI: 10.11646/zootaxa.5375.2.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Indexed: 01/16/2024]
Abstract
The present paper provides the description of a new species of the genus Karschiola Gaede, 1926 from central Mozambique and Zimbabwe: K. ndzou sp. n. The pairwise genetic distance between the two Karschiola species is calculated and a neighbour-joining tree based on DNA barcodes of two K. holoclera and five K. ndzou sp. n. specimens is provided. The paper is illustrated with eight colour photos of adults and 18 genitalia images, a distribution map and two habitat photos.
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Affiliation(s)
- Gyula M Lszl
- African Natural History Research Trust; Street Court; Kingsland; Leominster; HR6 9QA; United Kingdom.
| | - Anton V Volynkin
- Altai State University; Lenina Avenue 61; RF-656049; Barnaul; Russia.
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Schmauch NU, Pinto E, Rego F, Castro L, Sacarlal J, Rego G. Communication strategies used by medical physicians when delivering bad news at the Maputo Central Hospital, Mozambique: a cross-sectional study. BMC Palliat Care 2023; 22:186. [PMID: 37990181 PMCID: PMC10664502 DOI: 10.1186/s12904-023-01309-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Physicians' communication with patients and their families is important during both the disease diagnosis and prognosis stages and through the follow-up process. Effective physician communication improves patients' quality of life and satisfaction with care and helps reduce suffering for those newly diagnosed with advanced progressive illnesses. This study aims to identify the communication strategies physicians use in the transition to palliative care and how these professionals perceive their academic and clinical preparation concerning this task. METHODS A cross-sectional and quantitative study. Physicians providing palliative care at the Maputo Central Hospital, Mozambique, were invited to complete a 17-question questionnaire. This questionnaire was based on a Brazilian adaptation of the Setting-Perception-Invitation-Knowledge-Emotions-Strategy (SPIKES) tool, the P-A-C-I-E-N-T-E protocol, with additional questions regarding socio-demographic details and the integration of "communication of bad news" into hospital training. RESULTS Of the 121 participants, 62 (51.2%) were male, and 110 (90.9%) were general practitioners, with a median age of 36 years old. They had worked in clinical practice for a median of 8 years and in their current department for three years. The majority of the participants considered that they have an acceptable or good level of bad news communication skills and believed that they do it in a clear and empathic way, paying attention to the patient's requests and doubts; however, most were not aware of the existing tools to assist them in this task and suggested that delivering bad news ought to be integrated into the undergraduate medical course and included in hospital training. CONCLUSIONS This study adds to our understanding of physicians' strategies when communicating bad news in the context of palliative care at one Mozambique hospital. As palliative care is not fully implemented in Mozambique, it is important to use protocols suitable to the country's healthcare level to improve how doctors deal with patients and their family members.
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Affiliation(s)
- Natália Ubisse Schmauch
- Faculty of Medicine, University of Porto, Porto, Portugal.
- Pain Unit, Maputo Central Hospital, Maputo, Mozambique.
| | - Emilia Pinto
- Faculty of Medicine, University of Porto, Porto, Portugal
- Pain Unit, Maputo Central Hospital, Maputo, Mozambique
| | - Francisca Rego
- Faculty of Medicine, University of Porto, Porto, Portugal
| | - Luísa Castro
- Faculty of Medicine, University of Porto, Porto, Portugal
- Center for Research in Health Technologies and Services - CINTESIS, University of Porto, Porto, Portugal
| | - Jahit Sacarlal
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
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Shen H, Bai L, Huang H, Ding X, Wang R, LÜ H. Effects of Tropical Cyclone (TC) Hellen on the north-westward movement of chlorophyll in the northern Mozambique Channel. PLoS One 2023; 18:e0292728. [PMID: 37917656 PMCID: PMC10621922 DOI: 10.1371/journal.pone.0292728] [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: 05/29/2023] [Accepted: 09/26/2023] [Indexed: 11/04/2023] Open
Abstract
An intense tropical cyclone (TC), TC Hellen, occurred in the northern Mozambique Channel on March 27, 2014, and moved from the east coast of the African continent to the northern Madagascar island. TC Hellen dramatically altered the marine environment in the northern Mozambique Channel, resulting in a significant chlorophyll-a (Chl-a) bloom. A giant surface Chl-a northwest-ward movement from the northwest coast of Madagascar Island was first observed after the passage of TC Hellen in the northern Mozambique Channel. The dynamic mechanisms of these phenomenon were studied by satellite remote sensing, multisource reanalysis data, and Argo float data. The results show that transient northwestward-moving eddies, upwelling, and winds had important effects on the Chl-a bloom and its northwestward movement. Ekman transport driven by coastal southeasterly winds entrained waters with high Chl-a concentrations to the northwest, while TC Hellen enhanced cyclonic eddy upwelling and uplifted nutrient-rich deep water to the upper ocean. This vertical mixing and upwelling in turn triggered the Chl-a bloom in the offshore surface layer. This study provides insight into the reflection of phytoplankton dynamics by TCs in the northern Mozambique Channel.
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Affiliation(s)
- Hao Shen
- Jiangsu Key Laboratory of Marine Bioresources and Environment /Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
| | - Linfei Bai
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
- Lianyungang Meteorological Bureau, Lianyungang, Jiangsu province, China
| | - Haojie Huang
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
| | - Xiaoqi Ding
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
- Lianyungang Meteorological Bureau, Lianyungang, Jiangsu province, China
| | - Rui Wang
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
- Lianyungang Meteorological Bureau, Lianyungang, Jiangsu province, China
| | - Haibin LÜ
- Jiangsu Key Laboratory of Marine Bioresources and Environment /Jiangsu Key Laboratory of Marine Biotechnology, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
- School of Marine Technology and Geomatics, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
- Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Jiangsu Ocean University, Lianyungang, Jiangsu province, China
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Figueroa-Romero A, Bissombolo D, Meremikwu M, Ratsimbasoa A, Sacoor C, Arikpo I, Lemba E, Nhama A, Rakotosaona R, Llach M, Pons-Duran C, Sanz S, Ma L, Doderer-Lang C, Maly C, Roman E, Pagnoni F, Mayor A, Menard D, González R, Menéndez C. Prevalence of molecular markers of resistance to sulfadoxine-pyrimethamine before and after community delivery of intermittent preventive treatment of malaria in pregnancy in sub-Saharan Africa: a multi-country evaluation. Lancet Glob Health 2023; 11:e1765-e1774. [PMID: 37858587 DOI: 10.1016/s2214-109x(23)00414-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The effectiveness of community delivery of intermittent preventive treatment (C-IPT) of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine has been evaluated in selected areas of the Democratic Republic of the Congo, Madagascar, Mozambique, and Nigeria. We aimed to assess the effect of C-IPTp on the potential development of Plasmodium falciparum resistance to sulfadoxine-pyrimethamine, since it could threaten the effectiveness of this strategy. METHODS Health facility-based cross-sectional surveys were conducted at baseline and 3 years after C-IPTp implementation in two neighbouring areas per country, one with C-IPTp intervention, and one without, in the four project countries. Dried blood spots from children under five years of age with clinical malaria were collected. Sulfadoxine-pyrimethamine resistance-associated mutations of the P falciparum dhfr (Asn51Ile/Cys59Arg/Ser108Asn/Ile164Leu) and dhps (Ile431Val/Ser436Ala/Ala437Gly/Lys540Glu/Ala581Gly/Ala613Ser) genes were analysed. FINDINGS 2536 children were recruited between June 19 and Oct 10, 2018, during baseline surveys. Endline surveys were conducted among 2447 children between July 26 and Nov 30, 2021. In the Democratic Republic of the Congo, the dhfr/dhps IRNI/ISGEAA inferred haplotype remained lower than 10%, from 2% (5 of 296) at baseline to 8% (24 of 292) at endline, and from 3% (9 of 300) at baseline to 6% (18 of 309) at endline surveys in intervention and non-intervention areas respectively with no significant difference in the change between the areas. In Mozambique, the prevalence of this haplotype remained stable at over 60% (194 [64%] of 302 at baseline to 194 [64%] of 303 at endline, and 187 [61%] of 306 at baseline to 183 [61%] of 301 in endline surveys, in non-intervention and intervention areas respectively). No isolates harbouring the dhps ISGEAA genotype were found in Nigeria. In Madagascar, only five isolates with this haplotype were found in the non-intervention area (2 [>1%] of 300 at baseline and 3 [1%] of 300 at endline surveys). No isolates were found carrying the dhps ISGEGA genotype. INTERPRETATION C-IPTp did not increase the prevalence of molecular markers associated with sulfadoxine-pyrimethamine resistance after three years of programme implementation. These findings reinforce C-IPTp as a strategy to optimise the control of malaria during pregnancy, and support the WHO guidelines for prevention of malaria in pregnancy. FUNDING UNITAID [2017-13-TIPTOP].
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Affiliation(s)
- Antía Figueroa-Romero
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Kinshasa, Democratic Republic of the Congo
| | | | - Martin Meremikwu
- Cross River Health and Demographic Surveillance System, University of Calabar, Cross River State, Nigeria
| | | | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Iwara Arikpo
- Cross River Health and Demographic Surveillance System, University of Calabar, Cross River State, Nigeria
| | - Elsha Lemba
- Medecins d'Afrique, Kinshasa, Democratic Republic of the Congo
| | - Abel Nhama
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique; Instituto Nacional de Saúde (INS), Maputo, Mozambique
| | | | - Mireia Llach
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Clara Pons-Duran
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Sergi Sanz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Kinshasa, Democratic Republic of the Congo; Department of Basic Clinical Practice, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Laurence Ma
- Institut Pasteur, Université Paris Cité, Biomics Platform, Paris, France
| | - Cécile Doderer-Lang
- Université de Strasbourg, Institute of Parasitology and Tropical Diseases, Strasbourg, France
| | - Christina Maly
- Jhpiego, John Hopkins University Affiliate, Baltimore MD, USA
| | - Elaine Roman
- Jhpiego, John Hopkins University Affiliate, Baltimore MD, USA
| | - Franco Pagnoni
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Alfredo Mayor
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Didier Menard
- Université de Strasbourg, Institute of Parasitology and Tropical Diseases, Strasbourg, France; Malaria Genetics and Resistance Unit, Institut Pasteur, Paris, France; Institut Pasteur, Université Paris Cité, Malaria Parasite Biology and Vaccines Unit, Paris, France; CHU Strasbourg, Laboratory of Parasitology and Medical Mycology, Strasbourg, France
| | - Raquel González
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Kinshasa, Democratic Republic of the Congo; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
| | - Clara Menéndez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Kinshasa, Democratic Republic of the Congo; Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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Inteca G, Hagy B, Silva I, Amoda C, Cululo A, Farooq H. The tourism industry keeps beaches clean in Mozambique. Mar Pollut Bull 2023; 196:115615. [PMID: 37804669 DOI: 10.1016/j.marpolbul.2023.115615] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/09/2023]
Abstract
In this study, we conducted the first assessment of the litter abundance, diversity and predictors in Mozambique, by collecting approximately 2 tons of litter along six beaches across the country. We tested whether population, touristic industry, fishing, and recreation activities predict the quantity of macro litter for each of the 11 types and 141 subtypes of litter. Overall, we found that plastics made up 60.1 % of the items across all sampled beaches. Following plastics, clothing objects accounted for the second most weight (20.4 %) while foam objects were the second most abundant (15.7 %). More importantly, our results show that the tourism industry is a strong predictor for lower levels of litter across most types of litter while population density and fishing activity were strong predictors for higher levels. Our findings suggest that the tourism industry plays a crucial role in the country by maintaining the beaches clean.
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Affiliation(s)
- Gélica Inteca
- Faculty of Natural Sciences, Lúrio University, P.O. Box 958, Pemba, Mozambique.
| | - Badru Hagy
- Oceanographic Institute of Mozambique, P.O. Box 4603, Maputo, Mozambique
| | - Isabel Silva
- Faculty of Natural Sciences, Lúrio University, P.O. Box 958, Pemba, Mozambique
| | - Carlota Amoda
- Oceanographic Institute of Mozambique, P.O. Box 4603, Maputo, Mozambique
| | - Aniceto Cululo
- Faculty of Natural Sciences, Lúrio University, P.O. Box 958, Pemba, Mozambique
| | - Harith Farooq
- Faculty of Natural Sciences, Lúrio University, P.O. Box 958, Pemba, Mozambique; Center for Macroecology, Evolution and Climate, Globe Institute, University of Copenhagen, P.O. Box 2100, Copenhagen, Denmark; Gothenburg Global Biodiversity Centre, University of Gothenburg, Gothenburg, P.O. Box 461, 405 30 Gothenburg, Sweden
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Walker RH, Hutchinson MC, Becker JA, Daskin JH, Gaynor KM, Palmer MS, Gonçalves DD, Stalmans ME, Denlinger J, Bouley P, Angela M, Paulo A, Potter AB, Arumoogum N, Parrini F, Marshal JP, Pringle RM, Long RA. Trait-based sensitivity of large mammals to a catastrophic tropical cyclone. Nature 2023; 623:757-764. [PMID: 37968390 DOI: 10.1038/s41586-023-06722-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 10/06/2023] [Indexed: 11/17/2023]
Abstract
Extreme weather events perturb ecosystems and increasingly threaten biodiversity1. Ecologists emphasize the need to forecast and mitigate the impacts of these events, which requires knowledge of how risk is distributed among species and environments. However, the scale and unpredictability of extreme events complicate risk assessment1-4-especially for large animals (megafauna), which are ecologically important and disproportionately threatened but are wide-ranging and difficult to monitor5. Traits such as body size, dispersal ability and habitat affiliation are hypothesized to determine the vulnerability of animals to natural hazards1,6,7. Yet it has rarely been possible to test these hypotheses or, more generally, to link the short-term and long-term ecological effects of weather-related disturbance8,9. Here we show how large herbivores and carnivores in Mozambique responded to Intense Tropical Cyclone Idai, the deadliest storm on record in Africa, across scales ranging from individual decisions in the hours after landfall to changes in community composition nearly 2 years later. Animals responded behaviourally to rising floodwaters by moving upslope and shifting their diets. Body size and habitat association independently predicted population-level impacts: five of the smallest and most lowland-affiliated herbivore species declined by an average of 28% in the 20 months after landfall, while four of the largest and most upland-affiliated species increased by an average of 26%. We attribute the sensitivity of small-bodied species to their limited mobility and physiological constraints, which restricted their ability to avoid the flood and endure subsequent reductions in the quantity and quality of food. Our results identify general traits that govern animal responses to severe weather, which may help to inform wildlife conservation in a volatile climate.
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Affiliation(s)
- Reena H Walker
- Department of Fish and Wildlife Sciences, University of Idaho, Moscow, ID, USA
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Matthew C Hutchinson
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Department of Life and Environmental Sciences, University of California Merced, Merced, CA, USA
| | - Justine A Becker
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Department of Ecology, Montana State University, Bozeman, MT, USA
| | - Joshua H Daskin
- Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA
- Archbold Biological Station, Venus, FL, USA
| | - Kaitlyn M Gaynor
- Departments of Zoology and Botany, University of British Columbia, Vancouver, British Columbia, Canada
| | - Meredith S Palmer
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
| | - Dominique D Gonçalves
- Department of Scientific Services, Gorongosa National Park, Sofala, Mozambique
- Durrell Institute of Conservation and Ecology, University of Kent, Canterbury, UK
| | - Marc E Stalmans
- Department of Scientific Services, Gorongosa National Park, Sofala, Mozambique
| | - Jason Denlinger
- Department of Scientific Services, Gorongosa National Park, Sofala, Mozambique
| | - Paola Bouley
- Department of Conservation, Gorongosa National Park, Sofala, Mozambique
- Associação Azul Moçambique, Maputo, Mozambique
| | - Mercia Angela
- Department of Conservation, Gorongosa National Park, Sofala, Mozambique
| | - Antonio Paulo
- Department of Conservation, Gorongosa National Park, Sofala, Mozambique
| | - Arjun B Potter
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA
- Wake Forest University, Winston-Salem, NC, USA
| | - Nikhail Arumoogum
- Centre for African Ecology, School of Animal, Plant and Environmental Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Francesca Parrini
- Centre for African Ecology, School of Animal, Plant and Environmental Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jason P Marshal
- Centre for African Ecology, School of Animal, Plant and Environmental Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Robert M Pringle
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
| | - Ryan A Long
- Department of Fish and Wildlife Sciences, University of Idaho, Moscow, ID, USA.
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48
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Costa S, Guambe B, Boaventura C, Nordhagen S. Leveraging Emotion for Behavior Change: Lessons from Implementation of the "Emo-Demo" Behavior Change Technique in Rural Mozambique. J Health Commun 2023; 28:78-86. [PMID: 38146153 DOI: 10.1080/10810730.2023.2231888] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Innovative social behavior change communication (SBCC) can help improve child nutrition, but little is known about the process of implementing innovative nutrition SBCC strategies in resource-poor settings and associated challenges. This research study examines emotional demonstrations (Emo-Demos), interactive game-like group activities that aim to spark behavior change by pulling emotional levers. It seeks to determine whether they are feasible and acceptable for implementers and targeted community members in rural Mozambique, aiming to draw lessons for the application of similar highly interactive SBCC approaches in resource-poor settings-a key equity issue. This is done through a series of structured observations of the approach being delivered in seven communities as well as interviews with facilitators and participants. Results show the Emo-Demos were generally feasible to implement as planned and largely acceptable for both facilitators and participants. However, facilitators did not always understand the theory behind them, the importance of them being interactive, and the exact steps that needed to be followed to do them correctly. Participants universally reported enjoying the sessions and understood the lessons taught, and were able to translate them into potential behavior changes. However, few reported the expected emotional reaction to the sessions, and some had difficulty understanding the symbolic use of props in the exercises. The results underline the importance of strong training of SBCC facilitators, including on underlying theory; adapting approaches to local realities; and considering the incentives for participants to attend. These steps can help ensure high-quality SBCC that functions even in resource-poor settings, increasing intervention equity.
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Affiliation(s)
- Sofia Costa
- Feeding the Change, Universidade Lúrio (UniLúrio), Nampula, Mozambique
| | - Berta Guambe
- Mozambique Country Office, Global Alliance for Improved Nutrition, Maputo, Mozambique
| | - Cecilia Boaventura
- Department of Nutrition, Universidade Lúrio (UniLúrio), Nampula, Mozambique
| | - Stella Nordhagen
- Knowledge Leadership Team, Global Alliance for Improved Nutrition, Geneva, Switzerland
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49
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Coonahan E, Gage H, Chen D, Noormahomed EV, Buene TP, Mendes de Sousa I, Akrami K, Chambal L, Schooley RT, Winzeler EA, Cowell AN. Whole-genome surveillance identifies markers of Plasmodium falciparum drug resistance and novel genomic regions under selection in Mozambique. mBio 2023; 14:e0176823. [PMID: 37750720 PMCID: PMC10653802 DOI: 10.1128/mbio.01768-23] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/02/2023] [Indexed: 09/27/2023] Open
Abstract
IMPORTANCE Malaria is a devastating disease caused by Plasmodium parasites. The evolution of parasite drug resistance continues to hamper progress toward malaria elimination, and despite extensive efforts to control malaria, it remains a leading cause of death in Mozambique and other countries in the region. The development of successful vaccines and identification of molecular markers to track drug efficacy are essential for managing the disease burden. We present an analysis of the parasite genome in Mozambique, a country with one of the highest malaria burdens globally and limited available genomic data, revealing current selection pressure. We contribute additional evidence to limited prior studies supporting the effectiveness of SWGA in producing reliable genomic data from complex clinical samples. Our results provide the identity of genomic loci that may be associated with current antimalarial drug use, including artemisinin and lumefantrine, and reveal selection pressure predicted to compromise the efficacy of current vaccine candidates.
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Affiliation(s)
- Erin Coonahan
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Hunter Gage
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Daisy Chen
- Department of Pediatrics, University of California San Diego (UCSD), La Jolla, California, USA
| | - Emilia Virginia Noormahomed
- School of Medicine, University of California San Diego, La Jolla, California, USA
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute of Health Education and Research (MIHER), Maputo, Mozambique
| | - Titos Paulo Buene
- Department of Microbiology, Parasitology Laboratory, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Mozambique Institute of Health Education and Research (MIHER), Maputo, Mozambique
| | - Irina Mendes de Sousa
- Mozambique Institute of Health Education and Research (MIHER), Maputo, Mozambique
- Biological Sciences Department, Faculty of Sciences, Eduardo Mondlane University, Maputo, Mozambique
| | - Kevan Akrami
- School of Medicine, University of California San Diego, La Jolla, California, USA
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Lucia Chambal
- Mozambique Institute of Health Education and Research (MIHER), Maputo, Mozambique
- Department of Internal Medicine, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
- Maputo Central Hospital, Maputo, Mozambique
| | - Robert T. Schooley
- School of Medicine, University of California San Diego, La Jolla, California, USA
| | - Elizabeth A. Winzeler
- Department of Pediatrics, University of California San Diego (UCSD), La Jolla, California, USA
| | - Annie N. Cowell
- School of Medicine, University of California San Diego, La Jolla, California, USA
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50
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Gill MM, Herrera N, Guilaze R, Mussa A, Dengo N, Nhangave A, Mussá J, Perez P, Bhatt N. Virologic Outcomes and ARV Switch Profiles 2 Years After National Rollout of Dolutegravir to Children Less Than 15 Years in Southern Mozambique. Pediatr Infect Dis J 2023; 42:893-898. [PMID: 37409808 DOI: 10.1097/inf.0000000000004037] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
BACKGROUND Dolutegravir (DTG) was scaled up globally to optimize treatment for children living with HIV. We evaluated the rollout and virological outcomes after DTG introduction in Mozambique. METHODS Data from children 0-14 years with visits from September 2019 to August 2021 were extracted from records in 16 facilities in 12 districts. Among children ever on DTG, we report treatment switches, defined as changes in anchor drug, regardless of changes to nucleoside reverse transcriptase inhibitor (NRTI) backbones. Among those on DTG for ≥6 months, we described viral load suppression rates by children newly initiating and switching to DTG and by the NRTI backbone at the time of the DTG switch. RESULTS Overall, 3,347 children were ever on DTG-based treatment (median age 9.5 years; 52.8% female). Most children (3,202, 95.7%) switched to DTG from another antiretroviral regimen. During the 2-year follow-up, 9.9% never switched from DTG; 52.7% had 1 regimen change, of which 97.6% were switched to DTG. However, 37.2% of children experienced ≥2 anchor drug changes. Overall median time on DTG was 18.6 months; nearly all children ≥5 years (98.6%) were on DTG at the last visit. Viral suppression was 79.7% (63/79) for children newly initiating DTG and 85.8% (1,775/2,068) for those switching to DTG. Suppression rates were 84.8% and 85.7% among children who switched and maintained NRTI backbones, respectively. CONCLUSIONS Viral suppression rates of ≥80% with minor variations by backbone were achieved during the 2-year DTG rollout. However, there were multiple anchor drug switches for over one-third of children, which may be attributable in part to drug stockouts. Long-term pediatric HIV management will only be successful with immediate and sustainable access to optimized child-friendly drugs and formulations.
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Affiliation(s)
- Michelle M Gill
- From the Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Washington DC
| | - Nicole Herrera
- From the Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Washington DC
| | - Rui Guilaze
- Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique
| | - Abdul Mussa
- Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique
| | - Nataniel Dengo
- Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique
| | - Amancio Nhangave
- Gaza Provincial Health Directorate, Mozambique Ministry of Health
| | - Jaciara Mussá
- Inhambane Provincial Health Directorate, Mozambique Ministry of Health
| | - Patricia Perez
- Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique
| | - Nilesh Bhatt
- Research Department, Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique
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