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Rev. cuba. med. trop ; 73(2): e623, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347490


Introducción: En 2017 se realizó la Campaña de Cobertura Universal, en que se aplicó el nuevo modelo de distribución de mosquiteros impregnados con insecticida de larga duración, después de las bajas coberturas encontradas en 2015. Objetivo: Caracterizar el nuevo modelo de distribución de mosquiteros con insecticida de larga duración, aplicado en la Campaña 2017, en la provincia de Tete, Mozambique. Métodos: Se realizóun estudio cuantitativo, descriptivo, observacional y transversal. A partir de estadísticas univariadas, se estimó el porcentaje y sus intervalos de confianza del 95 % para los indicadores de registro correctos. Para encontrar la asociación entre los hogares registrados y los hogares de posesión, se calculó el coeficiente de correlación de Pearson (r) y el coeficiente de determinación (R2). Resultados: De los 3 284 hogares evaluados en la etapa de registro, al 98 por ciento se les asignaron calcomanías, al 99 por ciento cupones, y el criterio de adjudicación de mosquiteros impregnados con insecticida de larga duración fue correcto en el 97 por ciento, respectivamente. De los hogares registrados, 1 086 (97 por ciento) tuvieron acceso a al menos un mosquitero impregnado con insecticida de larga duración y 1 041 (92,9 por ciento) durmieron con estos mosquiteros la noche anterior a la encuesta. Conclusiones: La Campaña de Cobertura Universal, utilizando el nuevo modelo de distribución de mosquiteros impregnados con insecticida de larga duración, asegura un adecuado registro de los hogares, lo que ha contribuido al aumento de su posesión y uso, y al avance hacia el logro de las metas de cobertura universal en la comunidad(AU)

Introduction: As part of the Universal Coverage Campaign implemented in 2017, a new model was applied for the distribution of mosquito nets impregnated with long-lasting insecticide. Coverage had been found to be low in 2015. Objective: Characterize the new model for the distribution of mosquito nets impregnated with long-lasting insecticide applied in the 2017 Campaign in Tete Province, Mozambique. Methods: A cross-sectional observational descriptive quantitative study was conducted. Starting from univariate statistics, estimation was made of percentage and its 95 percent confidence intervals for correct registry indicators. Pearson's correlation coefficient (r) and the coefficient of determination (R2) were estimated to find the association between registered and possessing households. Results: Of the 3 284 households evaluated during the registration stage, 98 percent were given stickers and 99 percent received coupons. The criterion followed for the assignment of mosquito nets impregnated with long-lasting insecticide was correct in 97 percent , respectively. Of the households registered, 1 086 (97 percent) had access to at least one mosquito net impregnated with long-lasting insecticide, whereas 1 041 (92 percent) had slept under these mosquito nets the night before the survey. Conclusions: With the use of the new model for the distribution of mosquito nets impregnated with long-lasting insecticide, the Universal Coverage Campaign ensures the appropriate registration of households, contributing to an increase in their possession and use, and the attainment of universal coverage goals in the community(AU)

Humans , Male , Female , Unified Health System , Insecticides , Insecticide-Treated Bednets/standards , Health Promotion , Mozambique
Pesqui. bras. odontopediatria clín. integr ; 21(supl.1): e0030, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1346687


ABSTRACT Objective: To obtain reference values for tip, torque and in-out from digital models of Italian and Mozambican subjects in ideal occlusion using a repeatable and validated method and to compare these measurements with previously reported values. Material and Methods: Dental parameters were acquired from digital models of each subject, categorized to one of two groups: Italians (23 males, 27 females; mean age 28.3 years, ±5.7 years) and Mozambicans (14 males, 15 females; mean age, 23.4 years, ±5.9), using VAM software. All subjects had ideal occlusion, permanent dentition and no previous orthodontic treatment, fillings or prostheses. After normality of data was assumed (p<0.05), a paired t-test was performed to detect any statistical differences between the two groups (p<0.05). Then, classical inference (t-test and power analysis) was used to compare our data to those reported by other authors. Results: Mozambicans' incisors were more proclined, while their upper molars appeared to be more prominent regarding Italians'. Italians shown greater tip values, especially at the upper first premolars and lower first molars. In-out values were comparable between the two groups, except for the upper molars (more prominent in Mozambicans) and lower first molar (more prominent in Italians). Unlike other reports, upper second molars displayed negative tip in our samples. Conclusion: Pre-adjusted appliances with standard prescription should not be expected to guarantee optimal outcomes. Prescriptions specific for ethnicities are recommended and reference values should be reconsidered.

Humans , Male , Female , Adolescent , Adult , Orthodontic Appliances , Dentition, Permanent , Torque , Dental Occlusion , Italy , Mozambique , Orthodontics , Statistics, Nonparametric
Malar. j. (Online) ; 20(390): 1-12, 2021. Mapas, Tab.
Article in English | AIM, RSDM, AIM | ID: biblio-1352541


Background: Artemisinin-based combination therapy (ACT) has been the recommended first-line treatment for uncomplicated malaria in Mozambique since 2006, with artemether­lumefantrine (AL) and amodiaquine­artesunate (AS­AQ) as the first choice. To assess efficacy of currently used ACT, an in vivo therapeutic efficacy study was conducted. Methods: The study was conducted in four sentinel sites: Montepuez, Moatize, Mopeia and Massinga. Patients between 6 and 59 months old with uncomplicated Plasmodium falciparum malaria (2000­200,000 parasites/µl) were enrolled between February and September of 2018, assigned to either an AL or AS­AQ treatment arm, and monitored for 28 days. A Bayesian algorithm was applied to differentiate recrudescence from new infection using genotyping data of seven neutral microsatellites. Uncorrected and PCR-corrected efficacy results at day 28 were calculated. Results: Totals of 368 and 273 patients were enrolled in the AL and AS­AQ arms, respectively. Of these, 9.5% (35/368) and 5.1% (14/273) were lost to follow-up in the AL and AS­AQ arms, respectively. There were 48 and 3 recurrent malaria infections (late clinical and late parasitological failures) in the AL and AS­AQ arms, respectively. The day 28 uncorrected efficacy was 85.6% (95% confidence interval (CI) 81.3­89.2%) for AL and 98.8% (95% CI 96.7­99.8%) for AS­AQ, whereas day 28 PCR-corrected efficacy was 97.9% (95% CI 95.6­99.2%) for AL and 99.6% (95% CI 97.9­100%) for AS­AQ. Molecular testing confirmed that 87.4% (42/48) and 33.3% (1/3) of participants with a recurrent malaria infection in the AL and AS­AQ arms were new infections; an expected finding in a high malaria transmission area. Adverse events were documented in less than 2% of participants for both drugs. Conclusion: Both AL and AS­AQ have therapeutic efficacies well above the 90% WHO recommended threshold and remain well-tolerated in Mozambique. Routine monitoring of therapeutic efficacy should continue to ensure the treatments remain efficacious.

Child, Preschool , Malaria, Falciparum , Malaria/drug therapy , Parasites , Patients , Recurrence , Safety , Therapeutics , Algorithms , Polymerase Chain Reaction , Efficacy/methods , Monitoring , Molecular Diagnostic Techniques , Lost to Follow-Up , Artesunate/administration & dosage , Artemether/administration & dosage , Lumefantrine , Infections , Mozambique/epidemiology
Malar. j. (Online) ; 20(293): 1-10, 2021. Tab.
Article in English | AIM, RSDM, AIM | ID: biblio-1353124


Background: In Mozambique, socio-economic and cultural factors influence the wide adoption of disease preventive measures that are relevant for malaria control strategies to promote early recognition of disease, prompt seeking of medical care, sleeping under insecticide-treated nets (ITNs), and taking intermittent preventive treatment for pregnant women. However, there is a critical information gap regarding previous and ongoing malaria social and behavioural change (SBC) interventions. The aim of this study is to assess the knowledge, attitudes, practices of beneficiaries of SBC interventions. Methods: A descriptive cross-sectional survey was undertaken in 2018 in two rural districts of Zambezia Province, Mozambique. A structured questionnaire was administered to 773 randomly selected households. Respondents were the adult heads of the households. Descriptive statistics were done. Results: The main results show that 96.4% of respondents recalled hearing about malaria in the previous 6 months, 90.0% had knowledge of malaria prevention, and 70.0% of preventive measures. Of the 97.7% respondents that had received ITNs through a mass ITN distribution campaign, 81.7% had slept under an ITN the night before the survey. In terms of source of health information, 70.5% mentioned the role of community volunteers in dissemination of malaria prevention messages, 76.1% of respondents considered worship places (churches and mosques) to be the main places where they heard key malaria prevention messages, and 79.1% asserted that community dialogue sessions helped them better understand how to prevent malaria. Conclusions: Results show that volunteers/activists/teachers played an important role in dissemination of key malaria prevention messages, which brought the following successes: community actors are recognized and people have knowledge of malaria transmission, signs and symptoms, preventive measures, and where to get treatment. There is, however, room for improvement on SBC messaging regarding some malaria symptoms (anaemia and convulsions) and operational research is needed to ascertain the drivers of malaria prevalence and inform the SBC approach.

Humans , Pregnancy , Malaria , Socioeconomic Factors , Therapeutics/methods , Prevalence , Surveys and Questionnaires , Health Strategies , Knowledge , Cultural Factors , Control , Information , Malaria/prevention & control , Medical Assistance , Mozambique
Soc. sci. med. (1982) ; 291(114512)2021.
Article in English | AIM, RSDM, AIM | ID: biblio-1353234


Interactions between healthcare users and providers are an essential but often problematic element in therapeutic processes. In many settings worldwide, there has been a general recognition of the importance of adopting care approaches that understand patients as active agents, moving away from traditional paternalistic forms of interaction. Research shows that improving the quality of communication in therapeutic encounters fosters mutual understanding and cooperation in healthcare processes, helping to create the grounding conditions for building trusting relationships. But what are the communicative mechanisms through which trust in healthcare providers is cultivated? Going beyond the traditional 'doctor-patient' dyad analysis, and using data from a mixed-method study on medicine use in Maputo, Mozambique, this paper explores healthcare users' experiences and interpretations of their interactions with public healthcare professionals (medical doctors and prescribing nurses) and community pharmacy workers (pharmacists, technicians and other attendants). The analysis evolves around various communicative and relational aspects, emphasised by users as meaningful and underpinning different qualities of care, competence, integrity and trustworthiness. These attributes were assessed based on a combination of verbal conversation and information exchange, together with the use of other (non-verbal) situationally valued artefacts such as biomedical tools and communicative rituals performed by providers. This study shows that despite healthcare providers' different attributes of competence and authority, it is mainly their communicative performances during interactions that influence whether (symbolic) trust has the space to evolve or crystallise. Moreover, while performing certain rituals may be an effective form of communication, the lack of other (verbal and non-verbal) communicative elements during the interaction may compromise patient trust in what is being prescribed or advised. Efforts to improve the quality and responsiveness of healthcare services centred around citizens' needs should take users' perspectives into account and pay particular attention to these communicative and relational dimensions.

Humans , Therapeutics , Communication , Patients , Bioethics , Pharmaceutical Preparations , Ceremonial Behavior , Health Personnel , Information Dissemination , Trust , Drug Interactions , Elements , Medicine , Mozambique , Nurses
Rev. moçamb. ciênc. saúde ; 7(1): 40-44, Out. 2021.
Article in Portuguese | AIM, RSDM, AIM | ID: biblio-1344147


precaução transmissão cruzada e a importância de consciencializar e actualizar os profissionais de saúde sobre as medidas e os riscos de contaminação intra-hospitalar.

Eleven days after the COVID-19 Pandemic was decreed, Mozambique recorded the first positive case. Healthcare workers, due to the nature of their activity, have a high risk of contact with infected cases and although the exact number of infected healthcare workers to date in Mozambique is not yet discloses, we consider to be relevant the reflection in the prevention strategies adopted to guarantee protection and reduce the risk of contamination in hospital environmen...

Humans , eHealth Strategies , COVID-19/epidemiology , Working Environment/methods , National Health Strategies , Public Health , Risk , Health Personnel/statistics & numerical data , Environment , Disease Prevention , Epidemiological Monitoring , COVID-19/prevention & control , Hospitals , Mozambique/epidemiology
Rev. moçamb. ciênc. saúde ; 7(1): 36-39, Out. 2021. mapas, tab, Fig.
Article in Portuguese | AIM, RSDM, AIM | ID: biblio-1344133


Ao longo dos últimos dez anos, muitos passos foram dados para a evolução e progressão da especialidade de Gastroenterologia no nosso país, quer em termos de formação de novos especialistas, bem como no aumento de novos procedimentos endoscópicos, que vieram beneficiar muito aos utentes que frequentam o Sistema Nacional de Saúde (SNS). Moçambique é um país vasto, com uma área de 801.590 km² e uma população estimada em 28.861.863 habitantes, sendo cerca de 15 milhões do sexo feminino e cerca de 13 milhões do sexo masculino, com maior concentração populacional nas províncias de Nampula e Zambézia.3 Aproximadamente, 55% está na faixa etária dos 15 aos 64 anos de idade, com o rácio de um médico para 11.904 habitantes,4 facto que mostra que o país ainda tem muita carência de especialistas em gastroenterologia, para responder à demanda que, a cada dia, vem crescendo...

Humans , Male , Female , Specialization , Gastroenterology , Investments , Quality of Health Care , Endoscopy/trends , Medical Chaperones , Mozambique/epidemiology
Cad. Saúde Pública (Online) ; 37(7): e00212320, 2021.
Article in English | LILACS | ID: biblio-1285849


Abstract: In Mozambique old and new evils of body and spirit intertwine, thus allowing particular contours to modern life. Traditional diseases are reconfigured along the lines of a new thinking, and what Western medicine calls malnutrition is defined as xilala by the local traditional thinking. This study aimed to understand the point of view of both caregivers (mothers and grandmothers) of children participating in a Nutritional Rehabilitation Program and ethnomedicine experts, who find themselves entangled in a complex set of relationships through which different forms to comprehend body, health, and disease circulate. The supplement, as an object, has a life of its own and takes on new meanings when it leaves the hospital. When its use happens at home, it acquires a particularity: it becomes food. Thus, it ceases to be something inert and impersonal, which is a feature of standard medicine of the health institution. The local view centered on ethnomedicine is based on the certainty that a situation affecting a child cannot have a healing outcome if not by traditional medicine. Biomedical rationality erected from the confluence of the biological and technical sciences with their scientific postulates does not constitute the authorized discourse in this context.

Resumo: Em Moçambique, males velhos e novos do corpo e espírito se entrelaçam, permitindo contornos particulares na vida moderna. As doenças tradicionais são reconfiguradas em linha com um novo pensamento, e aquilo que a medicina ocidental chama de desnutrição é definida como xilala de acordo com o pensamento tradicional local. O estudo buscou compreender o ponto de vista das cuidadoras (mães e avós) de crianças participando em um Programa de Reabilitação Nutricional e de especialistas em etnomedicina, que se encontram emaranhados em um conjunto complexo de relações através das quais circulam diferentes maneiras de compreender o corpo, a saúde e a doença. Enquanto objeto, o suplemento alimentar tem vida própria e assume novos significados quando sai do hospital. Quando seu uso ocorre no domicílio, adquire uma particularidade: torna-se alimento. Portanto, deixa de ser algo inerte e impessoal, que é uma característica da medicina convencional nas instituições de saúde. A visão local centrada na etnomedicina tem como base a certeza de que a situação que aflige uma criança não pode ter a cura como desfecho, a não ser através da medicina tradicional. A racionalidade biomédica construída pela confluência das ciências biológicas e técnicas, com seus postulados científicos, não constitui o discurso autorizado nesse contexto.

Resumen: En Mozambique los viejos y nuevos demonios del cuerpo y el espíritu se entrelazan, permitiendo así conformar las particularidades de la vida moderna. Las enfermedades tradicionales se reconfiguran a lo largo de líneas nuevas de pensamiento, y lo que la medicina occidental denomina malnutrición se define como xilala por el pensamiento tradicional local. El objetivo de este estudio fue comprender el punto de vista de ambos proveedores de cuidados (madres y abuelas) de niños que participaban en el Programa de Rehabilitación Nutricional y expertos en etnomedicina, que se encuentran a sí mismos enmarañados en un complejo conjunto de relaciones, a través de las cuales existen diferentes formas de entender el cuerpo, la salud y la trasmisión de enfermedades. El suplemento alimenticio, como un objeto, tiene vida por sí mismo y toma nuevos significados cuando abandona el hospital. Cuando su consumo se produce en casa, adquiere una particularidad: se transforma en comida. Por ello, cesa de ser algo inerte e impersonal, que es una característica de la medicina estándar de una institución de salud. El punto de vista local centrado en la etnomedicina está basado en la certeza de que la situación que afecta al niño no puede tener un resultado curativo, si no es mediante la medicina tradicional. La racionalidad biomédica se erigió a partir de la confluencia de las ciencias biológicas y técnicas con sus postulados científicos, pero no constituye un discurso autorizado en este contexto.

Humans , Female , Child , Malnutrition/therapy , Mothers , Brazil , Caregivers , Mozambique
Rev. latinoam. enferm. (Online) ; 29: e3481, 2021. tab
Article in English | LILACS, BDENF | ID: biblio-1347618


Objective: 1)to assess the gestational age at the beginning of antenatal care and its covariates; 2)to assess the number of antenatal visits and its covariates; and 3)to identify the reasons for the late initiation of antenatal care and for attending less than four visits among postpartum women living in Nampula, Mozambique. Method: cross-sectional study conducted with 393 mothers who answered a structured instrument in face-to-face interviews. Logistic regression was used to analyze the covariates of having initiated antenatal care up to the 16thgestational week, having attended four or more antenatal visits, and reporting both situations simultaneously. Results: all postpartum women underwent antenatal care, but only 39.9% started it until the 16thgestational week, 49.1% attended four or more visits, and 34.1% reported both events. Having concluded high school (ORadj=1.99; 95%CI=1.19-3.31) or college (ORadj=3.87; 95%CI=1.47-10.18) were aspects associated with reporting both situations. The reasons for the late initiation of antenatal care and attending less than four visits were as follows: not finding it important to attend several visits, not having easy access to the health facility, not being aware about pregnancy, and not having a companion for the visits. Conclusion: the gestational age at the beginning of antenatal care and the number of antenatal visits are lower than the current recommendations in the country.

Objetivo: 1) analizar la edad gestacional al inicio del control prenatal y aspectos asociados; 2) analizar el número de consultas realizadas y aspectos asociados; y 3) identificar las razones del inicio tardío del control prenatal y de la realización de menos de cuatro consultas por parte de las mujeres posparto que residen en Nampula, Mozambique. Método: estudio transversal con 393 puérperas, que respondieron a un instrumento estructurado en entrevistas presenciales. Se utilizó regresión logística para analizar aspectos asociados a haber iniciado el control prenatal como máximo en la semana 16 de gestación, haber asistido a cuatro o más consultas prenatales y reportar ambas situaciones simultáneamente. Resultados: todas las puérperas realizaron el control prenatal, pero solo el 39,9% lo inició como máximo en la semana 16 de gestación; el 49,1% realizó cuatro o más consultas y el 34,1% informó ambos eventos. La educación secundaria (ORaj=1,99; IC95%=1,19-3,31) o la educación superior (ORaj=3,87; IC95% 1,47-10,18) fueron aspectos asociados al informe de ambas situaciones. Las razones del inicio tardío del control prenatal y de la realización de menos de cuatro consultas fueron: no considerar que fuera importante realizar varias consultas, no tener fácil acceso al centro de salud, no saber que estaba embarazada y no tener acompañante para las consultas. Conclusión: la edad gestacional para iniciar el control prenatal y el número de consultas realizadas son inferiores a las recomendaciones vigentes en el país.

Objetivo: 1) analisar a idade gestacional de início do pré-natal e aspectos associados; 2) analisar o número de consultas realizadas e aspectos associados; e 3) identificar as razões para o início tardio do pré-natal e para a realização de menos de quatro consultas entre puérperas residentes em Nampula, Moçambique. Método: estudo transversal com 393 puérperas, que responderam a um instrumento estruturado em entrevistas face a face. Utilizou-se regressão logística para analisar aspectos associados a ter iniciado o pré-natal até 16ª semana de gestação, ter realizado quatro ou mais consultas de pré-natal e relatar as duas situações simultaneamente. Resultados: todas as puérperas realizaram pré-natal, mas apenas 39,9% iniciaram pré-natal até a 16ª semana de gravidez; 49,1% realizaram quatro ou mais consultas e 34,1% relataram ambos eventos. O ensino secundário (ORaj=1,99; IC95%=1,19-3,31;) ou superior (ORaj=3,87; IC95% 1,47-10,18) foram aspectos associados a reportar ambas situações. As razões para início tardio do pré-natal e realização de menos de quatro consultas foram: não achar importante realizar várias consultas, não ter fácil acesso ao centro de saúde, não saber que estava grávida e não ter acompanhante para as consultas. Conclusão: a idade gestacional de início do pré-natal e o número de consultas realizadas são inferiores às recomendações vigentes no país.

Humans , Female , Pregnancy , Prenatal Care , Gestational Age , Maternal Health , Mozambique , Nursing Care
Medisan ; 24(5) tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1135207


Introducción: Algunos estudios resaltan la presencia de manifestaciones psiquiátricas en pacientes con diabetes mellitus. La depresión es el trastorno mental más frecuente en diabéticos; se considera que 1 de cada 3 pacientes con diabetes tienen depresión y, a su vez, el riesgo de tener un trastorno depresivo es 2 veces mayor que en la población general. Objetivo: Identificar algunos factores asociados con la depresión en pacientes diabéticos y su efecto en el control glucémico. Métodos: Se realizó un estudio descriptivo y transversal de 457 pacientes diabéticos, atendidos en el Hospital Central de Nampula, Mozambique, desde marzo de 2014 hasta diciembre de 2016. Como principales variables figuraron: frecuencia de los síntomas de depresión, trastornos depresivos, características sociodemográficas, eventos vitales actuales y control glucémico. Se utilizó el porcentaje como medida de resumen y como estadística inferencial la prueba de X2 de independencia y odds ratio, con un intervalo de confianza de 95 %. Resultados: La frecuencia de síntomas de depresión y de trastornos depresivos en la consulta externa fue de 32,3 y 24,3 %, respectivamente. Los factores mayormente asociados con la depresión fueron: el sexo femenino, estar viudo o divorciado y ser ama de casa. Por otra parte, experimentar 2 o más eventos vitales actuales incrementó la probabilidad de depresión y esta última se asoció con un mal control glucémico (p<0,05). Conclusiones: La frecuencia de depresión en pacientes diabéticos es elevada y está asociada con algunas variables sociodemográficas, con eventos vitales actuales y con un mal control glucémico.

Introduction: Some studies emphasize the presence of psychiatric signs in patients with diabetes mellitus. The depression is the most frequent mental disorder in diabetic patients; it is considered that 1 out of 3 patients with diabetes have depression and, in turn, the risk of having a depressive disorder is 2 times higher than in the general population. Objective: To identify some factors associated with the depression in diabetic patients and their effect in the glycemic control. Methods: A descriptive and cross-sectional study of 457 diabetic patients, assisted in the Central Hospital of Nampula, Mozambique, was carried out from March, 2014 to December, 2016. As main variables we can mention: frequency of the depression symptoms, depressive disorders, sociodemographic characteristics, current vital events and glycemic control. The percentage was used as summary measure and as inference statistics the chi-squared test of independence and odds ratio, with a 95 % confidence interval. Results: The frequency of depression symptoms and depressive disorders in the outpatient service was 32.3 and 24.3 %, respectively. The factors mostly associated with the depression were: the female sex, being widower or divorced and being a housewife. On the other hand, to experience 2 or more current vital events increased the depression probability and the latter was associated with a poor glycemic control (p <0.05). Conclusions: The frequency of depression in diabetic patients is high and it is associated with some sociodemographic variables, with current vital events and with a poor glycemic control.

Depression/epidemiology , Diabetes Mellitus , Glycemic Control/methods , Mozambique
Psicol. soc. (Online) ; 32: e213843, 2020.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1135953


Resumo O presente artigo se constrói a partir de reflexões baseadas numa psicanálise brasileira com interface na psicologia social, com o objetivo de dialogar com a Saúde Mental de Moçambique, um país que se subjetiva numa lógica não-ocidentalizada, cujo sistema de cuidado existente há séculos provém do curandeirismo, (re)conhecido no país como Medicina Tradicional. Sendo as políticas públicas de saúde mental regidas a partir de uma visão ocidental, este estudo questionou as reformulações teóricas necessárias para a inserção de novos dispositivos clínicos no país que incluíssem o saber tradicional. Como se trata de uma travessia, optou-se pelo método de escrita de cartas para melhor contemplar o encontro entre estas duas realidades tão diferentes e ao mesmo tempo tão semelhantes.

Resumen El presente artículo se construye desde reflexiones basadas en un psicoanálisis brasileño con interfaz en la psicología social, con el objetivo de dialogar con la Salud Mental de Mozambique, un país que se subjetiva en una lógica no occidentalizada, cuyo sistema de cuidado existente desde hace siglos se deriva del curanderismo, (re)conocido en el país como Medicina Tradicional. Siendo las políticas públicas de salud mental regidas dentro de una lógica occidental, se cuestionó las reformulaciones teóricas necesarias para la inserción de nuevos dispositivos clínicos en el país que incluyeran el saber tradicional. Como se trata de una travesía, se optó por el método de escritura de cartas para mejor contemplar el encuentro entre estas dos realidades tan diferentes y al mismo tiempo tan semejantes.

Abstract This article is built on reflections based on a Brazilian psychoanalysis with an interface in social psychology, aiming to integrate it into the Mozambican Mental Health. Mozambique is a country that operates in a non-westernized logic; with a care system that for centuries has come from healing practices, known in the country as Traditional Medicine. As public mental health policies are governed by a Western perspective, a question was raised about the theoretical reformulations that might be necessary for the insertion of new clinical devices in the country, including traditional knowledge. Being a traverse, the method of writing letters was chosen to better contemplate the encounter between these two realities, so different and yet so similar.

Psychoanalysis , Therapeutics , Correspondence as Topic , Mental Health , Medicine, Traditional , Methods , Mozambique/ethnology
J. infect. dev. ctries ; 14(9): 994-1000, 2020. ilus
Article in English | AIM, AIM | ID: biblio-1263556


Mozambique is located on the East Coast of Africa and was one of the last countries affected by COVID-19. The first case was reported on 22 March 2020 and since then the cases have increased gradually as they have in other countries worldwide. Environmental and population characteristics have been analyzed worldwide to understand their possible association with COVID-19. This article seeks to highlight the evolution and the possible contribution of risk factors for COVID-19 severity according to the available data in Mozambique. The available data highlight that COVID-19 severity can be magnified mainly by hypertension, obesity, cancer, asthma, HIV/SIDA and malnutrition conditions, and buffered by age (youthful population). Due to COVID-19 epidemic evolution, particularly in Cabo Delgado, there is the need to increase laboratory diagnosis capacity and monitor compliance of preventive measures. Particular attention should be given to Cabo Delgado, including its isolation from other provinces, to overcome local transmission and the spread of SARS-CoV-2

COVID-19 , Air Pollution , Mozambique , Risk Factors , SARS Virus
Journal of Public Health and Epidemiology ; 12(3): 246-260, 2020. ilus
Article in English | AIM, AIM | ID: biblio-1264499


The potential reasons why COVID-19 is not spreading rapidly in Sub-Saharan Africa include sociopolitical, biological and environmental variables. Among the latter, some studies indicate temperature and atmospheric pressure as significantly influential. Could they have impact on the number of COVID-19 cases in Mozambique? The aim of this study is to analyze the relationships between weather and the frequency of confirmed COVID-19 cases in Mozambique, Southern Africa. The study was conducted in Mozambique, Maputo area (Province and City) and Nampula Province. Daily history of weather variables ­ daily maximum and minimum temperatures and atmospheric pressure ­ was obtained from three online databases (AccuWeather, Time and Date AS and WeatherSpark) and the number of COVID-19 cases from official Government's daily Bulletins. The main statistical analyses were Pearson correlations between the variables. The first case was observed in the Maputo area on 22 March, 2020 and the cases in Mozambique increased exponentially up to 769 by 24 June, 2020. The first three cases in Nampula province were observed on 24 May 2020 but its frequency surpassed Maputo area's within one month. Temperatures showed negative correlations with the number of cases in all areas and pressure showed positive correlations in Maputo area and Nampula Province. A bubble chart allowed the visualization of the combined relationship of both weather variables and the number of cases, suggesting that the number of cases increases as temperature decreases and pressure increases. Temperature and atmospheric pressure seems to be correlated with the number of confirmed cases of COVID-19 in Mozambique. Thus, decision-makers should consider weather as a predictor of the rate at which the pandemic is spreading in the country

COVID-19 , Atmospheric Pressure , Mozambique , Temperature , Weather
Malar. j. (Online) ; 19(133): 1-14, 2020. Mapas, Tab, Ilus
Article in English | AIM, RSDM, AIM | ID: biblio-1348624


Background: Conceptualizing gender dynamics and ways of bridging entrenched gender roles will contribute to better health promotion, policy and planning. Such processes are explored in relation to malaria in Mozambique. Methods: A multi-method, qualitative study using focus group discussions (FGDs) and in-depth interviews (IDIs) explored the perspectives of community members, leaders and stakeholders on malaria. The study was conducted in Nampula Province, in an intervention district for the Tchova Tchova Stop Malaria (TTSM) gender-sensitive community dialogues, and in a non-intervention district. Results: Participants (n=106) took part in six FGDs and fve IDIs in each district. Those exposed to TTSM commonly stated that the programme infuenced more equalitarian gender roles, attitudes and uptake of protective malariarelated practices. These positive changes occurred within the context of an observed, gendered decision-making matrix, which aligns inward- or outward-facing decisions with malaria prevention or treatment. Decisions more dependent on male or elder sanctioning at community level are outward-facing decisions, while decisions falling within women's domain at household level are inward-facing decisions. Related to prevention, using bed nets was largely an inward-facing prevention decision for women, who were generally tasked with hanging, washing and mak ing nets usable. Net purchase and appropriation for malaria prevention (rather than for instance for fshing) was men's prerogative. Regular net use was associated with sleeping together more regularly, bringing couples closer. Attending antenatal care to access intermittent preventive treatment during pregnancy was often an outward-facing prevention decision, under the purview of older, infuential women and ultimately needing sanctioning by men. With respect to seeking care for malaria symptoms, women typically sought help from traditional healers frst. This inward-facing treatment decision was within their control, in contrast to the frequently transport-dependent, outward-facing decision to attend a health facility. Sharing decisions was described as a feature of a "harmonious household," something that was said to be encouraged by the TTSM intervention and that was both lived and aspirational.

Male , Female , Health Policy, Planning and Management , Population Studies in Public Health , Malaria/prevention & control , Beds/supply & distribution , World Health Organization , Family , Population Groups , Decision/prevention & control , Respect , Gender Identity , Men , Methods , Mozambique
Int. j. cancer ; 147((6):1629-1637): 1629-1637, 20200915. Fig., Tab., Mapa
Article in English | AIM, RSDM, AIM | ID: biblio-1354988


Results from two recently established population-based registries in Mozambique are reported: Beira in the central region (2014-2017) and Maputo, the capital city, in the South (2015-2017). The results are compared to those from Maputo (Lourenço Marques at the time) in 1956-1960 (appearing Cancer Incidence in Five Continents Vol 1), and with estimated incidence rates from other regions of Africa. The elevated prevalence of HIV infection (12.6% of adults in 2018) results in high rates for HIV-related cancers, and the greater prevalence in central Mozambique, compared to the south, largely explains the rather higher rates of Kaposi sarcoma (males), non-Hodgkin lymphoma, squamous cell carcinoma of conjunctiva and cervical cancer in Beira than in Maputo. Burkitt lymphoma is the commonest childhood cancer in Beira, with high rates typical of East Africa, while the low rates in Maputo are more typical of Southern Africa. Overall, 44% of cancers in Maputo and 52% in Beira are estimated to be caused by infectious agents. In the last 60 years, cancers more frequent in developed countries, such as breast and prostate, are emerging in Mozambique. The incidence of the former in Maputo has increased fivefold since 1956-1960, that of prostate cancer 2.5-fold, and that of large bowel cancer doubled. The results reported here were used to make national estimates of incidence, mortality and prevalence in Globocan 2018. The two registries were important in providing data to establish priority actions in the National Cancer Control Plan, and are a valuable resource to monitor progress toward its goals.

Humans , Male , Female , Adolescent , Middle Aged , Young Adult , Chancre , Neoplasms/immunology , HIV Infections/complications , HIV Infections/immunology , HIV Infections/epidemiology , Infections/complications , Mozambique/epidemiology , Neoplasms/virology
Clinics ; 75: e1771, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133419


OBJECTIVES: Physical activity (PA) may reduce cardiovascular risk and preserve functional capacity of people living with human immunodeficiency virus (HIV). However, only limited research objectively measured PA in patients with low socioeconomic status (SES) in low-income countries, particularly in South America and sub-Saharan Africa. This study compared the PA assessed by accelerometers in women of low SES living with HIV under common antiretroviral therapy (cART) from two major cities in Brazil (Rio de Janeiro, n=33; 40.1±6.1 years) and Mozambique (Maputo, n=50; 38.8±8.7 years). METHODS: Eligible women wore triaxial accelerometers during seven consecutive days, to estimate their habitual PA and daily energy expenditure. RESULTS: The proportion of participants with overweight/obesity was greater in Rio than Maputo (57% vs. 30%; p=0.021), as well as those classified as sedentary based on steps/day (45% vs. 22%; p=0.02). Sedentary time was prevalent (Median±IQD: Rio-1236±142 vs. Maputo-1192±135 min/day; p=0.15). Time spent in PA was short, but Brazilians exhibited lower amount of light (111±56 vs. 145±51 min/day; p<0.001) and moderate-to-vigorous PA (88±3 vs. 64±36 min/day; p=0.001) vs. Mozambicans. The proportion of patients performing 60 min/day of moderate-to-vigorous PA were 58% (Rio) and 82% (Maputo), respectively. Despite of this, estimated daily energy expenditure was equivalent in both groups (1976±579 vs. 1933±492 kcal; p=0.731). CONCLUSIONS: Women with low SES living with HIV in Maputo were more active vs. patients from Rio de Janeiro. Albeit sedentary behavior was prevalent, the proportion of patients complying with the minimum recommended PA for health was higher than values usually reported in developed countries.

Humans , Exercise , HIV Infections/drug therapy , Social Class , Brazil , Cross-Sectional Studies , Cities , Mozambique/epidemiology
Mem. Inst. Oswaldo Cruz ; 115: e200006, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1135222


BACKGROUND Occult hepatitis B virus (HBV) - characterized by the absence of detectable HBsAg in the presence of HBV DNA - represents a potential threat for blood safety. OBJECTIVES This study was conducted with the aim to investigate the serological and molecular characterization of occult HBV infection (OBI) among blood donors in Mozambique. METHODS 1,502 blood donors were tested for HBsAg. All HBsAg-negative individuals were tested for HBV DNA. Antibodies against HBV core, surface and HBe antigen (anti-HBc, anti-HBs, HBeAg) were measured in HBV DNA positive individuals. FINDINGS 1435 serum samples were HBsAg negative and 16 positive for HBV DNA, 14 confirmed to have OBI, corresponding to a frequency of 0.98%. Of the 14 OBI infections identified, 13/14 (92.8%) were positive for anti-HBc, 4/14 (28.5%) for anti-HBs, and no samples were reactive for HBeAg. Of the 14 OBI cases, nine samples (64.2%) were sequenced for the S/P region. Eight samples (88.9%) belonged to genotype A1 and one (11.1%) to genotype E. One escape mutation (T123A) associated with OBI and various amino acid substitutions for genotype A1 and E were observed. MAIN CONCLUSIONS Our results show the importance of using nucleic acid amplification test to detect occult hepatitis B infection in blood donors in Mozambique.

Humans , Male , Female , Adult , Blood Donors , Hepatitis B virus/isolation & purification , Hepatitis B virus/genetics , Nucleic Acid Amplification Techniques/methods , Hepatitis B/diagnosis , Hepatitis B Surface Antigens/genetics , Phylogeny , DNA, Viral , Polymerase Chain Reaction , Cross-Sectional Studies , Mozambique
Cad. Saúde Pública (Online) ; 36(supl.2): e00038320, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1132882


In Mozambique, the Expanded Program on Immunization (EPI) was implemented in 1979 with the objective of reducing child mortality and morbidity through the provision of immunization services. This study aims to describe the characteristics of the EPI and review the available information related to immunization service in Mozambique, its accomplishments and perspectives. A narrative review of the literature was carried out and the electronic databases accessed were VHL, Google Scholar, and PubMed between 1979 and 2019, using descriptors related to the theme. A total of 28 articles and other relevant sources have been consulted for the review. The national immunization coverage in Mozambique between 1997 (47%) and 2015 (66%) improved 19 percentual points; also immunization coverage of children under 12 months has increased from 44.3% (1997) to 57% (2015). The 2015 survey showed that out of the 11 provinces, only the southern and Cabo Delgado province could reach the 80% recommended goal at the provincial level. Zambézia, Nampula, and Tete provinces have been reporting low coverage over the years and Cabo Delgado presents coverage oscillation. The BCG, DPT3, Polio 3, and measles have reached 80% of coverage goal from 1997 to 2015. Our analysis have shown important improvements in national immunization, characterized by an overall increase in the national and provincial coverage and a decrease in the number of children that did not receive any vaccine. Despite these improvements, some provinces have lower coverages than expected and it is necessary to understand the determinants of dropout in children to retain them and provide timely and full immunization.

Em Moçambique, o Programa Alargado de Vacinação (PAV) foi implementado em 1979 com o compromisso de reduzir a morbimortalidade na população infantil através dos serviços de imunização. O presente estudo tem como objetivo descrever as características do PAV e revisar as informações disponíveis relacionadas aos serviços de imunização em Moçambique, os avanços e perspectivas. Foi realizada uma revisão narrativa da literatura, e as bases de dados acessadas foram BVS, Google Scholar e PubMed, entre 1979 e 2019, usando descritores relacionados ao tema. A revisão acessou um total de 28 artigos científicos, além de outras fontes relevantes. A cobertura nacional de vacinação em Moçambique entre 1997 (47%) e 2015 (66%) aumentou 19 pontos percentuais, e a cobertura de vacinação em crianças abaixo de 12 meses de idade aumentou de 44,3% (1997) para 57% (2015). De acordo com os dados de 2015, das 11 províncias, apenas as do Sul e a de Cabo Delgado atingiram a meta de cobertura recomendada de 80%. As províncias de Zambézia, Nampula e Tete mostraram baixas coberturas ao longo dos anos, enquanto Cabo Delgado mostrou oscilação na cobertura. As vacinas BCG, DPT3, Polio 3 e sarampo atingiram a meta de cobertura de 80% entre 1997 e 2015. Nossa análise mostrou avanços importantes na vacinação nacional, caracterizados por um aumento geral nas coberturas nacional e provinciais e uma queda no número de crianças que não receberam nenhuma vacina. Apesar desses avanços, algumas províncias tiveram coberturas aquém das metas, o que reforça a necessidade de entender os determinantes do abandono da imunização nas crianças, para retê-las e assegurar a imunização oportuna e completa.

En Mozambique, el Programa de Inmunización Expandido (EPI por sus siglas en inglés) fue implementado en 1979, con el compromiso de reducir la mortalidad infantil y la morbilidad a través de la provisión de servicios de inmunización. El objetivo del presente estudio es describir las características del EPI y revisar la información disponible, relacionada con el servicio de inmunización en Mozambique, así como sus logros y perspectivas. Se llevó a cabo una revisión narrativa de la literatura y se accedió a las siguientes bases de datos electrónicas: BVS, Google Scholar y PubMed para el período de 1979 a 2019, usando descriptores relacionados con el tema. Se tuvo acceso a un total de 28 artículos y otras fuentes relevantes para la revisión. La cobertura nacional de inmunización en Mozambique de 1997 (47%) a 2015 (66%) mejoró 19 puntos porcentuales y la cobertura de inmunización de los niños con menos de 12 meses se incrementó de un 44,3% (1997) a un 57% (2015). La encuesta de 2015 mostró que, de las 11 provincias, solamente la provincia del sur y la provincia de Cabo Delgado podrían alcanzar el 80% de la meta recomendada a nivel provincial. Las provincias de Zambézia, Nampula, y Tete han estado informando de baja cobertura a largo de estos años y Cabo Delgado tiene oscilaciones en la cobertura. BCG, DPT3, Polio 3 y sarampión han alcanzado un 80% de la meta de la cobertura de 1997-2015. Nuestro análisis ha mostrado importantes mejoras en la inmunización nacional, caracterizada por un aumento en general en la cobertura nacional y provincial, así como un decremento en el número de niños que no recibieron ninguna vacuna. A pesar de estas mejoras, algunas provincias tienen coberturas más bajas que las esperadas y existe una necesidad para entender los determinantes del abandono en niños para retenerlos y proporcionarles a tiempo una completa inmunización.

Humans , Infant , Child , Immunization , Vaccination , Brazil , Immunization Programs , Mozambique/epidemiology
Malar. j. (Online) ; 18(190): 1-11, 20190606. Mapa, Tab.
Article in English | AIM, RSDM, AIM | ID: biblio-1352353


Mozambique has historically been one of the countries with the highest malaria burden in the world. Starting in the 1960s, malaria control efforts were intensified in the southern region of the country, especially in Maputo city and Maputo province, to aid regional initiatives aimed to eliminate malaria in South Africa and eSwatini. Despite significant reductions in malaria prevalence, elimination was never achieved. Following the World Health Organization's renewed vision of a malaria­free­world, and considering the achievements from the past, the Mozambican National Malaria Control Programme (NMCP) embarked on the development and implementation of a strategic plan to accelerate from malaria control to malaria elimination in southern Mozambique. An initial partnership, supported by the Bill and Melinda Gates Foundation and the La Caixa Foundation, led to the creation of the Mozambican Alliance Towards the Elimination of Malaria (MALTEM) and the Malaria Technical and Advisory Committee (MTAC) to promote national ownership and partner coordination to work towards the goal of malaria elimination in local and cross­border initiatives. Surveillance systems to generate epidemiological and entomological intelligence to inform the malaria control strategies were strengthened, and an impact and feasibility assessment of various interventions aimed to interrupt malaria transmission were conducted in Magude district (Maputo Province) through the "Magude Project". The primary aim of this project was to generate evidence to inform malaria elimination strategies for southern Mozambique. The goal of malaria elimination in areas of low transmission intensity is now included in the national malaria strategic plan for 2017­22 and the NMCP and its partners have started to work towards this goal while evidence continues to be generated to move the national elimination agenda forward.

Disease Eradication/methods , Malaria/prevention & control , Prevalence , Program , Malaria/epidemiology , Mozambique/epidemiology