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J Infect Dev Ctries ; 15(12): 1792-1800, 2021 12 31.
Article in English | MEDLINE | ID: covidwho-1638107

ABSTRACT

INTRODUCTION: The novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), etiological agent of coronavirus disease 2019 (COVID-19) was first reported in China in December 2019 and spread worldwide. As of March 6th, 2021, there have been 116,670,105 million confirmed cases globally including 2,592,085 deaths. COVID-19 cases have been reported in 219 countries and territories, creating global panic. Mozambique has witnessed the evolution of COVID-19 epidemic associated with the weakness of health system, mostly in terms of laboratory diagnosis capacity, concerns on compliance to effective public health measures including physical distancing, use of masks in crowded indoor areas, hand hygiene, isolation and quarantine of people. METHODOLOGY: The data included in this study were collected from published articles regarding COVID-19 imported cases and severity in Africa, especially in Mozambique. Additionally, official documents of COVID-19 epidemiology from Minister of Health and National Institute of Health of Mozambique from 22nd of March 2020 to 1st of August 2020 were included. RESULTS: The SARS-CoV-2 strains imported mainly from South Africa and European countries might have been playing an important role on COVID-19 epidemic evolution in Mozambique. CONCLUSIONS: These circulating strains in the country, might be similar enough to the strains found in other countries, yet the genomic characterization is needed particularly during the phase of borders reopening through understanding the source of infections and guiding the implementation of containment and mitigation measures in the country.


Subject(s)
COVID-19/epidemiology , Communicable Diseases, Imported/epidemiology , Africa/epidemiology , Female , Global Health , Humans , Male , Mozambique/epidemiology , Pandemics , Patient Acuity , SARS-CoV-2
3.
BMJ Glob Health ; 6(9)2021 09.
Article in English | MEDLINE | ID: covidwho-1467698

ABSTRACT

In early 2019, following the 2015-2016 severe drought, the provinces of Sofala and Cabo Delgado, Mozambique, were hit by Cyclones Idai and Kenneth, respectively. These were the deadliest and most destructive cyclones in the country's history. Currently, these two provinces host tens of thousands of vulnerable households due to the climatic catastrophes and the massive influx of displaced people associated with violent terrorist attacks plaguing Cabo Delgado. The emergence of the COVID-19 pandemic added a new challenge to this already critical scenario, serving as a real test for Mozambique's public health preparedness. On the planetary level, Mozambique can be viewed as a 'canary in the coal mine', harbingering to the world the synergistic effects of co-occurring anthropogenic and natural disasters. Herein, we discuss how the COVID-19 pandemic has accentuated the need for an effective and comprehensive public health response in a country already deeply impacted by health problems associated with natural disasters and population displacement.


Subject(s)
COVID-19 , Cyclonic Storms , Emergencies , Humans , Mozambique/epidemiology , Pandemics , Public Health , SARS-CoV-2
5.
BMC Health Serv Res ; 21(1): 860, 2021 Aug 23.
Article in English | MEDLINE | ID: covidwho-1370939

ABSTRACT

BACKGROUND: The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community. METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites. RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%. CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.


Subject(s)
COVID-19 , Child Health Services , Child , Cross-Sectional Studies , Female , Humans , Mozambique/epidemiology , Pandemics , Pregnancy , Retrospective Studies , SARS-CoV-2
6.
Pan Afr Med J ; 38: 254, 2021.
Article in English | MEDLINE | ID: covidwho-1218865

ABSTRACT

Since the announcement of the coronavirus disease (COVID-19) pandemic in January 30th 2020, 68 countries reported to the World Health Organization that they were experiencing disruptions in malaria diagnosis and treatment. This situation had the potential to lead to delays in diagnosis and treatment, which could result in an increase in severe cases and deaths. This analysis was based on findings from a field visit, carried out between June 30th and July 1st, 2020, to a warehouse, to two health facilities, and a meeting with a community health worker, and an descriptive epidemiologic data analysis of health information system (HIS) to evaluate trends of the number of people tested for malaria and number of malaria cases reported, by comparing data from 2018, 2019 and 2020 for the period between January and May. The two health facilities and the warehouse had about two months of stock of antimalarial drugs, and patients with malaria symptoms were being tested for malaria at the COVID-19 screening site. The HIS data showed that the number of reported malaria cases decreased by 3.0% (177.646/172.246) in April, and 7.0% (173.188/161.812) in May, when comparing 2019 and 2020 data. People tested for malaria in community increased by 39.0% (190.370/264.730), between 2019 and 2020. The COVID-19 may have had a negative impact on the diagnosis and treatment of malaria in health facility (HF). The decrease in people tested for malaria in the health facilities may have overwhelmed the activities of the community.


Subject(s)
COVID-19 , Malaria/epidemiology , Population Surveillance/methods , Antimalarials/administration & dosage , Antimalarials/supply & distribution , Humans , Malaria/diagnosis , Malaria/drug therapy , Mass Screening/methods , Mozambique/epidemiology
8.
Int J Equity Health ; 20(1): 90, 2021 04 06.
Article in English | MEDLINE | ID: covidwho-1169964

ABSTRACT

BACKGROUND: This study aims to assess the COVID-19 response preparedness of the Mozambican health system by 1) determining the location of oxygen-ready public health facilities, 2) estimating the oxygen treatment capacity, and 3) determining the population coverage of oxygen-ready health facilities in Mozambique. METHODS: This analysis utilizes information on the availability of oxygen sources and delivery apparatuses to determine if a health facility is ready to deliver oxygen therapy to patients in need, and estimates how many patients can be treated with continuous oxygen flow for a 7-day period based on the available oxygen equipment at health facilities. Using GIS mapping software, the study team modeled varying travel times to oxygen-ready facilities to estimate the proportion of the population with access to care. RESULTS: 0.4% of all health facilities in Mozambique are prepared to deliver oxygen therapy to patients, for a cumulative total of 283.9 to 406.0 patients-weeks given the existing national capacity, under varying assumptions including ability to divert oxygen from a single source to multiple patients. 35% of the population in Mozambique has adequate access within one-hour driving time of an oxygen-ready health facility. This varies widely by region; 89.1% of the population of Maputo City was captured by the one-hour driving time network, as compared ot 4.4% of the population of Niassa province. CONCLUSIONS: The Mozambican health system faces the dual challenges of under-resourced health facilities and low geographic accessibility to healthcare as it prepares to confront the COVID-19 pandemic. This analysis also illustrates the disparity between provinces in preparedness to deliver oxygen therapy to patient, with Cabo Delgado and Nampula being particularly under-resourced.


Subject(s)
COVID-19/therapy , Health Facilities , Health Services Accessibility/statistics & numerical data , Oxygen Inhalation Therapy/methods , SARS-CoV-2 , Female , Humans , Mozambique/epidemiology , Pandemics
9.
Health Care Women Int ; 42(3): 288-303, 2021 03.
Article in English | MEDLINE | ID: covidwho-1078709

ABSTRACT

From the time when the first cases of COVID-19 were reported in Wuhan City, China, in December 2019, strict regulations are being implemented by policy makers to contain the spread of the virus. The measures taken in different countries spanned from complete isolation and lockdown to different degrees of restrictions to people's movement, contact between people, hygiene and sanitation. Accordingly, the success in containing the virus also differed. Italy was one among the worst-affected countries in the world despite the lockdown measures adopted. A combination of lockdown and Level-3 State of Emergency measures were adopted in Portugal and South Africa, which helped to delay and flatten the epidemic curve. The timely application of Level-3 State of Emergency in Mozambique resulted in recording low infection rates. Above all the tripod, orderly movement of people, social distance and hygiene and sanitation is the keystone measure to prevent spread of the virus. However, for successful outcome, the measures have to be tailored to the local context.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control/methods , COVID-19/epidemiology , Humans , Italy/epidemiology , Mozambique/epidemiology , Portugal/epidemiology , SARS-CoV-2 , South Africa/epidemiology
10.
Int J Environ Res Public Health ; 18(3)2021 01 26.
Article in English | MEDLINE | ID: covidwho-1050610

ABSTRACT

We assessed adherence to government recommendations implemented shortly after the introduction of COVID-19 in Mozambique in March 2020, through two online cross-sectional surveys in April and June 2020. We quantified adherence to preventive measures by a composite score comprising of five measures: physical distancing, face mask use, hand hygiene, cough hygiene, and avoidance of touching the face. 3770 and 1115 persons participated in the first and second round respectively. Wearing face masks, regular handwashing and cough hygiene all reached compliance rates of over 90% while physical distancing and avoiding to touch the face reached a compliance rate of 80-90%. A multivariable model investigating factors associated with adherence found that being older, more educated, and belonging to the healthcare sector increased the odds for higher adherence. Private workers and retired people, respondents receiving COVID-19 information through social media, and those who reported flu-like symptoms were less likely to adhere. 6% of respondents reported flu-like symptoms which aligned with the WHO clinical definition of COVID-19, suggesting low level community transmission. In conclusion, most respondents in this online survey in Mozambique complied well with strategies to prevent COVID-19. Whether the good preventive behaviour explains the low grade COVID-19 transmission requires further study.


Subject(s)
COVID-19 , Guideline Adherence , Guidelines as Topic , COVID-19/epidemiology , COVID-19/prevention & control , Cross-Sectional Studies , Guideline Adherence/statistics & numerical data , Humans , Mozambique/epidemiology , Surveys and Questionnaires
11.
Glob Public Health ; 16(1): 153-157, 2021 01.
Article in English | MEDLINE | ID: covidwho-894504

ABSTRACT

After the Ebola outbreaks the world is again facing a challenge in which human behaviours and contact history play crucial roles in determining the trends in disease spreading within and across communities. With the onset of the recent coronavirus disease (COVID-19) pandemic, several issues related to conducting social behavioural sciences research and related community engagement activities arise, especially in rural areas of low-income countries, where the coverage of information and communication technologies (ICTs) is limited and their application on field-based research would imply a biased selection of relatively more privileged minorities with access to on-line and other communication platforms not requiring physical contact. This article enumerates and discusses the different technical challenges that social behavioural sciences research and community engagement activities face in times of public health emergencies caused by pandemics such as COVID-19. It also highlights the possibility of using alternative approaches to maintain the engagement with members of rural communities in research and social action activities, as well as the ethical challenges arising from such approaches.


Subject(s)
COVID-19/epidemiology , Community Participation , Research , Social Sciences , Humans , Mozambique/epidemiology , Pandemics , Rural Population , SARS-CoV-2
12.
J Infect Dev Ctries ; 14(9): 994-1000, 2020 09 30.
Article in English | MEDLINE | ID: covidwho-841557

ABSTRACT

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.


Subject(s)
Air Pollution/adverse effects , Betacoronavirus , Coronavirus Infections/etiology , Pneumonia, Viral/etiology , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Child , Child, Preschool , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Mozambique/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Prognosis , Protective Factors , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Young Adult
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