Knowledge, Attitudes and Practices on Cholera and Water, Sanitation, and Hygiene among Internally Displaced Persons in Cabo Delgado Province, Mozambique.

In disaster situations, cholera outbreaks represent a public health emergency due to their high fatality rates and high spreading risk through camps for refugees and internally displaced persons (IDPs). The aim of this study is to examine water, sanitation, and hygiene attitudes and cholera knowledge, attitude, and practice (KAP) among people living in resettlement sites in Cabo Delgado, the northernmost province of Mozambique. Between January 1 and March 31, 2022, a cross-sectional survey was conducted by administering a face-to-face interview to IDPs and residents in six relocation sites in Cabo Delgado Province. A total of 440 people were enrolled in the study. Overall, 77.8% (N = 342) were female, 61% (N = 268) were younger than 35 years old, and 60.5% (N = 266) reported primary school to be the highest education level. Seventy-five percent (N = 334) of participants lived with children under 5 years old. Thirty-one percent (N = 140) and 11.8% (N = 52) of the respondents reported, respectively, at least one cholera case and at least one diarrheal-related death among their family members in the previous 2 years. In multivariate analysis, being female, being younger than 35 years old, having attained a higher education level, owning a phone, or having soap at home were factors significantly associated with improved cholera KAP. In severely deconstructed social contexts, continuous education and community sensitization are crucial to achieve and maintain positive cholera prevention attitudes.

A Percepção da Qualidade do Atendimento das Gestantes nos Centros de Saúde Apoiados pela Médicos com África CUAMM / The perception of quality of care for pregnant women in health centers supported by Doctors with Africa CUAMM

Introdução: Moçambique é um País em vias de desenvolvimento cujo maior desafio é diminuir a mortalidade materno e infantil, tanto que actividades conjuntas entre a comunidade e o serviço de saúde são essenciais para uma assistência e bem-estar da população. Foi desenvolvido no distrito de Montepuez e Balama de 2020 a 2022 um projecto "Os primeiros 1000 dias" que visava proporcionar cuidados básicos para a mulher e a criança. Métodologia: Foi desenvolvida uma avaliação do tipo qualitativo e usado o método quali-quantitativo quanto a abordagem e descritivo quanto aos objectivos. Foram conduzidos em grupos focais compostos por 10 mães que tiveram parto no período entre Junho de 2021 a Junho de 2022, totalizando 60 mulheres. Resultados: Relativo a idade um (2%) era menor de 14 anos e 23 (38%) tinham 19 a 25 anos. 36.7% (22/60) sabiam do significado e importância do CPN, 21.7% (13/60) sabiam e não frequentavam, 3.3% (2/60) sabiam, mas não acharam importante. Sobre acessibilidade aos serviços, 46.6% (28/60) referiram que a distância associada a questões logísticas condiciona o acesso. 70.0% (42/60) referiram que estão totalmente satisfeitas pelos serviços prestados. Sobre disponibilidade de recursos e insumos no dia do parto, 46.7% (28/60) elogiaram, 33.3% (20/60) referiram falta de alguns serviços como água, electricidade, banheiros e camas. Sobre aceitabilidade e vontade de poder frequentar a US face ao comportamento dos profissionais de Saúde e aos cuidados oferecidos, 73.3% (44/60) tiveram uma resposta totalmente positiva no que diz respeito a usar a mesma unidade sanitária caso estejam grávidas. Conclusão: As mulheres dos distritos de Balama e Montepuez estão satisfeitas pelos serviços prestados pelas US. Tanto que, 73.3% (44/60) garantem que voltariam ao mesmo hospital para receber cuidados de saúde.

Introduction: Mozambique is a developing country whose biggest challenge is to reduce maternal and child mortality, so much so that joint activities between the community and the health service are essential for the assistance and well-being of the population. A project "The first 1000 days" was developed in the district of Montepuez and Balama from 2020 to 2022, which aimed to provide basic care for women and children. Methods: In the evaluation, the qualitative-quantitative method was used. It was conducted in focus groups made up of 10 mothers who gave birth between June 2021 and June 2022, totaling 60 women. Results: Regarding age, one (2%) was under 14 years old and 23 (38%) were between 19 and 25 years old. 36.7% (22/60) knew the meaning and importance of the CPN, 21.7% (13/60) knew and did not attend, 3.3% (2/60) knew, but did not think it was important. Regarding accessibility to services, 46.6% (28/60) reported that the distance associated with logistical issues affects access. 70.0% (42/60) reported that they were completely satisfied with the services provided. Regarding the availability of resources and supplies on the day of birth, 46.7% (28/60) praised it, 33.3% (20/60) reported a lack of some services such as water, electricity, bathrooms and beds. Regarding acceptability and desire to be able to attend the US in light of the behavior of healthcare professionals and the care offered, 73.3% (44/60) had a completely positive response with regard to using the same healthcare unit if they are pregnant. Conclusion: Women in the districts of Balama and Montepuez are satisfied with the services provided by the US. So much so that 73.3% (44/60) guarantee that they would return to the same hospital to receive healthcare.

High Prevalence of Mental Health Disorders in Adolescents and Youth Living with HIV: An Observational Study from Eight Health Services in Sofala Province, Mozambique.

Adolescent mental health (MH) is a significant global health concern, which is extremely relevant when referring to adolescents and youth living with HIV (AYHIV). In Mozambique, ∼52% of the population is <18 years and the country has the world's eighth highest HIV prevalence (insert citation). We performed an observational study to evaluate anxiety, depression, post-traumatic stress disorder (PTSD) and alcohol-drug abuse in adolescents and youth assessing health services in Sofala Province, Mozambique. From November 20, 2019, to November 20, 2021, all adolescents and youth (10-24 years) accessing one of the psychological services offered at 8 Servicios Amigos dos Adolescentes (SAAJ) of the Sofala Province were screened by a psychologist using the following standardized tools: Generalized Anxiety Disorder-7 (GAD-7) for anxiety, Patient Health Questionnaire-9 (PHQ-9) for depression, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) for PTSD, and Cut down, Annoyed, Guilty, and Eye-opener Adapted to Include Drugs (CAGE-AID) for alcohol-drug abuse. Overall, 2108 adolescents and youth were included in the study (63% female, median age: 19 years). Of them, 1096 (52%) were HIV positive. AYHIV had higher scores at the four tools tested and for concomitant MH disorders (GAD-7, PHQ-9, PTSD-5, and CAGE). The multivariable logistic regressions showed a greater probability to be GAD-7 > 10 for women, [adjusting odds ratio (AOR): 1.46, 95% confidence interval (CI): 1.01-2.10], for workers (AOR: 2.18, 95% CI: 1.12-4.23) and people living with HIV (AOR: 1.78, 95% CI: 1.25-2.54). Higher values of CAGE (≥2) and PTSD (≥3) seemed to be associated only with HIV-positive status (AOR: 4.87, 95% CI: 3.72-6.38 and AOR: 1.73, 95% CI: 1.28-237). These data further reinforce the urgent need for a global health policy action with focused intervention on MH in AYHIV patients.

High Prevalence of Mental Health Disorders in Adolescents and Youth Living with HIV: An Observational Study from Eight Health Services in Sofala Province, Mozambique

Adolescent mental health (MH) is a significant global health concern, which is extremely relevant when referring to adolescents and youth living with HIV (AYHIV). In Mozambique, ∼52% of the population is <18 years and the country has the world's eighth highest HIV prevalence (insert citation). We performed an observational study to evaluate anxiety, depression, post-traumatic stress disorder (PTSD) and alcohol-drug abuse in adolescents and youth assessing health services in Sofala Province, Mozambique. From November 20, 2019, to November 20, 2021, all adolescents and youth (10-24 years) accessing one of the psychological services offered at 8 Servicios Amigos dos Adolescentes (SAAJ) of the Sofala Province were screened by a psychologist using the following standardized tools: Generalized Anxiety Disorder-7 (GAD-7) for anxiety, Patient Health Questionnaire-9 (PHQ-9) for depression, Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) for PTSD, and Cut down, Annoyed, Guilty, and Eye-opener Adapted to Include Drugs (CAGE-AID) for alcohol-drug abuse. Overall, 2108 adolescents and youth were included in the study (63% female, median age: 19 years). Of them, 1096 (52%) were HIV positive. AYHIV had higher scores at the four tools tested and for concomitant MH disorders (GAD-7, PHQ-9, PTSD-5, and CAGE). The multivariable logistic regressions showed a greater probability to be GAD-7 > 10 for women, [adjusting odds ratio (AOR): 1.46, 95% confidence interval (CI): 1.01-2.10], for workers (AOR: 2.18, 95% CI: 1.12-4.23) and people living with HIV (AOR: 1.78, 95% CI: 1.25-2.54). Higher values of CAGE (≥2) and PTSD (≥3) seemed to be associated only with HIV-positive status (AOR: 4.87, 95% CI: 3.72-6.38 and AOR: 1.73, 95% CI: 1.28-237). These data further reinforce the urgent need for a global health policy action with focused intervention on MH in AYHIV patients.

Mozambican Adolescents and Youths during the COVID-19 Pandemic: Knowledge and Awareness Gaps in the Provinces of Sofala and Tete.

(1) Background: Mozambique has an average population age of 17 years and adolescents and youths have a pivotal role in SARS-CoV-2 pandemic control. (2) Methods: We conducted a cross-sectional study in order to assess the awareness and information needs with regard to COVID-19 among a sample of adolescents and youths from two different Mozambican provinces. (3) Results: Only 25% of adolescents and youths had a high level of awareness and only 543/2170 participants reported a high level of knowledge regarding COVID-19. In our multivariate model, significant predictors of reporting a high level of knowledge about COVID-19 include female sex (O.R. = 1.47; 95% confidence interval (CI) 1.23-2.89), having a house without a thatched roof (O.R. = 1.85; 95% CI 1.02-2.95) and HIV-positive status (O.R. = 1.56; 95% CI 1.36-2.87). (4) Conclusions: Our study highlights an important and relevant knowledge gap in adolescents and youths with respect to the COVID-19 pandemic. Involving young people and adolescents in the fight against SARS-CoV-2 is an essential strategy, especially in countries where the national average age is young, such as Mozambique, and where this epidemic can aggravate an already fragile health system.