An epidemic of spastic paraparesis of unknown aetiology in Northern Mozambique.

This case study is based on a real-life outbreak investigation undertaken in Mozambique in 1981. This case study describes and promotes one particular approach to unknown disease outbreak investigation. Investigational procedures, however, may vary depending on location and outbreak. It is anticipated that the epidemiologist investigating an unknown disease outbreak will work within the framework of a "multidisciplinary investigation team". It is through the collaborative efforts of this team, with each member playing a critical role, that outbreak investigations are successfully completed. Some aspects of the original outbreak and investigation have, however, been altered to assist in meeting the desired teaching objectives and to allow completion of the case study in less than 3 hours.

Analysis of trauma admission data at an urban hospital in Maputo, Mozambique.

BACKGROUND: Trauma is a major public health concern. Worldwide, injuries resulted in 4.8 million deaths in 2013, an increase of 11 % since 1990. The majority of deaths from trauma in low-and middle-income countries occur in a pre-hospital setting. Morbidity from trauma contributes significantly to disability in these countries. Mozambique has experienced a rise in injury-related morbidity and mortality. Efforts are underway to prioritize surgical and anesthesiology care in the post-2015 Global Surgery agenda that will build on momentum of the Millennium Development Goals. Injury surveillance remains vital to defining priorities and implementing policy changes. METHODS: We performed a cross-sectional study between June and September, 2010 at the Hospital Central de Maputo (HCM). Data were collected on all patients admitted to the HCM emergency surgical services with a diagnosis of trauma. We describe patient characteristics and mechanism of traumatic injury by calculating simple proportions (for dichotomous or categorical variables) or medians with interquartile ranges (IQR) for continuous variables. Multivariable logistic regression analysis was used to estimate the mechanisms of trauma most associated with alcohol consumption. RESULTS: A total of 517 patients were approached for inclusion in this study. Of these, 441 (91.5 %) participants were followed from admission until discharge. Three hundred twenty-four participants (73.5 %) were male. The most common age group was 20-29 years old. The three principal mechanisms of injury were road traffic injury, fighting, and falls, accounting for 74 % of injuries recorded. Traumatic injury involving alcohol consumption was nine times more likely to occur at a recreation/sporting event (OR 9.0, 95 % CI 3.01-27.13, p ≤ 0.0001). CONCLUSIONS: As Mozambique prepares to respond to the post-2015 international development agenda, urgent action is required to scale-up its national injury surveillance networks. Injury prevention efforts in Mozambique should focus attention on improving road safety regulations and their implementation, as well as on interventions targeting violence reduction and the reduction of alcohol consumption at sporting events.

Training laypersons and hospital personnel in basic resuscitation techniques: an approach to impact the global trauma burden in Mozambique.

INTRODUCTION: Over half of prehospital deaths in low-income countries are the result of airway compromise, respiratory failure, or uncontrolled hemorrhage; all three conditions can be addressed using simple first-aid measures. For both hospital personnel and laypersons, a basic trauma resuscitation training in modified ABCD (airway, breathing, circulation, disability) techniques can be easily learned and applied to increase the number of first responders in Mozambique, a resource-challenged country. METHODS: A trauma training session was administered to 100 people in Mozambique: half were hospital personnel from 7 district medical centers and the other half were selected laypersons. This session included a pre-test, intervention, and post-test to evaluate and demonstrate first response skills. RESULTS: Eighty-eight people completed both the pre- and post-tests. Following the education intervention, both groups demonstrated an improvement in test scores. Hospital personnel had a mean post-test score of 60% (SD = 17, N = 43) and community laypeople had a mean score of 51% (SD = 16, N = 45). A t test for equal variances demonstrated significant difference between the post-intervention scores for the two groups (p = 0.01). All 100 participants were able to open an airway, externally control hemorrhage, and transport a patient with appropriate precautions. CONCLUSION: The trauma training session served as new information that improved knowledge as well as skills for both groups, and increased the number of capable responders in Mozambique. This study supports WHO recommendations to utilize the strengths of a developing nation-population-as the first step in establishing an organized trauma triage system.