Assessing the Vulnerability and Adaptation Needs of Mozambique's Health Sector to Climate: A Comprehensive Study.

Climate change poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, a climate-vulnerable nation, has experienced significant natural disasters in the past 42 years, impacting its health system. This study aims to assess Mozambique's health sector's vulnerability and adaptation needs to climate change. Following a methodology proposed by the World Health Organization and the Intergovernmental Panel for Climate Change, a six-step vulnerability and adaptation assessment was conducted to conduct the Health Vulnerability Index (HVI) for Mozambique's regions (n=161). The HVI integrates historical climate, epidemiological, and socio-economic data at the district level, and was computed using exposure, sensitivity, and adaptive capacity dimensions. The results revealed spatial patterns in exposure to climate variables, extreme weather events, and variations in sensitivity and adaptive capacity across the country. The HVI mirrored the exposure findings. Notably, high vulnerability was observed in several districts, while major urban centers displayed lower vulnerability. These findings highlight the country's vulnerability to climate change and underscore the potential for adverse impacts on livelihoods, the economy, and human health. The study provides a foundation for developing strategies and adaptation actions.

Sociodemographic characteristics of professional categories most affected by COVID-19 in Mozambique from March to July 2020

The risk of a worker becoming ill due to coronavirus disease 2019 (COVID-19) is related to occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the need to restore work activities in Mozambique, the study was conducted with the aim of identifying the occupational categories most affected by COVID-19 in the former in the period from March to July 2020. this is a cross-sectional descriptive study, in which data from professions of confirmed cases of COVID-19 from 22 March to 29 July 2020 in Mozambique were analyzed. The professionals' data were reported daily by the National Institute of Health (NIH) and merged into a single database and exported to Excel, the latter categorized according to standard operating procedure (SOP) and descriptive statistics performed for its analysis. in the period under analysis, 1,127 professionals were diagnosed with COVID-19, divided into 11 categories. Nampula province had the highest frequency of cases with 25.00% (277). The highest frequency of cases was registered in the domestic professional category, which had 16.77% (189/1,127) with the female sex being more frequent, 79.37% (150/189); and defense and security had 14.20% (160/1,127) of cases and male gender with 91.25% (146/160); Health workers had 13.04% (147/1,127), and the maximum number of COVID-19 cases was recorded in June with 58.50% (86/147). the professional categories most affected by COVID-19 in the period under review correspond to those groups that carry out activities requiring a physical presence at the workplace and from this; it is recommended that professionals reinforce preventive measures.

Sociodemographic characteristics of professional categories most affected by COVID-19 in Mozambique from March to July 2020.

Introduction: the risk of a worker becoming ill due to coronavirus disease 2019 (COVID-19) is related to occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the need to restore work activities in Mozambique, the study was conducted with the aim of identifying the occupational categories most affected by COVID-19 in the former in the period from March to July 2020. Methods: this is a cross-sectional descriptive study, in which data from professions of confirmed cases of COVID-19 from 22 March to 29 July 2020 in Mozambique were analyzed. The professionals' data were reported daily by the National Institute of Health (NIH) and merged into a single database and exported to Excel, the latter categorized according to standard operating procedure (SOP) and descriptive statistics performed for its analysis. Results: in the period under analysis, 1,127 professionals were diagnosed with COVID-19, divided into 11 categories. Nampula province had the highest frequency of cases with 25.00% (277). The highest frequency of cases was registered in the domestic professional category, which had 16.77% (189/1,127) with the female sex being more frequent, 79.37% (150/189); and defense and security had 14.20% (160/1,127) of cases and male gender with 91.25% (146/160); Health workers had 13.04% (147/1,127), and the maximum number of COVID-19 cases was recorded in June with 58.50% (86/147). Conclusion: the professional categories most affected by COVID-19 in the period under review correspond to those groups that carry out activities requiring a physical presence at the workplace and from this; it is recommended that professionals reinforce preventive measures.

Relatório de Avaliação Rápida da Situação de Saúde -Moçambique: Implementação piloto do novo quadro da OMS para apoiar o Desenvolvimento de Estratégias de Saúde Pública na Mineração Artesanal e de Pequena Escala de Ouro no Contexto da Convenção de Minamata sobre Mercúrio / Rapid Health Situation Assessment Report -Mozambique: Pilot Implementation of the New WHO Framework to Support the Development of Public Health Strategies in Artisanal and Small-Scale Gold Mining in the Context of the Minamata Convention on Mercury

A Mineração Artesanal e de Pequena Escala de Ouro (MAPEO) é, em termos gerais, a exploração de pequenos depósitos de ouro por indivíduos, pequenos grupos ou pequenas cooperativas (1). A MAPEO é, geralmente, um trabalho intensivo com nenhuma ou limitada mecanização, e pode ter baixos índices de recuperação. O sector é geralmente caracterizado por baixos níveis de capital, produtividade, segurança ocupacional e acesso limitado aos mercados de terra e comércio. A MAPEO é praticada em mais de 70 países em todo o mundo. Estima-se que 10-15 milhões de pessoas estejam envolvidas na MAPEO, incluindo 4-5 milhões de mulheres e 1 milhão de crianças, enquanto outros 80 a 100 milhões de meios de subsistência de pessoas estão afectados pela MAPEO (2, 3). A MAPEO é uma actividade importante em muitos países em desenvolvimento, uma vez que representa uma fonte primária e adicional de renda, particularmente em regiões rurais onde as alternativas económicas à agricultura são limitadas. Estima-se que o sector de MAPEO contribua com cerca de 25% da produção global de ouro (2)

Relatório de Avaliação Rápida da Situação de Saúde- Mpçambique / Rapid Health Assessment Report - Mozambique

A Mineração Artesanal e de Pequena Escala de Ouro (MAPEO) é, em termos gerais, a exploração de pequenos depósitos de ouro por indivíduos, pequenos grupos ou pequenas cooperativas (1). A MAPEO é, geralmente, um trabalho intensivo com nenhuma ou limitada mecanização, e pode ter baixos índices de recuperação. O sector é geralmente caracterizado por baixos níveis de capital, produtividade, segurança ocupacional e acesso limitado aos mercados de terra e comércio. A MAPEO é praticada em mais de 70 países em todo o mundo. Estima-se que 10-15 milhões de pessoas estejam envolvidas na MAPEO, incluindo 4-5 milhões de mulheres e 1 milhão de crianças, enquanto outros 80 a 100 milhões de meios de subsistência de pessoas estão afectados pela MAPEO (2, 3). A MAPEO é uma actividade importante em muitos países em desenvolvimento, uma vez que representa uma fonte primária e adicional de renda, particularmente em regiões rurais onde as alternativas económicas à agricultura são limitadas. Estima-se que o sector de MAPEO contribua com cerca de 25% da produção global de ouro

Debate público sobre o impacto das mudanças climáticas na saúde / Public debate on the impact of climate change on health

A localização geográ¬ca de Moçambique na zona intertropical, a jusante de bacias hidrográ¬cas partilhadas, à sua longa costa e a existência de extensas áreas com altitude abaixo do actual nível do mar in uenciam para a sua vulnerabilidade a eventos extremos de origem meteorológica tais como secas, cheias e ciclones tropicais e de origem geológica como é o caso de sismos e tsunamis de escala média1,2. Por isso, o país foi considerado como o mais afectado por fenómenos climáticos extremos em África em 2015, provocando danos estimados em 500 milhões de dólares america nos3. Embora a frequência de eventos climáticos extremos que assolam o país esteja a crescer nas últimas duas décadas, ainda é muito escassa a evidência sobre o impacto das mudanças do clima e do ambiente na ocorrência de doenças e no sistema de saúde em geral. Esta informação é crucial para o processo de formulação de políticas e plani¬cação ao nível do sector da saúde com vista a assegurar que medidas de resiliência, mitigação e prevenção sejam tomadas de modo a reduzir e aliviar o seu impacto devastador.

Spatio-temporal modelling of weekly malaria incidence in children under 5 for early epidemic detection in Mozambique.

Malaria is a major cause of morbidity and mortality in Mozambique. We present a malaria early warning system (MEWS) for Mozambique informed by seven years of weekly case reports of malaria in children under 5 years of age from 142 districts. A spatio-temporal model was developed based on explanatory climatic variables to map exceedance probabilities, defined as the predictive probability that the relative risk of malaria incidence in a given district for a particular week will exceed a predefined threshold. Unlike most spatially discrete models, our approach accounts for the geographical extent of each district in the derivation of the spatial covariance structure to allow for changes in administrative boundaries over time. The MEWS can thus be used to predict areas that may experience increases in malaria transmission beyond expected levels, early enough so that prevention and response measures can be implemented prior to the onset of outbreaks. The framework we present is also applicable to other climate-sensitive diseases.

Association between Precipitation and Diarrheal Disease in Mozambique.

Diarrheal diseases are a leading cause of morbidity and mortality in Africa. Although research documents the magnitude and pattern of diarrheal diseases are associated with weather in particular locations, there is limited quantification of this association in sub-Saharan Africa and no studies conducted in Mozambique. Our study aimed to determine whether variation in diarrheal disease was associated with precipitation in Mozambique. In secondary analyses we investigated the associations between temperature and diarrheal disease. We obtained weekly time series data for weather and diarrheal disease aggregated at the administrative district level for 1997-2014. Weather data include modeled estimates of precipitation and temperature. Diarrheal disease counts are confirmed clinical episodes reported to the Mozambique Ministry of Health (n = 7,315,738). We estimated the association between disease counts and precipitation, defined as the number of wet days (precipitation > 1 mm) per week, for the entire country and for Mozambique's four regions. We conducted time series regression analyses using an unconstrained distributed lag Poisson model adjusted for time, maximum temperature, and district. Temperature was similarly estimated with adjusted covariates. Using a four-week lag, chosen a priori, precipitation was associated with diarrheal disease. One additional wet day per week was associated with a 1.86% (95% CI: 1.05-2.67%), 1.37% (95% CI: 0.70-2.04%), 2.09% (95% CI: 1.01-3.18%), and 0.63% (95% CI: 0.11-1.14%) increase in diarrheal disease in Mozambique's northern, central, southern, and coastal regions, respectively. Our study indicates a strong association between diarrheal disease and precipitation. Diarrheal disease prevention efforts should target areas forecast to experience increased rainfall. The burden of diarrheal disease may increase with increased precipitation associated with climate change, unless additional health system interventions are undertaken.

Association between Precipitation and Diarrheal Disease in Mozambique

Diarrheal diseases are a leading cause of morbidity and mortality in Africa. Although research documents the magnitude and pattern of diarrheal diseases are associated with weather in particular locations, there is limited quantification of this association in sub-Saharan Africa and no studies conducted in Mozambique. Our study aimed to determine whether variation in diarrheal disease was associated with precipitation in Mozambique. In secondary analyses we investigated the associations between temperature and diarrheal disease. We obtained weekly time series data for weather and diarrheal disease aggregated at the administrative district level for 1997­2014. Weather data include modeled estimates of precipitation and temperature. Diarrheal disease counts are confirmed clinical episodes reported to the Mozambique Ministry of Health (n = 7,315,738). We estimated the association between disease counts and precipitation, defined as the number of wet days (precipitation > 1 mm) per week, for the entire country and for Mozambique's four regions. We conducted time series regression analyses using an unconstrained distributed lag Poisson model adjusted for time, maximum temperature, and district. Temperature was similarly estimated with adjusted covariates. Using a four-week lag, chosen a priori, precipitation was associated with diarrheal disease. One additional wet day per week was associated with a 1.86% (95% CI: 1.05­2.67%), 1.37% (95% CI: 0.70­2.04%), 2.09% (95% CI: 1.01­3.18%), and 0.63% (95% CI: 0.11­1.14%) increase in diarrheal disease in Mozambique's northern, central, southern, and coastal regions, respectively. Our study indicates a strong association between diarrheal disease and precipitation. Diarrheal disease prevention efforts should target areas forecast to experience increased rainfall. The burden of diarrheal disease may increase with increased precipitation associated with climate change, unless additional health system interventions are undertaken.

Chemical composition and biological activity of the essential oil from leaves of Moringa oleifera Lam. cultivated in Mozambique.

The antioxidant capacity and antimicrobial activity of the essential oil of Moringa oleifera (Moringaceae) grown in Mozambique was investigated. The chemical composition was studied by means of GC and GC-MS analysis. Hexacosane (13.9%), pentacosane (13.3%) and heptacosane (11.4%) were the main components. Ultra High Performance Chromatography-DAD analysis detected the flavonoids quercetin (126 µg/g) and luteolin (6.2 µg/g). The essential oil exhibited a relatively low free radical scavenging capacity. The antimicrobial activity of the essential oil was assayed against two Gram-positive strains (Bacillus cereus, Staphylococcus aureus), two Gram-negative strains (Escherichia coli, Pseudomonas aeruginosa), and five fungal strains of agro-food interest (Penicillium aurantiogriseum, Penicillium expansum, Penicillium citrinum, Penicillium digitatum, and Aspergillus niger spp.). B. cereus and P. aeruginosa, as well as the fungal strains were sensitive to the essential oil.

Molecular diversity of Mycobacterium tuberculosis isolates from patients with pulmonary tuberculosis in Mozambique.

BACKGROUND: Mozambique is one of the countries with the highest burden of tuberculosis (TB) in Sub-Saharan Africa, and information on the predominant genotypes of Mycobacterium tuberculosis circulating in the country are important to better understand the epidemic. This study determined the predominant strain lineages that cause TB in Mozambique. RESULTS: A total of 445 M. tuberculosis isolates from seven different provinces of Mozambique were characterized by spoligotyping and resulting profiles were compared with the international spoligotyping database SITVIT2.The four most predominant lineages observed were: the Latin-American Mediterranean (LAM, n = 165 or 37%); the East African-Indian (EAI, n = 132 or 29.7%); an evolutionary recent but yet ill-defined T clade, (n = 52 or 11.6%); and the globally-emerging Beijing clone, (n = 31 or 7%). A high spoligotype diversity was found for the EAI, LAM and T lineages. CONCLUSIONS: The TB epidemic in Mozambique is caused by a wide diversity of spoligotypes with predominance of LAM, EAI, T and Beijing lineages.