Visual impairment and associated factors in adults from three suburban communities in Nampula, Mozambique.

CLINICAL RELEVANCE: Scientific evidence on the burden of visual impairment, its causes, and associated factors are essential to monitor progress in eye health, identify priorities and develop strategies and policies that meet the needs of the population, towards the eradication of preventable blindness. BACKGROUND: The aim of this study was to determine the prevalence of visual impairment, its causes and associated factors in adults living in suburban communities in Nampula. METHODS: This is a cross-sectional study conducted from November 2019 to February 2020. Eye examinations were performed on adults aged ≥18 years covered by the Lúrio University program, 'one student, one family'. The odds ratio (OR) and adjusted odds ratio (aOR) were calculated to study the association between the dependent variable (presenting visual impairment) and independent variables (gender, age, school level, residence, family income and systemic diseases), with a 95% confidence interval. RESULTS: Distance and near presenting visual impairment had a prevalence of 16.3% and 21.1%, respectively, and were statistically associated with the age groups between 45-65 (OR:4.9) and >65 years (OR: 29.1), illiterate (OR:13.8), primary (OR:4.8) and secondary (aOR:37.5) school level, farmer (OR:32.8) and retired (OR:14.3) occupation, and presence of systemic diseases (OR :3.3). The main causes of presenting visual impairment were uncorrected refractive error and cataract. CONCLUSION: The prevalence of presenting visual impairment is relatively high, given the enormous effort undertaken within the framework of VISION 2020: The Right to Sight global initiative. There is a need to develop intervention plans targeted at the highest risk groups, with a view to achieving the 'one student, one family' program goals with respect to eye health.

Exploring Diagnostic Performance of a Screening Instrument for ADHD and DSM-5 Number of Symptoms Criterion in Primary School Students From Mozambique.

OBJECTIVE: To explore the ADHD diagnostic performance of a screening instrument, and which DSM-5 ADHD number of symptoms (criterion A) was best associated with impairment in a sample of students from 106 primary schools in Nampula, Mozambique. METHODS: A random sample of 748 students were assessed using SNAP-IV and 152 youths (76 positive and 76 negative screeners) were invited for psychiatric diagnostic confirmation. RESULTS: The performance of the screening instrument for predicting ADHD diagnosis was poor (all AUCs < 0.53). No other cut-off worked best in predicting impairment than the six symptoms cutoff suggested by DSM-5 for both inattention (AUC = 0.78; 95% CI [0.69, 0.86]) and hyperactivity/impulsivity (AUC = 0.75; 95% CI [0.67, 0.84]). CONCLUSION: Our findings highlight the adequacy of the DSM-5 ADHD criterion A in an African culture but indicate low diagnostic performance of a screening instruments only based in parent or teacher reports on symptoms to predict ADHD diagnosis.

Assessment of the distribution of human and material resources for eye health in the public sector in Nampula, Mozambique.

BACKGROUND: The unavailability of human and material resources can affect access to eye health services, constituting an obstacle in the fight against avoidable visual impairment. This study aimed to assess the availability and distribution of human and material resources for eye health in the public sector in Nampula province. METHODS: A mixed method approach was used, which included document reviews (to extract information regarding the number of professionals and inhabitants in each district) and application of a questionnaire to heads of the ophthalmology department in each health facility (to obtain the list of available equipment). The ratios of eye health professionals per population in Nampula province and each of its districts were calculated and evaluated taking into account the recommendations of the World Health Organization (WHO). Based on the level of care of each health facility, the availability of equipment was evaluated. RESULTS: Nampula Province has not reached the recommended ratio of eye health professionals per population in the different categories (ophthalmic technicians with 0.8 per 100 thousand inhabitants; optometrists and ophthalmologists with 0.4 and 0.2 per 250 thousand inhabitants, respectively). Most districts of Nampula did not reach the recommended ratio in the three categories of professionals, except Nampula City (provincial capital). However, there was a greater concentration of professionals and facilities with eye health services in the provincial capital. Primary and secondary level health facilities lacked some equipment to provide eye health services within their scope. CONCLUSIONS: There is an unequal distribution of the workforce in Nampula and the centralization of surgical services at the Central Hospital of Nampula level. Therefore, there is a need to review resource distribution strategies and decentralization policy of eye health services in Nampula.

Assessment of cataract surgery outcomes in Nampula (Mozambique): visual acuity, visual function and quality of life.

BACKGROUND: Despite advances in surgical techniques, cataract remains the leading cause of preventable blindness, and massive surgeries have been adopted as a strategy to change this situation. Monitoring the results of cataract surgeries has become imperative to ensure their quality. Therefore, this study aims to assess the cataract surgery outcomes performed at the Central Hospital of Nampula Mozambique. METHODS: This is a prospective and longitudinal study in which translation, cultural adaptation and validation of the visual function (VF) and quality of life (QoL) questionnaire were performed. The appearance, content, construct, criterion, internal consistency and responsiveness were validated using the most common methods and indicators. Visual acuity (VA), VF and QoL were evaluated on 447 patients before and after surgery by t-test and effect sizes. RESULTS: VF and QoL questionnaires showed one-dimension, good values of TLI (0.973, 0.951) and SRMR (0.057, 0.054), and for each item, weights > 0.7, H2 > 0.5, ranges > 5.8 and the RMSEA < 0.08. Correlations for criterion validity were high and for responsiveness were high for QoL and moderate for VF one and the ordinal Cronbach's alpha coefficients were greater than 0.97. Difference between VA, VF and QoL before and after surgery was statistically significant (p < 0.001). After surgery, 74.3% of patients had good, 23.5% had borderline and 2.2% had poor VA. CONCLUSIONS: The cataract surgery outcomes are outside the WHO recommendations regarding VA, but they have had a great impact on improving VF and QoL. The questionnaires showed excellent psychometric properties and should be used in daily clinical practice to evaluate the results of cataract surgeries.

Feasibility, Acceptability, and Protective Efficacy of Seasonal Malaria Chemoprevention Implementation in Nampula Province, Mozambique: Protocol for a Hybrid Effectiveness-Implementation Study.

BACKGROUND: Seasonal malaria chemoprevention (SMC) is a highly effective community-based intervention to prevent malaria infections in areas where the malaria burden is high and transmission occurs mainly during the rainy season. In Africa, so far, SMC has been implemented in the Sahel region. Mozambique contributes 4% of the global malaria cases, and malaria is responsible for one-quarter of all deaths in the country. Based on recommendations in the Malaria Strategic Plan, the Malaria Consortium, in partnership with the National Malaria Control Programme in Mozambique, initiated a phased SMC implementation study in the northern province of Nampula. The first phase of this 2-year implementation study was conducted in 2020-2021 and focused on the feasibility and acceptability of SMC. The second phase will focus on demonstrating impact. This paper describes phase 2 of the implementation study. OBJECTIVE: Specific objectives include the following: (1) to determine the effectiveness of SMC in terms of its reduction in incidence of malaria infection among children aged 3 to 59 months; (2) to determine the chemoprevention efficacy of sulfadoxine-pyrimethamine plus amodiaquine (SP+AQ) when used for SMC in Nampula Province, Mozambique, and the extent to which efficacy is impacted by drug resistance and drug concentrations; (3) to investigate the presence and change in SP+AQ- and piperaquine-resistance markers over time as a result of SMC implementation; and (4) to understand the impact of the SMC implementation model, determining the process and acceptability outcomes for the intervention. METHODS: This type 2, hybrid, effectiveness-implementation study uses a convergent mixed methods approach. SMC will be implemented in four monthly cycles between December 2021 and March 2022 in four districts of Nampula Province. Phase 2 will include four components: (1) a cluster randomized controlled trial to establish confirmed malaria cases, (2) a prospective cohort to determine the chemoprevention efficacy of the antimalarials used for SMC and whether drug concentrations or resistance influence the duration of protection, (3) a resistance marker study in children aged 3 to 59 months to describe changes in resistance marker prevalence over time, and (4) a process evaluation to determine feasibility and acceptability of SMC. RESULTS: Data collection began in mid-January 2022, and data analysis is expected to be completed by October 2022. CONCLUSIONS: This is the first effectiveness trial of SMC implemented in Mozambique. The findings from this trial will be crucial to policy change and program expansion to other suitable geographies outside of the Sahel. The chemoprevention efficacy cohort study is a unique opportunity to better understand SMC drug efficacy in this new SMC environment. TRIAL REGISTRATION: ClinicalTrials.gov NCT05186363; https://clinicaltrials.gov/ct2/show/NCT05186363. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/36403.

Covid-19 pandemic impact on maternal and child health services access in Nampula, Mozambique: a mixed methods research.

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.

Intestinal protozoa in hospitalized under-five children with diarrhoea in Nampula - a cross-sectional analysis in a low-income setting in northern Mozambique.

BACKGROUND: In Mozambique, infection by intestinal parasites is reported all over the country. However, infection in children with diarrhoea is mostly focused in the southern region of Mozambique. This work aims to determine the frequency and potential risk factors for infection by Cryptosporidium spp., Giardia lamblia, and Entamoeba histolytica in children under-five years hospitalized with diarrhoea in Hospital Central de Nampula, northern Mozambique. METHODS: A cross-sectional hospital-based surveillance was conducted between March 2015 and January 2018 in children admitted with diarrhoea in Hospital Central de Nampula. Sociodemographic information was obtained through semi-structured interviews applied to the children's caregivers. A single stool sample was collected from each child to detect antigens from Cryptosporidium spp., G. lamblia, and E. histolytica using an immune-enzymatic technique. Crude and adjusted odds ratios (with 95% Confidence Intervals) were obtained by logistic regression models to identify factors associated with infection by Cryptosporidium spp. and G. lamblia. RESULTS: The median age and interquartile intervals of our sample population was 12 months (8-20). Intestinal protozoa were detected in 21.4% (59/276). Cryptosporidium spp. was the most common protozoa (13.9% - 38/274), followed by G. lamblia (9.1% - 25/274) and E. histolytica (0.4% - 1/275). Children with illiterate caregiver's (p-value = 0.042) and undernourished (p-value = 0.011) were more likely to be infected by Cryptosporidium spp. G. lamblia was more common in children living in households with more than four members (p-value = 0.039). E. histolytica was detected in an eleven month's child, co-infected with Cryptosporidium spp. and undernourished. CONCLUSION: Cryptosporidium spp. and Giardia lamblia were the most common pathogenic intestinal protozoa detected in children with diarrhoea hospitalized in the Hospital Central de Nampula. Our findings obtained highlight the importance of exploring the caregiver's education level, children's nutritional status for infections with Cryptosporidium spp., and living conditions, namely crowded households for infections with G. lamblia in children younger than five years.

Relevância das Condições Meteorológicas para a Ocorrência da COVID-19 / Relevance of Meteorological Conditions for the Occurrence of COVID-19

Desde a declaração da COVID-19 como Emergência Internacional de Saúde Pública (PHEIC) pela Organização Mundial da Saúde (OMS), tem-se tentado identificar factores que afectam o comportamento da pandemia para garantir melhor controlo. Dos diversos factores, os meteorológicos estão entre os mais importantes. Objectivo: Analisar a relação estatística entre duas variáveis meteorológicas ­ temperatura e pressão atmosférica ­ e a frequência de casos confirmados de COVID-19 em Moçambique. Tipo de estudo: observacional e longitudinal e estatístico. Local: Moçambique, área de Maputo (Província e Cidade) e Província de Nampula. População: De acordo com o Censo 2017, Moçambique tem 27 909 798 habitantes, área de Maputo tem 3 595 547 e a Província de Nampula tem 6 102 867. Métodos: Os dados meteorológicos foram obtidos diariamente nas bases de dados AccuWeather, Time and Date AS e Weather Spark, e o número de casos confirmados de COVID-19 a partir da informação diária dos órgãos oficiais de comunicação do Governo de Moçambique.

Since the declaration of COVID-19 as an International Public Health Emergency (PHEIC) by the World Health Organization (WHO), efforts have been made to identify factors that affect the behavior of the pandemic to ensure better control. Of the various factors, meteorological ones are among the most important. Objective: To analyze the statistical relationship between two meteorological variables ­ temperature and atmospheric pressure ­ and the frequency of confirmed cases of COVID-19 in Mozambique. Type of study: observational and longitudinal and statistical. Location: Mozambique, Maputo area (Province and City) and Nampula Province. Population: According to the 2017 Census, Mozambique has 27,909,798 inhabitants, Maputo area has 3,595,547 and Nampula Province has 6,102,867. Methods: Meteorological data were obtained daily from AccuWeather, Time and Date databases. AS and Weather Spark, and the number of confirmed cases of COVID-19 from daily information from the official communication bodies of the Government of Mozambique.

Hansen's disease deformities in a high risk area in Mozambique: A case study

Abstract INTRODUCTION: Hansen's disease is no longer a public health problem in Mozambique, since 2008 (incidence under 1 / 10,000 inhabitants). The country is one of the most affected in the world and Nampula province's Murrupula district (incidence 1.7 / 10,000) has a high deformity rate (22% in 2010). This study aimed to identify high deformity rate associated determinants and proposals for better health program results. METHODS: This study involved a descriptive quantitative survey, systematic observation of patients and health professionals, and a survey of community volunteers. Data were analyzed using Epi Info 7.2. Pearson's chi-square and Fisher's exact test were used to assess statistical association with deformity, with a significance level of 5% and 95% confidence interval. Ethical procedures followed the Helsinki declaration (2013). RESULTS: Among 238 subjects, 175 were patients and 63 leprosy health staff. Most patients relied on subsistence agriculture facing social exclusion (43, 25%). The waiting time from first symptoms to diagnosis was over one year for 63%. Deformity affected 116 subjects (68%), particularly those who considered the disease as God's desire (p = 0.01), and practiced traditional treatments (p = 0.001). Among leprosy health staff, 35 (52%) were not trained on diagnosis and management. CONCLUSIONS: High deformity rate is associated with low economic status, the belief that the disease is God's desire, the use of traditional healers, late diagnosis, and poor disease management. A health education program targeting professionals and population, with infection screening and self-care groups can prevent deformities.

Contributions des tradipraticiens de santé au traitement antirétroviral : Étude de cas à Nampula, Mozambique.

Contexte: L'épidémie du virus de l'immunodéficience humaine au Mozambique est un problème grave de santé publique et le Ministère de la Santé a étendu le traitement antirétroviral à tous les districts du pays. Cependant, on constate un nombre élevé d'abandon du traitement encore insuffisamment évalué. L'Organisation Mondiale de la Santé recommande que les tradipraticiens de santé collaborent avec les systèmes nationaux de santé dans les pays en développement, pour combattre cette épidémie, mais il existe peu d'actions dans ce domaine à ce jour.Objectif: Évaluer la connaissance des tradipraticiens sur l'infection et leur disponibilité à coopérer avec les services de santé dans la Province de Nampula au Mozambique, pour améliorer les résultats du traitement antirétroviral.Lieux: Cinq centres de santé des districts de la Province de Nampula, au Nord du Mozambique, avec des taux élevés d'incidence du virus d'immunodéficience humaine et d'abandon du traitement.Méthodes: Une étude mixte transversale, utilisant des interviews ciblés et des discussions de groupes focaux. Les données quantitatives étaient traitées par fréquence et les données qualitatives par analyse de discours et ethnographie locale.Résultats: Nous avons interviewé 79 tradipraticiens de santé. La perte de poids était souvent considérée comme le signal principal de suspicion d'infection par le virus d'immunodéficience humaine et certains tradipraticiens ne pas les signes de la maladie ; la majorité pensait que les antirétroviraux améliorent la qualité de vie des patients, ne prétendait pas traiter l'infection, savait qu'elle n'est pas curable, avait une idée sur le concept de bonne adhésion au traitement et référait les cas compliqués au centre de santé. En ce qui concerne l'alimentation, la moitié considérait exclusivement les céréales comme l'aliment principal ; les fruits étaient importants pour un quart ; l'eau potable est ignorée. La majorité était prête à collaborer avec le système de santé et avait des propositions de coopération pratique : la qualification et la reconnaissance individuelle et la formation intégrée avec les professionnels de santé.Conclusion: Les tradipraticiens connaissaient l'infection par le virus d'immunodéficience humaine et les facteurs associés, mais il y a des lacunes. Ils ont signalé qu'ils utilisaient principalement les plantes médicinales, ce qui peut contribuer au traitement des infections opportunistes et la majorité référait déjà des patients au centre de santé ; mais la collaboration nécessite une procédure éducative et une articulation structurée. Les lacunes de connaissance empêchent une coopération efficace dans le combat contre l'épidémie. Le groupe est disponible pour coopérer avec le système de santé pour améliorer les résultats du traitement antirétroviral, mais pour ça il est nécessaire d'informer et former les tradipraticiens dans un processus intégré de collaboration avec les professionnels de santé conventionnels.

Sexual and physical intimate partner violence among women using antenatal care in Nampula, Mozambique.

The aim was to estimate the prevalence of sexual and physical intimate partner violence (IPV) and its associated factors, in a sample of pregnant women using antenatal care (ANC) in Nampula province - Mozambique. This cross-sectional study was carried out in six health units in Nampula, from February 2013 to January 2014. Overall, 869 participants answered the Conflict Tactics Scale 2. The lifetime and past year prevalence of sexual abuse was 49% and 46%, and of physical abuse was 46% and 44%, respectively. Lifetime and past year sexual abuse was significantly associated with living as a couple, alcohol drinking and having a past diagnosis of gonorrhea. Lifetime and past year physical abuse increased significantly with age and was associated with living as a couple, alcohol drinking and history with syphilis. The prevalence of lifetime and previous year violence among women using ANC was high and similar showing that most women were constantly exposed to IPV. ANC provides a window of opportunity for identifying and acting on violence against women.

Frequencia e caracterização dos genótipos de rotavirus do grupo A em crianças de 0 a 59 meses de idade, atendidas com diarreeia aguda na pediatria do Hospital Central de Nampula, 2015 / Frequency and characterization of group A rotavirus genotypes in children aged 0 to 59 months, treated with acute diarrhea in the pediatrics of the Hospital Central de Nampula, 2015

A doença diarreica na infância constitui um importante problema de saúde pública em Moçambique. A infecção pelo Rotavirus é a uma das causas mais comum de diarreia aguda grave a nível mundial, sendo a diarreia terceira causa de morbi-mortalidade infantil na maioria dos países em desenvolvimento e considerado responsável por custos elevados de assistência médica e de hospitalização. Na região norte de Moçambique, há pouca informação sobre a contribuição do Rotavirus na etiologia das doenças diarreicas. METODOLOGIA: De Março de 2015 a Fevereiro 2016, foi realizado um estudo descritivo transversal, onde foram incluídas de forma consecutiva crianças dos 0-59 meses, com diarreia aguda internadas nos serviços de pediatria do Hospital Central de Nampula e recolhidas amostras de fezes. Foram igualmente colhidos dados demográficos e clínicos através de um questionário padronizado. A detecção do Rotavirus foi realizada pelo teste ELISA, no laboratório de referência de virologia do INS. As amostras positivas por ELISA foram genotipadas por multiplex transcriptase reversa, reacção em cadeia de polimerase (RT-PCR). RESULTADOS: Das 296 crianças incluidas, o Rotavirus foi detectado em 26.7%, (79/296) sendo 53.2% (42/79) dos positivos do sexo masculino, 73.4% (58/79) dos casos positivos detectados foi na época fria. A distribuição de casos pelas faixas etárias e sua positividade foi a seguinte: 0-6 meses, 11.4% (9/79); 7-12 meses, 50.6% (40/79) sendo 55% masculino e 45% feminino ; 13-24 meses, 32.9% (26/79); 25-36 meses, 3.8% (3/79) e 37-59 meses, 1.3% (1/79). As 79 amostras positivas por ELISA foram genotipadas por multiplex RT-PCR. Nas amostras submetidas a RT-PCR, foram obtidas as seguintes combinações binárias mais frequentes de genótipos 77% G1P[8] , G2P[6] 15% e G9P[4] 5.0 %. CONCLUSÃO: O estudo reporta uma frequência alta de Rotavírus em Nampula. As crianças mais afectadas foram do sexo masculino, na faixa etária de 7-12 meses de idade. O Rotavirus ocorre ao longo do ano com maior frequência no inverno, o genótipo mais frequente foi o G1P[8].

Diarrheal disease in childhood is an important public health problem in Mozambique. Rotavirus infection is one of the most common cause of acute diarrhea worldwide. Diarrhea is the third leading cause of infant morbidity and mortality in most developing countries and responsible for high costs of medical care and hospitalization. In northern Mozambique, there is no information about Rotavirus contribution in the etiology of diarrheal diseases. METHODS: From March 2015 to February 2016, we conducted a cross-sectional study, in which were included consecutively children's for 0-59 months, hospitalized with acute diarrhea at the pediatric services of Nampula Central Hospital. In all children stool samples were collected. There were also collected demographic and clinical data through a standardized questionnaire. The detection of Rotavirus was performed by ELISA at the INS reference virology laboratory. The positive samples in the ELISA test were genotyped by multiplex reverse transcription-polymerase chain reaction RT-PCR. RESULTS: Within 296 included childen's, Rotavirus was detected in 26.7 % (79/296) from which 53.2% (42/79) of the positive cases were male children and 73.4% (58/79) of positive cases detected were detected in winter. The distribution of cases by age groups and their positivity was as follows: 0-6 months, 11.4% (9/79); 7-12 months, 50.6% (40/79) being that male 55% and female 45%; 13-24 months, 32.9% (26/79); 25-36 months, 3.8% (3/79) and 37-59 months, 1.3% (1/79). Those samples Positive in the ELISA test were genotyped by multiplex RT-PCR. From all 79 samples subjected to RT-PCR, Rotavirus genotype G1P[8] was detected in 77 % of samples, G2P[6] in 15% and 5% in G9P[4] . CONCLUSION: This study has shown a high frequency of Rotavirus in Nampula. The most affected children's were male, aged 7-12 months old. Rotavirus was detected in the two seasons more often in the winter and the predominant circulating genotype was G1P [8].

Impacto da campanha de distribuição de redes mosquiteiras realizada no ano 2013 nos distritos Mecuburi e Nacala-A-Velha para as prevalencias da filaríase linfática, 2914 / Impact of the mosquito net distribution campaign carried out in 2013 in Mecuburi and Nacala-A-Velha districts on the prevalence of lymphatic filariasis, 2914

A prevalência global da infecção pela filaríase linfática (FL) em Moçambique no ano 2015 era de 13%, sendo mais alta na Província de Nampula com 45%. O tratamento massivo para esta doença teve início em 2010 e, acções de controlo vectorial decorrem anualmente no país. O estudo se propôs a avaliar o impacto da campanha de distribuição massiva de redes mosquiteiras realizada no ano 2013 em dois distritos da Província de Nampula, na prevenção cruzada da FL para além da prevenção da malária que eram os objectivos da campanha. Métodos: Foi realizado um estudo descritivo, transversal para determinar a prevalência da FL em amostras de sangue colhidas no mesmo grupo nos anos 2013, antes e 2014 depois da campanha de distribuição de redes mosquiteiras. Para a análise, foi usada uma base de dados existente no Ministério da Saúde, cujos dados foram colhidos para a determinar a prevalência da malária entre os beneficiários de redes mosquiteiras na campanha realizada nos Distritos de Nacala-a-Velha e Mecuburi. A produção dos resultados foi baseada na análise de dados secundários usando o pacote estatístico Tableau softwareversão 7.0 e mapeados através do programa GIS ArcMapversão 10.2.2. Num intervalo de confiança (IC) de 95%, foram considerados estatisticamente significantes resultados que apresentem um p-valor <0,05. Resultados: No Distrito de Nacala-a-Velha a infecção pela FL em todos os antígenos teve uma prevalência global de 67%, antes e, 61% depois da campanha, para o Distrito de Mecuburi, a prevalência foi de 76%, antes e, 56% depois da campanha. Foram identificados os antígenos Wuchereria Bancrofti, Brugia Malayi14 e Brugia Malayi33, sendo o Brúgia Malay33o principal agente causador da FL com uma prevalência de 76% no Distrito de Mecuburi, p-valor <0,05 e 67% em Nacala-a-Velha. A maior prevalência foi reportada no sexo masculino e nas faixas etárias dos 5 ­ 14 anos e ≥ 15 anos de idade. Conclusões: A campanha de distribuição de redes mosquiteriras realizada no ano 2013 teve um impacto positivo na redução da prevalência da doença tendo passado de 76% para 56% em Mecuburi e de 67% para 61% em Nacala-a-Velha. Esta campanha levou a uma apreciável queda nas taxas de infecção por microfilarêmia pela redução de novas infecções em 31% no Distrito de Mecuburi e 10% em Nacala-a-Velha. O estudo mostra uma transmissão activa da FL ao identificar prevalências da infecção por parasitas não comuns em Moçambique nomeadamente Brugia Malayi33, Brugia Malayi14 para além doWuchereria Bancrofti mais descrita. A Brugia. Malayi33, foi responsável por altos níveis de prevalências.

The overall prevalence of lymphatic filariasis (LF) infection in Mozambique in 2015 was 13%, highest in Nampula Province with 45%. The massive treatment for this disease began in 2010 and, vectorial control actions is take place annually in the country. The study aimed to evaluate the impact of the campaign of massive distribution of mosquito nets carried out in 2013 in two districts of Nampula Province, in the cross-prevention of LF in addition to the prevention of malaria that were the objectives of the campaign. Methods: A descriptive, cross-sectional study was conducted to determine the prevalence of LF in blood samples collected in the same group in the years 2013, before and 2014 after the mosquito nets distribution campaign. For the analysis, a database was used in the Ministry of Health, whose data were collected to determine the prevalence of malaria among the recipients of mosquito nets in the campaign carried out in the Nacala-a-Velha and Mecuburi Districts. The production of the results was based on the analysis of secondary data using the statistical package Tableau softwareversion 7.0 and mapped through GIS program ArcMapversion 10.2.2. In a 95% confidence interval (CI), results with a p-value <0.05 were considered statistically significant. Results: In the Nacala-a-Velha District, LF infection in all antigens had an overall prevalence of 67%, before and, 61% after the campaign, for the District of Mecuburi, prevalence was 76%, before, 56% after the campaign. The Wuchereria Bancrofti, Brugia Malayi14and Brugia Malayi33antigens were identified, Brúgia Malay33being the main causa agent of LF with a prevalence of 76% in Mecuburi District, p-value <0.05 and 67% in Nacala-a-Velha. The highest prevalence was reported in males and in the age groups of 5 - 14 years and ≥ 15 years of age. Conclusions: The mosquito nets distribution campaign carried out in 2013 had a positive impact on reducing the prevalence of the disease from 76% to 56% in Mecuburi and from 67% to 61% in Nacala-a-Velha. This campaign led to a significant drop in microfilariae infection rates due to the reduction of new infections in 31% in Mecuburi District and 10% in Nacala-a-Velha. The study shows an active transmission of FL in identifying prevalences of parasitic infection not common in Mozambique, namely Brugia Malayi33, Brugia Malayi14in addition to the Wuchereria Bancroftidescribed above. The Brugia. Malayi33, was responsible for high levels of prevalence.

Hydrocephalus in children less than 1 year of age in northern Mozambique.

BACKGROUND: In developed countries, the incidence of neonatal hydrocephalus ranges from 3 to 5 cases per 1000 live births, but little is known about the frequency of hydrocephalus in Africa. In Mozambique, there is no primary information related to this disorder, but using the above data, the expected incidence of neonatal hydrocephalus would range from 2900 to 4800 cases per year. METHODS: This study is based on 122 children younger than 1 year with neonatal hydrocephalus, followed up between January 2010 and December 2012, their origin and treatment, and aims to evaluate difficulties with diagnosis, treatment, and follow-up in northern Mozambique. RESULTS: Identified cases were mainly less than 6 months old (77%), with severe macrocephaly and the classic stigmata of this condition. A high rate of follow-up loss (44.3%) was detected, particularly among children from more distant locations. Our findings contrast with the expected 1000-1700 cases that would occur in the area during the study period, being considerably lower. CONCLUSIONS: Hydrocephalus is a serious problem in sub-Saharan Africa, whose effects can be minimized by a better organization of the health system in hydrocephalus prevention, referral, and follow-up. New management alternatives to provide treatment to more children with this disorder and reduction of the follow-up difficulties caused due to geographical reasons for the children undergoing treatment are essential.