Post-independence health research productivity in Portuguese-speaking African countries: A bibliometric analysis of 43 years of research and higher education in Mozambique.

Background: Africa has a high double burden of infectious and non-communicable diseases underscoring the critical need for robust scientific research. However, it is also associated with low scientific research productivity. Mozambique, which gained independence in 1975, serves as a poignant example. However, there remains a notable scarcity of evidence evaluating the country's trajectory in scientific and academic development. This study aims to evaluate 43 years of health-related scientific knowledge production through bibliometric analysis, focusing on key indicators. Additionally, it seeks to characterize the higher education institutions within the country. Methods: The data was retrieved from the Web of Science Core Collection using an advanced search tool with Boolean research strategies, covering the period from 1976 to 2022 for all PALOP and 1976 to 2019 for Mozambique. To map Mozambican higher institutions, information was sourced from the Ministry of Science Technology and Higher Education database. Descriptive statistics were employed to summarize the findings, while the VOSviewer program version 1.6.19 was utilized to visualize distance-based bibliometric networks, focusing on co-authorship among institutions and keyword co-occurrence. Results: Portuguese-speaking African countries (PALOP) contribute 2.5 % (10,933 out of 442,309) to Africa's total scientific output, with Mozambique leading at 63.6 % (6,951 publications) followed by Angola at 16.6 % (1,811 publications). All PALOP countries experienced decreased scientific productivity during the third year of the COVID-19 pandemic. In Mozambique, over 70 % (1,710 out of 2,380) of health-related publications from 2011 to 2019 were concentrated in this period. Key journals for health sciences include PLOS ONE, Malaria Journal, and Tropical Medicine & International Health, focusing on HIV, malaria, and tuberculosis. Higher education institutions in Mozambique show regional disparities, with 67.9 % in the South and only 8.9 % in the North, indicating significant inequality in their distribution across the country. Conclusion: This study highlights Mozambique's significant progress in health research productivity over 43 years, establishing it as a leader among PALOP countries. The substantial increase in publications, particularly after 2008, underscores the nation's growing research capacity and commitment to addressing critical health challenges such as HIV, malaria, and tuberculosis. However, regional disparities in higher education access and limited research contributions from private universities remain high in Mozambique.

MARVEL-minimising the emergence and dissemination of HIV-1 drug resistance in Portuguese-speaking African Countries (PALOP): low-cost portable NGS platform for HIV-1 surveillance in Africa.

BACKGROUND: HIV-1 infections remain a global public health concern. Scaled-up antiretroviral treatment (ART) is crucial for reducing morbidity and mortality related to HIV/AIDS. The emergence of drug-resistance mutations (DRMs) compromises viral suppression and contributes to the continued HIV-1 transmission. Several reports indicate a recent increase in acquired (ADR) and transmitted (TDR) drug resistance in Africa, probably linked to the lack of implementation of HIV drug resistance (HIVDR) testing and suboptimal treatment adherence. Herein, we will develop a low-cost protocol using third-generation sequencing (Oxford Nanopore Technology) for HIV-1 surveillance in Portuguese-speaking African Countries - PALOP [Angola (AO), Cape Verde (CV), Mozambique (MZ), and Sao Tome & Principe (STP)]. METHODS: This is a multicentric cross-sectional study that includes around 600 adult patients newly diagnosed with HIV-1 in the PALOP. An epidemiological questionnaire previously validated by our research team will be used to collect sociodemographic and clinical data. Also, whole blood samples will be collected and the plasma samples will be subjected to drug resistance testing using an in-house low-cost NGS protocol. Data analysis will involve bioinformatics, biostatistics and machine learning techniques to generate accurate and up-to-date information about HIV-1 genetic diversity, ADR and TDR. DISCUSSION: The implementation of this low-cost NGS platform for HIV-1 surveillance in the PALOP will allow: (i) to increase DRM surveillance capacity in resource-limited settings; (ii) to understand the pattern and determinants of dissemination of resistant HIV-1 strains; and (iii) to promote the development of technical and scientific skills of African researchers for genomic surveillance of viral pathogens and bioinformatics analysis. These objectives will contribute to reinforcing the capacity to combat HIV infection in Africa by optimizing the selection of ART regimens, improving viral suppression, and reducing ADR or TDR prevalence in PALOPs, with relevant implications for public health.

Early effects of COVID-19 on maternal and child health service disruption in Mozambique.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Introduction: After the World Health Organization declared COVID-19 a pandemic, more than 184 million cases and 4 million deaths had been recorded worldwide by July 2021. These are likely to be underestimates and do not distinguish between direct and indirect deaths resulting from disruptions in health care services. The purpose of our research was to assess the early impact of COVID-19 in 2020 and early 2021 on maternal and child healthcare service delivery at the district level in Mozambique using routine health information system data, and estimate associated excess maternal and child deaths. Methods: Using data from Mozambique's routine health information system (SISMA, Sistema de Informação em Saúde para Monitoria e Avaliação), we conducted a time-series analysis to assess changes in nine selected indicators representing the continuum of maternal and child health care service provision in 159 districts in Mozambique. The dataset was extracted as counts of services provided from January 2017 to March 2021. Descriptive statistics were used for district comparisons, and district-specific time-series plots were produced. We used absolute differences or ratios for comparisons between observed data and modeled predictions as a measure of the magnitude of loss in service provision. Mortality estimates were performed using the Lives Saved Tool (LiST). Results: All maternal and child health care service indicators that we assessed demonstrated service delivery disruptions (below 10% of the expected counts), with the number of new users of family planing and malaria treatment with Coartem (number of children under five treated) experiencing the largest disruptions. Immediate losses were observed in April 2020 for all indicators, with the exception of treatment of malaria with Coartem. The number of excess deaths estimated in 2020 due to loss of health service delivery were 11,337 (12.8%) children under five, 5,705 (11.3%) neonates, and 387 (7.6%) mothers. Conclusion: Findings from our study support existing research showing the negative impact of COVID-19 on maternal and child health services utilization in sub-Saharan Africa. This study offers subnational and granular estimates of service loss that can be useful for health system recovery planning. To our knowledge, it is the first study on the early impacts of COVID-19 on maternal and child health care service utilization conducted in an African Portuguese-speaking country.

Early effects of COVID-19 on maternal and child health service disruption in Mozambique

After the World Health Organization declared COVID-19 a pandemic, more than 184 million cases and 4 million deaths had been recorded worldwide by July 2021. These are likely to be underestimates and do not distinguish between direct and indirect deaths resulting from disruptions in health care services. The purpose of our research was to assess the early impact of COVID-19 in 2020 and early 2021 on maternal and child healthcare service delivery at the district level in Mozambique using routine health information system data, and estimate associated excess maternal and child deaths...

Highlights from the 4th PALOP-AORTIC Conference on Cancer, 29-31 July 2020, Luanda, Angola.

The 4th Países Africanos de Língua Oficial Portuguesa (PALOP)-African Organisation for Research and Training in Cancer (AORTIC) Conference on Cancer was held in July 2020 in Luanda, Angola, under the theme: 'Training to better care'. It was hosted by the Ministry of Health of Angola and AORTIC. It was held virtually using an online platform. The PALOP organisation comprises Lusophone African countries. The conference brought together 360 delegates from 12 countries. Key themes covered during the conference included: Instruments for Proficient Cancer Control in PALOP, oncology education and training in PALOP, CanScreen5-International Agency for Research on Cancer platform to improve quality in tracking cancer, International Gynecologic Cancer Society-Global Curriculum and Mentorship Programme, Oncology Training/Intervention-Support Programmes, Telepathology and Cancer: Challenges and Opportunities, Cancer Burden in PALOP region and Sub-Saharan Africa, Breast Cancer-The current situation in PALOP and The African Breast Cancer Coalition-Disparities in outcomes study in PALOP Countries (ABC-DO-PALOP) study: a proposal. It has been demonstrated that the collaboration and exchange of experiences between African countries and amongst PALOP, in particular, are crucial, whether in the organisation of population-based cancer registries, in the realization of national oncology plans, in the creation of therapeutic recommendations and in strengthening capacities in radiotherapy, amongst other important topics in oncology. The PALOP oncology school will be a fundamental training tool to be administered for better care for cancer patients.

Formação em gestão para apoio à reforma da atenção primária à saúde em Portugal e países africanos lusófonos / Formation in management for supporting health reforms in Portugal and portuguese-speaking countries / Formación en gestión para apoyo de las reformas sanitarias en Portugal y en los países de lengua oficial portuguesa

Resumo Apresentamos lições que resultaram de atividades de capacitação dos gestores conduzidas em Portugal no contexto da reforma da atenção primária em saúde e nos países africanos de língua oficial portuguesa, em termos do planejamento e da gestão dos serviços hospitalares e de saúde pública. Descrevemos três programas de formação-ação realizados pela Unidade de Saúde Pública Internacional do Instituto de Higiene e Medicina Tropical de Lisboa, com o apoio de parceiros portugueses e internacionais como a Organização Mundial da Saúde e o Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro. Os programas foram desenvolvidos na base da identificação das necessidades de competências dos participantes e focaram a resolução de problemas concretos com o objetivo de ajudar os gestores a enfrentar as dificuldades inerentes aos processos de reforma. Apesar do seu valor intrínseco, por si só não se mostram suficientes, uma vez que são sempre necessários outros mecanismos, como o acompanhamento continuado dos gestores, sistemas de incentivos coerentes com os objetivos das reformas, ferramentas e recursos (financiamento, sistemas de informação, pessoal qualificado suficiente) adequados para implementar as mudanças. Além disso, a sustentabilidade das intervenções de fortalecimento das capacidades carece de apoio continuado dos decisores políticos.

Abstract We present lessons that have resulted from formation activities of managers conducted in Portugal in the context of primary health care reform and in the Portuguese-speaking African countries, regarding planning and management of hospital services. and public health. We describe three action-formation programs conducted by the International Public Health Unit of the Institute of Hygiene and Tropical Medicine-Lisbon, with the support of Portuguese and international partners such as the World Health Organization, and the Institute of Social Medicine of Universidade do Estado do Rio de Janeiro. The programs were developed on the basis of identifying participants' skills needs and focused on solving concrete problems in order to help managers address the difficulties inherent in reform processes. Despite their intrinsic value, they are not sufficient by themselves, as other mechanisms such as the continued monitoring of managers, incentive systems consistent with the objectives of reforms, tools and resources (funding, information systems, qualified staff) are always needed and sufficient to implement the changes. In addition, the sustainability of capacity-building interventions needs continued support from policy makers.

Resumen En ese artículo presentamos lecciones que resultaran de actividades de capacitación de los gestores conducidas en Portugal en el contexto de la reforma de la atención primaria en Salud y en los países africanos de lengua oficial portuguesa a nivel de planeamiento y de la gestión de los servicios hospitalarios y de salud pública. El artículo describe tres programas de formación-acción realizados por la Unidad de Salud Pública Internacional del Instituto de Higiene y Medicina Tropical, con el apoyo de socios portugueses e internacionales como la Organización Mundial de Salud, y el Instituto de Medicina Social, Universidad del Estado del Rio de Janeiro. Los programas se desarrollaron sobre la base de la identificación de las necesidades de competencias de los participantes y enfocaran en la resolución de problemas concretos con el objetivo de ayudar los gestores a enfrentar las dificultades inherentes a los procesos de reformas. A pesar de su valor intrínseco, no son suficientes por sí solas, ya que siempre son necesarios otros mecanismos, como el monitoreo continuo de los gestores, sistemas de incentivos coherentes con los objetivos de las reformas, herramientas y recursos (financiación, sistemas de información, personal cualificado suficiente) adecuados para implementar los cambios. Además, la sostenibilidad de las intervenciones de fortalecimiento de las capacidades carece de apoyo continuado de los responsables políticos.

Bibliotecas para formação de técnicos em saúde nos países africanos de língua portuguesa: um diagnóstico / Libraries for the training of health technicians in the african countries of portuguese language: a diagnosis / Bibliotecas para formación de técnicos en salud en los países africanos de lengua portuguesa: un diagnóstico

Resumo O objetivo foi analisar as condições em que se encontram as bibliotecas das instituições de formação de trabalhadores técnicos em saúde dos países africanos de língua oficial portuguesa no âmbito da Rede Internacional de Educação de Técnicos em Saúde. O levantamento dos dados foi realizado mediante pesquisa de campo baseada na aplicação de questionários aos trabalhadores responsáveis pelas bibliotecas ou instituições de ensino. Os resultados mostraram que a maior parte dos trabalhadores das bibliotecas não tinha formação específica para a atividade; o acervo disponível revelou disparidade em relação aos tipos e quantidades de materiais, além de serem apresentados em idiomas que não o português; os recursos físicos eram insuficientes, como ainda o espaço e a localização das bibliotecas; os recursos tecnológicos careciam de melhoria, incluindo-se o acesso à internet. Concluiu-se que as condições das bibliotecas pesquisadas eram insuficientes para oferecer suporte à formação da força de trabalho em nível técnico, como ainda para subsidiar a atividade docente, pois, além da insuficiência e desatualização das obras disponíveis, havia precariedade em instalações, mobiliário e equipamentos.

Abstract The objective was to analyze the conditions in which the libraries of the institutions of training of technical workers in health of the African countries of Portuguese official language within the framework of the International Network of Education of Health Technicians. Data collection was carried out through field research based on the application of questionnaires to workers responsible for libraries or educational institutions. The results showed that most of the workers in the libraries had no specific training for the activity; the available stock revealed a disparity in the types and quantities of materials, besides being presented in languages other than Portuguese; physical resources were insufficient, as were the space and location of libraries; technological resources lacked improvement, including access to the internet. It was concluded that the conditions of the libraries surveyed were insufficient to support the training of the workforce at a technical level, as well as to subsidize the teaching activity, since, in addition to insufficient and outdated works available, there was precariousness in facilities, furniture and equipments.

Resumen El objetivo fue analizar las condiciones en que se encuentran las bibliotecas de las instituciones de formación de trabajadores técnicos en salud de los países africanos de lengua oficial portuguesa en el marco de la Red Internacional de Educación de Técnicos en Salud. El levantamiento de los datos fue realizado mediante investigación de campo basada en la aplicación de cuestionarios a los trabajadores responsables de las bibliotecas o instituciones de enseñanza. Los resultados mostraron que la mayoría de los trabajadores de las bibliotecas no tenían formación específica para la actividad; el acervo disponible mostró disparidad en relación a los tipos y cantidades de materiales, además de ser presentados en idiomas distintos del portugués; los recursos físicos eran insuficientes, como el espacio y la localización de las bibliotecas; los recursos tecnológicos carecían de mejora, incluyendo el acceso a Internet. Se concluyó que las condiciones de las bibliotecas investigadas eran insuficientes para brindar apoyo a la formación de la fuerza de trabajo a nivel técnico, así como para subsidiar la actividad docente, pues, además de la insuficiencia y desactualización de las obras disponibles, había precariedad en instalaciones, mobiliario y equipos.

Study of InDel genetic markers with forensic and ancestry informative interest in PALOP's immigrant populations in Lisboa.

The migratory phenomenon in Portugal has become one of the main factors for the genetic variability. In the last few years, a new class of autosomal insertion/deletion markers-InDel-has attracted interest in forensic genetics. Since there is no data for InDel markers of Portuguese-speaking African countries (PALOP) immigrants living in Lisboa, our aim is the characterization of those groups of individuals by typing them with at least 30 InDel markers and to compare different groups of individuals/populations. We studied 454 bloodstain samples belonging to immigrant individuals from Angola, Guinea-Bissau, and Mozambique. DNA extraction was performed with the Chelex® 100 method. After extraction, all samples were typed with the Investigator® DIPplex method. Through the obtained results, allelic frequencies show that all markers are at Hardy-Weinberg equilibrium, and we can confirm that those populations show significant genetic distances between themselves, between them, and the host Lisboa population. Because of this, they introduce genetic variability in Lisboa population.

Closing the mental health gap in low-income settings by building research capacity: perspectives from Mozambique.

BACKGROUND: Neuropsychiatric disorders are the leading cause of disability worldwide, accounting for 22.7% of all years lived with disability. Despite this global burden, fewer than 25% of affected individuals ever access mental health treatment; in low-income settings, access is much lower, although nonallopathic interventions through traditional healers are common in many venues. Three main barriers to reducing the gap between individuals who need mental health treatment and those who have access to it include stigma and lack of awareness, limited material and human resources, and insufficient research capacity. We argue that investment in dissemination and implementation research is critical to face these barriers. Dissemination and implementation research can improve mental health care in low-income settings by facilitating the adaptation of effective treatment interventions to new settings, particularly when adapting specialist-led interventions developed in high-resource countries to settings with few, if any, mental health professionals. Emerging evidence from other low-income settings suggests that lay providers can be trained to detect mental disorders and deliver basic psychotherapeutic and psychopharmacological interventions when supervised by an expert. OBJECTIVES: We describe a new North-South and South-South research partnership between Universidade Eduardo Mondlane (Mozambique), Columbia University (United States), Vanderbilt University (United States), and Universidade Federal de São Paulo (Brazil), to build research capacity in Mozambique and other Portuguese-speaking African countries. CONCLUSIONS: Mozambique has both the political commitment and available resources for mental health, but inadequate research capacity and workforce limits the country's ability to assess local needs, adapt and test interventions, and identify implementation strategies that can be used to effectively bring evidence-based mental health interventions to scale within the public sector. Global training and research partnerships are critical to building capacity, promoting bilateral learning between and among low- and high-income settings, ultimately reducing the mental health treatment gap worldwide.

Estudo comparativo sobre percepções de características sócio-profissionais de trabalhadores em geral e de imigrantes negros dos PALOP africanos em Portugal / Comparative study about perceptions of socio-professional characteristics from ordinary workers and african PALOP immigrants in Portugal

Neste artigo apresenta-se um estudo comparativo sobre as percepções de características sócio-profissionais (positivas e negativas) de trabalhadores em geral e trabalhadores negros africanos, imigrantes de países de língua oficial portuguesa (PALOP), vistas por estes e por portugueses brancos que trabalham com imigrantes negros, numa amostra de 200 residentes de Lisboa, 100 de etnia branca e 100 de negra, de ambos os sexos, desempenhando funções de executante. Para a coleta de dados foi construído um questionário específico, administrado individual e colectivamente no local de trabalho dos participantes.Os resultados obtidos mostram que urge transformar e melhorar as condições sócio-laborais destes imigrantes - tornando mais céleres e transparentes suas condições de legalização e permanência em Portugal, responsabilizando empregadores em particular e, cidadãos em geral, pela denúncia de situações de exploração e ilegalidade - pois a integração social deverá ser sinônimo de convivência e respeito e não de assimilação.

This paper presents a comparative study about the perceptions of socio-professional characteristics (positive and negative) from ordinary workers and African workers from Portuguese expression countries (PALOP) perceived by those immigrants and also by Caucasian Portugueses working with them, a sample of almost 200 workers from Lisbon and surroundings, 100 Caucasian and 100 Afro-Descendents, from both genders. A specific questionnaire was built (based on previous interviews), collectively and individually administered in the subjects work place. The results allow one to conclude the need to transform and improve the immigrants socio-labor conditions, by making their conditions of legalization and permanence in Portugal quicker and transparent, and also by promoting the responsibility of employers in particular and of citizens in general for denouncing the situations of exploration and illegality, due to their social integration should be a signal of conviviality and of respect instead of assimilation.