Along the Indian Ocean Coast: Genomic Variation in Mozambique Provides New Insights into the Bantu Expansion.

The Bantu expansion, which started in West Central Africa around 5,000 BP, constitutes a major migratory movement involving the joint spread of peoples and languages across sub-Saharan Africa. Despite the rich linguistic and archaeological evidence available, the genetic relationships between different Bantu-speaking populations and the migratory routes they followed during various phases of the expansion remain poorly understood. Here, we analyze the genetic profiles of southwestern and southeastern Bantu-speaking peoples located at the edges of the Bantu expansion by generating genome-wide data for 200 individuals from 12 Mozambican and 3 Angolan populations using ∼1.9 million autosomal single nucleotide polymorphisms. Incorporating a wide range of available genetic data, our analyses confirm previous results favoring a "late split" between West and East Bantu speakers, following a joint passage through the rainforest. In addition, we find that Bantu speakers from eastern Africa display genetic substructure, with Mozambican populations forming a gradient of relatedness along a North-South cline stretching from the coastal border between Kenya and Tanzania to South Africa. This gradient is further associated with a southward increase in genetic homogeneity, and involved minimum admixture with resident populations. Together, our results provide the first genetic evidence in support of a rapid North-South dispersal of Bantu peoples along the Indian Ocean Coast, as inferred from the distribution and antiquity of Early Iron Age assemblages associated with the Kwale archaeological tradition.

Physical Activity Measured by Accelerometry in Mozambican Older Adult Women Attending a Regular Exercise Program.

Time spent in different Physical Activity (PA) Intensities of 72 Mozambican older adult women (67 ± 7 years old) was assessed by means of triaxial accelerometers for 7 consecutive days, and participants were stratified based on their body mass index, as being normal weight (NW, n = 23); overweight (n = 16); or obese (OB, n = 33). Overall, most daily time was spent in sedentary activities (614 ± 111 min or 69.1%) and light PA (181 ± 56 min or 20.2%). On average, moderate to vigorous PA (MVPA) was performed during 10.6% of the day (93 ± 44 min). Time spent in MVPA was significantly higher in the NW compared to OB category (112.8 ± 51.5 vs. 81.0 ± 36.3; p = .021). The overweight group did not differ in time spent in MVPA when compared to NW and OB group. Overall, 75% of the participants spent more than 60 min a day in MVPA (NW: 83%; overweight: 81%; OB: 67%). Pearson's correlation between body mass index and total MVPA controlling for age was -.39 (p < .001). It was concluded that Mozambican older adult women living in urban and rural areas of Maputo province engaged in relatively high Physical Activity Intensities compared with individuals of similar ages in high-income countries, regardless of their nutritional status.

Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross-sectional study.

OBJECTIVE: This study describes the distributions of body mass index (BMI) and movement behaviors among schoolchildren from 13 countries across a continuum of human development. METHODS: Data were from a cross-sectional study of 9-11-year-old children (n = 8055) recruited from 269 urban schools in 13 countries, and an additional 7 rural schools in one of these countries (Mozambique). BMI was derived from objectively measured heights and weights. Moderate- to vigorous-intensity physical activity (MVPA), sedentary time (SED), and sleep duration were assessed by waist-worn Actigraph GT3X+ accelerometers. Linear models were used to describe the distributions of BMI z-scores, MVPA, SED, and sleep among sites across varying Human Development Indices (HDIs). RESULTS: Mean MVPA, SED, and sleep duration were 63.1 ± 27.3 minutes/day, 508.7 ± 72.4 minutes/day, and 8.8 ± 0.9 hours/night, respectively. Overall, 2.1% of the sample were thin, 19.5% overweight, and 11.7% were obese. Density curves (BMI z-scores and SED) for urban children in Mozambique showed significantly higher mean values compared with rural children. Boys had significantly higher mean MVPA compared with girls. Mean BMI z-scores were positively associated (ß = .02; P = .004) with HDI, mean daily MVPA minutes were negatively associated (ß = -.38; P = .025) with HDI, and mean SED time was positively associated with HDI (ß = 1.18; P = .049). No significant association (ß = .01; P = .29) was observed between sleep duration and HDI. CONCLUSION: Our findings show distinct differences in BMI and movement behavior profiles between urban and rural children in Mozambique. Mean BMI z-scores, MVPA, and SED differed by country HDI. These findings support the need to include both rural and urban participants in study samples.

Prevalence and correlates of adherence to movement guidelines among urban and rural children in Mozambique: a cross-sectional study.

BACKGROUND: Insufficient physical activity, short sleep duration, and excessive recreational screen time are increasing globally. Currently, there are little to no data describing prevalences and correlates of movement behaviours among children in low-middle-income countries. The few available reports do not include both urban and rural respondents, despite the large proportion of rural populations in low-middle-income countries. We compared the prevalence of meeting 24-h movement guidelines and examined correlates of meeting the guidelines in a sample of urban and rural Mozambican schoolchildren. METHODS: This is cross-sectional study of 9-11 year-old children (n = 683) recruited from 10 urban and 7 rural schools in Mozambique. Moderate- to vigorous-intensity physical activity (MVPA) and sleep duration were measured by waist-worn Actigraph GT3X+ accelerometers. Accelerometers were worn 24 h/day for up to 8 days. Recreational screen time was self-reported. Potential correlates of meeting 24-h movement guidelines were directly measured or obtained from validated items of context-adapted questionnaires. Multilevel multivariable logit models were used to determine the correlates of movement behaviours. Meeting 24-h movement guidelines was defined as ≥60 min/day of MVPA, ≤2 h/day of recreational screen time, and between 9 and 11 h/night of sleep. RESULTS: More rural (17.7%) than urban (3.6%) children met all three 24-h movement guidelines. Mean MVPA was lower (82.9 ± 29.5 min/day) among urban than rural children (96.7 ± 31.8 min/day). Rural children had longer sleep duration (8.9 ± 0.7 h/night) and shorter recreational screen time (2.7 ± 1.9 h/day) than their urban counterparts (8.7 ± 0.9 h/night and 5.0 ± 2.3 h/day respectively). Parental education (OR: 0.37; CI: 0.16-0.87), school location (OR: 0.21; CI: 0.09-0.52), and outdoor time (OR: 0.67; CI: 0.53-0.85) were significant correlates of meeting all three 24-h movement guidelines. CONCLUSIONS: Prevalence and correlates of meeting movement guidelines differed between urban and rural schoolchildren in Mozambique. On average, both groups had higher daily MVPA minutes, shorter sleep duration, and higher recreational screen time than the 24-h movement guidelines recommend. These findings (e.g., higher than recommended mean daily MVPA minutes) differ from those from high-income countries and highlight the need to sample from both urban and rural areas.

Prevalence of overweight and obesity in Mozambique in 2005 and 2015.

OBJECTIVE: The ongoing demographic, nutritional and epidemiological transitions in sub-Saharan Africa highlight the importance of monitoring overweight and obesity. We aimed to assess the prevalence of overweight and obesity in Mozambique in 2014/2015 and compare the estimates with those obtained in 2005. DESIGN: Cross-sectional study conducted in 2014/2015, following the WHO Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). Prevalence estimates with 95 % CI were computed for different categories of BMI and abdominal obesity, along with age-, education- and income-adjusted OR. The age-standardized prevalence in the age group 25-64 years was compared with results from a STEPS survey conducted in 2005. SETTING: Mozambique. PARTICIPANTS: Representative sample of the population aged 18-64 years (n 2595). RESULTS: Between 2005 and 2014/2015, the prevalence of overweight and obesity increased from 18·3 to 30·5 % (P < 0·001) in women and from 11·7 to 18·2 % (P < 0·001) in men. Abdominal obesity increased among women (from 9·4 to 20·4 %, P < 0·001), but there was no significant difference among men (1·5 v. 2·1 %, P = 0·395). In 2014/2015, the prevalence of overweight and obesity was more than twofold higher in urban areas and in women; in the age group 18-24 years, it was highest in urban women and lowest in rural men. CONCLUSIONS: In Mozambique, there was a steep increase in the prevalence of overweight and obesity among adults between 2005 and 2014/2015. Overweight and obesity are more prevalent in urban areas and among women, already affecting one in five urban women aged 18-24 years.

Development and convergent validity of new self-administered questionnaires of active transportation in three African countries: Kenya, Mozambique and Nigeria.

BACKGROUND: There is currently a rapid physical activity transition taking place in developing countries that includes a decrease in active transportation. Building on findings from an earlier systematic review, this paper describes the development and convergent validity of self-administered child and parent questionnaires assessing active transportation of children in three African countries: Kenya, Mozambique and Nigeria. METHODS: A pilot study was conducted to examine the convergent validity of the developed questionnaires by comparing responses between children and their parents (N = 121; n = 43 for Mozambique, n = 24 for Kenya and n = 54 for Nigeria). After modification, the questionnaires were then administered to a larger convenient sample of both children and parents from Kenya (n = 1123), Mozambique (n = 1097) and Nigeria (n = 831) which defined the main study. The questionnaires assessed active transportation to/from 8 categories of destinations including school, friends' and relatives' home/houses, parks and playgrounds among others. Twenty items were used to assess child - and parent-perceived barriers to active transportation, and the parent questionnaire inquired about parent education and availability of cars, motorcycles, and bicycles. Spearman's rho was used to compare children's mode of travel in the pilot study while the prevalence-adjusted bias-adjusted kappa (PABAK) coefficient was used to compare convergent validity between children's and parents responses on active transportation in the main study. RESULTS: Findings of the main study show that convergent validity for active transportation to and from each destination in the combined sample ranged from 0.472 (from school) to 0.998 (to other places). Convergent validity for challenges/barriers to active transportation to school ranged from fair (0.30 - The route does not have good lighting) to substantial (0.77 - My child has a disability). It varied between countries from fair (n = 11-items) to moderate (n = 9-items) agreement in Kenya and from poor (n = 2-items) to fair (n = 16-items) agreement in Nigeria. Data from Mozambique was however missing and therefore could be included. CONCLUSIONS: The questionnaires provided valid information on the number of trips to/from various destinations and show acceptable and modest convergent validity for measuring barriers to active transport in a sample of children from three African countries. These questionnaires may be suitable for future research on active transport among school children in Sub-Saharan African countries.

Familial resemblance in gross motor coordination. The Peruvian Sibling Study on Growth and Health.

BACKGROUND: The development of gross motor coordination (GMC) is governed by biological and environmental factors whose effect sizes are still unclear. AIM: To investigate sibling resemblance in GMC, as well as biological and environmental correlates of GMC among Peruvian children. MATERIALS AND METHODS: The sample comprised 1256 biological siblings (6-15 years old), from three geographical areas of Peru. GMC was assessed using the Korperkoordinationtest für Kinder (KTK) test battery. Anthropometry, biological maturation and physical fitness (PF) were also measured. Multilevel modelling was performed using Stata 14 software. RESULTS: In general, sister-sister pairs (SS) showed the highest resemblance in GMC (ρ = 0.24) compared to brother-sister (BS) (ρ = 0.10) and brother-brother (BB) pairs (ρ = 0.07). On average, BB pairs had higher GMC than SS pairs and older siblings had higher GMC than younger siblings. Further, those with lower body mass index (BMI) and higher PF had higher GMC. There was also a significant interaction between age and PF with GMC. Siblings from the rainforest region demonstrated higher GMC than those from sea level and high-altitude siblings demonstrated lower GMC than their sea-level peers. CONCLUSION: These results demonstrate statistically significant sibling resemblance in GMC. Age, BMI, PF and geographical area were significant correlates of GMC.

Deficits in anthropometric indices of nutritional status and motor performance among low birth weight children from Maputo City, Mozambique.

OBJECTIVE: To evaluate associations between low birth weight (LBW) and anthropometry, body composition, physical fitness, and gross motor coordination among schoolchildren from Maputo, Mozambique. METHODS: A total of 353 children aged 7 to 10 years old from both genders born in Maputo (Mozambique) were sampled. The sample was divided into two groups: LBW (n = 155) and normal birth weight (NBW, n = 198). Body composition measurements and indices weight-for-age, height-for-age, and weight-for-height were assessed. Physical fitness was assessed by handgrip strength, flexibility, agility, long jump, and running speed. Gross motor coordination was evaluated by using the Korper Koordination Test fur Kinder (KTK) battery. RESULTS: LBW children were lighter and smaller than NBW children with reduced indices for weight-for-age and height-for-age. They also showed a reduced performance in handgrip strength and sideways movement tests. These differences remained significant even after adjustment for age, gender, body size, and fatness skinfold thickness. CONCLUSION: LBW seems to be the major factor that influences anthropometry, and is a predictor of low muscle strength and low performance on sideways movement tests. This result suggests that growth faltering in LBW children is associated with adverse health consequences, even after controlling for gender, age, fatness, and body size.

NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries.

BACKGROUND: Built environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa). METHODS: The original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries. RESULTS: The original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs > .75 %) or "good" (ICCs = 0.60 to 0.74) reliability. Seven (53.8 %) of the 13 computed NEWS scales demonstrated "excellent" agreement and the other six had "good" agreement. No items or scales demonstrated "poor" reliability (ICCs < .40). CONCLUSIONS: The systematic adaptation and initial psychometric evaluation of NEWS-Africa indicates the instrument is feasible and reliable for use with adults of diverse demographic characteristics in Africa. The measure is likely to be useful for research, surveillance of built environment conditions for planning purposes, and to evaluate physical activity and policy interventions in Africa.

Differences in motor performance between children and adolescents in Mozambique and Portugal: impact of allometric scaling.

BACKGROUND: Children from developed and developing countries have different anthropometric characteristics which may affect their motor performance (MP). AIM: To use the allometric approach to model the relationship between body size and MP in youth from two countries differing in socio-economic status-Portugal and Mozambique. SUBJECTS AND METHODS: A total of 2946 subjects, 1280 Mozambicans (688 girls) and 1666 Portuguese (826 girls), aged 10-15 years were sampled. Height and weight were measured and the reciprocal ponderal index (RPI) was computed. MP included handgrip strength, 1-mile run/walk, curl-ups and standing long jump tests. A multiplicative allometric model was adopted to adjust for body size differences across countries. RESULTS: Differences in MP between Mozambican and Portuguese children exist, invariably favouring the latter. The allometric models used to adjust MP for differences in body size identified the optimal body shape to be either the RPI or even more linear, i.e. approximately (height/mass(0.25)). Having adjusted the MP variables for differences in body size, the differences between Mozambican and Portuguese children were invariably reduced and, in the case of grip strength, reversed. CONCLUSION: These results reinforce the notion that significant differences exist in MP across countries, even after adjusting for differences in body size.

Secular trends in physical fitness of Mozambican school-aged children and adolescents.

OBJECTIVE: This study presents information about secular trends in physical fitness (PF) levels among Mozambican youth. METHODS: The sample comprises 3,851 subjects (1,791 boys; 2,060 girls) aged 8-15 years who were evaluated at three time points (1992, 1999, 2012). PF tests included handgrip strength, 10 m × 5 m shuttle-run, sit-and-reach, and 1-mile run/walk. Biological maturity was assessed by sexual characteristics, and percentage body fat was predicted using triceps and subscapular skinfolds. ANCOVA (controlling for age, maturity status, and percentage body fat) was used to compare mean differences in PF tests among the three time points, by sex. RESULTS: Children in 1992 were more flexible than those from 2012; boys handgrip strength increased from 1992 to 2012, while girls decreased their handgrip strength; youth in 1992 were faster and more agile than their 2012 peers; and a decrease was observed in cardiorespiratory fitness between 1992 and 1999 and between 1992 and 2012 for both sexes. CONCLUSIONS: A negative secular trend among Mozambican children's PF was observed over the last two decades, suggesting that socio-political, educational, and economical changes occurring during this period had a relevant effect on their PF. This negative trend suggests that development of intervention programs/strategies to improve PF among youth is warranted.

Model-based patterns of cardiovascular risk factors in Mozambique.

BACKGROUND: Risk factors for cardiovascular diseases tend to cluster, although evidence from settings under epidemiological transition is scarce. AIM: To identify patterns of clustering of cardiovascular risk factors and to quantify their association with sociodemographic characteristics, in Mozambique. SUBJECTS AND METHODS: A national representative sample (n = 3323) of subjects aged 25-64 years was evaluated in 2005, using the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). Patterns of joint exposure to high blood pressure, high fasting blood glucose, high body mass index, smoking, excessive alcohol consumption, low fruit/vegetables intake and insufficient physical activity were identified through latent class analysis. RESULTS: Three patterns were identified among women: (1) "healthier", lower frequency of most risk factors (53.0%); (2) "hypertension-overweight" (21.1%), more frequent among older and urban subjects; and (3) "hypertension-smoking-alcohol" (25.9%), whose frequency increased with age and decreased with education. In men, two clusters were identified: (1) "hypertension-overweight" (30.1%); and (2) "smoking" (69.9%). The frequency of the latter pattern was higher in urban areas and increased with age and education. CONCLUSION: Hypertension, overweight/obesity, smoking and excessive alcohol intake defined the main clusters of cardiovascular risk factors. This should be considered when planning prevention and control strategies for cardiovascular diseases in Mozambique.

Natural selection for the Duffy-null allele in the recently admixed people of Madagascar.

While gene flow between distantly related populations is increasingly recognized as a potentially important source of adaptive genetic variation for humans, fully characterized examples are rare. In addition, the role that natural selection for resistance to vivax malaria may have played in the extreme distribution of the protective Duffy-null allele, which is nearly completely fixed in mainland sub-Saharan Africa and absent elsewhere, is controversial. We address both these issues by investigating the evolution of the Duffy-null allele in the Malagasy, a recently admixed population with major ancestry components from both East Asia and mainland sub-Saharan Africa. We used genome-wide genetic data and extensive computer simulations to show that the high frequency of the Duffy-null allele in Madagascar can only be explained in the absence of positive natural selection under extreme demographic scenarios involving high genetic drift. However, the observed genomic single nucleotide polymorphism diversity in the Malagasy is incompatible with such extreme demographic scenarios, indicating that positive selection for the Duffy-null allele best explains the high frequency of the allele in Madagascar. We estimate the selection coefficient to be 0.066. Because vivax malaria is endemic to Madagascar, this result supports the hypothesis that malaria resistance drove fixation of the Duffy-null allele in mainland sub-Saharan Africa.

A systematic review of active transportation research in Africa and the psychometric properties of measurement tools for children and youth.

BACKGROUND: Previous systematic reviews indicate that active transportation (AT; the use of non-motorized travel modes such as walking, running and cycling) is an important source of daily physical activity (PA). However, no previous systematic review has examined travel behaviours among African children and youth or the psychometric properties of measurement tools used among children and youth worldwide. METHODS: Studies on AT among African children and youth (aged 5-17 years) were identified through 1) the MEDLINE and Embase databases; 2) manual searches of six African journals that are not indexed in these databases; and 3) the articles included in a previous systematic review on PA among children and youth in Sub-Saharan Africa. Second, literature on the psychometric properties of measurement tools for children and youth was searched using the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycInfo, SportDiscus, and Health and Psychosocial Instruments databases. Study quality was assessed with a modified version of the Downs and Black checklist. RESULTS: Twenty studies reported original data on AT among African children and youth. This evidence suggests that rates of AT to/from school are lower in urban areas and in youth attending higher SES schools. Two population-based studies reported rates of AT ranging between 19.8% and 66.6% in multiple countries. Studies conducted in Africa seldom examined non-school travel and only one reported data on the psychometric properties of their measures of travel behaviours. Nineteen studies conducted predominantly in high-income countries provided psychometric data. Child and parent reports were used in 17 studies, and these measures generally showed substantial to almost perfect test-retest reliability and convergent validity for school trips. Limited information was available regarding non-school trips. Objective measures of travel behaviours have been used much less often, and further validity and reliability assessments are warranted. CONCLUSION: These findings emphasize a need for more research examining travel behaviours among African children and youth, particularly for non-school travel. Further research is needed to develop valid and reliable measures of non-school travel and to examine their psychometric properties in the African context. These measures could then be used to evaluate AT promotion interventions.

Energy Expenditure, Intensity, and Perceived Effort in Recreational Functional Training.

Background: Functional training (FT) has become popular and seems to provoke health benefits. However, there are unsubstantiated claims regarding energy expenditure (EE) vs. weight-loss and cardiorespiratory improvements linked to FT. Objective: This study quantified the EE and intensity during FT performed in a conventional fitness center. Additionally, data of FT and moderate continuous walking (WLK) were compared. Methods: Healthy individuals with no previous experience with FT [n = 25, 11 males/14 females, 38.8 ± 9.3 years; 73.9 ± 13.8 Kg; 168.5 ± 8.5 cm; 26.0 ± 4.5 Kg/m2; 16 overweight (BMI >25 Kg/m2)] performed three FT sessions interspersed with 48 h (two familiarization, one assessment). The circuit included 4 rounds of 12 exercises performed at all-out intensity for 20 s with 1-min intervals between rounds. WLK was performed for 25 min with intensity corresponding to scores 3-5 on Borg CR-10 Scale. Outcomes were EE (kcal), movement counts estimated by triaxial accelerometry, heart rate reserve (%HRR), and rate of perceived exertion (RPE). Results: On average, FT sessions lasted 24 min and EE ranged between 124 and 292 kcal (188 ± 41 kcal), corresponding to 5-8 METs (6.1 ± 0.6 METs), and 70-80%HRR (74 ± 8%). Accelerometry (counts/min) showed that vigorous predominated over moderate intensity during FT and WLK (p = .01), with similar EE. The relative intensity and RPE were higher in FT vs. WLK (74% vs. 55%HRR and Borg 5-8 vs. 3-5, respectively; p < .0001). Conclusion: FT and WLK elicited EE consistent with recommendations to reduce cardiovascular disease risk, but only FT achieved relative intensities compatible with cardiorespiratory improvement. FT should be considered an option in health-oriented exercise programs for the general population.

Biopsychosocial Effects of a Conventional Exercise Program and Culturally Relevant Activities in Older Women From Mozambique.

AIM: This randomized controlled trial compared the effects of a Conventional Exercise Program (CEP) and Culturally Relevant Activities (CRA) on body mass, cardiovascular risk, functional fitness (strength, flexibility, cardiorespiratory fitness, and agility), self-efficacy, and self-esteem in older women dwelling in Mozambique. METHODS: Fifty-seven women (67 [7] y) underwent 60-minute sessions of CEP (n = 28) or CRA (n = 29) performed 3 days per week for 12 weeks. CRA included Mozambican traditional dances and games (intensity corresponding to scores 3-4 of BORG-CR10 scale), and CEP included 20-minute stationary cycling (65%-75% heart rate reserve) and a resistance training circuit (8 exercises, 15-repetition maximum). RESULTS: CEP and CRA (P < .05) showed increased percent fat (3.4% and 5.3%), waist circumference (3.3% and 5.8%), and cardiorespiratory fitness (14.4% and 9.4%), and decreased triglycerides (-20.0% and -77.8%). In CEP (P < .05), body mass (2.9%), body mass index (3.2%), and high-density lipoprotein (10.0%) increased, while glycemia (-4.8%) and total cholesterol (-9.8%) decreased. Blood pressure slightly increased in CEP (6.2%, P > .05) and CRA (4.3%, P < .05). Self-efficacy and self-esteem increased to similar levels in both groups (15%, P < .05). CONCLUSIONS: CEP and CRA were capable to improve biopsychosocial health-related variables in Mozambican older women. Culturally referenced PA interventions should be considered as an alternative in African countries.

Profile of Children with Undernutrition Admitted in Two Secondary-Level Hospitals in Maputo City, Mozambique.

Mozambique has one of the highest child undernutrition rates in Sub-Saharan Africa. The aim of this study was to characterize the profile of children from 1 to 14 years old hospitalized for undernutrition and to explore associated risk factors. Clinical, demographic, socioeconomic, and environmental data were collected. Anthropometric measurements and stool samples were collected from a child and their caretaker. The wealth index was determined using Principal Components Analysis. A total of 449 children and their caretakers were enrolled. The children had a median age of 1.0 year [IQR: 1.0-2.0], and 53.9% (242/449) were male. Most were admitted with severe undernutrition (35.7%, 159/449 kwashiorkor and 82.0%, 368/449 with -3SD Z-score indexes). The most common co-morbidities were HIV (30.0%, 120/400), diarrhea (20.0%; 80/400), and anemia (12.5%; 50/400). Among the caretakers, 9.5% (39/409) were underweight, 10.1% (40/397) were overweight, and 14.1% (56/397) were obese. Intestinal parasites were found in 24.8% (90/363) children and in 38.5% (77/200) caretakers. The majority of children (60.7%, 85/140) came from low- to middle-wealth households. Most were severely undernourished, suggesting that they seek medical care too late. The finding of overweight/obese caretakers in combination with undernourished children confirms that Mozambique is facing a double burden of malnutrition.

Impact of asymptomatic Plasmodium falciparum parasitemia on the imunohematological indices among school children and adolescents in a rural area highly endemic for malaria in southern Mozambique.

BACKGROUND: Asymptomatic Plasmodium falciparum parasitemia (APFP) has been reported to be highly prevalent in Sub-Saharan Africa, a region heavily burdened by malaria, yet, the impact of APFP on the immunological reference values have not yet been established. This study was aimed at i) determine the prevalence of APFP in children and adolescents living in a region highly endemic for malaria in southern Mozambique and its impact on the immuno-hematological indices and ii) determine the factors independently associated with APFP. METHODS: A cross sectional study was conducted in a rural area highly endemic for Malaria in southern Mozambique during the dry season. Apparently healthy children and adolescents were selected for the study. RESULTS: Blood samples were collected from 348 participants. Plasmodium falciparum was detected in 56.5% (194/343) of study subjects. APFP was more frequent in males and was associated with lower values of hemoglobin and platelets measurements. Parasitized and not parasitized individuals were similar in terms of lymphocyte counts, CD4+ and CD8+ T cells counts. Platelet count was the parameter with strongest association with APFP (OR: 0.991, p= 0.000) in children and its performance in guiding clinical suspicion was moderate (AUC: 0.70, p=0.000). Contrarily, in adolescents, the predictive value of platelets counts was low (AUC: 0.55). CONCLUSION: Overall, our finding demonstrated that APFP is highly prevalent in regions endemic for malaria in southern Mozambique and was associated with lower hematological parameters but unaltered lymphocyte counts, CD4+ and CD8+ T cells counts. Platelets count was of moderate performance in guiding clinical suspicion of APFP in children but not in adolescents.

Nutritional status and its association with physical fitness, physical activity and parasitological indicators in youths from rural Mozambique.

BACKGROUND: Little information exists about the relationship of nutritional status and motor performance conditional on asymptomatic parasitemia in rural African children. AIMS: The aims of this study were to (1) determine if malnourished youths from rural African areas have lower levels of physical fitness (PF) and physical activity (PA) compared to normal weight youths, (2) verify the biological relevance of anthropometric criteria used to classify nutritional status in youth, and (3) determine the prevalence of parasitological indicators, and its association with nutritional status and PF. METHODS: The sample comprised 794 youths (6-17 years) from Calanga, a rural community in Mozambique. PF tests were selected from standardized test batteries, and PA was estimated by accelerometry. Nutritional status was defined according to WHO recommendations for stunting, wasting and normal weight. Parasitological indicators were determined based on stool specimens' analysis. RESULTS: In general terms the normal group out-performed the other nutritional groups (stunted and wasted) for PF. However, no significant differences were found for PA among nutritional groups. There were also no significant differences in prevalence of intestinal parasites. CONCLUSIONS: Nutritional status was not associated with PA levels or the prevalence of parasitological indicators in youth, but was related to physical performance.

Short-term tracking of performance and health-related physical fitness in girls: the Healthy Growth in Cariri Study.

The main purpose of this study was to track the performance and health-related physical fitness of girls from Brazil's Cariri region. In the "Healthy Growth in Cariri Study", 294 girls from public and private schools were divided into four age cohorts--8, 10, 12, and 14 years--and followed for three consecutive years, with an assessment every 6 months. Shuttle run, hand grip, standing long jump, trunk lift, curl-up, 12-min run, and fatness were used to rate physical fitness performance and health-related components on each of six occasions. Tracking was done in a stepwise manner, using auto-correlation, by modelling the individual history of change in performance of each girl, and using Foulkes and Davies' γ-coefficient. SPSS 18.0 and TIMEPATH were used for data analysis. Auto-correlations evidenced low-to-moderate values in almost all components of performance and health-related physical fitness. Intra-individual tracking analysis showed large variation in all fitness components as a result of a wide spread in individual history of change in fitness performance. Population estimates of γ were low in all tests. Our results show low-to-moderate tracking of physical fitness components of girls. A wide range of intra-individual and inter-variability in fitness development was observed.