SARS-CoV-2 in Mozambican primary school-aged children at Maputo City and Province: a cross-sectional study from a low-income country.

BACKGROUND: Seroprevalence studies provide information on the true extent of infection and capture demographic and geographic differences, indicating the level of immunity against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). We sought to provide local evidence of SARS-CoV-2 exposure in school-aged children during in-class teaching in Maputo City and Province, Mozambique. METHODS: Between August and November 2022, we performed a cross-sectional study in school-aged children in four schools in rural, peri-urban, and urban areas of Maputo City and Province. A point-of-care test was used to evaluate SARS-CoV-2 antigens and anti-SARS-CoV-2-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Descriptive statistics were used to estimate the prevalence of the antigens and antibodies. Multiple logistic regression models were used to estimate the adjusted odds ratio (AOR) for the factors associated with anti-SARS-CoV-2 antibodies. RESULTS: A total of 736 school-aged children were analyzed. The prevalence of the SARS-CoV-2 antigen was 0.5% (4/736). The prevalence of SARS-CoV-2 antigens was 0.0% (0/245), 0.8% (2/240) and 0.8% (2/251), in the rural, peri-urban and urban areas respectively. The overall seroprevalence of the anti-SARS-CoV-2 antibodies (IgG or IgM) was 80.7% (594/736). In rural area anti-SARS-CoV-2 IgG or IgM antibodies were detected in 76.7% (188/245), while in peri-urban area they were detected in 80.0% (192/240) and in urban area they were detected in 85.3% (214/251). In the adjusted logistic regression model, school-aged children from the urban area were more likely to have anti-SARS-CoV-2 IgG or IgM antibodies than were school-aged children from the rural area (adjusted odds ratio: 1.679; 95% CI: 1.060-2.684; p-value = 0.028). CONCLUSIONS: During the in-class teaching period, active SARS-CoV-2 cases in school-aged children were observed. More than half of the school-aged children were exposed to SARS-CoV-2, and SARS-CoV-2 was significantly more common in the schools at the urban area than in the school in the rural area at Maputo City and Province.

Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies in the Mozambican Population: A Cross-Sectional Serologic Study in 3 Cities, July-August 2020.

BACKGROUND: The extent of population exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was uncertain in many African countries during the onset of the pandemic. METHODS: We conducted a cross-sectional study and randomly selected and surveyed general population and occupational groups from 6 July to 24 August 2020, in 3 cities in Mozambique. Anti-SARS-CoV-2-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were measured using a point-of-care rapid test. The prevalence was weighted for population (by age, sex, and city) and adjusted for test sensitivity and specificity. RESULTS: A total of 21 183 participants, including 11 143 from the general population and 10 040 from occupational groups, were included across all 3 cities. General population seropositivity (IgM or IgG) prevalence was 3.0% (95% confidence interval [CI], 1.0%-6.6%) in Pemba, 2.1% (95% CI, 1.2%-3.3%) in Maputo City, and 0.9% (95% CI, .1%-1.9%) in Quelimane. The prevalence in occupational groups ranged from 2.8% (95% CI, 1.3%-5.2%) to 5.9% (95% CI, 4.3%-8.0%) in Pemba, 0.3% (95% CI, .0%-2.2%) to 4.0% (95% CI, 2.6%-5.7%) in Maputo City, and 0.0% (95% CI, .0%-.7%) to 6.6% (95% CI, 3.8%-10.5%) in Quelimane, and showed variations between the groups tested. CONCLUSIONS: In the first representative COVID-19 serosurveys in Mozambique, in mid-2020, weighted and assay-adjusted seroprevalence in 3 provincial capitals of anti-SARS-CoV-2 ranged from 0.9% to 3.0%, whereas adjusted prevalence in occupational groups ranged from 0.0% to 6.6% with variation between groups. Exposure to SARS-CoV-2 was extensive during the first pandemic wave, and transmission may have been more intense among occupational groups. These data have been of utmost importance to inform public health intervention to control and respond to the pandemic in Mozambique.

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

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

Burden of COVID-19 in the Pediatric Population at Hospital Central de Maputo, Mozambique, October 2020 to October 2022.

The epidemiology and characteristics of SARS-CoV-2 in the hospitalized Mozambican pediatric population are scarce. We aimed to assess the burden of COVID-19 in the pediatric population at Hospital Central de Maputo and identify comorbidities and factors associated with death among hospitalized COVID-19 cases. A cross-sectional study was conducted from October 2020 to October 2022. Available records were retrieved from admission books. Univariate and bivariate analyses were reported to describe the sample characteristics. The frequency of pediatric cases admitted with COVID-19 was 0.6% (95% confidence interval (CI): 0.5-0.6; 364/63,753), and the frequency of pediatric cases hospitalized with COVID-19 was 2.5% (95% CI: 2.2-2.9; 173/6807). The monthly frequency of pediatric cases admitted and hospitalized with COVID-19 ranged from 0.1% to 5.4% and from 0.2% to 42.1%, respectively. In children hospitalized with COVID-19, underweight was the most observed comorbidity (17.4%; 19/109); death was observed in 30% (95% CI: 22.2-39.1; 33/110), and it was significantly higher in underweight children than in non-underweight children (61.5% [8/13] vs. 21.3% [16/75]; p-value = 0.005). Given the heightened risk of mortality among undernourished children compared to non-undernourished children, vaccination for COVID-19 should be prioritized for undernourished children.

Emerging Zoonotic Diseases among Pastoral Communities of Caia and Búzi Districts, Sofala, Mozambique: Evidence of Antibodies against Brucella, Leptospira, Rickettsia, and Crimean-Congo Hemorrhagic Fever Virus.

BACKGROUND: Emerging zoonotic diseases are an increasing threat to public health. There is little data on the seroprevalence of zoonotic diseases among pastoralists in the country. We aim to carry out a cross-sectional study on the prevalence of major zoonotic diseases among pastoral communities in the Caia and Búzi districts. METHODS: Between January and December 2018, a questionnaire was used to solicit socio-demographic data from consenting pastoralists with the collection of blood samples in the Caia and Búzi districts of the Sofala province. All samples were tested using ELISA commercial reagents for the detection of IgM antibodies against Brucella and Leptospira. Likewise, IgM and IgG antibodies against Rickettsia and CCHFV were determined using ELISA kits. RESULTS: A total of 218 samples were tested, of which 43.5% (95/218) were from the district of Caia and 56.4% (123/218) from the Búzi district. Results from both districts showed that the seroprevalence of IgM antibodies against Brucella and Leptospira was 2.7% (6/218) and 30.3% (67/218), respectively. Positivity rates for IgM and IgG anti-Rickettsia and CCHFV were 8.7% (19/218), 2.7% (6/218), 4.1% (9/218), and 0.9% (2/218), respectively. CONCLUSIONS: Results from our study showed evidence of antibodies due to exposure to Brucella, Leptospira, Rickettsia, and CCHFV with antibodies against Leptospira and Rickettsia being the most prevalent. Hence, laboratory diagnosis of zoonotic diseases is essential in the early detection of outbreaks, the identification of silent transmission, and the etiology of non-febrile illness in a pastoral community. There is a need to develop public health interventions that will reduce the risk of transmission.

Natural disasters, population displacement and health emergencies: multiple public health threats in Mozambique.

In early 2019, following the 2015-2016 severe drought, the provinces of Sofala and Cabo Delgado, Mozambique, were hit by Cyclones Idai and Kenneth, respectively. These were the deadliest and most destructive cyclones in the country's history. Currently, these two provinces host tens of thousands of vulnerable households due to the climatic catastrophes and the massive influx of displaced people associated with violent terrorist attacks plaguing Cabo Delgado. The emergence of the COVID-19 pandemic added a new challenge to this already critical scenario, serving as a real test for Mozambique's public health preparedness. On the planetary level, Mozambique can be viewed as a 'canary in the coal mine', harbingering to the world the synergistic effects of co-occurring anthropogenic and natural disasters. Herein, we discuss how the COVID-19 pandemic has accentuated the need for an effective and comprehensive public health response in a country already deeply impacted by health problems associated with natural disasters and population displacement.

Cyclone Idai as a Trigger for Pellagra Outbreak in Nhamatanda, Mozambique: A Case-Control Study.

In mid-June 2019, 3 months after cyclone Idai landfall in Mozambique, health authorities of Nhamatanda district reported an outbreak of Pellagra. Applying a mixed-method protocol, we carried out an investigation to characterize cases of pellagra, identify the associated factors for the outbreak using a case-control study, and explore the perceived impact on food security (availability, access, and usage) before and after Idai. We collected data from 121 cases and 121 controls and conducted in-depth interviews with 69 heads of households. The cases were more likely to be female (P < 0.01) and less educated (P < 0.01) than controls. Insufficient consumption of chicken and peanut before cyclone Idai arrival were statistically associated with pellagra (P < 0.05). From interviewed households' heads, 51% were experiencing food shortages even before the cyclone hit. Cyclone Idai served as a trigger to reduce niacin consumption below the threshold that protected Nhamatanda population from pellagra and caused a ≈2,300 case (707.9/100,000 inhabitants) outbreak.

Evolutionary analysis of Mycobacterium bovis genotypes across Africa suggests co-evolution with livestock and humans.

Mycobacterium bovis is the pathogenic agent responsible for bovine tuberculosis (bTB), a zoonotic disease affecting mostly cattle, but also transmittable to humans and wildlife. Genetic studies on M. bovis allow to detect possible routes of bTB transmission and the identification of genetic reservoirs that may provide an essential framework for public health action. We used a database with 1235 M. bovis genotypes collected from different regions in Africa with 45 new Mozambican samples. Our analyses, based on phylogeographic and population genetics' approaches, allowed to identify two clear trends. First, the genetic diversity of M. bovis is geographically clustered across the continent, with the only incidences of long-distance sharing of genotypes, between South Africa and Algeria, likely due to recent European introductions. Second, there is a broad gradient of diversity from Northern to Southern Africa with a diversity focus on the proximity to the Near East, where M. bovis likely emerged with animal domestication in the last 10,000 years. Diversity indices are higher in Eastern Africa, followed successively by Northern, Central, Southern and Western Africa, roughly correlating with the regional archaeological records of introduction of animal domesticates. Given this scenario M. bovis in Africa was probably established millennia ago following a concomitant spread with cattle, sheep and goat. Such scenario could translate into long-term locally adapted lineages across Africa. This work describes a novel scenario for the spread of M. bovis in Africa using the available genetic data, opening the field to further studies using higher resolution genomic data.

Risk factors associated with Leishmania exposure among dogs in a rural area of Ilha Solteira, SP, Brazil.

INTRODUCTION: We sought to determine risk factors (RFs) associated with the presence of antibodies against Leishmania in dogs from a rural area of Ilha Solteira, SP, Brazil. METHODS: Serum samples were collected from 250 dogs and tested using indirect enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence antibody tests (IFATs). Data concerning dogs, their environment, and their owners' knowledge of leishmaniasis were collected using a questionnaire. To determine RFs for contact with the parasite, univariate statistical analysis based on chi-squared and Fisher's exact tests, followed by logistic regression, was used. RESULTS: It was found that 79/250 (31.6%) of the dogs were positive by IFAT, and 72/250 (28.8%) by ELISA. A total of 82/250 dogs (32.8%) were positive in at least one test. The RFs associated with occurrences of Leishmania exposure were large body size (OR = 2.25; 95% CI = 1.26-4.04; p = 0.003), presence of chickens (OR = 1.94; 95% CI = 1.05-3.65; p = 0.023), and lack of knowledge about Leishmania among dog owners (OR = 1.74; 95% CI = 0.96-3.21; p = 0.049). After multivariate analysis, the RFs for occurrence of Leishmania exposure in dogs that remained significantly associated were the dog's size (large dogs) (OR = 1.2; 95% CI = 1.06-1.35; p = 0.003) and presence of chickens on the properties (small farms) (OR = 1.15; 95% CI = 1.02-1.30; p = 0.023). CONCLUSIONS: These results may be useful for improving preventive practices to reduce the incidence of Leishmania exposure among dogs in rural areas.

Contaminação de areia usada para consumo comercializada em mercados informais da cidade de maputo / Contamination of sand used for consumption sold in informal markets in maputo city

: O consumo da areia é comum em Maputo, sendo a sua comercialização feita em mercados informais. Na areia existem microrganismos contaminantes, alguns dos quais patógenos. O objectivo do nosso estudo foi determinar a contaminação microbiana da areia comercializada para o consumo em cinco mercados informais da cidade de Maputo. Métodos: Tratou-se de um estudo transversal, realizado de Janeiro a Março de 2021, no qual foram analisadas 25 amostras de areia colhidas aleatoriamente. Foi feita avaliação dos aspectos higiénico-sanitários para o comércio da areia com base numa lista de verificação padronizada, seguida de testes laboratoriais para a detecção e identificação de bactérias utilizando métodos microbiológicos padrão para alimentos e água (bactérias aeróbicas mesófilas, bolores e leveduras, Staphylococcus aureus, coliformes totais, coliformes fecais e Echerichia coli). Resultados: Todas as amostras apresentaram contaminação por bactérias aeróbicas mesófilas, bolores e leveduras. Os mercados Xiquelene e Fajardo apresentaram contaminação elevada de bactérias aeróbicas mesófilas (1,5x104 UFC/g), bolores e leveduras (1,0x104 UFC/g), respectivamente. Houve maior contaminação por S. aureus nos mercados Fajardo e Zimpeto Anexo (80% em ambos) em relação ao mercado Xiquelene (40%). O mercado Xiquelene apresentou a maior contaminação para coliformes totais, coliformes fecais e E. coli - 100%, 80% e 60%, respectivamente ­ não tendo sido encontrada contaminação no mercado Malanga. Conclusão: A contaminação de areia comercializada para consume nos mercados informais constitui risco importante para a saúde dos consumidores

Emerging Zoonotic Diseases among Pastoral Communities of Caia and Búzi Districts, Sofala, Mozambique: Evidence of Antibodies against Brucella, Leptospira, Rickettsia, and Crimean-Congo Hemorrhagic Fever Virus

Emerging zoonotic diseases are an increasing threat to public health. There is little data on the seroprevalence of zoonotic diseases among pastoralists in the country. We aim to carry out a cross-sectional study on the prevalence of major zoonotic diseases among pastoral communities in the Caia and Búzi districts. Methods: Between January and December 2018, a questionnaire was used to solicit socio-demographic data from consenting pastoralists with the collection of blood samples in the Caia and Búzi districts of the Sofala province. All samples were tested using ELISA commercial reagents for the detection of IgM antibodies against Brucella and Leptospira. Likewise, IgM and IgG antibodies against Rickettsia and CCHFV were determined using ELISA kits. Results: A total of 218 samples were tested, of which 43.5% (95/218) were from the district of Caia and 56.4% (123/218) from the Búzi district. Results from both districts showed that the seroprevalence of IgM antibodies against Brucella and Leptospira was 2.7% (6/218) and 30.3% (67/218), respectively. Positivity rates for IgM and IgG anti-Rickettsia and CCHFV were 8.7% (19/218), 2.7% (6/218), 4.1% (9/218), and 0.9% (2/218), respectively. Conclusions: Results from our study showed evidence of antibodies due to exposure to Brucella, Leptospira, Rickettsia, and CCHFV with antibodies against Leptospira and Rickettsia being the most prevalent. Hence, laboratory diagnosis of zoonotic diseases is essential in the early detection of outbreaks, the identification of silent transmission, and the etiology of non-febrile illness in a pastoral community. There is a need to develop public health interventions that will reduce the risk of transmission.

Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies in the Mozambican Population: A Cross-Sectional Serologic Study in 3 Cities, July­August 2020

Background The extent of population exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was uncertain in many African countries during the onset of the pandemic. Methods We conducted a cross-sectional study and randomly selected and surveyed general population and occupational groups from 6 July to 24 August 2020, in 3 cities in Mozambique. Anti­SARS-CoV-2­specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were measured using a point-of-care rapid test. The prevalence was weighted for population (by age, sex, and city) and adjusted for test sensitivity and specificity. Results A total of 21 183 participants, including 11 143 from the general population and 10 040 from occupational groups, were included across all 3 cities. General population seropositivity (IgM or IgG) prevalence was 3.0% (95% confidence interval [CI], 1.0%­6.6%) in Pemba, 2.1% (95% CI, 1.2%­3.3%) in Maputo City, and 0.9% (95% CI, .1%­1.9%) in Quelimane. The prevalence in occupational groups ranged from 2.8% (95% CI, 1.3%­5.2%) to 5.9% (95% CI, 4.3%­8.0%) in Pemba, 0.3% (95% CI, .0%­2.2%) to 4.0% (95% CI, 2.6%­5.7%) in Maputo City, and 0.0% (95% CI, .0%­.7%) to 6.6% (95% CI, 3.8%­10.5%) in Quelimane, and showed variations between the groups tested. Conclusions In the first representative COVID-19 serosurveys in Mozambique, in mid-2020, weighted and assay-adjusted seroprevalence in 3 provincial capitals of anti­SARS-CoV-2 ranged from 0.9% to 3.0%, whereas adjusted prevalence in occupational groups ranged from 0.0% to 6.6% with variation between groups. Exposure to SARS-CoV-2 was extensive during the first pandemic wave, and transmission may have been more intense among occupational groups. These data have been of utmost importance to inform public health intervention to control and respond to the pandemic in Mozambique.

Prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies in the Mozambican Population: A Cross-Sectional Serologic Study in 3 Cities, July-August 2020

The extent of population exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was uncertain in many African countries during the onset of the pandemic. Methods: We conducted a cross-sectional study and randomly selected and surveyed general population and occupational groups from 6 July to 24 August 2020, in 3 cities in Mozambique. Anti-SARS-CoV-2-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies were measured using a point-of-care rapid test. The prevalence was weighted for population (by age, sex, and city) and adjusted for test sensitivity and specificity. Results: A total of 21 183 participants, including 11 143 from the general population and 10 040 from occupational groups, were included across all 3 cities. General population seropositivity (IgM or IgG) prevalence was 3.0% (95% confidence interval [CI], 1.0%-6.6%) in Pemba, 2.1% (95% CI, 1.2%-3.3%) in Maputo City, and 0.9% (95% CI, .1%-1.9%) in Quelimane. The prevalence in occupational groups ranged from 2.8% (95% CI, 1.3%-5.2%) to 5.9% (95% CI, 4.3%-8.0%) in Pemba, 0.3% (95% CI, .0%-2.2%) to 4.0% (95% CI, 2.6%-5.7%) in Maputo City, and 0.0% (95% CI, .0%-.7%) to 6.6% (95% CI, 3.8%-10.5%) in Quelimane, and showed variations between the groups tested. Conclusions: In the first representative COVID-19 serosurveys in Mozambique, in mid-2020, weighted and assay-adjusted seroprevalence in 3 provincial capitals of anti-SARS-CoV-2 ranged from 0.9% to 3.0%, whereas adjusted prevalence in occupational groups ranged from 0.0% to 6.6% with variation between groups. Exposure to SARS-CoV-2 was extensive during the first pandemic wave, and transmission may have been more intense among occupational groups. These data have been of utmost importance to inform public health intervention to control and respond to the pandemic in Mozambique.

Natural disasters, population displacement and health emergencies: multiple public health threats in Mozambique

No início de 2019, após a grave seca de 2015-2016, as províncias de Sofala e Cabo Delgado, em Moçambique, foram atingidas pelos ciclones Idai e Kenneth, respectivamente. Estes foram os ciclones mais mortíferos e destrutivos da história do país. Actualmente, estas duas províncias acolhem dezenas de milhares de famílias vulneráveis ​​devido às catástrofes climáticas e ao afluxo maciço de pessoas deslocadas associadas aos violentos ataques terroristas que assolam Cabo Delgado. O surgimento da pandemia da COVID-19 acrescentou um novo desafio a este cenário já crítico, servindo como um verdadeiro teste à preparação da saúde pública de Moçambique. A nível planetário, Moçambique pode ser visto como um "canário na mina de carvão", anunciando ao mundo os efeitos sinérgicos da co-ocorrência de desastres antropogénicos e naturais. Aqui, discutimos como a pandemia da COVID-19 acentuou a necessidade de uma resposta de saúde pública eficaz e abrangente num país já profundamente afectado por problemas de saúde associados a catástrofes naturais e deslocamentos populacionais.

Risk factors associated with Leishmania exposure among dogs in a rural area of Ilha Solteira, SP, Brazil

Abstract INTRODUCTION: We sought to determine risk factors (RFs) associated with the presence of antibodies against Leishmania in dogs from a rural area of Ilha Solteira, SP, Brazil. METHODS: Serum samples were collected from 250 dogs and tested using indirect enzyme-linked immunosorbent assay (ELISA) and indirect immunofluorescence antibody tests (IFATs). Data concerning dogs, their environment, and their owners' knowledge of leishmaniasis were collected using a questionnaire. To determine RFs for contact with the parasite, univariate statistical analysis based on chi-squared and Fisher's exact tests, followed by logistic regression, was used. RESULTS: It was found that 79/250 (31.6%) of the dogs were positive by IFAT, and 72/250 (28.8%) by ELISA. A total of 82/250 dogs (32.8%) were positive in at least one test. The RFs associated with occurrences of Leishmania exposure were large body size (OR = 2.25; 95% CI = 1.26-4.04; p = 0.003), presence of chickens (OR = 1.94; 95% CI = 1.05-3.65; p = 0.023), and lack of knowledge about Leishmania among dog owners (OR = 1.74; 95% CI = 0.96-3.21; p = 0.049). After multivariate analysis, the RFs for occurrence of Leishmania exposure in dogs that remained significantly associated were the dog's size (large dogs) (OR = 1.2; 95% CI = 1.06-1.35; p = 0.003) and presence of chickens on the properties (small farms) (OR = 1.15; 95% CI = 1.02-1.30; p = 0.023). CONCLUSIONS: These results may be useful for improving preventive practices to reduce the incidence of Leishmania exposure among dogs in rural areas.

Prevalence of bovine tuberculosis and risk factor assessment in cattle in rural livestock areas of Govuro District in the Southeast of Mozambique.

BACKGROUND: Bovine tuberculosis (bTB), caused by Mycobacterium bovis, is an infectious disease of cattle that also affects other domestic animals, free-ranging and farmed wildlife, and also humans. In Mozambique, scattered surveys have reported a wide variation of bTB prevalence rates in cattle from different regions. Due to direct economic repercussions on livestock and indirect consequences for human health and wildlife, knowing the prevalence rates of the disease is essential to define an effective control strategy. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional study was conducted in Govuro district to determine bTB prevalence in cattle and identify associated risk factors. A representative sample of the cattle population was defined, stratified by livestock areas (n = 14). A total of 1136 cattle from 289 farmers were tested using the single comparative intradermal tuberculin test. The overall apparent prevalence was estimated at 39.6% (95% CI 36.8-42.5) using a diagnostic threshold cut-off according to the World Organization for Animal Health. bTB reactors were found in 13 livestock areas, with prevalence rates ranging from 8.1 to 65.8%. Age was the main risk factor; animals older than 4 years were more likely to be positive reactors (OR = 3.2, 95% CI: 2.2-4.7). Landim local breed showed a lower prevalence than crossbred animals (Landim × Brahman) (OR = 0.6, 95% CI: 0.4-0.8). CONCLUSIONS/SIGNIFICANCE: The findings reveal an urgent need for intervention with effective, area-based, control measures in order to reduce bTB prevalence and prevent its spread to the human population. In addition to the high prevalence, population habits in Govuro, particularly the consumption of raw milk, clearly may potentiate the transmission to humans. Thus, further studies on human tuberculosis and the molecular characterization of the predominant strain lineages that cause bTB in cattle and humans are urgently required to evaluate the impact on human health in the region.

Prevalence of bovine tuberculosis and risk factor assessment in cattle in rural livestock areas of Govuro District in the Southeast of Mozambique

Bovine tuberculosis (bTB), caused by Mycobacterium bovis, is an infectious disease of cattle that also affects other domestic animals, free-ranging and farmed wildlife, and also humans. In Mozambique, scattered surveys have reported a wide variation of bTB prevalence rates in cattle from different regions. Due to direct economic repercussions on livestock and indirect consequences for human health and wildlife, knowing the prevalence rates of the disease is essential to define an effective control strategy. Methodology/principal findings: A cross-sectional study was conducted in Govuro district to determine bTB prevalence in cattle and identify associated risk factors. A representative sample of the cattle population was defined, stratified by livestock areas (n = 14). A total of 1136 cattle from 289 farmers were tested using the single comparative intradermal tuberculin test. The overall apparent prevalence was estimated at 39.6% (95% CI 36.8-42.5) using a diagnostic threshold cut-off according to the World Organization for Animal Health. bTB reactors were found in 13 livestock areas, with prevalence rates ranging from 8.1 to 65.8%. Age was the main risk factor; animals older than 4 years were more likely to be positive reactors (OR = 3.2, 95% CI: 2.2-4.7). Landim local breed showed a lower prevalence than crossbred animals (Landim × Brahman) (OR = 0.6, 95% CI: 0.4-0.8). Conclusions/significance: The findings reveal an urgent need for intervention with effective, area-based, control measures in order to reduce bTB prevalence and prevent its spread to the human population. In addition to the high prevalence, population habits in Govuro, particularly the consumption of raw milk, clearly may potentiate the transmission to humans. Thus, further studies on human tuberculosis and the molecular characterization of the predominant strain lineages that cause bTB in cattle and humans are urgently required to evaluate the impact on human health in the region

Mapeamento e distribuição dos isolados do complexo mycobacterium tuberculosis provenientes de casos de tuberculose bovino em Moçambique / Mapping and distribution of mycobacterium tuberculosis complex isolates from bovine tuberculosis cases in Mozambique

A tuberculose bovina (bTB) é um problema sanitário importante em Moçambique e ainda a espera de uma ação organizada por parte dos Serviços Veterinários Oficiais. O presente estudo teve por objetivo investigar e mapear os genótipos de Mycobacterium bovis circulantes no país e paralelamente maximizar a utilização de abatedouros como fonte de informação epidemiológica da bTB. Durante o período de outubro de 2016 a abril de 2017 foram colhidas um total de 90 amostras de lesões sugestivas de tuberculose bovina nos abatedouros Municipais de Maputo e Maxixe e dois abatedouros privados da província de Maputo. Essas amostras, juntamente com outras 10, disponibilizadas pelo Laboratório Central de Veterinária e 72 do banco de amostras de Faculdade de Veterinária de Moçambique foram processadas para isolamento, identificação e discriminação molecular (MIRU-VNTR e spoligotyping) de micobactérias. Nos abatedouros foram coletados dados para calcular as prevalências de carcaças com lesões sugestivas de tuberculose e foi estimada em 0,63% e 80% das carcaças condenadas por tuberculose apresentaram lesões compatíveis com generalização da infecção. Foram obtidos 104 isolados identificados como gênero Mycobacterium, dos quais 80 foram compatíveis com o MTBC e 10 MNT. Destes 80 MTBC, 70 foram identificados como M. bovis. O MIRU-VNTR discriminou os 70 isolados de M. bovis em 47 perfis, agrupados em 3 complexos clonais e cinco singletons. Dos 24 loci estudados, os que apresentaram maiores polimorfismos foram MIRU 960, 2996 e QUB-4052. Em relação ao spoligotyping, foram identificados cinco perfis, dos quais o mais prevalente foi o SB0961, seguido do SB0140, SB2306, SB2481 (novo) e SB1099. Dos 70 isolados submetidos a análises dos complexos clonais africano 1, africano 2, europeu 1 e europeu 2, foram detectados apenas 18,5% de europeu. O distrito de Machanga foi o que apresentou maior diversidade de isolados e o Govuro maior número de isolados de M. bovis. Quando comparados as técnicas, o MIRU-VNTR apresentou maior poder de discriminação em relação ao spoligotyping. O complexo clonal europeu 1 está relacionado com o SB0140 que por sua vez é característico de isolados do Reino Unido e de países que tiveram trocas comerciais de bovinos com o país, incluindo os circunvizinhos a Moçambique e de onde há registros da importação de animais para Moçambique. A não identificação precisa dos complexos clonais dos spoligotyping SB0961, SB2306, SB2481 relacionados, podem ser derivados do BCG, que é sugestivo de evolução clonal própria de Moçambique e os complexos clonais até hoje existentes não são suficientes para discriminar os isolados de Moçambique. Embora os dados de abatedouros sugeriram que a prevalência da tuberculose bovina em Moçambique está entre as mais baixas dos países africanos, a predominância de carcaças com lesões generalizadas significa alto risco de exposição de animais e humanos, sobretudo das populações rurais que têm estreito contato com esses animais. Esse risco é ampliado em função da alta prevalência de humanos que vivem com HIV/AIDS no país. Assim, recomenda-se que Moçambique estruture programa de controle da doença nos animais e métodos de diagnóstico que detectem a infecção por M. bovis na população humana

Bovine tuberculosis (bTB) is a major sanitary problem in Mozambique and awaits organized action by the Official Veterinary Services. The aim of this work was to investigate and map the circulating Mycobacterium bovis genotypes in the country and to maximize the use of slaughterhouses as a source of epidemiological information for bTB. During the period from October 2016 to April 2017, a total of 90 samples with lesions suggestive of bovine tuberculosis were collected from Maputo and Maxixe Municipal abattoirs and two private abattoirs from the province of Maputo. These samples, together with 10 others provided by the Central Veterinary Laboratory and 72 from the Veterinary Faculty sample bank were processed for isolation, identification and molecular discrimination (MIRU-VNTR and spoligotyping) of mycobacteria. Samples collected in the slaughterhouses were analyzed by calculating the prevalence of carcasses with lesions suggestive of bTB, which was estimated at 0.63% and 80% of carcasses condemned for tuberculosis presented lesions compatible with generalized infection. A total of 104 isolates were identified as M. bovis as Mycobacterium genus were obtained, of which 80 were compatible with MTBC and 10 MNT. Of these 80 MTBC, 70 were identified as M. bovis. The MIRU-VNTR discriminated the 70 isolates of M. bovis in 47 profiles, grouped in 3 clonal complexes and 5 singletons. Of the 24 loci studied, the ones with the highest polymorphisms were MIRU 960, 2996 and QUB-4052. In relation to spoligotyping, five profiles were identified; SB0961 was the most prevalent, being SB0961, followed by SB0140, SB2306, SB2481 (new) and SB1099. Of the 70 isolates submitted to analyzes of the clonal complexes African 1, African 2, European 1 and European 2, only 18.5% of European complex were detected. Machanga district presented the greatest diversity of isolates, while Govuro district had largest number of isolates of M. bovis. The MIRU-VNTR presented greater power of discrimination in relation to spoligotyping. The European clonal complex 1 was related to SB0140 which in turn is characteristic of isolates from the United Kingdom and from countries that have had commercial trade in cattle with UK including those surrounding Mozambique and where there are records of imports of animals for Mozambique. The precise identification of the clonal complexes of the SB0961, SB2306 and SB2481 related spoligotypings subject to the BCG derivatives, is suggestive of the clonal evolution of Mozambique and that the clonal complexes to date are not sufficient to discriminate against the isolates from Mozambique. Although data from slaughterhouses suggested that the prevalence of bovine tuberculosis in Mozambique is among the lowest in African countries, the predominance of carcasses with generalized lesions means a high risk of animal and human exposure, especially of rural populations that have close contact with these animals. This risk is amplified due to the high prevalence of people that living with HIV/AIDS in the country. Thus, it is recommended that Mozambique structure a disease control program in animals and diagnostic methods that detect M. bovis infection in the human population