Screening approaches for cervical cancer in Mozambique in HIV positive and negative women.

OBJECTIVE: Cervical cancer (CC) is a global health issue, in Mozambique, 5300 new cases and 3800 deaths are reported each year. The WHO recommends the introduction of HPV molecular testing for CC screening, but Mozambique uses an approach based on visual inspection with acetic acid (VIA). This study aims to evaluate the feasibility of high-risk HPV (hrHPV) testing compared to actual approaches in Mozambique. METHODS: An observational study was carried out in the DREAM center in Zimpeto, Mozambique. Women aged 30-55 were included. HPV testing was performed with the Cobas HPV test. They were then screened with the current national recommendations based on VIA. Cryotherapy was performed on-site or referred for colposcopy if necessary. RESULTS: In the period, 1207 women were enrolled, 47.8% HIV+; 124 (10.3%) VIA+, and HPV DNA test was positive in 325 (26.9%) women. HPV positivity rates were higher in HIV-infected women. In the sample, 52.8% of the 124 VIA+ women were HPV uninfected and underwent unnecessary cryotherapy or colposcopy. Meanwhile, 24.7% of the 1083 VIA- women were actually HPV infected. In comparison, a screen, triage and treat approach based on hrHPV testing would only test and treat the 325 HPV-infected women. CONCLUSION: The study found high rates of hrHPV infection, particularly in HIV-positive women, with many concurrent or multiple infections. The current screening method misses important hrHPV infections and results in many unnecessary treatments. These results support the use of HPV molecular testing as the initial screening test for CC.

Aflatoxin B1 Contamination in Chicken Livers and Gizzards from Industrial and Small Abattoirs, Measured by ELISA Technique in Maputo, Mozambique.

Aflatoxins are the most toxic and carcinogenic mycotoxins produced by Aspergillus species. Aflatoxin B1 (AFB1) contamination in industrial and local chicken livers and gizzards in Maputo was investigated. One hundred boiler livers and 80 boiler gizzards were collected from industrial and local cutting poultry production sectors. The samples were analyzed by the ELISA method (MaxSignal®, Bioo Scientific Corporation). AFB1 was found in 39% of liver samples and 13.8% of gizzards, with mean levels of 1.73 µg/kg and 1.07 µg/kg, respectively. The frequency of contamination and AFB1 levels in samples from local sector producers was not significantly higher than those from industrial sector producers (p > 0.05). No correlation was found (p = 0.493; r² = 0.013) between AFB1 levels in livers and hepatic weights. The AFB1 levels were lower than the allowed limits, suggesting that these products do not pose high risk to consumers. Notwithstanding, there is a need to implement aflatoxin residue monitoring and controls in all chicken meat products; this economic and efficient technique appears to be valuable for improved food safety in Mozambique.