Investigation and contact tracing of the first cases of COVID-19 in Mozambique, 2020

Contact tracing is an important strategy to interrupt the spread of infectious disease and prevent new cases. After the confirmation of the first positive case of COVID-19 in Mozambique on March 22, 2020, case investigation and contact tracing were immediately initiated, which included clinical and laboratory monitoring of cases and contacts throughout the quarantine period. We aim to describe the methodology and impact of early investigation and contact tracing. in the context of implementation of the national COVID-19 preparedness and response plan, guidelines and forms for contact tracing were adapted from the existing World Health Organization (WHO) and The Centers for Disease Control and Prevention (CDC) guidelines. The case definition used was "patient with travel or residency history in a country reporting local transmission of COVID-19 during the 14 days prior to the onset of symptoms". The cases interviews were face to face and contacts were followed up daily by phone calls for 14 consecutive days: using a structured questionnaire. Data were entered in an electronic Excel database. We collected samples for diagnosis of those who developed symptoms and provided quarantine follow up. a total of 8 cases were confirmed, of which 6 (75%) were male. The average age of the cases was 51, median 44 (range: 31 to 80) years old. The majority of cases presented common symptoms of COVID-19, including headaches (50%), cough (37.5%), and fever (25%). Our case series included the country´s index case, two close positive contacts, and 5 additional cases that were not epidemiologically linked to the others and identified by the COVID-19 national surveillance system. All of them were identified in Maputo City from March 22 to March 28. Cases had a total of 123 contacts and all of them were tracked; 79 were contacts of the first case. From all the contacts in follow up, two had laboratory confirmed COVID-19. All cases and contacts were quarantined and none of them developed severe symptoms or required hospitalization. timely case identification and systematic contact tracing can be effective in breaking the chain of COVID-19 transmission when there is strong collaboration between epidemiological, laboratory surveillance and case management.

Fórum de pós-graduação: experiência e lições aprendidas / Post-graduate forum: fxperiences and lessons learned

O presente artigo apresenta os objectivos, a metodologia, e uma visão geral da experiência e das lições aprendidas nos dois fóruns de pós-graduação realizados no Instituto Nacional de Saúde (INS) em Março de 2016 e (mês) de 2017.. A iniciativa de implementar fóruns de pós-graduação surge por um lado, como uma ferramenta para melhoria de qualidade das formações e por outro, como oportunidade de intercâmbio entre os estudantes que frequentam os cursos de pós-graduação coordenados pelo INS e os técnicos do INS que se encontram em programas de pós-graduação. Espera-se que os fóruns de pós-graduação no INS estimulem o desenvolvimento de actividades académicas e contribuam para o enriquecimento dos programas institucionais de pós-graduação.

is report describes the objective, methodology, the experience and Lessons learned in the -rst and second post-graduation forums, performed at the National Institute of Health of Mozambique (Instituto Nacional de Saúde, INS); in March 2016 and 2017, respectively. e introduction of post-graduation forums, arises, on the one hand, as a tool for improving quality of training, on the other, as an opportunity to promote discussions in a collaborative way between students attending the post-graduate courses coordinated by INS and INS technicians in post-graduate programs in other national and international institutions. e post-graduate forums at INS will also stimulate the development of academic activities and contribute to the improvement INS post-graduation programs.

Seroepidemiologic Screening for Zoonotic Viral Infections, Maputo, Mozambique

In sub-Saharan Africa, febrile patients are often assumed to have, and are treated for, malaria, but when tested, many are malaria-negative. Because emerging diseases, such as chikungunya virus (CHIKV) and dengue virus (DENV) infections, cause outbreaks around the world (1­3), the importance of these pathogens has become more evident. However, low-income countries have limited epidemiologic data on alternative diagnoses to malaria (4,5) and poor laboratory capacity (1), which restrict further diagnostic investigations. An early study in Mozambique during the 1980s found antibodies to Rift Valley fever virus (RVFV) in 2% of pregnant women (6). More recently, a RVFV seroprevalence of 36.9% among cattle in the Maputo Province was shown in 2010­2011 (7). Furthermore, the movement of humans from rural areas to major cities, particularly to the capital of Maputo, might affect human illnesses and disease pattern of zoonotic viruses (3). We conducted a pilot study on CHIKV, DENV, hantavirus, RVFV, and West Nile virus (WNV) epidemiology in Mozambique. Ethical approval (registration no. IRB00002657) was granted by the National Bioethics Committee in Mozambique and by the Regional Ethical Review Board at Karolinska Institutet, Stockholm, Sweden (permit no. 2012/974­31/3)...

O potencial de um serviço de referência sentinela para doenças febris agudas na Cooperação Internacional ­ Moçambique, o que considerar para além da malária por p. Falciparum / The potential of a sentinel referral service for acute febrile illness in international cooperation - Mozambique, what to consider beyond malaria p. Falciparum

As síndromes febris agudas são motivo frequente de procura por assistência médica. A inespecificidade da apresentação clínica inicial dos diversos agentes etiológicos e a possibilidade de coinfecções seguem como um desafio. Em Moçambique, o facto da malária por P.falciparum ser endémica dificulta a identificação de outros agentes etiológicos. O objetivo deste trabalho é descrever uma série de casos provenientes de Moçambique atendidos em um serviço de referência sentinela para doenças febris agudas.

Acute febrile syndromes are a frequent reason for seeking medical attention. The nonspecificity of the initial clinical presentation of the various etiological agents and the possibility of co-infections remain a challenge. In Mozambique, the fact that P.falciparum malaria is endemic makes it difficult to identify other etiological agents. The aim of this paper is to describe a series of cases from Mozambique treated at a sentinel referral service for acute febrile diseases.

First serological evidence of hantavirus among febrile patients in Mozambique Ramalho

Objective: The occurrence of hantavirus in Sub-Saharan Africa is poorly studied and its clinical implications are unknown. This study aimed to determine the occurrence of hantavirus infection among febrile patients attending an outpatient clinic at a primary health care center located in a suburban area of the city of Maputo in Mozambique. Methods: Paired acute and convalescent samples from a total of 200 febrile patients aged >5 years who were recruited between February 2012 and October 2014 were screened for IgM and IgG antibodies against hantavirus using an ELISA. Acute samples were also screened for malaria and to determine hematological and clinical chemistry parameters. Results: Of the 200 patients enrolled, four had IgM antibodies in their acute sample and IgG antibodies in their convalescent sample, yielding a prevalence rate of 2%. Contact with rodents was higher among IgM-positive participants than IgM-negative participants (50.0% (2/4) vs. 15.3% (30/196)). IgM-positive patients presented significantly higher levels of creatinine and alanine aminotransferase and lower platelet counts than IgM-negative patients. Conclusions: The findings of this study demonstrate human exposure to hantavirus in Mozambique for the first time; however, further studies should be conducted to investigate its clinical implications. © 2017 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-