Perfil epidemiologico dos obitos por virus de imunodeficiencia humanas/sida em mocambique durante ano de 2019 / Epidemiological profile of human immunodeficiency virus/aids deaths in mozambique in 2019

Introdução: O HIV/SIDA é um problema de saúde pública no mundo. Em Moçambique a taxa de prevalência actualizada em 2021 foi 12,5%, e cerca de 27% e 11% das mortes em 2007 e 2019 que ocorreram em todas as idades estavam relacionados ao HIV. Foi objectivo deste trabalho analisar o perfil epidemiológico dos óbitos por HIV em Moçambique em 2019. Metodologia: Este é um estudo de coorte transversal, onde foram usados dados de secundarios de 2019 do Sistema de Vigilância de base Comunitária "COMSA". secundário recolhidos entre 01 de Janeiro a 31 de Dezembro de 2019. Foi considerado como critério de inclusão, todos os óbitos por HIV registados no COMSA. Usou-se método automatizado para determinação da causas de morte por HIV (Inter-VA 5). Para análise dos dados foi usado teste Q-quadrado e análise multivariada, considerou-se variável dependente o resultado de teste de HIV. o Todas as analises foram feitas em STATA, a um nivel de significancia de 5% Resultados Em 2019, foram registados 3364 óbitos, dos quais 18,7% (632/3364) foram óbitos por HIV classificados por Inter -VA 5, dos quais 52,9% (334/632) eram do sexo feminino. Cerca de 44,8% (283/632) dos indivíduos que morreram tinham feito o teste de HIV antes da sua morte, e receberam resultado positivo. Jovens de 15-24 anos tiveram uma percentagem de 2,9% (18/632) 25-29 Anos 8,2 % (52/632),18,7% (118/632) entre 30-39 anos, 15,1% (95/632) entre 40-49 anos e 36,4% (230/632) para 50+ anos. Escolaridade, 57,2% (361/632) sem nível de escolaridade, 30,7% (194/632) nível primário. Residência, 69,4% (438/632) eram da área rural. Dos determinantes para ocorrência de HIV, 67,9% (425/632) ocorreram em domicílios; 28,1% (177/632) tinham um índice de riqueza muito alto, 19,6% (124/632) alto. Na análise multivariada, percebeu-se que as pessoas que morreram nas faixas etárias de 25- 29 anos tinham 5,1 chances (RC=5,1; 95% [IC=2,478-10.8]) de serem positivos para HIV; 30- 39 anos (RC=6,5; 95% [IC=3,7-11,4]), 40-49 anos (RC= 4,7; 95% [IC=2,7-8,3]). As pessoas que faleceram na província de Tete (RC=0,2, 95% [IC=0,86-581]). Os que viviam na área rural (RC=.608, 95%[CI=423-.874]); os que estavam a uma distâncias de 2 horas para uma unidade sanitária tinham 0,46 chances (OR=0,46, 95% ([0,245-0,897]) de serem HIV positivo. Conclusão: Maior percentagem de óbitos por HIV no sexo feminino e sem escolaridade. Verificou-se maior percentagem de óbitos por HIV em crianças menores de 5 anos de idade. Faixa etária, distância, residência foram associada ao resultado positivo do HIV. Incentiva-se a realização de testes de HIV, palestras de prevenção do HIV nas áreas rurais.

Introduction: HIV/AIDS is a public health problem in the world. In Mozambique the updated prevalence rate in 2021 was 12.5%, and about 27% and 11% of deaths in 2007 and 2019 that occurred in all ages were HIV-related. It was the objective of this work to analyze the epidemiological profile of HIV deaths in Mozambique in 2019. Method: This is a cross-sectional cohort study, where secondary 2019 data from the Community Based Surveillance System "COMSA". secondary collected between January 1 to December 31, 2019 were used. It was considered as inclusion criteria, all HIV deaths recorded in COMSA. Automated method was used for determining the cause of HIV death (Inter-VA 5). Q-squared test and multivariate analysis were used for data analysis, and the dependent variable was the HIV test result. o All analyses were performed in STATA, at a 5% significance level. Results: In 2019, 3364 deaths were recorded, of which 18.7% (632/3364) were HIV deaths classified by Inter -VA 5 , of which 52.9% (334/632) were female. About 44.8% (283/632) of the individuals who died had been tested for HIV prior to their death, and received a positive result. Young people aged 15-24 years had a percentage of 2.9% (18/632) 25-29 Years 8.2% (52/632), 18.7% (118/632) between 30-39 years, 15.1% (95/632) between 40-49 years and 36.4% (230/632) for 50+ years. Education, 57.2% (361/632) no education level, 30.7% (194/632) primary level. Residence, 69.4% (438/632) were from rural area. Of the determinants for HIV occurrence, 67.9% (425/632) occurred in households; 28.1% (177/632) had a very high wealth index, 19.6% (124/632) high. In multivariate analysis, it was realized that people who died in the age groups 25-29 years had (CR=5.1; 95% [CI=2.478-10.8]) odds of being HIV positive; 30-39 years (CR=6.5; 95% [CI=3.7-11.4]), 40-49 years (CR=4.7; 95% [CI=2.7- 8.3]). Those who died in Tete province (CR=0.2, 95% [CI=0.86-581]). Those who lived in the rural area (RC=.608, 95%[CI=423-.874]). Those who were within 2 hours distance to a health facility (OR=0.46, 95% ([0.245-0.897]), Conclusion: Higher percentage of HIV deaths among females and those with no education. There was a higher percentage of HIV deaths in children under 5 years of age. Age group, distance, residence were associated with HIV positive result. HIV testing is encouraged, HIV prevention lectures in rural areas.

Evaluation of the health information system for monitoring and evaluating the voluntary medical male circumcision program in Mozambique, 2013-2019.

Introduction: the prevalence of human immunodeficiency virus (HIV) in Mozambique has increased from 11.5% in 2009 to 13.2% in 2015. The Mozambique Ministry of Health (MOH) developed a 5-year strategy (2013-2017) for male voluntary medical circumcision (VMMC) to increase in the provinces where there is the greatest number of HIV. We aimed to evaluate the health information system for monitoring and evaluating VMMC in Mozambique from 2013-2019. Methods: we reviewed the records of the National Health Information System for Monitoring and Evaluation (SIS-MA) database for VMMC of the MOH. The evaluation was based on the updated guidelines for the evaluation of public health surveillance systems of the Centers for Disease Control and Prevention. Results: the coverage rate for VMMC in Mozambique in the period under study was (89%) (1,784,335/2,000,000). The system was expected to circumcise for the year 2019 (162,052) and 390,590 was reached, exceeding the target 241.0% (390,590/162,052). Of the total number of men circumcised, 0.7% (12,391/1,784,335) were HIV-positive (previously tested) and 0.4% (6,382/1,784,335) had a record of adverse events in the period under review (2013-2019). Zambézia Province had the highest VMMC coverage (in numbers) at 16.0% (396,876/2,476,395) while Maputo City had the least 19.7% (107,104/543,096). The system was able to operate both online and offline and continue functioning with introducing new changes (e.g. the new male circumcision complication reporting). Conclusion: the system was representative, flexible, simple, with good data quality and low acceptability. We recommended continuous and routine entry of quality data into the system, guide organizations for improved functioning.

Profile of people seeking health services during Pope Francis' visit to Mozambique, 2019.

Pope Francis visited Mozambique from September 4-6, 2019. During the visit, a real-time surveillance system for mass gathering events was implemented in all places where people gathered in Maputo City for early detection of possible outbreaks and other health-related events. The system was implemented at four sites were mass gathering events occurred over the three-day visit. Data were collected by administering a simple questionnaire on a tablet, which collected information about sociodemographics, syndromic diagnoses, and outcomes of the patients that sought medical care. Additionally, a descriptive epidemiological assessment was performed during the event. A total of 150 individuals were attended at the designated places during the event. Of these, 56.7% were female and 90.7% aged > 15 years. The majority of the patients (74.7%) sought care on the third day of the event, which was held at the Zimpeto National Stadium. The most common diagnoses were hypertension (20.7%), hypothermia (15.3%), and headache (11.3%). Almost all cases (95.0%) were discharged, (4.0%) cases were transferred and (1.0%) case resulted in death on the way to the health facility. The surveillance system strategy developed to detect real-time public health events during the Pope?s visit was successfully implemented. No outbreak was identified during the event.

Profile of people seeking health services during Pope Francis' visit to Mozambique, 2019

Pope Francis visited Mozambique from September 4-6, 2019. During the visit, a real-time surveillance system for mass gathering events was implemented in all places where people gathered in Maputo City for early detection of possible outbreaks and other health-related events. The system was implemented at four sites were mass gathering events occurred over the three-day visit. Data were collected by administering a simple questionnaire on a tablet, which collected information about sociodemographics, syndromic diagnoses, and outcomes of the patients that sought medical care. Additionally, a descriptive epidemiological assessment was performed during the event. A total of 150 individuals were attended at the designated places during the event. Of these, 56.7% were female and 90.7% aged > 15 years. The majority of the patients (74.7%) sought care on the third day of the event, which was held at the Zimpeto National Stadium. The most common diagnoses were hypertension (20.7%), hypothermia (15.3%), and headache (11.3%). Almost all cases (95.0%) were discharged, (4.0%) cases were transferred and (1.0%) case resulted in death on the way to the health facility. The surveillance system strategy developed to detect real-time public health events during the Popes visit was successfully implemented. No outbreak was identified during the event.