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1.
J Sci Food Agric ; 100(1): 212-217, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31487046

RESUMO

BACKGROUND: The growing need to classify the origin of honey in a simple way is leading to the development of affordable analytical equipment that is in-line and manageable, enabling rapid on-site screening. The aim of this work was therefore to evaluate whether an electronic tongue (made of four metallic electrodes: Ir, Rh, Pt, Au), based on potential multistep pulse voltammetry with electrochemical polishing, is able to differentiate between honey samples from Spain, Honduras, and Mozambique. RESULTS: It was demonstrated, for the first time, that automatic pulse voltammetry, in combination with principal component analysis (PCA) statistical analysis, was able to differentiate honey samples from these three countries. A partial least squares (PLS) analysis predicted the level of certain physicochemical parameters, the best results being for conductivity and moisture with correlation coefficients of 0.948 and 0.879, whereas the weakest correlation was for the sugars. CONCLUSION: The tool proposed in this study could be applied to identify the country origin of the three types of multifloral honey considered here. It also offers promising perspectives for expanding knowledge of the provenance of honey. All of this could be achieved when a comprehensive database with the information generated by this electronic tongue has been created. © 2019 Society of Chemical Industry.


Assuntos
Nariz Eletrônico , Mel/análise , Análise Discriminante , Condutividade Elétrica , Contaminação de Alimentos , Honduras , Mel/classificação , Análise dos Mínimos Quadrados , Moçambique , Análise de Componente Principal , Espanha
2.
BMC Infect Dis ; 19(1): 1022, 2019 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-31791273

RESUMO

BACKGROUND: Few countries in sub-Saharan Africa know the magnitude of their HIV epidemic among people who inject drugs (PWID). This was the first study in Mozambique to measure prevalence of HIV, HBV, and HCV, and to assess demographic characteristics and risk behaviors in this key population. METHODS: We used respondent-driven sampling (RDS) to conduct a cross-sectional behavioral surveillance survey of PWID in two cities of Mozambique lasting six months. Participants were persons who had ever injected drugs without a prescription. Participants completed a behavioral questionnaire and provided blood specimens for HIV, hepatitis B surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) testing. We performed RDS-adjusted analysis in R 3.2 using RDSAT 7.1 weights. RESULTS: We enrolled 353 PWID in Maputo and 139 in Nampula/Nacala; approximately 95% of participants were men. Disease prevalence in Maputo and Nampula/Nacala, respectively, was 50.1 and 19.9% for HIV, 32.1 and 36.4% for HBsAg positivity, and 44.6 and 7.0% for anti-HCV positivity. Additionally, 8% (Maputo) and 28.6% (Nampula/Nacala) of PWID reported having a genital sore or ulcer in the 12 months preceding the survey. Among PWID who injected drugs in the last month, 50.3% (Maputo) and 49.6% (Nampula/Nacala) shared a needle at least once that month. Condomless sex in the last 12 months was reported by 52.4% of PWID in Maputo and 29.1% in Nampula/Nacala. Among PWID, 31.6% (Maputo) and 41.0% (Nampula/Nacala) had never tested for HIV. In multivariable analysis, PWID who used heroin had 4.3 (Maputo; 95% confidence interval [CI]: 1.2, 18.2) and 2.3 (Nampula/Nacala; 95% CI: 1.2, 4.9) greater odds of having HIV. CONCLUSION: Unsafe sexual behaviors and injection practices are frequent among PWID in Mozambique, and likely contribute to the disproportionate burden of disease we found. Intensified efforts in prevention, care, and treatment specific for PWID have the potential to limit disease transmission.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Abuso de Substâncias por Via Intravenosa/epidemiologia , Adolescente , Adulto , Idoso , Cidades/epidemiologia , Estudos Transversais , Epidemias , Feminino , Infecções por HIV/sangue , Soropositividade para HIV/epidemiologia , Hepatite B/sangue , Antígenos de Superfície da Hepatite B/análise , Antígenos de Superfície da Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Hepatite C/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique/epidemiologia , Vigilância da População/métodos , Prevalência , Assunção de Riscos , Estudos Soroepidemiológicos , Comportamento Sexual/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto Jovem
3.
Global Health ; 15(1): 67, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31847863

RESUMO

BACKGROUND: Countries must be able to describe and monitor their populations health and well-being needs in an attempt to understand and address them. The Sustainable Development Goals (SDGs) have re-emphasized the need to invest in comprehensive health information systems to monitor progress towards health equity; however, knowledge on the capacity of health information systems to be able do this, particularly in low-income countries, remains very limited. As a case study, we aimed to evaluate the current capacity of the national health information systems in Mozambique, and the available indicators to monitor health inequalities, in line with SDG 3 (Good Health and Well Being for All at All Ages). METHODS: A data source mapping of the health information system in Mozambique was conducted. We followed the World Health Organization's methodology of assessing data sources to evaluate the information available for every equity stratifier using a three-point scale: 1 - information is available, 2 - need for more information, and 3 - an information gap. Also, for each indicator we estimated the national average inequality score. RESULTS: Eight data sources contain health information to measure and monitor progress towards health equity in line with the 27 SDG3 indicators. Seven indicators bear information with nationally funded data sources, ten with data sources externally funded, and ten indicators either lack information or it does not applicable for the matter of the study. None of the 27 indicators associated with SDG3 can be fully disaggregated by equity stratifiers; they either lack some information (15 indicators) or do not have information at all (nine indicators). The indicators that contain more information are related to maternal and child health. CONCLUSIONS: There are important information gaps in Mozambique's current national health information system which prevents it from being able to comprehensively measure and monitor health equity. Comprehensive national health information systems are an essential public health need. Significant policy and political challenges must also be addressed to ensure effective interventions and action towards health equity in the country.


Assuntos
Equidade em Saúde/organização & administração , Sistemas de Informação em Saúde , Indicadores Básicos de Saúde , Saúde Pública , Disparidades nos Níveis de Saúde , Humanos , Moçambique , Desenvolvimento Sustentável , Organização Mundial da Saúde
4.
Global Health ; 15(Suppl 1): 0, 2019 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-31775785

RESUMO

In many African countries, hundreds of health-related NGOs are fed by a chaotic tangle of donor funding streams. The case of Mozambique illustrates how this NGO model impedes Universal Health Coverage. In the 1990s, NGOs multiplied across post-war Mozambique: the country's structural adjustment program constrained public and foreign aid expenditures on the public health system, while donors favored private contractors and NGOs. In the 2000s, funding for HIV/AIDS and other vertical aid from many donors increased dramatically. In 2004, the United States introduced PEPFAR in Mozambique at nearly 500 million USD per year, roughly equivalent to the entire budget of the Ministry of Health. To be sure, PEPFAR funding has helped thousands access antiretroviral treatment, but over 90% of resources flow "off-budget" to NGO "implementing partners," with little left for the public health system. After a decade of this major donor funding to NGOs, public sector health system coverage had barely changed. In 2014, the workforce/ population ratio was still among the five worst in the world at 71/10000; the health facility/per capita ratio worsened since 2009 to only 1 per 16,795. Achieving UHC will require rejection of austerity constraints on public sector health systems, and rechanneling of aid to public systems building rather than to NGOs.


Assuntos
Cooperação Internacional , Organizações/economia , Cobertura Universal do Seguro de Saúde/organização & administração , Infecções por HIV/tratamento farmacológico , Infecções por HIV/economia , Humanos , Moçambique , Setor Público/organização & administração , Estados Unidos
5.
Pan Afr Med J ; 33: 208, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692729

RESUMO

The Mozambican Field Epidemiology and Laboratory Training Program (Moz-FELTP) is a two-year, competency-based post-graduate training and service program designed to build sustainable public health capacity in applied epidemiology. Despite the efforts, Moz-FELTP residents have historically difficulty to publishing their work for a variety of reasons that includes language barriers, lack of writing skills and motivation, limited budgetary support and lack of effective mentorship. This outline the need for different approaches to continuous improving the publication, such scientific writing mentorship for non-English FELTP residents.


Assuntos
Epidemiologia/educação , Linguagem , Editoração/estatística & dados numéricos , Pesquisa/educação , Educação Baseada em Competências , Humanos , Laboratórios , Mentores , Moçambique , Publicações Periódicas como Assunto/estatística & dados numéricos , Saúde Pública
6.
Zootaxa ; 4638(2): zootaxa.4638.2.9, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31712481

RESUMO

The genus Cestradoretus Ohaus, 1912 was erected by Ohaus (1912) to accommodate a Madagascan Adoretini species, C. tenuirostris Ohaus, 1912. This genus is characterized by the adults having the apex of the labrum with a long, fine, acute process curved downwards. In the addition to the above mentioned paper, Ohaus (1912) also described C. acomys Ohaus, 1912 from Tanzania, and later moved Adoretus tarsatus Klug, 1855, described from Mozambique, to Cestradoretus (Ohaus 1916).  Later, Machatschke (1965) described two species from Africa, C. freyi Machatschke, 1965 from Botswana and C. minusculus Machatschke, 1965 from Somalia, and Frey (1976) described C. clypealis Frey, 1976 from Somalia. Thus, Cestradoretus included six species, one from Madagascar and five from Africa.


Assuntos
Besouros , Animais , Botsuana , Madagáscar , Moçambique , Somália , Tanzânia
7.
Zootaxa ; 4571(2): zootaxa.4571.2.3, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-31715816

RESUMO

Present paper contains the first comprehensive summary of the Nolini species of the Maputo Special Reserve collected between November 2016 and February 2018. The Nolini fauna counts 21 species in total, 17 species are proved to be new for the fauna of Mozambique, two species are new to science and described here as Mecothrix maputuana sp. n. and Meganola shangaana sp. n. The subgenus Mecothrix Hacker, 2012 is upgraded to genus rank. Mecothrix cana Hacker, 2012 and Nola submelanoscelis Hacker, 2012 are downgraded to subspecies rank (Mecothrix aegyptiaca cana Hacker, 2012 stat. n., Nola biangulata submelanoscelis Hacker, 2012 stat. n.). Meganola meridianissima Hacker, 2012 syn. n. and Meganola kakamega Hacker, 2012 syn. n. are synonymized with Meganola bispermutata Hacker, 2012, in addition Nolidia nanoxantha Hacker, 2012 syn. n. and Nolidia polionana Hacker, 2012 syn. n. are synonymised with Nolidia elachistomorpha Hacker, 2012. Nolidia elachistomorpha is transferred to the genus Hampsonola László, Ronkay Ronkay, 2015 (Hampsonola elachistomorpha (Hacker, 2012) comb. n.). With 43 colour and 40 black and white figures.


Assuntos
Mariposas , Distribuição Animal , Animais , Cor , Quênia , Moçambique
8.
Zootaxa ; 4682(1): zootaxa.4682.1.1, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31715941

RESUMO

A list of 60 species of the Tettigoniidae (Orthoptera) recorded from Gorongosa National Park and provinces Sofala and Manica in central Mozambique is provided and their natural history is discussed. Of these, 58 species are illustrated and bioacoustic data are presented for 47 species. Two new genera and 9 new species are described: Gorongosa carri gen. et sp. n., Ovonotus abreuae gen. et sp. n., Afroagraecia muagurai sp. n., Enyaliopsis iaculator sp. n., Eurycorypha parkeri sp. n., Eurycorypha stalmansi sp. n., Eulioptera carolli sp. n., Eulioptera mutembai sp. n., and Parpyrrhicia guytonae sp. n. Four species of Ruspolia are recognized as potentially new and their bioacoustic data are presented. Pseudorhynchus pungens meridionalis Ragge, 1969 is synonymized with Pseudorhynchus pungens pungens (Schaum, 1853); Angustithorax spiniger Massa, 2015 is synonymized with Oxyecous magnus Ragge, 1956; and the synonymy of Lanista africana (Walker, 1870) with Lanista annulicornis (Walker, 1869) is reversed. Two species, G. carri and O. abreuae, appear to be endemic to Mt. Gorongosa and 24 species are recorded for the first time from Mozambique.


Assuntos
Formigas , Ortópteros , Distribuição Animal , Animais , Moçambique , Parques Recreativos
9.
Rev Soc Bras Med Trop ; 52: e20190257, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31778400

RESUMO

INTRODUCTION: Mozambique is one of three countries with high prevalence of tuberculosis (TB), TB/human immunodeficiency virus coinfection, and multidrug-resistant TB. We aimed to describe Mycobacterium tuberculosis spoligotypes circulating among drug resistant (DR) strains from Beira, Mozambique comparing them with genotypes in the country. METHODS: We performed spoligotyping of 79 M. tuberculosis suspected of DR-TB compared all spoligotype patterns published on the international database and PubMed. RESULTS: Both in Beira and Mozambique (n=578), the main clades were Latin-American-Mediterranean, East-African-Indian, Beijing and T, with no extensively DR TB cases. CONCLUSIONS: Beira and Mozambique share the same population genetic structure of M. tuberculosis.


Assuntos
Variação Genética/genética , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/microbiologia , Técnicas de Tipagem Bacteriana , Genótipo , Humanos , Moçambique , Mutação/genética , Filogenia
10.
Zootaxa ; 4623(3): zootaxa.4623.3.7, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31716251

RESUMO

Currently 10 species are listed in the genus Ophthalmothrips: amyae and conocephalus from South Africa, pomeroyi from Tanzania, lesnei from Mozambique, breviceps and faurei from India, formosanus from Taiwan, longiceps and miscanthicola from East Asia, and yunnanensis from China. Here, conocephalus is newly recorded from Madagascar, faurei from China and Japan, lesnei from Kenya, pomeroyi from Zaire (Democratic Republic of Congo), and the first records of males of lesnei and pomeroyi are provided. A key to males and females of the 10 species is provided.


Assuntos
Tisanópteros , Animais , China , República Democrática do Congo , Extremo Oriente , Feminino , Índia , Japão , Quênia , Madagáscar , Masculino , Moçambique , África do Sul , Taiwan , Tanzânia
11.
Zootaxa ; 4613(2): zootaxa.4613.2.1, 2019 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-31716410

RESUMO

For the first time large numbers of thecideide brachiopods have been collected from the Mozambique Channel, more particularly from the western part of the Comorian Island of Mayotte (France). The moderately diverse brachiopod fauna is from a submarine cave situated on the second barrier reef encircling this island, with three different genera being found: Thecidellina, Ospreyella and Minutella. The last genus is represented by M. cf. minuta (Cooper, 1981), which was first discovered around Madagascar. Ospreyella is represented by a new species (O. mayottensis sp. nov.) as is Thecidellina, which is represented by T. leipnitzae sp. nov. This species is markedly distinct from T. europa Logan et al., 2015 from Europa Island in the southern Mozambique Channel (1,200 km south of Mayotte), providing an example of allopatric speciation in an isolated cryptic habitat.


Assuntos
Invertebrados , Animais , Comores , França , Ilhas , Madagáscar , Moçambique
12.
Zootaxa ; 4668(3): zootaxa.4668.3.7, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31716621

RESUMO

The present paper contains descriptions of four new species of the genus Tumicla Wallengren, 1863: T. elephantina sp. nov. (South Mozambique), T. mbeghai sp. nov. (NE Tanzania), T. admiranda sp. nov. (SE Democratic Republic of the Congo) and T. smithi sp. nov. (Central Zambia). The male paratype specimen of T. doa Kühne 2007 is proved to be not conspecific with the holotype female but belongs to an undescribed species described here as T. mbeghai sp. nov. rendering Tumicla doa to be known by the female holotype only. Adults, male and female genitalia of the new and related species are illustrated.


Assuntos
Mariposas , Animais , República Democrática do Congo , Feminino , Masculino , Moçambique , Tanzânia , Zâmbia
13.
Zootaxa ; 4646(3): zootaxa.4646.3.6, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31717005

RESUMO

A new species of tree snake Dipsadoboa montisilva Branch, Conradie Tolley sp. nov. (Serpentes: Colubridae) is described from the 'sky islands' of Mount Mabu and Mount Ribáuè in northern Mozambique. Features of scalation, colour, body form and habitat distinguish the new species from other Dipsadoboa. This is supported by a phylogenetic analysis using one mitochondrial marker (cytochrome b) that shows the new Mozambican species is divergent from other sampled Dipsadoboa, including D. flavida and D. aulica, the only congeners known to occur in Mozambique. Morphologically, the new Dipsadoboa forms part of the D. werneri-shrevei complex from east and southeast Africa, but differs in having higher subcaudal counts, a different temporal pattern and only two supralabials entering the orbit. Phylogenetically, it occurs in a clade with D. shrevei and D. werneri. The status of D. shrevei in East Africa is reassessed, particularly in terms of the poorly-known Dipsadoboa shrevei kageleri from northern Tanzania. It is morphologically well defined from D. shrevei shrevei and utilises a different habitat. Although based on limited genetic data, it appears to be well-defined from typical D. shrevei and is accordingly raised to specific status. The only Tanzanian record for typical D. shrevei from Mtene, Rondo Plateau in southeast Tanzania is well isolated from the species' range to the west (e.g. Zambia, Angola) and the published scalation features, particularly ventral counts, do not fully accord with D. shrevei. The Rondo Plateau population is treated as Dipsadoboa incerta sedis, and because we return D. shrevei to its binomial status, we can no longer consider D. shrevei as occurring in Tanzania. Biogeographically, the Rondo Plateau population may have a stronger affinity to the new Mozambican species. The discovery of isolated populations of the new species in mid-altitude forest remnants on Mt Mabu and Mt Ribáuè emphasizes the high conservation importance of the Mozambique forest 'sky islands' from which numerous other endemic new species have been recently discovered. These species are impacted by ongoing habitat destruction through slash and burn clearing for subsistence agriculture.


Assuntos
Colubridae , Angola , Animais , Florestas , Ilhas , Moçambique , Filogenia , Tanzânia , Zâmbia
14.
BMC Public Health ; 19(1): 1406, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664976

RESUMO

BACKGROUND: Cost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique's school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program. METHODS: We collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods-identification and measurement of resource quantities and valuation by application of unit costs, and gross costing-for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program. RESULTS: The total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15-$23) in year two, and $24 (CI: $22-$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively. CONCLUSION: National adaptation and scale-up of Mozambique's school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.


Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/economia , Serviços de Saúde Escolar/economia , Serviços de Saúde Escolar/organização & administração , Criança , Custos e Análise de Custo , Feminino , Humanos , Esquemas de Imunização , Moçambique/epidemiologia , Infecções por Papillomavirus/epidemiologia , Avaliação de Programas e Projetos de Saúde
16.
Pan Afr Med J ; 33: 187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565147

RESUMO

Fumonisin B1 (FB1) is a mycotoxin frequently found in agricultural commodities. The toxin poses a considerable risk for human and animal health. FB1 is among several mycotoxins produced by Fusarium spp. contaminating virtually any cereal and other Poaceae. Their intracellular action includes the promotion of oxidative stress through the generation of reactive oxygen species (ROS) that damage biomolecules such as DNA. These toxic effects were observed in vivo and in vitro. However, the association between esophageal lesions and oxidative stress induced by FB1. Studies in China, Iran and South Africa showed higher exposure to fumonisins in areas with higher risk of esophageal cancer (EC). Exposure to mycotoxins may be inevitable in Mozambique. How mycotoxins, particularly fumonisins from the contaminated food, can be associated with the emergence of EC in Mozambique? Herein, we revise the literature and present some pieces of evidence in order to highlight the burden of mycotoxins and to provide evidence-based considerations for the stakeholders involved in the management of the EC agenda in Mozambique. The information presented herein supports the need to implement novel and/or to revisit the existent detoxification methods to reduce the global burden of mycotoxins and its outcomes in health management.


Assuntos
Carcinógenos Ambientais/toxicidade , Neoplasias Esofágicas/epidemiologia , Fumonisinas/toxicidade , Micotoxinas/toxicidade , Animais , Neoplasias Esofágicas/etiologia , Contaminação de Alimentos/prevenção & controle , Fusarium/metabolismo , Humanos , Moçambique/epidemiologia , Estresse Oxidativo/fisiologia , Espécies Reativas de Oxigênio/metabolismo
17.
Malar J ; 18(1): 326, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547813

RESUMO

BACKGROUND: Poor knowledge on the afebrile Plasmodium falciparum biology limits elimination approaches to target asymptomatic malaria. Therefore, the association of parasite factors involved in cytoadhesion, parasite multiplication and gametocyte maturation with afebrile malaria was assessed. METHODS: Plasmodium falciparum isolates were collected from febrile (axillary temperature ≥ 37.5 °C or a reported fever in the previous 24 h) and afebrile (fever neither at the visit nor in the previous 24 h) individuals residing in Southern Mozambique. var, PfSir2a and Pfs25 transcript levels were determined by reverse transcriptase quantitative PCRs (RT-qPCRs) and compared among 61 pairs of isolates matched by parasite density, age and year of sample collection. RESULTS: The level of varC and PfSir2a transcripts was higher in P. falciparum isolates from afebrile individuals (P ≤ 0.006), while varB and DC8 genes (P ≤ 0.002) were higher in isolates from individuals with febrile infections. After adjusting the analysis by area of residence, doubling the relative transcript unit (RTU) of varC and PfSir2a was associated with a 29.7 (95% CI 4.6-192.3) and 8.5 (95% CI 1.9-32.2) fold increases, respectively, of the odds of being afebrile. In contrast, doubling the RTU of varB and DC8 was associated with a 0.8 (95% CI 0.05-0.6) and 0.2 (95% CI 0.04-0.6) fold changes, respectively, of the odds of being afebrile. No significant differences were found for Pfs25 transcript levels in P. falciparum isolates from afebrile and febrile individuals. CONCLUSIONS: var and gametocyte-specific transcript patterns in febrile and afebrile infections from southern Mozambique matched by age, parasite density and recruitment period suggest similar transmissibility but differential expression of variant antigens involved in cytoadhesion and immune-evasion.


Assuntos
Expressão Gênica , Malária Falciparum/diagnóstico , Plasmodium falciparum/genética , Proteínas de Protozoários/genética , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Malária Falciparum/parasitologia , Masculino , Moçambique , Proteínas de Protozoários/metabolismo , Adulto Jovem
18.
BMC Public Health ; 19(1): 1031, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370810

RESUMO

BACKGROUND: In Mozambique cervical cancer is a public health threat, due to its high incidence and limited access to early diagnosis of precancerous lesions. International organisations are supporting the introduction of human papillomavirus (HPV) vaccines in low- and middle-income countries. Some of these countries recently conducted demonstration programmes, which included evaluation of acceptability, coverage, and practicality of implementation and of integration in existing programmes. Information on costs of delivering the vaccine is needed to overcome the challenges of reaching vaccine potential recipients in rural and remote areas. METHODS: We estimated the financial and economic costs of delivering HPV vaccination to ten-year-old girls at schools for the first vaccination cycle of the demonstration programme in the Manhiça district (southern Mozambique), delivered throughout 2014. We also estimated costs of an alternative scenario with a reduced number of doses and personnel, which was analogous to the second vaccination cycle delivered throughout 2015. Cost estimates followed a micro-costing approach and included interviews with key informants at different administrative levels through the administration of standard questionnaires developed by the World Health Organisation. RESULTS: Considering only data from the first vaccination cycle (2014), which consisted in the administration of three doses, the average economic cost was US$17.59 per dose and US$52.29 per fully-immunised girl (FIG). Financial cost per dose (US$6.07) and per FIG (US$17.95) were substantially lower. The economic cost was US$15.53 per dose and US$31.14 per FIG when estimating an alternative cost scenario with reduced number of doses and personnel. CONCLUSIONS: The average economic cost per dose was lower than the ones recently reported for low- and middle-income countries. However, our estimation of the financial cost per FIG was higher than the ones observed elsewhere (ranging from US$2.49 in India to US$20.36 in Vietnam) due to the high percentage of out-of-school girls which, reduced vaccine coverage and, therefore, reduced the denominator. Due to budget constraints, if Mozambique is to implement nation-wide HPV vaccination targeted to ten-year-old girls at schools, a reduction in personnel costs should be operated either by restricting the outreach vaccinator team or the number of supervision visits.


Assuntos
Custos e Análise de Custo/estatística & dados numéricos , Programas de Imunização/economia , Vacinas contra Papillomavirus/economia , Serviços de Saúde Escolar/economia , Criança , Feminino , Humanos , Moçambique , Avaliação de Programas e Projetos de Saúde , Neoplasias do Colo do Útero/prevenção & controle
19.
BMC Health Serv Res ; 19(1): 538, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370854

RESUMO

BACKGROUND: Antenatal care (ANC) provides a range of critical health services during pregnancy that can improve maternal and neonatal health outcomes. In Mozambique, only half of women receive four or more ANC visits, which are provided for free at public health centers by maternal and child health (MCH) nurses. Waiting time has been shown to contribute to negative client experiences, which may be a driver of low maternity care utilization. A recent pilot study of a program to schedule ANC visits demonstrated that scheduling care reduces waiting time and results in higher rates of complete ANC. This study aims to explore client experiences with waiting time for ANC in standard practice and care and after the introduction of appointment scheduling. METHODS: This study uses a series of qualitative interviews to unpack client experiences with ANC waiting time with and without scheduled care, in order to better understand the impact of waiting time on client experiences. Thirty-eight interviews were collected in May to June 2017 at three pilot study clinics in southern Mozambique, with a focus on two paired intervention and comparison facilities sharing similar facility characteristics. Data were analyzed using inductive thematic analysis methods using NVivo software. RESULTS: Clients described strong motivations to seek ANC, pointing to the need to address convenience of care, and highlighted direct and indirect costs of seeking care that were exacerbated by long waiting times. Direct costs include time and transport costs of going to the clinic, while indirect costs include being unable to fulfill household and work obligations. Other barriers to complete ANC utilization of four or more visits include transport costs, negative provider experiences, and delayed ANC initiation, which limit the potential number of clinic contacts. CONCLUSIONS: Findings demonstrate that the scheduling intervention improves the client experience of seeking care by allowing women to both seek ANC and fulfill other productive obligations. Innovation in healthcare delivery should consider adapting models that minimize waiting times.


Assuntos
Atitude Frente a Saúde , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cuidado Pré-Natal/organização & administração , Listas de Espera , Adulto , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Moçambique , Projetos Piloto , Gravidez , Pesquisa Qualitativa , Adulto Jovem
20.
Pan Afr Med J ; 33: 52, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448015

RESUMO

Introduction: The use of mass gatherings as spaces to practice health surveillance has been growing in recent years. In Mozambique, the 9th National Festival of Culture in 2016 was selected for this practice. A specific public health surveillance system to facilitate rapid detection of outbreaks and other health-related events was implemented for this event with real time data collection and analysis. Methods: A descriptive epidemiological evaluation of all the health consultations that occurred in fixed posts prepared for the event was conducted. The data were collected through electronic mobile system (tablets) in real time, with the aid of a form designed for this purpose and sent directly to the incident command system (ICS). Results: During the event, a total of 355 patients were assisted, 52.3% were female, 87.0% were from Beira city and the artists were the group that most frequently sought health care at 59.4%. The largest number of visits took place on the third day (36.4%). People over 45 years of age were the age group that most frequently sought health care (30.8%). The main provisional diagnoses of those who were attended to during the festival was arterial hypertension (20.3%), followed by febrile syndrome (19.0%), with falls being the most frequent causes of trauma during the festival (60.0%). Conclusion: The system of monitoring in real time using mobile technologies proved to be efficient for the monitoring of the main health events during the mass gatherings. This profile of health consultations encourages the health sector to plan strategies and actions geared to the reality of care for this type of event.


Assuntos
Computadores de Mão , Surtos de Doenças , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância em Saúde Pública/métodos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Coleta de Dados/métodos , Feminino , Férias e Feriados , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique/epidemiologia , Adulto Jovem
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