The Mulher Study: cervical cancer screening with primary HPV testing in Mozambique.

OBJECTIVE: To evaluate cervical cancer screening with primary human papillomavirus (HPV) testing in Mozambique, a country with one of the highest burdens of cervical cancer globally. METHODS: Women aged 30-49 years were prospectively enrolled and offered primary HPV testing using either self-collected or provider-collected specimens. Patients who tested positive for HPV underwent visual assessment for treatment using visual inspection with acetic acid to determine eligibility for thermal ablation. If ineligible, they were referred for excision with a loop electrosurgical excision procedure, for cold knife conization, or for cervical biopsy if malignancy was suspected. RESULTS: Between January 2020 and January 2023, 9014 patients underwent cervical cancer screening. Median age was 37 years (range 30-49) and 4122 women (45.7%) were patients living with HIV. Most (n=8792, 97.5%) chose self-collection. The HPV positivity rate was 31.1% overall and 39.5% among patients living with HIV. Of the 2805 HPV-positive patients, 2588 (92.3%) returned for all steps of their diagnostic work-up and treatment, including ablation (n=2383, 92.1%), loop electrosurgical excision procedure (n=169, 6.5%), and cold knife conization (n=5, 0.2%). Thirty-one patients (1.2%) were diagnosed with cancer and referred to gynecologic oncology. CONCLUSION: It is feasible to perform cervical cancer screening with primary HPV testing and follow-up in low-resource settings. Participants preferred self-collection, and the majority of screen-positive patients completed all steps of their diagnostic work-up and treatment. Our findings provide important information for further implementation and scale-up of cervical cancer screening and treatment services as part of the WHO global strategy for the elimination of cervical cancer.

The Capulana study: a prospective evaluation of cervical cancer screening using human papillomavirus testing in Mozambique.

BACKGROUND: Cervical cancer is the leading cause of cancer and related deaths among women in Mozambique. There is limited access to screening and few trained personnel to manage women with abnormal results. Our objective was to implement cervical cancer screening with human papillomavirus (HPV) testing, with navigation of women with abnormal results to appropriate diagnostic and treatment services. METHODS: We prospectively enrolled women aged 30-49 years living in Maputo, Mozambique, from April 2018 to September 2019. All participants underwent a pelvic examination by a nurse, and a cervical sample was collected and tested for HPV using the careHPV test (Qiagen, Gaithersburg, Maryland, USA). HPV positive women were referred for cryotherapy or, if ineligible for cryotherapy, a loop electrosurgical excision procedure. Women with findings concerning for cancer were referred to the gynecologic oncology service. RESULTS: Participants (n=898) had a median age of 38 years and 20.3% were women living with the human immunodeficiency virus. HPV positivity was 23.7% (95% confidence interval 21.0% to 26.6%); women living with human immunodeficiency virus were twice as likely to test positive for HPV as human immunodeficiency virus negative women (39.2% vs 19.9%, p<0.001). Most HPV positive women (194 of 213, 91.1%) completed all steps of their diagnostic work-up and treatment. Treatment included cryotherapy (n=158, 77.5%), loop electrosurgical excision procedure (n=30, 14.7%), or referral to a gynecologist or gynecologic oncologist (n=5, 2.5%). Of eight invasive cervical cancers, 5 (2.8%) were diagnosed in women living with human immunodeficiency virus and 3 (0.4%) in human immunodeficiency virus negative women (p=0.01). CONCLUSION: Cervical cancer screening with HPV testing, including appropriate follow-up and treatment, was feasible in our study cohort in Mozambique. Women living with human immunodeficiency virus appear to be at a significantly higher risk for HPV infection and the development of invasive cervical cancer than human immunodeficiency virus negative women.

Mycobacterium tuberculosis causing tuberculous lymphadenitis in Maputo, Mozambique.

BACKGROUND: The zoonosis bovine tuberculosis (TB) is known to be responsible for a considerable proportion of extrapulmonary TB. In Mozambique, bovine TB is a recognised problem in cattle, but little has been done to evaluate how Mycobacterium bovis has contributed to human TB. We here explore the public health risk for bovine TB in Maputo, by characterizing the isolates from tuberculous lymphadenitis (TBLN) cases, a common manifestation of bovine TB in humans, in the Pathology Service of Maputo Central Hospital, in Mozambique, during one year. RESULTS: Among 110 patients suspected of having TBLN, 49 had a positive culture result. Of those, 48 (98%) were positive for Mycobacterium tuberculosis complex and one for nontuberculous mycobacteria. Of the 45 isolates analysed by spoligotyping and Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat (MIRU-VNTR), all were M. tuberculosis. No M. bovis was found. Cervical TBLN, corresponding to 39 (86.7%) cases, was the main cause of TBLN and 66.7% of those where from HIV positive patients. We found that TBLN in Maputo was caused by a variety of M. tuberculosis strains. The most prevalent lineage was the EAI (n = 19; 43.2%). Particular common spoligotypes were SIT 48 (EAI1_SOM sublineage), SIT 42 (LAM 9), SIT 1 (Beijing) and SIT53 (T1), similar to findings among pulmonary cases. CONCLUSIONS: M. tuberculosis was the main etiological agent of TBLN in Maputo. M. tuberculosis genotypes were similar to the ones causing pulmonary TB, suggesting that in Maputo, cases of TBLN arise from the same source as pulmonary TB, rather than from an external zoonotic source. Further research is needed on other forms of extrapulmonary TB and in rural areas where there is high prevalence of bovine TB in cattle, to evaluate the risk of transmission of M. bovis from cattle to humans.

Expanding Cervical Cancer Screening in Mozambique: Challenges Associated With Diagnosing and Treating Cervical Cancer.

PURPOSE: Mozambique has one of the highest burdens of cervical cancer globally. Treatment options are few as most women present with advanced disease, and there are limited trained health professionals and health care resources. The objective of this study was to describe the outcomes of women diagnosed with invasive cancer as part of the Mozambican women undergoing cervical cancer screening with human papillomavirus (HPV) testing in conjunction with family planning services (MULHER) study. MATERIALS AND METHODS: Women age 30-49 years were prospectively enrolled in the MULHER study and offered screening with primary HPV testing followed by treatment of screen-positive women with thermal ablation or excision as appropriate. Women with cervical examination findings suspicious for cancer were referred to one of the three gynecologic oncologists in the country. RESULTS: Between January 2020 and January 2023, 9,014 women underwent cervical cancer screening and 30 women were diagnosed with cervical cancer. In this cohort, four patients (13.3%) had early-stage disease, 18 (60.0%) had locally advanced disease, one (3.3%) had distant metastatic disease, and seven (23.3%) did not have staging information available. Five patients (16.6%) died without receiving oncologic treatment, and seven patients (23.3%) are still awaiting treatment. Of the remaining 18 patients, three (17.6%) underwent surgery and four (23.5%) received radiotherapy. Eleven (36.7%) patients received only chemotherapy. CONCLUSION: As cervical screening programs are implemented in low-resource settings, there will likely be an increase in the number of women diagnosed with invasive cervical cancer. Our results in Mozambique demonstrate the need to increase access to advanced surgery, radiation, and palliative care services.

p16 Expression Correlates with Invasive Ocular Surface Squamous Neoplasms in HIV-Infected Mozambicans.

BACKGROUND: p16 immunohistochemistry is widely used to diagnose human papillomavirus (HPV)-related squamous neoplasms of cervix, anogenital, head, and neck tissues. The incidence of these HPV-related squamous neoplasms is markedly increased in the HIV-infected population. Ocular surface squamous neoplasia (OSSN) is also more common in HIV-infected patients. However, the expression pattern of p16 in OSSN among HIV-infected patients is unclear. Here, we examined the expression of p16 in OSSN surgical excisions collected from a large HIV-infected cohort from -Mozambique. METHODS: OSSN surgical tissue specimens were collected from 75 Mozambican patients. Formalin-fixed, paraffin-embedded tissue blocks from these OSSNs were sectioned, stained with hematoxylin and eosin (H&E), and p16 expression by immunohistochemistry. H&E slides were reviewed to determine if OSSNs were noninvasive conjunctival intraepithelial neoplasms or invasive squamous cell carcinomas (SCC). Cases were classified as p16 positive or negative based on diffuse nuclear and cytoplasmic expression of p16 in neoplastic cells. RESULTS: p16 positivity was found in a minority of OSSN cases (14/75). p16 positivity was significantly associated with the invasive SCC type of OSSN in HIV-infected patients (p value of 0.026). CONCLUSIONS: The majority of OSSNs in our HIV-infected cohort do not express p16. However, those cases that are p16-positive are significantly more likely to be the invasive SCC form of OSSN. We propose that p16 expression may identify more aggressive OSSNs in HIV-infected populations.

Bilharziose vesical: granuloma rico em eosinólos com ovo de schistosoma viável / Bladder bilharziosis: eosinol-rich granuloma with viable schistosoma eggs

A bilharziose é causada por parasitas que vivem em água doce, como rios ou lagos, em regiões tropicais e subtropicais de todo o mundo, sendo altamente prevalente em Moçambique. Um estudo de prevalência realizado em 1996 em três escolas primárias da cidade de Maputo, encontrou uma prevalência de 11,3%.1 Em 2014 a prevalência em doentes assistidos num centro de saúde da cidade da Beira foi de 23%,2 e foi encontrada uma correlação entre bilharziose urinária e nível de anemia em estudantes da zona Norte de Moçambique.3...

Potencial ornamental de acessos de pimenta / Potential for ornamental use of pepper accessions

O objetivo deste trabalho foi avaliar o potencial ornamental de dez acessos de pimenta Capsicum spp. procedentes da Coleção de Germoplasma da Universidade Federal do Piauí, Brasil. O experimento foi conduzido em casa de vegetação, no Departamento de Fitotecnia, do Centro de Ciências Agrárias, no município de Teresina, Piauí, obedecendo ao delineamento experimental inteiramente casualizado, com três repetições. Na caracterização morfoagronômica dos acessos, conforme orientação do Bioversity International, utilizaram-se os seguintes descritores qualitativos e quantitativos para o gênero Capsicum: forma da folha, hábito de crescimento da planta, antocianina no nó da planta, posição da flor, cor da corola, cor do fruto no estado intermediário e maduro, forma do fruto, forma do ápice do fruto, textura da epiderme do fruto, comprimento do fruto, comprimento do pedicelo, persistência do fruto maduro e altura da planta. Dentre os dez acessos avaliados, sete foram considerados com potencial ornamental: CGC-06 (C. chinense), CGC-07 (C. chinense), CGC-11 (C. annuum var. glabriusculum), CGC-23 (C. chinense), CGC-36 (C. annuum var. glabriusculum), CGC-59 (C. annuum var. glabriusculum) e CGC-67 (C. annuum var. glabriusculum). O CGC 11 apresentou estética mais harmoniosa, com flores eretas, as quais são de fácil percepção; frutos eretos e vistosos e folhas de formato lanceolado.

The objective of this research was to evaluate the potential for ornamental use of ten Capsicum spp. accessions from Germplasm Collection of Federal University of Piauí, Brazil The experiment was carried out in a greenhouse at the Department of Plant Science, Centre of Agricultural Sciences, in Teresina City, Piauí State, according to the completely randomized design, with three replications. In the morphoagronomic characterization of pepper accessions, according to Bioversity International, the following qualitative and quantitative descriptors for the Capsicum genus were used: leaf shape, plant growth habit, anthocyanin node of the plant, flower position, color of the corolla, fruit color and mature in the intermediate state, fruit shape, fruit shape of apex of the texture of the fruit skin , fruit length, length of pedicel, persistence of ripe fruit and plant height. Among the ten accessions, seven were considered with ornamental potential: CGC-06 (C. chinense), CGC-07 (C. chinense), CGC-11 (C. annuum var. glabriusculum), CGC-23 (C. chinense), CGC-36 (C. annuum var. glabriusculum), CGC-59 (C. annuum var. glabriusculum) and CGC-67 (C. annuum var. glabriusculum). The CGC 11 was the more harmonious aesthetic accession, by presenting erect flowers , which are easy to read; erect and showy fruits and lanceolate leaves format.

Diversidade genética entre acessos de espécies cultivadas de pimentas / Genetic diversity among accessions of cultivated peppers species

O conhecimento da diversidade genética entre acessos em bancos de germoplasma é importante para fins de conservação de recursos genéticos e uso em programas de melhoramento genético. Neste estudo, objetivou-se avaliar a divergência genética entre 23 acessos de pimentas do gênero Capsicum, a partir de sete descritores quantitativos e 19 qualitativos multicategóricos, com auxílio de técnicas multivariadas. Pela análise de variância, evidenciaram-se diferenças significativas entre os acessos de pimentas para todos os descritores quantitativos. Os coeficientes de variação (CV) do experimento variaram de 8,97 (LF) a 30,91 por cento (NFA). O Método de agrupamento de otimização via Tocher detectou a formação de oito grupos, tanto para descritores quantitativos, quanto para os qualitativos multicategóricos. Pelo Método UPGMA, formaram-se três grupos baseando-se nos descritores quantitativos e quatro grupos com base nos qualitativos. Há diversidade genética inter e intraespecífica no Banco de Germoplasma de Capsicum spp. da Universidade Federal do Piauí, com evidências de que não existem duplicatas entre os acessos estudados.

The knowledge of the genetic diversity among the accessions in germplasm banks it is important for the conservation of genetic resources and the use in breeding programs. This study aimed to evaluate the genetic divergence of 23 accessions of the genus Capsicum, and was based in seven quantitative and nineteen qualitative multicategorical descriptors and using multivariate techniques. The analyses of variance revealed significant difference (P<0.05) among the accessions of peppers for all quantitative descriptors. The coefficient variation ranged from 8,97 percent (LF) to 30,91 percent (NFA). The Tocher optimization method detected eight clusters for quantitative descriptors and also in as well as qualitative multicategoric descriptors. The UPGMA method detected three clusters for quantitative descriptors and four clusters within qualitative multicategoricdescriptors. There is genetic diversity inter and intraspecific in germplasm bank of Capsicum coming from The Federal University of Piauí, and these results indicate that there are not duplicated accessions.

Processamento do presunto "cook-in" de cordeiros / Processing of cook-in ham of lambs

Este trabalho teve por objetivo desenvolver tecnologia para produto curado (presunto "cook-in"), com pernis de cordeiros cruza Texel x Corriedale em associaçäo com tratamentos tecnológicos (massagem em "tumbler" e processo "cook-in"). O estudo foi desenvolvido pela EMBRAPA/CPPSUL e Universidade Federal de Santa Maria, RS, Brasil. Após as análises da composiçäo química, a carne foi injetada manualmente com 20 por cento de salmoura composta por água + gelo 79 por cento, cloreto de sódio 7,52 por cento, condimento para presunto 4,70 por cento, fosfatos 1,97 por cento, sais de cura 1,88 por cento, sacarose 3,38 por cento e glutamato monossódico 0,19 por cento. Os presuntos foram avaliados quanto à composiçäo química (umidade, proteína, gordura, cinzas, pigmentos totais e pH), parâmetros sensoriais (cor, aroma, sabor, textura e aceitabilidade) e rendimento. Uma das principais características dos presuntos obtidos com pernil de cordeiros cruza Texel x Corriedale foi o baixo conteúdo de gordura associado ao bom rendimento e à excelente aceitabilidade.

Produção de carne em ovinos de cinco genótipos: 1. Crescimento e desenvolvimento / Meat production in sheep of five genotypes: 1. Growth and development

O trabalho foi realizado no Centro de Pesquisa de Pecuária dos Campos Sulbrasileiros - CPPSUL - EMBRAPA de Bagé, RS, nos anos de 1994/95, com cordeiros das raças Texel, Romney Marsh, Corriedale, Ideal e Merino nascidos e criados até o desmame (10 semanas) em campo nativo, (predominância de Paspalum notatum Flügge e Axonopus affïnis Chase). Objetivou estudar aspectos relativos ao crescimento e desenvolvimento, com suplementação alimentar a campo, até o abate aos 7,5 meses de idade. A partir do desmame, iniciou-se a suplementaçào dos cordeiros (10 por raça, recebendo 200 g/cab./dia) com uma ração contendo 17% de PB e 75% de NDT. Até uma semana pós-desmame a ração foi oferecida em regime de confinamento e. após, a campo até o abate. Os resultados mostraram que os pesos ao nascer foram semelhantes (P>0,05), porém, do desmame e a partir deste, o crescimento ponderal e o desenvolvimento de cordeiros Texel e Romney Marsh foram sempre superiores aos de Corriedale, Ideal e Merino. Após o desmame, principalmente nos primeiros 45 dias, a capacidade de conversão dos alimentos (suplemento + pasto) foi maior nas raças Texel, Romney Marsh e Ideal. Em todos os genótipos, observou-se que as variações de peso corporal (em relação ao tempo), após os 5,5 meses de idade, pouco contribuíram no peso final de abate.

The work was carried out at the Centro de Pesquisa de Pecuária dos Campos Sulbrasileiros (CPPSUL) of EMBRAPA, Bagé, RS, during 1994/95 with male lambs of the Texel, Romney Marsh, Corriedale, Polwarth and Merino breeds, bom and raised up to weaning (10 weeks) on native pasture (mainly composed by de Paspalum notatum Flügge e Axonopus affïnis Chase). Growth and development up to slaughtering at 7.5 months were evaluated. After weaning, besides the native pasture, all lambs (10 per breed) werefed with a concentrate containing 17% of crude protein and 75% of dry matter basis (200 g/lamb/day), until the slaughtering age. The results showed that birth weight of breeds was similar (P>0.05); however, the liveweight at weaning and the liveweights after weaning of both Texel and Romney Marsh lambs were greater than those of Corriedale, Polwart and Merino lambs. They showed liveweights always similar. The first fourty five days after weaning, lambs of Texel, Romney Marsh and Polwarth breeds showed greater food conversion. In all genotypes, liveweight gains after 5.5 months of age had no importam contribution (in relation to time) to the slaughtering weight.

Produção de carne em ovinos de cinco genótipos: 2. Componentes do peso vivo / Meat production in sheep of five genotypes: 2. Live weight components

O estudo foi realizado com o objetivo de quantificar e comparar o peso vivo ao abate e seus componentes em cordeiros das raças Merino, Ideal Corriedale, Romney Marsh e Texel. Foram abatidos 50 cordeiros, sendo dez de cada raça, com idade de 225 dias. Os animais foram criados em condições extensivas de campo nativo até o desmame (10 semanas), na região sul do Brasil (Bagé, RS) e castrados aos 30 dias de idade. A partir do desmame, iniciou-se a suplementação dos cordeiros (200g/cab./dia) com uma ração contendo 17% de proteína bruta e 75% de nutrientes digestíveis totais. Até uma semana pós-desmame, a ração foi oferecida em regime de confinamento e, após, a campo até o abate. O genótipo apresentou um efeito sobre os componentes do peso vivo. Entretanto, pode ocorrer de não se detectar diferença entre genótipos em valores absolutos e existir diferença em valores percentuais (caso da cabeça), ou ser verificado diferenças entre alguns componentes do peso vivo em valores absolutos e não em valores percentuais (caso que ocorreu para coração, pulmões e fígado). A raça Texel apresentou valores absolutos superiores em relação às raças Merino Ideal, Corriedale e Romney Marsh. Porém, em valores percentuais, com exceção da carcaça, que igualmente apresentou maior valor, nos demais componentes não foram superiores. A raça Merino e a Ideal apresentaram uma percentagem de pele superior às demais raças.

Fifty (ten per breed) Merino, Polwarth, Corriedale, Romney Marsh and Texel lambs were castrated at 30 days of age and raised up to weaning (ten weeks) on native pasture (mainly composed by Paspalum notatum Flügge and Axonoplus qffïnis Chase) in the Southern (Bagé, RS) region of Brazil. Following weaning, the animals were feedloted during one week and each lamb was daily fed 200 grams of a diet containing 17% of crude protein and 75% of dry matter basin. The animals were then moved to pasture up to 225 days of age when they were slaughtered to compare their live weight as a total and its components. Live weight was influenced by genotypes. This effect might not be observed in absolute numbers, but in percentage (head), or vice-versa, as shown by heart, lungs and liver. The Texel breed showed higher absolute values as compared to Merino. Polwarth, Corriedale and Romney Marsh. Percentualy, this superiority was only observed in carcass. Merino and Polwarth showed higher skin percentage, as compared to other breeds.

Supervivência do vírus da febre aftosa tipo O1 em Carcaças de ovinos infectados experimentalmente, antes e após o processo de maturação / Survival of foot and mouth disease virus O1 in carcasses of experimentally infected sheep, before and after the maturation process

Foi estudada a supervivência do vírus da febre aftosa tipo O cepa O1 Campos em carcaças de ovinos infectados experimentalmente. Enfatiza-se a importância do conhecimento epidemiológico da região de onde se originam os ovinos destinados ao abate e o rigor do exame ante-mortem

Influência do cruzamento Ile de France x Corriedale (F1) nos parâmetros de qualidade da carne de cordeiro / Influence of crossbreeding Ile de France x Corriedale (F1) in the quality parameters of lamb meat

O cruzamento entre fêmeas de raça de dupla aptidäo - lÝ e carne - (Corriedale) com carneiros tipo carne (Ile de France) vem sendo uma prática muito utilizada para produçäo de carne de cordeiro. Neste trabalho, observamos que ocorreram mudanças significativas em relaçäo ao peso dos animais, peso das carcaças e área de lombo. Näo foram observadas diferenças com relaçäo ao pH inicial, pH final, grau de gordura de cobertura e marmoreio entre as cruzas (IF x C) e a raça Corriedale. O teor de gordura, o colesterol e a matéria insaponificável no longissimus foram semelhantes e näo diferiram estatisticamente, já a percentagem de esterol da raça Corriedale foi superior à das cruzas. Foram identificados vinte e dois picos de ácidos graxos. Observou-se diferenças entre os ácidos graxos saturados, o ácido esteárico apresentou valores de 21,90 por cento para a cruza IF x C e 18,35 por cento para a raça Corriedale, com nível de significância de 0,001...