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Nevirapine Hair And Plasma Concentrations And Hiv-1 Viral Suppression Among Hiv Infected Ante-Partum And Post-Partum Women Attended In A Mother And Child Prevention Program In Maputo City, Mozambique, Rosa Marlene Cuco, Osvaldo Loquiha, Adelino Juga, Aleny Couto, Bindiya Meggi, Adolfo Vubil, Esperança Sevene, Nafissa Osman, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Introduction: Prevention of mother to child transmission of HIV (PMTCT) is frequently challenged by irregular access to more effective anti-retroviral therapy. Nevirapine single dose (sdNVP), sdNVP+AZT+3TC for MTCT prophylaxis and NVP+ AZT+3TC for treatment and PMTCT were withdrawn due to low genetic resistance barrier and low efficacy. However current PMTCT lines in Mozambique include DTG+3TC+TDF, TDF+3TC+EFV, DTG +ABC+3TC, and AZT + NVP syrup prophylaxis for exposed babies. We assessed NVP hair and plasma concentrations and association with HIV-1RNA suppression among HIV+ ante-partum and post-partum women under PMTCT in Maputo, Mozambique.

Methods: From December 2013 to November 2014, prospectively …

Serial Lung Ultrasounds In Pediatric Pneumonia In Mozambique And Pakistan, Amy Sarah Ginsburg, Muhammad Imran Nisar, Lola Madrid, Jennifer L. Lenahan, Benazir Baloch, Pio Vitorino, Jun Hwang, Alessandro Lamort, Nee Kanth, Fyezah Jehan

Department of Paediatrics and Child Health

Lung ultrasound (LUS) is a promising point-of-care imaging technology for diagnosing and managing pneumonia. We sought to explore serial LUS examinations in children with chest-indrawing pneumonia in resource-constrained settings and compare their clinical and LUS imaging courses longitudinally. We conducted a prospective, observational study among children aged 2 through 23 months with World Health Organization Integrated Management of Childhood Illness chest-indrawing pneumonia and among children without fast breathing, chest indrawing or fever (no pneumonia cohort) at 2 district hospitals in Mozambique and Pakistan. We assessed serial LUS at enrollment, 2, 6, and 14 days, and performed a secondary analysis of …

Prevalence And Risk Factors Associated With Hiv/Hepatitis B And Hiv/Hepatitis C Co-Infections Among People Who Inject Drugs In Mozambique, Cynthia Semá Baltazar, Makini Boothe, Timothy Kellogg, Paulino Ricardo, Isabel Sathane, Erika Fazito, Henry F. Raymond, Marleen Temmerman, Stanley Luchters

Obstetrics and Gynaecology, East Africa

Background: There is scare information about HIV co-infections with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) among People Who Inject Drugs (PWID) in Mozambique. This information is critical to ensure the treatment necessary to decrease the progression of liver disease and the transmission of both HIV and hepatitis. We assess the prevalence of HIV, HBV and HCV co-infections as well as associated risk factors among PWID.

Methods: The first Bio-Behavioral Surveillance Survey was conducted in 2013-2014 among persons who self-reported to have ever injected drugs. Using respondent-driven sampling, PWID aged 18 years and older were recruited …

Willingness To Pay For Improved Vision In Mozambique, Stephen Thompson, Kovin Naidoo, Carmen Gonzalez-Alvarez, Geoff Harris, James Loughman

Articles

The burden of vision impairment due to uncorrected refractive error (needing spectacles) in Mozambique is known to be significant. To improve the planning and provision of eye health services, a better understanding of how vision is valued by patients is needed. The willingness to pay (WTP) for improved vision through correcting refractive error was investigated in Nampula, Mozambique, using stated choice and bidding game methodologies. The mean WTP values were found to be 388.92 Meticals (US$13) for stated choice and 469.89 Meticals (US$16) for the bidding game. The mean WTP values for rural dwellers were found to be lower than …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

The Impact Of Income On Nutrition: A Case Study Of Northern Mozambique, Hunter Swanigan, Lawton Lanier Nalley

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

In 2017, Mozambique ranked as one of the least developed countries in the world by measures of health, education, and income. With a minimal annual income, purchasing adequate food to meet recommended levels of nutrients for a healthy diet is difficult, leaving 40% of the country undernourished. This study analyzed what foods are available during the dry months (hungry season) of May through October in the Nampula province of Mozambique to determine if it is possible to meet recommended levels of nutrients from purchasing and growing food. Three different levels of income were used to determine what percentage of the …

The Impact Of Maternal Literacy Skills On Child Weight In Mozambique, Ashley Watson, Shannon Self-Brown, Iris Feinberg, Whitney Rostad

Journal of the Georgia Public Health Association

Background: Infant mortality is a serious public health problem. One factor that is strongly associated with infant mortality is low weight in children. The percentage of underweight children under the age of five in Mozambique was 16% in 2012. In order to reduce the number of underweight children in this country, contributing caregiver characteristics of this problem should be investigated. One potentially relevant characteristic is maternal literacy, which has been under investigated. Objective: This study aims to determine whether maternal literacy affected the weight and body-mass-index (BMI) of children ages 0 to 3 years old in Mozambique.

Methodology: A cross-sectional …

Mapping Maternal Mortality Rate Via Spatial Zero-Inflated Models For Count Data: A Case Study Of Facility-Based Maternal Deaths From Mozambique, Osvaldo Loquiha, Niel Hens, Leonardo Chavane, Marleen Temmerman, Nafissa Osman, Christel Faes, Marc Aerts

Obstetrics and Gynaecology, East Africa

Maternal mortality remains very high in Mozambique, with estimates from 2015 showing a maternal mortality ratio of 489 deaths per 100,000 live births, even though the rates tend to decrease since 1990. Pregnancy related hemorrhage, gestational hypertension and diseases such as malaria and HIV/AIDS are amongst the leading causes of maternal death in Mozambique, and a significant number of these deaths occur within health facilities. Often, the analysis of data on maternal mortality involves the use of counts of maternal deaths as outcome variable. Previously we showed that a class of hierarchical zero-inflated models were very successful in dealing with …

Maternal Death And Delays In Accessing Emergency Obstetric Care In Mozambique, Leonardo Antonio Chavane, Patricia Bailey, Osvaldo Loquiha, Martinho Dgedge, Marc Aerts, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Despite declining trends maternal mortality remains an important public health issue in Mozambique. The delays to reach an appropriate health facility and receive care faced by woman with pregnancy related complications play an important role in the occurrence of these deaths. This study aims to examine the contribution of the delays in relation to the causes of maternal death in facilities in Mozambique.

Methods: Secondary analysis was performed on data from a national assessment on maternal and neonatal health that included in-depth maternal death reviews, using patient files and facility records with the most comprehensive information available. Statistical models …

Mozambique: Hiv/Aids, Camila Davila

Global Public Health

Mozambique is a country located in Southeastern Africa near the Mozambique Channel and the Indian Ocean. The president of this nation is Filipe Jacinto Nyusi. The total population is 26, 573, 706 which is composed of mostly 99.68% Africans and other minorities. Its national language is Portuguese although most of the population speaks Emarkhuwa. Most of the population is Catholic and a few others include Muslims and Zionist Christians. Mozambique faces several challenges with malaria, poverty, malnutrition, HIV/AIDS, and illicit drugs. HIV/AIDS is a common health problem that targets the immune system and is transmitted through bodily fluids such as …

Provision Of Medical Supply Kits To Improve Quality Of Antenatal Care In Mozambique: A Stepped-Wedge Cluster Randomised Trial, Ana Pilar Betrán, Eduardo Bergel, Sally Griffin, Armando Melo, My Huong Nguyen, Alicia Carbonell, Santos Mondlane, Mario Merialdi, Marleen Temmerman, A Metin Gülmezoglu

Obstetrics and Gynaecology, East Africa

Background: High levels of maternal and newborn mortality and morbidity remain a daunting reality in many lowincome countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care.

Methods: We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served …

Competency-Based Assessment Of Refractive Error Measurement In A Mozambique Optometry School, Kajal Shah, Kovin Naidoo, Luigi Bilotto, James Loughman

Articles

Background: The aims of this study were to develop a process for assessing refractive error management competence among the first two cohorts of students in a new optometry program at Unilúrio in Mozambique and to understand the effectiveness of implementing the process in the context of a low resource environment. Methods: The assessment methods were developed using information from a literature review and a focus group discussion and implemented on 15 students. Results: The exams consisted of direct observation of two patients, short-answer questions and a structured oral examination. Conclusion: The use of existing checklists and rating skills helped to …

Development Of Socially Responsive Competency Frameworks For Ophthalmic Technicians And Optometrists In Mozambique, Kajal Shah, Kevin Naidoo, James Loughman

Articles

There is an extreme paucity of eye care personnel and training facilities in developing countries. This study was designed to develop a comprehensive framework of competency standards for ophthalmic technicians and optometrists, in Mozambique. This could then inform the evolution of socially responsive curricula for both cadres. Methods A modified Delphi technique was used with a ten member expert panel consisting of optometrists, ophthalmic technicians and ophthalmologists, all with experience of working in a developing country context. The competencies were derived from literature, primary research data and observations from a competency development workshop. The first round involved scoring the relevance …

Student Educational Background, Perceptions And Expectations Towards Optometry: An Emerging Eye Health Profession Mozambique., James Loughman, Ving Fai Chan, Vanessa Raquel Moodley, Luigi Bilotto, Kovin Naidoo

Articles

Background: The University of Lurio, School of Optometry in Mozambique is a new program in Africa. The school, the first to serve Portuguese-speaking Africa, can act as a template for such initiatives in other African countries and other limited-resource settings around the world. A major challenge facing such programs is the lack of knowledge about the profession, which impacts the recruitment of students and their expectations of the program. This study was conducted to understand students’ pre-enrollment educational background, perceptions and career expectations as an optometrist in Mozambique so as to inform future enrollment and other similar initiatives. Methods: First-year …

Evaluations Of Refraction Competencies Of Ophthalmic Technicians In Mozambique., James Loughman, Kajal Shah, Kovin Naidoo, Margarida Chagunda

Articles

Purpose: Ophthalmic technicians (OT) work at health facilities in Mozambique and are trained to provide primary and secondary eye care services including basic refraction. This study was designed to assess OT competence and confidence in refraction, and investigate whether an upskilling programme is effective in developing their competence and confidence at refraction. Methods: Thirty-one trainee OTs and 16 qualified OTs were recruited to the study. A background questionnaire was administered to determine the demographic profile of the OTs. A confidence levels questionnaire explored their self-reported skills.

Barriers To Utilisation Of Refractive Services In Mozambique., James Loughman, Stephen Thompson, Carmen Gonzalez-Alvarez, Kovin Naidoo, Farai Chinanayi, Geoff Harris

Articles

Mozambique has a population of more than 25 million people.1 Nampula Province has just fewer than 4 million people.2 Although Mozambique is currently experiencing unprecedented economic growth rates, buoyed by the discovery of natural resources, significant challenges remain for the population, such as adequate health care, including eye health services. VISION 2020 is a global initiative to eliminate avoidable blindness by the year 2020. Its core strategies are focused on human resource development, infrastructure development, and disease control.3 The Mozambique Eyecare Project delivered a regional optometry model for Lusophone Africa, based on the VISION 2020 core strategies. A key output …

Changes In Malaria Prevention And Incidence Due To Political Restructuring Of Mozambique And South Africa, Nirmala K. Shivakumar

Undergraduate Research Posters

The UN’s current Millennium Development Goal puts pressure on many countries to decrease malaria incidence by 2015, including Mozambique and South Africa. While Mozambique and South Africa have continually worked to decrease malaria incidence for the last five decades, neither country can claim elimination of disease by UN standards. This study analyzes the changes in political structure and the simultaneous changes in the malaria prevention programs of Mozambique and South Africa after the end of their respective civil wars in 1992 and 1994. This study analyzed public health, historical, and social science journal articles. This study examined political power distribution, …

Factors Affecting The Academic Performance Of Optometry Students In Mozambique., James Loughman, Kajal Shah, Kovin Naidoo, Luigi Bilotto

Articles

Purpose. The Mozambique Eyecare Project is a higher education partnership for the development, implementation, and evaluation of a model of optometry training at UniLu´ rio in Mozambique. There are many composite elements to the development of sustainable eye health structures, and appropriate education for eye health workers remains a key determinant of successful eye care development. However, from the first intake of 16 students, only 9 students graduated from the program, whereas only 6 graduated from the second intake of 24 students. This low graduation rate is attributable to a combination of substandard academic performance and student dropout. The aim …

Challenges And Opportunities For Implementing Evidence-Based Antenatal Care In Mozambique: A Qualitative Study, Adriano Biza, Ingeborg Jille-Traas, Mercedes Colomar, Maria Belizan, Jennifer Requejo Harris, Beatrice Crahay, Mario Merialdi, My Huong Nguyen, Fernando Althabe, Alicia Aleman, Eduardo Berge, Alicia Carbonell, Leonardo Chavane, Therese Delvaux, Diederike Geelhoed, Metin Gülmezoglu, Celsa Regina Malapende, Armando Melo, Nafissa Bique Osman, Mariana Widmer, Marleen Temmerman, Ana Pilar Betrán

Obstetrics and Gynaecology, East Africa

Background: Maternal mortality remains a daunting problem in Mozambique and many other low-resource countries. High quality antenatal care (ANC) services can improve maternal and newborn health outcomes and increase the likelihood that women will seek skilled delivery care. This study explores the factors influencing provider uptake of the recommended package of ANC interventions in Mozambique.

Methods: This study used qualitative research methods including key informant interviews with stakeholders from the health sector and a total of five focus group discussions with women with experience with ANC or women from the community. Study participants were selected from three health centers located …

The Development Of A Public Optometry System In Mozambique: A Cost Benefit Analysis, James Loughman, Stephen Thompson, Geoff Harris, Luigi Bilotto, Jorge Ferrao, Kovin Naidoo

Articles

Background: The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa. …

An Economic Analysis Of The Impact Of Refractive Error In Mozambique, Stephen Thompson

Conference Papers

Mozambique eyecare project carried out in June 2013 to estimate the socio-economic benefit of an Optometry Programme by calculating the benefits of addressing refractive error in terms of productivity gained as a result of the intervention.

The Development Of A Public Optometry System In Mozambique: A Cost Benefit Analysis, Stephen Thompson, James Loughman

Articles

The economic burden of uncorrected refractive error (URE) is thought to be high in Mozambique, largely as a consequence of the lack of resources and systems to tackle this largely avoidable problem. The Mozambique Eyecare Project (MEP) has established the first optometry training and human resource deployment initiative to address the burden of URE in Lusophone Africa. The nature of the MEP programme provides the opportunity to determine, using Cost Benefit Analysis (CBA), whether investing in the establishment and delivery of a comprehensive system for optometry human resource development and public sector deployment is economically justifiable for Lusophone Africa.

Considerations In The Design Of An Eye Health Programme For Nampula, Mozambique, Aoife Phelan, Lisa O'Donoghue, Kovin Naidoo, Kathryn Saunders, James Loughman

Conference Papers

Introduction/Purpose:

There are almost twelve million children (<18 >years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3]

In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself …

Considerations In The Design Of An Eye Health Programme For Nampula, Mozambique, Aoife Phelan, Lisa O'Donoghue, Kovin Naidoo, Kathryn Saunders, James Loughman

Other

Introduction/Purpose:

There are almost twelve million children (years) in Mozambique with minimal access to eye care. [1] Annual screening of school children by teachers for uncorrected refractive error is one of the most cost effective health interventions in Sub Saharan Africa.[2] The International Agency for the Prevention of Blindness (IAPB) has recommended that child eye health interventions be incorporated into National School Health Initiatives.[3]

In view of the IAPB position this presentation sets out to identify and discuss the main considerations in the design of a child eye health strategy, for the province of Nampula, Mozambique, which aligns itself with …

The Development Of A Public Optometry System In Mozambique: A Cost Benefit Analysis, Stephen Thompson, James Loughman

Conference Papers

No abstract provided.

Addressing Uncorrected Refractive Error Through Human Resource Development In The Context Of Mozambique, Stephen Thompson, James Loughman, Prasidh Ramson, Luigi Bilotto, Kovin Naidoo

Conference Papers

This paper presents results from a national situational analysis. An International Agency for Prevention of Blindness (IAPB) tool was used to map current eye care services recorded including human resource and equipment. Data was analysed against VISION 2020 Human Resource targets.

Addressing The Burden Of Uncorrected Refractive Error In Mozambique, Stephen Thompson, James Loughman, Prasidh Ramson, Luigi Bilotti, Geoff Harris, Kovin Naidoo

Conference Papers

A situational analysis indicates a lack of eye health personnel who can and do refract. The logical course of action would be to train more eye health personnel. A conservative estimated annual burden of URE in lost productivity in Mozambique is $14,486,692. To achieve the V2020 target ratio, an extra 184 workers are needed in six provinces analysed.The analysis assumes the existing personnel are well trained and dedicate time to offering a refraction service. It also assumes that the patient receives the care they require. Other aspects of the situational analysis suggest this is currently not always the case. A …

One Student One Family And The Mozambique Eyecare Project, Stephen Thompson, Aoife Phelan, Tatiana Santana, Elizebete Catarino, Vivien Ocampo, Cesar Faria, James Loughman

Articles

Background - The Mozambique Eyecare Programme is funded by Irish Aid and designed to address the need for optometric education in Lusophone Africa. It is a multi-partner collaboration between Universidade Lúrio, Mozambique, Technological University Dublin, Ireland, University of Ulster, Northern Ireland, and The International Centre for Eyecare Education (ICEE) an international Non Government Organisation. A key output from the programme is the development of an optometry school based at Universidade Lúrio, the first of its kind in Mozambique. The aim is to address unmet eye care needs through human resource development.

All students enrolled at Universidade Lúrio, including the optometry …

The Mozambique Eyecare Programme – A Partnership Which Addresses Avoidable Blindness In Lusophone Africa, Aoife Phelan, James Loughman, Eva Doyle

Conference Papers

According to the WHO about 831 million people are visually impaired worldwide, 45 million of them are blind. Most people with visual impairment are older, and females are more at risk at every age, in every part of the world. Uncorrected Refractive Error accounts for over half of all visual impairment. About 87% of the worlds visually impaired live in developing countries. The Mozambique Eyecare Programme (MEP) is a cross institutional collaboration between governments, higher education institutions, non-governmental organisations and corporations. The aims of this Programme are to collaborate to provide a sustainable solution to the problem of avoidable blindness …

Reproductive Health Services For Populations At High Risk Of Hiv: Performance Of A Night Clinic In Tete Province, Mozambique, Yves Lafort, Diederike Geelhoed, Luisa Cumba, Carla Das Dores Mosse Lázaro, Wim Delva, Stanley Luchters, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Background: Different models exist to provide HIV/STI services for most-at-risk populations (MARP). Along the Tete traffic corridor in Mozambique, linking Malawi and Zimbabwe, a night clinic opening between 4 and 10 PM was established targeting female sex workers (FSW) and long-distance truck drivers (LDD). The clinic offers free individual education and counselling, condoms, STI care, HIV testing, contraceptive services and outreach peer education. To evaluate this clinic model, we assessed relevance, service utilisation, efficiency and sustainability.

Methods: In 2007-2009, mapping and enumeration of FSW and LDD was conducted; 28 key informants were interviewed; 6 focus group discussions (FGD) were held …