Young at risk-people in Maputo City, Mozambique, present a high willingness to participate in HIV trials: Results from an HIV vaccine preparedness cohort study

Introduction Vaccine efficacy testing requires engagement of willing volunteers with high disease incidence. We evaluated factors associated with willingness to participate in potential future HIV vaccine trials in Maputo, Mozambique. Methods Adults aged 18–35 years without HIV and who reported at least two sexual partners in the 3 months prior to screening were enrolled into a 24-month observational study. They were asked at screening and exit if they would be willing to participate in a theoretical HIV vaccine study. Bivariate and multivariate logistic regression analyses were done between willingness to participate, demographic, sexual behavior, and motivational factors for screening visit data. Logistic regression with generalized estimating equations (GEE) was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors potentially associated with willingness to participate for data from both visits. Results A total of 577 participants without HIV were eligible, including 275 (48%) women. The mean age was 22.2 (SD ± 3.9) years. At screening 529 (92%) expressed willingness to participate and the proportion remained stable at 378 (88%) of the 430 participants retained through the exit visit (p = 0.209). Helping the country (n = 556) and fear of needles (n = 26) were the top motive and barrier for willingness to participate, respectively. Results from the GEE binary logistic regression (screening visit and exit visit) showed that wanting to learn how to avoid risk behaviors (aOR 3.33, 95% CI: 1.61–6.86) and feeling protected against HIV infection (aOR 2.24, 95% CI: 1.07–4.7) were associated with willingness to participate in HIV vaccine studies. Conclusion The majority of our study population in Mozambique expressed willingness to participate in a theoretical HIV vaccine trial. Participation in a HIV vaccine trial was seen as a way to contribute to the fight against HIV but was associated with some unrealistic expectations such as protection against HIV. This reinforces the need for continuous mobilization and awareness of potential participants to HIV vaccine trial.

Rationing of Electricity in Maputo City Residences through Education and Awareness Actions

The level of rational use of electricity consumption by households in Mozambique is very low. This paper assesses whether, with the implementation of education and awareness actions through the door-to-door method, is possible to change the consumption habits and rationalize residential electricity consumption in Maputo city, Mozambique. The data was collected through questionnaires, observations, and interviews related to the habits of electricity consumption, the use of electrical equipment, and consumption of household appliances. This was followed by awareness creation on the use of electricity. The results show that after the campaign, the level of knowledge of the measures of rational use of electricity by consumers was increased by 55.3%, the level of adoption of the measures learned was increased by 30.5% and the monthly household consumption was decreased by 16.8%. Household consumption depends on the electrical equipment, and replacement of at least one 60W incandescent lamp in each residence with a 15W fluorescent lamp could bring a significant reduction in energy consumption. For example, the annual consumption of each family can be reduced by 94KWh and 23GWh in the entire City. The low level of rational use of electricity in Maputo city is due to lack of knowledge of the measures and little adoption of the known measures, use of inefficient equipment, low availability of the efficient equipment in the local markets, high cost of efficient technologies, and houses that offer few opportunities for rationing. Rationing; Electricity consumers; Habits; Awareness; Maputo; Mozambique.

How prepared is Mozambique to treat COVID-19 patients? A new approach for estimating oxygen service availability, oxygen treatment capacity, and population access to oxygen-ready treatment facilities

Background This study aims to assess the COVID-19 response preparedness of the Mozambican health system by 1) determining the location of oxygen-ready public health facilities, 2) estimating the oxygen treatment capacity, and 3) determining the population coverage of oxygen-ready health facilities in Mozambique. Methods This analysis utilizes information on the availability of oxygen sources and delivery apparatuses to determine if a health facility is ready to deliver oxygen therapy to patients in need, and estimates how many patients can be treated with continuous oxygen flow for a 7-day period based on the available oxygen equipment at health facilities. Using GIS mapping software, the study team modeled varying travel times to oxygen-ready facilities to estimate the proportion of the population with access to care. Results 0.4% of all health facilities in Mozambique are prepared to deliver oxygen therapy to patients, for a cumulative total of 283.9 to 406.0 patients-weeks given the existing national capacity, under varying assumptions including ability to divert oxygen from a single source to multiple patients. 35% of the population in Mozambique has adequate access within one-hour driving time of an oxygen-ready health facility. This varies widely by region; 89.1% of the population of Maputo City was captured by the one-hour driving time network, as compared ot 4.4% of the population of Niassa province. Conclusions The Mozambican health system faces the dual challenges of under-resourced health facilities and low geographic accessibility to healthcare as it prepares to confront the COVID-19 pandemic. This analysis also illustrates the disparity between provinces in preparedness to deliver oxygen therapy to patient, with Cabo Delgado and Nampula being particularly under-resourced.

Sanitary governmentalities: Producing and naturalizing social differentiation in Maputo City, Mozambique (1887–2017)

Maputo, Mozambique’s capital city, is marked by clear socio-spatial divisions in access to sanitation services and distributions of environmental risks. Current development plans tend to reproduce these inequalities and suggest that some residents’ sanitary needs are more important than others. We contest this logic of differentiation underpinning current interventions in Maputo, revealing how the assumption of different sanitary needs has become normalized and naturalized in the urban environment. We use a genealogy of sanitation in Maputo and the former colonial city of Lourenço Marques to trace how colonial power relations worked to normatively distinguish urban spaces and the people who live in them, making some residents and places more deserving of public protection and investments than others. Drawing on Foucauldian theorizations of governmentality, we analyse colonial authorities’ sanitary plans and interventions to show how differences and separations between spaces and bodies were and are produced. Projects of drainage and land reclamation created clean, dry and sanitary habitats for the privileged white few, the existence of which simultaneously created the wet, unhealthy and muddy spaces deemed good enough for the non-white majority. Such manufactured spatial distinctions, in turn, worked to strengthen the perception of differences in cleanliness between people. These differences were consequently mobilized by the Lourenço Marques health service to further mark and legitimize racial segregation. This is how social and spatial inequalities became naturalized in the urban environment over time, culminating in the stark sanitary divides that continue to mark the contemporary city.

High Frequency of Cryptosporidium hominis Infecting Infants Points to A Potential Anthroponotic Transmission in Maputo, Mozambique

Cryptosporidium is one of the most important causes of diarrhea in children less than 2 years of age. In this study, we report the frequency, risk factors and species of Cryptosporidium detected by molecular diagnostic methods in children admitted to two public hospitals in Maputo City, Mozambique. We studied 319 patients under the age of five years who were admitted due to diarrhea between April 2015 and February 2016. Single stool samples were examined for the presence of Cryptosporidium spp. oocysts, microscopically by using a Modified Ziehl–Neelsen (mZN) staining method and by using Polymerase Chain Reaction and Restriction Fragment Length Polymorphism (PCR-RFLP) technique using 18S ribosomal RNA gene as a target. Overall, 57.7% (184/319) were males, the median age (Interquartile range, IQR) was 11.0 (7–15) months. Cryptosporidium spp. oocysts were detected in 11.0% (35/319) by microscopy and in 35.4% (68/192) using PCR-RFLP. The most affected age group were children older than two years, [adjusted odds ratio (aOR): 5.861; 95% confidence interval (CI): 1.532–22.417; p-value < 0.05]. Children with illiterate caregivers had higher risk of infection (aOR: 1.688; 95% CI: 1.001–2.845; p-value < 0.05). An anthroponotic species C. hominis was found in 93.0% (27/29) of samples. Our findings demonstrated that cryptosporidiosis in children with diarrhea might be caused by anthroponomic transmission.

Geographic information system and multi-criteria decision analysis as an assessment method for landfill site selection

&lt;p&gt;Municipal solid waste (MSM) has been increasingly difficult to deal with, especially for cities of developing countries. In these cities, the increase in waste generation leads to open dumping and the development of landfills without the consideration of environmental assessment and monitoring, which may result in environmental disturbance and risk to human health. Therefore, the main goal of this study was to access the adequacy of the placement of new landfills for Maputo city, Mozambique. The study used the geographic information system (GIS) based on a multi-criteria decision approach that combined environmental, social, and technical variables to aid in the assessment of potential landfill sites. Results indicate that approximately 50% of the area is suitable for landfill placement. A further on-site evaluation is important to validate the obtained results, nonetheless, this preliminary site selection can be integrated into the MSW landfill selection to optimize waste management.&lt;/p&gt;

Identifying the commonly used antibiotics for self-medication in urban Mozambique: a qualitative study

ObjectivesThe study aimed at identifying the commonly used non-prescribed antibiotics (NPAs) and the main health conditions leading to the practices of self-medication with antibiotics (SMAs) in Maputo city, Mozambique.DesignCross-sectional qualitative study based on individual and group interviews.SettingThe study was conducted in nine pharmacies of three socioeconomic areas of Maputo city, from October 2018 to March 2019.ParticipantsThe study included 32 pharmacy clients and 17 pharmacists. The pharmacy clients included men 10 (31%) and women 22 (69%) ranging from 19 to 67 years while the pharmacists included men 6 (35,3%) and women 11 (64,7%) with ages ranging from 24 to 47 years.FindingsThe majority of the pharmacy clients 30 (93.75%) admitted frequent use of NPAs, 15 (88.2%) out of the 17 pharmacists admitted dispensing NPAs. While the majority of the participants (16) mentioned the use of amoxicillin, also known as ‘two colours medicine’, 14 mentioned the use of cotrimoxazole and seven mentioned amoxicillin with clavulanic acid. Two to five participants also used tetracycline, ciprofloxacin, azithromycin, doxycycline, erythromycin, metronidazole and phenoxymethylpenicillin. The above mentioned NPAs were used to treat self-perceived sore throat, fever, pain, cough, vaginal discharge, eye problems, the common influenza, urinary infections, respiratory tract infections, wounds and toothaches.ConclusionsAntibiotics are perceived as essential medical resources to manage health and illnesses. While taking an active role in their health-disease process, participants commonly used amoxicillin, ‘two colours’, cotrimoxazole and amoxicillin with clavulanic acid to manage their health and that of their families. In this sense, the practices of SMAs were perceived as part of the self-care process and not necessarily as misuse of antibiotics. A wideunderstanding of health-seeking beliefs and behaviours regarding the utilisation of antibiotics is needed to inform public health experts, health policymakers and other stake-holders in designing and implementing public health education and health promotion programsat all levels in Mozambique.