RESUMEN
Background: Mozambique suffers recurrent annual cholera outbreaks especially during the rainy season between October to March. The African Cholera Surveillance Network (Africhol) was implemented in Mozambique in 2011 to generate accurate detailed surveillance data to support appropriate interventions for cholera control and prevention in the country. Methodology/principal findings: Africhol was implemented in enhanced surveillance zones located in the provinces of Sofala (Beira), Zambézia (District Mocuba), and Cabo Delgado (Pemba City). Data were also analyzed from the three outbreak areas that experienced the greatest number of cases during the time period under observation (in the districts of Cuamba, Montepuez, and Nampula). Rectal swabs were collected from suspected cases for identification of Vibrio cholerae, as well as clinical, behavioral, and socio-demographic variables. We analyzed factors associated with confirmed, hospitalized, and fatal cholera using multivariate logistic regression models. A total of 1,863 suspected cases and 23 deaths (case fatality ratio (CFR), 1.2%) were reported from October 2011 to December 2015. Among these suspected cases, 52.2% were tested of which 23.5% were positive for Vibrio cholerae O1 Ogawa. Risk factors independently associated with the occurrence of confirmed cholera were living in Nampula city district, the year 2014, human immunodeficiency virus infection, and the primary water source for drinking. Conclusions/significance: Cholera was endemic in Mozambique during the study period with a high CFR and identifiable risk factors. The study reinforces the importance of continued cholera surveillance, including a strong laboratory component. The results enhanced our understanding of the need to target priority areas and at-risk populations for interventions including oral cholera vaccine (OCV) use, and assess the impact of prevention and control strategies. Our data were instrumental in informing integrated prevention and control efforts during major cholera outbreaks in recent years.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Cólera/epidemiología , Estaciones del Año , Factores Socioeconómicos , Vigilancia de la Población , Enfermedades Endémicas , Mozambique/epidemiologíaRESUMEN
Background: In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities. Methodology/principal findings: We reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01). Conclusions/significance: Implementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures...
Asunto(s)
Humanos , Animales , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Rabia/mortalidad , Rabia/prevención & control , Brotes de Enfermedades/prevención & control , Profilaxis Posexposición/métodos , Hepatitis Infecciosa Canina/prevención & control , Mordeduras y Picaduras de Insectos/epidemiología , Mordeduras y Picaduras/prevención & control , Factores de Riesgo , MozambiqueRESUMEN
Para determinar a prevalência, identificar os comportamentos de risco e os níveis de informaçäo sobre a esquistossomose urinária, realizou-se um estudo transversal, entre outubro e novembro de 1996, em três escolas primárias da Area de Saúde 1§ de Junho, na cidade de Maputo, Moçambique. Efetuaram-se inquéritos epidemiológicos e recolheram-se amostras únicas de urina de 434 escolares de ambos os sexos, selecionados ao acaso, da segunda a quinta classes. A idade média foi de 11,3 anos (amplitude 6-16). A prevalência encontrada foi de 11,3 por cento (49/434). O grupo etário de 15 e mais anos apresentou a prevalência mais elevada (13,6 por cento), enquanto o de 10 a 14 anos, a maior intensidade de infecçäo (204 ovos/10 ml de urina). Apenas 18,9 por cento dos escolares já tinham ouvido falar na doença. Destes, só 19,5 por cento (16/82) sabiam como esta se manifestava. Cerca de 50 por cento dos escolares reportaram contatos freqüentes com potenciais focos de transmissäo de esquistossomose. Os resultados sugerem que a esquistossomose urinária é um problema de saúde pública nas escolas da Area de Saúde 1§ de Junho.