Catholic University of Mozambique
Beira, Mozambique

The Catholic University of Mozambique is a university in Mozambique. The university was founded on 10 August 1996 by the Mozambican conference of Bishops. At the time, higher education in Mozambique was only available in the capital, Maputo. The university currently has locations in Beira, Chimoio, Cuamba, Nampula, Pemba, Quelimane and Tete. One of the intentions was to make higher education available to central and northern Mozambique. As of 2007, approximately 3,270 students were enrolled at the university. The rector is Prof. Dr. Padre Alberto Ferreira. Wikipedia.

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Ferrao J.L.,Catholic University of Mozambique | Mendes J.M.,New University of Lisbon | Painho M.,New University of Lisbon | Zacarias S.,Direccao Provincial de Saude de Manica
Malaria Journal | Year: 2017

Background: The United Nation’s sustainable development goal for 2030 is to eradicate the global malaria epidemic, primarily as the disease continues to be one of the major concerns for public health in sub-Saharan Africa. In 2015, the region accounted for 90% of malaria deaths. Mozambique recorded a malaria mortality rate of 42.75 (per 100,000). In Chimoio, Mozambique’s fifth largest city, malaria is the fourth leading cause of death (9.4%). Few data on malaria mortality exists in Mozambique, particularly in relation to Chimoio. The objective of this study was to characterize malaria mortality trends and its spatial distribution in Chimoio. Methods: Malaria mortality data and climate data were extracted from the Chimoio Civil Registration records, and the Regional Weather station, from 2010 to 2014. The malaria crude mortality rate was calculated. ANOVA, Tukey’s, Chi square, and time series were carried out and an intervention analysis ARIMA model developed. Results: A total of 944 malaria death cases were registered in Chimoio, 729 of these among Chimoio residents (77%). The average malaria mortality by gender was 44.9% for females and 55.1% for males. The age of death varied from 0 to 96 years, with an average age of 25.9 (SE = 0.79) years old. January presented the highest average of malaria deaths, and urban areas presented a lower crude malaria mortality rate. Rural neighbourhoods with good accessibility present the highest malaria crude mortality rate, over 85 per 100,000. Seasonal ARMA (2,0)(1,0)12 fitted the data although it was not able to capture malaria mortality peaks occurring during malaria outbreaks. Intervention effect properly fit the mortality peaks and reduced ARMA’s root mean square error by almost 25%. Conclusion: Malaria mortality is increasing in Chimoio; children between 1 and 4 years old represent 13% of Chimoio population, but account for 25% of malaria mortality. Malaria mortality shows seasonal and spatial characteristics. More studies should be carried out for malaria eradication in the municipality. © 2017 The Author(s).

Ferrao J.L.,Catholic University of Mozambique | Mendes J.M.,New University of Lisbon | Painho M.,New University of Lisbon
Parasites and Vectors | Year: 2017

Background: Mozambique was recently ranked fifth in the African continent for the number of cases of malaria. In Chimoio municipality cases of malaria are increasing annually, contrary to the decreasing trend in Africa. As malaria transmission is influenced to a large extent by climatic conditions, modelling this relationship can provide useful insights for designing precision health measures for malaria control. There is a scarcity of information on the association between climatic variability and malaria transmission risk in Mozambique in general, and in Chimoio in particular. Therefore, the aim of this study is to model the association between climatic variables and malaria cases on a weekly basis, to help policy makers find adequate measures for malaria control and eradication. Methods: Time series analysis was conducted using data on weekly climatic variables and weekly malaria cases (counts) in Chimoio municipality, from 2006 to 2014. All data were analysed using SPSS-20, R 3.3.2 and BioEstat 5.0. Cross-correlation analysis, linear processes, namely ARIMA models and regression modelling, were used to develop the final model. Results: Between 2006 and 2014, 490,561 cases of malaria were recorded in Chimoio. Both malaria and climatic data exhibit weekly and yearly systematic fluctuations. Cross-correlation analysis showed that mean temperature and precipitation present significantly lagged correlations with malaria cases. An ARIMA model (2,1,0) (2,1,1)52, and a regression model for a Box-Cox transformed number of malaria cases with lags 1, 2 and 3 of weekly malaria cases and lags 6 and 7 of weekly mean temperature and lags 12 of precipitation were fitted. Although, both produced similar widths for prediction intervals, the last was able to anticipate malaria outbreak more accurately. Conclusion: The Chimoio climate seems ideal for malaria occurrence. Malaria occurrence peaks during January to March in Chimoio. As the lag effect between climatic events and malaria occurrence is important for the prediction of malaria cases, this can be used for designing public precision health measures. The model can be used for planning specific measures for Chimoio municipality. Prospective and multidisciplinary research involving researchers from different fields is welcomed to improve the effect of climatic factors and other factors in malaria cases. © 2017 The Author(s).

Posse M.,Catholic University of Mozambique | Posse M.,Radboud University Nijmegen | Tirivayi N.,Maastricht University | Saha U.R.,Radboud University Nijmegen | Baltussen R.,Radboud University Nijmegen
Journal of AIDS and Clinical Research | Year: 2013

Background: The availability of Antiretroviral Treatment (ART) has changed the course of HIV/AIDS, by transforming it into a chronic condition. However, important challenges remain in the management of HIV/AIDS. These challenges are exacerbated by the fact that in resource limited settings, food insecurity and HIV/AIDS overlap. The aim of our study was to evaluate the effect of a food assistance program on adherence to ART in Sofala province, Mozambique. Methods: In order to assess the effect of the food assistance program on adherence we used propensity score matching with difference in differences estimation. We compared food assistance recipients with controls. We measured adherence based on pill pick-up, a pharmacy adherence measure. Results: During the food assistance programme, the adherence of food assistance recipients who received food assistance for a period of six and 12 months and non-food assistance recipients is not significantly different as the average impact is only 0.4% (p=0.94) and -2.3% (p=0.73) respectively. For the period after food assistance had been terminated, adherence is still not significantly different between the two groups, as the average impact is 5.3% (p=0.44) and 1.9% (p=0.65). Conclusion: Our study suggests that food assistance provided to HIV/AIDS patients in Sofala province in Mozambique had no effect on their adherence to ART. Our results indicate that although efforts have been put forth to reduce food insecurity among HIV/AIDS patients, more should be done to ensure that these efforts really result in the improvement of adherence to ART. © 2013 Posse M, et al.

Frambach J.M.,Maastricht University | Manuel B.A.F.,Eduardo Mondlane University | Fumo A.M.T.,Catholic University of Mozambique | Van Der Vleuten C.P.M.,Maastricht University | Driessen E.W.,Maastricht University
Medical Teacher | Year: 2015

Background: Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region.Aim: To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum in a sub-Saharan African context.Methods: Using mixed methods we compared junior doctors and fifth-year students from two Mozambican medical schools: one with an innovative problem- and community-based curriculum and one with a conventional lecture- and discipline-based curriculum. A questionnaire on professional competencies was administered, semi-structured interviews were conducted, and work diaries were collected. The findings were integrated in a conceptual model.Results: Six areas of tension between global health care ideals and local health care practice emerged from the data that challenged doctors' motivation and preparedness for practice. Four elements of the innovative curriculum equipped students and graduates with skills, attitudes and competencies to better cope with these tensions. Students and graduates from the innovative curriculum rated significantly higher levels on various competencies and expressed more satisfaction with the curriculum and its usefulness for their work.Conclusion: An innovative problem- and community-based curriculum can improve sub-Saharan African doctors' motivation and preparedness to tackle the challenges of health care practice in this region. © 2015 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

Millard P.S.,Catholic University of Mozambique | Bru J.,Polytechnic University of Valencia | Berger C.A.,Catholic University of Mozambique
BMJ Open | Year: 2012

Background: Point-of-care electronic medical records (EMRs) are a key tool to manage chronic illness. Several EMRs have been developed for use in treating HIV and tuberculosis, but their applicability to primary care, technical requirements and clinical functionalities are largely unknown. Objectives: This study aimed to address the needs of clinicians from resource-limited settings without reliable internet access who are considering adopting an open-source EMR. Study eligibility criteria: Open-source point-of-care EMRs suitable for use in areas without reliable internet access. Study appraisal and synthesis methods: The authors conducted a comprehensive search of all open-source EMRs suitable for sites without reliable internet access. The authors surveyed clinician users and technical implementers from a single site and technical developers of each software product. The authors evaluated availability, cost and technical requirements. Results: The hardware and software for all six systems is easily available, but they vary considerably in proprietary components, installation requirements and customisability. Limitations: This study relied solely on self-report from informants who developed and who actively use the included products. Conclusions and implications of key findings: Clinical functionalities vary greatly among the systems, and none of the systems yet meet minimum requirements for effective implementation in a primary care resource-limited setting. The safe prescribing of medications is a particular concern with current tools. The dearth of fully functional EMR systems indicates a need for a greater emphasis by global funding agencies to move beyond disease-specific EMR systems and develop a universal open-source health informatics platform.

Pfeiffer A.,Catholic University of Mozambique
Education for health (Abingdon, England) | Year: 2011

A key element of the doctor-patient relationship is to understand the patient's and doctor's perceptions of quality care. To assess the perceptions of good and bad doctors among first-year medical students and local community members in a semi-urban, African settings. Using open-ended and closed dichotomous questions, 115 first-year medical students in Beira, Mozambique were surveyed regarding their perceptions of a 'good' and 'bad' doctor. Students then surveyed 611 community members in a predominately poor, semi-urban neighbourhood. Answers to open-ended questions provided by both groups produced the same four most important positive characteristics, with good diagnostic and therapeutic skills and dedication ranked highest. Closed-ended questions revealed that local community members felt that being concerned/considerate and diagnosing well were equally important (19.5% and 17.5%, respectively) compared to students (17.5% and 41.2%, respectively). The most important negative characteristics to the open-ended question for both groups were discrimination and contemptuous behaviour: 29.3% for community members and 27.4% for medical students. The biggest difference between groups was poor attending skills: 17.3% by community members and 3.9% by medical students. This study highlights differences and similarities between the perceptions of medical students and community members concerning a 'good' and a 'bad' doctor. Our data suggest that perceptions are guided by the experiences and values of those interviewed. Results indicate that medical education in developing countries should focus on patient-centered care, including communication skills and attitudes, besides training knowledgeable doctors.

Posse M.,Catholic University of Mozambique | Posse M.,Radboud University Nijmegen | Baltussen R.,Radboud University Nijmegen
Cost Effectiveness and Resource Allocation | Year: 2013

Background: As care and antiretroviral treatment (ART) for people living with HIV/AIDS become widely available, the number of people accessing these resources also increases. Despite this exceptional progress, the estimated coverage in low- and middle-income countries is still less than half of all people who need treatment. In addition, treatment discontinuation and non-adherence are still concerns for ART programs. Governments and partner institutions have sought to implement a variety of interventions addressing the main reasons behind the low coverage of, discontinuation of, and non-adherence to ART. Food assistance is one of those interventions; increasing evidence suggests that this type of intervention has the potential to improve ART outcomes. However, to our knowledge, no study has estimated its costs in detail. The objective of this study was to assess the costs of a program providing food assistance to HIV/AIDS patients in Sofala province, Mozambique, in 2009.Methods: We performed a retrospective analysis of the costs of providing food assistance, based on financial and economic costs. We used the ingredients approach to estimate costs, which involved multiplying the total estimated quantities of goods and services actually employed in providing the intervention by their respective unit prices.Results: In 2009, the cost of providing food assistance to HIV/AIDS patients was $2.27 million, with capital and recurrent costs accounting for 1% and 99% of total costs, respectively. Food made up the largest component, at 49% of total costs. At 24%, transport operating costs were the second largest item. The cost per patient served was $288 over 3 months.Conclusion: The food distribution program carries significant costs. To assess whether it provides value for money, the present study results should be interpreted in conjunction with the program's impact, and in comparison with other programs that aim to improve adherence to ART. Our costing analysis revealed important management information, indicating that the program incurred relatively large overhead costs. This result raises questions regarding the efficiency of implementing this food distribution program. © 2013 Posse and Baltussen; licensee BioMed Central Ltd.

Millard P.S.,Catholic University of Mozambique
South African Medical Journal | Year: 2012

A key issue facing countries that are scaling up circumcision services is the technical difficulty, resources used, complications, and time to healing using open surgical techniques, the only methods approved by the major external funding agency, PEPFAR. The WHO has developed a framework for evaluating new circumcision devices, and two promising disposable plastic devices that have been partially evaluated are the Shang Ring and the Prepex system. However, given South Africa's disastrous experience with the Tara KLamp, healthy scepticism about plastic ring devices is justified. The Gomco clamp has been used in children and adults since 1935 in the USA, but there are no published studies demonstrating its use in adults. Cyanoacrylate tissue adhesive, widely used in all areas of medicine, has been shown to be superior to sutures in circumcision in terms of safety, ease of use, operative time, and cosmetic results. Our experience in Mozambique suggests that Gomco clamp circumcision plus tissue adhesive closure meets all the WHO criteria for the ideal circumcision technique, and we strongly recommend that African researchers conduct clinical trials to compare it with open surgical circumcision.

Millard P.S.,Catholic University of Mozambique | Millard P.S.,University of Pittsburgh | Wilson H.R.,Catholic University of Mozambique | Veldkamp P.J.,University of Pittsburgh | Sitoe N.,Catholic University of Mozambique
South African Medical Journal | Year: 2013

Background. Voluntary medical male circumcision (VMMC) is a priority HIV preventive intervention. To facilitate male circumcision scaleup, the World Health Organization is actively seeking circumcision techniques that are quicker, easier, and safer than open surgical methods. Objective. To compare conventional open surgical circumcision with suturing with a minimally invasive technique using the Gomco circumcision clamp plus tissue adhesive. Methods. We conducted a non-blinded randomised controlled trial comprising 200 male volunteers >18 years of age, seen at the outpatient university teaching clinic of the Catholic University of Mozambique. We compared two interventions - open surgical circumcision with suturing v. Gomco instrument plus tissue adhesive. Our primary outcome was intraoperative time and our secondary outcomes included: ease of performance, post-operative pain, adverse events, time to healing, patient satisfaction and cosmetic result. Results. The intraoperative time was less with the Gomco/tissue adhesive technique (mean 12.8 min v. 22.5 min; p<0.001). Adverse events were similar except that wound disruption was greater in the Gomco/tissue adhesive group, with no difference in wound healing at 4 weeks. Levels of satisfaction were high in both groups. The cosmetic result was superior in the Gomco/tissue adhesive group. Conclusions. This study has important implications for the scale-up of VMMC services. Removing the foreskin with the Gomco instrument and sealing the wound with cyanoacrylate tissue adhesive in adults is quicker, is an easier technique to learn, and is potentially safer than open surgical VMMC. A disposable plastic, Gomco-like device should be produced and evaluated for use in resource-limited settings.

Dos Anjos Luis A.,Catholic University of Mozambique | Cabral P.,New University of Lisbon
International Journal for Equity in Health | Year: 2016

Background: Access to healthcare services has an essential role in promoting health equity and quality of life. Knowing where the places are and how much of the population is covered by the existing healthcare network is important information that can be extracted from Geographical Information Systems (GIS) and used in effective healthcare planning. The aim of this study is to measure the geographic accessibility of population to existing Healthcare Centers (HC), and to estimate the number of persons served by the health network of Mozambique. Methods: Health facilities' locations together with population, elevation, and ancillary data were used to model accessibility to HC using GIS. Two travel time scenarios used by population to attend HC were considered: (1) Driving and; and (2) Walking. Estimates of the number of villages and people located in the region served, i.e. within 60 min from an HC, and underserved area, i.e. outside 60 min from an HC, are provided at national and province level. Results: The findings from this study highlight accessibility problems, especially in the walking scenario, in which 90.2 % of Mozambique was considered an underserved area. In this scenario, Maputo City (69.8 %) is the province with the greatest coverage of HC. On the other hand, Tete (93.4 %), Cabo Delgado (93 %) and Gaza (92.8 %) are the provinces with the most underserved areas. The driving scenario was less problematic, with about 66.9 % of Mozambique being considered a served area. We also found considerable regional disparities at the province level for this scenario, ranging from 100 % coverage in Maputo City to 48.3 % in Cabo Delgado. In terms of population coverage we found that the problem of accessibility is more acute in the walking scenario, in which about 67.3 % of the Mozambican population is located in underserved areas. For the driving scenario, only 6 % of population is located in underserved areas. Conclusions: This study highlights critical areas in Mozambique in which HC are lacking when assessed by walking and driving travel time distance. The majority of Mozambicans are located in underserved areas in the walking scenario. The mapped outputs may have policy implications and can be used for future decision making processes and analysis. © 2016 The Author(s).

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