Osvaldo Inlamea

Transmission of water, vector, and foodborne diseases tends to increase with climate variability, disproportionately affecting vulnerable communities. Globally, this dynamic contributes to adverse health outcomes in low- and middle-income countries such as Mozambique. Nevertheless, the influence of climate variability on disease patterns remains unclear. We assessed the potential relationship between climate variables and diseases, including diarrheal diseases, malaria, and malnutrition, in four districts around the Revuè sub-basin. An ecological, longitudinal, retrospective study conducted from 2016 to 2024 used secondary weekly disease data and annual malnutrition records. We applied a Generalized Additive Model framework to evaluate non-linear associations between climate factors and disease case counts. Our main findings showed that while higher maximum temperature was associated with increased cumulative malaria case counts, cumulative and heavy rainfall (~100 mm/week) was associated with decreased diarrheal disease case counts. Higher prevalence of moderate acute malnutrition is associated with a decrease in annual mean total precipitation (p = 0.0062). In contrast, higher prevalence of severe acute malnutrition is associated with a decrease in annual mean temperature (p = 0.0312). This study contributes to understanding climate variables associated with water, vector, and foodborne diseases, enhancing our understanding of factors contributing to overall food insecurity and affecting public health.

Background: The global nutrition crisis continues to disproportionately affect vulnerable populations’ health in regions where artisanal mining is high. Objective: This study assessed the nutritional status of children, adolescents, and women living in the Revuè sub-basin, who are potentially exposed to heavy metal contaminants. Methods: An observational and cross-sectional design was used to combine anthropometric and sociodemographic data with laboratory analysis for the assessment of heavy metal contaminants in drinking water sources. Results: Results indicated a high prevalence of stunting among children under five (28.4% of boys and 19.9% of girls) while female adolescents were underweight (25.7%), particularly during the rainy season. In contrast, 19% of women were overweight and 3.1% were obese. A modified Poisson regression analysis revealed a significant negative association between mercury exposure (RR = 0.77, p = 0.02) and stunting in children, whereas higher educational attainment among husbands was protective for women (RR = 0.76, p = 0.03). The assessment of mercury exposure through water consumption showed statistically significant variations across regions and seasons (p < 0.001). Water analyses identified high concentrations of arsenic (0.03 mg/L, 95% CI: 0.02–0.10) and mercury (0.09 mg/L (95% CI: 0.003–0.009), exceeding safety standards. Conclusion: Overall, these findings highlight the nutritional and health risks potentially linked to artisanal mining.

Introduction: Low- and middle-income countries are facing a new double burden: an increasing frequency of extreme weather events that disrupt healthcare services for people living with non-communicable diseases (NCDs) and a rising prevalence of NCDs. In Mozambique, NCDs are the second leading cause of death among adults, and climate-related disasters, occurring with increasing intensity, exacerbate this problem. Objective: This study aims to understand the challenges and opportunities for addressing the needs of persons living with NCDs in the aftermath of extreme weather events in Mozambique between 2019 and 2023. Methods: This qualitative study employed a combination of focus group discussions (FGD) and in-depth interviews in five provinces severely affected by cyclones. A total of 36 in-depth interviews were conducted with key stakeholders and individuals living with NCDs. Five FGDs were held with community members. Rapid qualitative analysis was used to identify themes, which were presented using the socioecological model (SEM) framework. Results: Three main themes and 14 subthemes emerged. The main themes were: (1) an overall lack of disaster preparedness leading to challenges for the general population; (2) persons with NCDs could not adequately manage their condition; and (3) the need to integrate NCD management into disaster preparedness and response plans. Barriers to NCD management were identified at all levels of the SEM, with the majority at the organisational level. Participants identified recommendations that can serve as models for addressing some identified barriers. Conclusion: Persons living with NCDs cannot adequately manage their conditions during extreme weather events in Mozambique due to barriers at all levels of the SEM. Addressing this challenge requires multilevel strategies that integrate NCD management into disaster preparedness and response plans, leverage existing programmes and strengthen health system resilience. Future work needs to evaluate the implementation of integrated disaster response plans to inform scale-up and scale-out.

Background: To reduce the spread and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), schools implemented a series of non-pharmacological interventions such as handwashing stations and cleaning protocols. A baseline assessment of the available interventions and readiness scores for SARS-CoV-2 prevention was conducted in primary schools in Maputo City, Mozambique. Methods: A cross-sectional study was conducted between August and October 2023. Data were collected using a semi-structured questionnaire that assessed the availability of preventive measures. Readiness scores were calculated, based on the relative frequency of available preventive measures against SARS-CoV-2, recommended by the government. Schools with readiness scores of 100% were considered ready. Results: Of the enrolled schools, 60.6% (66/109) were from the public sector. The median readiness score for preventive measures against SARS-CoV-2 implemented in schools was 70%. Water was the most frequent available measure, with 98.2% (107/109). Ash/soap for handwashing (47.7% [52/109]) and functioning thermometers (31.2% [34/109]) were the least available measures. Private schools showed significantly higher readiness scores compared with public schools (p<0.001). Conclusions: Private compared with public schools had higher readiness scores for preventive measures against SARS-CoV-2 in Maputo City, Mozambique. These findings suggest a need for targeted interventions to improve readiness in public schools.

The epidemiology and characteristics of SARS-CoV-2 in the hospitalized Mozambican pediatric population are scarce. We aimed to assess the burden of COVID-19 in the pediatric population at Hospital Central de Maputo and identify comorbidities and factors associated with death among hospitalized COVID-19 cases. A cross-sectional study was conducted from October 2020 to October 2022. Available records were retrieved from admission books. Univariate and bivariate analyses were reported to describe the sample characteristics. The frequency of pediatric cases admitted with COVID-19 was 0.6% (95% confidence interval (CI): 0.5–0.6; 364/63,753), and the frequency of pediatric cases hospitalized with COVID-19 was 2.5% (95% CI: 2.2–2.9; 173/6807). The monthly frequency of pediatric cases admitted and hospitalized with COVID-19 ranged from 0.1% to 5.4% and from 0.2% to 42.1%, respectively. In children hospitalized with COVID-19, underweight was the most observed comorbidity (17.4%; 19/109); death was observed in 30% (95% CI: 22.2–39.1; 33/110), and it was significantly higher in underweight children than in non-underweight children (61.5% [8/13] vs. 21.3% [16/75]; p-value = 0.005). Given the heightened risk of mortality among undernourished children compared to non-undernourished children, vaccination for COVID-19 should be prioritized for undernourished children.

Background: Emerging zoonotic diseases are an increasing threat to public health. There is little data on the seroprevalence of zoonotic diseases among pastoralists in the country. We aim to carry out a cross-sectional study on the prevalence of major zoonotic diseases among pastoral communities in the Caia and Búzi districts. Methods: Between January and December 2018, a questionnaire was used to solicit socio-demographic data from consenting pastoralists with the collection of blood samples in the Caia and Búzi districts of the Sofala province. All samples were tested using ELISA commercial reagents for the detection of IgM antibodies against Brucella and Leptospira. Likewise, IgM and IgG antibodies against Rickettsia and CCHFV were determined using ELISA kits. Results: A total of 218 samples were tested, of which 43.5% (95/218) were from the district of Caia and 56.4% (123/218) from the Búzi district. Results from both districts showed that the seroprevalence of IgM antibodies against Brucella and Leptospira was 2.7% (6/218) and 30.3% (67/218), respectively. Positivity rates for IgM and IgG anti-Rickettsia and CCHFV were 8.7% (19/218), 2.7% (6/218), 4.1% (9/218), and 0.9% (2/218), respectively. Conclusions: Results from our study showed evidence of antibodies due to exposure to Brucella, Leptospira, Rickettsia, and CCHFV with antibodies against Leptospira and Rickettsia being the most prevalent. Hence, laboratory diagnosis of zoonotic diseases is essential in the early detection of outbreaks, the identification of silent transmission, and the etiology of non-febrile illness in a pastoral community. There is a need to develop public health interventions that will reduce the risk of transmission.

Climate change (CC) poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, a climate-vulnerable nation, has experienced significant natural disasters in the past 42 years, impacting its health system. This study aims to assess Mozambique’s health sector vulnerability and adaptation needs to climate change. Following a methodology proposed by the World Health Organization and Intergovernmental Panel for Climate Change, a six-step vulnerability and adaptation assessment was conducted. The Health Vulnerability Index (HVI), integrating historical climate, epidemiological, and socio-economic data at the district level (n=162), was computed using exposure, sensitivity, and adaptive capacity dimensions. The Results revealed spatial patterns in exposure to climate variables, extreme weather events, and variations in sensitivity and adaptive capacity across the country. The HVI mirrored the exposure findings. Notably, high vulnerability was observed in several districts, while major urban centers displayed lower vulnerability. These findings highlight the country’s vulnerability to climate change and underscore the potential for adverse impacts on livelihoods, the economy, and human health. The study provides a foundation for developing strategies and adaptation actions.

Background and objective: Changes in climate patters have been reported around the world. There is evidence that such changes can affect human health, particularly with climate sensitive diseases like Malaria and diarrhea. This effects are exacerbated in low and middle-income countries such as...

The floods associated with the landfall of cyclones Idai and Kenneth in Mozambique between March and April 2019 had a major impact on the country’s public health, and placed the affected population at risk for vector- and rodent-borne diseases. Aiming to improve the diagnostic capacity, yield...