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1. Sustained clinical benefit of malaria chemoprevention with sulfadoxine-pyrimethamine (SP) in pregnant women in a region with high SP resistance markers

Author

Matambisso, Glória, Brokhattingen, Nanna, Maculuve, Sónia, Cístero, Pau, Mbeve, Henriques, Escoda, Anna, Bambo, Gizela, Cuna, Boaventura, Melembe, Cardoso, Ndimande, Nelo, Tetteh, Kevin K.A., Drakeley, Chris, Gamain, Benoit, Chitnis, Chetan, Chauhan, Virander, Quintó, Llorenç, Macete, Eusébio, and Mayor, Alfredo

Published
2024
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2. Prevalence of and risk factors for microscopic and submicroscopic malaria infections in pregnancy: a systematic review and meta-analysis

Author

van Eijk, Anna Maria, Stepniewska, Kasia, Hill, Jenny, Taylor, Steve M., Rogerson, Stephen J., Cottrell, Gilles, Chico, R. Matthew, Gutman, Julie R., Tinto, Hallidou, Unger, Holger W., Yanow, Stephanie K., Accrombessi, Manfred, Adegnika, Ayola A., Ahmed, Rukhsana, Arango-Flórez, Eliana María, Arevalo-Herrera, Myriam, Arinaitwe, Emmanual, Arnaldo, Paulo, Ashorn, Per, Ashorn, Ulla, Bardaji, Azucena, Betuela, Inoni, Bharti, Praveen K., Bohissou, Francis, Bôtto-Menezes, Camila, Braun, Vera, Briand, Valerie, Briggs, Jessica, Castellanos, María Eugenia, Chandramohan, Daniel, Chaponda, Enesia Banda, Chitnis, Chetan, Cohee, Lauren M., Cot, Michel, d'Alessandro, Umberto, Denoeud-Ndam, Lise, Desai, Meghna, Dicko, Alassane, Ding, Xavier, Dorsey, Grant, Duffy, Patrick E., Elbadry, Maha A., Enosse, Sonia M., Fan, Yue, Fievet, Nadine, Fried, Michal, Genton, Blaise, Gonzalez, Raquel, Greenwood, Brian, Kalilani, Linda, Kattenberg, Johanna H., Kayentao, Kassoum, Khairallah, Carole, King, Christopher L., Kochar, Dhanpat Kumar, Kochar, Swati, Koukouikila-Koussounda, Felix, Landis, Sarah H., Laufer, Miriam K., Leke, Rose F., Macete, Eusebio, Maculuve, Sonia, Madanitsa, Mwayiwawo, Mahamar, Almahamoudou, Maleta, Ken, Malhotra, Indu, Zoleko Manego, Rella, Martinez-Espinosa, Flor Ernestina, Massougbodji, Achille, Mathanga, Don, Menegon, Michela, Menendez, Clara, Mens, Petra, Meremikwu, Martin, Mockenhaupt, Frank P., Mombo-Ngoma, Ghyslain, Mosha, Dominic, Mueller, Ivo, Nahum, Alain, Natureeba, Paul, Ndam, Nicaise, Ntoumi, Francine, Oduwole, Olabisi A., Okech, Bernard A., Ome-Kaius, Maria, Otieno, Kephas, Padilla, Norma, Ramharter, Michal, Rochford, Rosemary, Rosanas-Urgell, Anna, Ruperez, Maria, Sabourin, Katherine R., Sanz, Sergi, Schallig, Henk D., Scott, Susana, Sevene, Esperanca, Severini, Carlo, Tagbor, Harry, Taylor, Diane Wallace, Traore Coulibaly, Maminata, Vasquez, Ana, Walker-Abbey, Annie, Wylie, Blair J., Zannou, Djimon M., Meshnick, Stephen R., ter Kuile, Feiko O., Mayor, Alfredo, Taylor, Steve M, Rogerson, Stephen J, Chico, R Matthew, Gutman, Julie R, Tinto, Halidou, Unger, Holger W, Yanow, Stephanie K, Meshnick, Steven R, and ter Kuile, Feiko O

Published
2023
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3. The epidemiology of severe malaria at Manhiça District Hospital, Mozambique: a retrospective analysis of 20 years of malaria admissions surveillance data

Author

Guinovart, Caterina, Sigaúque, Betuel, Bassat, Quique, Loscertales, Mari Paz, Nhampossa, Tacilta, Acácio, Sozinho, Machevo, Sónia, Maculuve, Sónia, Bambo, Gisela, Mucavele, Hélio, Soriano-Gabarró, Montse, Saifodine, Abuchahama, Nhacolo, Ariel, Nhalungo, Delino, Sacoor, Charfudin, Saúte, Francisco, Aponte, John J, Menéndez, Clara, Macete, Eusébio, and Alonso, Pedro L

Published
2022
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4. Causes and circumstances of maternal death: a secondary analysis of the Community-Level Interventions for Pre-eclampsia (CLIP) trials cohort

Author

Woo Kinshella, Mai-Lei, Wong, Hubert, von Dadelszen, Peter, Vilanculo, Faustino, Vidler, Marianne, Valá, Anifa, Ukah, Ugochi V, Tu, Domena K, Thabane, Lehana, Tchavana, Corsino, Thornton, Jim, Sotunsa, John O, Singer, Joel, Sheikh, Sana, Sharma, Sumedha, Sevene, Esperança, Schuurman, Nadine, Sawchuck, Diane, Sacoor, Charfudin, Revankar, Amit P, Raza, Farrukh, Ramdurg, Umesh Y, Qureshi, Rahat N, Pires, Rosa, Payne, Beth A, Nobela, Vivalde, Nkumbula, Cláudio, Nhancolo, Ariel, Nhamirre, Zefanias, Munguambe, Khátia, Mungarwadi, Geetanjali I, Mulungo, Dulce, Mocumbi, Sibone, Mitton, Craig, Merialdi, Mario, Memon, Javed, Matavele, Analisa, Mastiholi, Sphoorthi S, Mandlate, Ernesto, Mallapur, Ashalata A, Magee, Laura A, Maculuve, Sónia, Macuacua, Salésio, Macete, Eusébio, Macamo, Marta, Lui, Mansun, Li, Jing, Lewis, Gwyneth, Lewin, Simon, Lee, Tang, Langer, Ana, Kudachi, Uday S, Kodkany, Bhalachandra S, Knight, Marian, Kengapur, Gudadayya S, Kavi, Avinash J, Katageri, Geetanjali, Kariya, Chirag, Karadiguddi, Chandrappa C, Kamble, Namdev A, Joshi, Anjali M, Hutton, Eileen, Hussain, Amjad, Honnungar, Narayan V, Hoodbhoy, Zahra, Grobman, William, Goudar, Shivaprasad S, Gonçálves, Emília, Firoz, Tabassum, Fillipi, Veronique, Filimone, Paulo, Engelbrecht, Susheela M, Dunsmuir, Dustin T, Dumont, Guy, Drebit, Sharla K, Donnay, France, Dharamsi, Shafik, Dhamanekar, Vaibhav B, Derman, Richard, Darlow, Brian, Cutana, Silvestre, Chougala, Keval S, Chiaú, Rogério, Charantimath, Umesh, Byaruhanga, Romano Nkumbwa, Bone, Jeffrey N, Boene, Helena, Biz, Ana Ilda, Bique, Cassimo, Bhutta, Zulfiqar A, Betrán, Ana Pilar, Bellad, Mrutyunjaya B, Bannale, Shashidhar G, Aukes, Annet M, Augusto, Orvalho, Arion, Kristina, Ansermino, J Mark, Amose, Felizarda, Ahmed, Imran, and Adetoro, Olalekan O

Published
2021
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5. Blood pressure thresholds in pregnancy for identifying maternal and infant risk: a secondary analysis of Community-Level Interventions for Pre-eclampsia (CLIP) trial data

Author

Woo Kinshella, Mai-Lei, Wong, Hubert, Vilanculo, Faustino, Vala, Anifa, Ukah, Ugochi V, Tu, Domena K, Thabane, Lehana, Tchavana, Corsino, Thornton, Jim, Sotunsa, John O, Sheikh, Sana, Sharma, Sumedha, Schuurman, Nadine, Sawchuck, Diane, Revankar, Amit P, Raza, Farrukh, Ramdurg, Umesh Y, Pires, Rosa, Payne, Beth A, Nobela, Vivalde, Nkumbula, Cláudio, Nhancolo, Ariel, Nhamirre, Zefanias, Mungarwadi, Geetanjali I, Mulungo, Dulce, Mocumbi, Sibone, Mitton, Craig, Merialdi, Mario, Memon, Javed, Matavele, Analisa, Mastiholi, Sphoorthi S, Mandlate, Ernesto, Maculuve, Sónia, Macuacua, Salésio, Macete, Eusébio, Macamo, Marta, Lui, Mansun, Li, Jing, Lewis, Gwyneth, Lewin, Simon, Lee, Tang, Langer, Ana, Kudachi, Uday S, Kodkany, Bhalachandra S, Knight, Marian, Kengapur, Gudadayya S, Kavi, Avinash J, Katageri, Geetanjali M, Kariya, Chirag, Karadiguddi, Chandrappa C, Kamble, Namdev A, Joshi, Anjali M, Hutton, Eileen, Hussain, Amjad, Hoodbhoy, Zahra, Honnungar, Narayan V, Grobman, William, Gonçálves, Emília, Firoz, Tabassum, Fillipi, Veronique, Filimone, Paulo, Engelbrecht, Susheela M, Dunsmuir, Dustin T, Dumont, Guy, Drebit, Sharla K, Donnay, France, Dharamsi, Shafik, Dhamanekar, Vaibhav B, Derman, Richard, Darlow, Brian, Cutana, Silvestre, Chougala, Keval S, Chiaú, Rogério, Charantimath, Umesh S, Byaruhanga, Romano Nkumbwa, Boene, Helena, Biz, Ana Ilda, Bique, Cassimo, Betrán, Ana Pilar, Bannale, Shashidhar G, Augusto, Orvalho, Ansermino, J Mark, Amose, Felizarda, Ahmed, Imran, Adetoro, Olalekan O, Bone, Jeffrey N, Magee, Laura A, Singer, Joel, Nathan, Hannah, Qureshi, Rahat N, Sacoor, Charfudin, Sevene, Esperança, Shennan, Andrew, Bellad, Mrutyunjaya B, Goudar, Shivaprasad S, Mallapur, Ashalata A, Munguambe, Khátia, Vidler, Marianne, Bhutta, Zulfiqar A, and von Dadelszen, Peter

Published
2021
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6. Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique

Author

Mayor, Alfredo, primary, Brokhattingen, Nanna, additional, Matambisso, Gloria, additional, Silva, Clemente da, additional, Vickers, Eric Neubauer, additional, Pujol, Arnau, additional, Mbeve, Henriques, additional, Cistero, Pau, additional, Maculuve, Sonia, additional, Cuna, Boaventura, additional, Melembe, Cardoso, additional, Ndimande, Nelo, additional, Palmer, Brian, additional, García, Manuel, additional, Munguambe, Humberto, additional, Lopez, Julia Montana, additional, Nhamussa, Lidia, additional, Simone, Wilson, additional, Chidimatembue, Arlindo, additional, Galatas, Beatriz, additional, Guinovart, Caterina, additional, Rovira-Vallbona, Eduard, additional, Saute, Francisco, additional, Aide, Pedro, additional, Aranda-Díaz, Andrés, additional, Greenhouse, Bryan, additional, and Macete, Eusebio, additional

Published
2023
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7. Identifying Immune Correlates of Protection Against Plasmodium falciparum Through a Novel Approach to Account for Heterogeneity in Malaria Exposure

Author

Valmaseda, Aida, Macete, Eusebio, Nhabomba, Augusto, Guinovart, Caterina, Aide, Pedro, Bardají, Azucena, Bassat, Quique, Nhampossa, Tacilta, Maculuve, Sonia, Casellas, Aina, Quintó, Llorenç, Sanz, Sergi, Jiménez, Alfons, Feng, Gaoqian, Langer, Christine, Reiling, Linda, Reddy, K. Sony, Pandey, Alok, Chitnis, Chetan E, Chauhan, Virander S, Aguilar, Ruth, Aponte, John J., Dobaño, Carlota, Beeson, James G, Gaur, Deepak, Menéndez, Clara, Alonso, Pedro L, and Mayor, Alfredo

Published
2018

10. Detecting temporal and spatial malaria patterns from first antenatal care visits

Author

Pujol, Arnau, primary, Brokhattingen, Nanna, additional, Matambisso, Gloria, additional, Mbeve, Henriques, additional, Cisteró, Pau, additional, Escoda, Anna, additional, Maculuve, Sonia, additional, Cuna, Boaventura, additional, Melembe, Cardoso, additional, Ndimande, Nelo, additional, Munguambe, Humberto, additional, Lopez, Julia Montana, additional, Nhamussa, Lidia, additional, Simone, Wilson, additional, Tetteh, Kevin, additional, Drakeley, Chris, additional, Gamain, Benoît, additional, Chitnis, Chetan, additional, Chauhan, Virander Singh, additional, Quintó, Llorenç, additional, Chidimatembue, Arlindo, additional, Soler, Helena Martí, additional, Galatas, Beatriz, additional, Guinovart, Caterina, additional, Saute, Francisco, additional, Aide, Pedro, additional, Macete, Eusebio, additional, and Mayor, Alfredo, additional

Published
2023
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11. Efficacy and safety of dihydroartemisinin–piperaquine for treatment of Plasmodium falciparum uncomplicated malaria in adult patients on antiretroviral therapy in Malawi and Mozambique: an open label non-randomized interventional trial

Author

Sevene, Esperança, Banda, Clifford G., Mukaka, Mavuto, Maculuve, Sonia, Macuacua, Salésio, Vala, Anifa, Piqueras, Mireia, Kalilani-Phiri, Linda, Mallewa, Jane, Terlouw, Dianne J., Khoo, Saye H., Lalloo, David G., and Mwapasa, Victor

Published
2019
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14. Changing Trends in P. falciparum Burden, Immunity, and Disease in Pregnancy

Author

Mayor, Alfredo, Bardají, Azucena, Macete, Eusebio, Nhampossa, Tacilta, Fonseca, Ana Maria, González, Raquel, Maculuve, Sonia, Cisteró, Pau, Rupérez, Maria, Campo, Joe, Vala, Anifa, Sigaúque, Betuel, Jiménez, Alfons, Machevo, Sonia, de la Fuente, Laura, Nhama, Abel, Luis, Leopoldina, Aponte, John J., Acácio, Sozinho, Nhacolo, Arsenio, Chitnis, Chetan, Dobaño, Carlota, Sevene, Esperanza, Alonso, Pedro Luis, and Menéndez, Clara

Published
2015
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16. Mothers’ satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique

Author

Mocumbi, Sibone, Högberg, Ulf, Lampa, Erik, Sacoor, Charfudin, Vala, Anifa, Bergström, Anna, von Dadelszen, Peter, Munguambe, Khatia, Hanson, Claudia, Sevene, Esperanca, Macete, Eusebio, Amose, Felizarda, Pires, Rosa, Nhamirre, Zefanias, Macamo, Marta, Matavele, Analisa, Vilanculo, Faustino, Nhancolo, Ariel, Cutana, Silvestre, Mandlate, Ernesto, Macuacua, Salesio, Bique, Cassimo, Maculuve, Sonia, Biz, Ana Ilda, Mulungo, Dulce, Augusto, Orvalho, Filimone, Paulo, Nobela, Vivalde, Tchavana, Corsino, Nkumbula, Claudio, Payne, Beth, Vidler, Marianne, Sharma, Sumedha, Li, Jing (Larry), Lee, Tang, Tu, Domena, Dube, Alison, Bone, Jeffrey, Dunsmuir, Dustin, and Madhavan, Meera

Subjects
Adult, medicine.medical_specialty, Cross-sectional study, Population, Reproductive medicine, Psychological intervention, Mothers, Reproduktionsmedicin och gynekologi, lcsh:Gynecology and obstetrics, Satisfaction with care, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Surveys and Questionnaires, Obstetrics, Gynecology and Reproductive Medicine, medicine, Humans, Childbirth, 030212 general & internal medicine, education, Mozambique, lcsh:RG1-991, Quality of Health Care, education.field_of_study, 030219 obstetrics & reproductive medicine, business.industry, Parturition, Facility-based childbirth, Obstetrics and Gynecology, Professional-Patient Relations, Delivery, Obstetric, Perinatal Care, Cross-Sectional Studies, Physical abuse, Physical Abuse, Patient Satisfaction, Family medicine, Structured interview, Regression Analysis, Female, Customer satisfaction, Health Facilities, Experiences of care, business, Research Article
Abstract

Background Client satisfaction is an essential component of quality of care. Health system factors, processes of care as well as mothers’ characteristics influence the extent to which care meets the expectations of mothers and families. In our study, we specifically aimed to address the mothers’ experiences of, and satisfaction with, care during childbirth. Methods A population-based cross-sectional study, using structured interviews with published sequences of questions assessing satisfaction, including 4358 mothers who gave birth during the 12 months before June 2016 to estimate satisfaction with childbirth care. Regression analysis was used to determine the predictors of client satisfaction. Results Most mothers (92.5%) reported being satisfied with care during childbirth and would recommend that a family member to deliver at the same facility. Specifically, 94.7% were satisfied with the cleanliness of the facility, 92.0% reported being satisfied with the interaction with the healthcare providers, but only 49.8% felt satisfied with the assistance to feed their baby. Mothers who had negative experiences during the process of care, such as being abandoned when needing help, disrespect, humiliation, or physical abuse, reported low levels of satisfaction when compared to those who had not had such experiences (68.5% vs 93.5%). Additionally, they reported higher levels of dissatisfaction (20.1% vs 2.1%). Regression analysis revealed that mothers who gave birth in primary level facilities tended to be more satisfied than those who gave birth in hospitals, and having a companion increased, on average, the overall satisfaction score, with 0.06 in type II health centres (CI 0.03–0.10) and with 0.05 in type I health centres (CI − 0.02 – 0.13), compared to − 0.01(CI -0.08 – 0.07) in the hospitals, irrespective of age, education and socio-economic background. Conclusion Childbirth at the primary level facilities contributes to the level of satisfaction. The provision of childbirth care should consider women’s preferences and needs, including having a companion of choice. We highlight the challenge in balancing safety of care versus satisfaction with care and in developing policies on the optimum configuration of childbirth care. Interventions to improve the interaction with providers and the provision of respectful care are recommended. Electronic supplementary material The online version of this article (10.1186/s12884-019-2449-6) contains supplementary material, which is available to authorized users.

Published
2019

17. Intermittent preventive treatment of malaria in pregnancy with mefloquine in HIV-infected women receiving Cotrimoxazole prophylaxis: a multicenter randomized placebo-controlled trial

Author

Gonzalez, Raquel, Desai, Meghna, Macete, Eusebio, Ouma, Peter, Kakolwa, Mwaka A., Abdulla, Salim, Aponte, John J., Bulo, Helder, Kabanywanyi, Abdunoor M., Katana, Abraham, Maculuve, Sonia, Mayor, Alfredo, Nhacolo, Arsenio, Otieno, Kephas, Pahlavan, Golbahar, Ruperez, Maria, Sevene, Esperanca, Slutsker, Laurence, Vala, Anifa, Williamsom, John, and Menendez, Clara

Subjects
Antimalarials -- Health aspects, Malaria -- Care and treatment -- Research -- Analysis, Pregnant women -- Care and treatment, HIV infection -- Care and treatment, Biological sciences
Abstract

Background: Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is recommended for malaria prevention in HIV-negative pregnant women, but it is contraindicated in HIV-infected women taking daily cotrimoxazole prophylaxis (CTXp) because of potential added risk of adverse effects associated with taking two antifolate drugs simultaneously. We studied the safety and efficacy of mefloquine (MQ) in women receiving CTXp and long-lasting insecticide treated nets (LLITNs). Methods and Findings: A total of 1,071 HIV-infected women from Kenya, Mozambique, and Tanzania were randomized to receive either three doses of IPTp-MQ (15 mg/kg) or placebo given at least one month apart; all received CTXp and a LLITN. IPTp-MQ was associated with reduced rates of maternal parasitemia (risk ratio [RR], 0.47 [95% CI 0.27-0.82]; p = 0.008), placental malaria (RR, 0.52 [95% CI 0.29-0.90]; p = 0.021), and reduced incidence of non-obstetric hospital admissions (RR, 0.59 [95% CI 0.37-0.95]; p = 0.031) in the intention to treat (ITT) analysis. There were no differences in the prevalence of adverse pregnancy outcomes between groups. Drug tolerability was poorer in the MQ group compared to the control group (29.6% referred dizziness and 23.9% vomiting after the first IPTp-MQ administration). HIV viral load at delivery was higher in the MQ group compared to the control group (p = 0.048) in the ATP analysis. The frequency of perinatal mother to child transmission of HIV was increased in women who received MQ (RR, 1.95 [95% CI 1.14-3.33]; p = 0.015). The main limitation of the latter finding relates to the exploratory nature of this part of the analysis. Conclusions: An effective antimalarial added to CTXp and LLITNs in HIV-infected pregnant women can improve malaria prevention, as well as maternal health through reduction in hospital admissions. However, MQ was not well tolerated, limiting its potential for IPTp and indicating the need to find alternatives with better tolerability to reduce malaria in this particularly vulnerable group. MQ was associated with an increased risk of mother to child transmission of HIV, which warrants a better understanding of the pharmacological interactions between antimalarials and antiretroviral drugs. Trial registration: ClinicalTrials.gov NCT 00811421; Pan African Clinical Trials Registry PACTR 2010020001813440 Please see later in the article for the Editors' Summary., Introduction Many African pregnant women are infected with HIV, and many of them are also exposed to falciparum malaria [1,2]. It is estimated that at least 1 million pregnancies per [...]

Published
2014
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18. Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

Author

Instituto de Salud Carlos III, Ministerio de Asuntos Exteriores y Cooperación (España), Generalitat de Catalunya, Madrid, Lola, Varo, Rosauro, Maculuve, Sonia, Nhampossa, Tacilta, Muñoz-Almagro, Carmen, Calderón, Enrique J., Esteva, Cristina, Carrilho, Carla, Ismail, Mamudo, Vieites, Begoña, Friaza Patiño, Vicente, Lozano-Domínguez, María del Carmen, Menéndez, Clara, Bassat, Quique, Instituto de Salud Carlos III, Ministerio de Asuntos Exteriores y Cooperación (España), Generalitat de Catalunya, Madrid, Lola, Varo, Rosauro, Maculuve, Sonia, Nhampossa, Tacilta, Muñoz-Almagro, Carmen, Calderón, Enrique J., Esteva, Cristina, Carrilho, Carla, Ismail, Mamudo, Vieites, Begoña, Friaza Patiño, Vicente, Lozano-Domínguez, María del Carmen, Menéndez, Clara, and Bassat, Quique

Abstract

[Background] Congenital cytomegalovirus (cCMV) infection is the most prevalent congenital infection acquired worldwide, with higher incidence in developing countries and among HIV-exposed children. Less is known regarding vertical transmission of parvovirus B19 (B19V) and enterovirus (EV). We aimed to assess the prevalence of CMV, B19V and EV vertical transmission and compare results of screening of congenital CMV obtained from two different specimens in a semirural Mozambican maternity., [Methods] A cross sectional study was conducted among pregnant mothers attending Manhiça District Hospital upon delivery. Information on maternal risk factors was ascertained. Dried umbilical cord (DUC) samples were collected in filter paper for CMV, B19V and EV detection by real-time polymerase chain reaction (RT-PCR), and nasopharyngeal aspirates (NPA) to test for CMV by RT-PCR. Maternal blood samples and placental biopsy samples were also obtained to investigate CMV maternal serology, HIV status and immunopathology., [Results] From September 2014 to January 2015, 118 mothers/newborn pairs were recruited. Prevalence of maternal HIV infection was 31.4% (37/118). CMV RT-PCR was positive in 3/115 (2.6%) of DUC samples and in 3/96 (6.3%) of NPA samples obtained from neonates. The concordance of the RT-PCR assay through DUC with their correspondent NPA sample was moderate (Kappa = 0.42 and p<0.001. No differences on cCMV prevalence were found among HIV-exposed and unexposed. All (100%) mothers were seropositive for CMV IgG. RT-PCR of EV and B19V in DUC were both negative in all screened cases. No histological specific findings were found in placental tissues. No risk factors associated to vertical transmission of these viral infections were found., [Conclusions] This study indicates the significant occurrence of vertical transmission of CMV in southern Mozambique. Larger studies are needed to evaluate the true burden, clinical relevance and consequences of congenital infections with such pathogens in resource-constrained settings.

Published
2018

21. Congenital cytomegalovirus, parvovirus and enterovirus infection in Mozambican newborns at birth: A cross-sectional survey

Author

Madrid, Lola, primary, Varo, Rosauro, additional, Maculuve, Sonia, additional, Nhampossa, Tacilta, additional, Muñoz-Almagro, Carmen, additional, Calderón, Enrique J., additional, Esteva, Cristina, additional, Carrilho, Carla, additional, Ismail, Mamudo, additional, Vieites, Begoña, additional, Friaza, Vicente, additional, Lozano-Dominguez, María del Carmen, additional, Menéndez, Clara, additional, and Bassat, Quique, additional

Published
2018
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22. Determinants of virological failure and antiretroviral drug resistance in Mozambique

Author

Rupérez, María, Pou, Christian, Maculuve, Sonia, Cedeño, Samandhy, Luis, Leopoldina, Rodríguez, Judith, Letang, Emilio, Moltó, José, Macete, Eusébio, Clotet, Bonaventura, Alonso, Pedro, Menéndez, Clara, Naniche, Denise, Paredes, Roger, Rupérez, María, Pou, Christian, Maculuve, Sonia, Cedeño, Samandhy, Luis, Leopoldina, Rodríguez, Judith, Letang, Emilio, Moltó, José, Macete, Eusébio, Clotet, Bonaventura, Alonso, Pedro, Menéndez, Clara, Naniche, Denise, and Paredes, Roger

Abstract

Objectives The objective of this study was to inform public health actions to limit first-line ART failure and HIV drug resistance in Mozambique. Methods This was a cross-sectional study. HIV-1-infected adults on first-line ART for at least 1 year attending routine visits in the Manhiça District Hospital, in a semi-rural area in southern Mozambique with no HIV-1 RNA monitoring available, were evaluated for clinical, socio-demographic, therapeutic, immunological and virological characteristics. Factors associated with HIV-1 RNA ≥1000 copies/mL and HIV drug resistance were determined using multivariate logistic regression. Results The study included 334 adults on first-line ART for a median of 3 years, of which 65% (214/332) had suppressed viraemia, 11% (37/332) had low-level viraemia (HIV-1 RNA 150-999 copies/mL) and 24% (81/332) had overt virological failure (HIV-1 RNA ≥1000 copies/mL). HIV drug resistance was detected in 89% of subjects with virological failure, but in none with low-level viraemia. Younger age [OR = 0.97 per additional year (95% CI = 0.94-1.00), P = 0.039], ART initiation at WHO stage III/IV [OR = 2.10 (95% CI = 1.23-3.57), P = 0.003] and low ART adherence [OR = 2.69 (95% CI = 1.39-5.19), P = 0.003] were associated with virological failure. Longer time on ART [OR = 1.55 per additional year (95% CI = 1.00-2.43), P = 0.052] and illiteracy [OR = 0.24 (95% CI = 0.07-0.89), P = 0.033] were associated with HIV drug resistance. Compared with HIV-1 RNA, clinician's judgement of ART failure, based on clinical and immunological outcomes, only achieved 29% sensitivity and misdiagnosed 1 out of every 4.5 subjects. Conclusions Public health programmes in Mozambique should focus on early HIV diagnosis, early ART initiation and adherence support. Virological monitoring drastically improves the diagnosis of ART failure, enabling a better use of resources

Published
2017

23. Identifying Immune Correlates of Protection Against Plasmodium falciparum Through a Novel Approach to Account for Heterogeneity in Malaria Exposure

Author

Valmaseda, Aida, primary, Macete, Eusebio, additional, Nhabomba, Augusto, additional, Guinovart, Caterina, additional, Aide, Pedro, additional, Bardají, Azucena, additional, Bassat, Quique, additional, Nhampossa, Tacilta, additional, Maculuve, Sonia, additional, Casellas, Aina, additional, Quintó, Llorenç, additional, Sanz, Sergi, additional, Jiménez, Alfons, additional, Feng, Gaoqian, additional, Langer, Christine, additional, Reiling, Linda, additional, Reddy, K Sony, additional, Pandey, Alok, additional, Chitnis, Chetan E, additional, Chauhan, Virander S, additional, Aguilar, Ruth, additional, Aponte, John J, additional, Dobaño, Carlota, additional, Beeson, James G, additional, Gaur, Deepak, additional, Menéndez, Clara, additional, Alonso, Pedro L, additional, and Mayor, Alfredo, additional

Published
2017
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24. Resisting and tolerating P. falciparum in pregnancy under different malaria transmission intensities

Author

Ndam, Nicaise Tuikue, primary, Mbuba, Emmanuel, additional, González, Raquel, additional, Cisteró, Pau, additional, Kariuki, Simon, additional, Sevene, Esperança, additional, Rupérez, María, additional, Fonseca, Ana Maria, additional, Vala, Anifa, additional, Maculuve, Sonia, additional, Jiménez, Alfons, additional, Quintó, Llorenç, additional, Ouma, Peter, additional, Ramharter, Michael, additional, Aponte, John J., additional, Nhacolo, Arsenio, additional, Massougbodji, Achille, additional, Briand, Valerie, additional, Kremsner, Peter G., additional, Mombo-Ngoma, Ghyslain, additional, Desai, Meghna, additional, Macete, Eusebio, additional, Cot, Michel, additional, Menéndez, Clara, additional, and Mayor, Alfredo, additional

Published
2017
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25. Multiplexing detection of IgG against Plasmodium falciparum pregnancy-specific antigens

Author

Fonseca, Ana Maria, primary, Quinto, Llorenç, additional, Jiménez, Alfons, additional, González, Raquel, additional, Bardají, Azucena, additional, Maculuve, Sonia, additional, Dobaño, Carlota, additional, Rupérez, Maria, additional, Vala, Anifa, additional, Aponte, John J., additional, Sevene, Esperanza, additional, Macete, Eusebio, additional, Menéndez, Clara, additional, and Mayor, Alfredo, additional

Published
2017
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26. Reengagement of HIV-infected children lost to follow-up after active mobile phone tracing in a rural area of Mozambique.

Author

Fernández-Luis, Sheila, Fuente-Soro, Laura, Augusto, Orvalho, Bernardo, Edson, Nhampossa, Tacilta, Maculuve, Sonia, Hernández, Terence Manning, Naniche, Denise, López-Varela, Elisa, and Manning Hernández, Terence

Subjects
TELEPHONES, TELEPHONE calls, CELL phones, RURAL geography, FOLLOW-up studies (Medicine), CHILDREN, THERAPEUTICS
Abstract

Introduction: Retention in care and reengagement of lost to follow-up (LTFU) patients are priority challenges in pediatric HIV care. We aimed to assess whether a telephone-call active tracing program facilitated reengagement in care (RIC) in the Manhiça District Hospital, Mozambique.Methods: Telephone tracing of LTFU children was performed from July 2016 to March 2017. Both ART (antiretroviral treatment) and preART patients were included in this study. LTFU was defined as not attending the clinic for ≥120 days after last attended visit. Reengagement was determined 3 months after an attempt to contact.Results: A total of 144 children initially identified as LTFU entered the active tracing program and 37 were reached by means of telephone tracing. RIC was 57% (95% CI, 39-72%) among children who could be reached versus 18% (95% CI, 11-26%) of those who could not be reached (p = 0.001).Conclusion: Telephone tracing could be an effective tool for facilitating reengagement in pediatric HIV care. However, the difficulty of reaching patients is an obstacle that can undermine the program. [ABSTRACT FROM AUTHOR]

Published
2019
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28. Changing Trends inP. falciparumBurden, Immunity, and Disease in Pregnancy

Author

Mayor, Alfredo, primary, Bardají, Azucena, additional, Macete, Eusebio, additional, Nhampossa, Tacilta, additional, Fonseca, Ana Maria, additional, González, Raquel, additional, Maculuve, Sonia, additional, Cisteró, Pau, additional, Rupérez, Maria, additional, Campo, Joe, additional, Vala, Anifa, additional, Sigaúque, Betuel, additional, Jiménez, Alfons, additional, Machevo, Sonia, additional, de la Fuente, Laura, additional, Nhama, Abel, additional, Luis, Leopoldina, additional, Aponte, John J., additional, Acácio, Sozinho, additional, Nhacolo, Arsenio, additional, Chitnis, Chetan, additional, Dobaño, Carlota, additional, Sevene, Esperanza, additional, Alonso, Pedro Luis, additional, and Menéndez, Clara, additional

Published
2015
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29. Multiplexing detection of IgG against Plasmodium falciparum pregnancy-specific antigens.

Author

Quinto, Llorenç, Fonseca, Ana Maria, Jiménez, Alfons, González, Raquel, Bardají, Azucena, Dobaño, Carlota, Rupérez, Maria, Aponte, John J., Menéndez, Clara, Mayor, Alfredo, Maculuve, Sonia, Vala, Anifa, Macete, Eusebio, and Sevene, Esperanza

Subjects
PREGNANCY complications, PLASMODIUM falciparum, PARASITE antigens, IMMUNOGLOBULIN G, IMMUNOASSAY
Abstract

Background: Pregnant women exposed to Plasmodium falciparum generate antibodies against VAR2CSA, the parasite protein that mediates adhesion of infected erythrocytes to the placenta. There is a need of high-throughput tools to determine the fine specificity of these antibodies that can be used to identify immune correlates of protection and exposure. Here we aimed at developing a multiplex-immunoassay to detect antibodies against VAR2CSA antigens. Methods and findings: We constructed two multiplex-bead arrays, one composed of 3 VAR2CSA recombinant-domains (DBL3X, DBL5Ɛ and DBL6Ɛ) and another composed of 46 new peptides covering VAR2CSA conserved and semi-conserved regions. IgG reactivity was similar in multiplexed and singleplexed determinations (Pearson correlation, protein array: R2 = 0.99 and peptide array: R2 = 0.87). IgG recognition of 25 out of 46 peptides and all recombinant-domains was higher in pregnant Mozambican women (n = 106) than in Mozambican men (n = 102) and Spanish individuals (n = 101; p<0.05). Agreement of IgG levels detected in cryopreserved plasma and in elutions from dried blood spots was good after exclusion of inappropriate filter papers. Under heterogeneous levels of exposure to malaria, similar seropositivity cutoffs were obtained using finite mixture models applied to antibodies measured on pregnant Mozambican women and average of antibodies measured on pregnant Spanish women never exposed to malaria. The application of the multiplex-bead array developed here, allowed the assessment of higher IgG levels and seroprevalences against VAR2CSA-derived antigens in women pregnant during 2003–2005 than during 2010–2012, in accordance with the levels of malaria transmission reported for these years in Mozambique. Conclusions: The multiplex bead-based immunoassay to detect antibodies against selected 25 VAR2CSA new-peptides and recombinant-domains was successfully implemented. Analysis of field samples showed that responses were specific among pregnant women and dependent on the level of exposure to malaria. This platform provides a high-throughput approach to investigating correlates of protection and identifying serological markers of exposure for malaria in pregnancy. [ABSTRACT FROM AUTHOR]

Published
2017
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31. MOESM3 of Efficacy and safety of dihydroartemisinin–piperaquine for treatment of Plasmodium falciparum uncomplicated malaria in adult patients on antiretroviral therapy in Malawi and Mozambique: an open label non-randomized interventional trial

Author

Sevene, Esperança, Banda, Clifford, Mavuto Mukaka, Maculuve, Sonia, Salésio Macuacua, Anifa Vala, Piqueras, Mireia, Kalilani-Phiri, Linda, Mallewa, Jane, Terlouw, Dianne, Saye Khoo, Lalloo, David, and Mwapasa, Victor

Subjects
3. Good health
Abstract

Additional file 3. Details of serious adverse events that occurred during follow up.

32. MOESM3 of Efficacy and safety of dihydroartemisinin–piperaquine for treatment of Plasmodium falciparum uncomplicated malaria in adult patients on antiretroviral therapy in Malawi and Mozambique: an open label non-randomized interventional trial

Author

Sevene, Esperança, Banda, Clifford, Mavuto Mukaka, Maculuve, Sonia, Salésio Macuacua, Anifa Vala, Piqueras, Mireia, Kalilani-Phiri, Linda, Mallewa, Jane, Terlouw, Dianne, Saye Khoo, Lalloo, David, and Mwapasa, Victor

Subjects
3. Good health
Abstract

Additional file 3. Details of serious adverse events that occurred during follow up.

33. Determinants of virological failure and antiretroviral drug resistance in Mozambique

Author

Rupérez, María, Pou, Christian, Maculuve, Sonia, Cedeño, Samandhy, Luis, Leopoldina, Rodríguez, Judith, Letang, Emilio, Moltó, José, Macete, Eusébio, Clotet, Bonaventura, Alonso, Pedro, Menéndez, Clara, Naniche, Denise, Paredes, Roger, Rupérez, María, Pou, Christian, Maculuve, Sonia, Cedeño, Samandhy, Luis, Leopoldina, Rodríguez, Judith, Letang, Emilio, Moltó, José, Macete, Eusébio, Clotet, Bonaventura, Alonso, Pedro, Menéndez, Clara, Naniche, Denise, and Paredes, Roger

Abstract

Objectives The objective of this study was to inform public health actions to limit first-line ART failure and HIV drug resistance in Mozambique. Methods This was a cross-sectional study. HIV-1-infected adults on first-line ART for at least 1 year attending routine visits in the Manhiça District Hospital, in a semi-rural area in southern Mozambique with no HIV-1 RNA monitoring available, were evaluated for clinical, socio-demographic, therapeutic, immunological and virological characteristics. Factors associated with HIV-1 RNA ≥1000 copies/mL and HIV drug resistance were determined using multivariate logistic regression. Results The study included 334 adults on first-line ART for a median of 3 years, of which 65% (214/332) had suppressed viraemia, 11% (37/332) had low-level viraemia (HIV-1 RNA 150-999 copies/mL) and 24% (81/332) had overt virological failure (HIV-1 RNA ≥1000 copies/mL). HIV drug resistance was detected in 89% of subjects with virological failure, but in none with low-level viraemia. Younger age [OR = 0.97 per additional year (95% CI = 0.94-1.00), P = 0.039], ART initiation at WHO stage III/IV [OR = 2.10 (95% CI = 1.23-3.57), P = 0.003] and low ART adherence [OR = 2.69 (95% CI = 1.39-5.19), P = 0.003] were associated with virological failure. Longer time on ART [OR = 1.55 per additional year (95% CI = 1.00-2.43), P = 0.052] and illiteracy [OR = 0.24 (95% CI = 0.07-0.89), P = 0.033] were associated with HIV drug resistance. Compared with HIV-1 RNA, clinician's judgement of ART failure, based on clinical and immunological outcomes, only achieved 29% sensitivity and misdiagnosed 1 out of every 4.5 subjects. Conclusions Public health programmes in Mozambique should focus on early HIV diagnosis, early ART initiation and adherence support. Virological monitoring drastically improves the diagnosis of ART failure, enabling a better use of resources

34. Genomic malaria surveillance of antenatal care users detects reduced transmission following elimination interventions in Mozambique.

Author

Mayor A, Brokhattingen N, Matambisso G, da Silva C, Vickers EN, Pujol A, Mbeve H, Cistero P, Maculuve S, Cuna B, Melembe C, Ndimande N, Palmer B, García M, Munguambe H, Lopez JM, Nhamussa L, Simone W, Chidimatembue A, Galatas B, Guinovart C, Rovira-Vallbona E, Saute F, Aide P, Aranda-Díaz A, Greenhouse B, and Macete E

Abstract

Routine sampling of pregnant women at first antenatal care (ANC) visits could make Plasmodium falciparum genomic surveillance more cost-efficient and convenient in sub-Saharan Africa. We compared the genetic structure of parasite populations sampled from 289 first ANC attendees and 93 children from the community in Mozambique between 2015 and 2019. Samples were amplicon sequenced targeting 165 microhaplotypes and 15 drug resistance genes. Metrics of genetic diversity and relatedness, as well as the prevalence of drug resistance markers, were consistent between the two populations. In an area targeted for elimination, intra-host genetic diversity declined in both populations (p=0.002-0.007), while for the ANC population, population genetic diversity was also lower (p=0.0004), and genetic relatedness between infections were higher (p=0.002) than control areas, indicating a recent reduction in the parasite population size. These results highlight the added value of genomic surveillance at ANC clinics to inform about changes in transmission beyond epidemiological data., Competing Interests: Declaration of interest All authors reported no conflicts of interest.

Published
2023
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35. Detecting temporal and spatial malaria patterns from first antenatal care visits.

Author

Pujol A, Brokhattingen N, Matambisso G, Mbeve H, Cisteró P, Escoda A, Maculuve S, Cuna B, Melembe C, Ndimande N, Munguambe H, Lopez JM, Nhamussa L, Simone W, Tetteh K, Drakeley C, Gamain B, Chitnis C, Chauhan VS, Quintó L, Chidimatembue A, Soler HM, Galatas B, Guinovart C, Saute F, Aide P, Macete E, and Mayor A

Abstract

Pregnant women attending first antenatal care (ANC) visits represent a promising malaria surveillance target in Sub-Saharan Africa. Here we assessed the spatio-temporal relationship between malaria at ANC (n=6,471), in children at the community(n=9,362) and at health facilities (n=15,467) in southern Mozambique (2016-2019). ANC P. falciparum rates detected by quantitative polymerase chain reaction mirrored rates in children, regardless of gravidity and HIV status (Pearson correlation coefficient [PCC]>0.8, χ²<1.1), with a 2-3 months lag. Only at rapid diagnostic test detection limits at moderate-to-high transmission, multigravidae showed lower rates than children (PCC=0.61, 95%CI[-0.12-0.94]). Seroprevalence against the pregnancy-specific antigen VAR2CSA reflected declining malaria trends (PCC=0.74, 95%CI[0.24-0.77]). 80% (12/15) of hotspots detected from health facility data using a novel hotspot detector, EpiFRIenDs, were also identified with ANC data. The results show that ANC-based malaria surveillance offers contemporary information on temporal trends and the geographic distribution of malaria burden in the community.

Published
2023
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