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Desde que os primeiros casos da infecção por SARS-CoV-2 foram reportados na Cidade de Wuhan (China), mundialmente, no decurso da pandemia, foram reportadas vagas ou ondas de infeções por SARS-CoV-2, com significativo impacto na morbidade e mortalidade por COVID-19, sobretudo causadas por circulação de variantes de preocupação do vírus que emergiram ao longo do tempo, incluindo em Moçambique. Para além de medidas de Saúde Pública implementadas desde as fases inicias da pandemia, como identificação de casos e seu isolamento, encerramento das escolas e outros lugares de aglomeração de pessoas, distanciamento social e medidas de higiene e proteção individual e coletiva, foram introduzidos, ao nível global e no país, os Programas Nacionais de Vacinação Contra a COVID-19. Com a introdução da vacinação, esperava-se conseguir um controle mais eficaz da pandemia. Contudo, isso não aconteceu e ainda persistem alguns desafios. Assim, neste artigo, com base na revisão documental e dos dados epidemiológicos disponíveis nas plataformas digitais, descreve-se e compara-se a evolução da epidemia em Moçambique em relação ao continente Africano e o Mundo no geral e são avançadas algumas das possíveis explicações para a evolução observada da pandemia da COVID-19. Por outro lado, algumas considerações são apresentadas em torno dos avanços alcançados e os desafios persistentes no país e ao nível global com a introdução do programa de vacinação contra a COVID-19., Anais do Instituto de Higiene e Medicina Tropical, v. 21 (2022): Estratégias de vacinação em contexto pandémico

BACKGROUNDMozambique has an under-resourced and fragile healthcare system that is already facing a high burden of comorbidities. Determining the cost of COVID-19 treatment is therefore an early priority to inform the resource-constrained pandemic response. This study aimed to estimate the economic cost of treating patients with severe COVID-19 in Mozambique. METHODOLOGYCost data were collected retrospectively from the provider perspective. A “one-way” deterministic sensitivity analysis was performed to test the robustness of the assumptions. RESULTSThe total economic cost of treatment for inpatients with severe COVID-19 at Centro da Matola 1 (CM1) was 21,157,159 MZN, corresponding to US$334,501. The economic cost per capita per day was 22,039 MZN, corresponding to US$348. The costs of treatment for patients with tuberculosis and patients with pneumonia did not vary considerably, ranging between 176,122 MZN (US$2,785) and 176,113 MZN (US$2,784) for the affected comorbidities; without co-morbidities, 176,105 MZN (US$2,784) to 176,087 MZN (US $2,784), respectively. COVID-19 patients co- infected with bronchopneumonia and HIV were the ones with the least costly morbidities, ranging from 88,085 MZN (US$1,393) to 88,053 MZN (US$1,392). CONCLUSIONThe results show a substantial cost to treat COVID-19 inpatients in a resource-constrained context. The course of the pandemic substantially impacted the total costs and consequently, there has been an increase in the demand for resources. Revising priority setting values and resource allocation shall be taken into consideration for timely adjustments to save lives, considering the scenario of a high burden of commodities versus resource constraints in Mozambican public health services. Additionally, it is highly recommended that the cost analysis be regularly updated to illustrate the current cost and contribute to informing the efficient allocation of resources.

Background: Research to discover an effective and safe vaccine is crucial to decrease HIV burden. However, it is paramount to understand social-behavioral aspects, such as underlying perceptions about HIV, misconceptions about HIV vaccine research and its volunteers, and the effects of experimental vaccines on trial participants, that can impede trial conduct and eventual vaccine uptake. Methods: This research project is divided into 2 studies conducted in Maputo, Mozambique, using both quantitative and qualitative methods and the health belief model. As part of a 2-year follow-up incidence study, a willingness to participate questionnaire was administered to a cohort of 577 HIV-negative young adult participants, at screening and at the exit visit (study I). Research subjects who participated in a phase II HIV vaccine preventative clinical trial, answered to the same semi-structured questionnaire (31 participants) before and after unblinding (1-year interval) and participated in 12 in-depth interviews and 3 focus group discussion (study II). Results: A total of 577 participants were screened, including 275 (48%) women. 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. The health belief model was used to explain the decision-making progress to participate in a HIV vaccine study. HIV susceptibility, infection severity and benefits of participating in a HIV vaccine trial must outweigh barriers for trial participation in order to promote the switch from intention to action (actual participation in HIV vaccine trials). Participants also suffered negative social harm driven mainly by HIV stigma from family and peers regarding their participation in HIV vaccine trials. Conclusion: The present research reports a continuous high intention to participate in HIV vaccine trial among young adults in Maputo city and identified the factors associated with it. It also describes how actual participants of a phase II HIV clinical trial reason their participation and the factors associated with their retention participation in the HIV vaccine trial.