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IntroductionGlobally, low birth weight (LBW) is prevalent in low-income countries. Although the economic assessment of interventions to reduce this burden is essential to guide health policies, research that illustrates the magnitude of LBW by country and region as a way to support the design of public policies is still relatively scarce.ObjectiveTo analyze the temporal trend of fetal growth of newborns in Brazil, in the period from 2010 to 2020.MethodsA time series study, whose data source was the Live Births Information System (SINASC), of the Department of Information and Informatics of the Unified Health System (DATASUS), linked to the Ministry of Health, Brazil. The Prais-Winsten linear model was applied to analyse the annual proportions of LBW. The annual percentage changes (APC) and its respective 95% confidence intervals (95%CI) were calculated. To visualize the dynamics of evolution in each Federation Unit (FU), prevalence rate averages of LBW were calculated and displayed on thematic maps.ResultsBetween 2010 and 2020, there was a trend toward stabilization of the increasing proportions of low birth weight in the North, Northeast and Centre-West regions. In Brazil and the other regions these tendencies remained stable.ConclusionTo improve the living conditions of the population, public policies and actions aimed at reducing social inequalities and inequity is health are necessary, such as strengthening the Unified Health System (SUS), income transfer programs, quota policies for vulnerable groups, and gender to improve access to education for women and the labour sector.WHAT IS ALREADY KNOWN ON THIS TOPICIn Brazil, health social inequalities have a historical explanation due to the socio-economic and political system that encourages a competitive economic development model.Improved access to education and health care has reduced the risk of low birth weight (LBW) in all Brazilian regions in recent years.Differences in trends in LBW rates and associated factors within and between regions of Brazil.WHAT THIS STUDY ADDSThe study provides relevant information on the trend of LBW rates in recent years and makes a comparison between regions and the country as a whole.There were differences in the trend of LBW between Brazilian regions, with an increasing trend in the North, Northeast and Central-West regions, but on the other hand, the South and Southeast regions remain stationary.Stationary trend in the prevalence of BPN in Brazil in recent years (2010-2020), findings that should be associated with the improvement in the living conditions of the population.HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICYIt can be taken into account when building public policies aimed at improving the living conditions of the population public policies and actions aimed at reducing health inequalities and inequities are needed.

Background: Although not a communicable disease, the term “stroke epidemic” is being used widely in the literature. The “epidemic” of stroke might be due to over the time social transmission of unhealthy activities such as unhealthy diet, physical inactivity, and smoking. The aim of this study is to determine the endemic/epidemic pattern of stroke in Maputo Central Hospital in the first semester of 2019. Methods: A cross-sectional study was carried out collecting secondary data (registered cases) from hospitalized patients with stroke. Data from 2014-18 were used to generate the epidemic thresholds. Four threshold epidemic detection methods were used: mean + 2SD; C-SUM; C-SUM + 1.96SD; and the 3rd quartile. Data from January to June 2019 were used to analyze the 2019 trend over the thresholds. Results: An epidemic pattern of stroke was observed during the first semester of 2019 when 3rd quartile and C-SUM threshold epidemic method was used. This epidemic pattern of stroke was not observed when mean+2SD and C-SUM+1.96SD threshold epidemic method was used. A relatively stable pattern of stroke occurrence with high registered cases was observed during the study period. Conclusions: Stroke is an endemic disease for the Maputo Central Hospital, with an epidemic pattern during the first semester of 2019. Adoption of threshold methods for stroke surveillance might well add value for the control of the stroke epidemics.

IntroductionBirth weight is described as one of the main determinants of newborns’ chances of survival. Among the associated causes, or risk factors, the mother’s nutritional status strongly influences fetal growth and birth weight outcomes of the concept. This study evaluates the association between food deserts, small for gestational age (SGA), large for gestational age (LGA) and low birth weight (LBW) newborns.DesignThis is a cross-sectional population study, resulting from individual data from the Live Birth Information System (SINASC), and municipal data from mapping food deserts (CAISAN) in Brazil. The newborn’s size was defined as follows: appropriate for gestational age (between 10th and 90th percentile), SGA (th percentile), LGA (>90th percentile), and low birth weight in natura and ultra-processed foods. Logistic regression modeling was conducted to investigate the associations of interest.ResultsWe analyzed 2,632,314 live births in Brazil in 2016. Following due adjustment, it was observed that women from municipalities in which there was a limited supply of in natura foods presented a higher chance of a SGA [OR2nd tertile:1.06 (1.05-1.07)] and LBW [OR2nd tertile: 1.11(1.09-1.12)] newborn. On the other hand, municipalities in which there was a greater supply of ultra-processed foods presented higher chances for a SGA [OR3rd tertile:1.04 (1.02-1.06)] and LBW [OR2nd tertile:1.13 (1.11-1.16)] newborn. Stratification showed that Black and Mixed/Brown women were associated with SGA [OR3rd tertile: 1.09 (1.01-1.18)] and [OR3rdtertile:1.06 (1.04-1.09)], respectively, and mixed-race women were also associated with LBW [OR3rd tertile:1.17 (1.14-1.20)], while indigenous women were associated with LGA [OR3rd tertile: 1.20(1.01-1.45)].ConclusionsLiving in areas with limited access to healthy foods was associated with an increased chance of SGA and low weight newborns, especially between Black and Mixed/Brown women. Initiatives focused on minimizing the effects of these food environments, and which aim to reduce social inequalities, are urgently required in the Brazilian context.

BackgroundLeptospirosis is an occupational, neglected febrile disease of bacterial origin transmitted between humans and animals. In this manuscript we summarize available data onLeptospirainfection in HIV uninfected and in people living with HIV from the Southern African Development Community (SADC) countries, identifying gaps in knowledge and recommend future research priorities.MethodologyArticles published between 1990 and 2021 were accessed by an online search of Google Scholar and Medline/PubMed performed between February 2020 and July 2022. The STATA program was used for the Meta-analysis. Pooled prevalence values with 95% confidence intervals and heterogeneity were determined.ResultsThirty studies from eight SADC countries, reporting the prevalence onLeptospirawere reviewed. A pooled prevalence of 19% (CI: 13–25%), a heterogeneity level of 96% and index score ranging from 2 to 9 was determined. Only four (4) studies reported HIV co-infection status. Three species ofLeptospira(Leptospira interrogans(4),L.kirschneri(3),Leptospira borgpetersenii(1) and 23 serogroups were identified. The most frequently reported serogroups were Icterohaemorrhagiae (13), Grippotyphosa and Australis (10) followed by Sejroe (8).ConclusionStudies on human leptospirosis in the SADC region are scarce, especially in people living with HIV. Additional studies aimed at determining the prevalence and the role of the pathogen in people living with HIV, including detailed clinical, molecular and demographic data are recommended.

Introdução: As doenças cardiovasculares (DCV) são consideradas a principal causa de morte no mundo, sendo considerada um problema de saúde pública, a preocupação aumenta à medida que atualmente o número de mortes em indivíduos mais jovens e em grupos vulneráveis. O objetivo do estudo foi determinar a associação entre o nível de escolaridade e a morte prematura por doenças cardiovasculares em adultos. Metodologia: Trata-se de um estudo transversal de caráter analítico, resultante de dados provenientes do Sistema de informação de mortalidade do Brasil em 2018. Para análise estatística realizou-se uma análise bivariada pelo de teste de Qui-quadrado e posteriormente foram submetidas a uma análise multivariada mediante modelo de regressão logística para o controle de fatores de confusão e modificação, ajustando-se os valores de razão de mortalidade proporcional (RMP). Resultado: foram analisados 452.282 óbitos; 16,7% dos quais foram atribuídos a doenças cardiovascular, em relação ao nível de escolaridade, observou-se uma maior prevalência de óbito por doenças DCV (17,3%) em analfabetos ou com ensino fundamental e do sexo masculino (62,8%). Após o ajuste completo para os possíveis fatores de confusão, o analfabetismo ou possuir apenas o ensino fundamental, permaneceu fortemente associada ao risco de morrer prematuramente por DCV (RMP =1,31; 95% IC 1,27-1,24, p

Introdução: A insegurança alimentar é um problema de saúde púbica, devido aos seus efeitos na saúde de pessoas infectadas pelo HIV, apesar dos benefícios indiscutíveis do tratamento antirretroviral. Objetivo: analisar a prevalência e fatores associados à insegurança alimentar em pessoas que vivem com HIV/AIDS. Metodologia: Trata-se de um estudo transversal, realizado com 206 pacientes atendidos, em maio-julho de 2022. Foram coletados dados socioeconômicos, demográficos, de estilo de vida e de segurança alimentar. Avaliou-se a insegurança alimentar por meio da Escala Brasileira de Insegurança Alimentar, e as suas associações através do teste qui-quadrado de Pearson/teste exato de Fisher e razão de prevalência. Resultados: A prevalência de insegurança alimentar (grave) foi mais elevada em homens (78,9%), com idade de 18-30 anos (88,9%), sem nenhum nível de escolaridade (82,4%), desempregados (72,3%), casados (73,1%), em agregados de 4 a 6 membros (77,3%) e morando em condições de habitação inadequada (70,2%), com estádio II da doença (78,4%), não fumantes (71,9%), consumidores regulares de bebidas alcoólicas (73,7%) e que praticavam atividade física (76,4%). Encontrou-se associações estatísticas entre insegurança alimentar e faixa etária (p = 0,001), escolaridade (p = 0,001), situação de emprego (p < 0,011), número de pessoas por domicílio (p < 0,028), ser fumante (p < 0,013) e estádio da doença (p < 0,017). Conclusão: estes resultados, sugerem a investimentos em políticas que visam a melhoria da produção agrícola, da renda, escolaridade, acesso a emprego e redução dos níveis de pobreza são necessárias para aumentar a disponibilidade, melhoria de acesso e utilização dos alimentos.

The further development of research capacity in low- and middle-income countries is critical to the delivery of evidence-based healthcare, the design of sound health policy and effective resource allocation. Research capacity is also critical for the retention of highly skilled faculty and staff and for institutional internationalization.We summarize the accomplishments, challenges and legacy of a five-year program to train biomedical researchers entitled "Enhanced Advanced Biomedical Research Training for Mozambique (EABRTM)".A program conducted from 2015-2021 built upon the Medical Education Partnership Initiative to develop research capacity at Eduardo Mondlane University (UEM) and allied institutions. The project included design and implementation of postgraduate training programs and bolstered physical and human research infrastructure.The program supported development and implementation of UEM's first doctoral (Bioscience and Public Health) and master (Biosciences) programs with 31 and 23 students enrolled to date, respectively. Three master programs were established at Lúrio University from which 176/202 (87.1%) and 107/202 (53.0%) students obtained a Postgraduate Diploma or master's degree, respectively. Scholarships were awarded to 39 biomedical researchers; 13 completed master degrees, one completed a PhD and five remain in doctoral studies. Thirteen administrative staff and four biomedical researchers were trained in research administration and in biostatistics, respectively. A total of 119 courses and seminars benefited 2,142 participants. Thirty-five manuscripts have been published to date in peer-reviewed international journals of which 77% are first-authored by Mozambicans and 44% last-authored by Africans. Sustainability was achieved through 59 research projects awarded by international agencies, totaling $16,363,656.42 and funds ($ 7,319,366.11) secured through 2025.The EABRTM program substantially increased research and mentorship capacity and trained a new generation of biostatisticians and research administrators. These programmatic outcomes significantly increased the confidence of early stage Mozambican researchers in their ability to successfully pursue their career goals.