Search

Isac Rodrigues Comia,1– 3,&ast; Leonardo Manuel,1– 3,&ast; Regina Daniel Miambo,3,4 Awa Abdul Carimo,3,5 Percílio da Floca Manjate,3,5 Ana Edith Maholela,3,6 Lucas Raimundo Banze,2,3 Titos Paulo Buene,2,3 Noémia Nhancupe,2,3 Irina M Sousa,3,7 Constance A Benson,8 Robert T Schooley,9 Jahit Sacarlal,2 Emília Virgínia Noormahomed2,3,9 1Department of Research and Extension, Faculty of Health Sciences, Lúrio University, Nampula, Mozambique; 2Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique; 3Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique; 4Department of Para-Clinics, Faculty of Veterinary, Eduardo Mondlane University, Maputo, Mozambique; 5Department of Medicine, Eduardo Mondlane University, Maputo, Mozambique; 6Department of Medicine, Maputo Central Hospital, Maputo, Mozambique; 7Department of Biological Sciences, Faculty of Sciences, Eduardo Mondlane University, Maputo, Mozambique; 8Department of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, CA, USA; 9Department of Medicine, Division of Infectious Diseases, University of California, San Diego, CA, USA&ast;These authors contributed equally to this workCorrespondence: Emília Virgínia Noormahomed, Av. Salvador Allende, 702, Maputo, Mozambique, Tel +258828810907, Fax +25821304684, Email enoormahomed@gmail.comIntroduction: This study aims to determine the baseline seroprevalence of leptospirosis, a zoonotic and neglected disease, in people living with HIV (PWH) in Maputo, Mozambique, and to evaluate the relationship between selected HIV-related factors that might influence risk of coinfection with leptospirosis, such as degree of immunosuppression, as assessed by CD4 cell count, World Health Organization (WHO) HIV/AIDS clinical stage and antiretroviral therapy (ART) intake.Methods: This was a descriptive cross-sectional analysis of 157 PWH, aged over 18 years old, admitted to the Maputo Central Hospital, in Maputo, Mozambique, between March 2020 and October 2021. The study participants were recruited as a convenience sample regardless of the reasons for their admission. We collected sociodemographic and clinical data, including ART and WHO HIV/AIDS clinical stage, and blood for CD4 cell count and detection of Leptospira IgG antibodies using a commercial Kit ab247199 Leptospira IgG ELISA (www.abcam.com/ab247199) with sensitivity and specificity of 100% and 97.3%, respectively. Laboratory testing was performed at the Faculty of Medicine, Eduardo Mondlane University and Laboratory of Clinical Analysis, in Maputo.Results: Participants were aged 18 to 72 years (median age 39 years; SD ± 10.5), the majority were female 100 (63.7%), from urban areas 138 (87.9%), with secondary-level education 80 (51%). The overall seroprevalence of Leptospira IgG antibodies was 40.1%. The median CD4 cell count was 385 cells/μl (02 to 2297; SD ± 378.47). Higher seroprevalence of Leptospira antibodies was found among participants with CD4 cell counts < 250 cells/μl (54.8%), WHO HIV/AIDS stage IV (70.2%) and those on ART (92%), though there were no statistically significant differences between groups with and without Leptospira antibodies.Conclusion: Our study confirmed that Leptospira antibodies are highly prevalent in PWH in Maputo; however, Leptospira infection was not associated with the degree of immunosuppression, WHO HIV/AIDS clinical stage, or the use of ART. Our data support the need for routine screening for leptospirosis in PWH in Mozambique. Future studies are warranted to characterize the incidence and outcomes of symptomatic leptospirosis in this patient population and to identify circulating serovars and species in the country and region, as well as the implicated reservoirs.Keywords: leptospirosis, co-infection Leptospira and HIV, Leptospira IgG, Mozambique

Importance: Malaria is a devastating disease caused by Plasmodium parasites. The evolution of parasite drug resistance continues to hamper progress toward malaria elimination, and despite extensive efforts to control malaria, it remains a leading cause of death in Mozambique and other countries in the region. The development of successful vaccines and identification of molecular markers to track drug efficacy are essential for managing the disease burden. We present an analysis of the parasite genome in Mozambique, a country with one of the highest malaria burdens globally and limited available genomic data, revealing current selection pressure. We contribute additional evidence to limited prior studies supporting the effectiveness of SWGA in producing reliable genomic data from complex clinical samples. Our results provide the identity of genomic loci that may be associated with current antimalarial drug use, including artemisinin and lumefantrine, and reveal selection pressure predicted to compromise the efficacy of current vaccine candidates., Competing Interests: The authors declare no conflict of interest.

Background: In resource-limited settings, viral load monitoring of HIV-infected patients receiving antiretroviral therapy (ART) is not readily available because of high costs. Here, we compared the accuracy and costs of quantitative and qualitative pooled methods with standard viral load testing., Methods: Blood was collected prospectively from 461 patients receiving first-line ART in Mozambique who had not been evaluated previously with viral load testing. Screening for virologic failure of ART was performed quantitatively (ie, standard viral loads) and qualitatively [one and 2 rounds of polymerase chain reaction (PCR)]. Individual samples and minipools of 5 samples were then analyzed using both methods. The relative efficiency, accuracy, and costs of each method were calculated based on viral load thresholds for ART failure., Results: Standard viral load testing of individual samples revealed a high rate of ART failure (19%-23%) across all virologic failure thresholds, and the majority of the patients (93%) with viral loads >1500 copies per milliliter had genotypic resistance to drugs in their ART regimen. Pooled quantitative screening and deconvolution testing had positive and negative predictive values exceeding 95% with cost savings of $11,250 compared with quantitative testing of each sample individually. Pooled qualitative screening and deconvolution testing had a higher cost savings of $30,147 for 1 PCR round and $25,535 for 2 PCR rounds compared with quantitative testing each sample individually. Both pooled qualitative PCR methods had positive and negative predictive values ≥90%, but the pooled 1-round PCR method had a sensitivity of 64%., Conclusions: Given the high rate of undiagnosed ART failure and drug resistance in this cohort, it is clear that virologic monitoring is urgently needed in this population. Here, we compared alternative methods of virologic monitoring with standard viral load testing of individual samples and found these methods to be cost saving and accurate. The test characteristics of each method will likely need to be considered for each local population before it is adopted.

This study evaluated the prevalence of Tinea capitis among schoolchildren at one primary school and also identified the causative agents. Scalp flakes were collected from children presenting clinical signs suggestive of Tinea capitis. Dermatophytes were identified by following standard mycological procedures. This study found a clinical prevalence of Tinea capitis of 9.6% (110/1149). The dermatophytes isolated were Microsporum audouinii, Trichophyton violaceum, and Trichophyton mentagrophytes. The most prevalent causative agent in this study was Microsporum audouinii, thus confirming the findings from previous cross-sectional studies carried out in the city of Maputo.

The study was carried out in two rural primary schools of the District of Magude, the largest district of Maputo Province in 2001. The prevalence of tinea capitis in each school was 11.6% (49/422) and 6.8% (18/263) and affected predominantly male children. The most common dermatophytes isolated from both schools were Microsporum audouinii. However, Trichophyton mentagrophytes was also found to be an important causal agent of tinea capitis in the District of Magude. Although the prevalence of tinea capitis found in our study is relatively high compared to previous cross-sectional studies carried out in Mozambique, it is still closely related to the prevalence rates reported for African countries. Tinea capitis continues to be an important public health issue in Mozambique, particularly in primary school setting.