Factors associated with attempted suicide during adolescence

Thesis (M.A.)--University of the Witwatersrand, Faculty of Humanities, 1991.This study examines factors associated with attempted suicide during adolescence. The sample consists of 10 Black adolescent girls who atempted suicide in the past year, and were admitted to Baragwanath Hospital. Each subject was questioned on demographic information and completed the Separation Anxiety Test (Hansburg, 1972) and Section 1 of the Inventory of Parent and Peer Attachment (Armsden and Greenberg, 1987), which assesses attachment to a parent. Subjects were also required to answer questions on their choice of responses. Common trends were found to exist among adolescent girls who attempt suicide. Adolescent girls who attempt suicide have disruptive home environments where parents experience marital problems. They show a low degree of attachment, high degree of hostility, stress avoidance during the stage of identity crisis, and they maintain a poor attachment-individuation balance. These findings suggest that the most common treatment strategy, ie. crisis intervention is not sufficient as it does not deal with underlying problems of adolescent suicide

El ‘Moderno Tropical’ en Mozambique. La construcción de un paisaje a través del clima

The Modern Movement historiography has tended to neglect the architectural works developed in the African continent, particularly in Sub-Saharan Africa, giving us a partial picture of a much broader frame. In this context, the distinctive feature of the Mozambican modern architecture (1948-1975) was its ability to respond to the specificities of the environment in which it operates by crossing the principles of the International Style with the constructive solutions of the local cultures, along with the Brazilian experience. . From this point of view, the excellence of this heritage lies, precisely, in this quest for a sustainable design, intrinsically linked to the place and the tropical climate. In order to contribute on the understanding and consolidation of knowledge about the Modern Movement in lusophone Africa, and especially in Mozambique, the present dissertation attempts to build a small narrative of this architecture, taking as guiding thread the climate issue, through a series of projects, that in some way influenced the definition of its language, and their paths in the landscape of the country. Based on a cross reading of the urban and architectural evolution in the Mozambican territory, along with a systematic analysis of four case studies in the city of Quelimane, this research work aims to contribute on the characterization of the vocabulary used and developed in this period from the perspective of what grants it its uniqueness. In this way we will try as well to demonstrate and prove the validity of the solutions adopted in that period in accordance with what we call today sustainable development

El ‘Moderno Tropical’ en Mozambique. La construcción de un paisaje a través del clima

The Modern Movement historiography has tended to neglect the architectural works developed in the African continent, particularly in Sub-Saharan Africa, giving us a partial picture of a much broader frame. In this context, the distinctive feature of the Mozambican modern architecture (1948-1975) was its ability to respond to the specificities of the environment in which it operates by crossing the principles of the International Style with the constructive solutions of the local cultures, along with the Brazilian experience. . From this point of view, the excellence of this heritage lies, precisely, in this quest for a sustainable design, intrinsically linked to the place and the tropical climate. In order to contribute on the understanding and consolidation of knowledge about the Modern Movement in lusophone Africa, and especially in Mozambique, the present dissertation attempts to build a small narrative of this architecture, taking as guiding thread the climate issue, through a series of projects, that in some way influenced the definition of its language, and their paths in the landscape of the country. Based on a cross reading of the urban and architectural evolution in the Mozambican territory, along with a systematic analysis of four case studies in the city of Quelimane, this research work aims to contribute on the characterization of the vocabulary used and developed in this period from the perspective of what grants it its uniqueness. In this way we will try as well to demonstrate and prove the validity of the solutions adopted in that period in accordance with what we call today sustainable development

gaps in knowledge and research opportunities

Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii that afflicts humans worldwide and wild and domestic warm-blooded animals. In immunocompetent individuals, the acute phase of infection presents transient low or mild symptoms that remain unnoticed. In immunocompromised patients, T. gondii is a life-threatening opportunistic infection, which can result from the reactivation of latent infection or primary infection. Moreover, congenital toxoplasmosis, which results from the transplacental passage of tachyzoites into the fetus during a pregnant primary infection, can lead to miscarriage, stillbirth, or ocular and neurologic disease, and neurocognitive deficits in the newborns. Thus, the present review aims to address the current knowledge of T. gondii infection and toxoplasmosis in Africa and especially in Mozambique, stressing the importance of identifying risk factors and promote awareness among the health care providers and population, assessing the gaps in knowledge and define research priorities. In Mozambique, and in general in southern African countries, clinical disease and epidemiological data have not yet been entirely addressed in addition to the implications of T. gondii infection in immunocompetent individuals, in pregnant women, and its relation with neuropsychiatric disorders. The main gaps in knowledge in Mozambique include lack of awareness of the disease, lack of diagnostic methods in health facilities, lack of genetic data, and lack of control strategies.[Figure not available: see fulltext.]publishersversionpublishe

The Evolution of Mentorship Capacity Development in Low- and Middle-Income Countries: Case Studies from Peru, Kenya, India, and Mozambique.

Following the Fogarty International Center-supported "Mentoring the Mentors" workshops in South America, Africa, and Asia, approaches and guidelines for mentorship at institutions within these low- and middle-income country (LMIC) contexts, appropriate for the respective regional resources and culture, were implemented. Through the presentation of case studies from these three geographic regions, this article illustrates the institutional mentorship infrastructure before the workshop and the identified gaps used to implement strategies to build mentorship capacity at the Universidad Peruana Cayetano Heredia (Peru), Kenya Medical Research Institute (Kenya), Saint John's Research Institute (India), and Eduardo Mondlane University (Mozambique). These case studies illustrate three findings: first, that mentorship programs in LMICs have made uneven progress, and institutions with existing programs have exhibited greater advancement to their mentoring capacity than institutions without formal programs before the workshops. Second, mentoring needs assessments help garner the support of institutional leadership and create local ownership. Third, developing a culture of mentorship that includes group mentoring activities at LMIC institutions can help overcome the shortage of trained mentors. Regardless of the stage of mentoring programs, LMIC institutions can work toward developing sustainable, culturally effective mentorship models that further the partnership of early career scientists and global health

Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique

Introduction: Leptospirosis is a neglected zoonotic disease caused by a bacteria of the genus Leptospira. In Africa, it is frequently mistaken for frequently occurring conditions such as malaria. The aim of this study was to identify rodent species involved in the transmission of the disease, the prevalence of pathogenic Leptospira spp. in selected rodent species and risk factors for human leptospirosis. Material and Methods: We conducted a descriptive and exploratory epidemiological and molecular study in Mozambique Island city in 2015. Six neighborhoods, comprising 30 households each were randomly selected. People from the selected 180 households were interviewed regarding their awareness of the disease, the presence of rodents in their houses, chemicals used to eliminate them, sewage disposal, water supply system, and other key issues related to the disease. In each neighborhood, we trapped 10 rodents for a morphometric study to identify their species and for molecular isolation of Leptospira DNA. We extracted kidneys from 57/60 of rodents trapped and performed nested polymerase chain reaction targeting rrs 16S ribosomal RNA and lipL32 genes for identification of Leptospira genus and pathogenic Leptospira spp. respectively. Results: Of the 180 participants 92 (51%) reported having heard of leptospirosis;107 (59%) have had the disease; 151 (83%) reported the existence of rats in their house; 100 (56%) had latrines; 118 (66%) used chemicals to kill the rats; 102 (57%) used well water and 114 (63%) used trash containers. The most prevalent rodent species captured was Rattus norvegicus 36/60 (60%), followed by Rattus rattus 19/60 (31.67%) and Mus musculus 3/60 (5%). Sequences of rrs 16S rRNA gene were identified rrs 16S ribosomal DNA RNA was identified in 20/57 (35.%) rodents. Out these two were positive for lipL32 gene, giving an overall pathogenic Leptospira infection of 3.5% (2/57). The rodent species identified as carriers of pathogenic Leptospira were Rattus norvegicus (1) and R. rattus (1). Conclusion: This is the first study in Mozambique to identify the presence of pathogenic species of Leptospira using molecular tools. Leptospirosis risk factors in Mozambique Island city are rodent’s infestation, limited disease awareness, lack of access to clean water, insufficient resources for waste collection, greater clustering of households, poor sanitation environment and degradation of living conditions. Pathogenic Leptospira spp. are present in the area studied and at least two species of rodents, the R. rattus and R. norvegicus are potentially involved in the transmission of the causal agents of the disease.publishersversionpublishe

A Cross-sectional Serological Study of Cysticercosis, Schistosomiasis, Toxocariasis and Echinococcosis in HIV-1 Infected People in Beira, Mozambique

Background: Helminthic infections are highly endemic in Mozambique, due to limited access to healthcare and resources for disease prevention. Data on the subclinical prevalence of these diseases are scarce due to the fact that an immunological and imaging diagnosis is not often available in endemic areas. We conducted a cross-sectional study on HIV1+ patients from Beira city in order to determine the seroprevalence of cysticercosis, schistosomiasis, toxocariasis and echinoccocosis and its possible interaction with HIV infection. Methodology/Principal Findings: Patients (601) were voluntarily recruited at the Ponta Gea Health Center and their demographic and clinical data were recorded (including CD4+ cell count and antiretroviral regimen). Mean age was 39.7 years, 378 (62.9%) were women and 223 (37.1%) were men. Four hundred seventy-five (475) patients (79%) were already on highly active antiretroviral therapy (HAART), and 90 started therapy after being enrolled in the study. For serological testing we used a Multiplex Western Blot IgG from LDBIO Diagnostics. The overall seroprevalence was 10.2% for cysticercosis, 23% for schistosomiasis, 7.3% for toxocariasis and 17.3% for echinococcosis. Conclusions/Significance: Neither age nor the CD4+ count were significantly associated with the seroprevalence of the helminths studied. However, patients with CD4+ between 200–500/µl had a higher seroprevalence to all helminths than those with less than 200/µl cells/and those with more than 500 cells/µl. Female gender was significantly associated with cysticercosis and schistosomiasis, and being in HAART with toxocariasis. Headache was significantly associated with cysticercosis and toxocariasis. There was no association between epilepsy and seropositivity to any of the parasites. The study concluded that a clear understanding of the prevalence and manifestations of these coinfections, how best to diagnose subclinical cases, and how to manage diseases with concomitant antiretroviral therapy is needed.The study was funded by the US National Institutes of Health through an International Pilot Grant from the UCSD Center for AIDS Research ((http://cfar.ucsd.edu/), grant number NIAID 5 P30 AI 036214. The Parasitology laboratory was renovated and equipped with support from the Gilead Foundation (Foster City, CA, USA (http://www.gilead.com/)). The manuscript writting was sponsored by Grant Number R24TW008908 from the Fogarty International Center (http://www.nih.gov/), to whom we express our gratitude. The content is solely the responsibility of the authors and does not necessarily represent the official views of the “Fogarty International Center or the National Institutes of Health.” This award is supported by funds provided to the NIH and HRSA under the “Tom Lantos and Henry Hyde United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008,” Public Law 110–293, which is more commonly known as the U.S. Presidents Emergency Plan for AIDS Relief (PEPFAR). Co-funding is also provided by the NIH Office of Research on Women's Health and the Office of AIDS Research

A prospective observational study of bacteraemia in adults admitted to an urban Mozambican hospital

Background. Bacteraemia is a common cause of fever among patients presenting to hospitals in sub-Saharan Africa. The worldwide rise of antibiotic resistance makes empirical therapy increasingly difficult, especially in resource-limited settings.Objectives. To describe the incidence of bacteraemia in febrile adults presenting to Maputo Central Hospital (MCH), an urban referral hospital in the capital of Mozambique, and characterise the causative organisms and antibiotic susceptibilities. We aimed to describe the antibiotic prescribing habits of local doctors, to identify areas for quality improvement. Methods. Inclusion criteria were: (i) ≥18 years of age; (ii) axillary temperature ≥38°C or ≤35°C; (iii) admission to MCH medical wards in the past 24 hours; and (iv) no receipt of antibiotics as an inpatient. Blood cultures were drawn from enrolled patients and incubated using the BacT/Alert automated system (bioMérieux, France). Antibiotic susceptibilities were tested using the Kirby-Bauer disc diffusion method. Results. Of the 841 patients enrolled, 63 (7.5%) had a bloodstream infection. The most common isolates were Staphylococcus aureus, Escherichia coli, and non-typhoidal Salmonella. Antibiotic resistance was common, with 20/59 (33.9%) of all bacterial isolates showing resistance to ceftriaxone, the broadest-spectrum antibiotic commonly available at MCH. Receipt of insufficiently broad empirical antibiotics was associated with poor in-hospital outcomes (odds ratio 8.05; 95% confidence interval 1.62 - 39.91; p=0.04). Conclusion. This study highlights several opportunities for quality improvement, including educating doctors to have a higher index of suspicion for bacteraemia, improving local antibiotic guidelines, improving communication between laboratory and doctors, and increasing the supply of some key antibiotics.

A prospective observational study of bacteraemia in adults admitted to an urban Mozambican hospital

Background. Bacteraemia is a common cause of fever among patients presenting to hospitals in  sub-Saharan Africa. The worldwide rise of antibiotic resistance makes empirical therapy increasingly  difficult, especially in resource-limited settings.Objectives. To describe the incidence of bacteraemia in febrile adults presenting to Maputo Central Hospital (MCH), an urban referral hospital in the capital of Mozambique, and characterise the causative  organisms and antibiotic susceptibilities. We aimed to describe the antibiotic prescribing habits of local doctors, to identify areas for quality improvement.Methods. Inclusion criteria were: (i) .18 years of age; (ii) axillary temperature .38‹C or .35‹C; (iii) admission to MCH medical wards in the past 24 hours; and (iv) no receipt of antibiotics as an inpatient. Blood cultures were drawn from enrolled patients and incubated using the BacT/Alert automated system (bioMerieux, France). Antibiotic susceptibilities were tested using the Kirby-Bauer disc diffusion method.Results. Of the 841 patients enrolled, 63 (7.5%) had a bloodstream infection. The most common isolates were Staphylococcus aureus, Escherichia coli, and non-typhoidal Salmonella. Antibiotic resistance was common, with 20/59 (33.9%) of all bacterial isolates showing resistance to ceftriaxone, the broadest-spectrum antibiotic commonly available at MCH. Receipt of insufficiently broad empirical antibiotics was associated with poor in-hospital outcomes (odds ratio 8.05; 95% confidence interval 1.62 - 39.91;  p=0.04).Conclusion. This study highlights several opportunities for quality improvement, including educating doctors to have a higher index of suspicion for bacteraemia, improving local antibiotic guidelines,  improving communication between laboratory and doctors, and increasing the supply of some key antibiotics