Randomly selected parturients with term singleton pregnancies from two different settings, 83 from Mozambique and 90 from Sweden, entered the study. All of them underwent elective cesarean section, which enabled sterile harvesting of amniotic fluid (AF). AF samples were then tested for antibacterial activity (ABA). Background data and nutritional status were compared. Average age was 32.7 and 30.7 years (n.s.), average parity 6.6 and 1.6 (p
The aim of the study was to investigate inflammatory cytokines, interleukin-1 beta (IL-1 beta), interleukin-1 receptor antagonist (IL-1ra), IL-6, IL-8 in amniotic fluid, in a cohort of Swedish pregnant women from early to late pregnancy and Mozambican late pregnant women with and without signs of histologic chorioamnionitis. Eleven Swedish women were studied from early pregnancy (week 16-17) to late pregnancy (week 37-38). Amniotic fluid was collected via amniocentesis in early pregnancy and also in late pregnancy during elective Caesarean section. From Mozambican women, amniotic fluid was harvested transmurally through the uterus wall during elective Caesarean section. Half of the group of 30 women showed histological signs of chorioamnionitis and half of the group did not show such signs. A statistical, significant increase in IL-1ra, Il-6 and IL-8 values from early to late pregnancy was seen in the Swedish pregnant women. Among the Mozambican women, no statistically significant increase in the above-mentioned interleukins was observed when comparing women with and without histological signs of chorioamnionitis. Term Swedish and Mozambican women did not show differences in cytokine levels. There were no detectable values of IL-1 beta in either Swedish or Mozambican women. IL-1ra, IL-6 and IL-8 increased in amniotic fluid from the second to the third trimester in the Swedish cohort. No correlation was found between histological chorioamnionitis and elevated cytokine levels of amniotic fluid in term pregnant women not in labour. An equally good cytokine response was found among Swedish and Mozambican third-trimester non-labouring women.
For many non-governmental organizations, the treatment of war trauma among refugees has become a key issue in humanitarian assistance. There is, however, as yet little independent evaluation of the notions and therapeutic practices which inform humanitarian interventions in refugees' mental health. By drawing on intensive anthropological fieldwork, the paper problematizes two central issues in these interventions: the role of past experiences in refugees' present well-being, on the one hand, and the need to verbalize trauma in a therapy, on the other. An alternative approach to refugees' mental health draws on current theoretical insights into non-discursive bodily practices. The paper substantiates these insights by focusing on the therapeutic salience of funerals and spirit exorcism among Mozambican refugees in Malawi. By exorcizing the vengeful spirits of those who had died during the war, refugees were also healing their war traumas. It was not so much the loss as the difficulty in observing a full range of rituals that characterized refugees' predicament. The paper concludes by suggesting ways in which humanitarian assistance could utilize these insights.
The paper introduces the so-called climate change mainstreaming approach, where vulnerability and adaptation measures are assessed in the context of general development policy objectives. The approach is based on the application of a limited set of indicators. These indicators are selected as representatives of focal development policy objectives, and a stepwise approach for addressing climate change impacts, development linkages, and the economic, social and environmental dimensions related to vulnerability and adaptation are introduced. Within this context it is illustrated using three case studies how development policy indicators in practice can be used to assess climate change impacts and adaptation measures based on three case studies, namely a road project in flood prone areas of Mozambique, rainwater harvesting in the agricultural sector in Tanzania and malaria protection in Tanzania. The conclusions of the paper confirm that climate risks can be reduced at relatively low costs, but the uncertainty is still remaining about some of the wider development impacts of implementing climate change adaptation measures.
Previous studies have shown that three point mutations in exon 1 and a particular promoter haplotype of the mannan-binding lectin (MBL) gene lead to a dramatic decrease in the serum concentration of MBL. In this study, MBL genotypes and serum concentrations were determined in unrelated individuals in a population from Mozambique (n = 154) and in two native Indian tribes from Argentina (i.e., the Chiriguanos (n = 43) and the Mapuches (n = 25)). In both populations, the MBL concentrations were low compared with those found in Eskimo, Asian, and European populations. In Africans, the low serum concentrations were due to a high allele frequency (0.24) of the codon 57 (C) variant, which resulted in a high frequency of individuals with MBL deficiency (0.06), and were also due to the effect of a relatively high frequency (0.13) of low-producing promoter haplotypes. The low concentrations in the South American populations were primarily due to an extremely high allele frequency of the codon 54 (B) variant in both the Chiriguanos (0.42) and the Mapuches (0.46), resulting in high frequencies of individuals with MBL deficiency (0.14 and 0.16, respectively). In the search for additional genetic variants, we found five new promoter mutations that might help to elucidate the evolution of the MBL gene. Taken together, the results of this study show that different molecular mechanisms are the basis for low MBL levels on the two continents.
Strains of the Beijing genotype family of Mycobacterium tuberculosis are a cause of particular concern because of their increasing dissemination in the world and their association with drug resistance. Phylogenetically, this family includes distinct ancient and modern sublineages. The modern strains, contrary to the ancestral counterparts, demonstrated increasing prevalence in many world regions that suggest an enhanced bacterial pathogenicity. We therefore evaluated virulence of modern versus ancient Beijing strains with similar epidemiological and genotype characteristics. For this, we selected six strains that had very similar 24-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing profiles and belonged to the region of difference 181 (RD181) subgroup but differed using markers (mutT2 and mutT4 genes and NTF locus) that discriminate between modern and ancient Beijing sublineages. The strains were isolated from native patients in Brazil and Mozambique, countries with a low prevalence of Beijing strains. The virulence levels of these strains were determined in models of pulmonary infection in mice and in vitro macrophage infection and compared with that of a strain from Russia, part of the epidemic and hypervirulent Beijing clone B0/W148, and of the laboratory strain H37Rv. The results showed that two of the three modern Beijing strains were highly pathogenic, exhibiting levels of virulence comparable with that of the epidemic Russian strain. In contrast, all isolates of the ancient sublineage displayed intermediate or low virulence. The data obtained demonstrate that the strains of the modern Beijing sublineage are more likely to exhibit highly virulent phenotypes than ancient strains and suggest that genetic alterations characteristic of the modern Beijing sublineage favor selection of highly virulent bacteria.
The author starts her nursing routine by taking vaccines to health posts after filling up her car at the hospital complex housing the health care directorate, a pharmacy, and a car repair shop for the only ambulance and 3 communal transport cars in Quelimane, the capital Zambezi province, Mozambique. At the health post 40-50 women with children are waiting for consultation. Adult patients are also waiting for treatment of wounds and injections. Later mothers are instructed about treatment of a condition with the help of a nurse speaking the local dialect, as Portuguese is not understood by all. Nurses prescribe chloroquine to feverish children, iron pills for anemia, paracetamol, and antihelminthics because of the shortage of doctors. Child vaccination updates and monthly checks of infants is stressed to mothers as malnutrition, anemia, and infections are rampant among them. Child mortality in those under 5 reaches 40%. Mothers of children with birth weight of under 2000 gm are given a special consultation. A demonstration is held about the preparation of a nutritious diet with local foods. Later blood tests and fracture photos are taken at the hospital. The birth of a child weighing 2400 gm is assisted at an outside health station, the 5th born to a mother who is advised about family planning and regular infant care visits. Before returning home the author gets a coconut as a present picked from 1 of the numerous trees in the area whose crop is processed for coconut oil sustaining the locals' livelihood.