Frequency and distribution of neglected tropical diseases in Mozambique:a systematic review

Background:Neglected tropical diseases(NTDs)affect more than one billion people living in vulnerable conditions.In spite of initiatives recently contributing to fill NTDs gaps on national and local prevalence and distribution,more epidemiological data are still needed for effective control and elimination interventions.Main text:Mozambique is considered one of the countries with highest NTDs burden although available data is scarce.This study aims to conduct a systematic review on published available data about the burden and distribution of the different NTDs across Mozambique since January 1950 until December 2018.We identified manuscripts from electronic databases(Pubmed,EmBase and Global Health)and paper publications and grey literature from Mozambique Ministry of Health.Manuscripts fulfilling inclusion criteria were:crosssectional studies,ecological studies,cohorts,reports,systematic reviews,and narrative reviews capturing epidemiological information of endemic NTDs in Mozambique.Case-control studies,letters to editor,case reports and case series of imported cases were excluded.A total of 466 manuscripts were initially identified and 98 were finally included after the revision following PRISMA guidelines.Eleven NTDs were reported in Mozambique during the study span.Northern provinces(Nampula,Cabo Delgado,Niassa,Tete and Zambezia)and Maputo province had the higher number of NTDs detected.Every disease had their own report profile:while schistosomiasis have been continuously reported since 1952 until nowadays,onchocerciasis and cysticercosis last available data is from 2007 and Echinococcosis have never been evaluated in the country.Thus,both space and time gaps on NTDs epidemiology have been identified.Conclusions:This review assembles NTDs burden and distribution in Mozambique.Thus,contributes to the understanding of NTDs epidemiology in Mozambique and highlights knowledge gaps.Hence,the study provides key elements to progress towards the control and interruption of transmission of these diseases in the country.

Community‑based screening of Chagas disease among Latin American migrants in a non‑endemic country: an observational study

Background:Chagas disease is a parasitic disease endemic to Latin America,but it has become a disease of global concern due to migration fows.Asymptomatic carriers may host the parasite for years,without knowing they are infected.The aim of this study is to assess prevalence of Chagas disease and evaluate the participants’level of knowl‑edge between Latin American migrants attending a community-based screening campaign.Methods:Three community-based campaigns were performed in Alicante(Spain)in 2016,2017 and 2018,including educational chats and blood tests for Trypanosoma cruzi serology.Participants completed a questionnaire assessing knowledge about the mechanisms of transmission,disease presentation,diagnosis,and treatment.People seroposi‑tive for T.cruzi underwent diagnostic confrmation by two diferent tests.Results were analyzed by multivariable logistic regression and expressed as adjusted odds ratios(aORs),adjusting for age,sex,and time in Spain.Results:A total of 596 participants were included in the study;17%were aged under 18 years.Prevalence in adults was 11%[54/496;95%confdence interval(CI):8.3–14.5%]versus 0%among children.All but one case were in Bolivians.Diagnosis was independently associated with having been born in Bolivia(aOR:102,95%CI:13–781)and a primary school-level education(aOR:2.40,95%CI:1.14–5.06).Of 54 people diagnosed with Chagas disease(most of whom were asymptomatic),42(77.7%)returned to the clinic at least once,and 24(44.4%)received treatment.Multivariable analysis showed that coming from Argentina(aOR:13,95%CI:1.61–1188)or Bolivia(aOR:1.90,95%CI:1.19–3.39)and having received information about Chagas disease in Spain(aOR:4.63,95%CI:2.54–8.97)were associ‑ated with a good level of knowledge on the disease.Having primary level studies(aOR:0.59,95%CI:0.34–0.98)and coming from Ecuador(aOR:4.63,95%CI:2.52–847)were independently associated with a lower level of knowledge.Conclusions:Community-based interventions are a good strategy for diagnosing neglected diseases such as Chagas disease in non-endemic countries and for identifying and treating infected,asymptomatic individuals.