INTRODUCTION:Medication availability and costs can be highly variable across countries and in different time periods. We aimed to conduct a survey among local experts to obtain information on the availability and costs of allergic rhinitis medications in different countries. METHODS:We sent a survey to members of the Allergic Rhinitis and its Impact on Asthma (ARIA) group, asking for the availability and the lowest cost of specific allergic rhinitis medications in their respective countries. Data in local currencies were converted to 2024 US Dollars adjusted for Purchasing Power Parity (PPP). We compared the costs of different medication classes, assuming, for each class, the least expensive drug in each country, as well as full treatment adherence. RESULTS:We received responses from ARIA experts in 51 different countries. Intranasal corticosteroids (INCS) and oral antihistamines (OAH) were available in all countries, but this was not observed for intranasal antihistamines (INAH) or for INAH+INCS. In most countries, OAH was the least costly drug class, while INAH+INCS was the most expensive. Among INCS, beclomethasone was the medication most frequently identified as the cheapest, while cetirizine and loratadine were the OAH most frequently reported as the least expensive. Among INAH+INCS, azelastine-fluticasone was more frequently identified as less costly than olopatadine-mometasone. CONCLUSION:There is an important across-country and across-class variability in terms of costs of allergic rhinitis medications. The results of this study will inform the ARIA-EAACI 2024-2025 guidelines.
BACKGROUND:Limited data is available about the availability of multiple sclerosis (MS) therapies and services in Africa. OBJECTIVE:We aimed to investigate the availability, affordability, frequency of usage, and insurance coverage of MS therapies and services across Africa. METHODS:A comprehensive web-based survey was constructed and distributed to neurologists from different African countries. The survey addresses availability, affordability, frequency of use, and insurance coverage of different therapies and services of MS. RESULTS:Respondents represented 27 African countries. Intravenous methylprednisolone was always available in most countries (88.9%), while interferons were completely or partially available in 13 countries (48.1%). The most available disease-modifying therapies (DMTs) were rituximab (22 countries, 81%), followed by interferon beta 1a intramuscular type (12, 44.4%). Availability of other DMTs was variable, while specific MS services were limited. Affordability is limited in most countries, and the use of DMTs was related to insurance coverage. Most associated therapies and investigations were more available and affordable, but less insured. Neurologists were the main healthcare providers, but traditional healers had a role in 14.8% of countries. CONCLUSION:Significant challenges characterize MS care in Africa. MS therapies, particularly DMTs and services, are inaccessible and unaffordable in most African countries.
Background: Surgical site infections (SSIs) are among the most common healthcare-associated infections worldwide and impose a disproportionate burden in low- and middle-income countries (LMICs). In Mozambique, persistent health system constraints—including limited infection prevention and control (IPC) capacity, weak surveillance infrastructure, and rising antimicrobial resistance (AMR)—likely amplify this burden. This review synthesizes available evidence on SSI incidence, etiology, antimicrobial resistance patterns, risk factors, and surveillance practices in Mozambican healthcare settings. Methods: A structured literature search was conducted in PubMed, Embase, Scopus, Web of Science, WHO Global Index Medicus, and Google Scholar for studies published between 2000 and September 2025. Eligible studies reported SSI incidence or prevalence, causative pathogens, AMR profiles, or associated risk factors in Mozambique. Additional data were retrieved from WHO reports, Joint External Evaluations (JEEs), and national surveillance assessments. Results: Published evidence remains scarce and fragmented, with no comprehensive national estimates of SSI incidence identified. The most commonly reported pathogens were Staphylococcus aureus (including MRSA), Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., and Escherichia coli. MRSA prevalence in hospital settings ranged from 15% to 42%. Gram-negative isolates frequently demonstrated extended-spectrum β-lactamase (ESBL) production, suggesting substantial antimicrobial pressure. Reported risk factors were consistent with regional findings and included inadequate hand hygiene, suboptimal sterilization practices, prolonged lab or, malnutrition, HIV infection, and perioperative anemia. National SSI surveillance is largely absent, and only one hospital currently reports AMR data to the WHO Global Antimicrobial Resistance Surveillance System (GLASS). Conclusions: SSIs represent a significant yet underrecognized public health challenge in Mozambique. Despite increasing multidrug resistance, systematic data collection and coordinated national surveillance remain limited. Strengthening IPC programs, establishing structured SSI surveillance, expanding microbiological laboratory capacity, and implementing antibiotic stewardship initiatives are urgent priorities to improve surgical outcomes and reinforce national health security.
Background Cerebral aneurysms are rare in pediatric populations, accounting for less than 5% of all aneurysms. Etiologies are often congenital or infectious. To date, no cases of pediatric cerebral aneurysms have been reported in Mozambique. Case Presentation: We report the first documented case of a pediatric cerebral aneurysm in Mozambique. A 13-year-old boy was admitted to the Pediatric Intensive Care Unit (PICU) with a five-day history of sudden severe headache, fever, and right-sided focal seizures. Imaging revealed a right frontal parafalcine subdural empyema, which was surgically drained. Although the patient initially improved, he was readmitted 15 days later with a sudden loss of consciousness and generalized seizures. Encephalic Computed Tomography and angiography revealed intraventricular hemorrhage and ruptured aneurysms of the pericallosal and right middle cerebral arteries. Neurosurgical intervention was not available; The blood culture isolated Staphylococcus aureus , and broad-spectrum was considered, as well as supportive care, and the patient survived with neurological sequelae. Discussion This case highlights a rare and severe presentation of pediatric cerebral aneurysm associated with subdural empyema of likely infectious etiology. The vascular territories affected were atypical, and diagnosis was delayed due to the condition's rarity and limited resources. Conclusion Despite being rare, cerebral aneurysms in children should be considered in cases of neurological deterioration, especially with signs of intracranial infection. Early neuroimaging and timely neurosurgical care are essential for better outcomes in resource-limited settings.
