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: Empiric antibiotic prescribing is frequently used in low- and middle-income countries because microbiological diagnostic capacity is often limited, highlighting the need for locally generated microbiological data to support evidence-informed empiric antibiotic selection. However, data on pediatric antibiotic prescribing practices in Mozambique remain scarce. This study aimed to characterize empiric antibiotic prescribing among hospitalized pediatric patients at Maputo Central Hospital prior to the implementation of a syndromic antibiogram intervention. Methods: An exploratory, retrospective, descriptive baseline analysis was conducted among pediatric patients aged 1 month to 14 years admitted with suspected bacterial infections between January and December 2023, prior to the implementation of a syndromic antibiogram intervention. Sociodemographic, clinical, microbiological, and antibiotic prescribing data were extracted from clinical records. Antibiotics were classified according to the WHO AWaRe framework, and associations between patient characteristics, treatment strategies, and outcomes were analyzed using R software version 4.6.0. Results: A total of 358 pediatric patients were included, with a median age of 14 months (IQR: 6–48), and 57% were male. Lower respiratory tract infections were the most frequent diagnosis. Empiric treatment predominated, accounting for 89% of cases, whereas microbiologically guided therapy was observed in only 11%. Urinary tract infections showed significantly higher proportions of microbiologically guided treatment compared with respiratory infections (p < 0.001). Monotherapy predominated, while Watch antibiotics accounted for 64.7% of prescriptions. Prolonged hospitalization was associated with respiratory distress, decreased skin turgor, referral status, infection type, and anemia. Conclusions: Pediatric antibiotic prescribing was characterized by extensive empiric therapy and high Watch antibiotic use, highlighting important antimicrobial stewardship challenges in Mozambique.
Antimicrobial resistance is a major public health challenge, particularly in low- and middle-income countries, where antimicrobial stewardship is often lacking. This study assessed the knowledge, attitudes, and practices of healthcare professionals in pediatric settings regarding antimicrobial resistance and antimicrobial stewardship at Maputo Central Hospital, Mozambique. A cross-sectional study was conducted among pediatric healthcare professionals using a self-administered questionnaire. Descriptive and inferential statistical analyses were performed to assess knowledge, attitudes, and practices, and their associated factors for inappropriate prescribing. Of 108 eligible participants, 82 (76
