Malaria remains a major cause of morbidity and mortality among children under five years of age in Mozambique despite ongoing prevention and control interventions. Understanding the sociodemographic and household factors associated with malaria is essential for designing targeted public health strategies. This study aimed to determine the burden of malaria and identify its associated factors among children aged 6–59 months in Mozambique. This study used secondary data from the nationally representative 2022–23 Mozambique Demographic and Health Survey. A weighted sample of 4,016 children aged 6–59 months who underwent malaria rapid diagnostic testing (mRDT) was included in the analysis. Descriptive statistics were used to summarize participants’ characteristics and estimate malaria prevalence. Associations between malaria and independent variables were assessed using modified Poisson regression with robust variance estimation. Adjusted prevalence ratios (APRs) with 95

BackgroundTuberculosis (TB), HIV, and malaria continue to impose major economic hardship on households in Sub-Saharan Africa. While global frameworks such as the WHO End TB Strategy and Universal Health Coverage (UHC) emphasize social protection, evidence remains limited on how national policies translate these commitments into practice.ObjectivesThis study assessed how national TB, HIV, and malaria policies and strategic plans in Kenya, Malawi, Mozambique, Nigeria, and Zambia define and operationalize social-protection mechanisms to reduce household economic burden. It also examined alignment with global targets on catastrophic-cost elimination and financial-risk protection, and identified policy–practice and equity gaps.MethodsA structured policy and document review was conducted in five countries, covering strategic plans, operational guidelines, and financing frameworks published between 2015 and 2025. Documents were sourced from government portals and partner repositories, including the Global Fund, PEPFAR, WHO IRIS, and UNAIDS. Analysis used a five-domain matrix adapted from WHO Health Systems Building Blocks and the Global UHC Readiness Framework: (A) Social Support Types, (B) Financial Protection, (C) Implementation Details, (D) Targeting & Equity, and (E) Coordination & Accountability. Domains were scored from 0 to 3 (0 = absent, 3 = high readiness). Two reviewers independently coded data and resolved discrepancies by consensus. Domain averages were used to generate national readiness indices for cross-country comparison.ResultsA total of 111 policy documents were reviewed. No country had institutionalized catastrophic-cost monitoring. Overall readiness ranged from 2.6 to 2.9, indicating moderate to high preparedness to integrate social protection within infectious-disease programs. Malawi (2.9) and Zambia (2.8) scored highest due to costed, multisectoral frameworks and insurance linkages. Kenya (2.7) demonstrated strong coordination and legal anchoring but lacked formal catastrophic-cost monitoring. Mozambique (2.6) and Nigeria (2.7) scored lower in financial protection due to donor dependence and limited accountability. Implementation and coordination were strongest domains (3.0), while financial protection was weakest (2.1).ConclusionThough national policies increasingly acknowledge social protection in infectious-disease control, significant gaps persist in financial-risk monitoring, budgeting, and accountability. Institutionalizing catastrophic-cost surveillance, integrating costed interventions into financing strategies, and reinforcing multisectoral coordination are critical to protect households from the economic impacts of infectious diseases.

Pediatric tuberculosis diagnosis relies heavily on imaging, yet access, equipment standards, and dose monitoring differ widely across health systems. Evidence describing how these contextual factors influence imaging use and radiation exposure in children remains scarce. To describe pediatric tuberculosis imaging practices and estimated radiation doses across two distinct resource settings, Spain (hospital-based, high-resource) and Mozambique (primary care-based, low-resource), to inform strategies for safe, equitable, and context-appropriate imaging. A descriptive mixed-methods study combined retrospective data of children (<16 years) diagnosed with tuberculosis (Spain 2015–2021; Mozambique 2018–2021) with complementary surveys of imaging providers. In Spain, chest X-ray and computed tomography parameters were extracted from digital imaging and communications in medicine files to estimate organ-specific doses using the National Cancer Institute dosimetry systems for radiography and computed tomography. In Mozambique, dose estimates were based on standardized pediatric protocols and site survey parameters due to limited digital data. Surveys captured information on imaging access, guideline use, and professional training. Imaging data were available for 84 Spanish and 83 Mozambican children. In Spain, children underwent multiple chest X-rays (mean four per child) and computed tomographies (mean three per child), resulting in cumulative lung doses up to 20 mGy cm2, remaining below diagnostic reference levels. In Mozambique, most children had one or two chest X-rays, with cumulative lung doses <0.05 mGy cm2. Survey findings indicated structured dose optimization and quality assurance practices in Spain, versus limited equipment and predominantly non-physician interpretation in Mozambique. Context-appropriate improvements in pediatric imaging such as strengthened infrastructure, training, dose monitoring, and quality assurance are essential to ensure safe exposure and equitable, reliable tuberculosis diagnosis for children.

Transactional and intergenerational sexual relationships, often termed “sugar daddy-marandza” dynamics, are a key driver of HIV among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA). This narrative review synthesizes evidence from 29 studies across the region, using the term “marandza"—originating in Mozambique—as an illustrative lens to examine a region-wide phenomenon. The review confirms these relationships consistently increase HIV vulnerability due to power imbalances, economic dependency, and patriarchal norms. Poverty, consumerism, and peer pressure propel AGYW into these partnerships, which are characterized by low condom use and limited negotiation power. The findings demonstrate that the issue is rooted in structural inequalities rather than cultural specificity. Digital platforms are increasingly facilitating these transactional encounters. Effective response requires multisectoral, gender-transformative interventions focusing on economic empowerment, social norm change with men and boys, and youth-friendly health services. Future research should evaluate integrated program models and the evolving role of digital technology in reshaping these relationships.

BACKGROUND:Diagnosing tuberculosis (TB) in children is challenging because of nonspecific symptoms, low microbiological yield, and imaging limitations. Comprehensive point-of-care ultrasound (cPOCUS) may detect mediastinal lymphadenopathy, but evidence remains limited. METHODS:We conducted a prospective observational study in four tertiary hospitals in Spain (May 2023-June 2024) enrolling children (0-18 years) with presumptive TB. All participants underwent chest X-ray (CXR) and cPOCUS; chest CT was performed when clinically indicated. cPOCUS assessed lung, mediastinal, and abdominal compartments using a standardized protocol. Images were independently reviewed by expert readers blinded to clinical data. Diagnostic performance was evaluated against a final TB classification based on clinical, immunological, microbiological, and conventional radiological findings, excluding cPOCUS. RESULTS:Twenty-seven children were included (median age 9.0 years), of whom 12 (44.4%) had TB disease. CT was performed in 14 (51.9%). Only 22.2% of cPOCUS examinations were complete. Mediastinal lymphadenopathy was the most frequent abnormality. cPOCUS detected abnormalities in 58.3%-63.6% of TB cases, particularly aortopulmonary window lymph nodes and small subpleural consolidations, with moderate sensitivity and high specificity (80.0%-86.7%). Inter-reader agreement was high (κ = 0.92). CONCLUSIONS:In this pilot prospective study, cPOCUS demonstrated limited diagnostic performance but high inter-reader reliability. These exploratory findings suggest that cPOCUS may complement standard imaging for selected abnormalities (particularly aortopulmonary window lymphadenopathy), but larger studies with optimized protocols are needed before broader clinical implementation.

Tuberculosis (TB) remains a significant global public health challenge. Childhood TB treatment outcomes in Mozambique remain poorly understood. This retrospective cohort study aims to identify factors associated with unsuccessful outcomes in children. We analysed children (0–14 years) treated for TB between 2018 and 2021 in 16 selected health facilities. Logistic regression was undertaken to identify factors associated with unsuccessful outcomes reported as Odds ratios (ORs) with 95

Diagnosing tuberculosis (TB) in children is challenging due to non-specific symptoms, paucibacillary disease, and difficulty producing sputum. Chest X-rays (CXRs), though widely used, are often inaccessible in low-resource settings and involve radiation. Ultrasound (US) is a radiation-free, portable, and potentially low-cost alternative that can detect pulmonary and extrapulmonary TB features. However, its diagnostic accuracy in paediatric TB remains unclear. This systematic review and meta-analysis assessed US diagnostic performance for paediatric TB across anatomical sites. Following PRISMA-DTA guidelines, we searched five databases through May 2025. Studies were included if they involved children under 15 with presumptive TB and reported US diagnostic accuracy data. Data extraction, quality assessment (QUADAS-2), and meta-analyses using a bivariate random-effects model were conducted. Graham's TB classification served as the reference standard. CXR was used as a comparator where available, with agreement assessed via Cohen's kappa. Of 17 019 records, 7 studies involving 945 children met inclusion criteria. Pooled US sensitivity was 52% (95% CI: 46-58%), and specificity was 76% (95% CI: 67-83%). US showed high specificity but low sensitivity across most features, including abdominal lymphadenopathy and pericardial effusion; pleural effusion had slightly higher sensitivity (18%). Agreement with CXR was moderate (kappa 0.24-0.42). Variability in US protocols, operator skills, and reference standards limited generalizability. Only one study had low risk of bias across all QUADAS-2 domains. US is a promising adjunct for paediatric TB diagnosis in resource-limited settings, but standardization and validation are needed to improve its standalone utility.

In Sub-Saharan Africa, maternal health remains a significant public health challenge, and women with disabilities (WWD) experience profound inequities in access to essential healthcare services. In Mozambique, although national strategies promote disability inclusion, systemic and structural barriers continue to undermine equitable access to maternal health services. This study explores the intersection of maternal health and disability inclusion in Mozambique, identifying barriers faced by women with disabilities and opportunities to improve service accessibility and quality. A mixed-methods design was employed, integrating a desk review with stakeholder consultations and an interactive workshop. The desk review examined national policies and relevant literature on maternal health and disability inclusion in Mozambique. Stakeholder consultations were conducted via surveys across multiple regions, engaging WWD, healthcare providers, policymakers, and disability advocates. Key findings were validated and refined through participatory workshops involving diverse stakeholders. Quantitative data were analysed descriptively, while qualitative responses were thematically analysed. The study found that women with disabilities in Mozambique face multifaceted barriers to maternal health, including inaccessible infrastructure, lack of adapted medical equipment, financial constraints, inadequate provider training, communication gaps and stigmatizing attitudes. Among 81 surveyed participants, over 80

Rifampicin-Resistant Tuberculosis (RRTB) is associated with a high risk of mortality during treatment. This study aims to describe the baseline characteristics associated with incidence of mortality in persons with rifampicin-resistant tuberculosis (P-RRTB) in a rural setting in Mozambique. We analyzed cohort data collected retrospectively from paper medical files and electronic medical records of P-RRTB who were routinely treated at Carmelo Hospital of Chokwe (Gaza province, Mozambique), from 1st January 2015 to 31st December 2020. Kaplan-Meier survival curves and adjusted Cox regression analyses were used to model the time to death and associated factors of mortality. Overall, 151 P-RRTB contributed to a total number of 1812 person-months (PM) of treatment follow-up. The overall mortality rate was 1.9 per 100 person-months (95% confidence interval [CI]: 1.3-2.1). Adjusted Cox regression predicted higher risk of mortality in those treated with injectable anti-RRTB second line drugs (SLD), (adjusted hazard ratio [aHR] 3.72, 95% CI 1.23-11.22, p = 0.020), had a parenchymal lesion with more than 50% fibrosis (aHR 3.06, 95% CI 1.38-6.79, p = 0.006), presented right ventricular dysfunction on the echocardiogram with venous assessment (aHR 3.18, 95% CI 1.15-8.83, p = 0.026), and manifested baseline hemoglobin (Hgb) = 8.0-9.9 g/dL (aHR 2.82, 95% CI 1.09-7.27, p = 0.032), as well Hgb < 7.9 g/dL (aHR 3.06, 95%CI 1.24-7 0.51, p = 0.015). However, lower risk of mortality was predicted in those who had an optimal immunovirological response to ART (aHR 0.18, 95% CI 0.04-0.93, p = 0.040). Kaplan-Meier analysis showed higher cumulative incidence of mortality after 3 months of follow-up, above 26% in those with immunovirological failure to ART therapy (p = 0.006), 45% with Hgb < 7.9 g/dL (p < 0.001), 23% in treated with injectables-based drugs (p = 0.03), 39% with parenchymal lesion > 50% fibrosis on the chest X-ray (p < 0.001), 56% with right ventricular dysfunction (p = 0.003). Mortality risk among P-RRTB was higher in those with anemia, injectable anti-RRTB medications, lung lesions > 50% fibrosis, and right ventricular dysfunction.

Background: Tuberculous meningitis (TBM) is the most severe form of tuberculosis and is associated with high morbidity and mortality, especially in resource-limited settings. In Mozambique, where both tuberculosis and HIV are highly prevalent, TBM poses significant diagnostic and therapeutic challenges. This study aimed to describe the clinical characteristics and to identify predictors of TBM mortality among persons living with HIV (PLWH) in a rural hospital in Mozambique. Methods: We conducted a retrospective cohort study at Carmelo Hospital of Chokwe (CHC) between 2015 and 2020. We included 372 PLWH diagnosed with TBM (PTBM); data on demographics, clinical presentation, and laboratory findings were extracted from patient records. TBM diagnosis was considered for confirmed cases based on a hospital-adapted algorithm incorporating clinical features, cerebrospinal fluid (CSF) analysis, TB-LAM, and Xpert MTB/RIF testing. Cox proportional hazard models were used to identify independent predictors of mortality, and Kaplan–Meier survival curves with log-rank tests were used to assess survival differences across clinical subgroups. Significance was considered at a p value ≤ 0.05 with an adjusted hazard ratio (AHR) 95% CI in the multivariate analysis. Results: Overall, 372 PTBM contributed to a total of 3720 person-months (PM) of treatment follow-up, corresponding to a mortality incidence of 3.76 deaths per 100 person-months. Factors independently associated with increased mortality included male sex (adjusted hazard ratio [aHR]: 1.80; 95% CI: 1.21–2.68; p = 0.004), BMI < 18.5 kg/m2 (aHR: 2.84; 95% CI: 1.46–5.55; p = 0.002), Immunovirological failure to ART (aHR: 2.86; 95% CI: 1.56–5.23; p = 0.001), CSF opening pressure >40 cmH2O (aHR: 2.67; 95% CI: 1.46–4.86; p = 0.001), and TBM severity grading III (aHR: 4.59; 95% CI: 1.79–11.76; p = 0.001). TBM involving other organs also significantly worsened survival (aHR: 2.03; 95% CI: 1.27–3.25; p = 0.003). Conclusions: TBM mortality in PLWH was driven by ART failure, high CSF pressure, and malnutrition. Male sex and severe neurology also increased risk. Urgent interventions are proposed: optimize ART, manage intracranial pressure, provide nutritional support, and use corticosteroids. An integrated care approach is essential to improving survival in resource-limited settings.

Background: Point of care ultrasound (POCUS) is increasingly recognized as a valuable tool for mediastinal assessment in children, particularly in resource-limited settings where advanced radiological options such as computed tomography (CT) scans are often unavailable. In high-income countries, POCUS is gaining traction as a complementary imaging method, offering a safer, radiation-free alternative. Methods: To overcome the operator-dependent nature of mediastinal POCUS, a standardized protocol was developed. The protocol includes clear techniques and detailed descriptions of normal and pathological findings, aiming to enhance consistency and diagnostic accuracy. Results: The standardized protocol improved reliability in mediastinal POCUS assessments, especially in the context of paediatric pulmonary tuberculosis, a condition often marked by lymph node involvement. Given the challenges of obtaining respiratory samples in children and their typically low diagnostic yield, POCUS emerged as a particularly suitable diagnostic modality. Conclusions: Mediastinal POCUS, guided by a standardized protocol, represents a safe, affordable, point-of-care, and non-ionizing option for identifying mediastinal lymphadenopathy. Its application holds promise for improving the diagnosis of paediatric tuberculosis, especially in settings with limited access to advanced radiological imaging

Drug Resistance Tuberculosis (DRTB) is associated with a high risk of mortality during treatment. This study aims to describe the incidence and baseline characteristics associated with mortality in persons with drug resistance tuberculosis (P-DRTB) in a rural setting, in Mozambique. We analyzed cohort data collected retrospectively from paper medical files and electronic medical records of persons with DRTB (P-DRTB) who were routinely treated at Carmelo Hospital of Chokwe (Gaza province, Mozambique), from 1st January 2015 to 31st December 2020. Kaplan-Meier survival curves and adjusted Cox regression analyses were used to model the time to death and associated factors of mortality. Overall, 151 P-DRTB contributed to a total number of 1812 person-months (PM) of treatment follow-up. The overall mortality rate was 1.9 per 100 person-months (95% confidence interval [CI]: 1.3–2.1). Adjusted Cox regression predicted higher risk of mortality in those treated with DRTB injectable SLD, (adjusted hazard ratio [aHR] 3.72, 95% CI 1.23–11.22, p = 0.020), had a parenchymal lesion with more than 50% fibrosis (aHR 3.06, 95% CI 1.38–6.79, p = 0.006), presented right ventricular dysfunction on the venous cardio ultrasound (aHR 3.18, 95% CI 1.15–8.83, p = 0.026), and manifested baseline hemoglobin (Hgb) = 8.0–9.9 g/dL as well Hgb < 7.9 g/dL (aHR 2.82, 95% CI 1.09–7.27, p = 0.032; aHR 3.06, 95%CI 1.24–7 .51, p = 0.015) respectively. However, lower risk of mortality was predicted in those who had an optimal immunovirological response to ART (aHR 0.18, 95% CI 0.04–0.93, p = 0.040). Kaplan-Meier analysis showed higher cumulative incidence of mortality after 3 months of follow-up, above 26% in those with immunovirological failure to ART therapy p = 0.006), 45% with Hgb < 7.9g/dL (p < 0.001), 23% in treated with injectables-based drugs (p = 0.03), 39% with parenchymal lesion > 50% fibrosis on the chest X-ray (test p = < 0.001), 56% with right ventricular dysfunction (p = 0.003). Mortality risk among P-DRTB was higher in those with anemia, injectable DRTB medications, lung lesions > 50% fibrosis, and right ventricular dysfunction.

IntroductionCardiovascular diseases contribute significantly to global morbidity and mortality. MicroRNAs are crucial in the development and progression of these diseases by regulating gene expression in various cells and tissues. Their roles in conditions like atherosclerosis, heart failure, myocardial infarction, and arrhythmias have been widely researched.Materials and MethodsThe present study provides an overview of existing evidence regarding miRNAs' role in cardiovascular disease pathogenesis. Furthermore, the study examines current state-of-the-art technologies used in the study of miRNAs in cardiovascular disease. As a final point, we examine how miRNAs may serve as disease biomarkers, therapeutic targets, and prognostic indicators.ResultsIn cardiology, microRNAs, small noncoding RNA molecules, are crucial to the posttranscriptional regulation of genes. Their role in regulating cardiac cell differentiation and maturation is critical during the development of the heart. They maintain the cardiac function of an adult heart by contributing to its electrical and contractile activity. By binding to messenger RNA molecules, they inhibit protein translation or degrade mRNA. Several cardiovascular diseases are associated with dysregulation of miRNAs, including arrhythmias, hypertension, atherosclerosis, and heart failure. miRNAs can be used as biomarkers to diagnose and predict diseases as well as therapeutic targets. A variety of state-of-the-art technologies have aided researchers in discovering, profiling, and analyzing miRNAs, including microarray analysis, next-generation sequencing, and others.ConclusionDeveloping new diagnostics and therapeutic approaches is becoming more feasible as researchers refine their understanding of miRNA function. Ultimately, this will reduce the burden of cardiovascular disease around the world.

Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.

Background Tuberculosis (TB) remains a significant global health challenge, particularly in children, where diagnosis is challenging. Radiological resources such as chest X-rays and CT scans play a crucial role in early screening and diagnosis, especially in the absence of microbiological confirmation of disease. However, radiological capacity and access vary widely across regions and countries.Methods This study retrospectively audited licensed X-ray and CT units in Mozambique, South Africa and Spain in 2022. Population data were used to calculate units per million people. The study used choropleth maps to visualise regional disparities and to explore potential interactions between radiological capacity, population density and TB notifications.Results Mozambique had the lowest radiological capacity, with 3.6 X-ray units and 0.4 CT units per million people, compared with South Africa's 34.2 X-ray units, 5.8 CT units and Spain's 811.5 X-ray units and 19.3 CT units. The private sector exhibited higher capacity than the public sector in all countries. Regional disparities were evident, particularly in Mozambique, highlighting urban-rural discrepancies and in-country inequalities.Conclusion This study underscores significant disparities in radiological capacity between low-income, middle-income and high-income countries, with economic factors playing a pivotal role. Addressing these disparities is crucial for improving TB and other disease diagnostic capabilities, particularly in resource-limited settings. Potential solutions include establishing dedicated national radio-diagnostic departments, developing national guidelines and integrating portable AI-powered X-ray or point-of-care ultrasonography technology. These findings provide valuable insights for policymakers and stakeholders to advocate for improved radiological resources and equitable healthcare access.

Introduction: Approximately 50 million people worldwide have epilepsy, with many not achieving seizure freedom. Organ-on-chip technology, which mimics organ-level physiology, could revolutionize drug development for epilepsy by replacing animal models in preclinical studies. The authors’ goal is to determine if customized micro-physiological systems can lead to tailored drug treatments for epileptic patients. Materials and methods: A comprehensive literature search was conducted utilizing various databases, including PubMed, Ebscohost, Medline, and the National Library of Medicine, using a predetermined search strategy. The authors focused on articles that addressed the role of personalized micro-physiological systems in individual drug responses and articles that discussed different types of epilepsy, diagnosis, and current treatment options. Additionally, articles that explored the components and design considerations of micro-physiological systems were reviewed to identify challenges and opportunities in drug development for challenging epilepsy cases. Results: The micro-physiological system offers a more accurate and cost-effective alternative to traditional models for assessing drug effects, toxicities, and disease mechanisms. Nevertheless, designing patient-specific models presents critical considerations, including the integration of analytical biosensors and patient-derived cells, while addressing regulatory, material, and biological complexities. Material selection, standardization, integration of vascular systems, cost efficiency, real-time monitoring, and ethical considerations are also crucial to the successful use of this technology in drug development. Conclusion: The future of organ-on-chip technology holds great promise, with the potential to integrate artificial intelligence and machine learning for personalized treatment of epileptic patients.

Introduction:Sleep disorders represent common complaints in different medical illnesses. They encompass a risk for diverse inflammatory, metabolic, and cardiovascular diseases. Sleep disorders include disorders of hypersomnolence, insomnia, parasomnias, sleep-related movement disorders, circadian rhythm sleep-wake-disorders, and sleep-related breathing disorders, each one of which was associated with increased cardiovascular disease risk in a different mechanism. In this review, the authors address the most recent research on the correlation between sleep and CVD. Methods:The literature on sleep disorders and their potential links to various cardiovascular diseases was reviewed in narrative form. For the published papers up to June 2023, the authors searched the databases of PubMed and Google Scholar. Literature demonstrating the relationship between these illnesses, pathophysiological mechanisms, diagnosis, and various therapeutic approaches was included. Results:Sleep disorders were significantly linked to heart rate variability, hypertension, and obesity, which can eventually result in cardiovascular consequences and affect mortality and morbidity. The disruption in sleep cycles, which can be noticed in different sleep disorders, can obviously result in blood pressure, heart rate, and other cardiac functions. The clinical assessment acts as the cornerstone in the diagnosis of different spectrums of sleep disorders. The management of sleep disorders ranges from cognitive-behavioral therapy to continuous positive airway pressure (CPAP). Conclusion:Additional research on the topic is needed to pinpoint any potential links and pathological processes. To improve clinical treatment and preventive measures, further observational studies should emphasize the reliability of early diagnostic signs.

Introduction: Socioeconomic and demographic conditions in a country can influence tuberculosis incidence and mortality, with nearly 95% of tuberculosis-related deaths occurring in poorer countries. Mozambique is among the 30 countries with the highest TB burden. Objective: The study aimed to estimate the average direct medical cost of treating drug-resistant tuberculosis in 19 health centers in Maputo City, Mozambique. Methods: A retrospective analysis of direct medical costs was conducted on patients aged 18 and older who completed 20-month drug-resistant tuberculosis treatment regimens in Maputo City in 2019. Results: This analysis covered 140 patients who completed a 20-month treatment regimen, with 64.3% (78) being male and 35.7% (62) female. Approximately 50% of the participants were aged between 29 and 47. The average direct medical cost of DRTB treatment was $4789.43, reaching up to $6568.00, with a standard deviation of $753.26, including clinical interventions and treatment. Conclusion: The direct medical costs for a basic treatment package for a patient with drug-resistant TB in Mozambique equal 36 minimum wages. Developing alternative and innovative funding mechanisms and identifying ways to mitigate costs through the use of generic medicines would be beneficial.