SynopsisThe point prevalence of depression measured on one occasion between 2 and 5 months after childbirth was estimated to be 13·1% in 352 mothers living in urban Portugal; the criterion was a score of 13 or more on a translated version of the Edinburgh Post-natal Depression Scale (EPDS). More detailed comparisons were made between a subgroup of 118 mothers and 118 matched controls who had not borne a child in the previous 2 years. Post-natal women were twice as likely as non-childbearing controls to meet the EPDS criterion for depression. In comparison with controls, they were also more severely depressed as judged by their total scores on another questionnaire, the Zung Scale. Comparisons of individual symptom scores (Zung Scale) showed that childbearing women, as a whole, reported more somatic symptoms than controls, but when only those women judged to be depressed or dysphoric by the EPDS were compared, this difference disappeared. Stepwise logistic analyses of symptoms contributing to the categorization of a ‘case’ of post-natal versus non-post-natal depression did not reveal any very clear divergences in selfreported psychopathology. In childbearing women, two factors were found significantly to contribute to higher depression scores; women with more children and those from lower socioeconomic groups were most at risk.
Mineworkers are considered a population at risk for HIV due to risk behaviors associated with migratory work patterns. This was the first study in Mozambique to determine the prevalence of HIV and associated demographic and risk behaviors, and assess use and access to prevention and healthcare services among Mozambicans working in South African mines. Men who had worked in a South African mine in the past 12 months were recruited between February and May 2012 using time location sampling (TLS) at the Ressano Garcia border between Mozambique and South Africa. Demographic and behavioral data were collected through a standardized questionnaire, and HIV prevalence was estimated by testing dried blood spots (DBS) with two enzyme immunoassays. In total, 432 eligible mine workers were recruited. Mean age was 43 years. Most were married or cohabitating; among them, 12.6 % had two or more wives/marital partners in Mozambique. In the 12 months preceding the survey, 24.7 % had an occasional sexual partner, and 6.6 % had at least one partner who was a female sex worker. Only one in five (18.5 %) used a condom during last sex. HIV prevalence among mineworkers was 22.3 %, and 74.6 % of those who tested positive as part of the survey did not know their status. HIV prevalence was significantly higher (p = 0.018) among those that were uncircumcised (31.2 %) than those who were circumcised (18.5 %). Multiple partners (multiple spouses, cross-border relations, and multiple occasional partnerships), inconsistent condom use, and a high proportion of infected mineworkers who do not know their HIV status increases the risk of HIV transmission in this population. Combination strategies involving the promotion of condom use, HIV testing, and male circumcision should be strengthened among mineworkers.
This is the first integrated biological and behavioral survey among female sex workers (FSW) in Mozambique. Using respondent-driven sampling, 400, 411 and 429 FSW were enrolled respectively in Maputo, Beira and Nampula in 2011-2012. Estimates were produced using RDSAT 7.1. HIV prevalence was 31.2%, 23.6%, and 17.8% in each location respectively. Among HIV-positive FSW, 48.1%, 79.8% and 89.6% in each city, were unaware of their serostatus. Condom use at last sex with a client was 85.8%, 73.4% and 62.8% among FSW, respectively. HIV was associated with current age, age of first sex for money, low educational level, and having had a genital ulcer in the last six months. Results suggest the urgent need to increase behavioral and structural interventions in this key population.
Compared to other infectious agents, HTLV-1 is present at relatively low levels among blood donors in Mozambique. Cost and logistics will present as major challenges for introducing HTLV-1/2 screening in blood banks. In blood banks in Southern Africa where EIA testing is possible, a sequential algorithm of two EIAs may be a cost-efficient option for HTLV-1/2 screening.
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