clinicaltrials.gov Identifier: NCT00552006.

in the two paediatric wards of HCB, a 728-bed referral hospital in Beira, the second-largest city in Mozambique. A maximum of 150 and 60 children are treated in the 100-bed paediatric ward and the 24-bed malnutrition ward, respectively; one bed is therefore often occupied by more than one child. One family member is allowed to stay in the Objectives. A prospective surveillance study was conducted to investigate the epidemiology and patterns of antibiotic resistance among uropathogens from hospitalised children in Beira, Mozambique. Additionally, information regarding determinants of a urinary tract infection (UTI) was obtained. Methods. Bacterial species identification, antimicrobial susceptibility testing and extended-spectrum beta-lactamase testing were performed for relevant bacterial isolates. Results. Analysis of 170 urine samples from 148 children yielded 34 bacterial isolates, predominantly Escherichia coli and Klebsiella spp., causative of a urinary tract infection in 29 children; 30/34 isolates (88.2%) from 26/29 children (89.7%) were considered highly resistant micro-organisms (HRMOs). No significant determinants of urinary tract infection with HRMOs were detected when analysing gender, antibiotic use during hospital admission and HIV status. Conclusion. This study shows, for the first time in Mozambique, an extremely high prevalence of HRMOs among uropathogens from hospitalised children with a urinary tract infection.

Context:A key element of the doctor-patient relationship is to understand the patient's and doctor's perceptions of quality care. Objectives: To assess the perceptions of good and bad doctors among first-year medical students and local community members in a semi-urban, African setting.Methods: Using open-ended and closed dichotomous questions, 115 first-year medical students in Beira, Mozambique were surveyed regarding their perceptions of a 'good' and 'bad' doctor. Students then surveyed 611 community members in a predominately poor, semi-urban neighbourhood. Results: Answers to open-ended questions provided by both groups produced the same four most important positive characteristics, with good diagnostic and therapeutic skills and dedication ranked highest. Closed-ended questions revealed that local community members felt that being concerned/considerate and diagnosing well were equally important (19.5% and 17.5%, respectively) compared to students (17.5% and 41.2%, respectively). The most important negative characteristics to the open-ended question for both groups were discrimination and contemptuous behaviour: 29.3% for community members and 27.4% for medical © A Pfeiffer, BH Noden, ZA Walker, R Aarts, J Ferro, 2011. A licence to publish this material has been given to Education for Health: http://www.educationforhealth.net/ 2 students. The biggest difference between groups was poor attending skills: 17.3% by community members and 3.9% by medical students. Conclusion:This study highlights differences and similarities between the perceptions of medical students and community members concerning a 'good' and a 'bad' doctor. Our data suggest that perceptions are guided by the experiences and values of those interviewed. Results indicate that medical education in developing countries should focus on patient-centered care, including communication skills and attitudes, besides training knowledgeable doctors.