IntroductionDelayed uptake of clinical services impedes favorable clinical outcomes in Mozambique. Care is delayed among patients who initiate care with traditional healers; patients with conditions like human immunodeficiency virus (HIV) or tuberculosis are rarely referred to the health system in a timely fashion.MethodsWe conducted a pre-post educational intervention with traditional healers, assessing healer referral rates and HIV knowledge in three rural districts in Zambézia Province.ResultsThe median monthly referral rate prior to the intervention was 0.25 patients (interquartile range [IQR]: 0–0.54) compared with a post-intervention rate of 0.34 patients (IQR: 0–0.71), a 35% increase (p = 0.046). A median HIV knowledge score of 67% (IQR: 59–78) was noted 4-months pre-intervention and a median score of 81% (IQR: 74–89) was recorded 2½ months post-intervention (p<0.001). One hundred and eleven healers referred 127 adults, 36 pregnant women, and 188 children to health facilities. Referred patients were most likely to be diagnosed with bronchopneumonia (20% adults; 13% children) and/or malaria (15% adults; 37% children). Of 315 non-pregnant persons referred, 3.5% were tested for HIV and 2.5% were tested for tuberculosis.DiscussionWe engaged traditional healers with some success; referral rates were low, but increased post-intervention. Once seen in the clinics, patients were rarely tested for HIV or tuberculosis, though symptoms suggested screening was indicated. We found increased referral rates through an inexpensive intervention with traditional healers, a viable, cost-effective method of directing patients to health facilities. However, quality improvement within the clinics is necessary before a substantial impact can be expected.

BackgroundMalaria is a leading cause of mortality and morbidity in Mozambique, with nearly three-quarters of the country’s malaria-related deaths occurring in children younger than five years. A malaria vaccine is not yet available, but planning is underway for a possible introduction, as soon as one becomes available. In an effort to inform the planning process, this study explored sociocultural and health communications issues among individuals at the community level who are both responsible for decisions about vaccine use and who are likely to influence decisions about vaccine use.MethodsResearchers conducted a qualitative study in two malaria-endemic districts in southern Mozambique. Using criterion-based sampling, they conducted 23 focus group discussions and 26 in-depth interviews. Implementation was guided by the engagement of community stakeholders.ResultsCommunity members recognize that malaria contributes to high death rates and affects the workforce, school attendance, and the economy. Vaccines are seen as a means to reduce the threat of childhood illnesses and to keep children and the rest of the community healthy. Perceived constraints to accessing vaccine services include long queues, staff shortages, and a lack of resources at health care facilities. Local leaders play a significant role in motivating caregivers to have their children vaccinated. Participants generally felt that a vaccine could help to prevent malaria, although some voiced concern that the focus was only on young children and not on older children, pregnant women, and the elderly. Probed on their understanding of vaccine efficacy, participants voiced various views, including the perception that while some vaccines did not fully prevent disease they still had important benefits. Overall, it would be essential for local leaders to be involved in the design of specific messages for a future malaria vaccine communications strategy, and for those messages to be translated into local languages.ConclusionsAcceptance of routine childhood vaccines bodes well for a future malaria vaccine. Vaccinating children is a well-established routine that is viewed favourably in Mozambique. A communications strategy would need to build on existing immunization efforts and use trusted sources—including current government dissemination arrangements—to deliver health information.

Objective Healers provide support for acute and chronic illnesses in rural Mozambique, such as socially acceptable traditional “vaccinations” (subcutaneous cuts in the skin to rub herbs directly into the bloody lesion). We aimed to document the frequency of blood exposure by traditional practitioners in Mozambique. Methods We conducted surveys with a simple random sample of 236 traditional healers in Zambézia province. Chi-square and Wilcoxon rank sum tests were used to compare “injection” behaviors across districts. Results Healers treated a median of 8 patients in the past month (IQR: 4–15). 75% conducted “injections”. These healers “injected” a median of 4 patients (IQR: 1–8), used a new razor a median of 3 times (IQR: 1–8), and almost never used gloves. Lifetime blood exposures among those who provided “injections” during treatments were estimated to be 1,758 over a healer’s career. Conclusion The majority of healers is exposed repeatedly to patient blood. Given the high prevalence of HIV, hepatitis B and C virus, and other blood-borne agents, specific healer practices are an occupational hazard and reuse of razors is risky for their clients.

The relationship between common medicinal plants and major health problems in Africa, specifically Mozambique, is presented here. Emphasis is given to plant species largely used to solve or slow down diarrhoea, malaria, respiratory, and sexual complaints. These diseases, together with malnutrition/ anaemia, mental diseases, and rheumatism/arthritis are the main concern of healthcare countrywide. Diarrhoea is divided into common diarrhoea, bloody-diarrhoea, and cholera; plant species are normally used to slow down diarrhoea recurrence. Tannin is the main chemical compound with both anti-diarrhoeal and antiseptic properties. Traditional medicine seems to be rather helpful in alleviating malaria symptoms such as fever, vomiting, and diarrhoea. Special reference is made to Momordica balsamina, which is highly used to cure vomiting apparently associated with bilis and fever. Rauvolfia caffra contains reserpine, a compound used as anti-hypertension agent. This species is also used as an anti-malarial agent. Traditional medicine seems to have a role in slowing opportunistic infections related to the AIDS virus such as diarrhoea, pneumonia, and skin infections. Prostate hypertrophy is traditionally medicated using mostly Prunus africana and Hypoxis hemerocallidea, species known to contain phytosterol. Research for bioactive compounds in African plants is still in its infancy.

Background Epilepsy is a chronic brain disease that affects about 50 million people worldwide, mainly in developing countries. It is treated with anticonvulsant drugs, but in some cases, conventional anticonvulsants have not been effective, leading patients to turn to alternative herbal treatments. The study aimed to identify plants used in traditional medicine for the treatment of epilepsy in southern Mozambique, record the parts used, the method of preparation as well as the mode of administration. Methodology: The study was conducted between April to June 2019. 53 Traditional Medicine Practitioners were interviewed using a semi-structured questionnaire. The data was analyzed by calculating the Percentage of Citation (%FC) and Informant Factor Consensus (IFC). Results A total of 32 medicinal plants belonging to 18 botanical families were identified for the treatment of epilepsy in the southern part of Mozambique. The species, Hugonia orientalis Engl (22.64%), Maclura africana Bur (16.98%), Strychnos spinosa Lam (13.21%), Terminalia sericea Bruch ex DC (13.21%) and Manilkara mochisia (Bark) Dubard (11.32%) were the most cited. The families Annonaceae and Menispermaceae (4 species) were the most representative in number of species. The root was the most commonly used plant part (54.2%), the frequently used preparation mode was decoction (71%), and administration of the remedies was often by oral route. Conclusion Medicinal plants still play an important role in primary health care in the study area. However there is a need to develop pharmacological studies based on these plants to understand the mechanism of action of the bioactive compounds and for the future development of new and more effective anticonvulsant drugs