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Estratégias de coping adoptadas por mulheres grávidas em tratamento anti-retroviral para lidar com os desafios da gravidez e da terapia em unidades sanitárias seleccionadas da cidade da Matola: um estudo analítico transversal

2026-06-11T09:36:43Z

Title: Estratégias de coping adoptadas por mulheres grávidas em tratamento anti-retroviral para lidar com os desafios da gravidez e da terapia em unidades sanitárias seleccionadas da cidade da Matola: um estudo analítico transversal Authors: Munguambe, Hélder Glécio Filimão Abstract: A infecção causada pelo Vírus da Imunodeficiência Humana (HIV) permanece um relevante problema de saúde pública, afectando de forma desproporcional mulheres jovens em idade reprodutiva, particularmente na África Subsaariana. Durante a gravidez, a vivência do HIV impõe desafios adicionais de natureza psicológica e social, podendo comprometer a adesão ao tratamento antirretroviral (TARV), considerado fundamental para a saúde materna e para a prevenção da transmissão vertical. Neste contexto, as estratégias de coping assumem um papel central na adaptação psicológica e na gestão das exigências associadas à gravidez e ao tratamento. A presente dissertação teve como objectivo analisar a relação entre as estratégias de coping adoptadas por mulheres grávidas em tratamento antirretroviral e a adesão ao TARV. Metodologicamente, apresenta-se como um estudo analítico transversal, com uma abordagem quantitativa, realizado entre julho e novembro de 2025, envolvendo uma amostra de 384 mulheres grávidas em seguimento TARV. A recolha de dados foi efectuada através de um questionário sócio-demográfico e do Inventário de Estratégias de Coping de Folkman e Lazarus. A análise estatística incluiu estatística descritiva e inferencial, recorrendo aos pacotes SPSS, com testes de correlação, regressão e análise de variância. Os resultados revelaram que a maior parte dos participantes era jovem, com predominância de inserção no sector informal e níveis médios a elevados de escolaridade, sendo observada uma elevada proporção de não adesão ao tratamento. As estratégias de coping mais frequentemente utilizadas foram a reavaliação positiva, a fuga e a aceitação da responsabilidade. Verificaram- se associações estatisticamente significativas entre várias estratégias de coping e a adesão ao TARV, destacando-se a reavaliação positiva como preditor favorável da adesão. Conclui-se que as estratégias de coping tem um papel importante na adesão ao TARV entre mulheres grávidas vivendo com HIV. Os achados evidenciam a necessidade de integrar intervenções psicossociais focadas no fortalecimento de estratégias de coping adaptativas nos serviços de saúde materna, de modo a promover a adesão terapêutica, o bem-estar psicológico e a redução da transmissão vertical do HIV.

Knowledge and practices of healthcare professionals regarding antibiotic use in a district hospital, Southern Mozambique: a cross-sectional study

2026-05-25T12:56:17Z

Title: Knowledge and practices of healthcare professionals regarding antibiotic use in a district hospital, Southern Mozambique: a cross-sectional study Authors: Faiela, Candido; Cambaco, Olga; Boene, Helena; Monnier, Annelie A.; Wertheim, Heiman F. L.; Munguambe, Khatia; Sevene, Esperança Abstract: ackling the worldwide problem of antibiotic resistance requires addressing the lack of knowledge about antibiotics and understanding the impact of resistance. This study aimed to assess healthcare professionals' (HCP) knowledge about antibiotics and antibiotic resistance and the antibiotic prescription practices for outpatients at the Manhiça District Hospital in Mozambique. This cross-sectional study assessed the knowledge and practices of 20 HCPs about antibiotic use and resistance and evaluated quality indicators of antibiotic use of 200 prescriptions. We observed that 20% of the participants incorrectly placed amoxicillin in the cephalosporin group, and 10% considered antibiotic resistance a rejection reaction by the patient's body. However, the HCPs showed Knowledge level A. Antibiotics featured in 88% of prescriptions, with an average of one antibiotic per prescription. Cotrimoxazole (30.77%) and amoxicillin (26.15%) were the most frequently prescribed antibiotics. Cotrimoxazole was more prescribed for adults (21.54%) and amoxicillin for children (17.95%). Seasonal variation was observed with an increased winter consumption of cotrimoxazole and phenoxymethylpenicillin in summer. The results revealed a high level of knowledge of HCPs about how to use and identify antibiotics. A higher frequency of broad-spectrum antibiotic prescriptions was observed with cotrimoxazole and amoxicillin being the most prescribed.

Antibiotic prescription for HIV-positive patients in primary health care in Mozambique: A cross-sectional study

2026-05-25T12:56:02Z

Title: Antibiotic prescription for HIV-positive patients in primary health care in Mozambique: A cross-sectional study Authors: Faiela, Candido; Sevene, Esperança Abstract: ntibiotic overuse is a major public health challenge worldwide and it can result in the emergence and spread of drug resistance. In Mozambique, there are limited data related to primary care physicians’ antibiotic prescription patterns. The aim of this study was to assess the antibiotic prescription patterns for HIV- positive patients in primary health care. Methods: A prospective cross-sectional quantitative study was conducted in eight primary health care units in Southern Mozambique. The study was based on recording outpatient prescriptions using a structured questionnaire. Three hundred and sixty-nine prescriptions and clinical records of HIV-positive patients from 31 prescribers were assessed. A total of eight general practitioners, 13 medical technicians and 10 nurses participated. Results: Antibiotics were used in 65.9% of prescriptions, with an average of 0.9 antibiotics per prescription. Of a total of 334 prescribed antibiotics, 69.8% were for the treatment of infections and 30.2% for prophylaxis. Penicillin (29.2%), sulphonamides (19.7%), and quinolones (16.3%) were the most prescribed classes of antibiotics for treatment. For prophylaxis, only sulphonamides (93.1%) and macrolides (6.9%) were prescribed. The diagnosis was the only variable that had a significant association with antibiotic prescription (p < 0.001). Most of penicillins (68.0%) and sulphonamides (21.4%) were prescribed to treat infections related to the respiratory tract. Conclusion: The prescription of antibiotics was high and influenced by patient clinical conditions. Antibiotics were prescribed either for treatment or prophylaxis of infections, mostly to treat respiratory tract infections. Prescribers should be encouraged to adopt a rational use of antibiotics to reduce unnecessary prescriptions

De-implementation strategy to reduce unnecessary antibiotic prescriptions for ambulatory HIV-infected patients with upper respiratory tract infections in Mozambique: a study protocol of a cluster randomized controlled trial

2026-05-25T12:24:38Z

Title: De-implementation strategy to reduce unnecessary antibiotic prescriptions for ambulatory HIV-infected patients with upper respiratory tract infections in Mozambique: a study protocol of a cluster randomized controlled trial Authors: Faiela, Candido; Moon, Troy D.; Sidat, Mohsin; Sevene, Esperança Abstract: Antibiotics are globally overprescribed for the treatment of upper respiratory tract infections (URTI), especially in persons living with HIV. However, most URTIs are caused by viruses, and antibiotics are not indicated. De-implementation is perceived as an important area of research that can lead to reductions in unnecessary, wasteful, or harmful practices, such as excessive or inappropriate antibiotic use for URTI, through the employment of evidence-based interventions to reduce these practices. Research into strategies that lead to successful de-implementation of unnecessary antibiotic prescriptions within the primary health care setting is limited in Mozambique. In this study, we propose a protocol designed to evaluate the use of a clinical decision support algorithm (CDSA) for promoting the de-implementation of unnecessary antibiotic prescriptions for URTI among ambulatory HIV-infected adult patients in primary healthcare settings. Methods This study is a multicenter, two-arm, cluster randomized controlled trial, involving six primary health care facilities in Maputo and Matola municipalities in Mozambique, guided by an innovative implementation science framework, the Dynamic Adaption Process. In total, 380 HIV-infected patients with URTI symptoms will be enrolled, with 190 patients assigned to both the intervention and control arms. For intervention sites, the CDSAs will be posted on either the exam room wall or on the clinician´s exam room desk for ease of reference during clinical visits. Our sample size is powered to detect a reduction in antibiotic use by 15%. We will evaluate the effectiveness and implementation outcomes and examine the effect of multi-level (sites and patients) factors in promoting the de-implementation of unnecessary antibiotic prescriptions. The effectiveness and implementation of our antibiotic de-implementation strategy are the primary outcomes, whereas the clinical endpoints are the secondary outcomes. Discussion This research will provide evidence on the effectiveness of the use of the CDSA in promoting the de-implementation of unnecessary antibiotic prescribing in treating acute URTI, among ambulatory HIV-infected patients. Findings will bring evidence for the need to scale up strategies for the de-implementation of unnecessary antibiotic prescription practices in additional healthcare sites within the country.