2022
“If it weren’t for my traditional healer, I would be dead”: Engaging traditional healers to support people living with HIV in rural Mozambique
Audet CM, Pettapiece-Phillips M, Tian Y, Shepherd BE, Vermund SH, Salato J. “If it weren’t for my traditional healer, I would be dead”: Engaging traditional healers to support people living with HIV in rural Mozambique. PLOS ONE 2022, 17: e0270565. PMID: 35763519, PMCID: PMC9239464, DOI: 10.1371/journal.pone.0270565.Peer-Reviewed Original ResearchConceptsTraditional healersPsychosocial supportCommunity health worker interventionPre-post intervention study designWorker interventionHealth worker interventionMedication possession ratioMedication side effectsIntervention study designPositive test resultsHome-based supportObserved therapyPossession ratioClinical outcomesHIV treatmentPoor adherencePost-intervention participantsHealth facilitiesPatient's desireSide effectsZambézia ProvinceCare servicesStudy designHIVTherapy
2020
Monitoring Pharmacy and Test Kit Stocks in Rural Mozambique: U.S. President's Emergency Plan for AIDS Relief Surveillance to Help Prevent Ministry of Health Shortages
Bravo M, Peratikos MB, Muicha AS, Mahagaja E, Alvim MFS, Green AF, Wester CW, Vermund SH. Monitoring Pharmacy and Test Kit Stocks in Rural Mozambique: U.S. President's Emergency Plan for AIDS Relief Surveillance to Help Prevent Ministry of Health Shortages. AIDS Research And Human Retroviruses 2020, 36: 415-426. PMID: 31914787, PMCID: PMC7232670, DOI: 10.1089/aid.2019.0057.Peer-Reviewed Original ResearchConceptsRural Zambézia ProvinceHuman immunodeficiency virusPresident's Emergency PlanMedication supplyU.S. President's Emergency PlanTimes higher oddsMedication classesViral suppressionDiagnostic test kitsImmunodeficiency virusPharmacy dataStudy midpointOrdinal logistic regressionHigher oddsCare providersLower oddsZambézia ProvinceTuberculosis testingMonitoring of drugsLogistic regressionAIDS ReliefHealth shortagesARVEmergency plansCalendar time
2016
Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission
Audet CM, Salato J, Blevins M, Silva W, González‐Calvo L, Vermund SH, Gaspar F. Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission. Tropical Medicine And International Health 2016, 21: 1476-1480. PMID: 27580349, PMCID: PMC5093076, DOI: 10.1111/tmi.12775.Peer-Reviewed Original ResearchConceptsBlood exposureOccupational hazardsBlood-borne agentsTraditional healersWilcoxon rank sum testRank sum testHepatitis BC virusChronic illnessInfectious disease transmissionHigh prevalenceZambézia ProvincePast monthHealers' practicesChi-squareTraditional practitionersMedianPatientsDisease transmissionInjectionRandom sampleRural MozambiqueExposureHealersSimple random sample
2015
Determinants of undernutrition among children aged 6 to 59 months in rural Zambézia Province, Mozambique: results of two population-based serial cross-sectional surveys
Rose ES, Blevins M, González-Calvo L, Ndatimana E, Green AF, Lopez M, Olupona O, Vermund SH, Moon TD, For the Ogumaniha-SCIP Zambézia Consortium. Determinants of undernutrition among children aged 6 to 59 months in rural Zambézia Province, Mozambique: results of two population-based serial cross-sectional surveys. BMC Nutrition 2015, 1: 41. PMID: 27182448, PMCID: PMC4864006, DOI: 10.1186/s40795-015-0039-1.Peer-Reviewed Original ResearchAge z-scoreCross-sectional surveyZ-scoreZambézia ProvincePopulation-based cross-sectional surveyRural Zambézia ProvinceSerial cross-sectional surveysHeight z-scoreOdds of stuntingAge 6 monthsPrevalence of stuntingAge 5 yearsDeterminants of undernutritionDietary diversity scoreNon-linear associationLower oddsAnthropometric measurementsGreater oddsHousehold food insecurityMultidimensional interventionsSTATA 13.1UndernutritionLogistic regressionUnderweightConclusionsA combinationImplementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique
Edwards LJ, Moisés A, Nzaramba M, Cassimo A, Silva L, Mauricio J, Wester CW, Vermund SH, Moon TD. Implementation of a Health Management Mentoring Program: Year-1 Evaluation of Its Impact on Health System Strengthening in Zambézia Province, Mozambique. International Journal Of Health Policy And Management 2015, 4: 353-361. PMID: 26029894, PMCID: PMC4450730, DOI: 10.15171/ijhpm.2015.58.Peer-Reviewed Original ResearchConceptsHealth systemZambézia ProvinceRural Zambézia ProvinceDistrict-level health systemGlobal healthHealth system capacityFirst yearHealth system performanceMonthly complianceMozambican MinistrySite mentoringOutcome evaluationLinear regressionVanderbilt InstituteCapacity domainsHealthOverall improvementZambéziaRegressionMentorship programHIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey
Paulin HN, Blevins M, Koethe JR, Hinton N, Vaz L, Vergara AE, Mukolo A, Ndatimana E, Moon TD, Vermund SH, Wester CW. HIV testing service awareness and service uptake among female heads of household in rural Mozambique: results from a province-wide survey. BMC Public Health 2015, 15: 132. PMID: 25881182, PMCID: PMC4339241, DOI: 10.1186/s12889-015-1388-z.Peer-Reviewed Original ResearchConceptsHealth service accessService uptakeVCT servicesRural Zambézia ProvinceHigh HIV prevalencePopulation-based surveyRemote rural settingsConclusionsMost womenRural MozambiqueHigh HIVVoluntary counselingTwo-stage cluster sampleHIV prevalenceProvince-wide surveyService accessHIV stigmaHealth facilitiesZambézia ProvinceStigma scoresTesting utilizationStigma reductionLogistic regressionBaseline measuresSurvey domainsVCT
2014
Assessing spatial patterns of HIV knowledge in rural Mozambique using geographic information systems
Buehler CP, Blevins M, Ossemane EB, González‐Calvo L, Ndatimana E, Vermund SH, Sidat M, Olupona O, Moon TD. Assessing spatial patterns of HIV knowledge in rural Mozambique using geographic information systems. Tropical Medicine And International Health 2014, 20: 353-364. PMID: 25430042, DOI: 10.1111/tmi.12437.Peer-Reviewed Original ResearchConceptsHIV knowledgeAntiretroviral therapyEnumeration areasMedian scorePopulation-based cluster surveyMore HIV knowledgeHIV knowledge scoresMultivariable linear regression modelsLow HIV knowledgePoor HIV knowledgeHIV knowledge levelsDistrict of residenceHealth facilitiesZambézia ProvinceNumber of childrenKnowledge scoreProgram plannersTherapyMore educationLinear regression modelsScoresAssessment toolRural MozambiqueRegression modelsRespondent agePoor Clinical Outcomes for HIV Infected Children on Antiretroviral Therapy in Rural Mozambique: Need for Program Quality Improvement and Community Engagement
Vermund SH, Blevins M, Moon TD, José E, Moiane L, Tique JA, Sidat M, Ciampa PJ, Shepherd BE, Vaz LM. Poor Clinical Outcomes for HIV Infected Children on Antiretroviral Therapy in Rural Mozambique: Need for Program Quality Improvement and Community Engagement. PLOS ONE 2014, 9: e110116. PMID: 25330113, PMCID: PMC4203761, DOI: 10.1371/journal.pone.0110116.Peer-Reviewed Original ResearchConceptsCombination antiretroviral therapyAntiretroviral therapyInfant diagnosisClinical outcomesEarly infant diagnosisPoor clinical outcomeYears of ageResource-limited settingsUnknown clinical outcomesCohort mortality ratesQuality improvement effortsART initiationCART initiationRural MozambiqueHIV servicesAdults 15HIV prevalenceKaplan-MeierHigher hemoglobinMedication pickupClinical dataOutcome treatmentNational guidelinesCase findingZambézia ProvinceAntiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning
Moon TD, Ossemane EB, Green AF, Ndatimana E, José E, Buehler CP, Wester CW, Vermund SH, Olupona O. Antiretroviral Therapy Program Expansion in Zambézia Province, Mozambique: Geospatial Mapping of Community-Based and Health Facility Data for Integrated Health Planning. PLOS ONE 2014, 9: e109653. PMID: 25329169, PMCID: PMC4201452, DOI: 10.1371/journal.pone.0109653.Peer-Reviewed Original ResearchConceptsHIV populationZambézia ProvinceCommunity-based VCTCommunity-based voluntary counselingHIV testing resultsProgram demographic informationHIV seropositivity rateHealth facility dataProgram expansionHIV careVoluntary counselingSeropositivity rateTesting deliveryEvidence-based decisionsHealth planningTreatment monitoringGeospatial mappingDemographic informationHealth estimatesClinicFacility dataCommunity-BasedProgram planningCareVCT
2013
Educational Intervention Increased Referrals to Allopathic Care by Traditional Healers in Three High HIV-Prevalence Rural Districts in Mozambique
Audet CM, Salato J, Blevins M, Amsalem D, Vermund SH, Gaspar F. Educational Intervention Increased Referrals to Allopathic Care by Traditional Healers in Three High HIV-Prevalence Rural Districts in Mozambique. PLOS ONE 2013, 8: e70326. PMID: 23936407, PMCID: PMC3731350, DOI: 10.1371/journal.pone.0070326.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusReferral ratesTraditional healersHealth facilitiesNon-pregnant personsFavorable clinical outcomeHIV knowledge scoresPost-intervention ratesMonthly referral rateRural districtsClinical outcomesImmunodeficiency virusPregnant womenHIV knowledgeZambézia ProvincePatientsKnowledge scoreInexpensive interventionClinical servicesHealth systemMedian scoreEducational interventionTuberculosisCareClinic
2012
Poor-quality health services and lack of programme support leads to low uptake of HIV testing in rural Mozambique
Audet CM, Groh K, Moon TD, Vermund SH, Sidat M. Poor-quality health services and lack of programme support leads to low uptake of HIV testing in rural Mozambique. African Journal Of AIDS Research 2012, 11: 327-335. PMID: 25860191, PMCID: PMC4837645, DOI: 10.2989/16085906.2012.754832.Peer-Reviewed Original ResearchPatient's HIV statusHIV statusHIV testingHIV infectionHigh burdenPoor quality health servicesFood supplement programWorld's highest burdenClinical service deliveryHIV diseaseZambézia ProvinceClinical practiceHealth servicesLow uptakePoor accessFatalistic beliefsHIVRural districtsInfectionFocus group discussionsRural MozambiquePurposeful samplingGender-specific focus group discussionsIntentional disclosureService deliveryHIV/AIDS-Related Attitudes and Practices Among Traditional Healers in Zambézia Province, Mozambique
Audet CM, Blevins M, Moon TD, Sidat M, Shepherd BE, Pires P, Vergara A, Vermund SH. HIV/AIDS-Related Attitudes and Practices Among Traditional Healers in Zambézia Province, Mozambique. Journal Of Alternative And Complementary Medicine 2012, 18: 1133-1141. PMID: 23171035, PMCID: PMC3513988, DOI: 10.1089/acm.2011.0682.Peer-Reviewed Original ResearchConceptsZambézia ProvinceTraditional healersHuman immunodeficiency virus infection/HIV/AIDS careHealth systemAllopathic providersTreatment practicesAllopathic health systemSymptoms/signsHIV/AIDS-related attitudesPatient's symptoms/signsFormal health providersHIV/AIDS trainingHIV/AIDSHIV patientsHIV diseaseHIV pathogenesisImmunodeficiency syndromeUninfected personsInfection/Late presentationHIV trainingInfectious originHIV knowledgeReferral practicesImplementation of cervical cancer screening using visual inspection with acetic acid in rural Mozambique: successes and challenges using HIV care and treatment programme investments in Zambézia Province
Moon TD, Silva‐Matos C, Cordoso A, Baptista AJ, Sidat M, Vermund SH. Implementation of cervical cancer screening using visual inspection with acetic acid in rural Mozambique: successes and challenges using HIV care and treatment programme investments in Zambézia Province. Journal Of The International AIDS Society 2012, 15: 17406. PMID: 22713260, PMCID: PMC3499800, DOI: 10.7448/ias.15.2.17406.Peer-Reviewed Original ResearchConceptsLoop electrosurgical excision procedureHIV careCervical cancerProvincial HospitalZambézia ProvinceCervical cancer screening servicesMaternal child health nursesAntiretroviral therapy rolloutVIA-positive womenCancer screening servicesElectrosurgical excision procedureChild health nursesSquamous intraepithelial lesionsCervical cancer screeningChronic disease screeningHealth manpower shortagesRural MozambiqueExcision procedureHIV testingIntraepithelial lesionsHIV statusClinic nursesScreening servicesCancer screeningHealth nursesHIV knowledge and health-seeking behavior in Zambézia Province, Mozambique
Audet CM, Sidat M, Blevins M, Moon TD, Vergara A, Vermund SH. HIV knowledge and health-seeking behavior in Zambézia Province, Mozambique. SAHARA-J Journal Of Social Aspects Of HIV/AIDS 2012, 9: 41-46. PMID: 23237020, PMCID: PMC3868210, DOI: 10.1080/17290376.2012.665257.Peer-Reviewed Original ResearchConceptsHealth-seeking behaviourHIV transmissionZambézia ProvinceTraditional healersCommunity health care workersGovernment health clinicsCommunity health workersHealth care workersTransmission of HIVHIV prevalence ratesMajority of participantsHIV knowledgeTransmission knowledgeHealth clinicsHIV preventionHealth workersPrevalence ratesPrevention knowledgeMultiple-choice questionnaireSerious illnessHIV educationInfection rateClinical sitesCondom useLevel of knowledge
2011
Enrolment and programmatic trends and predictors of antiretroviral therapy initiation from President's Emergency Plan for AIDS Relief (PEPFAR)-supported public HIV care and treatment sites in rural Mozambique
Moon TD, Burlison JR, Blevins M, Shepherd BE, Baptista A, Sidat M, Vergara AE, Vermund SH. Enrolment and programmatic trends and predictors of antiretroviral therapy initiation from President's Emergency Plan for AIDS Relief (PEPFAR)-supported public HIV care and treatment sites in rural Mozambique. International Journal Of STD & AIDS 2011, 22: 621-627. PMID: 22096045, DOI: 10.1258/ijsa.2011.010442.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyART initiationAntiretroviral therapy initiationHIV treatment programsCells/μLContinuous drug supplyPresident's Emergency PlanHIV careTherapy initiationHIV testingMedian ageSaharan AfricaTreatment expansionZambézia ProvinceRoutine dataPatient record systemPatientsTreatment programOlder ageAIDS ReliefHealth manpowerCells/Drug supplyRecord systemTreatment sitesBarriers to antiretroviral therapy adherence in rural Mozambique
Groh K, Audet CM, Baptista A, Sidat M, Vergara A, Vermund SH, Moon TD. Barriers to antiretroviral therapy adherence in rural Mozambique. BMC Public Health 2011, 11: 650. PMID: 21846344, PMCID: PMC3171727, DOI: 10.1186/1471-2458-11-650.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnti-Retroviral AgentsAttitude of Health PersonnelAttitude to HealthCommunity Health ServicesCommunity Health WorkersCommunity-Based Participatory ResearchConfidentialityFemaleFocus GroupsHealth Services AccessibilityHIV InfectionsHumansMaleMedication AdherenceMozambiqueProfessional-Patient RelationsQualitative ResearchRural Health ServicesSocioeconomic FactorsConceptsHealth care workersCare workersAntiretroviral therapyPoor adherenceRural Zambézia ProvinceAntiretroviral therapy adherenceSuboptimal adherenceLack of confidentialityPatient adherencePoor treatmentTherapy adherencePatient preferencesMedications resultsChronic diseasesFocus groupsSide effectsZambézia ProvinceHospital staffHigh mortalityClinical sitesViral mutationsEffective interventionsAdherenceTraditional medicineMedications