2024
Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique
De Schacht C, Amorim G, Calvo L, Ntasis E, Van Rompaey S, Matsimbe J, Martinho S, Graves E, Alvim M, Green A, Kassim H, Carlos I, Wester C, Audet C. Time spent at health facility is a key driver of patient satisfaction, but did not influence retention to HIV care: A serial cross-sectional study in Mozambique. PLOS ONE 2024, 19: e0299282. PMID: 38635537, PMCID: PMC11025808, DOI: 10.1371/journal.pone.0299282.Peer-Reviewed Original ResearchConceptsHealth facilitiesOdds of viral suppressionPatient satisfactionSatisfaction scoresHIV careHigher oddsViral suppressionAdherence to antiretroviral therapyClient-provider communicationStudy assessed patient satisfactionAssociated with higher oddsReduce patient waiting timesMedian satisfaction scorePatient waiting timesCross-sectional studyGeneralized linear regression modelsOverall satisfaction scoreAssociated with lower retentionAssociated with retentionHealth servicesExit interviewsAssociated with timeClient-providerClinical servicesLinear regression models
2023
Antibiotic prescribing practices for acute respiratory illness in children less than 24 months of age in Kenema, Sierra Leone: is it time to move beyond algorithm driven decision making?
Moon T, Sumah I, Amorim G, Alhasan F, Howard L, Myers H, Green A, Grant D, Schieffelin J, Samuels R. Antibiotic prescribing practices for acute respiratory illness in children less than 24 months of age in Kenema, Sierra Leone: is it time to move beyond algorithm driven decision making? BMC Infectious Diseases 2023, 23: 626. PMID: 37749485, PMCID: PMC10519098, DOI: 10.1186/s12879-023-08606-0.Peer-Reviewed Original ResearchConceptsAcute respiratory illnessMonths of ageAntibiotic prescribing practicesKenema Government HospitalPrescribing practicesRespiratory illnessPediatric acute respiratory illnessPrescribing of antibioticsRespiratory tract infectionsClinical decision support toolCause of mortalityHospital stayRespiratory symptomsStudy nursesTract infectionsClinical courseMedication historyPediatric wardUnnecessary antibioticsProspective studyAntibiotic utilizationResultsA totalAntibiotic useClinical signsChest radiographs
2020
‘I married when I was 16… due to poverty, I had no other way’: multi-level factors influencing HIV-related sexual risk behaviours among adolescent girls in Zambézia, Mozambique
Ridgeway K, Lenzi R, Packer C, González-Calvo L, Moon T, Green A, Burke H. ‘I married when I was 16… due to poverty, I had no other way’: multi-level factors influencing HIV-related sexual risk behaviours among adolescent girls in Zambézia, Mozambique. Culture Health & Sexuality 2020, 23: 414-430. PMID: 32427049, DOI: 10.1080/13691058.2020.1715483.Peer-Reviewed Original ResearchConceptsAdolescent girlsBehavior one yearInterpersonal-level factorsRisk behaviorsGirls ages 13Sexual risk behaviorsSelf-reported sexual riskGirls' behaviorFirst time pointAge 13Sexual risk reductionFamily supportHousehold economic stabilityBehavior changeFuture interventionsMulti-level factorsGirlsSexual riskTime pointsInterventionDepth interviewsAdolescentsBehaviorOne-yearSupportMonitoring 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 timeMultiple Concurrent Illnesses Associated with Anemia in HIV-Infected and HIV-Exposed Uninfected Children Aged 6–59 Months, Hospitalized in Mozambique
Duffy C, Kenga D, Gebretsadik T, Maússe F, Manjate A, Zaqueu E, Fernando H, Green A, Sacarlal J, Moon T. Multiple Concurrent Illnesses Associated with Anemia in HIV-Infected and HIV-Exposed Uninfected Children Aged 6–59 Months, Hospitalized in Mozambique. American Journal Of Tropical Medicine And Hygiene 2020, 102: 605-612. PMID: 31933456, PMCID: PMC7056436, DOI: 10.4269/ajtmh.19-0424.Peer-Reviewed Original ResearchConceptsHospital admissionMultiple concurrent illnessesEtiology of anemiaAcute respiratory illnessFactors of anemiaHistory of feverDiagnosis of bacteremiaDiagnosis of malariaGastroenteritis/diarrheaChildren Aged 6Concurrent illnessHIV-InfectedUninfected childrenAntiretroviral therapyAnemia managementCommon diagnosisRespiratory illnessHospitalized childrenMultiple etiologiesBlood culturesMild anemiaNonphysician cliniciansRelative oddsDual diagnosisHIV
2019
Immunodeficiency at Antiretroviral Therapy Start: Five-Year Adult Data (2012–2017) Based on Evolving National Policies in Rural Mozambique
Arinze F, Gong W, Green A, De Schacht C, Carlucci J, Silva W, Claquin G, Tique J, Stefanutto M, Graves E, Van Rompaey S, Alvim M, Tomo S, Moon T, Wester C. Immunodeficiency at Antiretroviral Therapy Start: Five-Year Adult Data (2012–2017) Based on Evolving National Policies in Rural Mozambique. AIDS Research And Human Retroviruses 2019, 36: 39-47. PMID: 31359762, PMCID: PMC9836686, DOI: 10.1089/aid.2019.0043.Peer-Reviewed Original ResearchConceptsCD4 cell countMedian CD4 cell countAntiretroviral therapyART initiationSevere immunodeficiencyCell countMedian changeHealth facilitiesHigher median CD4 cell countsMultivariable logistic regression modelAdvanced HIV diseaseAntiretroviral therapy (ART) startMedian CD4 cellProvider-initiated testingCombination antiretroviral therapyStage 4 diseaseTreatment-naive adultsLogistic regression modelsUniversal HIVOlder patientsCD4 cellsHIV diseaseTherapy startMale sexFemale sexA longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique
Burke H, Packer C, González-Calvo L, Ridgeway K, Lenzi R, Green A, Moon T. A longitudinal qualitative evaluation of an economic and social empowerment intervention to reduce girls’ vulnerability to HIV in rural Mozambique. Evaluation And Program Planning 2019, 77: 101682. PMID: 31369827, DOI: 10.1016/j.evalprogplan.2019.101682.Peer-Reviewed Original ResearchConceptsInequitable gender normsSocial empowerment interventionLongitudinal qualitative evaluationFocus group discussionsGender normsMulti-sector interventionsIntergenerational sexDepth interviewsVulnerable girlsCommunity membersGirls' sexual behaviorRural MozambiqueSexual behaviorGroup discussionsMixed-methods evaluationEmpowerment interventionBusiness trainingSchool attendanceHouseholdsMozambiqueBusinessMoneyRisky sexVulnerabilityIDIHIV Rapid Diagnostic Test Inventories in Zambézia Province, Mozambique: A Tale of 2 Test Kits
Wahlfeld C, Muicha A, Harrison P, Kipp A, Claquin G, Silva W, Green A, Wester C, Moon T. HIV Rapid Diagnostic Test Inventories in Zambézia Province, Mozambique: A Tale of 2 Test Kits. International Journal Of Health Policy And Management 2019, 8: 292-299. PMID: 31204445, PMCID: PMC6571497, DOI: 10.15171/ijhpm.2019.07.Peer-Reviewed Original ResearchConceptsHIV rapid diagnostic testsRapid diagnostic testsHealth facilitiesZambézia ProvinceDiagnostic testsTest kitIdentification of PLHIVHealth facility levelMixed-effects logistic regressionOutcomes of interestSpecific health facilityProvincial health authoritiesHIV testUNAIDS 90Treat programsUni-GoldSpecific healthcare facilitiesHealth authoritiesLogistic regressionSurveillance dataFacility levelStudy periodEssential medicinesConfirmatory testHealthcare facilities
2018
Exploring intersections of localised gender norms and unanticipated effects of a sexual and reproductive health intervention: implications of respect and being a “good girl” in Zambézia Province, Mozambique
Lenzi R, Packer C, Ridgeway K, Moon T, Green A, González-Calvo L, Burke H. Exploring intersections of localised gender norms and unanticipated effects of a sexual and reproductive health intervention: implications of respect and being a “good girl” in Zambézia Province, Mozambique. Culture Health & Sexuality 2018, 21: 575-590. PMID: 30328775, DOI: 10.1080/13691058.2018.1498540.Peer-Reviewed Original ResearchConceptsGender normsGood girlGender-based violenceSocial empowerment interventionHead of householdFocus group discussionsReproductive health programsReproductive health interventionsEmpower girlsUnanticipated effectsEmic definitionDepth interviewsCommunity membersRural communitiesImplications of respectGirls' riskGroup discussionsInfluential menEmpowerment interventionSchool attendanceMozambiqueNormsCommunityProgram evaluationZambézia ProvinceHazardous alcohol use among female heads-of-household in rural Mozambique
Wainberg M, Oquendo M, Peratikos M, Gonzalez-Calvo L, Pinsky I, Duarte C, Yu Q, Green A, Martinho S, Moon T, Audet C. Hazardous alcohol use among female heads-of-household in rural Mozambique. Alcohol 2018, 73: 37-44. PMID: 30261452, PMCID: PMC6173647, DOI: 10.1016/j.alcohol.2018.03.011.Peer-Reviewed Original ResearchConceptsAlcohol Use Disorders Identification TestHazardous drinking behaviorAlcohol consumptionAlcohol usePopulation-based cross-sectional studyMajor public health burdenMarital statusPublic health burdenCross-sectional studyCurrent alcohol consumptionAdverse health eventsMultivariable proportional odds modelPHQ-8 scoresDrinking behaviorPrevalence of womenDisorders Identification TestHazardous alcohol useOverall prevalenceHealth burdenProtective effectHigh riskHazardous drinkersZambézia ProvinceHazardous drinkingSociodemographic characteristics
2017
Depression among female heads-of-household in rural Mozambique: A cross-sectional population-based survey
Audet C, Wainberg M, Oquendo M, Yu Q, Peratikos M, Duarte C, Martinho S, Green A, González-Calvo L, Moon T. Depression among female heads-of-household in rural Mozambique: A cross-sectional population-based survey. Journal Of Affective Disorders 2017, 227: 48-55. PMID: 29053975, PMCID: PMC5805617, DOI: 10.1016/j.jad.2017.10.022.Peer-Reviewed Original ResearchConceptsOdds of depressionCross-sectional population-based surveyUnmet mental health needsPrevalence of depressionPositive depression screeningPopulation-based surveyDepression screening toolsMental health needsAdditional yearRural MozambiqueIncreased oddsDepression screeningRisk factorsHigh suicide ratesCultural risk factorsNearest clinicHealth needsMental illnessScreening toolWeighted percentageDepressionNational dataOddsMore educationRural districtsDeterminants of full vaccination status in children aged 12–23 months in Gurùé and Milange districts, Mozambique: results of a population-based cross-sectional survey
Shemwell S, Peratikos M, González-Calvo L, Renom-Llonch M, Boon A, Martinho S, Cherry C, Green A, Moon T. Determinants of full vaccination status in children aged 12–23 months in Gurùé and Milange districts, Mozambique: results of a population-based cross-sectional survey. International Health 2017, 9: 234-242. PMID: 28810665, PMCID: PMC5881253, DOI: 10.1093/inthealth/ihx020.Peer-Reviewed Original ResearchConceptsFull vaccination statusVaccination statusVaccine uptakeLower oddsPopulation-based cross-sectional surveyNearest health facilityCross-sectional surveyFamily-centered approachFull vaccinationMore family-centered approachHealth facilitiesVaccination targetsZambézia ProvinceLogistic regressionAge 12Health decisionsMonthsChildrenDescriptive statisticsOddsFemalesStatusVaccinationHospitalUptakePrevalence and determinants of malaria among children in Zambézia Province, Mozambique
Carlucci J, Blevins Peratikos M, Cherry C, Lopez M, Green A, González-Calvo L, Moon T, the Ogumaniha-SCIP Zambézia Consortium. Prevalence and determinants of malaria among children in Zambézia Province, Mozambique. Malaria Journal 2017, 16: 108. PMID: 28274257, PMCID: PMC5343407, DOI: 10.1186/s12936-017-1741-z.Peer-Reviewed Original ResearchConceptsSymptomatic malariaPercent of childrenZambézia ProvinceHealth facilitiesMalaria diagnosisDiagnostic testsMalaria rapid diagnostic testsMethodsA cross-sectional surveyPrevalence of feverRural Zambézia ProvinceMultivariable logistic regressionPrevalence of malariaCause of deathDeterminants of malariaFocus districtsPeak malaria transmissionBed net useRapid diagnostic testsPositive test resultsTwo-stage cluster sample designOutcomes of interestCross-sectional surveyCluster sample designMedian ageCase definition
2016
Understanding intra-vaginal and labia minora elongation practices among women heads-of-households in Zambézia Province, Mozambique
Audet C, Blevins M, Cherry C, González-Calvo L, Green A, Moon T. Understanding intra-vaginal and labia minora elongation practices among women heads-of-households in Zambézia Province, Mozambique. Culture Health & Sexuality 2016, 19: 616-629. PMID: 27921861, PMCID: PMC5460297, DOI: 10.1080/13691058.2016.1257739.Peer-Reviewed Original ResearchConceptsTimes higher oddsAntenatal care visitsLabia minora elongationHigher oddsLast pregnancyCare visitsHIV testZambézia ProvinceVaginal practicesSelf-reported HIV statusHIV acquisitionHIV infectionHIV statusVaginal infectionsProtective effectSubstance useOddsWomenPregnancyInfectionVisitsLittle evidencePrevalenceAnticipated participationHeadPredictors of Health-Care Utilization Among Children 6–59 Months of Age in Zambézia Province, Mozambique
Bayham M, Blevins M, Lopez M, Olupona O, González-Calvo L, Ndatimana E, Green A, Moon T. Predictors of Health-Care Utilization Among Children 6–59 Months of Age in Zambézia Province, Mozambique. American Journal Of Tropical Medicine And Hygiene 2016, 96: 493-500. PMID: 27821686, PMCID: PMC5303059, DOI: 10.4269/ajtmh.16-0233.Peer-Reviewed Original ResearchConceptsHealth care utilizationMedian ageMonths of ageRespiratory illnessChildren 6Zambézia ProvincePopulation-based cross-sectional surveyLogistic regressionMillennium Development Goal 4Children's median ageMothers' median ageMultivariable logistic regressionHealth careHigher maternal educationProportion of childrenYears of ageCross-sectional surveyHealth care servicesRespiratory symptomsSTATA 13.1Maternal educationChild mortalityDiarrheaFeverLast childFactors associated with the use of mosquito bed nets: results from two cross-sectional household surveys in Zambézia Province, Mozambique
Moon T, Hayes C, Blevins M, Lopez M, Green A, González-Calvo L, Olupona O, The Ogumaniha-SCIP Zambézia Consortium. Factors associated with the use of mosquito bed nets: results from two cross-sectional household surveys in Zambézia Province, Mozambique. Malaria Journal 2016, 15: 196. PMID: 27068575, PMCID: PMC4827200, DOI: 10.1186/s12936-016-1250-5.Peer-Reviewed Original ResearchConceptsInsecticide-treated netsMosquito bed netsMosquito netsBed netsChildren 0Zambézia ProvinceUtilization of ITNsPopulation-based cross-sectional surveyPrevious nightMultivariable logistic regression analysisOverall disease burdenCross-sectional household surveyHigher maternal educationLogistic regression analysisBed net usageTimes higher oddsTwo-stage cluster sample designOutcomes of interestCross-sectional surveyHousehold monthly incomeITN availabilityCluster sample designPregnant womenDisease burdenHealth facilities
2014
Antiretroviral 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 planningCareVCTMultidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions
Victor B, Blevins M, Green AF, Ndatimana E, González-Calvo L, Fischer EF, Vergara AE, Vermund SH, Olupona O, Moon TD. Multidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions. PLOS ONE 2014, 9: e108654. PMID: 25268951, PMCID: PMC4182519, DOI: 10.1371/journal.pone.0108654.Peer-Reviewed Original ResearchConceptsMultidimensional poverty measuresMultidimensional poverty measurementMultidimensional poverty indexContext-specific indicatorsMultidimensional povertyPoverty measurementPoverty measuresEvidence-based planningPoverty gapPoverty indexPoverty conditionsAverage deprivationPovertyPublic health interventionsFemale headsSocial determinantsMultidimensional phenomenonIntervention deploymentRural MozambiqueHouseholdsProgram implementersHealth interventionsLocal languageGeospatial mapsGeospatial visualizationClinical Mentorship of Nurse Initiated Antiretroviral Therapy in Khayelitsha, South Africa: A Quality of Care Assessment
Green A, de Azevedo V, Patten G, Davies M, Ibeto M, Cox V. Clinical Mentorship of Nurse Initiated Antiretroviral Therapy in Khayelitsha, South Africa: A Quality of Care Assessment. PLOS ONE 2014, 9: e98389. PMID: 24887260, PMCID: PMC4041881, DOI: 10.1371/journal.pone.0098389.Peer-Reviewed Original ResearchConceptsAntiretroviral treatmentEligible patientsLong-term side effectsART start dateART-eligible patientsBaseline blood workClinical mentorship programInitiated antiretroviral therapyUniversal ART accessHIV-positive patientsTB/HIVNumber of patientsCross-sectional studyRoutine clinical dataResource limited settingsHIV treatment accessART initiationNurse initiationAntiretroviral therapyPatient characteristicsPositive patientsMore patientsBlood workClinical presentationNurses' confidence