Background: Antibiotics are synthetic or natural substances used to treat bacterial infectious diseases. When used incorrectly, they can be a factor in the development of antimicrobial resistance, increased treatment time, costs, and mortality. The present study aimed to assess the pattern of inappropriate use of antibiotics and their predictors in pediatric patients admitted to the Central Hospital in Nampula, Mozambique. Methods: A cross-sectional, retrospective study with a quantitative approach was conducted between January and July 2019. The population consisted of children ages 0–10 years hospitalized in the pediatric ward I. Binary logistic regression was used to determine risk factors for the inappropriate use of antibiotics with 95% confidence interval. Results: The prevalence of antibiotic use among pediatric patients was 97.5%. Of the 464 antibiotics prescribed, 39.9% were for patients suffering from gastroenteritis, 21.8% and 9.1% for those affected with pneumonia and malaria, respectively. Most antibiotics were for parenteral use (95.9%, 445/464). Many (36.5%) of the prescriptions had errors, primarily in the duration of treatment (74.0%) or dosage (24.4%). Binary logistic regression analysis revealed that patients prescribed ≥ 3 antibiotics (OR = 2.83, 95% CI 1.245–6.462, p-value = 0.013) or hospitalized for a short time (OR = 1.88, 95% CI 1.133–2.3140, p-value = 0.015) were more likely to experience inappropriate use of antibiotics. Conclusion: The study showed both a high prevalence of antibiotic use and a high error rate in prescriptions, especially among patients prescribed ≥ 3 antibiotics or hospitalized for a short time. These results are concerning, since inappropriate and excessive use of antibiotics is a major factor in the development of antibiotic-resistant microorganisms. Therefore, policies to reduce the inappropriate and excessive use of antibiotics are necessary.

Antibiotics are often prescribed inappropriately, either when they are not needed or with an unnecessarily broad spectrum of activity. This is a serious problem that can lead to the development of antimicrobial resistance (AMR). This study was conducted to assess the antibiotic prescribing pattern in pediatric patients hospitalized at a quaternary hospital in Nampula, Mozambique, using the WHO indicators and Framework as a reference. A retrospective study was conducted using secondary data obtained from medical records. The study population consisted of children aged 0–10 years who were hospitalized in a quaternary-level hospital ward in Nampula, Mozambique. The pattern of antibiotic prescriptions was assessed using indicators and the WHO classification of antibiotics into AWaRe categories. Descriptive statistics were applied. A total of 464 antibiotics were prescribed during the study. The age groups of 1–3 years and 28 days-12 months were prescribed more antibiotics. The most common antibiotics were ceftriaxone and crystallized penicillin, which were frequently prescribed for patients suffering from bronchopneumonia, gastroenteritis, and malaria. 74.8% of the antibiotics prescribed belonged to the Access group, while 23.7% belonged to the Watch group. There were no prescriptions of antibiotics from the Reserve group. The average number of antibiotics per prescription was 1.51 (SD ± 0.725). The percentage of antibiotic prescribing was 97.5%, with 96.20% by injection. All antibiotics prescribed were on the essential medicines list and prescribed by generic name. These results are concerning and highlight the urgency of strengthening antimicrobial optimization measures, as well as implementing the AWaRe framework in antibiotic prescribing as an essential strategy to combat AMR.

Background: Malnutrition is a public health problem that affects physical and psychosocial well-being. It manifests as a rapid deterioration in nutritional status and bilateral edema due to inadequate food intake or illness. Methods: This study is a retrospective cohort of 1208 children with severe acute malnutrition (SAM) in Sofala Province from 2018 to 2022. It includes hospitalized children aged 6–59 months with SAM and related complications. The dependent variable is recovery, and the independent variables include age, sex of the child, vomiting, dehydration, hypoglycemia, nutritional edema and anthropometry. Survival curves were plotted using the Kaplan–Meier method, and bivariable and multivariable Cox regression analyses were performed. Results: The crude analysis revealed significant factors for nutritional recovery in children with SAM, including age, weight, height, malaria, diarrhea and dehydration. Children under 24 months had a 28% lower likelihood of recovery. Weight below 6.16 kg decreased the likelihood by 2%, and height above 71.1 cm decreased it by 20%. Conversely, malaria, diarrhea and dehydration increased the likelihood of recovery. However, after adjustment, only diarrhea remained a significant predictor of nutritional recovery. Conclusion: This study found that diarrhea is a predictor of nutritional recovery in children with SAM.

Antimicrobial resistance (AMR) in Sub-Saharan Africa (SSA) represents a public health crisis that threatens treatment effectiveness and increases morbidity and mortality. This commentary highlights the urgent need for an integrated and collaborative approach among stakeholders to contain AMR, including strengthening healthcare infrastructure, promoting the rational use of antibiotics, and implementing effective monitoring policies. Adopting the One Health approach, investing in the continuous training of professionals, and leveraging innovative technologies such as artificial intelligence (AI) and machine learning (ML) are key strategies to mitigate the issue. However, challenges such as the scarcity of high-quality data still hinder the application of these solutions. Given this scenario, immediate and concrete actions are essential to prevent the worsening of AMR and ensure the sustainability of antimicrobial treatments in the region.

Background: Natural therapeutic agents, such as Cymbopogon citratus essential oil, have gained prominence for their potential antimicrobial properties. This study aimed to evaluate the antimicrobial activity of the essential oil and hydrolate of Cymbopogon against clinically relevant strains of Candida albicans, Escherichia coli, and Pseudomonas aeruginosa. Methods. Essential oil was extracted using the steam distillation method with a Clevenger apparatus, and prepared in three concentrations (50, 75 and 100%) using Dimethyl Sulfoxide. Component quantification was performed using gas chromatography coupled with mass spectrometry. Antimicrobial activity was evaluated using the Kirby-Bauer disk diffusion technique, employing discs impregnated with essential oil. Pure cultures of microorganisms, including Escherichia coli, Pseudomonas aeruginosa, and Candida albicans isolated from Leukorrhea samples, were utilized. The Welch Test was applied to analyze potential differences in inhibition zones of microorganisms in response to essential oil at different concentrations. Results: The essential oil exhibited a yield of 0.98%, with a yellow coloration, clear appearance, and pH of 5.65. Major compounds identified through gas chromatography coupled with mass spectrometry included Beta Myrcene, 6-Methyl-5-hepten-2-one, Ethanol, 2-(3,3-dimethylcyclohexylidene)-, (Z), (1R)-2,6,6-Trimethylbicyclo [3.1.1] hept-2-ene, Isoneral, and Isogeranial. Antimicrobial activity was observed against all three tested species, where the complete inhibition of C. albicans growth was observed with an inhibitory concentration of 50%. However, the hydrosol exhibited modest antibacterial activity against the tested strains. Statistically significant differences in inhibition diameters were observed for the different studied concentrations (p<0.05). Conclusion: The C. citratus essential oil possesses effective antimicrobial activity, proposing a potential antimicrobial alternative. Therefore, the importance of future investigations to explore its therapeutic applicability is underscored.

Background: Cervical cancer (CC) is the third most common cancer among women worldwide and the second most prevalent neoplasm in Mato Grosso, Brazil, in 2020. This study aimed to analyze overall survival (OS), identify prognostic factors, and develop a nomogram to predict the long-term prognosis of CC patients using population-based data from Mato Grosso, Brazil. Methods: Integrated data from the Mortality Information System (SIM) and the Population-Based Cancer Registry (RCBP) were used for patients diagnosed with CC between 2001 and 2018. Group differences were analyzed using the Log-rank test, and survival analysis was performed using the Kaplan-Meier method. Univariable and multivariable Cox regression models were applied to identify predictors of OS. A nomogram was developed to predict OS at 1, 3, 5, and 10 years. The accuracy of the model was assessed using the C-index, receiver operating characteristic (ROC) curve, and calibration plots. Results: The median follow-up time was 12 years (range: 6.28 − 17.1). The OS rates at 1, 3, 5, and 10 years were 95.4%, 91.3%, 89.9%, and 88.3%, respectively. Age, histological type, and disease stage were identified as independent prognostic factors for OS. The C-index for OS was 0.869, and the areas under the ROC curve for 1, 3, 5, and 10 years were 0.910, 0.897, 0.895, and 0.884, respectively, indicating good discrimination. The nomogram demonstrated good agreement with the observed survival rates. Conclusion: The developed nomogram predicts OS for CC patients at 1, 3, 5, and 10 years, showing good concordance with the observed survival rates and serving as a useful tool for guiding personalized interventions. Notably, disease staging and histopathological type were the most significant prognostic factors for OS.