Introduction In sub-Saharan Mozambique, high adolescent fertility rates are a significant public health problem. Understanding the consequences of teenage pregnancies facilitates effective strategies for improving the quality of care of both mother and the newborn. Aims To identify the factors associated with adolescent motherhood in Tete (Mozambique). Methods This was a cross-sectional study including 821 pregnant women (255 teenagers) admitted to the general maternity ward of the Provincial Hospital between March and October 2016. The survey included clinical data of the mother and newborn. Results The overall prevalence of adolescent deliveries was 31.8% (95% CI 27.9%-34.2%). Multivariate analysis showed that independent factors associated with teenage motherhood were: number of pregnancies (OR 0.066; 95% CI 0.040-0.110), pregnancy follow-up (OR 0.29; CI 0.173-0.488) and previous abortions (OR 4.419; 95% CI 1.931-10.112). When the age of the mother was analysed as a continuous variable, positively associated factors were body mass index, arterial hypertension, HIV infection, previous abortions, pregnancy followup, and the weight of the newborn. Negatively associated factors were episiotomy and respiratory distress in the newborn.

Background Plasmodium falciparum infection in pregnant women in sub-Saharan Africa is often asymptomatic. As these forms of malaria are often submicroscopic and difficult to diagnose by conventional methods (microscopy and/or rapid diagnostic test), diagnosis requires the use of molecular techniques such as polymerase chain reaction (PCR). This study analyses the prevalence of subclinical malaria and its association with adverse maternal and neonatal outcomes, a topic that has been scarcely evaluated in the literature. Methods A cross-sectional study was conducted using semi-nested multiplex PCR to assess the presence of P. falciparum in placental and peripheral blood of 232 parturient pregnant women at the Hospital Provincial de Tete, Mozambique between March 2017 and May 2019. Multivariate regressions were performed to assess the associations of maternal subclinical malaria with several maternal and neonatal outcomes after controlling for the presence of preeclampsia/eclampsia (PE/E) and HIV infection, as well as for other maternal and pregnancy characteristics. Results In total, 17.2% (n = 40) of the women studied had positive PCR for P. falciparum (7 in placental blood only, 3 in peripheral blood only). We found a significant association between subclinical malaria and a higher peripartum mortality risk, which persisted after controlling for maternal comorbidity and maternal and pregnancy characteristics (adjusted odds ratio: 3.50 [1.11–10.97]). In addition, PE/E and HIV infections were also significantly associated with several adverse maternal and neonatal outcomes. Conclusion This study demonstrated the association of subclinical malaria, as well as of PE/E and HIV, in pregnant women with adverse maternal and neonatal outcomes. Therefore, molecular methods may be sensitive tools to identify asymptomatic infections that can reduce the impact on peripartum mortality and their contribution to sustained transmission of the parasite in endemic countries.

Resumen. Todos los países, cualquiera que sea su grado de desarrollo, se esfuerzan por proporcionar unos cuidados sanitarios adecuados a sus ciudadanos. Gozar de buena salud es una condición básica para el desarrollo y la seguridad de las personas, a pesar de lo cual persisten enormes desigualdades en salud entre los países. Los educadores médicos tienen un papel clave en la reducción de estas desigualdades al abordar uno de los aspectos esenciales del problema: la acusada escasez de médicos que sufren algunas regiones, especialmente en el África subsahariana. Una de las mayores dificultades para afrontar esta cuestión es la falta de profesores cualificados, lo que podría solventarse mediante estancias cortas de graduados procedentes de países desarrollados que voluntariamente quisieran participar en este tipo de iniciativas. Pero el mundo de la educación médica tampoco es un terreno justo, equilibrado y equitativo, y trabajar en países pobres y alejados supone un reto importante. En este artículo, presentamos la experiencia en el diseño y desarrollo de un proyec