Genomic epidemiology of SARS-CoV-2 during the first four waves in Mozambique

Abstract

Mozambique reported the first case of coronavirus disease 2019 (COVID-19) in March 2020 and it has since spread to all provinces in the country. To investigate the introductions and spread of SARS-CoV-2 in Mozambique, 1 142 whole genome sequences sampled within Mozambique were phylogenetically analyzed against a globally representative set, reflecting the first 25 months of the epidemic. The epidemic in the country was marked by four waves of infection, the first associated with B.1 ancestral lineages, while the Beta, Delta, and Omicron Variants of Concern (VOCs) were responsible for most infections and deaths during the second, third, and fourth waves. Large-scale viral exchanges occurred during the latter three waves and were largely attributed to southern African origins. Not only did the country remain vulnerable to the introductions of new variants but these variants continued to evolve within the borders of the country. Due to the Mozambican health system already under constraint, and paucity of data in Mozambique, there is a need to continue to strengthen and support genomic surveillance in the country as VOCs and Variants of interests (VOIs) are often reported from the southern African region.

Cervical cancer in Mozambique: Clinical characteristics, treatment and survival of incident cases admitted to the Oncology Service of Maputo Central Hospital in 2016‐2018

“…Unfortunately, no information regarding chemotherapy adherence or interruption could be analysed, as well changes in the chemotherapy scheme over time, which may also contribute to explain the differences found in overall survival across years of diagnosis. Although the first case of COVID‐19 in Mozambique was only reported on 22 March 2020, and the reported number of cases and deaths in 2020 were relatively low, 31 we cannot excluded the hypothesis of the pandemic having had some impact on the demand or in the interruption of planned care, therefore influencing the observed survival in patients diagnosed in 2018. Concerning radiotherapy, external radiotherapy became available at MCH only in August 2019, 8 and brachytherapy was not available, which justifies that only a small proportion of patients performed these treatments (6.5% and 1.3% of all patients, respectively).…”

High SARS‐CoV‐2 Exposure in Rural Southern Mozambique After Four Waves of COVID‐19: Community‐Based Seroepidemiological Surveys

“…Furthermore, the migration to and from southern African countries, particularly South Africa, has an important significance for the spread of the virus. The latter is especially relevant because a significant part of the Manhiça male adult population migrates to that country and travels back and forth regularly, mostly during the holiday season, and because of forced circumstances such as repatriations, medical needs, and others, also South Africa has been shown to be an important source for the introduction SARS‐CoV‐2 variants [ 13 , 14 ].…”

“…As of March 2023, around 230,000 confirmed cases and around two thousand deaths (representing 0.03% of the global deaths) were reported. The country experienced four epidemic waves [ 12 ], dominated by the wild‐type SARS‐CoV‐2, Beta, Delta, and Omicron variants during the first (September–December 2020), second (January–March 2021), third (June–September 2021), and fourth (December 2021–January 2022) waves [ 13 , 14 ]. Following global recommendations, Mozambique introduced vaccination against SARS‐CoV‐2, one year after the first confirmed case through the COVAX mechanism and with financial support from international donors [ 15 , 16 ].…”