Language Policy and Practice in the Multilingual Southern African Development Community

ERIC Educational Resources Information Center

Mooko, Theophilus

2009-01-01

This study explores the language policy and practice of the Southern African Development Community (SADC), an African regional economic organisation made up of 14 member states (Angola, Botswana, Democratic Republic of Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, United Republic of Tanzania, Zambia…

An Outbreak of Wild Poliovirus in the Republic of Congo, 2010–2011

PubMed Central

Patel, Minal K.; Konde, Mandy Kader; Didi-Ngossaki, Boris Hermann; Ndinga, Edouard; Yogolelo, Riziki; Salla, Mbaye; Shaba, Keith; Everts, Johannes; Armstrong, Gregory L.; Daniels, Danni; Burns, Cara; Wassilak, Steve; Pallansch, Mark; Kretsinger, Katrina

2015-01-01

Background The Republic of Congo has had no cases of wild poliovirus type 1 (WPV1) since 2000. In October 2010, a neurologist noted an abnormal number of cases of acute flaccid paralysis (AFP) among adults, which were later confirmed to be caused by WPV1. Methods Those presenting with AFP underwent clinical history, physical examination, and clinical specimen collection to determine if they had polio. AFP cases were classified as laboratory-confirmed, clinical, or nonpolio AFP. Epidemiologic features of the outbreak were analyzed. Results From 19 September 2010 to 22 January 2011, 445 cases of WPV1 were reported in the Republic of Congo; 390 cases were from Pointe Noire. Overall, 331 cases were among adults; 378 cases were clinically confirmed, and 64 cases were laboratory confirmed. The case-fatality ratio (CFR) was 43%. Epidemiologic characteristics differed among polio cases reported in Pointe Noire and cases reported in the rest of the Republic of Congo, including age distribution and CFR. The outbreak stopped after multiple vaccination rounds with oral poliovirus vaccine, which targeted the entire population. Conclusions This outbreak underscores the need to maintain high vaccination coverage to prevent outbreaks, the need to maintain timely high-quality surveillance to rapidly identify and respond to any potential cases before an outbreak escalates, and the need to perform ongoing risk assessments of immunity gaps in polio-free countries. PMID:22911642

First reported chikungunya fever outbreak in the republic of Congo, 2011.

PubMed

Moyen, Nanikaly; Thiberville, Simon-Djamel; Pastorino, Boris; Nougairede, Antoine; Thirion, Laurence; Mombouli, Jean-Vivien; Dimi, Yannick; Leparc-Goffart, Isabelle; Capobianchi, Maria Rosaria; Lepfoundzou, Amelia Dzia; de Lamballerie, Xavier

2014-01-01

Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011. We analysed 317 suspected cases, of which 308 (97.2%) lived in the city of Brazzaville (66.6% in the South area). Amongst them, 37 (11.7%) were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1) demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis. We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better understanding the environmental, microbiological and

First Reported Chikungunya Fever Outbreak in the Republic of Congo, 2011

PubMed Central

Pastorino, Boris; Nougairede, Antoine; Thirion, Laurence; Mombouli, Jean-Vivien; Dimi, Yannick; Leparc-Goffart, Isabelle; Capobianchi, Maria Rosaria; Lepfoundzou, Amelia Dzia; de Lamballerie, Xavier

2014-01-01

Background Chikungunya is an Aedes -borne disease characterised by febrile arthralgia and responsible for massive outbreaks. We present a prospective clinical cohort study and a retrospective serological study relating to a CHIK outbreak, in the Republic of Congo in 2011. Methodology and Findings We analysed 317 suspected cases, of which 308 (97.2%) lived in the city of Brazzaville (66.6% in the South area). Amongst them, 37 (11.7%) were CHIKV+ve patients (i.e., biologically confirmed by a real-time RT-PCR assay), of whom 36 (97.3%) had fever, 22 (66.7%) myalgia and 32 (86.5%) arthralgia. All tested negative for dengue. The distribution of incident cases within Brazzaville districts was compared with CHIKV seroprevalence before the outbreak (34.4% in 517 blood donors), providing evidence for previous circulation of CHIKV. We applied a CHIK clinical score to 126 patients recruited within the two first day of illness (including 28 CHIKV+ves (22.2%)) with sensitivity (78.6%) and specificity (72.4%) values comparing with those of the referent study in Reunion Island. The negative predictive value was high (92%), but the positive predictive value (45%) indicate poor potential contribution to medical practice to identify CHIKV+ve patients in low prevalence outbreaks. However, the score allowed a slightly more accurate follow-up of the evolution of the outbreak than the criterion "fever+arthralgia". The complete sequencing of a Congolase isolate (Brazza_MRS1) demonstrated belonging to the East/Central/South African lineage and was further used for producing a robust genome-scale CHIKV phylogenetic analysis. Conclusions/Significance We describe the first Chikungunya outbreak declared in the Republic of Congo. The seroprevalence study conducted amongst blood donors before outbreak provided evidence for previous CHIKV circulation. We suggest that a more systematic survey of the entomological situation and of arbovirus circulation is necessary in Central Africa for better

New Foci of Buruli Ulcer, Angola and Democratic Republic of Congo

PubMed Central

Kibadi, Kapay; Panda, Mbutu; Tamfum, Jean-Jacques Muyembe; Fraga, Alexandra G.; Filho, Adhemar Longatto; Anyo, Gladys; Pedrosa, Jorge; Nakazawa, Yoshinori; Suykerbuyk, Patrick; Meyers, Wayne M.

2008-01-01

We report 3 patients with laboratory-confirmed Buruli ulcer in Kafufu/Luremo, Angola, and Kasongo-Lunda, Democratic Republic of Congo. These villages are near the Kwango/Cuango River, which flows through both countries. Further investigation of artisanal alluvial mining as a risk factor for Buruli ulcer is recommended. PMID:18976574

Rights of the Child in the Democratic Republic of the Congo.

ERIC Educational Resources Information Center

Cosandey, Olivier

This report to the United Nations Convention on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the Convention by Democratic Republic of the Congo (DRC). The report's introductory summary asserts that although the DRC has ratified the Convention and other international…

3 CFR 8618 - Proclamation 8618 of December 21, 2010. To Take Certain Actions Under the African Growth and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... designated the Democratic Republic of Congo (DRC) as an eligible sub-Saharan African country pursuant to... “Democratic Republic of Congo” from the list of beneficiary sub-Saharan African countries. (3) In order to...

Discordances with HIV-1 RNA quantitative determinations by three commercial assays in Pointe Noire, Republic of Congo.

PubMed

Bruzzone, Bianca; Bisio, Francesca; Caligiuri, Patrizia; Mboungou, Franc A Mayinda; Nigro, Nicola; Sticchi, Laura; Ventura, Agostina; Saladini, Francesco; Zazzi, Maurizio; Icardi, Giancarlo; Viscoli, Claudio

2014-07-01

Accurate HIV-1 RNA quantitation is required to support the scale up of antiretroviral therapy in African countries. Extreme HIV-1 genetic variability in Africa may affect the ability of commercially available assays to detect and quantify HIV-1 RNA accurately. The aim of this study was to compare three real-time PCR assays for quantitation of plasma HIV-1 RNA levels in patients from the Republic of Congo, an area with highly diversified HIV-1 subtypes and recombinants. The Abbott RealTime HIV-1, BioMérieux HIV-1 EasyQ test 1.2 and Cobas AmpliPrep/Cobas TaqMan HIV-1 1.0 were compared for quantitation of HIV-1 RNA in 37 HIV-1 seropositive pregnant women enrolled in the Kento-Mwana project for prevention of mother-to-child transmission in Pointe-Noire, Republic of Congo. The sample panel included a variety of HIV-1 subtypes with as many as 21 (56.8%) putative unique recombinant forms. Qualitative detection of HIV-1 RNA was concordant by all three assays in 33/37 (89.2%) samples. Of the remaining 4 (10.8%) samples, all were positive by Roche, three by Abbott and none by BioMérieux. Differences exceeding 1Log in positive samples were found in 4/31 (12.9%), 10/31 (32.3%) and 5/31 (16.1%) cases between Abbott and BioMérieux, Roche and BioMérieux, and Abbott and Roche, respectively. In this sample panel representative of highly polymorphic HIV-1 in Congo, the agreement among the three assays was moderate in terms of HIV-1 RNA detectability and rather inconsistent in terms of quantitation. Copyright © 2014. Published by Elsevier B.V.

Exposure to Lyssaviruses in Bats of the Democratic Republic of the Congo.

PubMed

Kalemba, Lem's N; Niezgoda, Michael; Gilbert, Amy T; Doty, Jeffrey B; Wallace, Ryan M; Malekani, Jean M; Carroll, Darin S

2017-04-01

Lyssavirus infections in the Democratic Republic of Congo are poorly documented. We examined 218 bats. No lyssavirus antigens were detected but Lagos bat virus (LBV) neutralizing antibodies (VNA) were detected in Eidolon helvum and Myonycteris torquata . Four samples with LBV VNA reacted against Shimoni bat virus.

Late Pan-African and early Mesozoic brittle compressions in East and Central Africa: lithospheric deformation within the Congo-Tanzania Cratonic area

NASA Astrophysics Data System (ADS)

Delvaux, D.; Kipata, M. L.; Macheyeki, A. S.

2012-04-01

Tectonic reconstructions leading to the formation of the Central-African part of Gondwana have so far not much taken into account constraints provided by the evolution of brittle structures and related stress field. This is largely because little is known on continental brittle deformation in Equatorial Africa before the onset of the Mesozoic Central-African and Late Cenozoic East-African rifts. We present a synthesis of fault-kinematic data and paleostress inversion results from field surveys covering parts of Tanzania, Zambia and the Democratic Republic of Congo. It is based on investigations along the eastern margin of the Tanzanian craton, in the Ubendian belt between the Tanzanian craton and Bangweulu block, in the Lufilian Arc between the Kalahari and Congo cratons and along the Congo intracratonic basin. Paleostress tensors were computed for a substantial database by interactive stress tensor inversion and data subset separation, and the relative succession of major brittle events established. Two of them appear to be of regional importance and could be traced from one region to the other. The oldest one is the first brittle event recorded after the paroxysm of the Terminal Pan-African event that led to the amalgamation Gondwana at the Precambrian-Cambrian transition. It is related to compressional deformation with horizontal stress trajectories fluctuating from an E-W compression in Central Tanzania to NE-SW in the Ubende belt and Lufilian Arc. The second event is a transpressional inversion with a consistent NW-SE compression that we relate to the far-field effects of the active margin south of Gondwana during the late Triassic - early Jurassic.

Teaching and Supporting Students with Intellectual Disabilities in Democratic Republic of Congo

ERIC Educational Resources Information Center

Aldersey, Heather Michelle; Haines, Shana Jackson

2018-01-01

Children with intellectual disabilities (ID) often experience challenges due to low learning expectations and educational quality and limited educational access. Often, in locations impacted by higher levels of poverty, such as Kinshasa, Democratic Republic of the Congo, educational disparities for children with ID are even more pronounced. To…

Contrasting biogeochemical characteristics of right-bank tributaries of the Oubangui River, and a comparison with the mainstem river (Congo basin, Central African Republic).

NASA Astrophysics Data System (ADS)

Bouillon, Steven; Yambélé, Athanase; Gillikin, David P.; Teodoru, Cristian; Darchambeau, François; Lambert, Thibault; Borges, Alberto V.

2014-05-01

The Oubangui is a major right-bank tributary of the Congo River, draining an area of ~500,000 km² of mainly wooded savannahs. Here, we describe data on the physico-chemical characteristics and biogeochemistry of contrasting tributaries within the central Oubangui catchment collected during 3 field surveys between 2010 and 2012, with land use ranging from wooded savannahs to humid tropical rainforest. Compared to data from two years of sampling at high temporal resolution on the mainstem river in Bangui (Central African Republic), these tributaries show a remarkably wide range of biogeochemical signatures, from highly diluted blackwaters (low turbidity, pH, conductivity and total alkalinity (TA)) in rivers draining dense rainforests to those more typical for (sub)tropical savannah systems. Based on carbon stable isotope data (δ13C), the majority of sites show a corresponding dominance of C3-derived organic matter, with a tendency for increased C4 contributions the more turbid sites such as the Mpoko River. δ13C of dissolved organic carbon (DOC) were generally similar to those of particulate organic carbon (POC) across the different tributaries. δ13C of dissolved inorganic carbon (DIC) ranged between -28.1 ‰ in low-TA rainforest (blackwater) rivers to -5.8 ‰ in the mainstem Oubangui. These variations were strongly correlated to both partial pressure of CO2 (pCO2) and to the estimated contribution of carbonate weathering to total alkalinity, suggesting an important control of the dominant weathering regime (silicate versus carbonate weathering) on DIC and CO2 fluxes. All tributaries were consistently oversaturated in dissolved greenhouse gases (CH4, N2O, and CO2) with respect to atmospheric equilibrium, with highest levels observed in rivers draining rainforest vegetation. The high diversity observed within this subcatchment of the Congo River basin is equivalent to that observed in much larger, heterogeneous catchments, and underscores the importance of

Perioperative mortality: Analysis of 3 years of operative data across 7 general surgical projects of Médecins Sans Frontières in Democratic Republic of Congo, Central African Republic, and South Sudan.

PubMed

Davies, Jessica F; Lenglet, Annick; van Wijhe, Marten; Ariti, Cono

2016-05-01

The African continent has the greatest burden of surgical disability-adjusted life years, yet the least is known about operative care here. This analysis describes the surgical patients admitted to 7 hospitals supported by the Médécins Sans Frontières (MSF) over 3 years in 3 conflict-affected countries-Eastern Democratic Republic of Congo, Central African Republic, and South Sudan. A standardized operative data collection tool was used for routine collection of operative inpatient data between 2011 and 2013 at 7 MSF surgical facilities. Surgical records of 14,482 patients were analyzed to describe surgical epidemiology, major procedures, and perioperative mortality. The perioperative mortality rate (POMR) was calculated within 2 days of admission (POMR2) and within 30 days from admission (POMR30). The POMR is used as a marker of quality of operative care. Caesarean delivery was the most common major procedure performed and had a POMR30 of 5.28 per 1,000 admissions. The overall inpatient mortality was 19.67 per 1,000 admissions. Children had greater POMR than adults for the same procedure types (47.97 vs 15.89 deaths per 1,000 admissions, P < .001); 85.1% of all major procedures were emergency procedures and between 3 and 30% of admissions were related to violence. After adjustment, perioperative death was associated with emergency surgery, violence, and age younger than 15 years. POMRs varied by age group and type of major procedure performed. Collecting surgical data is achievable and can inform future planning and support for national surgical programs. More information is needed on operative outcomes in adults and children in low-resource settings to improve quality and access to care. Copyright © 2016 Elsevier Inc. All rights reserved.

Factors Affecting Performance of Agricultural Extension: Evidence from Democratic Republic of Congo

ERIC Educational Resources Information Center

Ragasa, Catherine; Ulimwengu, John; Randriamamonjy, Josee; Badibanga, Thaddee

2016-01-01

Purpose: As part of the institutional reforms and agricultural restructuring in the Democratic Republic of Congo (DRC), this paper provides an assessment of the performance of the agricultural extension system as well as factors explaining it. Method: This paper involves key informants' interviews and surveys of 107 extension organizations and 162…

Sediment-hosted stratabound copper assessment of the Neoproterozoic Roan Group, central African copperbelt, Katanga Basin, Democratic Republic of the Congo and Zambia: Chapter T in Global mineral resource assessment

USGS Publications Warehouse

Zientek, Michael L.; Bliss, James D.; Broughton, David W.; Christie, Michael; Denning, Paul; Hayes, Timothy S.; Hitzman, Murray W.; Horton, John D.; Frost-Killian, Susan; Jack, Douglas J.; Master, Sharad; Parks, Heather L.; Taylor, Cliff D.; Wilson, Anna B.; Wintzer, Niki E.; Woodhead, Jon

2014-01-01

This study estimates the location, quality, and quantity of undiscovered copper in stratabound deposits within the Neoproterozoic Roan Group of the Katanga Basin in the Democratic Republic of the Congo and Zambia. The study area encompasses the Central African Copperbelt, the greatest sediment-hosted copper-cobalt province in the world, containing 152 million metric tons of copper in greater than 80 deposits. This study (1) delineates permissive areas (tracts) where undiscovered sediment-hosted stratabound copper deposits may occur within 2 kilometers of the surface, (2) provides a database of known sediment-hosted stratabound copper deposits and prospects, (3) estimates numbers of undiscovered deposits within these permissive tracts at several levels of confidence, and (4) provides probabilistic estimates of amounts of copper and mineralized rock that could be contained in undiscovered deposits within each tract. The assessment, conducted in January 2010 using a three-part form of mineral resource assessment, indicates that a substantial amount of undiscovered copper resources might occur in sediment-hosted stratabound copper deposits within the Roan Group in the Katanga Basin. Monte Carlo simulation results that combine grade and tonnage models with estimates of undiscovered deposits indicate that the mean estimate of undiscovered copper in the study area is 168 million metric tons, which is slightly greater than the known resources at 152 million metric tons. Furthermore, significant value can be expected from associated metals, particularly cobalt. Tracts in the Democratic Republic of the Congo (DRC) have potential to contain near-surface, undiscovered deposits. Monte Carlo simulation results indicate a mean value of 37 million metric tons of undiscovered copper may be present in significant prospects.

Poliomyelitis Outbreak,Pointe-Noire, Republic of the Congo, September 2010–February 2011

PubMed Central

Llosa, Augusto E.; Mouniaman-Nara, Isabelle; Kouassi, Felix; Ngala, Joseph; Boxall, Naomi; Porten, Klaudia; Grais, Rebecca F.

2011-01-01

On November 4, 2010, the Republic of the Congo declared a poliomyelitis outbreak. A cross-sectional survey in Pointe-Noire showed poor sanitary conditions and low vaccination coverage (55.5%), particularly among young adults. Supplementary vaccination should focus on older age groups in countries with evidence of immunity gaps. PMID:21801636

Nocturnal enuresis in children in Kinshasa, Democratic Republic of Congo.

PubMed

Aloni, Michel N; Ekila, Mathilde B; Ekulu, Pépé M; Aloni, Muriel L; Magoga, Kumbundu

2012-10-01

  To determine the prevalence of nocturnal enuresis in children of Kinshasa in Democratic Republic of Congo.   In all, 506 questionnaires were sent to parents of children aged 6-12 years randomly selected from four primary schools in Kinshasa, Democratic Republic of Congo. The questionnaire was designed to collect information about prevalence and factors associated with nocturnal enuresis.   A total of 415 (82.0%) were correctly completed. In this series, 109 children were identified as nocturnal enuresis in which 50 boys and 56 girls (p > 0.05). Factors associated with nocturnal enuresis were deep sleep, young age and familial history of enuresis (p < 0.05). Only 11% of patients have been consulted by doctors. Twelve children (11.0%) were treated by healers traditional. In the other part, 43 children (39.4%) were frequently punished by their parents. The common self-help strategies were 79 children (72.5%) were submitted to fluid restrictions before going to sleep and 68 (62.4%) were waking the child at night to void.   In Kinshasa, the prevalence of nocturnal enuresis was high to those reported in Asian and Western countries. Nocturnal enuresis remains an important clinical problem in children but only a small percentage of parents seek medical help. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Contribution to the knowledge of Afrotropical Dryinidae, Embolemidae and Sclerogibbidae (Hymenoptera), with description of new species from Central African Republic and Uganda.

PubMed

Olmi, Massimo; van Noort, Simon; Guglielmino, Adalgisa

2016-01-01

, 1963 (Sclerogibbidae); from Ivory Coast: Adryinus oweni Olmi, 1984 (Gonatopodinae); from Cameroon and South Africa: Gonatopus operosus Olmi, 1993 (Gonatopodinae); from Democratic Republic of the Congo and Zambia: Neodryinus antiquus Benoit, 1954 (Gonatopodinae); from South Africa: Anteon striatum Olmi, 2005b (Anteoninae). Including the above new records, 23 species of Dryinidae (previously six), two species of Embolemidae (previously none) and three species of Sclerogibbidae (previously two) are now known from Central African Republic. For Uganda, 39 species of Dryinidae (previously 23), one species of Embolemidae (previously none) and four species of Sclerogibbidae (previously four) are now known. Additional new faunistic records are provided for Cameroon, Democratic Republic of the Congo, Ivory Coast, Mali, South Africa and Zambia.

Contribution to the knowledge of Afrotropical Dryinidae, Embolemidae and Sclerogibbidae (Hymenoptera), with description of new species from Central African Republic and Uganda

PubMed Central

Olmi, Massimo; van Noort, Simon; Guglielmino, Adalgisa

2016-01-01

Benoit, 1963 (Sclerogibbidae); from Ivory Coast: Adryinus oweni Olmi, 1984 (Gonatopodinae); from Cameroon and South Africa: Gonatopus operosus Olmi, 1993 (Gonatopodinae); from Democratic Republic of the Congo and Zambia: Neodryinus antiquus Benoit, 1954 (Gonatopodinae); from South Africa: Anteon striatum Olmi, 2005b (Anteoninae). Including the above new records, 23 species of Dryinidae (previously six), two species of Embolemidae (previously none) and three species of Sclerogibbidae (previously two) are now known from Central African Republic. For Uganda, 39 species of Dryinidae (previously 23), one species of Embolemidae (previously none) and four species of Sclerogibbidae (previously four) are now known. Additional new faunistic records are provided for Cameroon, Democratic Republic of the Congo, Ivory Coast, Mali, South Africa and Zambia. PMID:27110196

New strategy for peace enforcement: the intervention brigade in the Democratic Republic of Congo

DTIC Science & Technology

With the introduction of MONUSCO’s Force Intervention Brigade in the Democratic Republic of Congo (DRC), the United Nations (UN), for the first time...can reduce risk by rebalancing its strategy or by separating the intervention brigade’s offensive mission from MONUSCO’s defensive one .

New Information and Communication Technologies in the Democratic Republic of Congo: Strategies and Measures

ERIC Educational Resources Information Center

Nsomwe-a-nfunkwa, Banza

2006-01-01

This article will primarily allow a definition of the strategic development of ICT in the Democratic Republic of Congo, to be put forward. For the most part it involves the precision of many types of measures and strategies (such as institutional, regulatory, infrastructural measures), human resources, the development of content and partnerships,…

Background Report on Eastern Democratic Republic of the Congo

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warren, Tracy A

Each month, approximately 45,000 people die from violence, hunger, disease, and other effects of displacement as a result of war in the Democratic Republic of the Congo (DRC). The country is often said to be plagued by a 'resource curse.' During each period in history since its discovery by the West, the DRC has possessed the resources the world craves and the world has sought these without regard for the consequences to the Congolese people. The catastrophic consequences of Congo's history of natural resource exploitation are the direct and indirect death of millions of Congolese people. The current war inmore » Congo is multi-causal in nature but explanations are often reduced to describing it as an ethic conflict based on objective grievance. Objective grievance such as inequality, ethnic tensions, land disputes, and lack of democracy do exist, but they are neither necessary nor sufficient to explain the cause of the violent conflict, and more importantly, they fall short in explaining why this conflict has continued for years. The reality is the conflict is an economic war in which the trade of conflict minerals, gold and the 3Ts (tin, tantalum, tungsten), is directly linked to the financial sustainability of the groups fighting each other in eastern DRC. Objective grievance is a by-product of the conflict, used to create a false but plausible moral justification to continue violence. This paper examines the history of conflict in the DRC and the socio-economic variables contributing to the current war fought over conflict minerals.« less

Violence against sex workers by police and military in Democratic Republic of Congo.

PubMed

Ombeni, Alphonse Mihigo; Crago, Anna Louise

2008-12-01

Sex workers in the Sud-Kivu district of the Democratic Republic of Congo (DRC) are regularly subjected to sexual and other forms of violence. In this article, based on a presentation at a concurrent session at the conference, Alphonse Mihigo Ombeni and Anna Louise Crago describe the negative impacts of this violence on the sex workers' health and working conditions. Many have become HIV-positive.

Tobacco Use and Secondhand Smoke Exposure During Pregnancy in Two African Countries: Zambia and the Democratic Republic of the Congo

PubMed Central

Chomba, Elwyn; Tshefu, Antoinette; Onyamboko, Marie; Kaseba - Sata, Christine; Moore, Janet; McClure, Elizabeth M; Moss, Nancy; Goco, Norman; Bloch, Michele; Goldenberg, Robert L

2013-01-01

Objective To study pregnant women’s knowledge, attitudes and behaviors towards tobacco use and secondhand smoke (SHS) exposure, and exposure to advertising for and against tobacco products in Zambia and the Democratic Republic of the Congo (DRC). Design Prospective cross-sectional survey between November 2004 and September 2005. Setting Antenatal care clinics in Lusaka, Zambia and Kinshasa, DRC. Population Pregnant women in Zambia (909) and the DRC (847). Methods Research staff administered a structured questionnaire to pregnant women attending antenatal care clinics. Main Outcome Measures Pregnant women’s use of tobacco, exposure to SHS, knowledge of the harms of tobacco, and exposure to advertising for and against tobacco products. Results Only about 10% of pregnant women reported having ever tried cigarettes (6.6% Zambia; 14.1% DRC). However, in the DRC, 41.8% of pregnant women had ever tried other forms of tobacco, primarily snuff. About 10% of pregnant women and young children were frequently or always exposed to SHS. Pregnant women’s knowledge of the hazards of smoking and SHS exposure was extremely limited. About 13% of pregnant women had seen or heard advertising for tobacco products in the last 30 days. Conclusions Tobacco use and SHS exposure pose serious threats to the health of women, infants, and children. In many African countries, maternal and infant health outcomes are often poor and will likely worsen if maternal tobacco use increases. Our findings suggest that a “window of opportunity” exists to prevent increased tobacco use and SHS exposure of pregnant women in Zambia and the DRC. PMID:20230310

Characterizing pediatric surgical capacity in the Eastern Democratic Republic of Congo: results of a pilot study.

PubMed

Cairo, Sarah B; Kalisya, Luc Malemo; Bigabwa, Richard; Rothstein, David H

2018-03-01

Characterize pediatric surgical capacity in the eastern Democratic Republic of Congo (DRC) to identify areas of potential improvement. The Pediatric Personnel, Infrastructure, Procedures, Equipment, and Supplies (PediPIPES) survey was used in two representative eastern DRC provinces to assess existing surgical infrastructure and capacity. We compared our results to previously published reports from other sub-Saharan African countries. Fourteen hospitals in the eastern DRC and 37 in 19 sub-Saharan African (SSA) countries were compared. The average PediPIPES index for the DRC was 7.7 compared to 13.5 for SSAs. The greatest disparities existed in the areas of personnel and infrastructure. Running water was reportedly available to 57.1% of the hospitals in the DRC, and the majority of hospitals (78.6%) were dependent on generators and solar panels for electricity. Only two hospitals in the DRC (14.3%) reported a pediatric surgeon equivalent on staff, compared to 86.5% of facilities sampled in SSA reporting ≥ 1 pediatric surgeon. Significant barriers in personnel, infrastructure, procedures, equipment, and supplies impede the provision of adequate surgical care to children. Further work is needed to assess allocation and utilization of existing resources, and to enhance training of personnel with specific attention to pediatric surgery.

Are the Rural Schools of the Democratic Republic of Congo Ready for the $100 Laptop?

ERIC Educational Resources Information Center

Banza, Nsomwe-a- Nfunkwa

2006-01-01

The situation of schools in the Democratic Republic of Congo in matters concerning new information and communication technologies remains alarming. Given the primary role of these technologies in teaching and learning, as well as the concern of giving Congolese rural schools access to these tools, considering the problems of lack of electricity,…

Invasive Salmonella enterica Serotype Typhimurium Infections, Democratic Republic of the Congo, 2007–2011

PubMed Central

Ley, Benedikt; Le Hello, Simon; Lunguya, Octavie; Lejon, Veerle; Muyembe, Jean-Jacques; Jacobs, Jan

2014-01-01

Infection with Salmonella enterica serotype Typhimurium sequence type (ST) 313 is associated with high rates of drug resistance, bloodstream infections, and death. To determine whether ST313 is dominant in the Democratic Republic of the Congo, we studied 180 isolates collected during 2007–2011; 96% belonged to CRISPOL type CT28, which is associated with ST313. PMID:24655438

Evolution and estimated age of the C5 Lukala carbonate-evaporite ramp complex in the Lower Congo region (Democratic Republic of Congo): New perspectives in Central Africa

NASA Astrophysics Data System (ADS)

Delpomdor, F.; Van Vliet, N.; Devleeschouwer, X.; Tack, L.; Préat, A.

2018-01-01

New detailed lithological, sedimentological, chemostratigraphic data were obtained from exploration drilling samples on the C5 carbonate-dominated formation of the Neoproterozoic Lukala Subgroup (former Schisto-Calcaire Subgroup) from the West Congo Belt (WCB) in the Democratic Republic of Congo. This formation records the last post-Marinoan sea-level events that occurred in the whole basin, followed by the development of the Araçuaï-West Congo Orogen between 630 and 560 Ma. The C5 Formation consists of back-reef lagoonal and peritidal/sabkha cycles of ∼2.0 m in thickness, that record a short-time marine regression, rapidly flooded by a marine transgression with deposition of organic-rich argillaceous carbonates or shales under dysoxia and anoxia conditions. These dysoxic/anoxic waters were rapidly followed by a regional-scale marine transgression, favouring mixing with well-oxygenated waters, and the development of benthic Tonian to Cambro-Ordovician Obruchevella parva-type 'seagrasses' in the nearshore zones of the lagoons. New δ13C and 87Sr/86Sr isotopic data in the C5 Formation of the Lukala Subgroup are used in the frame of a correlation with the Sete Lagoas Formation in Brazil. Relatively comparable negative to positive δ13C excursions point to marine flooding of the whole basin and allow extension of the debatable Late Ediacaran age of the uppermost Sete Lagoas and C5 formations. Sr isotope ;blind dating; failed due to low Sr concentration related to a dolomitization event close 540 Ma. Several tentative datings of the C5 Formation converge to a Late Ediacaran age ranging between 575 and 540 Ma. As the overlying Mpioka folded Subgroup, the C5 series suffered the Pan African deformation, dated at 566 ± 42 Ma. Unlike the previously generally accepted interpretation, our data suggests that the Mpioka Subgroup was deposited in the Early Cambrian.

Detection of Human Monkeypox in the Republic of the Congo Following Intensive Community Education

PubMed Central

Reynolds, Mary G.; Emerson, Ginny L.; Pukuta, Elisabeth; Karhemere, Stomy; Muyembe, Jean J.; Bikindou, Alain; McCollum, Andrea M.; Moses, Cynthia; Wilkins, Kimberly; Zhao, Hui; Damon, Inger K.; Karem, Kevin L.; Li, Yu; Carroll, Darin S.; Mombouli, Jean V.

2013-01-01

Monkeypox is an acute viral infection with a clinical course resembling smallpox. It is endemic in northern and central Democratic Republic of the Congo (DRC), but it is reported only sporadically in neighboring Republic of the Congo (ROC). In October 2009, interethnic violence in northwestern DRC precipitated the movement of refugees across the Ubangi River into ROC. The influx of refugees into ROC heightened concerns about monkeypox in the area, because of the possibility that the virus could be imported, or that incidence could increase caused by food insecurity and over reliance on bush meat. As part of a broad-based campaign to improve health standards in refugee settlement areas, the United Nations International Children's Emergency Fund (UNICEF) sponsored a program of intensive community education that included modules on monkeypox recognition and prevention. In the 6 months immediately following the outreach, 10 suspected cases of monkeypox were reported to health authorities. Laboratory testing confirmed monkeypox virus infection in two individuals, one of whom was part of a cluster of four suspected cases identified retrospectively. Anecdotes collected at the time of case reporting suggest that the outreach campaign contributed to detection of suspected cases of monkeypox. PMID:23400570

Identification of diverse Bartonella genotypes among small mammals from Democratic Republic of Congo and Tanzania.

PubMed

Gundi, Vijay A K B; Kosoy, Michael Y; Makundi, Rhodes H; Laudisoit, Anne

2012-08-01

Small mammals from the Democratic Republic (DR) of the Congo and Tanzania were tested to determine the prevalence and genetic diversity of Bartonella species. The presence of Bartonella DNA was assessed in spleen samples of the animals by rpoB- and gltA-polymerase chain reactions (PCRs). By rpoB-PCR, Bartonella was detected in 8 of 59 animals of DR Congo and in 16 of 39 Tanzanian animals. By gltA-PCR, Bartonella was detected in 5 and 15 animals of DR Congo and Tanzania, respectively. The gene sequences from Arvicanthis neumanni were closely related to Bartonella elizabethae. The genotypes from Lophuromys spp. and from Praomys delectorum were close to Bartonella tribocorum. Five genogroups were not genetically related to any known Bartonella species. These results suggest the need to conduct further studies to establish the zoonotic risks linked with those Bartonella species and, in particular, to verify whether these agents might be responsible for human cases of febrile illness of unknown etiology in Africa.

Sparks creating light? Strengthening peripheral disease surveillance in the Democratic Republic of Congo

PubMed Central

Mossoko, M.; Nyakio Kakusu, J. P.; Nyembo, J.; Mangion, J. P.; Van Laeken, D.; Van den Bergh, R.; Van den Boogaard, W.; Manzi, M.; Kibango, W. K.; Hermans, V.; Beijnsberger, J.; Lambert, V.; Kitenge, E.

2016-01-01

Setting: The Democratic Republic of Congo suffers from an amalgam of disease outbreaks and other medical emergencies. An efficient response to these relies strongly on the national surveillance system. The Pool d'Urgence Congo (PUC, Congo Emergency Team) of Médecins Sans Frontières is a project that responds to emergencies in highly remote areas through short-term vertical interventions, during which it uses the opportunity of its presence to reinforce the local surveillance system. Objective: To investigate whether the ancillary strengthening of the peripheral surveillance system during short-term interventions leads to improved disease notification. Design: A descriptive paired study measuring disease notification before and after 12 PUC interventions in 2013–2014. Results: A significant increase in disease notification was observed after seven mass-vaccination campaigns and was sustained over 6 months. For the remaining five smaller-scaled interventions, no significant effects were observed. Conclusion: The observed improvements after even short-term interventions underline, on the one hand, how external emergency actors can positively affect the system through their punctuated actions, and, on the other hand, the dire need for investment in surveillance at peripheral level. PMID:27358796

Malaria epidemiological research in the Republic of Congo.

PubMed

Koukouikila-Koussounda, Felix; Ntoumi, Francine

2016-12-23

Reliable and comprehensive information on the burden of malaria is critical for guiding national and international efforts in malaria control. The purpose of this review is to provide an overview of published data and available information on malaria resulting from field studies/investigations conducted in the Republic of Congo (RoC) from 1992 to 2015, as baseline for assisting public health authorities and researchers to define future research priorities as well as interventions. This review considers data from peer-reviewed articles and information from the National Malaria Control Programme reports, based on field investigations or samples collected from 1992 to 2015. Peer-reviewed papers were searched throughout online bibliographic databases PubMed, HINARI and Google Scholar using the following terms: "malaria", "Congo", "Brazzaville", "prevalence", "antimalarial", "efficacy", "falciparum", "genetic", "diversity". Original articles and reviews were included and selection of relevant papers was made. Twenty-eight published articles were included in this review and two additional records from the National Malaria Control Programme were also considered. The majority of studies were conducted in Brazzaville and Pointe-Noire. The present systematic review reveals that number of studies have been conducted in the RoC with regard to malaria. However, their results cannot formally be generalized at the country level. This suggests a need for implementing regular multisite investigations and surveys that may be representative of the country, calling for the support and lead of the Ministry of Health.

Tumor size and stage of breast cancer in Côte d'Ivoire and Republic of Congo - Results from population-based cancer registries.

PubMed

Islami, Farhad; Lortet-Tieulent, Joannie; Okello, Catherine; Adoubi, Innocent; Mbalawa, Charles Gombé; Ward, Elizabeth M; Parkin, D Maxwell; Jemal, Ahmedin

2015-12-01

Breast cancer is now the leading female cancer in sub-Saharan Africa, but there is relatively little information on breast cancer characteristics from this region. We studied, on a population basis, the size and stage of female breast cancer at diagnosis in Côte d'Ivoire and Republic of Congo. Data on tumor size and stage of breast cancer at diagnosis were collected by population-based cancer registries in Abidjan (the capital of Côte d'Ivoire; 141 cases) and Brazzaville (the capital of Republic of Congo; 139 cases) from a random group of female breast cancer cases that were diagnosed in 2008-2009 using the same protocol. The majority of breast cancers in both countries were advanced cancers. In Côte d'Ivoire, 68% of tumors were ≥5 cm in diameter and 74% of cancers were stage III or IV at diagnosis; the corresponding proportions in Republic of Congo were 63% and 81%. These results underscore the importance of increased awareness about early detection of breast cancer, as well as expansion of the capacity to provide appropriate diagnosis, treatment, and palliative care in sub-Saharan Africa. Copyright © 2015 Elsevier Ltd. All rights reserved.

Characteristics and geological significance of Re-Os isotopic system of evaporites in Mboukoumassi deposit, the Republic of Congo

NASA Astrophysics Data System (ADS)

Zhao, Xianfu; Wang, Zongqi; Liu, Chenglin; Li, Chao; Jiao, Pengcheng; Zhao, Yanjun; Zhang, Fan

2018-02-01

Evaporite dating has been an open problem. The study investigates the Re-Os isotopic system in the organic-rich sedimentary rocks to constrain the infilling of sedimentary basin and related geological events. In the Mboukoumassi potash deposit in the Republic of Congo (Congo-Brazzaville) in West Africa, several layers of organic-rich dark shale were found in the evaporite series. Through drilling core, the dark shale in the evaporite is found to satisfy the requirements of Re-Os isotope test. The result shows that the Re-Os isochron age of the dark shale in the study area ranges from 78.7 ± 1.1 to 96 ± 7 Ma, which is the first precise age of the Mboukoumassi potash deposit in the Republic of Congo (Congo-Brazzaville), West Africa. Therefore, the age of deposition of this set of evaporite may be Cenomanian-Turonian, which is younger than the age previously thought (around 113-125Ma, Aptian). The Re-Os isotopic dating technique used for the pioneering study on the precise dating of the Mboukoumassi potash deposit provides a new approach to the study of the sedimentary age of ancient evaporite deposits. The initial 187Os/188Os value decreasing from 2.02 ± 0.21 to 0.982 ± 0.03 for the core sample reflects the source rock chang along the core, and this is consistent with the geological evolution of the basin.

Geochronology and nature of the Palaeoproterozoic basement in the Central African Copperbelt (Zambia and the Democratic Republic of Congo), with regional implications

NASA Astrophysics Data System (ADS)

Rainaud, C.; Master, S.; Armstrong, R. A.; Robb, L. J.

2005-07-01

U-Pb SHRIMP zircon age data, together with geochemical analyses, from the basement to the Katanga Supergroup in the Central African Copperbelt reveal the existence of a widespread Palaeoproterozoic magmatic arc terrane. The Lufubu schists represent a long-lived calc-alkaline volcanic arc sequence and, where dated in both Zambia and the Democratic Republic of Congo (DRC), yield ages of 1980 ± 7, 1968 ± 9, 1964 ± 12 and 1874 ± 8 Ma. The oldest dated unit from the region, the Mkushi granitic gneiss from south-east of the Zambian Copperbelt, has an age of 2049 ± 6 Ma. The copper-mineralized Mtuga aplites, which crosscut the foliation in the Mkushi gneisses, have mainly xenocrystic, zoned zircons with cores dated at ca. 2.07-2.00 Ga. Overgrowths on these cores are dated at 1059 ± 26 Ma, which is interpreted as the intrusive age of the aplites. An augen gneiss from the Mulungushi Bridge locality yielded an emplacement age of 1976 ± 5 Ma. The Mufulira Pink Granite has an age of 1994 ± 7 Ma, while the Chambishi granite has been dated at 1983 ± 5 Ma, an age within error of Lufubu schist metavolcanics from elsewhere in the Chambishi basin. The gneisses, granitoids and acid-intermediate calc-alkaline metavolcanics are considered to represent stages in the evolution of one or more magmatic arcs that formed episodically over a 200 million year period between 2050 and 1850 Ma. We suggest naming this assemblage of rocks the "Lufubu Metamorphic Complex". The rocks of the Lufubu Metamorphic Complex are interpreted to be part of a regionally extensive Palaeoproterozoic magmatic arc terrane stretching from northern Namibia to northern Zambia and the DRC. This terrane is termed the Kamanjab-Bangweulu arc and is inferred to have collided with the Archaean Tanzanian craton during the ca. 2.0-1.9 Ga Ubendian orogeny, to produce a new composite minicontinental entity that we term the "Kambantan" terrane. The Kambantan terrane was accreted onto the southern margin of the Congo

A biomass representative land cover classification for the Democratic Republic of Congo derived from the Forets D'Afrique Central Evaluee par Teledetection (FACET) data set

NASA Astrophysics Data System (ADS)

Molinario, G.; Hansen, M.; Potapov, P.; Altstatt, A. L.; Justice, C. O.

2012-12-01

The FACET forest cover and forest cover loss 2000-2005-2010 data set has been produced by South Dakota State University, the University of Maryland and the Kinshasa-based Observatoire Satellital des Forets D'Afrique Central (OSFAC) with funding from the USAID Central African Regional Program for the Environment (CARPE). The product is now available or being finalized for the DRC, the ROC and Gabon with plans to complete all Congo Basin countries. While FACET provides unprecedented synoptic detail in the extent of Congo Basin forest and the forest cover loss, additional information is required to stratify land cover into types indicative of biomass content. Analysis of the FACET patterns of deforestation, more detailed remote sensing analysis of biophysical attributes within the FACET land cover classes and GIS-derived classes of degradation obtained through variable distance buffers based on relevant literature and ground truth data are combined with the existing FACET classes to produce a ranking of land cover from low biomass to high biomass for the Democratic Republic of Congo. The resulting classification can be used in all Reduced Emissions from Degradation and Deforestation (REDD) pre-inventory phases when baseline forest cover needs to be known and the location and amount of forest biomass inventory plots needs to be designed. FACET cover loss classes were kept in the classification and can provide the Monitoring, Reporting and Verification tools needed for REDD projects. The project will be demonstrated for the Maringa Lopori Wamba Landscape of the DRC where this work was funded by the African Wildlife Foundation to support the design of a REDD pilot project.

Treatment outcomes for human African Trypanosomiasis in the Democratic Republic of the Congo: analysis of routine program data from the world's largest sleeping sickness control program.

PubMed

Hasker, E; Mpanya, A; Makabuza, J; Mbo, F; Lumbala, C; Kumpel, J; Claeys, Y; Kande, V; Ravinetto, R; Menten, J; Lutumba, P; Boelaert, M

2012-09-01

To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database. Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%). High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes. © 2012 Blackwell Publishing Ltd.

Collaborative Medical Engagement and Needs Assessment in the Democratic Republic of the Congo: A Preliminary Report from Muanda

PubMed Central

Lesho, Emil; Okito, Edmond Amisi; Mann, Kelly; McCullough, Michael; Hesse, Elisabeth

2014-01-01

The Democratic Republic of the Congo is the second largest and fourth most populous country in Africa. More than two decades of ongoing conflicts have degraded its healthcare system. A broad range of tropical diseases, along with opportunities for collaborative medical engagements (CMEs), are prevalent. However, reports from such events in this country are sparse. In June 2013, a CME was conducted in the western town of Muanda. Twenty-two hours of didactic sessions were collaboratively presented, and 158 patients were collaboratively evaluated. Durable dental and respiratory equipment, infrastructure improvements, and training opportunities were the top needs identified by the providers. Whether the regional referral hospital received sustainable benefit remains under investigation. However, the approach and needs assessment described herein provide a framework for future engagements or assistance. This CME established a precedence of medical partnership in the region because it led to the largest multidisciplinary joint collaboration in the history of the Democratic Republic of the Congo. PMID:24534813

Collaborative medical engagement and needs assessment in the Democratic Republic of the Congo: a preliminary report from Muanda.

PubMed

Lesho, Emil; Okito, Edmond Amisi; Mann, Kelly; McCullough, Michael; Hesse, Elisabeth

2014-04-01

The Democratic Republic of the Congo is the second largest and fourth most populous country in Africa. More than two decades of ongoing conflicts have degraded its healthcare system. A broad range of tropical diseases, along with opportunities for collaborative medical engagements (CMEs), are prevalent. However, reports from such events in this country are sparse. In June 2013, a CME was conducted in the western town of Muanda. Twenty-two hours of didactic sessions were collaboratively presented, and 158 patients were collaboratively evaluated. Durable dental and respiratory equipment, infrastructure improvements, and training opportunities were the top needs identified by the providers. Whether the regional referral hospital received sustainable benefit remains under investigation. However, the approach and needs assessment described herein provide a framework for future engagements or assistance. This CME established a precedence of medical partnership in the region because it led to the largest multidisciplinary joint collaboration in the history of the Democratic Republic of the Congo.

Genetic Assessment of African Swine Fever Isolates Involved in Outbreaks in the Democratic Republic of Congo between 2005 and 2012 Reveals Co-Circulation of p72 Genotypes I, IX and XIV, Including 19 Variants

PubMed Central

Mulumba–Mfumu, Leopold K.; Achenbach, Jenna E.; Mauldin, Matthew R.; Dixon, Linda K.; Tshilenge, Curé Georges; Thiry, Etienne; Moreno, Noelia; Blanco, Esther; Saegerman, Claude; Lamien, Charles E.; Diallo, Adama

2017-01-01

African swine fever (ASF) is a devastating disease of domestic pigs. It is a socioeconomically important disease, initially described from Kenya, but subsequently reported in most Sub-Saharan countries. ASF spread to Europe, South America and the Caribbean through multiple introductions which were initially eradicated—except for Sardinia—followed by re‑introduction into Europe in 2007. In this study of ASF within the Democratic Republic of the Congo, 62 domestic pig samples, collected between 2005–2012, were examined for viral DNA and sequencing at multiple loci: C-terminus of the B646L gene (p72 protein), central hypervariable region (CVR) of the B602L gene, and the E183L gene (p54 protein). Phylogenetic analyses identified three circulating genotypes: I (64.5% of samples), IX (32.3%), and XIV (3.2%). This is the first evidence of genotypes IX and XIV within this country. Examination of the CVR revealed high levels of intra-genotypic variation, with 19 identified variants. PMID:28218698

Genetic Assessment of African Swine Fever Isolates Involved in Outbreaks in the Democratic Republic of Congo between 2005 and 2012 Reveals Co-Circulation of p72 Genotypes I, IX and XIV, Including 19 Variants.

PubMed

Mulumba-Mfumu, Leopold K; Achenbach, Jenna E; Mauldin, Matthew R; Dixon, Linda K; Tshilenge, Curé Georges; Thiry, Etienne; Moreno, Noelia; Blanco, Esther; Saegerman, Claude; Lamien, Charles E; Diallo, Adama

2017-02-18

African swine fever (ASF) is a devastating disease of domestic pigs. It is a socioeconomically important disease, initially described from Kenya, but subsequently reported in most Sub-Saharan countries. ASF spread to Europe, South America and the Caribbean through multiple introductions which were initially eradicated-except for Sardinia-followed by re‑introduction into Europe in 2007. In this study of ASF within the Democratic Republic of the Congo, 62 domestic pig samples, collected between 2005-2012, were examined for viral DNA and sequencing at multiple loci: C-terminus of the B646L gene (p72 protein), central hypervariable region (CVR) of the B602L gene, and the E183L gene (p54 protein). Phylogenetic analyses identified three circulating genotypes: I (64.5% of samples), IX (32.3%), and XIV (3.2%). This is the first evidence of genotypes IX and XIV within this country. Examination of the CVR revealed high levels of intra-genotypic variation, with 19 identified variants.

Intellectual and Developmental Disabilities in Kinshasa, Democratic Republic of the Congo: Causality and Implications for Resilience and Support

ERIC Educational Resources Information Center

Aldersey, Heather M.; Turnbull, H. Rutherford, III; Turnbull, Ann P.

2014-01-01

This article reports results of a 7-month qualitative study on intellectual and related developmental disabilities in Kinshasa, Democratic Republic of the Congo, particularly as they relate to the causes and meaning of intellectual and developmental disabilities (IDD). This study raises important questions related to the understanding of…

Married women's autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo.

PubMed

Sano, Yuji; Antabe, Roger; Atuoye, Kilian Nasung; Braimah, Joseph A; Galaa, Sylvester Z; Luginaah, Isaac

2018-03-12

Although use of modern contraception is considered beneficial in lowering maternal and child mortality rates, the prevalence of contraceptive use remains low in the Democratic Republic of Congo. This study examined modern contraceptive use and its linkage to women's autonomy. Data were drawn from the 2013-2014 Democratic Republic of Congo Demographic and Health Survey. We selected unsterilized and non-pregnant married women who have given birth in the last three years (N = 6680). Logistic regression models were fitted to explore the relationship between women's autonomy and modern contraceptive use. The study found that only 7.1% of married women who had delivered within three years used modern contraceptive methods. After controlling for socioeconomic and demographic factors, the association between women's autonomy and modern contraceptive use remained positively significant (OR = 1.16; 95% CI = 1.05, 1.29). The findings from this study indicate that it is not enough to provide women with educational and employment opportunities to increase the uptake of modern contraception, but also to enhance women's assertiveness to make their own decisions regardless of their partners' preferences within household settings. It is critical for government and other stakeholders to roll out programs aimed at reducing gender inequality and improving women's autonomy in decision-making about reproductive health.

Lamprologus markerti, a new lamprologine cichlid (Teleostei: Cichlidae) endemic to the lower Congo River in the Democratic Republic of Congo, west-central Africa.

PubMed

Tougas, Stephanie; Stiassny, Melanie L J

2014-08-15

A new Lamprologus is described from the lower Congo River (LCR) in the Democratic Republic of Congo. Lamprologus markerti, new species, is readily distinguished from L. tigripictilis and L. werneri, the LCR endemic lamprologines with which it was once taxonomically conflated, in the possession of a reduced number of gill rakers on the first arch (9-11 versus 12-17), a longer head (32.1-34.7% SL versus 29.3-31.9 and 29.1-32.9% SL, respectively), and a longer predorsal length (33.0-35.9% SL versus 29.3-32.7 and 28.5-32.6% SL, respectively). Further, L. markerti lacks a second intestinal loop present in both L. tigripictilis and L. werneri, and has a highly reduced infraorbital series often consisting of a single first infraorbital (lachrymal) element. 

Description of Hylopanchax paucisquamatus (Cyprinodontiformes: Poeciliidae), a new lampeye species from the Odzala-Kokoua National Park, Republic of Congo.

PubMed

Sonnenberg, Rainer; Friel, John P; Van der Zee, Jouke R

2014-08-05

A new deep-bodied Hylopanchax species is described from the northwestern Congo basin. Hylopanchax paucisquamatus, new species, was collected in the Odzala-Kokoua National Park in the Likouala River drainage of the Republic of Congo. It differs from its congeners, including the deep-bodied H. leki and H. ndeko, by a unique combination of morphological characters, including low number of mid-longitudinal and transverse scales, number of dorsal-fin rays, and position of dorsal-fin origin in relation to anal-fin. It is the only deep-bodied species currently known outside the Kasaï River drainage.

Malaria surveillance in the Democratic Republic of the Congo: comparison of microscopy, PCR, and rapid diagnostic test.

PubMed

Doctor, Stephanie M; Liu, Yunhao; Whitesell, Amy; Thwai, Kyaw L; Taylor, Steve M; Janko, Mark; Emch, Michael; Kashamuka, Melchior; Muwonga, Jérémie; Tshefu, Antoinette; Meshnick, Steven R

2016-05-01

Malaria surveillance is critical for control efforts, but diagnostic methods frequently disagree. Here, we compare microscopy, PCR, and a rapid diagnostic test in 7137 samples from children in the Democratic Republic of the Congo using latent class analysis. PCR had the highest sensitivity (94.6%) and microscopy had the lowest (76.7%). Copyright © 2016 Elsevier Inc. All rights reserved.

Unintended pregnancy and its correlates among currently pregnant women in the Kwango District, Democratic Republic of the Congo.

PubMed

Dhakal, Sarita; Song, Jin Sung; Shin, Dong Eun; Lee, Tae Ho; So, Ae Young; Nam, Eun Woo

2016-06-16

Unintended pregnancy is an important reproductive health problem in both developed and developing countries and is most prominent in low-middle income countries. In the Democratic Republic of the Congo, the total fertility rate is high at 5.9 births per women, and a mother's probabily of dying at an age between 15-49 years is also high (53 %). Women with unintended pregnancies are less likely to utilize available necessary services for their own health and the health of their children. Therefore, unintended pregnancy is a crucial factor of maternal health in the Democratic Republic of the Congo. This study aims to identify the prevalence of unintended pregnancy and its associated factors in the Democratic Republic of the Congo. Data were collected from June 20 to 29, 2014 among women aged 15-49 years who had children younger than 5 years old. The women were from a representative sample of 602 households. Multiple logistic regression analysis was performed to evaluate the associations between the dependent variable and the explanatory variables. Unintended pregnancy was reported in 51.4 % of the respondents. Multivariate logistic regression showed an association between education status (AOR, 3.4; CI, 1.21-9.90) and age of the last child (AOR, 5.17; CI, 1.23-21.70) with an unintended pregnancy. Unintended pregnancies were low among women who owner a cell phone (AOR, 0.18; CI, 0.47-0.73) and those who were aware of family planning method (AOR 0.20; CI, 0.06-0.60). The unintended pregnancy rate high and was significantly associated with female education, previous use of family planning methods, ownership of cell phone, and age of the last child. Maternal health interventions should focus on increasing family planning service utilization, awareness of family planning, and access to communication and income.

A New Clade of African Body and Head Lice Infected by Bartonella quintana and Yersinia pestis-Democratic Republic of the Congo.

PubMed

Drali, Rezak; Shako, Jean-Christophe; Davoust, Bernard; Diatta, Georges; Raoult, Didier

2015-11-01

The human body louse is known as a vector for the transmission of three serious diseases-specifically, epidemic typhus, trench fever, and relapsing fever caused by Rickettsia prowazekii, Bartonella quintana, and Borrelia recurrentis, respectively-that have killed millions of people. It is also suspected in the transmission of a fourth pathogen, Yersinia pestis, which is the etiologic agent of plague. To date, human lice belonging to the genus Pediculus have been classified into three mitochondrial clades: A, B, and C. Here, we describe a fourth mitochondrial clade, Clade D, comprising head and body lice. Clade D may be a vector of B. quintana and Y. pestis, which is prevalent in a highly plague-endemic area near the Rethy Health District, Orientale Province, Democratic Republic of the Congo. © The American Society of Tropical Medicine and Hygiene.

A System Dynamics Framework for Assessing Nation-Building in the Democratic Republic of the Congo

DTIC Science & Technology

2009-03-23

of the genocide to flee into the Democratic Republic of the Congo where they continued their campaign to rid Rwanda of all Tutsis. Groups such as the...3.1.1: Rwanda Chapter 3.1.2: Uganda Chapter 3.2: Belgium Chapter 3.3: China Chapter 3.4: India Chapter 3.5: United States Chapter 4: System Dynamics... Rwanda (Democratic Forces for the Liberation of Rwanda ) mostly comprised of ethnic Hutu militia. GNI – Gross National Income IDA – International

In vitro susceptibility to quinine and microsatellite variations of the Plasmodium falciparum Na+/H+ exchanger (Pfnhe-1) gene: the absence of association in clinical isolates from the Republic of Congo

PubMed Central

2011-01-01

Background Quinine is still recommended as an effective therapy for severe cases of Plasmodium falciparum malaria, but the parasite has developed resistance to the drug in some cases. Investigations into the genetic basis for quinine resistance (QNR) suggest that QNR is complex and involves several genes, with either an additive or a pairwise effect. The results obtained when assessing one of these genes, the plasmodial Na+/H+ exchanger, Pfnhe-1, were found to depend upon the geographic origin of the parasite strain. Most of the associations identified have been made in Asian strains; in contrast, in African strains, the influence of Pfnhe on QNR is not apparent. However, a recent study carried out in Kenya did show a significant association between a Pfnhe polymorphism and QNR. As genetic differences may exist across the African continent, more field data are needed to determine if this association exists in other African regions. In the present study, association between Pfnhe and QNR is investigated in a series of isolates from central Africa. Methods The sequence analysis of the polymorphisms at the Pfnhe-1 ms4760 microsatellite and the evaluation of in vitro quinine susceptibility (by isotopic assay) were conducted in 74 P. falciparum isolates from the Republic of Congo. Results Polymorphisms in the number of DNNND or NHNDNHNNDDD repeats in the Pfnhe-1 ms4760 microsatellite were not associated with quinine susceptibility. Conclusions The polymorphism in the microsatellite ms4760 in Pfnhe-1 that cannot be used to monitor quinine response in the regions of the Republic of Congo, where the isolates came from. This finding suggests that there exists a genetic background associated with geographic area for the association that will prevent the use of Pfnhe as a molecular marker for QNR. The contribution of Pfnhe to the in vitro response to quinine remains to be assessed in other regions, including in countries with different levels of drug pressure. PMID:21314947

Conservation Education and Environmental Communication in Great Ape Re-Introduction Projects: Two Cases from the Republic of Congo

ERIC Educational Resources Information Center

Cartwright, Barbara J.; Wall, John E.; Kaya, J. A. Placide

2012-01-01

Among species recovery tools available, re-introduction of animals to the wild is one of the more complex. Since the mid-1990s two successful great ape re-introductions have taken place in the Republic of Congo, leading some conservationists to revisit re-introduction as a strategy. This research explored the role of conservation education and…

Retinoblastoma in the Democratic Republic of Congo: 20-Year Review from a Tertiary Hospital in Kinshasa

PubMed Central

Kazadi Lukusa, Aimé; Aloni, Michel Ntetani; Kadima-Tshimanga, Bertin; Mvitu-Muaka, Moïse; Gini Ehungu, Jean Lambert; Ngiyulu, René; Ekulu Mfutu, Pépé; Budiongo Nzazi, Aléine

2012-01-01

Background. To determine clinical profile and management of retinoblastoma among children at Kinshasa in Democratic Republic of Congo. Patients and methods. The medical records of patients with a diagnosis of retinoblastoma seen at the University Hospital of Kinshasa from January 1985 till December 2005 were retrospectively reviewed. Demographic profile, clinical data, modes of treatment and outcome were analysed. Results. A total of 49 children, of whom 40 had adequate data on record were identified as retinoblastoma (28 males and 12 females). Nine cases had bilateral disease. The median age at the first symptoms was 9 months (range, 1 month to 6 years) for unilateral retinoblastoma and 18 months (range, 1 month to 3.5 years) for bilateral retinoblastoma. The median age at the first oncology consultation was 2.4 years (range, 6 months to 6 years) for unilateral retinoblastoma and 2.4years (range, 9 months to 4 years) for bilateral disease. Leukokoria was present in 67.5% of subjects. Seventy-five percent abandoned the treatment. The mortality was 92.5%. Conclusion. In Democratic Republic of Congo, retinoblastoma remains a life threatening disease characterized by late referral to a specialized unit and affordability of chemotherapy; all leading to an extension of the disease and high mortality. PMID:22619679

Monkeypox

MedlinePlus

... Rohingya Democratic Republic of the Congo Ethiopia Iraq Nigeria Somalia South Sudan Syrian Arab Republic Yemen All ... Republic of the Congo, Cameroon, Central African Republic, Nigeria, Ivory Coast, Liberia, Sierra Leone, Gabon and South ...

76 FR 63935 - Notification of the Removal of Conditions of Entry on Vessels Arriving From the Republic of Congo

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... arriving from the country of the Republic of Congo. DATES: The policy announced in this notice is effective... published a Notice of Policy in the Federal Register, (74 FR 45230), announcing that it had determined that... entry announced in the previously published Notice of Policy. With this notice, the current list of...

A Regime Legitimacy Explanation of African Peacekeeping

DTIC Science & Technology

2011-09-01

DDR Dearming, Demobilization and Reintegration DRC Democratic Republic of the Congo ECOWAS Economic Community of West African States FAR Forces...Nations Human Development Index xiv THIS PAGE INTENTIONALLY LEFT BLANK 1 I. INTRODUCTION Just 14 years after the genocide of at least a half...increase their moral authority externally by adhering to, or even leading, international norms based on human security. The methodology will be both

Collaboration between Higher Education and Labor Market in Kinshasa, DR Congo

ERIC Educational Resources Information Center

Etshim, Rachal

2017-01-01

The transition of new graduate students from school to the labor market in Democratic Republic of Congo has been a major topic for debate over the last twenty years. This study identifies the factors affecting collaboration between higher education and the labor market in Kinshasa, the Capital city of the Democratic Republic of Congo. Even though…

Ebola Virus Disease, Democratic Republic of the Congo, 2014.

PubMed

Nanclares, Carolina; Kapetshi, Jimmy; Lionetto, Fanshen; de la Rosa, Olimpia; Tamfun, Jean-Jacques Muyembe; Alia, Miriam; Kobinger, Gary; Bernasconi, Andrea

2016-09-01

During July-November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control.

Democratic Republic of the Congo: undoing government by predation.

PubMed

Rackley, Edward B

2006-12-01

This paper draws on two periods of field research, conducted in 2004, to consider the state of governance in the Democratic Republic of the Congo (DRC). The first measures the paralysing impact of illegal taxation on riverine trade in the western provinces; the second documents civilian attempts to seek safety from violence in the troubled east, and evaluates third-party efforts to provide protection and security. Analysis of study findings suggests that the DRC's current governance crisis is neither historically novel nor driven exclusively by mineral resources, extraction rights or trafficking. Rather, government by predation is an endemic and systematic feature of the civil and military administration, ensuring the daily economic survival of soldiers and officials, who are able to wield their authority in a 'riskfree' environment, without oversight or accountability. The paper's conclusion tries to make sense of the persistence of corruption in social and political life, and assess the capacity of ordinary citizens to reverse their predicament.

Democratic Republic of Congo: Background and U.S. Policy

DTIC Science & Technology

2013-06-29

after Darfur) in number of troops, but others are much larger compared to local population size, such as those in Côte d’Ivoire, Haiti, Lebanon ...professionalization and the prevention and treatment of sexual and gender-based violence (e.g., P.L. 111-32, P.L. 111-212); • Restricting certain types...present in DRC, the Central African Republic, South Sudan, and possibly Sudan. LRA massacres, mass abductions, sexual assault, and looting have caused

Immunization of African Indigenous Pigs with Attenuated Genotype I African Swine Fever Virus OURT88/3 Induces Protection Against Challenge with Virulent Strains of Genotype I.

PubMed

Mulumba-Mfumu, L K; Goatley, L C; Saegerman, C; Takamatsu, H-H; Dixon, L K

2016-10-01

The attenuated African swine fever virus genotype I strain OURT88/3 has previously been shown to induce protection of European breeds of domestic pigs against challenge with virulent isolates. To determine whether protective immune responses could also be induced in indigenous breeds of pigs from the Kinshassa region in Democratic Republic of Congo, we immunized a group of eight pigs with OURT88/3 strain and challenged the pigs 3 weeks later with virulent genotype I strain OURT88/1. Four of the pigs were protected against challenge. Three of the eight pigs died from African swine fever virus and a fourth from an unknown cause. The remaining four pigs all survived challenge with a recent virulent genotype I strain from the Democratic Republic of Congo, DRC 085/10. Control groups of non-immune pigs challenged with OURT88/1 or DRC 085/10 developed signs of acute ASFV as expected and had high levels of virus genome in blood. © 2015 Blackwell Verlag GmbH.

Wave clouds over the Central African Republic

NASA Image and Video Library

2016-02-04

On January 27, 2016, the Moderate Resolution Imaging Spectroradiometer (MODIS) aboard NASA’s Aqua satellite passed over the Central African Republic and captured a true-color image of wave clouds rippling over a fire-speckled landscape. Wave clouds typically form when a mountain, island, or even another mass of air forces an air mass to rise, then fall again, in a wave pattern. The air cools as it rises, and if there is moisture in the air, the water condenses into clouds at the top of the wave. As the air begins to sink, the air warms and the cloud dissipates. The result is a line of clouds marking the crests of the wave separated by clear areas in the troughs of the wave. In addition to the long lines of clouds stretching across the central section of the country, clouds appear to line up in parallel rows near the border of the Democratic Republic of the Congo. In this area, small sets of grayish cloud appear to be lined up with the prevailing wind, judging by the plumes of smoke rising from red hotspots near each set of clouds. Clouds like this, that line in parallel rows parallel with the prevailing wind, are known as “cloud streets”. Each red “hotspot” marks an area where the thermal sensors on the MODIS instrument detected high temperatures. When accompanied by typical smoke, such hotspots are diagnostic for actively burning fires. Given the time of the year, the widespread nature, and the location of the fires, they are almost certainly agricultural fires that have been deliberately set to manage land. Image Credit: Jeff Schmaltz, MODIS Land Rapid Response Team, NASA GSFC NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on

Ebola virus disease in the Democratic Republic of Congo.

PubMed

Maganga, Gaël D; Kapetshi, Jimmy; Berthet, Nicolas; Kebela Ilunga, Benoît; Kabange, Felix; Mbala Kingebeni, Placide; Mondonge, Vital; Muyembe, Jean-Jacques T; Bertherat, Eric; Briand, Sylvie; Cabore, Joseph; Epelboin, Alain; Formenty, Pierre; Kobinger, Gary; González-Angulo, Licé; Labouba, Ingrid; Manuguerra, Jean-Claude; Okwo-Bele, Jean-Marie; Dye, Christopher; Leroy, Eric M

2014-11-27

The seventh reported outbreak of Ebola virus disease (EVD) in the equatorial African country of the Democratic Republic of Congo (DRC) began on July 26, 2014, as another large EVD epidemic continued to spread in West Africa. Simultaneous reports of EVD in equatorial and West Africa raised the question of whether the two outbreaks were linked. We obtained data from patients in the DRC, using the standard World Health Organization clinical-investigation form for viral hemorrhagic fevers. Patients were classified as having suspected, probable, or confirmed EVD or a non-EVD illness. Blood samples were obtained for polymerase-chain-reaction-based diagnosis, viral isolation, sequencing, and phylogenetic analysis. The outbreak began in Inkanamongo village in the vicinity of Boende town in Équateur province and has been confined to that province. A total of 69 suspected, probable, or confirmed cases were reported between July 26 and October 7, 2014, including 8 cases among health care workers, with 49 deaths. As of October 7, there have been approximately six generations of cases of EVD since the outbreak began. The reported weekly case incidence peaked in the weeks of August 17 and 24 and has since fallen sharply. Genome sequencing revealed Ebola virus (EBOV, Zaire species) as the cause of this outbreak. A coding-complete genome sequence of EBOV that was isolated during this outbreak showed 99.2% identity with the most closely related variant from the 1995 outbreak in Kikwit in the DRC and 96.8% identity to EBOV variants that are currently circulating in West Africa. The current EVD outbreak in the DRC has clinical and epidemiologic characteristics that are similar to those of previous EVD outbreaks in equatorial Africa. The causal agent is a local EBOV variant, and this outbreak has a zoonotic origin different from that in the 2014 epidemic in West Africa. (Funded by the Centre International de Recherches Médicales de Franceville and others.).

Outbreak of human monkeypox, Democratic Republic of Congo, 1996 to 1997.

PubMed Central

Hutin, Y. J.; Williams, R. J.; Malfait, P.; Pebody, R.; Loparev, V. N.; Ropp, S. L.; Rodriguez, M.; Knight, J. C.; Tshioko, F. K.; Khan, A. S.; Szczeniowski, M. V.; Esposito, J. J.

2001-01-01

Human monkeypox is a zoonotic smallpox-like disease caused by an orthopoxvirus of interhuman transmissibility too low to sustain spread in susceptible populations. In February 1997, 88 cases of febrile pustular rash were identified for the previous 12 months in 12 villages of the Katako-Kombe Health Zone, Democratic Republic of Congo (attack rate = 22 per 1,000; case-fatality rate = 3.7%). Seven were active cases confirmed by virus isolation. Orthopoxvirus- neutralizing antibodies were detected in 54% of 72 patients who provided serum and 25% of 59 wild-caught animals, mainly squirrels. Hemagglutination-inhibition assays and Western blotting detected antibodies in 68% and 73% of patients, respectively. Vaccinia vaccination, which protects against monkeypox, ceased by 1983 after global smallpox eradication, leading to an increase in the proportion of susceptible people. PMID:11384521

Emergence of vaccine-derived polioviruses, Democratic Republic of Congo, 2004-2011.

PubMed

Gumede, Nicksy; Lentsoane, Olivia; Burns, Cara C; Pallansch, Mark; de Gourville, Esther; Yogolelo, Riziki; Muyembe-Tamfum, Jean Jacques; Puren, Adrian; Schoub, Barry D; Venter, Marietjie

2013-10-01

Polioviruses isolated from 70 acute flaccid paralysis patients from the Democratic Republic of Congo (DRC) during 2004-2011 were characterized and found to be vaccine-derived type 2 polioviruses (VDPV2s). Partial genomic sequencing of the isolates revealed nucleotide sequence divergence of up to 3.5% in the viral protein 1 capsid region of the viral genome relative to the Sabin vaccine strain. Genetic analysis identified at least 7 circulating lineages localized to specific geographic regions. Multiple independent events of VDPV2 emergence occurred throughout DRC during this 7-year period. During 2010-2011, VDPV2 circulation in eastern DRC occurred in an area distinct from that of wild poliovirus circulation, whereas VDPV2 circulation in the southwestern part of DRC (in Kasai Occidental) occurred within the larger region of wild poliovirus circulation.

Chronic illness needing palliative care in Kinshasa hospitals, Democratic Republic of the Congo (DRC).

PubMed

Lofandjola Masumbuku, Jacques; Sumaili Kiswaya, Ernest; Mairiaux, Philippe; Gillain, Daniel; Petermans, Jean

2017-01-01

Chronic illnesses are a major public health problem in low-income countries. In the Democratic Republic of the Congo (DRC), few data are available, especially in palliative care. In this context, the present study aimed at describing the patterns of diseases in Kinshasa hospitals as well as risk factors associated with patients' evolving status and length of hospital stay. A prospective study was conducted in ten hospitals of Kinshasa, over a 1-year period. A total of 2699 patients with a chronic condition (non-communicable diseases (NCD) and/or AIDS) were consecutively enrolled in the study between January and December, 2013. Out of 2699 patients studied, 36.9% were suffering from cardiovascular diseases, 29.7% from comorbidity and 17.5% from AIDS. 27.5% of patients died while hospitalized, and 67.4% were lost to follow-up. The risk factors independently associated with death in hospitals were AIDS (adjusted OR = 2.2) and age over 65 years old (adjusted OR = 1.7). Peri-urban and rural areas were significantly associated with a mean adjusted hospital stay longer than 3 days. The length of stay (LOS) was shorter for women and patients living in urban areas. Patients survived for a median of 10 days (range 7-20 days). This study reveals the high proportion of patients suffering from advanced chronic diseases, including cardiovascular diseases, AIDS and comorbidity. It demonstrates the need for palliative care (PC) in medical practices in Kinshasa, the capital of the Democratic Republic of the Congo.

Intellectual and developmental disabilities in Kinshasa, Democratic Republic of the Congo: causality and implications for resilience and support.

PubMed

Aldersey, Heather M; Turnbull, H Rutherford; Turnbull, Ann P

2014-06-01

This article reports results of a 7-month qualitative study on intellectual and related developmental disabilities in Kinshasa, Democratic Republic of the Congo, particularly as they relate to the causes and meaning of intellectual and developmental disabilities (IDD). This study raises important questions related to the understanding of resilience of persons affected by IDD and the nature and purpose of support they use or desire.

Antimalarial activity of medicinal plants from the Democratic Republic of Congo: A review.

PubMed

Memvanga, Patrick B; Tona, Gaston L; Mesia, Gauthier K; Lusakibanza, Mariano M; Cimanga, Richard K

2015-07-01

Malaria is the most prevalent parasitic disease and the foremost cause of morbidity and mortality in the Democratic Republic of Congo. For the management of this disease, a large Congolese population recourses to traditional medicinal plants. To date the efficacy and safety of many of these plants have been validated scientifically in rodent malaria models. In order to generate scientific evidence of traditional remedies used in the Democratic Republic of Congo for the management of malaria, and show the potential of Congolese plants as a major source of antimalarial drugs, this review highlights the antiplasmodial and toxicological properties of the Congolese antimalarial plants investigated during the period of 1999-2014. In doing so, a useful resource for further complementary investigations is presented. Furthermore, this review may pave the way for the research and development of several available and affordable antimalarial phytomedicines. In order to get information on the different studies, a Google Scholar and PubMed literature search was performed using keywords (malaria, Congolese, medicinal plants, antiplasmodial/antimalarial activity, and toxicity). Data from non-indexed journals, Master and Doctoral dissertations were also collected. Approximately 120 extracts and fractions obtained from Congolese medicinal plants showed pronounced or good antiplasmodial activity. A number of compounds with interesting antiplasmodial properties were also isolated and identified. Some of these compounds constituted new scaffolds for the synthesis of promising antimalarial drugs. Interestingly, most of these extracts and compounds possessed high selective activity against Plasmodium parasites compared to mammalian cells. The efficacy and safety of several plant-derived products was confirmed in mice, and a good correlation was observed between in vitro and in vivo antimalarial activity. The formulation of several plant-derived products also led to some clinical trials

Trace metal distributions in the sediments from river-reservoir systems: case of the Congo River and Lake Ma Vallée, Kinshasa (Democratic Republic of Congo).

PubMed

Mwanamoki, Paola M; Devarajan, Naresh; Niane, Birane; Ngelinkoto, Patience; Thevenon, Florian; Nlandu, José W; Mpiana, Pius T; Prabakar, Kandasamy; Mubedi, Josué I; Kabele, Christophe G; Wildi, Walter; Poté, John

2015-01-01

The contamination of drinking water resources by toxic metals is a major problem in many parts of the world, particularly in dense populated areas of developing countries that lack wastewater treatment facilities. The present study characterizes the recent evolution with time of some contaminants deposited in the Congo River and Lake Ma Vallée, both located in the vicinity of the large city of Kinshasa, capital of Democratic Republic of Congo (DRC). Physicochemical parameters including grain size distribution, organic matter and trace element concentrations were measured in sediment cores sampled from Congo River (n = 3) and Lake Ma Vallée (n = 2). The maximum concentration of trace elements in sediment profiles was found in the samples from the sites of Pool Malebo, with the values of 107.2, 111.7, 88.6, 39.3, 15.4, 6.1 and 4.7 mg kg(-1) for Cr, Ni, Zn, Cu, Pb, As and Hg, respectively. This site, which is characterized by intense human activities, is especially well known for the construction of numerous boats that are used for regular navigation on Congo River. Concerning Lake Ma Vallée, the concentration of all metals are generally low, with maximum values of 26.3, 53.6, 16.1, 15.3, 6.5 and 1.8 mg kg(-1) for Cr, Ni, Zn, Cu, Pb and As, respectively. However, the comparison of the metal profiles retrieved from the different sampled cores also reveals specific variations. The results of this study point out the sediment pollution by toxic metals in the Congo River Basin. This research presents useful tools for the evaluation of sediment contamination of river-reservoir systems.

REDD+ projects in the Democratic Republic of Congo: impacts on future emissions, income and biodiversity

NASA Astrophysics Data System (ADS)

Mosnier, Aline; Bocqueho, Geraldine; Mant, Rebecca; Obersteiner, Michael; Havlik, Petr; Kapos, Val; Fritz, Steffen; Botrill, Leo

2014-05-01

The Democratic Republic of Congo (DRC) encompasses a large rainforest area which has been rather preserved up to now. However, pressure on the forests is increasing with high population growth, transition toward political stability and the abundance of minerals in the country. REDD+ is a developing mechanism under the UNFCCC that aims to support developing countries that want to make efforts to reduce their emissions from deforestation and forest degradation. The REDD+ strategy in DRC combines an independent national fund and independent REDD+ projects at the local level that are at the initial stage of implementation. The objective of this paper is to assess i) emissions reduction due to the implementation of the REDD+ pilot projects taking into account potential leakage and ii) potential co-benefits of REDD+ pilot projects in terms of biodiversity and rural income by 2030. We use the land use economic model CongoBIOM adapted from GLOBIOM which represents land-based activities and land use changes at a 50x50km resolution level. It includes domestic and international demand for agricultural products, fuel wood and minerals which are the main deforestation drivers in the Congo Basin region. Finally, we run a sensitivity analysis on emissions from land use change according to three different above and below ground living biomass estimates: downscaled FAO, NASA and WHRC.

Description of a large measles epidemic in Democratic Republic of Congo, 2010-2013.

PubMed

Mancini, Silvia; Coldiron, Matthew E; Ronsse, Axelle; Ilunga, Benoît Kebela; Porten, Klaudia; Grais, Rebecca F

2014-01-01

Although measles mortality has declined dramatically in Sub-Saharan Africa, measles remains a major public health problem in countries like the Democratic Republic of Congo (DRC). Here, we describe the large measles epidemic that occurred in the Democratic Republic of Congo between 2010 and 2013 using data from the national surveillance system as well as vaccine coverage surveys to provide a snapshot of the epidemiology of measles in DRC. Standardized national surveillance data were used to describe measles cases from 2010 to 2013. Attack rates and case fatality ratios were calculated and the temporal and spatial evolution of the epidemic described. Data on laboratory confirmation and vaccination coverage surveys as a part of routine program monitoring are also presented. Between week 1 of 2010 and week 45 of 2013, a total of 294,455 cases and 5,045 deaths were reported. The cumulative attack rate (AR) was 0.4%. The Case Fatality Ratio (CFR) was 1.7% among cases reported in health structures through national surveillance. A total of 186,178 cases (63%) were under 5 years old, representing an estimated AR of 1.4% in this age group. Following the first mass vaccination campaigns, weekly reported cases decreased by 21.5%. Results of post-vaccination campaign coverage surveys indicated sub-optimal (under 95%) vaccination coverage among children surveyed. The data reported here highlight the need to seek additional means to reinforce routine immunization as well as ensure the timely implementation of Supplementary Immunization Activities to prevent large and repeated measles epidemics in DRC. Although reactive campaigns were conducted in response to the epidemic, strategies to ensure that children are vaccinated in the routine system remains the foundation of measles control.

A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care.

PubMed

Mukwege, Denis; Berg, Marie

2016-10-01

Denis Mukwege and Marie Berg describe the One Stop Centre at Panzi Hospital in Eastern Democratic Republic of Congo that provides care for girls and women who have been raped in combination with extreme bodily harm.

Physiotherapy for poliomyelitis: a descriptive study in the Republic of Congo.

PubMed

Mancini, Silvia; Coldiron, Matthew E; Nicholas, Sarala; Llosa, Augusto E; Mouniaman-Nara, Isabelle; Ngala, Joseph; Grais, Rebecca F; Porten, Klaudia

2014-10-23

A large poliomyelitis outbreak occurred in 2010 in the Republic of Congo. This paper describes the demographic and clinical characteristics of poliomyelitis cases and their outcomes following physiotherapy. Demographic and clinical data were collected on 126 individuals between November 23, 2010 and March 23, 2011. The male/female ratio was 2.5 and the median age was 19 years (IQR: 13.5-23). The most severe forms of the disease were more common in older patients, 81 of the 126 patients (64.3%) had multiple evaluations of muscle strength. Among patients with multiple evaluations, 38.1% had improved strength at final evaluation, 48.3% were stable and 13.6% had decreased strength. Most acute poliomyelitis patients receiving physiotherapy had improved or stable muscle strength at their final evaluation. These descriptive results highlight the need for further research into the potential benefits of physiotherapy in polio affected patients.

Feasibility Analysis of an Evidence-Based Positive Prevention Intervention for Youth Living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

ERIC Educational Resources Information Center

Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J. L.; Edmonds, A.; Golin, C. E.; Moracco, K.; Behets, F.

2013-01-01

We evaluated the feasibility of a Positive Prevention intervention adapted for youth living with HIV/AIDS (YLWH) ages 15-24 in Kinshasa, Democratic Republic of the Congo. We conducted in-depth interviews and focus group discussions with intervention facilitators and YLWH participants on the following four areas of a feasibility framework:…

Public Expenditure Review of the Education Sector in the Democratic Republic of Congo: An Efficiency, Effectiveness, and Equity Analysis. Report No. ACS14542

ERIC Educational Resources Information Center

Bollag, Burton, Ed.

2015-01-01

A sound education sector is fundamental for the economic, social, and political transformation of the Democratic Republic of Congo (DRC). The DRC has achieved significant progress in its education sector over the last decade, demonstrating strong resilience following a particularly violent period in its history. The DRC's development trajectory…

Prevalence of vitamin A deficiency in pregnant and lactating women in the Republic of Congo.

PubMed

Samba, Claude; Tchibindat, Félicité; Gourmel, Bernard; Houzé, Patrick; Malvy, Denis

2013-03-01

Vitamin A status in a sample of pregnant and lactating women living in several representative regions of Congo was assessed and compared between August and September 2004. This survey was conducted using a randomized two-stage cluster-sampling method with stratification on 90 clusters, each consisting of at least 15 women. Vitamin A status was determined in a total of 1,054 individuals, using the impression cytology with transfer (ICT) test, the modified relative dose response test (MRDR test) on dried blood spots (DBS), and clinical examination to detect signs of xerophthalmia. The clinical criterion defining vitamin A deficiency was the presence of active xerophthalmia (Bitot's spots [X1B]), active corneal disease), and/or night blindness (XN stage). The prevalence of clinical signs of stage XN and X1B xerophthalmia in the Republic of Congo was found to be 16% and 19% respectively. The prevalence of clinical signs (X1B) was greater in the rural north than in urban areas, with a gradient running from urban (5%) to rural area (33%); 27% of all the ICT tests showed that the subjects were suffering from vitamin A deficiency. The deficiency rates were significantly higher (p < 0.001) in urban surroundings (Brazzaville) than in the rural northern regions. The biochemical MRDR test showed the presence of vitamin A deficiency (> or = 0.06) in 26% of the mothers in Brazzaville compared to 6% in the town of Kouilou; 44% of the women had retinol levels of < 10 microg/dL in the rural north whereas these percentages were significantly lower in the urban areas surveyed (chi-square = 62.30, p < 0.001). A significant correlation was found to exist (p < 0.001) between the ICT test and the MRDR test on DBS. In the population as a whole, 30% of the mothers suffering from malarial attack had abnormally low MRDR levels (> or = 0.06) compared to no malaria. The results of the present study confirm that vitamin A deficiency is a serious public-health issue in pregnant and lactating

Prevalence of Vitamin A Deficiency in Pregnant and Lactating Women in the Republic of Congo

PubMed Central

Tchibindat, Félicité; Gourmel, Bernard; Houzé, Patrick; Malvy, Denis

2013-01-01

Vitamin A status in a sample of pregnant and lactating women living in several representative regions of Congo was assessed and compared between August and September 2004. This survey was conducted using a randomized two-stage cluster-sampling method with stratification on 90 clusters, each consisting of at least 15 women. Vitamin A status was determined in a total of 1,054 individuals, using the impression cytology with transfer (ICT) test, the modified relative dose response test (MRDR test) on dried blood spots (DBS), and clinical examination to detect signs of xerophthalmia. The clinical criterion defining vitamin A deficiency was the presence of active xerophthalmia (Bitot's spots [X1B]), active corneal disease), and/or night blindness (XN stage). The prevalence of clinical signs of stage XN and X1B xerophthalmia in the Republic of Congo was found to be 16% and 19% respectively. The prevalence of clinical signs (X1B) was greater in the rural north than in urban areas, with a gradient running from urban (5%) to rural area (33%); 27% of all the ICT tests showed that the subjects were suffering from vitamin A deficiency. The deficiency rates were significantly higher (p<0.001) in urban surroundings (Brazzaville) than in the rural northern regions. The biochemical MRDR test showed the presence of vitamin A deficiency (≥0.06) in 26% of the mothers in Brazzaville compared to 6% in the town of Kouilou; 44% of the women had retinol levels of <10 μg/dL in the rural north whereas these percentages were significantly lower in the urban areas surveyed (chi-square=62.30, p<0.001). A significant correlation was found to exist (p<0.001) between the ICT test and the MRDR test on DBS. In the population as a whole, 30% of the mothers suffering from malarial attack had abnormally low MRDR levels (≥0.06) compared to no malaria. The results of the present study confirm that vitamin A deficiency is a serious public-health issue in pregnant and lactating mothers in the Republic

The Implementation of the Responsibility to Protect (R2P) Norms by the African Standby Force in Sub-Saharan Africa

DTIC Science & Technology

2017-06-09

S) Major Augustin Hodali 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...support of many individuals and organizations . First, I am whole-heartedly thankful to the Rwandan Government and particularly the Rwanda Defense Forces...African Standby Force AU African Union DRC Democratic Republic of the Congo MONUSCO United Nations Organization Stabilization Mission in the Democratic

Emergence of Vaccine-derived Polioviruses, Democratic Republic of Congo, 2004–2011

PubMed Central

Lentsoane, Olivia; Burns, Cara C.; Pallansch, Mark; de Gourville, Esther; Yogolelo, Riziki; Muyembe-Tamfum, Jean Jacques; Puren, Adrian; Schoub, Barry D.; Venter, Marietjie

2013-01-01

Polioviruses isolated from 70 acute flaccid paralysis patients from the Democratic Republic of Congo (DRC) during 2004–2011 were characterized and found to be vaccine-derived type 2 polioviruses (VDPV2s). Partial genomic sequencing of the isolates revealed nucleotide sequence divergence of up to 3.5% in the viral protein 1 capsid region of the viral genome relative to the Sabin vaccine strain. Genetic analysis identified at least 7 circulating lineages localized to specific geographic regions. Multiple independent events of VDPV2 emergence occurred throughout DRC during this 7-year period. During 2010–2011, VDPV2 circulation in eastern DRC occurred in an area distinct from that of wild poliovirus circulation, whereas VDPV2 circulation in the southwestern part of DRC (in Kasai Occidental) occurred within the larger region of wild poliovirus circulation. PMID:24047933

Taenia solium Cysticercosis in the Democratic Republic of Congo: How Does Pork Trade Affect the Transmission of the Parasite?

PubMed Central

Kabwe, Constantin; Maketa, Vivi; Lukanu, Philippe; Lutumba, Pascal; Polman, Katja; Matondo, Peter; Speybroeck, Niko; Dorny, Pierre; Sumbu, Julienne

2010-01-01

Background Taenia solium, a zoonotic parasite that is endemic in most developing countries where pork is consumed, is recognised as the main cause of acquired epilepsy in these regions. T. solium has been reported in almost all of the neighboring countries of Democratic Republic of Congo (DRC) but data on the current prevalence of the disease in the country itself are lacking. This study, focusing on porcine cysticercosis (CC), makes part of a first initiative to assess whether cysticercosis is indeed actually present in DRC. Methods An epidemiological study on porcine CC was conducted (1) on urban markets of Kinshasa where pork is sold and (2) in villages in Bas-Congo province where pigs are traditionally reared. Tongue inspection and ELISA for the detection of circulating antigen of the larval stage of T. solium were used to assess the prevalence of active CC in both study sites. Findings The overall prevalence of pigs with active cysticercosis did not significantly differ between the market and the village study sites (38.8 [CI95%: 34–43] versus 41.2% [CI95%: 33–49], respectively). However, tongue cysticercosis was only found in the village study site together with a significantly higher intensity of infection (detected by ELISA). Interpretation Pigs reared at village level are sold for consumption on Kinshasa markets, but it seems that highly infected animals are excluded at a certain level in the pig trade chain. Indeed, preliminary informal surveys on common practices conducted in parallel revealed that pig farmers and/or buyers select the low infected animals and exclude those who are positive by tongue inspection at village level. This study provides the only recent evidence of CC presence in DRC and gives the first estimates to fill an important gap on the African taeniasis/cysticercosis distribution map. PMID:20838646

A legacy of low-impact logging does not elevate prevalence of potentially pathogenic protozoa in free-ranging gorillas and chimpanzees in the Republic of Congo: logging and parasitism in African apes.

PubMed

Gillespie, Thomas R; Morgan, David; Deutsch, J Charlie; Kuhlenschmidt, Mark S; Salzer, Johanna S; Cameron, Kenneth; Reed, Trish; Sanz, Crickette

2009-12-01

Many studies have examined the long-term effects of selective logging on the abundance and diversity of free-ranging primates. Logging is known to reduce the abundance of some primate species through associated hunting and the loss of food trees for frugivores; however, the potential role of pathogens in such primate population declines is largely unexplored. Selective logging results in a suite of alterations in host ecology and forest structure that may alter pathogen dynamics in resident wildlife populations. In addition, environmental pollution with human fecal material may present a risk for wildlife infections with zoonotic protozoa, such as Cryptosporidium and Giardia. To better understand this interplay, we compared patterns of infection with these potentially pathogenic protozoa in sympatric western lowland gorillas (Gorilla gorilla gorilla) and chimpanzees (Pan troglodytes troglodytes) in the undisturbed Goualougo Triangle of Nouabalé-Ndoki National Park and the adjacent previously logged Kabo Concession in northern Republic of Congo. No Cryptosporidium infections were detected in any of the apes examined and prevalence of infection with Giardia was low (3.73% overall) and did not differ between logged and undisturbed forest for chimpanzees or gorillas. These results provide a baseline for prevalence of these protozoa in forest-dwelling African apes and suggest that low-intensity logging may not result in long-term elevated prevalence of potentially pathogenic protozoa.

A Legacy of Low-Impact Logging does not Elevate Prevalence of Potentially Pathogenic Protozoa in Free-Ranging Gorillas and Chimpanzees in the Republic of Congo: Logging and Parasitism in African Apes

PubMed Central

Morgan, David; Deutsch, J. Charlie; Kuhlenschmidt, Mark S.; Salzer, Johanna S.; Cameron, Kenneth; Reed, Trish; Sanz, Crickette

2010-01-01

Many studies have examined the long-term effects of selective logging on the abundance and diversity of free-ranging primates. Logging is known to reduce the abundance of some primate species through associated hunting and the loss of food trees for frugivores; however, the potential role of pathogens in such primate population declines is largely unexplored. Selective logging results in a suite of alterations in host ecology and forest structure that may alter pathogen dynamics in resident wildlife populations. In addition, environmental pollution with human fecal material may present a risk for wildlife infections with zoonotic protozoa, such as Cryptosporidium and Giardia. To better understand this interplay, we compared patterns of infection with these potentially pathogenic protozoa in sympatric western lowland gorillas (Gorilla gorilla gorilla) and chimpanzees (Pan troglodytes troglodytes) in the undisturbed Goualougo Triangle of Nouabalé-Ndoki National Park and the adjacent previously logged Kabo Concession in northern Republic of Congo. No Cryptosporidium infections were detected in any of the apes examined and prevalence of infection with Giardia was low (3.73% overall) and did not differ between logged and undisturbed forest for chimpanzees or gorillas. These results provide a baseline for prevalence of these protozoa in forest-dwelling African apes and suggest that low-intensity logging may not result in long-term elevated prevalence of potentially pathogenic protozoa. PMID:20238141

Women's Status and Intimate Partner Violence in the Democratic Republic of Congo.

PubMed

Tlapek, Sarah Myers

2015-09-01

Women's greatest risk of violence in the Democratic Republic of Congo (DRC) may come from an intimate partner, but few studies have analyzed context-specific risk and protective factors for intimate partner violence (IPV) in the DRC. This study analyzed data from the most recent Demographic and Health Survey (DHS) in Congo to assess risk and protective factors for IPV and the role of women's status, a factor implicated in prior IPV research. Using a sample of 1,821 married or cohabiting women between the ages of 15 and 49, four logistic regression models tested relationships between physical, sexual, emotional, or any violence and independent variables of interest. Results indicated that 68.2% of respondents had experienced at least one of the three types of IPV. An attitude of acceptance toward spousal violence was associated with increased risk for physical and emotional IPV. Women who were the only wife of their husband were half as likely to experience IPV compared with women whose husbands had other wives or women who did not know their husbands' marital status. Partner's use of alcohol was associated with nearly doubled risk for both physical and sexual IPV. The study's results indicate that IPV occurs frequently and is justified as acceptable by many women in the DRC. Findings suggest that awareness-raising campaigns may be a helpful intervention and that partner characteristics should be considered when assessing women's risk for IPV. © The Author(s) 2014.

Gravimetric maps of the Central African Republic

NASA Technical Reports Server (NTRS)

Albouy, J.; Godivier, R. (Principal Investigator)

1982-01-01

Gravimetric maps of the Central African Republic are described including a map of Bouguer anomalies at 1/1,000,000 in two sections (eastern sheet, western sheet) and a map, in color, of Bouguer anomalies at 1/2,000,000. Instrumentation, data acquisition, calibration, and data correction procedures are discussed.

Sexual violence-related fistulas in the Democratic Republic of Congo.

PubMed

Onsrud, Mathias; Sjøveian, Solbjørg; Luhiriri, Roger; Mukwege, Dennis

2008-12-01

To determine the magnitude of traumatic gynecologic fistulas caused by sexual violence in the Democratic Republic of Congo. A retrospective analysis of hospital records from 604 consecutive patients who received treatment for gynecologic fistulas at Panzi Hospital between November 2005 and November 2007. Of the 604 patients, 24 (4%) reported that their fistulas had been caused by sexual violence; of these, 5 (0.8%) had developed fistulas as a direct result of forced penetration with foreign objects and/or gang rapes. Of the remaining patients, 6 had a fistula before they were raped, 9 developed iatrogenic fistulas following inappropriate instrumentation to manage rape-induced spontaneous abortion or stillbirth, or after abdominal hysterectomy, and 4 developed fistulas after prolonged and obstructed labor. Traumatic fistulas are rare compared to obstetric fistulas. Fistulas indirectly related to sexual violence are likely to be more common than those directly related. All fistulas resulting from sexual violence, whether direct or indirect, should be considered traumatic and special care should be given to these women.

Genomic analysis of filoviruses associated with four viral hemorrhagic fever outbreaks in Uganda and the Democratic Republic of the Congo in 2012.

PubMed

Albariño, C G; Shoemaker, T; Khristova, M L; Wamala, J F; Muyembe, J J; Balinandi, S; Tumusiime, A; Campbell, S; Cannon, D; Gibbons, A; Bergeron, E; Bird, B; Dodd, K; Spiropoulou, C; Erickson, B R; Guerrero, L; Knust, B; Nichol, S T; Rollin, P E; Ströher, U

2013-08-01

In 2012, an unprecedented number of four distinct, partially overlapping filovirus-associated viral hemorrhagic fever outbreaks were detected in equatorial Africa. Analysis of complete virus genome sequences confirmed the reemergence of Sudan virus and Marburg virus in Uganda, and the first emergence of Bundibugyo virus in the Democratic Republic of the Congo. Published by Elsevier Inc.

"Congo" red: out of Africa?

PubMed

Steensma, D P

2001-02-01

Congo red is the essential histologic stain for demonstrating the presence of amyloidosis in fixed tissues. To the best of my knowledge, nothing has been written about why the stain is named "Congo." To understand the etymology and history of the Congo red histologic stain. Primary sources were consulted extensively, including 19th-century corporate documents, newspapers, legal briefs, patents, memoirs, and scientific papers. Sources were obtained from multiple university libraries and German corporate archives. To Europeans in 1885, the word Congo evoked exotic images of far-off central Africa known as The Dark Continent. The African Congo was also a political flashpoint during the Age of Colonialism. "Congo" red was introduced in Berlin in 1885 as the first of the economically lucrative direct textile dyes. A patent on Congo red was filed by the AGFA Corporation of Berlin 3 weeks after the conclusion of the well-publicized Berlin West Africa Conference. During these important diplomatic talks, German Chancellor Otto von Bismarck presided over a discussion of free trade issues in the Congo River basin. A challenge to AGFA's Congo red patent led to a precedent-setting decision in intellectual property law. The Congo red stain was named "Congo" for marketing purposes by a German textile dyestuff company in 1885, reflecting geopolitical current events of that time.

Understanding the hydrodynamics of the Congo River

NASA Astrophysics Data System (ADS)

O'Loughlin, Fiachra; Bates, Paul

2014-05-01

We present the results of the first hydrodynamic model of the middle reach of the Congo Basin, which helps our understanding of the behaviour of the second largest river in the world. In data sparse area, hydrodynamic models, utilizing a mixture of limited in-situ measurements and remotely sensed datasets, can be used to understand and identify key features that control large river systems. Unlike previous hydrodynamic models for the Congo Basin, which concentrated on only a small area, we look at the entire length of the Congo's middle reach and its six main tributaries (Kasai, Ubangai, Sangha, Ruki, Lulonga and Lomami). This corresponds to: a drainage area of approximately two and a half million kilometres squared; over 5000 kilometres of river channels; and incorporates some of the largest and most important global wetlands. The hydrodynamic model is driven by a mixture of in-situ and modelled discharges. In situ measurements are available at five locations. Two were obtained from the Global River Discharge Centre (GRDC) at Kinshasa and Bangui, and data for Kisangani, Ouesso and Lediba were obtained from local agencies in the Democratic Republic of the Congo and the Republic of Congo. Using the gauging station at Kinshasa as the downstream boundary, the remaining in-situ measurements account for 61 percent of the discharge and represent 72 percent of the total drainage area. Modelled discharges are used to account for the missing discharge and corresponding area. Calibration and validation of the model was undertaken using a mixture of in-situ measurements, discharge and water level at Kinshasa, and water surface heights along the main reach obtained from both laser and radar altimeters. Through the hydrodynamic model we will investigate: how important constraints, identified by a previous study, are to the behaviour of the Congo; what impacts the wetlands have on the Congo Basin; how the wetlands and main channel interact with each other. Our results will

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

PubMed

Hawkes, Michael; Katsuva, Jean Paul; Masumbuko, Claude K

2009-12-23

Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Prospective cohort study, satisfaction questionnaire and decision analysis. Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo

PubMed Central

2009-01-01

Background Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Methods Prospective cohort study, satisfaction questionnaire and decision analysis. Results Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. Conclusions CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence. PMID:20028563

Situation Report--Bahrain, Central African Republic, Gabon, Iraq, Jordan, Kuwait, Lesotho, Libya, Saudi Arabia, Swaziland, Syria, Yemen Arab Republic.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in twelve foreign countries are presented in these situation reports. Countries included are Bahrain, Central African Republic, Gabon, Iraq, Jordan, Kuwait, Lesotho, Libya, Saudi Arabia, Swaziland, Syria, and Yemen Arab Republic. Information is provided, where appropriate and available, under two…

Onchocerciasis control in the Democratic Republic of Congo (DRC): challenges in a post-war environment.

PubMed

Makenga Bof, J-C; Maketa, V; Bakajika, D K; Ntumba, F; Mpunga, D; Murdoch, M E; Hopkins, A; Noma, M M; Zouré, H; Tekle, A H; Katabarwa, M N; Lutumba, P

2015-01-01

To evaluate onchocerciasis control activities in the Democratic Republic of Congo (DRC) in the first 12 years of community-directed treatment with ivermectin (CDTI). Data from the National Programme for Onchocerciasis (NPO) provided by the National Onchocerciasis Task Force (NOTF) through the annual reports of the 21 CDTI projects for the years 2001-2012 were reviewed retrospectively. A hypothetical-inputs-process-outputs-outcomes table was constructed. Community-directed treatment with ivermectin expanded from 1968 communities in 2001 to 39 100 communities by 2012 while the number of community-directed distributors (CDD) and health workers (HW) multiplied. By 2012, there were ratios of 1 CDD per 262 persons and 1 HW per 2318 persons at risk. More than 80% of the funding came from the fiduciary funds of the African Programme for Onchocerciasis Control. The cost of treatment per person treated fell from US$ 1.1 in 2001 to US$ 0.1 in 2012. The therapeutic coverage increased from 2.7% (2001) to 74.2% (2012); the geographical coverage, from 4.7% (2001) to 93.9% (2012). Geographical coverage fell in 2005 due to deaths in loiasis co-endemic areas, and the therapeutic coverage fell in 2008 due to insecurity. Challenges to CDTI in DRC have been serious adverse reactions to ivermectin in loiasis co-endemic areas and political conflict. Targets for personnel or therapeutic and geographical coverages were not met. Longer term funding and renewed efforts are required to achieve control and elimination of onchocerciasis in DRC. © 2014 John Wiley & Sons Ltd.

Phytochemical analysis and biological evaluation of selected African propolis samples from Cameroon and Congo.

PubMed

Papachroni, Danai; Graikou, Konstantia; Kosalec, Ivan; Damianakos, Harilaos; Ingram, Verina; Chinou, Ioanna

2015-01-01

The objective of this study was the chemical analysis of four selected samples of African propolis (Congo and Cameroon) and their biological evaluation. Twenty-one secondary metabolites belonging to four different chemical groups were isolated from the 70% ethanolic extracts of propolis and their structures were elucidated on the basis of spectral evidence. Three triterpenes and two diprenyl-flavonoids were identified from Congo propolis, which has been investigated for the first time, while thirteen triterpenes, three diprenyl-flavonoids, two monoterpenic alcohols and one fatty acid ester have been identified from Cameroon propolis samples. To our knowledge, the identified diprenyl-flavonoids, as well as five of the isolated and determined triterpenes, are reported for the first time in propolis. Moreover, the total polyphenol content was estimated in all extracts and the antimicrobial activities of all four extracts were studied against six Gram-positive and -negative bacteria and three pathogenic fungi, showing an interesting antibacterial profile.

Raman spectroscopy as a tool to characterize heterogenite (CoO·OH) (Katanga Province, Democratic Republic of Congo)

NASA Astrophysics Data System (ADS)

Burlet, C.; Vanbrabant, Y.; Goethals, H.; Thys, T.; Dupin, L.

2011-10-01

Natural heterogenite (CoO·OH) samples were studied by Raman microspectroscopy, electronic microprobe and Electronic BackScattered Diffraction (EBSD). Raw samples and polished sections were made from 10 mines covering the Katanga copperbelt (Katanga Province, Democratic Republic of Congo). Four typical Raman responses have been obtained leading to investigate the laser-induced dehydroxylation of heterogenite into a Co-spinel structure. The results are also compared with EBSD patterns from oven heated heterogenite samples. A close relationship was established between the chemical substitutions of Co by mainly Cu, Ni, Mn and Al and their impact on the mineral Raman response.

Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo.

PubMed

Mukendi, Deby; Lilo Kalo, Jean-Roger; Mpanya, Alain; Minikulu, Luigi; Kayembe, Tharcisse; Lutumba, Pascal; Barbé, Barbara; Gillet, Philippe; Jacobs, Jan; Van Loen, Harry; Yansouni, Cédric P; Chappuis, François; Ravinetto, Raffaella; Verdonck, Kristien; Boelaert, Marleen; Winkler, Andrea S; Bottieau, Emmanuel

2017-11-01

There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3-6 months after discharge. No neuroimaging was available. Severe headache (199, 56.7%), gait/walking disorders (97, 27.6%), epileptic seizure (87, 24.8%), and focal neurological deficit (86, 24.5%) were the predominant presentations, often in combination. Infections of the CNS were documented in 63 (17.9%) patients and mainly included bacterial meningitis and unspecified meningoencephalitis (33, 9.4%), second-stage human African trypanosomiasis (10, 2.8%), and human immunodeficiency virus (HIV)-related neurological disorders (10, 2.8%). Other focal/systemic infections with neurological manifestations were diagnosed in an additional 60 (17.1%) cases. The leading noncommunicable conditions were epilepsy (61, 17.3%), psychiatric disorders (56, 16.0%), and cerebrovascular accident (23, 6.6%). Overall fatality rate was 8.2% (29/351), but up to 23.8% for CNS infections. Sequelae were observed in 76 (21.6%) patients. Clinical presentations and etiologies of neurological disorders were very diverse in this rural Central African setting and caused considerable mortality and morbidity.

Molecular surveillance of Plasmodium falciparum drug resistance in the Republic of Congo: four and nine years after the introduction of artemisinin-based combination therapy.

PubMed

Koukouikila-Koussounda, Felix; Jeyaraj, Sankarganesh; Nguetse, Christian N; Nkonganyi, Charles Nchotebah; Kokou, Kossiwa Clarisse; Etoka-Beka, Mandingha K; Ntoumi, Francine; Velavan, Thirumalaisamy P

2017-04-19

Resistance to anti-malarial drugs hinders efforts on malaria elimination and eradication. Following the global spread of chloroquine-resistant parasites, the Republic of Congo adopted artemisinin-based combination therapy (ACT) in 2006 as a first-line treatment for uncomplicated malaria. To assess the impacts after implementation of ACT, a molecular surveillance for anti-malarial drug resistance was conducted in Congo 4 and 9 years after the introduction of ACT. Blood samples of 431 febrile children aged 1-10 years were utilized from two previous studies conducted in 2010 (N = 311) and 2015 (N = 120). All samples were screened for malaria parasites using nested PCR. Direct sequencing was used to determine the frequency distribution of genetic variants in the anti-malarial drug-resistant Plasmodium falciparum genes (Pfcrt, Pfmdr1, Pfatp6, Pfk13) in malaria-positive isolates. One-hundred and nineteen (N = 70 from 2010 and N = 49 from 2015) samples were positive for P. falciparum. A relative decrease in the proportion of chloroquine-resistant haplotype (CVIET) from 100% in 2005, 1 year before the introduction and implementation of ACT in 2006, to 98% in 2010 to 71% in 2015 was observed. Regarding the multidrug transporter gene, a considerable reduction in the frequency of the mutations N86Y (from 73 to 27%) and D1246Y (from 22 to 0%) was observed. However, the prevalence of the Y184F mutation remained stable (49% in 2010 compared to 54% in 2015). Isolates carrying the Pfatp6 H243Y was 25% in 2010 and this frequency was reduced to null in 2015. None of the parasites harboured the Pfk13 mutations associated with prolonged artemisinin clearance in Southeast Asia. Nevertheless, 13 new Pfk13 variants are reported among the investigated isolates. The implementation of ACT has led to the decline in prevalence of chloroquine-resistant parasites in the Republic of Congo. However, the constant prevalence of the PfMDR1 Y184F mutation, associated with lumefantrine

Ebola virus disease in the Democratic Republic of the Congo, 1976-2014

PubMed Central

Rosello, Alicia; Mossoko, Mathias; Flasche, Stefan; Van Hoek, Albert Jan; Mbala, Placide; Camacho, Anton; Funk, Sebastian; Kucharski, Adam; Ilunga, Benoit Kebela; Edmunds, W John; Piot, Peter; Baguelin, Marc; Muyembe Tamfum, Jean-Jacques

2015-01-01

The Democratic Republic of the Congo has experienced the most outbreaks of Ebola virus disease since the virus' discovery in 1976. This article provides for the first time a description and a line list for all outbreaks in this country, comprising 996 cases. Compared to patients over 15 years old, the odds of dying were significantly lower in patients aged 5 to 15 and higher in children under five (with 100% mortality in those under 2 years old). The odds of dying increased by 11% per day that a patient was not hospitalised. Outbreaks with an initially high reproduction number, R (>3), were rapidly brought under control, whilst outbreaks with a lower initial R caused longer and generally larger outbreaks. These findings can inform the choice of target age groups for interventions and highlight the importance of both reducing the delay between symptom onset and hospitalisation and rapid national and international response. DOI: http://dx.doi.org/10.7554/eLife.09015.001 PMID:26525597

Putative Adult Neurogenesis in Old World Parrots: The Congo African Grey Parrot (Psittacus erithacus) and Timneh Grey Parrot (Psittacus timneh).

PubMed

Mazengenya, Pedzisai; Bhagwandin, Adhil; Manger, Paul R; Ihunwo, Amadi O

2018-01-01

In the current study, we examined for the first time, the potential for adult neurogenesis throughout the brain of the Congo African grey parrot ( Psittacus erithacus ) and Timneh grey parrot ( Psittacus timneh ) using immunohistochemistry for the endogenous markers proliferating cell nuclear antigen (PCNA), which labels proliferating cells, and doublecortin (DCX), which stains immature and migrating neurons. A similar distribution of PCNA and DCX immunoreactivity was found throughout the brain of the Congo African grey and Timneh grey parrots, but minor differences were also observed. In both species of parrots, PCNA and DCX immunoreactivity was observed in the olfactory bulbs, subventricular zone of the lateral wall of the lateral ventricle, telencephalic subdivisions of the pallium and subpallium, diencephalon, mesencephalon and the rhombencephalon. The olfactory bulb and telencephalic subdivisions exhibited a higher density of both PCNA and DCX immunoreactive cells than any other brain region. DCX immunoreactive staining was stronger in the telencephalon than in the subtelencephalic structures. There was evidence of proliferative hot spots in the dorsal and ventral poles of the lateral ventricle in the Congo African grey parrots at rostral levels, whereas only the dorsal accumulation of proliferating cells was observed in the Timneh grey parrot. In most pallial regions the density of PCNA and DCX stained cells increased from rostral to caudal levels with the densest staining in the nidopallium caudolaterale (NCL). The widespread distribution of PCNA and DCX in the brains of both parrot species suggest the importance of adult neurogenesis and neuronal plasticity during learning and adaptation to external environmental variations.

Healthcare providers' perspectives on the social reintegration of patients after surgical fistula repair in the eastern Democratic Republic of Congo.

PubMed

Young-Lin, Nichole; Namugunga, Esperance N; Lussy, Justin P; Benfield, Nerys

2015-08-01

To understand perspectives of local health providers on the social reintegration of patients who have undergone fistula repair in the eastern Democratic Republic of Congo. In a qualitative study, semi-structured individual interviews were conducted with patient-care professionals working with women with fistula at HEAL Africa Hospital (Goma) and Panzi Hospital (Bukavu) between June and August 2011. The interviews were transcribed and themes elicited through manual coding. Overall, 41 interviews were conducted. Successful surgical repair was reported to be the most important factor contributing to patients' ability to lead a normal life by all providers. Family acceptance-especially from the husband-was deemed crucial for reintegration by 39 (95%) providers, and 29 (71%) believed this acceptance was more important than the ability to work. Forty (98%) providers felt that, on the basis of African values, future childbearing was key for family acceptance. Because of poor access and the high cost of cesarean deliveries, 28 (68%) providers were concerned about fistula recurrence. Providers view postsurgical childbearing as crucial for social reintegration after fistula repair. However, cesarean deliveries are costly and often inaccessible. More work is needed to improve reproductive health access for women after fistula repair. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Two new Phrynobatrachus species (Amphibia: Anura: Phrynobatrachidae) from the Republic of the Congo.

PubMed

Rödel, Mark-Oliver; Burger, Marius; Zassi-Boulou, Ange Ghislain; Emmrich, Mike; Penner, Johannes; Barej, Michael F

2015-10-14

We describe two new species of puddle frogs, genus Phrynobatrachus, from the south-western Republic of the Congo. One of them, P. horsti sp. nov., occurs also in neighbouring Gabon and is morphologically most similar to the Cameroonian P. ruthbeateae. It differs from the latter species by smaller males with longer thighs and shanks. The new species comprises various colour morphs but always has less conspicuous black borders between flanks and belly than P. ruthbeateae. The distinct and large black axillary blotch of P. ruthbeateae is either much smaller in P. horsti sp. nov., or broken into numerous irregularly shaped smaller dots. Similarly, a black transversal line at the anterior ventral border of thighs and the black face mask is less distinct and irregularly delimitated in P. horsti sp. nov. when compared to P. ruthbeateae. The mean genetic difference in the sampled region of the 16S rRNA gene between P. horsti sp. nov. and 40 other western African congeners range from 3.66-18.10%. The second new species, P. mayokoensis sp. nov., differs from all other known congeners by the combination of a compact and warty body, the absence of a spiny eyelid tubercle and pedal webbing, a conspicuous black triangle on throat and anterior part of the belly, and a distinct large red blotch on the anterior-proximal surface of the thighs. It exhibited a mean genetic difference in the 16S rRNA to 40 other western African congeners ranging from 1.34-16.98%. The genetically most similar sequence stems from a GenBank entry of a Gabonese frog, determined as P. ogoensis. A comparison of the new species with P. ogoensis syntypes confirmed their specific distinctiveness, most convincingly underlined by the absence of pedal webbing in the new species and the pronounced pedal webbing in P. ogoensis. The GenBank entry thus most likely is based on a misidentification and P. mayokoensis sp. nov. may also occur in neighbouring Gabon. The discovery of the two new frog species is further

Visual inspection with acetic acid and Lugol's iodine in cervical cancer screening at the general referral hospital Kayembe in Mbuji-Mayi, Democratic Republic of Congo

PubMed Central

Desire, Banza Kamba; Philippe, Cilundika Mulenga; Thierry, Kabengele; Félix, Kitenge Wa Momat; Wembodinga, Gilbert Utshudienyema; Prosper, Kakudji Luhete; Oscar, Luboya Numbi

2016-01-01

Introduction Cervical cancer is the leading cause of morbidity and mortality of women from cancer in the developing World. It is the primary cause of reduced life expectancy in Sub-Saharan countries such as Democratic Republic of Congo. The aim of this work was to determinate the socio-demographic profile of women with precancerous and cancerous lesions of the cervix, to determinate the frequency of VIA and VILI positive cases and to show the challenges that can be faced in managing patients with abnormalities in the city of Mbuji-Mayi in the Democratic Republic of Congo. Methods As part of its activities, the “Association de Lutte contre le Cancer du Col utérin” (ALCC) organized a community outreach followed by free voluntary testing for cervical cancer for two weeks (26thMarch to 10th April 2011) at the General Referral Hospital Kayembe in Mbuji-Mayi (Democratic Republic of Congo). Results A total of 229 women were examined. 38% of tests (VIA + VILI) were positive with 6 clinically suspected cases of invasive cancer at stage 1 (7% of cases). Nearly 70% of patients were still of childbearing age and had started their first sexual intercourse before 18 years of age and 86% of cases were multiparous. Given the material, financial and technical constraints, 75% of patients were placed in a monitoring program of 9 months to 1 year (= expectation and another test) while 11% of them were selected for a biopsy to be locally practiced and sent to the pathologist. Nearly 8% of the cases were candidates for hysterectomy. Conclusion Given the difficulties encountered and the frequency of positive tests, we recommend another study with a larger sample, improved working conditions (mainly equipment) and the association of another test such as the Human Papilloma Virus (HPV) test. PMID:27217888

The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo.

PubMed

Maman, Suzanne; Cathcart, Rebecca; Burkhardt, Gillian; Omba, Serge; Behets, Frieda

2009-03-01

Literature from the U.S. has documented the importance of spirituality on the psychological health of people living with HIV/AIDS; however there is little published data on the ways in which people living with HIV/AIDS in Africa turn to religion for support. We conducted 40 in-depth interviews with HIV-positive women who were pregnant or had recently given birth in Kinshasa, Democratic Republic of Congo to inform the development of a comprehensive family-centered HIV treatment and care program. Women described how they relied upon their faith and turned to church leaders when they were diagnosed with HIV and prepared to share their diagnosis with others. The women used prayer to overcome the initial shock, sadness and anger of learning their HIV diagnosis. They turned to their church leaders to help them prepare for disclosing their diagnosis to others, including their partners. Church leaders were also important targets for disclosure by some women. Women's faith played an important role in their long-term coping strategies. Conceptualizing their infection as a path chosen by God, and believing that God has the power to cure their infection comforted women and provided them with hope. In settings like the Democratic Republic of the Congo, where there is a strong foundation of faith, we need to recognize how individuals draw upon their different health belief systems in order to develop and implement coherent and effective prevention, treatment and care strategies.

Spatial Patterns of Forest Cover Loss in the Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Molinario, G.; Hansen, M.; Potapov, P.; Justice, C. O.

2013-12-01

Three groups of metrics of spatial patterns of forest cover loss were calculated for the Democratic Republic of Congo (DRC). While other studies had previously assessed landscape patterns in the Congo Basin, they had done so for small areas due to data limitations. The input data for this study, the Forets d;Afrique Central Evaluee par Teledetection(FACET), allowed the analysis to be performed at the national level. FACET is a landsat-scale dataset giving an unprecedented synoptic view of forest cover and forest cover loss for the DRC for three time periods: 2000, 2005 and 2010. The three groups of metrics evaluated the following spatial characteristics of forest cover loss for the same standard 1.5km unit of area: proportions of typologies of forest lost, forest fragmentation and proximity of forest loss patches from other land cover types. Results indicate that there are several different typologies of forest cover loss in the DRC, and offer quantitative explanations of these differences, providing a valuable locally-relevant tool for land use planning, available at the national level. Spatial patterns of forest cover loss highlight differences between areas of high primary forest loss due to agriculture conversion in frontier deforestation, such as in the east of the country, areas of equivalent primary and secondary forest loss emanating from the rural complex and areas of variable proportions of primary and secondary forest loss but important ecological repercussions of forest fragmentation due to isolated, but systematic forest perforations. Typologies of spatial patterns of forest cover loss are presented as well as their correlated drivers, and ecological, conservation and land use planning considerations are discussed.

Ecologic Features of Plague Outbreak Areas, Democratic Republic of the Congo, 2004–2014

PubMed Central

Shako, Jean-Christophe; Gaudart, Jean; Sudre, Bertrand; Ilunga, Benoit Kebela; Shamamba, Stomy Karhemere Bi; Diatta, Georges; Davoust, Bernard; Tamfum, Jean-Jacques Muyembe; Piarroux, Renaud; Piarroux, Martine

2018-01-01

During 2004–2014, the Democratic Republic of the Congo (DRC) declared 54% of plague cases worldwide. Using national data, we characterized the epidemiology of human plague in DRC for this period. All 4,630 suspected human plague cases and 349 deaths recorded in DRC came from Orientale Province. Pneumonic plague cases (8.8% of total) occurred during 2 major outbreaks in mining camps in the equatorial forest, and some limited outbreaks occurred in the Ituri highlands. Epidemics originated in 5 health zones clustered in Ituri, where sporadic bubonic cases were recorded throughout every year. Classification and regression tree characterized this cluster by the dominance of ecosystem 40 (mountain tropical climate). In conclusion, a small, stable, endemic focus of plague in the highlands of the Ituri tropical region persisted, acting as a source of outbreaks in DRC. PMID:29350136

Elimination of cholera in the democratic Republic of the Congo: the new national policy.

PubMed

Muyembe, Jean Jacques; Bompangue, Didier; Mutombo, Guy; Akilimali, Laurent; Mutombo, Annie; Miwanda, Berthe; Mpuruta, Jean de Dieu; Deka, Kabunga Kambale; Bitakyerwa, Fataki; Saidi, Jaime Mufitini; Mutadi, Armand Luhembwe; Kakongo, Raphael Senga; Birembano, Freddy; Mengel, Martin; Gessner, Bradford D; Ilunga, Benoît Kebela

2013-11-01

We evaluated published and unpublished data on cholera cases and deaths reported from clinical care facilities in the 56 health districts of the Democratic Republic of Congo to the National Ministry of Health during 2000-2011. Cholera incidence was highest in the eastern provinces bordering lakes and epidemics primarily originated in this region. Along with a strong seasonal component, our data suggest a potential Vibrio cholerae reservoir in the Rift Valley lakes and the possible contribution of the lakes' fishing industry to the spread of cholera. The National Ministry of Health has committed to the elimination-rather than control-of cholera in DRC and has adopted a new national policy built on improved alert, response, case management, and prevention. To achieve this goal and implement all these measures it will require strong partners in the international community with a similar vision.

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Will Passive Protection Save Congo Forests?

PubMed

Galford, Gillian L; Soares-Filho, Britaldo S; Sonter, Laura J; Laporte, Nadine

2015-01-01

Central Africa's tropical forests are among the world's largest carbon reserves. Historically, they have experienced low rates of deforestation. Pressures to clear land are increasing due to development of infrastructure and livelihoods, foreign investment in agriculture, and shifting land use management, particularly in the Democratic Republic of Congo (DRC). The DRC contains the greatest area of intact African forests. These store approximately 22 billion tons of carbon in aboveground live biomass, yet only 10% are protected. Can the status quo of passive protection - forest management that is low or nonexistent - ensure the preservation of this forest and its carbon? We have developed the SimCongo model to simulate changes in land cover and land use based on theorized policy scenarios from 2010 to 2050. Three scenarios were examined: the first (Historical Trends) assumes passive forest protection; the next (Conservation) posits active protection of forests and activation of the national REDD+ action plan, and the last (Agricultural Development) assumes increased agricultural activities in forested land with concomitant increased deforestation. SimCongo is a cellular automata model based on Bayesian statistical methods tailored for the DRC, built with the Dinamica-EGO platform. The model is parameterized and validated with deforestation observations from the past and runs the scenarios from 2010 through 2050 with a yearly time step. We estimate the Historical Trends trajectory will result in average emissions of 139 million t CO2 year-1 by the 2040s, a 15% increase over current emissions. The Conservation scenario would result in 58% less clearing than Historical Trends and would conserve carbon-dense forest and woodland savanna areas. The Agricultural Development scenario leads to emissions of 212 million t CO2 year-1 by the 2040s. These scenarios are heuristic examples of policy's influence on forest conservation and carbon storage. Our results suggest that 1

Will Passive Protection Save Congo Forests?

PubMed Central

Galford, Gillian L.; Soares-Filho, Britaldo S.; Sonter, Laura J.; Laporte, Nadine

2015-01-01

Central Africa’s tropical forests are among the world’s largest carbon reserves. Historically, they have experienced low rates of deforestation. Pressures to clear land are increasing due to development of infrastructure and livelihoods, foreign investment in agriculture, and shifting land use management, particularly in the Democratic Republic of Congo (DRC). The DRC contains the greatest area of intact African forests. These store approximately 22 billion tons of carbon in aboveground live biomass, yet only 10% are protected. Can the status quo of passive protection — forest management that is low or nonexistent — ensure the preservation of this forest and its carbon? We have developed the SimCongo model to simulate changes in land cover and land use based on theorized policy scenarios from 2010 to 2050. Three scenarios were examined: the first (Historical Trends) assumes passive forest protection; the next (Conservation) posits active protection of forests and activation of the national REDD+ action plan, and the last (Agricultural Development) assumes increased agricultural activities in forested land with concomitant increased deforestation. SimCongo is a cellular automata model based on Bayesian statistical methods tailored for the DRC, built with the Dinamica-EGO platform. The model is parameterized and validated with deforestation observations from the past and runs the scenarios from 2010 through 2050 with a yearly time step. We estimate the Historical Trends trajectory will result in average emissions of 139 million t CO2 year-1 by the 2040s, a 15% increase over current emissions. The Conservation scenario would result in 58% less clearing than Historical Trends and would conserve carbon-dense forest and woodland savanna areas. The Agricultural Development scenario leads to emissions of 212 million t CO2 year-1 by the 2040s. These scenarios are heuristic examples of policy’s influence on forest conservation and carbon storage. Our results

Characterization of asymptomatic Plasmodium falciparum infection and its risk factors in pregnant women from the Republic of Congo.

PubMed

Francine, Ntoumi; Damien, Bakoua; Anna, Fesser; Michael, Kombo; Christevy, Vouvoungui J; Felix, Koukouikila-Koussounda

2016-01-01

Malaria in pregnancy remains a serious public health problem in the Republic of Congo despite the implementation of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) in 2006. The aim of this cross-sectional study was to characterize Plasmodium falciparum infections and determine possible risk factors in pregnant Congolese women attending an antenatal clinic in a periurban area of southern Brazzaville. This study was conducted from March 2012 to December 2013 in a site where several years ago, high malaria resistance to SP was reported. Pregnant women were enrolled during antenatal visits and the number of received IPTp-SP doses was recorded as well as individual sociodemographic data. Peripheral blood was collected and P. falciparum infection was checked by microscopy and by PCR targeting P. falciparum merozoite surface protein gene (msp2). Haemoglobin concentration was measured and P. falciparum positive samples were typed for msp2 allelic diversity. A total of 363 pregnant women were recruited. The prevalence of asymptomatic P. falciparum infection was 7% and 19% by microscopy and by PCR, respectively. More than one half (51.5%) of the pregnant women were anaemic. Multivariate analysis indicated that P. falciparum infection was associated with anaemia. It was also observed that women who have received IPTp-SP have significantly lower prevalence of infection. The administration of IPTp-SP did not influence the multiplicity of infection (MOI). This first study investigating asymptomatic malaria infection on pregnant women of the Republic of Congo shows that P. falciparum infections were clearly associated with maternal anaemia, and use of IPTp-SP reduced the risk of carrying asymptomatic infections. Copyright © 2015 Elsevier B.V. All rights reserved.

Central African Republic.

PubMed

1989-11-01

The Central African Republic contains 242,000 square miles, which rolling terrain almost 2000 feet above sea level. The climate is tropical, and it has a population of 2.8 million people with a 2.5% growth rate. There are more than 80 ethnic groups including Baya 34%, Banda 28%, Sara 10%, Mandja 9%, Mboum 9%, and M'Baka 7%. The religions are traditional African 35%, protestant 25%, Roman Catholic 25%, and Muslim 15%, and the languages are French and Sangho. The infant mortality rate is 143/1000, with expectancy at 49 years and a 40% literacy rate. The work force of 1 million is 70% agricultural, industry 6% and commerce and service 6% and government 3%. The government consists of a president assisted by cabinet ministers and a single party. Natural resources include diamonds, uranium, timber, gold, and oil, and major industries are beverages, textiles, and soap. Agricultural products feature coffee, cotton, peanuts, tobacco, food crops and livestock. Most of the population live in rural areas and most of the 80 ethnic groups have their own language. This is one of the world's least developed countries, with a per capita income of $375/year. The main problems with development are the poor transportation infrastructure, and the weak internal and international marketing systems. The US and various international organizations have aided in agriculture development, health programs, and family planning. US investment is mainly in diamond and gold mining, and although oil drilling has been successful it is not economically feasible at current prices.

Battles on women's bodies: war, rape and traumatisation in eastern Democratic Republic of Congo.

PubMed

Trenholm, J E; Olsson, P; Ahlberg, B M

2011-01-01

Rape has been used as a weapon in the conflict in eastern Democratic Republic of Congo (DRC) in unprecedented ways. Research into the phenomenon of war-rape is limited, particularly in this context. The aim of this study was to explore perceptions of local leaders in eastern DRC concerning rape and raped women in the war context. Local leaders were chosen for their ability to both reflect and influence their constituencies. Interviews were conducted with 10 local leaders and transcripts subjected to qualitative content analysis. The study suggests that mass raping and the methods of perpetration created a chaos effectively destroying communities and the entire society and that humanitarian aid was often inappropriate. Furthermore, an exclusive focus on raped women missed the extent of traumatisation entire communities suffered. More significantly, the lack of political will, corruption, greed and inappropriate aid creates a tangled web serving to intensify the war. This complexity has implications for humanitarian interventions including public health.

Prevalence of antibodies to alphaviruses and flaviviruses in free-ranging game animals and nonhuman primates in the greater Congo basin.

PubMed

Kading, Rebekah C; Borland, Erin M; Cranfield, Mike; Powers, Ann M

2013-07-01

Vector-borne and zoonotic pathogens have comprised a significant proportion of the emerging infectious diseases in humans in recent decades. The role of many wildlife species as reservoirs for arthropod-borne viral pathogens is poorly understood. We investigated the exposure history of various African wildlife species from the Congo basin to mosquito-borne flaviviruses and alphaviruses by testing archived serum samples. Sera from 24 African forest buffalo (Syncerus caffer nanus), 34 African elephants (Loxodonta africana), 40 duikers (Cephalophus and Philantomba spp.), 25 mandrills (Mandrillus sphinx), 32 mountain gorillas (Gorilla beringei beringei), five Grauer's gorillas (Gorilla beringei graueri), two L'Hoest's monkeys (Cercopithecus lhoesti), two golden monkeys (Cercopithecus kandti), and three chimpanzees (Pan troglodytes) sampled between 1991 and 2009 were tested for antibodies against chikungunya virus (CHIKV), o'nyong-nyong virus (ONNV), West Nile virus (WNV), dengue 2 virus (DENV-2), and yellow fever virus (YFV) by plaque reduction neutralization test. Specific neutralizing antibodies against ONNV were found in African forest buffalo in the Democratic Republic of the Congo (DRC) and Gabon, duikers in the DRC, and mandrills in Gabon, providing novel evidence of enzootic circulation of ONNV in these countries. African forest buffalo in the DRC and Gabon also demonstrated evidence of exposure to CHIKV, WNV, and DENV-2, while mandrills in Gabon were antibody positive for CHIKV, DENV-2, WNV, and YFV. All of the elephants tested had a strong neutralizing antibody response to WNV. We also document results from a survey of gorillas for arboviruses, of which 4/32 (13%) had antibody to an alphavirus or flavivirus. Overall, our results demonstrate a high prevalence of neutralizing antibodies against multiple arboviruses in wildlife in equatorial Africa.

Seed predation by bonobos (Pan paniscus) at Kokolopori, Democratic Republic of the Congo.

PubMed

Georgiev, Alexander V; Thompson, Melissa Emery; Lokasola, Albert Lotana; Wrangham, Richard W

2011-10-01

We compared the feeding ecology of the Hali-Hali community of bonobos (Pan paniscus) at Kokolopori, a new field site in the Democratic Republic of the Congo, between two periods 5 months apart. During the first study period (SP1), bonobos relied heavily on the dry seeds of Guibourtia (Caesalpiniaceae), mostly eaten from the ground. The second period (SP2) was characterized by high consumption of ripe tree fruit. Terrestrial herbaceous vegetation (THV) contributed little to the diet in either study period. The low amount of ripe fruit and the high reliance on seeds in the diet during SP1 were associated with high cortisol production and low levels of urinary C-peptide in females, suggesting nutritional stress. However, female gregariousness was not constrained during the fruit-poor period, probably because high seed abundance on the ground ameliorated scramble feeding competition. This is the first description of extensive seed predation by bonobos. It suggests that bonobo feeding ecology may be more similar to that of chimpanzees than previously recognized.

Hepatic and pulmonary cystic echinococcosis in a patient from the Central African Republic.

PubMed

Develoux, Michel; Enache-Angoulvant, Adela; Gounant, Valerie; Brian, Emmanuel; Khalil, Antoine; Bazelly, Bernard; Hennequin, Christophe

2011-03-01

Apical lung opacity was diagnosed in an asymptomatic 30 year-old woman native of Central African Republic by routine chest X-ray. CT scan demonstrated an excavated pulmonary mass and revealed a simple hepatic cyst. Tuberculosis was suspected but mycobacterial cultures remained negative. Three months later, ultrasonography showed septations within the hepatic lesion suggestive of cystic echinococcosis. The detection of seric anti-Echinococcus antibodies was positive. Hepatic and pulmonary cysts were removed surgically and association with three-month course of albendazole resulted in a favorable outcome. Cystic echinococcosis is exceptional in Central Africa and to our knowledge never reported from the Central African Republic. Copyright © 2011 Elsevier Ltd. All rights reserved.

Population genetics of Trypanosoma brucei gambiense in sleeping sickness patients with treatment failures in the focus of Mbuji-Mayi, Democratic Republic of the Congo.

PubMed

Pyana, Patient Pati; Sere, Modou; Kaboré, Jacques; De Meeûs, Thierry; MacLeod, Annette; Bucheton, Bruno; Van Reet, Nick; Büscher, Philippe; Belem, Adrien Marie Gaston; Jamonneau, Vincent

2015-03-01

Human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC) is caused by the protozoan Trypanosoma brucei gambiense. Until recently, all patients in the second or neurological stage of the disease were treated with melarsoprol. At the end of the past and the beginning of the present century, alarmingly high relapse rates in patients treated with melarsoprol were reported in isolated HAT foci. In the Mbuji-Mayi focus of DRC, a particular mutation that confers cross resistance for pentamidine and melarsoprol was recently found for all strains studied. Nevertheless, treatment successfully cured a significant proportion of patients. To check for the existence of other possible genetic factors of the parasites, we genotyped trypanosomes isolated from patients before and after treatment (relapsing patients) with eight microsatellite markers. We found no evidence of any genetic correlation between parasite genotype and treatment outcome and we concluded that relapse or cure probably depend more on patients' factors such as disease progression, nutritional or immunological status or co-infections with other pathogens. The existence of a melarsoprol and pentamidine resistance associated mutation at such high rates highlights an increasing problem, even for other drugs, especially those using the same transporters as melarsoprol and pentamidine. Copyright © 2014 Elsevier B.V. All rights reserved.

Exclusive Breastfeeding and Clinical Malaria Risk in 6-Month-Old Infants: A Cross-Sectional Study from Kinshasa, Democratic Republic of the Congo

PubMed Central

Brazeau, Nicholas F.; Tabala, Martine; Kiketa, Landry; Kayembe, Dyna; Chalachala, Jean Lambert; Kawende, Bienvenu; Lapika, Bruno; Meshnick, Steven R.; Yotebieng, Marcel

2016-01-01

The World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. However, the effect of EBF on malaria risk remains unclear. In the present study, 137 EBF infants and 358 non-EBF infants from the Democratic Republic of the Congo were assessed for fever and malaria infections by polymerase chain reaction, at 6 months of age. EBF was associated with a reduced risk of clinical malaria (odds ratio = 0.13; 95% confidence interval = 0.00–0.80), suggesting a protective effect of EBF against malaria. PMID:27549632

Acute Crises and Complications of Sickle Cell Anemia Among Patients Attending a Pediatric Tertiary Unit in Kinshasa, Democratic Republic Of Congo.

PubMed

Aloni, Michel Ntetani; Kadima, Bertin Tshimanga; Ekulu, Pépé Mfutu; Budiongo, Aléine Nzazi; Ngiyulu, René Makuala; Gini-Ehungu, Jean Lambert

2017-06-01

In the Democratic Republic of Congo, the incidence of sickle cell anemia (SCA) is estimated to affect 30,000 to 40,000 neonates per year. However, there is paucity of data on acute clinical manifestations in sickle cell children. In these circumstances, it is difficult to develop a health care policy for an adequate management of sickle cell patients. This was a seven years' retrospective study of children admitted with acute sickle cell crisis in the Department of Pediatrics in University Hospital of Kinshasa, Kinshasa, the Democratic Republic of Congo. A total of 108 patients were identified as having SCA. There were 56 (51%) girls and 52 (49%) boys. Median age was 10.5 years (range 1-24 years). No child was diagnosed by neonatal screening. The median age of diagnosis of sickle cell anemia was 90 months (range: 8-250 months). The median age at the first transfusion was 36 months (range 4-168). In this series, 61 (56.5%) patients were eligible for hydroxyurea. However, this treatment was only performed in 4 (6.6%) of them. Pain episodes, acute anemic crisis and severe infection represent respectively 38.2%, 34.3% and 21.9% of events. Altered sensorium and focal deficit were encountered occasionally and represented 3.4% of acute events. Acute renal manifestations, cholelithiasis and priapism were rarely reported, in this cohort. In Kinshasa, the care of patients suffering from sickle cell anemia is characterized by the delayed diagnosis and low detection of organ complications compared to reports of Western countries. This situation is due to resources deficiencies.

Acute Crises and Complications of Sickle Cell Anemia Among Patients Attending a Pediatric Tertiary Unit in Kinshasa, Democratic Republic Of Congo

PubMed Central

Aloni, Michel Ntetani; Kadima, Bertin Tshimanga; Ekulu, Pépé Mfutu; Budiongo, Aléine Nzazi; Ngiyulu, René Makuala; Gini-Ehungu, Jean Lambert

2017-01-01

In the Democratic Republic of Congo, the incidence of sickle cell anemia (SCA) is estimated to affect 30,000 to 40,000 neonates per year. However, there is paucity of data on acute clinical manifestations in sickle cell children. In these circumstances, it is difficult to develop a health care policy for an adequate management of sickle cell patients. This was a seven years’ retrospective study of children admitted with acute sickle cell crisis in the Department of Pediatrics in University Hospital of Kinshasa, Kinshasa, the Democratic Republic of Congo. A total of 108 patients were identified as having SCA. There were 56 (51%) girls and 52 (49%) boys. Median age was 10.5 years (range 1-24 years). No child was diagnosed by neonatal screening. The median age of diagnosis of sickle cell anemia was 90 months (range: 8-250 months). The median age at the first transfusion was 36 months (range 4-168). In this series, 61 (56.5%) patients were eligible for hydroxyurea. However, this treatment was only performed in 4 (6.6%) of them. Pain episodes, acute anemic crisis and severe infection represent respectively 38.2%, 34.3% and 21.9% of events. Altered sensorium and focal deficit were encountered occasionally and represented 3.4% of acute events. Acute renal manifestations, cholelithiasis and priapism were rarely reported, in this cohort. In Kinshasa, the care of patients suffering from sickle cell anemia is characterized by the delayed diagnosis and low detection of organ complications compared to reports of Western countries. This situation is due to resources deficiencies. PMID:28626540

Worrying exposure to trace elements in the population of Kinshasa, Democratic Republic of Congo (DRC).

PubMed

Tuakuila, J; Lison, D; Lantin, A-C; Mbuyi, F; Deumer, G; Haufroid, V; Hoet, P

2012-11-01

The particularly high rate of urbanization in Kinshasa (Democratic Republic of Congo) is associated with environmental degradation. Outdoor and indoor air pollution, as well as water pollution and waste accumulation, are issues of major concern. However, little documented information exists on the nature and extent of this pollution. A biomonitoring study was conducted to document exposure to trace elements in a representative sample of the population in Kinshasa. Fifteen trace elements were measured by ICP-MS, CV-AAS, or HG-AFS in spot urine samples from 220 individuals (50.5% women) aged 6-70 years living in the urban area and from 50 additional subjects from the rural area of Kinshasa. Data were compiled as geometric means and selected percentiles, expressed without (μg/L) or with creatinine adjustment (μg/g cr). Overall, living in urban Kinshasa was associated with elevated levels of several parameters in urine as compared to the population living in the rural area (Asi, Ba, Cd, Cr, and V) as well as compared to an urban population of the southeast of Congo (Al, As, Cd, Cr, Cu, Pb, Mn, Ni, Se, V, and Zn). Elevated levels were also found by comparison with the reference values in databases involving American, Canadian, French, or German populations. This study provides the first biomonitoring database in the population of Kinshasa, revealing elevated levels for most urinary TE as compared to other databases. Toxicologically relevant elements such as Al, As, Cd, Pb, and Hg reach levels of public health concern.

15 CFR Supplement No. 1 to Part 710 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Verde Central African Republic Chad Chile China*** Colombia Comoros Congo (Republic of the) Cook Islands...., China includes Hong Kong and Macau; the Netherlands includes Aruba and the Netherlands Antilles). [71 FR...

15 CFR Supplement No. 1 to Part 710 - States Parties to the Convention on the Prohibition of the Development, Production, Stockpiling...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Verde Central African Republic Chad Chile China*** Colombia Comoros Congo (Republic of the) Cook Islands...., China includes Hong Kong and Macau; the Netherlands includes Aruba and the Netherlands Antilles). [71 FR...

Correlates of syphilis seropositivity and risk for syphilis-associated adverse pregnancy outcomes among women attending antenatal care clinics in the Democratic Republic of Congo.

PubMed

Taylor, Melanie M; Ebrahim, Shahul; Abiola, Nadine; Kinkodi, Didine Kaba; Mpingulu, Minlangu; Kabuayi, Jean Pierre; Ekofo, Felly; Newman, Daniel R; Peterman, Thomas A; Kamb, Mary L; Sidibe, Kassim

2014-09-01

Screening and treatment for syphilis among pregnant women is the primary means of prevention of congenital syphilis. Sentinel surveillance for syphilis can inform these prevention efforts. We reviewed antenatal syphilis screening results to assess trends and to identify correlates of seropositivity among women attending antenatal care clinics in the Democratic Republic of Congo during 2011. Syphilis seropositivity among the 17,669 women attending the antenatal care clinics during 2011 was 4.2% (range 0.4%-16.9%). Syphilis seropositivity was significantly higher among women attending rural clinics (5.0%) as compared to urban clinics (3.0%) and those tested in antenatal care clinics in the provinces of Equateur (7.6%) and Orientale (7.7%) as compared to other provinces (p < 0.001). Based on the antenatal care syphilis seroprevalence and national pregnancy estimates, we estimate that approximately 128,591 pregnant women countrywide would have tested seropositive for syphilis during 2011. Over 85,000 adverse pregnancy outcomes would have resulted from these maternal infections, assuming prenatal syphilis diagnosis and treatment were not available. The prevalence of syphilis was highest in rural areas, but exceeded 1% in every area, indicating a need to assure screening and treatment throughout Democratic Republic of Congo. These sentinel surveillance estimates can be used to guide national congenital syphilis prevention efforts. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Nutritional monitoring of preschool-age children by community volunteers during armed conflict in the Democratic Republic of the Congo.

PubMed

Bisimwa, Ghislain; Mambo, Thierry; Mitangala, Prudence; Schirvel, Carole; Porignon, Denis; Dramaix, Michèle; Donnen, Philippe

2009-06-01

The coverage of preschool preventive medical visits in developing countries is still low. Consequently, very few children benefit from continuous monitoring during the first 5 years of life. To assess community volunteers' effectiveness in monitoring the growth of preschool-age children in a context of endemic malnutrition and armed conflict. Community volunteers were selected by village committees and trained to monitor children's growth in their respective villages. Community volunteers monitored 5479 children under 5 years of age in the Lwiro Health Sector of the Democratic Republic of the Congo from January 2004 to December 2005 under the supervision of the district health office. Children's weight was interpreted according to weight-for-age curves drawn on the growth sheet proposed by the World Health Organization and adopted by the Democratic Republic of the Congo. During the 2-year program, the volunteers weighed children under 5 years of age monthly. The median percentage of children weighed per village varied between 80% and 90% for children of 12-59 months, and 80% and 100% for children of less than 12 months even during the conflict period. The median percentage of children between 12 and 59 months of age per village ranked as highly susceptible to malnutrition by the volunteers decreased from 4.2% (range, 0% to 35.3%) in 2004 to 2.8% (range, 0.0% to 18.9%) in 2005. The decentralization of weighing of children to the community level could be an alternative for improving growth monitoring of preschool-age children in situations of armed conflict or political instability. This option also offers an opportunity to involve the community in malnutrition care and can be an entry point for other public health activities.

Results from the Survey of Antibiotic Resistance (SOAR) 2011–14 in the Democratic Republic of Congo, Ivory Coast, Republic of Senegal and Kenya

PubMed Central

Kacou-Ndouba, A.; Revathi, G.; Mwathi, P.; Seck, A.; Diop, A.; Kabedi-Bajani, M. J.; Mwiti, W.; Anguibi-Pokou, M. J.; Morrissey, I.; Torumkuney, D.

2016-01-01

Objectives To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011–14. Methods Bacterial isolates were collected and MICs determined using Etest® for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2. Results Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (∼65%) but 87%–100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with β-lactamase prevalence of 39% and 4%, respectively. Furthermore, β-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries. Conclusions There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility. PMID

76 FR 61134 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

... DEPARTMENT OF STATE [Public Notice 7622] Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the Congo Pursuant to Section 7086(c)(2) of the Department of State... respect to the Democratic Republic of the Congo and I hereby waive such restriction. This determination...

Alluvial diamond resource potential and production capacity assessment of the Central African Republic

USGS Publications Warehouse

Chirico, Peter G.; Barthelemy, Francis; Ngbokoto, Francois A.

2010-01-01

In May of 2000, a meeting was convened in Kimberley, South Africa, and attended by representatives of the diamond industry and leaders of African governments to develop a certification process intended to assure that rough, exported diamonds were free of conflict concerns. This meeting was supported later in 2000 by the United Nations in a resolution adopted by the General Assembly. By 2002, the Kimberly Process Certification Scheme (KPCS) was ratified and signed by diamond-producing and diamond-importing countries. Over 70 countries were included as members of the KPCS at the end of 2007. To prevent trade in "conflict diamonds" while protecting legitimate trade, the KPCS requires that each country set up an internal system of controls to prevent conflict diamonds from entering any imported or exported shipments of rough diamonds. Every diamond or diamond shipment must be accompanied by a Kimberley Process (KP) certificate and be contained in tamper-proof packaging. The objective of this study was (1) to assess the naturally occurring endowment of diamonds in the Central African Republic (potential resources) based on geological evidence, previous studies, and recent field data and (2) to assess the diamond-production capacity and measure the intensity of mining activity. Several possible methods can be used to estimate the potential diamond resource. However, because there is generally a lack of sufficient and consistent data recording all diamond mining in the Central African Republic and because time to conduct fieldwork and accessibility to the diamond mining areas are limited, two different methodologies were used: the volume and grade approach and the content per kilometer approach. Estimates are that approximately 39,000,000 carats of alluvial diamonds remain in the eastern and western zones of the CAR combined. This amount is roughly twice the total amount of diamonds reportedly exported from the Central African Republic since 1931. Production capacity is

High School Students Are a Target Group for Fight against Self-Medication with Antimalarial Drugs: A Pilot Study in University of Kinshasa, Democratic Republic of Congo.

PubMed

Kabongo Kamitalu, Ramsès; Aloni, Michel Ntetani

2016-01-01

Aim. To assess the self-medication against malaria infection in population of Congolese students in Kinshasa, Democratic Republic of Congo (DRC). Methods. A cross-sectional study was carried out in University of Kinshasa, Kinshasa, Democratic Republic of Congo. Medical records of all students with malaria admitted to Centre de Santé Universitaire of University of Kinshasa from January 1, 2008, to April 30, 2008, were reviewed retrospectively. Results. The median age of the patients was 25.4 years (range: from 18 to 36 years). The majority of them were male (67.9%). Artemisinin-based combination treatments (ACTs) was the most used self-prescribed antimalarial drugs. However, self-medication was associated with the ingestion of quinine in 19.9% of cases. No case of ingestion of artesunate/artemether in monotherapy was found. All the medicines taken were registered in DRC. In this series, self-prescribed antimalarial was very irrational in terms of dose and duration of treatment. Conclusion. This paper highlights self-medication by a group who should be aware of malaria treatment protocols. The level of self-prescribing quinine is relatively high among students and is disturbing for a molecule reserved for severe disease in Congolese health care policy in management of malaria.

Population genetics of Glossina palpalis palpalis from central African sleeping sickness foci.

PubMed

Melachio, Trésor Tito Tanekou T T; Simo, Gustave; Ravel, Sophie; De Meeûs, Thierry; Causse, Sandrine; Solano, Philippe; Lutumba, Pascal; Asonganyi, Tazoacha; Njiokou, Flobert

2011-07-18

Glossina palpalis palpalis (Diptera: Glossinidae) is widespread in west Africa, and is the main vector of sleeping sickness in Cameroon as well as in the Bas Congo Province of the Democratic Republic of Congo. However, little is known on the structure of its populations. We investigated G. p. palpalis population genetic structure in five sleeping sickness foci (four in Cameroon, one in Democratic Republic of Congo) using eight microsatellite DNA markers. A strong isolation by distance explains most of the population structure observed in our sampling sites of Cameroon and DRC. The populations here are composed of panmictic subpopulations occupying fairly wide zones with a very strong isolation by distance. Effective population sizes are probably between 20 and 300 individuals and if we assume densities between 120 and 2000 individuals per km2, dispersal distance between reproducing adults and their parents extends between 60 and 300 meters. This first investigation of population genetic structure of G. p. palpalis in Central Africa has evidenced random mating subpopulations over fairly large areas and is thus at variance with that found in West African populations of G. p. palpalis. This study brings new information on the isolation by distance at a macrogeographic scale which in turn brings useful information on how to organise regional tsetse control. Future investigations should be directed at temporal sampling to have more accurate measures of demographic parameters in order to help vector control decision.

Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo.

PubMed

Albutt, Katherine; Kelly, Jocelyn; Kabanga, Justin; VanRooyen, Michael

2017-04-01

Studies report that between 6 per cent and 29 per cent of survivors of sexual violence in eastern Democratic Republic of the Congo (DRC) are rejected by their families and communities. This research project was designed to provide insights into survivors' experiences of stigmatisation and rejection. Surveys were conducted with 310 women as they sought psychosocial services in eastern DRC. In total, 44.3 per cent of women reported suffering rejection after sexual violence. The majority of women felt that their status in the household (58.0 per cent) and community (54.9 per cent) diminished after rape. The odds of rejection were greater among women reporting ongoing displacement, pregnancy owing to sexual violence, worsening family relations, and diminished community status. This work highlights the extremely high levels of loss associated with the war in eastern DRC, particularly among survivors of sexual violence. The rejection of a survivor of rape has concrete and devastating psychosocial consequences. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Limited sterile processing capabilities for safe surgery in low-income and middle-income countries: experience in the Republic of Congo, Madagascar and Benin.

PubMed

Fast, Olive; Fast, Christina; Fast, Dan; Veltjens, Suzanne; Salami, Zouliha; White, Michelle C

2017-01-01

It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care. Our tool identified widespread lack of knowledge of techniques and resources needed for sterile processing. Only 12% of workers in Republic of Congo and Benin had sterile processing training and none in Madagascar. None of the hospitals surveyed met basic standards for cleaning, disinfection and sterilisation as defined by the WHO/Pan American Health Organization. Examples of poor practice included lack of cleaning supplies (basic brushes and detergents), incorrect drying and storage of surgical instruments, and inattention to workflow causing cross-contamination. Bleach (sodium hypochlorite) solutions, damaging to instruments, were used universally. In our experience, using an assessment tool allowed identification of specific gaps in sterile processing capacity. Many of the gaps are amenable to simple solutions requiring minimal resources and achievable by most hospitals. We recommend that stakeholders seeking to strengthen surgical health systems in low-resource settings incorporate sterile processing capacity assessments and training into their programmes.

Limited sterile processing capabilities for safe surgery in low-income and middle-income countries: experience in the Republic of Congo, Madagascar and Benin

PubMed Central

Fast, Olive; Fast, Christina; Fast, Dan; Veltjens, Suzanne; Salami, Zouliha

2017-01-01

It is highly difficult to perform safe surgery without sterile instruments, yet the capacity to adequately clean, disinfect and sterilise surgical instruments in low-income and middle-income countries is largely unknown. Sterile Processing Education Charitable Trust developed an assessment tool and, in partnership with Mercy Ships, evaluated the sterile processing capacity in 59 facilities in Madagascar, Benin and the Republic of Congo. This data-driven analysis paper illustrates how lack of sterile processing capacity acts as a barrier to safe surgical care. Our tool identified widespread lack of knowledge of techniques and resources needed for sterile processing. Only 12% of workers in Republic of Congo and Benin had sterile processing training and none in Madagascar. None of the hospitals surveyed met basic standards for cleaning, disinfection and sterilisation as defined by the WHO/Pan American Health Organization. Examples of poor practice included lack of cleaning supplies (basic brushes and detergents), incorrect drying and storage of surgical instruments, and inattention to workflow causing cross-contamination. Bleach (sodium hypochlorite) solutions, damaging to instruments, were used universally. In our experience, using an assessment tool allowed identification of specific gaps in sterile processing capacity. Many of the gaps are amenable to simple solutions requiring minimal resources and achievable by most hospitals. We recommend that stakeholders seeking to strengthen surgical health systems in low-resource settings incorporate sterile processing capacity assessments and training into their programmes. PMID:29225957

Mosquito-borne viruses circulating in Kinshasa, Democratic Republic of the Congo.

PubMed

Mbanzulu, Kennedy Makola; Wumba, Roger; Mukendi, Jean-Pierre Kambala; Zanga, Josué Kikana; Shija, Fortunate; Bobanga, Thierry Lengu; Aloni, Michel Ntetani; Misinzo, Gerald

2017-04-01

Diseases caused by mosquito-borne viruses are among the most important emerging diseases that threaten human and animal health, particularly in Africa. However, little attention has been paid to these diseases in the Democratic Republic of the Congo (DRC). The present cross-sectional study was undertaken between March and May 2014 to investigate the presence of mosquito-borne viruses in mosquitoes collected from five municipalities of Kinshasa, DRC. Mosquitoes were collected using BG-Sentinel traps and battery-powered aspirators. Female mosquitoes were pooled according to their genera and sampling locations, preserved in RNAlater, and later screened for viruses using reverse transcription PCR (RT-PCR) assays. A total of 2922 mosquitoes were collected and 29 pools of female mosquitoes, containing approximately 30 mosquitoes each, were tested. Twelve of the 29 (41.4%) mosquito pools were found to be infected with at least one arbovirus, with eight (27.5%) pools positive for Alphavirus, nine (31%) for Flavivirus, and five (17.2%) for Bunyaviridae. Chikungunya, o'nyong'nyong, and Rift valley fever viruses were detected. The present study shows that mosquitoes in Kinshasa carry mosquito-borne viruses that may have serious public health implications. Further investigations on the presence of mosquito-borne viruses in the human and livestock populations of Kinshasa and DRC are recommended. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Time and Origin of Cichlid Colonization of the Lower Congo Rapids

PubMed Central

Schwarzer, Julia; Misof, Bernhard; Ifuta, Seraphin N.; Schliewen, Ulrich K.

2011-01-01

Most freshwater diversity is arguably located in networks of rivers and streams, but, in contrast to lacustrine systems riverine radiations, are largely understudied. The extensive rapids of the lower Congo River is one of the few river stretches inhabited by a locally endemic cichlid species flock as well as several species pairs, for which we provide evidence that they have radiated in situ. We use more that 2,000 AFLP markers as well as multilocus sequence datasets to reconstruct their origin, phylogenetic history, as well as the timing of colonization and speciation of two Lower Congo cichlid genera, Steatocranus and Nanochromis. Based on a representative taxon sampling and well resolved phylogenetic hypotheses we demonstrate that a high level of riverine diversity originated in the lower Congo within about 5 mya, which is concordant with age estimates for the hydrological origin of the modern lower Congo River. A spatial genetic structure is present in all widely distributed lineages corresponding to a trisection of the lower Congo River into major biogeographic areas, each with locally endemic species assemblages. With the present study, we provide a phylogenetic framework for a complex system that may serve as a link between African riverine cichlid diversity and the megadiverse cichlid radiations of the East African lakes. Beyond this we give for the first time a biologically estimated age for the origin of the lower Congo River rapids, one of the most extreme freshwater habitats on earth. PMID:21799840

Congo: Elections and the Battle for Mineral Resources

ERIC Educational Resources Information Center

Social Education, 2007

2007-01-01

Twenty million voters cast ballots July 30, 2006, in the Democratic Republic of the Congo's first free election since 1960. A runoff election three months later, between transitional president Joseph Kabila and transitional vice president Jean-Pierre Bemba, gave Kabila a mandate to lead the war-torn nation for five more years. The elections, in…

Infant feeding practices and determinants of poor breastfeeding behavior in Kinshasa, Democratic Republic of Congo: a descriptive study.

PubMed

Yotebieng, Marcel; Chalachala, Jean Lambert; Labbok, Miriam; Behets, Frieda

2013-10-01

Although breastfeeding is almost universally accepted in the Democratic Republic (DR) of Congo, by the age of 2 to 3 months 65% of children are receiving something other than human milk. We sought to describe the infant feeding practices and determinants of suboptimal breastfeeding behaviors in DR Congo. Survey questionnaire administered to mothers of infants aged ≤ 6 months and healthcare providers who were recruited consecutively at six selected primary health care facilities in Kinshasa, the capital. All 66 mothers interviewed were breastfeeding. Before initiating breastfeeding, 23 gave their infants something other than their milk, including: sugar water (16) or water (2). During the twenty-four hours prior to interview, 26 (39%) infants were exclusively breastfed (EBF), whereas 18 (27%), 12 (18%), and 10 (15%) received water, tea, formula, or porridge, respectively, in addition to human milk. The main reasons for water supplementation included "heat" and cultural beliefs that water is needed for proper digestion of human milk. The main reason for formula supplementation was the impression that the baby was not getting enough milk; and for porridge supplementation, the belief that the child was old enough to start complementary food. Virtually all mothers reported that breastfeeding was discussed during antenatal clinic visit and half reported receiving help regarding breastfeeding from a health provider either after birth or during well-child clinic visit. Despite a median of at least 14 years of experience in these facilities, healthcare workers surveyed had little to no formal training on how to support breastfeeding and inadequate breastfeeding-related knowledge and skills. The facilities lacked any written policy about breastfeeding. Addressing cultural beliefs, training healthcare providers adequately on breastfeeding support skills, and providing structured breastfeeding support after maternity discharge is needed to promote EBF in the DR Congo.

Phylogeny of imported and reestablished wild polioviruses in theDemocratic Republic of the Congo from 2006 to 2011.

PubMed

Gumede, Nicksy; Jorba, Jaume; Deshpande, Jagadish; Pallansch, Mark; Yogolelo, Riziki; Muyembe-Tamfum, Jean Jacques; Kew, Olen; Venter, Marietjie; Burns, Cara C

2014-11-01

The last case of polio associated with wild poliovirus (WPV) indigenous to the Democratic Republic of the Congo (DRC) was reported in 2001, marking a major milestone toward polio eradication in Africa. However, during 2006-2011, outbreaks associated with WPV type 1 (WPV1) were widespread in the DRC, with >250 reported cases. WPV1 isolates obtained from patients with acute flaccid paralysis (AFP) were compared by nucleotide sequencing of the VP1 capsid region (906 nucleotides). VP1 sequence relationships among isolates from the DRC and other countries were visualized in phylogenetic trees, and isolates representing distinct lineage groups were mapped. Phylogenetic analysis indicated that WPV1 was imported twice in 2004-2005 and once in approximately 2006 from Uttar Pradesh, India (a major reservoir of endemicity for WPV1 and WPV3 until 2010-2011), into Angola. WPV1 from the first importation spread to the DRC in 2006, sparking a series of outbreaks that continued into 2011. WPV1 from the second importation was widely disseminated in the DRC and spread to the Congo in 2010-2011. VP1 sequence relationships revealed frequent transmission of WPV1 across the borders of Angola, the DRC, and the Congo. Long branches on the phylogenetic tree signaled prolonged gaps in AFP surveillance and a likely underreporting of polio cases. The reestablishment of widespread and protracted WPV1 transmission in the DRC and Angola following long-range importations highlights the continuing risks of WPV spread until global eradication is achieved, and it further underscores the need for all countries to maintain high levels of poliovirus vaccine coverage and sensitive surveillance to protect their polio-free status. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

PubMed Central

Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

2018-01-01

Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013–14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014–2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges.

PubMed

Kwete, Dieudonné; Binanga, Arsene; Mukaba, Thibaut; Nemuandjare, Théophile; Mbadu, Muanda Fidele; Kyungu, Marie-Thérèse; Sutton, Perri; Bertrand, Jane T

2018-03-21

Momentum for family planning in the Democratic Republic of the Congo (DRC) is evident in multiple ways: strong political will, increasing donor support, a growing number of implementing organizations, innovative family planning programming, and a cohesive family planning stakeholder group. Between 2013 and 2017, the modern contraceptive prevalence rate (mCPR) in the capital city of Kinshasa increased from 18.5% to 26.7% among married women, but as of 2013-14, it was only 7.8% at the national level. The National Multisectoral Strategic Plan for Family Planning: 2014-2020 calls for achieving an mCPR of 19.0% by 2020, an ambitious goal in light of formidable challenges to family planning in the DRC. Of the 16,465 health facilities reporting to the national health information system in 2017, only 40% offer family planning services. Key challenges include uncertainty over the political situation, difficulties of ensuring access to family planning services in a vast country with a weak transportation infrastructure, funding shortfalls for procuring adequate quantities of contraceptives, weak contraceptive logistics and supply chain management, strong cultural norms that favor large families, and low capacity of the population to pay for contraceptive services. This article describes promising initiatives designed to address these barriers, consistent with the World Health Organization's framework for health systems strengthening. For example, the national family planning coordinating mechanism is being replicated at the provincial level to oversee the expansion of family planning service delivery. Promising initiatives are being implemented to improve the supply and quality of services and generate demand for family planning, including social marketing of subsidized contraceptives at both traditional and non-traditional channels and strengthening of services in military health facilities. To expand contraceptive access, family planning is being institutionalized in

Schistosomiasis in Belgian military personnel returning from the Democratic Republic of Congo.

PubMed

Aerssens, Cptannelies; De Vos, Daniel; Pirnay, Jean-Paul; Yansouni, Cedric; Clerinx, Joannes; Van Gompel, Alfons; Soentjens, Patrick

2011-11-01

The detection of schistosomiasis cases among Belgian military personnel returning from a mission in the Democratic Republic of Congo (DRC) prompted a nested case-control study of all military personnel deployed in the DRC between 2005 and 2008 to identify all infections and to start appropriate treatment. Of 197 patients exposed at Lake Tanganyika in the Kalemie area of DRC, 49 (24.9%) were diagnosed with schistosomiasis. Swimming was significantly more frequent than wading in the seropositive group than in the seronegative group (88.9% vs. 73.6%; odds ratio [OR], 2.86; 95% confidence interval [CI], 0.97-9.01). Thirty-one of 49 patients (63.3%) were symptomatic; including skin problems in 34.7%, respiratory symptoms in 12.2%, fever in 14.3%, and 51.0% with gastrointestinal problems. Median eosinophil counts were significantly higher in seropositive patients (375 vs. 138 per tL; Wilcoxon rank sum test [Ws] = 10,559.00; p < 0.01; r = -0.49). In total, 20 (40.8%) of the 49 patients were treated for symptomatic infections and the remainder for asymptomatic schistosomiasis. Our study emphasizes the need for active systematic post-tropical screening in military personnel after deployment to Schistosoma-endemic regions of the world.

78 FR 76698 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

... DEPARTMENT OF STATE [Public Notice 8552] Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the Congo Pursuant to Section 7031(b)(3) of the Department of State... similar provisions of law in prior year Acts with respect to the Democratic Republic of the Congo and I...

Y-chromosomal variation in sub-Saharan Africa: insights into the history of Niger-Congo groups.

PubMed

de Filippo, Cesare; Barbieri, Chiara; Whitten, Mark; Mpoloka, Sununguko Wata; Gunnarsdóttir, Ellen Drofn; Bostoen, Koen; Nyambe, Terry; Beyer, Klaus; Schreiber, Henning; de Knijff, Peter; Luiselli, Donata; Stoneking, Mark; Pakendorf, Brigitte

2011-03-01

Technological and cultural innovations as well as climate changes are thought to have influenced the diffusion of major language phyla in sub-Saharan Africa. The most widespread and the richest in diversity is the Niger-Congo phylum, thought to have originated in West Africa ∼ 10,000 years ago (ya). The expansion of Bantu languages (a family within the Niger-Congo phylum) ∼ 5,000 ya represents a major event in the past demography of the continent. Many previous studies on Y chromosomal variation in Africa associated the Bantu expansion with haplogroup E1b1a (and sometimes its sublineage E1b1a7). However, the distribution of these two lineages extends far beyond the area occupied nowadays by Bantu-speaking people, raising questions on the actual genetic structure behind this expansion. To address these issues, we directly genotyped 31 biallelic markers and 12 microsatellites on the Y chromosome in 1,195 individuals of African ancestry focusing on areas that were previously poorly characterized (Botswana, Burkina Faso, Democratic Republic of Congo, and Zambia). With the inclusion of published data, we analyzed 2,736 individuals from 26 groups representing all linguistic phyla and covering a large portion of sub-Saharan Africa. Within the Niger-Congo phylum, we ascertain for the first time differences in haplogroup composition between Bantu and non-Bantu groups via two markers (U174 and U175) on the background of haplogroup E1b1a (and E1b1a7), which were directly genotyped in our samples and for which genotypes were inferred from published data using linear discriminant analysis on short tandem repeat (STR) haplotypes. No reduction in STR diversity levels was found across the Bantu groups, suggesting the absence of serial founder effects. In addition, the homogeneity of haplogroup composition and pattern of haplotype sharing between Western and Eastern Bantu groups suggests that their expansion throughout sub-Saharan Africa reflects a rapid spread followed by

[Medicine and health in the Democratic Republic of Congo: from Independence to the Third Republic].

PubMed

Wembonyama, S; Mpaka, S; Tshilolo, L

2007-10-01

The birth and mortality rates in the Democratic Republic of Congo (DRC), a former Belgian colony, are high, i.e., 48.9/1000 and 17/1000 respectively. The DRC also has one of the highest maternal death rates in the world, i.e., 1289/100,000 live births. Health conditions have not improved since independence. Access to drinking water is limited, living conditions are poor, and food availability in households is low. The mean health services utilization rate in the DRC is estimated to be 0.15 visits/inhabitant/year. The incidence of transmissible diseases is rising. This increase is observed even for illnesses that were under control before independence such as sleeping sickness, onchocerciasis, leprosy, and tuberculosis. One the main causes of mortality and morbidity in the population is malaria that is responsible for the deaths of 150,000 to 250,000 children under the age of 5 every year. The HIV prevalence rate is 4.5% with 1.19 million persons with AIDS and 930,000 orphans whose parents died of AIDS. Other potentially epidemic diseases including bubonic plaque and Ebola hemorrhagic fever are serious threats. Non-transmissible diseases are also on the rise including diabetes, systemic arterial hypertension, cancer and neglected diseases such as sickle cell anemia. To meet these challenges, the country's health authorities have established a program called the Strategy for Reinforcement of the Health System (SRHS). One goal of the SRHS is to develop health zones in order to improve access to quality health care for the whole population.

Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo.

PubMed

Mpanya, Alain; Hendrickx, David; Vuna, Mimy; Kanyinda, Albert; Lumbala, Crispin; Tshilombo, Valéry; Mitashi, Patrick; Luboya, Oscar; Kande, Victor; Boelaert, Marleen; Lefèvre, Pierre; Lutumba, Pascal

2012-01-01

Control of human African trypanosomiasis (sleeping sickness) in the Democratic Republic of Congo is based on mass population active screening by mobile teams. Although generally considered a successful strategy, the community participation rates in these screening activities and ensuing treatment remain low in the Kasai-Oriental province. A better understanding of the reasons behind this observation is necessary to improve regional control activities. Thirteen focus group discussions were held in five health zones of the Kasai-Oriental province to gain insights in the regional perceptions regarding sleeping sickness and the national control programme's activities. Sleeping sickness is well known among the population and is considered a serious and life-threatening disease. The disease is acknowledged to have severe implications for the individual (e.g., persistence of manic periods and trembling hands, even after treatment), at the family level (e.g., income loss, conflicts, separations) and for communities (e.g., disruption of community life and activities). Several important barriers to screening and treatment were identified. Fear of drug toxicity, lack of confidentiality during screening procedures, financial barriers and a lack of communication between the mobile teams and local communities were described. Additionally, a number of regionally accepted prohibitions related to sleeping sickness treatment were described that were found to be a strong impediment to disease screening and treatment. These prohibitions, which do not seem to have a rational basis, have far-reaching socio-economic repercussions and severely restrict the participation in day-to-day life. A mobile screening calendar more adapted to the local conditions with more respect for privacy, the use of less toxic drugs, and a better understanding of the origin as well as better communication about the prohibitions related to treatment would facilitate higher participation rates among the Kasai

Exclusive Breastfeeding and Clinical Malaria Risk in 6-Month-Old Infants: A Cross-Sectional Study from Kinshasa, Democratic Republic of the Congo.

PubMed

Brazeau, Nicholas F; Tabala, Martine; Kiketa, Landry; Kayembe, Dyna; Chalachala, Jean Lambert; Kawende, Bienvenu; Lapika, Bruno; Meshnick, Steven R; Yotebieng, Marcel

2016-10-05

The World Health Organization recommends exclusive breastfeeding (EBF) for the first 6 months of life. However, the effect of EBF on malaria risk remains unclear. In the present study, 137 EBF infants and 358 non-EBF infants from the Democratic Republic of the Congo were assessed for fever and malaria infections by polymerase chain reaction, at 6 months of age. EBF was associated with a reduced risk of clinical malaria (odds ratio = 0.13; 95% confidence interval = 0.00-0.80), suggesting a protective effect of EBF against malaria. © The American Society of Tropical Medicine and Hygiene.

Mapping Biomass for REDD in the Largest Forest of Central Africa: the Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Shapiro, Aurelie; Saatchi, Sassan

2014-05-01

With the support of the International Climate Initiative (ICI) of the Federal Ministry of the Environment, Conservation, and Nuclear Security, the implementation of the German Development Bank KfW, the World Wide Fund for Nature (WWF) Germany, the University of California Los Angeles (UCLA) and local DRC partners will produce a national scale biomass map for the entire forest coverage of the Democratic Republic of Congo (DRC) along with feasibility assessments of different forest protection measures within a framework of a REDD+ model project. The « Carbon Map and Model (CO2M&M) » project will produce a national forest biomass map for the DRC, which will enable quantitative assessments of carbon stocks and emissions in the largest forest of the Congo Basin. This effort will support the national REDD (Reducing Emissions from Deforestation and Degradation) program in DRC, which plays a major role in sustainable development and poverty alleviation. This map will be developed from field data, complemented by airborne LiDAR (Light Detection and Ranging) and aerial photos, systematically sampled throughout the forests of the DRC and up-scaled to satellite images to accurately estimate carbon content in all forested areas. The second component of the project is to develop specific approaches for model REDD projects in key landscapes. This project represents the largest LiDAR-derived mapping effort in Africa, under unprecedented logistical constraints, which will provide one of the poorest nations in the world with the richest airborne and satellites derived datasets for analyzing forest structure, biomass and biodiversity.

Coprophagy in wild bonobos (Pan paniscus) at Wamba in the Democratic Republic of the Congo: a possibly adaptive strategy?

PubMed

Sakamaki, Tetsuya

2010-01-01

Four cases of coprophagy and two cases of fecal inspection were identified during the 1142 h of observing wild bonobos at Wamba in the Luo Scientific Reserve in the Democratic Republic of the Congo. At least 5 females in the study group practiced coprophagy and/or fecal inspection. According to our daily behavioral observations, boredom and stress, insufficient roughage, and the search for essential nutrients could not explain the coprophagy. Several episodes observed in this study indicated that bonobos might have sought and ingested certain valuable food items, such as hard Dialium seeds, in feces during relatively lean seasons. Although coprophagy occurred only rarely among wild bonobos, this practice appeared to represent a possibly adaptive feeding strategy during periods of food scarcity rather than a behavioral abnormality.

From health advice to taboo: community perspectives on the treatment of sleeping sickness in the Democratic Republic of Congo, a qualitative study.

PubMed

Mpanya, Alain; Hendrickx, David; Baloji, Sylvain; Lumbala, Crispin; da Luz, Raquel Inocêncio; Boelaert, Marleen; Lutumba, Pascal

2015-04-01

Socio-cultural and economic factors constitute real barriers for uptake of screening and treatment of Human African Trypanosomiasis (HAT) in the Democratic Republic of Congo (DRC). Better understanding and addressing these barriers may enhance the effectiveness of HAT control. We performed a qualitative study consisting of semi-structured interviews and focus group discussions in the Bandundu and Kasaï Oriental provinces, two provinces lagging behind in the HAT elimination effort. Our study population included current and former HAT patients, as well as healthcare providers and program managers of the national HAT control program. All interviews and discussions were voice recorded on a digital device and data were analysed with the ATLAS.ti software. Health workers and community members quoted a number of prohibitions that have to be respected for six months after HAT treatment: no work, no sexual intercourse, no hot food, not walking in the sun. Violating these restrictions is believed to cause serious, and sometimes deadly, complications. These strong prohibitions are well-known by the community and lead some people to avoid HAT screening campaigns, for fear of having to observe such taboos in case of diagnosis. The restrictions originally aimed to mitigate the severe adverse effects of the melarsoprol regimen, but are not evidence-based and became obsolete with the new safer drugs. Correct health information regarding HAT treatment is essential. Health providers should address the perspective of the community in a constant dialogue to keep abreast of unintended transformations of meaning.

A Nosocomial Outbreak of Human Monkeypox in the Central African Republic

PubMed Central

Nakoune, Emmanuel; Lampaert, Emmanuel; Ndjapou, Séverin Gervais; Janssens, Carole; Zuniga, Isabel; Van Herp, Michel; Fongbia, Jean Paul; Koyazegbe, Thomas Daquin; Selekon, Benjamin; Komoyo, Giscard Francis; Garba-Ouangole, Sandra Miriella; Manengu, Casimir; Manuguerra, Jean-Claude; Kazanji, Mirdad; Gessain, Antoine; Berthet, Nicolas

2017-01-01

Abstract An outbreak of familial monkeypox occurred in the Central African Republic in 2015/2016 by 3 transmission modes: familial, health care–related, and transport-related. Ten people (3 children and 7 adults) were infected. Most presented with cutaneous lesions and fever, and 2 children died. The viral strain responsible was a Zaire genotype strain. PMID:29732376

Heterogenite vs asbolane: a mineralogical study of cobalt oxides from the DRC (Democratic Republic of the Congo)

NASA Astrophysics Data System (ADS)

Burlet, Christian; Vanbrabant, Yves; Decree, Sophie

2014-05-01

The largest cobalt ore reserves are located in DRC, the Democratic Republic of Congo. Most of cobalt is observed as black cobaltic oxide minerals: heterogenite [HCoO2] and asbolane [(Ni,Co)2-xMn(O,OH)4.nH2O] which are hardly differentiable since they exhibit similar macroscopic habit and textures. These minerals are frequently observed in similar environment (oxidized horizon of ore deposits) and they are commonly poorly-crystallized limiting their study with XRD. Their chemical composition is also not very well-constrained since they exhibit significant chemical substitutions with cations as Cu, Co, Ni, Mn. Our observations on a set of heterogenite and asbolane samples from DRC combined with samples from other localities shows that each phase, even under an amorphous form, can be readily distinguished by Raman microspectrometry. This technique is therefore attractive during ore deposit characterization campaigns or during the follow-up extraction operations where it is important to distinguish the main constituting Co-phase(s). The main advantage of this technique is its speed since no sample preparation is required during the collection Raman spectra that usually last few tens of seconds. The method provides information at a μm-scale and several points are thus required to fully characterize ore batches composed of different mineralogical phases. Our petrographical observations show also that asbolane and heterogenite mineralogical phases can coexist at a μm-scale as two distinct phases into 'heterogenite' ore. The distinction between heterogenite and asbolane from our sample set can also be conducted on a chemical base showing that heterogenite represents the richer Co-phase with variable Cu concentrations. By contrast, only Mn traces are usually observed in heterogenite minerals from DRC except in few samples, but always in lower concentration than in asbolane. The latter shows variable Mn/(Mn+Co) ratio between 0.85 and 0.3 and the decrease of this value is

Batwanema gen. n. and Chokwenema gen. n. (Oxyurida, Hystrignathidae), new nematode genera as parasites of Passalidae (Coleoptera) from the Democratic Republic of Congo

PubMed Central

Morffe, Jans; García, Nayla

2013-01-01

Abstract Two new genera and species parasitizing passalid beetles from the Democratic Republic of Congo are described. Batwanema congo gen. n. et sp. n. is characterized by having females with the cervical cuticle armed with scale-like projections, arranged initially in rows of eight elements that gradually divide and form pointed spines toward the end of the spiny region, two cephalic annuli, clavate procorpus and genital tract monodelphic-prodelphic. Two Malagasian species of Artigasia Christie, 1934 were placed in this genus as B. latum (Van Waerebeke, 1973) comb. n. and B. annulatum (Van Waerebeke, 1973) comb. n. Chokwenema lepidophorum gen. n. et sp. n. is characterized by having females with the cervical cuticle armed with scale-like projections, arranged initially in rows of eight elements (similar to Batwanema) that divide gradually, forming spines; a single cephalic annule cone-like, truncated, moderately inflated; procorpus sub-cylindrical and genital tract didelphic-amphidelphic. PMID:24363593

The Quality of Medicines Used in Children and Supplied by Private Pharmaceutical Wholesalers in Kinshasa, Democratic Republic of Congo: A Prospective Survey.

PubMed

Schiavetti, Benedetta; Wynendaele, Evelien; De Spiegeleer, Bart; Mbinze, Geremie J; Kalenda, Nicodème; Marini, Roland; Melotte, Vera; Hasker, Epco; Meessen, Bruno; Ravinetto, Raffaella; Van der Elst, Josiane; Mutolo Ngeleka, Daniel

2018-03-01

Poor-quality medicines are a threat to public health in many low- and middle-income countries, and prospective surveys are needed to inform corrective actions. Therefore, we conducted a cross-sectional survey on a sample of products used for children and available in the private market in Kinshasa, Democratic Republic Congo: amoxicillin (AX) and artemether/lumefantrine (AL), powders for suspension, and paracetamol (PC) tablets 500 mg. Overall, 417 products were covertly purchased from 61 wholesalers. To obtain a representative sample, the products were weighted on their market shares and a subset of 239 samples was randomly extracted to undergo in-depth visual inspection locally, and they were chemically assessed at two accredited laboratories in Belgium. Samples were defined of "poor-quality" if they failed to comply with at least one specification of the International Pharmacopoeia (for AL) or United States Pharmacopoeia 37 (for AX and PC). Results are reported according to the Medicine Quality Assessment Reporting Guideline. The visual inspection detected nonconformities in the aspects of antimalarial powders for suspension, and poor-quality labels across all medicine types. According to chemical analysis, 27.2% samples were of poor quality and 59.5% of AL samples were underdosed in artemether. Poor quality was more frequent for locally manufactured antimalarials (83.3%, P = 0.021; 86.4%, P = 0.022) and PC (4.8%, P = 0.000). The poor quality of the surveyed products may decrease the treatment's efficacy and favor the development of resistances to antimalarials. It is hoped that these findings may guide the corrective actions of the Democratic Republic of Congo Regulatory Authority, which was the main partner in the research.

The Quality of Medicines Used in Children and Supplied by Private Pharmaceutical Wholesalers in Kinshasa, Democratic Republic of Congo: A Prospective Survey

PubMed Central

Schiavetti, Benedetta; Wynendaele, Evelien; De Spiegeleer, Bart; Mbinze, Geremie J.; Kalenda, Nicodème; Marini, Roland; Melotte, Vera; Hasker, Epco; Meessen, Bruno; Ravinetto, Raffaella; Van der Elst, Josiane; Mutolo Ngeleka, Daniel

2018-01-01

Abstract. Poor-quality medicines are a threat to public health in many low- and middle-income countries, and prospective surveys are needed to inform corrective actions. Therefore, we conducted a cross-sectional survey on a sample of products used for children and available in the private market in Kinshasa, Democratic Republic Congo: amoxicillin (AX) and artemether/lumefantrine (AL), powders for suspension, and paracetamol (PC) tablets 500 mg. Overall, 417 products were covertly purchased from 61 wholesalers. To obtain a representative sample, the products were weighted on their market shares and a subset of 239 samples was randomly extracted to undergo in-depth visual inspection locally, and they were chemically assessed at two accredited laboratories in Belgium. Samples were defined of “poor-quality” if they failed to comply with at least one specification of the International Pharmacopoeia (for AL) or United States Pharmacopoeia 37 (for AX and PC). Results are reported according to the Medicine Quality Assessment Reporting Guideline. The visual inspection detected nonconformities in the aspects of antimalarial powders for suspension, and poor-quality labels across all medicine types. According to chemical analysis, 27.2% samples were of poor quality and 59.5% of AL samples were underdosed in artemether. Poor quality was more frequent for locally manufactured antimalarials (83.3%, P = 0.021; 86.4%, P = 0.022) and PC (4.8%, P = 0.000). The poor quality of the surveyed products may decrease the treatment’s efficacy and favor the development of resistances to antimalarials. It is hoped that these findings may guide the corrective actions of the Democratic Republic of Congo Regulatory Authority, which was the main partner in the research. PMID:29313479

Two new genera of nematode (Oxyurida, Hystrignathidae) parasites of Passalidae (Coleoptera) from the Democratic Republic of Congo

PubMed Central

Morffe, Jans; García, Nayla

2013-01-01

Abstract Two new genera and species parasitizing passalid beetles from the Democratic Republic of Congo are described. Kongonema meyeri gen. n. sp. n. is characterized by having females with the cervical cuticle unarmed, first cephalic annule cone-like and truncate, sub-cylindrical procorpus and genital tract didelphic-amphidelphic. The males of Kongonema meyeri gen. n. sp. n. have the procorpus sub-cylindrical, the dorsal cuticle of the tail end thickened, a single large, median mammiform pre-cloacal papilla and a pair of small, pre-cloacal, sub-lateral papillae at a short distance before the level of the cloaca. Lubanema decraemerae gen. n. sp. n. is characterized by the body markedly fusiform, cuticle unarmed and strongly annulated, procorpus sub-cylindrical, isthmus as a constriction between procorpus and basal bulb, genital tract monodelphic-prodelphic and the posterior end rounded with a very short tail appendage. PMID:23653491

Factors influencing acceptability of voluntary HIV testing among pregnant women in Gamboma, Republic of Congo.

PubMed

Ghoma-Linguissi, Laure Stella; Ebourombi, Dagene Fruinovy; Sidibe, Anissa; Kivouele, Thomas Serge; Vouvoungui, Jeannhey Christevy; Poulain, Pierre; Ntoumi, Francine

2015-11-06

This study was carried out to identify factors affecting the acceptability of voluntary HIV testing among pregnant women in a semi-rural city, Gamboma, Republic of Congo. A cross-sectional study was conducted between January and September 2012. Pregnant women attending antenatal heath care at an integrated health center were enrolled after informed consent and followed through voluntary HIV testing. Among 136 participants, 98 women (72 %) accepted voluntary HIV testing after pre-test counseling. Women with basic education, those who cited blood transfusion as a mode of transmission and prevention of mother-to-child transmission (MTCT) were more likely to accept testing as well those informed about free HIV testing. Interestingly, pregnant women who had heard about HIV/AIDS from hospital setting were less likely to accept testing. Our data indicate that increasing general education on HIV transmission/prevention modes is crucial for increasing acceptability of screening. Furthermore, HIV/AIDS knowledge disseminated to patients in hospital settings should be carefully monitored. Lastly, scaling-up MTCT services along with a better and larger community information, may address accessibility barriers observed in the present study.

Monitoring and reporting attacks on education in the Democratic Republic of the Congo and Somalia.

PubMed

Bennouna, Cyril; van Boetzelaer, Elburg; Rojas, Lina; Richard, Kinyera; Karume, Gang; Nshombo, Marius; Roberts, Leslie; Boothby, Neil

2018-04-01

The United Nations' Monitoring and Reporting Mechanism is charged with documenting six grave violations against children in a time of conflict, including attacks on schools. Many of these incidents, however, remain unreported across the globe. This study explores whether or not a local knowledge base of education and child protection actors in North and South Kivu Provinces, Democratic Republic of the Congo, and in Mogadishu, Somalia, could contribute to a more complete record of attacks on education in those areas. Hundreds of semi-structured interviews were conducted with key informants across the three settings, and in total 432 attacks on education were documented. Purposive samples of these reports were verified and a large majority was confirmed. Local non-governmental organisations and education institutions were most knowledgeable about these incidents, but most never reported them to a monitoring authority. The study concludes that attack surveillance and response were largely insufficient, and recommends investing in mechanisms that utilise local knowledge to address these shortcomings. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Severe malaria in children: A descriptive report from Kinshasa, the Democratic Republic of Congo.

PubMed

Kunuanunua, Thomas S; Nsibu, Célestin N; Bodi, Joseph M; Tshibola, Thérèse K; Makusi Bura, Mimy; Magoga, Kumbundu; Ekila, Mathilde B; Situakibanza, Hypolite T; Aloni, Michel N

2015-08-01

The decline of susceptibility of Plasmodium falciparum to chloroquine and sulfadoxine-pyrimethamine resulted in the change of drug policy. This policy has probably changed the facies of the severe form of malaria. A prospective study was conducted in Kinshasa, the Democratic Republic of Congo. Data on children aged ≤13 years, diagnosed with severe malaria were analyzed. In total, 378 children were included with an overall median age of 8 years (age range: 1-13 years). Dark urine was seen in 25.1% of cases. Metabolic acidosis (85.2%), hypoglycemia (62.2%) and hemoglobin ≤5 g/dl (39.1%) were the common laboratories features. Severe malaria anemia, cerebral malaria and Blackwater fever (BWF) were found in 39.1, 30.1 and 25.4%, respectively. Mortality rate was 4%. BWF emerges as a frequent form of severe malaria in our midst. Availing artemisin-based combination treatments in the health care system is a priority to reduce the incidence of BWF in our environment. © The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Referral hospitals in the Democratic Republic of Congo as complex adaptive systems: similar program, different dynamics.

PubMed

Karemere, Hermès; Ribesse, Nathalie; Kahindo, Jean-Bosco; Macq, Jean

2015-01-01

In many African countries, first referral hospitals received little attention from development agencies until recently. We report the evolution of two of them in an unstable region like Eastern Democratic Republic of Congo when receiving the support from development aid program. Specifically, we aimed at studying how actors' network and institutional framework evolved over time and what could matter the most when looking at their performance in such an environment. We performed two cases studies between 2006 and 2010. We used multiple sources of data: reports to document events; health information system for hospital services production, and "key-informants" interviews to interpret the relation between interventions and services production. Our analysis was inspired from complex adaptive system theory. It started from the analysis of events implementation, to explore interaction process between the main agents in each hospital, and the consequence it could have on hospital health services production. This led to the development of new theoretical propositions. Two events implemented in the frame of the development aid program were identified by most of the key-informants interviewed as having the greatest impact on hospital performance: the development of a hospital plan and the performance based financing. They resulted in contrasting interaction process between the main agents between the two hospitals. Two groups of services production were reviewed: consultation at outpatient department and admissions, and surgery. The evolution of both groups of services production were different between both hospitals. By studying two first referral hospitals through the lens of a Complex Adaptive System, their performance in a context of development aid takes a different meaning. Success is not only measured through increased hospital production but through meaningful process of hospital agents'" network adaptation. Expected process is not necessarily a change; strengthened

High human exposure to cobalt and other metals in Katanga, a mining area of the Democratic Republic of Congo.

PubMed

Banza, Célestin Lubaba Nkulu; Nawrot, Tim S; Haufroid, Vincent; Decrée, Sophie; De Putter, Thierry; Smolders, Erik; Kabyla, Benjamin Ilunga; Luboya, Oscar Numbi; Ilunga, Augustin Ndala; Mutombo, Alain Mwanza; Nemery, Benoit

2009-08-01

The human health impact of the historic and current mining and processing of non-ferrous metals in the African Copperbelt is not known. This study assessed the exposure to metals in the population of Katanga, in the south east of the Democratic Republic of Congo, using biomonitoring. Seventeen metals (including Cd, Co, Cu, Pb, U) and non-metals (including As) were measured by ICP-MS in urine spot samples from 351 subjects (32% women), aged 2-74 yr (mean 33 yr). Forty subjects (controls) lived 400 km outside the mining area; 311 subjects lived in the mining area, either very close (< 3 km) (n=179; 6 communities) or moderately close (3-10 km) (n=132; 4 communities) to mines or smelting plants. For all metals (except Ni) urinary concentrations were significantly higher in subjects from the mining area than in control subjects. In subjects living very close to mines or smelting plants, the geometric means (25th-75th percentile) of urinary concentrations, expressed as microg/g creatinine, were 17.8 (10.9-29.0) for As, 0.75 (0.38-1.16) for Cd, 15.7 (5.27-43.2) for Co, 17.1 (8.44-43.2) for Cu, 3.17 (1.47-5.49) for Pb and 0.028 (0.013-0.065) for U, these values being significantly higher than those of subjects living 3-10 km from mines or industrial operations. Urinary Co concentrations were markedly elevated, exceeding 15 microg/g creatinine in 53% of the subjects, and even 87% of children (<14 yr), living very close to the mining areas. Urinary As was also high (79% above 10 microg/g creatinine in subjects living very close to the mining areas). Compared with background values from the US general population, subjects living very close to areas of mining or refining had 4-, 43-, 5- and 4-fold higher urinary concentrations of Cd, Co, Pb and U, respectively. This first biomonitoring study of metal exposure in the African Copperbelt reveals a substantial exposure to several metals, especially in children. The urinary Co concentrations found in this population are the highest

An Examination of Indiscipline in Secondary Schools in the Congo.

ERIC Educational Resources Information Center

Bafoua, Justin

The purpose of this study was to: (1) investigate some of the causes of lack of discipline in secondary schools in the Congo Republic according to teachers, students, and parents; (2) look into the effects that discipline problems have on the students' performances and their development as responsible citizens and (3) suggest or recommend measures…

Plasmodium falciparum: Differential Selection of Drug Resistance Alleles in Contiguous Urban and Peri-Urban Areas of Brazzaville, Republic of Congo

PubMed Central

Tsumori, Yoko; Ndounga, Mathieu; Sunahara, Toshihiko; Hayashida, Nozomi; Inoue, Megumi; Nakazawa, Shusuke; Casimiro, Prisca; Isozumi, Rie; Uemura, Haruki; Tanabe, Kazuyuki; Kaneko, Osamu; Culleton, Richard

2011-01-01

The African continent is currently experiencing rapid population growth, with rising urbanization increasing the percentage of the population living in large towns and cities. We studied the impact of the degree of urbanization on the population genetics of Plasmodium falciparum in urban and peri-urban areas in and around the city of Brazzaville, Republic of Congo. This field setting, which incorporates local health centers situated in areas of varying urbanization, is of interest as it allows the characterization of malaria parasites from areas where the human, parasite, and mosquito populations are shared, but where differences in the degree of urbanization (leading to dramatic differences in transmission intensity) cause the pattern of malaria transmission to differ greatly. We have investigated how these differences in transmission intensity affect parasite genetic diversity, including the amount of genetic polymorphism in each area, the degree of linkage disequilibrium within the populations, and the prevalence and frequency of drug resistance markers. To determine parasite population structure, heterozygosity and linkage disequilibrium, we typed eight microsatellite markers and performed haplotype analysis of the msp1 gene by PCR. Mutations known to be associated with resistance to the antimalarial drugs chloroquine and pyrimethamine were determined by sequencing the relevant portions of the crt and dhfr genes, respectively. We found that parasite genetic diversity was comparable between the two sites, with high levels of polymorphism being maintained in both areas despite dramatic differences in transmission intensity. Crucially, we found that the frequencies of genetic markers of drug resistance against pyrimethamine and chloroquine differed significantly between the sites, indicative of differing selection pressures in the two areas. PMID:21858115

Mortality trends and risk factors in advanced stage-2 Human African Trypanosomiasis: A critical appraisal of 23 years of experience in the Democratic Republic of Congo.

PubMed

Kazumba, Léon Mbiyangandu; Kaka, Jean-Claude Tshinzobe; Ngoyi, Dieudonné Mumba; Tshala-Katumbay, Désiré

2018-06-01

We conducted a retrospective study on mortality trends and risk factors in 781 naïve cases of advanced stage-2 sleeping sickness admitted between 1989 and 2012 at the National Reference Center for Human African Trypanosomiasis (HAT), Department of Neurology, Kinshasa University, Democratic Republic of Congo (DRC). Death was the outcome variable whereas age, gender, duration of disease, location of trypanosomes in body fluids, cytorachy, protidorachy, clinical status (assessed on a syndromic and functional basis) on admission, and treatment regimen were predictors in logistic regression models run at the 0.05 significance level. Death proportions were 17.2% in the standard melarsoprol schedule (3-series of intravenous melarsoprol on 3 successive days at 3.6 mg/kg/d, with a one-week interval between the series, ARS 9); 12.1% in the short schedule melarsoprol (10 consecutive days of intravenous melarsoprol at 2.2 mg/kg/d, ARS 10), 5.4% in the first-line eflornithine (14 days of eflornithine at 400 mg/kg/d in 4 infusions a day DFMO B), 9.1% in the NECT treatment regimen (eflornithine for 7 days at 400, mg/kg/d in 2 infusions a day combined with oral nifurtimox for 10 days at 15 mg/kg/d in 3 doses a day); and high (36%) in the group with select severely affected patients given eflornithine because of their clinical status on admission, at the time when this expensive drug was kept for treatment of relapses (14 days at 400 mg/kg/d in 4 infusions a day, DFMO A). After adjusting for treatment, death odds ratios were as follows: 10.40 [(95% CI: 6.55-16.51); p = .000] for clinical dysfunction (severely impaired clinical status) on admission, 2.14 [(95% CI: 1.35-3.39); p = .001] for high protidorachy, 1.99 [(95% CI: 1.18-3.37); p = .010] for the presence of parasites in the CSF and 1.70 [(95% CI: 1.03-2.81); p = .038] for high cytorachy. A multivariable analysis within treatment groups retained clinical status on admission (in ARS 9, ARS 10 and DFMO B groups) and high

Family and community rejection and a Congolese led mediation intervention to reintegrate rejected survivors of sexual violence in Eastern Democratic Republic of Congo.

PubMed

Kohli, Anjalee; Tosha, Maphie; Ramazani, Paul; Safari, Octave; Bachunguye, Richard; Zahiga, Isaya; Iragi, Aline; Glass, Nancy

2013-01-01

Our purpose in this study is to describe the multiple and inter-related health, economic, and social reasons for rejection and to provide an example of a Congolese-led family mediation program to reintegrate survivors into their families. We conducted this study in Eastern Democratic Republic of Congo (DRC) and included two focus group discussions and twenty-seven interviews. Rejection extends beyond physical dislocation to include economic and social aspects. Family mediation is a process requiring knowledge of traditions and norms. Understanding the context of rejection and supporting promising local reintegration efforts will likely improve health, economic, and social outcomes for the survivor, her family, and her community.

Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo.

PubMed

Patel, Jaymin C; Taylor, Steve M; Juliao, Patricia C; Parobek, Christian M; Janko, Mark; Gonzalez, Luis Demetrio; Ortiz, Lucia; Padilla, Norma; Tshefu, Antoinette K; Emch, Michael; Udhayakumar, Venkatachalam; Lindblade, Kim; Meshnick, Steven R

2014-06-01

Imported malaria threatens control and elimination efforts in countries that have low rates of transmission. In 2010, an outbreak of Plasmodium falciparum malaria was reported among United Nations peacekeeping soldiers from Guatemala who had recently returned from the Democratic Republic of the Congo (DRC). Epidemiologic evidence suggested that the soldiers were infected in the DRC, but local transmission could not be ruled out in all cases. We used population genetic analyses of neutral microsatellites to determine the outbreak source. Genetic relatedness was compared among parasites found in samples from the soldiers and parasite populations collected in the DRC and Guatemala; parasites identified in the soldiers were more closely related to those from the DRC. A phylogenetic clustering analysis confirms this identification with >99.9% confidence. Thus, results support the hypothesis that the soldiers likely imported malaria from the DRC. This study demonstrates the utility of molecular genotyping in outbreak investigations.

From Health Advice to Taboo: Community Perspectives on the Treatment of Sleeping Sickness in the Democratic Republic of Congo, a Qualitative Study

PubMed Central

Mpanya, Alain; Hendrickx, David; Baloji, Sylvain; Lumbala, Crispin; da Luz, Raquel Inocêncio; Boelaert, Marleen; Lutumba, Pascal

2015-01-01

Background Socio-cultural and economic factors constitute real barriers for uptake of screening and treatment of Human African Trypanosomiasis (HAT) in the Democratic Republic of Congo (DRC). Better understanding and addressing these barriers may enhance the effectiveness of HAT control. Methods We performed a qualitative study consisting of semi-structured interviews and focus group discussions in the Bandundu and Kasaï Oriental provinces, two provinces lagging behind in the HAT elimination effort. Our study population included current and former HAT patients, as well as healthcare providers and program managers of the national HAT control program. All interviews and discussions were voice recorded on a digital device and data were analysed with the ATLAS.ti software. Findings Health workers and community members quoted a number of prohibitions that have to be respected for six months after HAT treatment: no work, no sexual intercourse, no hot food, not walking in the sun. Violating these restrictions is believed to cause serious, and sometimes deadly, complications. These strong prohibitions are well-known by the community and lead some people to avoid HAT screening campaigns, for fear of having to observe such taboos in case of diagnosis. Discussion The restrictions originally aimed to mitigate the severe adverse effects of the melarsoprol regimen, but are not evidence-based and became obsolete with the new safer drugs. Correct health information regarding HAT treatment is essential. Health providers should address the perspective of the community in a constant dialogue to keep abreast of unintended transformations of meaning. PMID:25856578

Identification of pathogens for differential diagnosis of fever with jaundice in the Central African Republic: a retrospective assessment, 2008-2010.

PubMed

Gadia, Christelle Luce Bobossi; Manirakiza, Alexandre; Tekpa, Gaspard; Konamna, Xavier; Vickos, Ulrich; Nakoune, Emmanuel

2017-11-29

Febrile jaundice results clinically in generalized yellow coloration of the teguments and mucous membranes due to excess plasma bilirubin, accompanied by fever. Two types are found: conjugated and unconjugated bilirubin jaundice. Jaundice is a sign in several diseases due to viruses (viral hepatitis and arbovirus), parasites (malaria) and bacteria (leptospirosis). In the Central African Republic (CAR), only yellow fever is included on the list of diseases for surveillance. The aim of this study was to identify the other pathogens that can cause febrile jaundice, for better management of patients. Between 2008 and 2010, 198 sera negative for yellow fever IgM were randomly selected from 2177 samples collected during yellow fever surveillance. Laboratory analyses targeted four groups of pathogens: hepatitis B, C, delta and E viruses; dengue, chikungunya, Zika, Crimean-Congo haemorrhagic fever, West Nile and Rift Valley arboviruses; malaria parasites; and bacteria (leptospirosis). Overall, 30.9% sera were positive for hepatitis B, 20.2% for hepatitis E, 12.3% for hepatitis C and 8.2% for malaria. The majority of positive sera (40.4%) were from people aged 16-30 years. Co-infection with at least two of these pathogens was also found. These findings suggest that a systematic investigation should be undertaken of infectious agents that cause febrile jaundice in the CAR.

Evidence of Mumps Infection Among Children in the Democratic Republic of Congo.

PubMed

Doshi, Reena H; Alfonso, Vivian H; Hoff, Nicole A; Mukadi, Patrick; Gerber, Sue; Bwaka, Ado; Higgins, Stephen G; Mwamba, Guillaume Ngoie; Okitolonda, Emile; Muyembe, Jean-Jacques; Rimoin, Anne W

2017-05-01

Mumps is an acute viral infection and while the infection is usually mild, complications can lead to permanent sequelae including brain damage and deafness. The burden of mumps is currently unknown the Democratic Republic of Congo (DRC), we therefore assessed susceptibility to mumps infection among children 6-59 months of age. In collaboration with the 2013-2014 DRC Demographic and Health Survey, we conducted a serosurvey to assess population immunity to vaccine preventable diseases. Dried blood spot samples were collected from children 6 to 59 months of age and processed at the UCLA-DRC laboratory in Kinshasa, DRC using the Dynex Technologies Multiplier FLEX chemiluminescent immunoassay platform (Dynex multiplex assay, Chantilly, VA). Logistic multivariate analyses were used to determine risk factors for mumps seropositivity. Serologic and survey data were matched for 7195, 6-59 month-old children, among whom 22% were positive and 3% indeterminate for mumps antibodies in weighted analyses. In multivariate analyses, the odds of seropositivity increased with increasing age, female gender, number of children in household, increasing socioeconomic status and province (Kinshasa with the highest odds of positive test result compared with all other provinces). These data suggest that mumps virus is circulating in DRC and risk of exposure increases with age. At present, the introduction of a combined measles-mumps-rubella vaccine remains unlikely, as the capacity to maintain adequate vaccine coverage levels for routine immunization must be improved before additional antigens can be considered for the routine immunization schedule.

Discharge and other hydraulic measurements for characterizing the hydraulics of Lower Congo River

USGS Publications Warehouse

Oberg, Kevin; Shelton, John M.; Gardiner, Ned; Jackson, P. Ryan

2009-01-01

The first direct measurements of discharge of the Lower Congo River below Malebo Pool and upstream from Kinganga, Democratic Republic of Congo (DRC) were made in July 2008 using acoustic Doppler current profilers, differential GPS, and echo sounders. These measurements were made in support of research that is attempting to understand the distribution of fish species in the Lower Congo River and reasons for separation of species within this large river. Analyses of these measurements show that the maximum depth in the Lower Congo River was in excess of 200 m and maximum water velocities were greater than 4 m/s. The discharge measured near Luozi, DRC was 35,800 m3/s, and decreased slightly beginning midway through the study. Local bedrock controls seem to have a large effect on the flow in the river, even in reaches without waterfalls and rapids. Dramatic changes in bed topography are evident in transects across the river.

The Democratic Republic of Congo: Background and Current Developments

DTIC Science & Technology

2011-04-29

Rwanda and Uganda, marched into Kinshasa and ousted longtime dictator Mobutu Sese Seko. Within one year, tensions between then- President Laurent...Congolese were registered to vote in the 2006 elections, including 2.9 million in Kinshasa , the capital. In the presidential elections, there were 33...Bemba and the Movement for the Liberation of Congo (MLC) In March 2007, the Congolese army and Bemba’s militia clashed in Kinshasa , forcing Bemba to

The African Lithosphere

NASA Astrophysics Data System (ADS)

Priestley, K.; Debayle, E.; McKenzie, D.; Pilidou, S.

2007-12-01

There have been a number of prior, large scale surface wave studies of Africa, the majority of which rely on fundamental mode observations. In this study we use a large data set of multi-mode surface waves recorded over epicentral distances most of which are shorter than 6000 km, to investigate the Sv wave speed heterogeneity of the upper mantle beneath Africa. The inclusion of the higher mode data allow us to build an upper mantle model for the African plate with a horizontal resolution of a few hundred kilometers and a vertical resolution of a few tens of kilometers extending to about 400 km depth. Our tomographic images of the upper mantle beneath Africa displays significant shear velocity features, much of which correlate with surface geology. High velocity mantle persists beneath the West African and Congo cratons to 225-250 km depth, but the high velocity root beneath Kalahari Craton extends to only about 175 km depth. Low velocity upper mantle underlies the Pan- African terranes of Africa with the exception of the Damara mobile belt separating the Congo and Kalahari Cratons. The Damara mobile belt is underlain by a thick high velocity upper mantle lid which is indistinguishable from that beneath the Congo Craton to the north and the Kalahari Craton to the south. Low velocity upper mantle underlie the Hoggar, Tebesti and Darfur volcanic areas of northern Africa, and very low velocities underlie the Afar region to at least 400 km depth. We use the relationship between shear velocity and temperature of Priestley & McKenzie (2006) to derive a model for the African thermal lithosphere. Two types of lithosphere underlie Africa. Thick lithosphere underlies most of western Africa and all of southern Africa; in the latter the extent of the thick lithosphere is significantly different from the distribution of Archean crust mapped at the surface. Thick lithosphere forms one continuous structure beneath the Congo and Kalahari Cratons. Other than the Pan-African Damara

Assessment of pfcrt 72-76 haplotypes eight years after chloroquine withdrawal in Kinshasa, Democratic Republic of Congo.

PubMed

Mvumbi, Dieudonné Makaba; Boreux, Raphael; Sacheli, Rosalie; Lelo, Mvumbi; Lengu, Bobanga; Nani-Tuma, Situakibanza; Melin, Pierrette; Ntumba, Kayembe; Lunganza, Kalala; DeMol, Patrick; Hayette, Marie-Pierre

2013-12-20

In 2001, the World Health Organization (WHO) has recommended the use of artemisinin-based combination therapy (ACT) as the first-line treatment of uncomplicated malaria cases, as monotherapies had become ineffective in many parts of the world. As a result, the Democratic Republic of Congo (DRC) withdrew chloroquine (CQ) from its malaria treatment policy in 2002 and an artesunate (AS)-amodiaquine (AQ) combination became the ACT of choice in DRC in 2005. AQ-resistance (AQR) has been reported in several parts of the world and mutations in codons 72-76 of the Plasmodium falciparum chloroquine-resistance transporter (pfcrt) gene have been strongly correlated with resistance, especially mutations encoding the SVMNT haplotype. This haplotype was first identified in Southeast Asia and South America but was recently reported in two African countries neighbouring DRC. These facts raised two questions: the first about the evolution of CQ resistance (CQR) in DRC and the second about the presence of the SVMNT haplotype, which would compromise the use of AQ as a partner drug for ACT. A total of 213 thick blood films were randomly collected in 2010 from a paediatric clinic in Kinshasa, DRC. Microscopy controls and real-time polymerase chain reaction (RT-PCR) were performed for Plasmodium species identification. Haplotypes of the pfcrt gene were determined by sequencing. The K76T mutation was detected in 145 out of 198 P. falciparum-positive samples (73.2%). In these 145 resistant strains, only the CVIET haplotype was detected. This study is the first to assess the molecular markers of resistance to CQ and AQ after the introduction of ACT in DRC. The results suggest first that CQR is decreasing, as wild-type pfcrt haplotypes were found in only 26.8% of the samples and secondly that the SVMNT haplotype is not yet present in Kinshasa, suggesting that AQ remains valid as a partner drug for ACT in this region.

Human rabies: a descriptive observation of 21 children in Kinshasa, the Democratic Republic of Congo.

PubMed

Muyila, Delphin I; Aloni, Michel N; Lose-Ekanga, Marie Josée; Nzita, Jules M; Kalala-Mbikay, Alexandre; Bongo, Henri L; Esako, Mathilde N; Malonga-Biapi, Jean Pierre; Mputu-Dibwe, BenoÎt; Aloni, Muriel L; Ekila, Mathilde B

2014-10-01

Human rabies has recently emerged as a significant public health threat in Kinshasa, Democratic Republic of Congo (DRC). However, there is little epidemiological information on human rabies especially in children. We performed at Pediatrics Department of General Reference hospital of Kinshasa between December 2008 and July 2009, a retrospective study to assess the incidence and to describe their clinical aspects and outcome. A total of 21 cases were observed, rather three cases per month. There were 12 boys (57·1%) and 9 girls (42·9%). Biting animal was found to be dog in all cases (100%). The dog was not immunized in all of cases. On admission, all patients (100%) showed furious rabies manifestations. Only two (9·5%) had their wounds treated and received an anti-rabies vaccine (ARV) after the bite incident. Two (9·5%) patients received rabies immunoglobulin (RIG). The case-fatality rate was 100%. The disease emerges as a new major public health problem because of a lack of knowledge regarding rabies risk, the poor management of dog bites. Preventative vaccination for rabies should be recommended in the population of Kinshasa, area at high risk to contract rabies, particularly in children.

Preventing risky behaviours among young adolescents in eastern Democratic Republic of Congo: A qualitative study.

PubMed

Kohli, Anjalee; Remy, Mitima Mpanano; Binkurhorhwa, Arsene Kajabika; Mitima, Clovis Murhula; Mirindi, Alfred Bacikenge; Mwinja, Nadine Bufole; Banyewesize, Jean Heri; Ntakwinja, Gisele Mushengezi; Perrin, Nancy A; Glass, Nancy

2017-04-26

This qualitative study explores and describes adolescent risk behaviours, specifically consumption of alcohol and use of violence; the perceived consequences of these behaviours on future well-being and relationships; and collaboratively identifies the essential components of a prevention intervention for risk behaviours (alcohol use, violence) among young adolescents while strengthening the protective individual and relationship factors in post-conflict Democratic Republic of Congo. One-on-one in-depth interviews were conducted with 28 male and female youth, 20 parents/guardians and 20 stakeholders in three rural villages of South Kivu Province. Trained interviewers conducted interviews and participated in daily debriefing. Descriptive qualitative analysis was used to analyse the data. Youth use of violence and alcohol was associated with a range of factors including peer influence, parent behaviours, school enrolment and poverty. The consequences of risk behaviour include damaged family and social bonds, reduced economic and educational productivity and promise. Community-based, multilevel prevention interventions that promote protective factors and reduce youth exposure and vulnerability to risk factors may have immediate and long-term impact on youth health and behaviour. Such a programme could engage youth, adults and local stakeholders in a range of social, educational and economic activities.

Barriers to Surgical Care and Health Outcomes: A Prospective Study on the Relation Between Wealth, Sex, and Postoperative Complications in the Republic of Congo.

PubMed

Lin, Brian M; White, Michelle; Glover, Ana; Wamah, Greta Peterson; Trotti, Davi L; Randall, Kirstie; Alkire, Blake C; Cheney, Mack L; Parker, Gary; Shrime, Mark G

2017-01-01

Approximately thirty percent of the global burden of disease is comprised of surgical conditions. However, five billion people lack access to surgery, with complex factors acting as barriers. We examined whether patient demographics predict barriers to care, and the relation between these factors and postoperative complications in a prospective cohort. Participants included people presenting to a global charity in Republic of Congo with a surgical condition between August 2013 and May 2014. The outcomes were self-reported barrier to care and postoperative complications documented by medical record. Logistic regression was used to adjust for covariates. Of 1237 patients in our study, 1190 (96.2 %) experienced a barrier to care and 126 (10.2 %) experienced a postoperative complication. The most frequently reported barrier was cost (73 %), followed by lack of provider (8.2 %). Greater wealth was associated with decreased odds of cost as a barrier (OR 0.72 [0.57, 0.90]). Greater wealth (OR 1.52 [1.03, 2.25]) and rural home location (OR 3.35 [1.16, 9.62]) were associated with increased odds of no surgeon being available. Cost as a barrier (OR 2.82 [1.02, 7.77]), female sex (OR 3.45 [1.62, 7.33]), and lack of surgeon (OR 5.62 [1.68, 18.77]) were associated with increased odds of postoperative complication. Patient wealth was not associated with odds of postoperative complication. Barriers to surgery were common in Republic of Congo. Patient wealth and home location may predict barriers to surgery. Addressing gender disparities, access to providers, and patient perception of barriers in addition to removal of barriers may help maximize patient health benefits.

Estimates and Determinants of Sexual Violence Against Women in the Democratic Republic of Congo

PubMed Central

Palermo, Tia; Bredenkamp, Caryn

2011-01-01

Objectives. We sought to provide data-based estimates of sexual violence in the Democratic Republic of Congo (DRC) and describe risk factors for such violence. Methods. We used nationally representative household survey data from 3436 women selected to answer the domestic violence module who took part in the 2007 DRC Demographic and Health Survey along with population estimates to estimate levels of sexual violence. We used multivariate logistic regression to analyze correlates of sexual violence. Results. Approximately 1.69 to 1.80 million women reported having been raped in their lifetime (with 407 397–433 785 women reporting having been raped in the preceding 12 months), and approximately 3.07 to 3.37 million women reported experiencing intimate partner sexual violence. Reports of sexual violence were largely independent of individual-level background factors. However, compared with women in Kinshasa, women in Nord-Kivu were significantly more likely to report all types of sexual violence. Conclusions. Not only is sexual violence more generalized than previously thought, but our findings suggest that future policies and programs should focus on abuse within families and eliminate the acceptance of and impunity surrounding sexual violence nationwide while also maintaining and enhancing efforts to stop militias from perpetrating rape. PMID:21566049

Sea Surface Salinity Variability in Response to the Congo River Discharge

NASA Astrophysics Data System (ADS)

Moller, D.; Chao, Y.; Farrara, J. D.; Schumann, G.; Andreadis, K.

2014-12-01

Sea surface salinity (SSS) variability associated with the Congo River discharge is examined using Aquarius satellite-retrieved SSS data and vertical profiles of salinity measured by the Argo floats. The Congo River plume can be clearly identified in the Aquarius SSS data with a westward extension of 500 to 1000 km off the coast of the Democratic Republic of Congo (DRC). The peak amplitude of the SSS variability associated with the Congo River discharge exceeds 2.0 psu. Using the first two years of Aquarius data, a well-defined seasonal cycle is described: maximum fresh-water anomalies are found in the boreal winter and spring seasons. The fresh-water anomalies during the 2012-2013 winter and spring seasons are significantly fresher than the 2011-2012 winter and spring seasons. Vertical profiles of salinity derived from the Argo floats reveal that these fresh-water anomalies can be traced to 40 meters below the sea surface. Combining the Aquarius SSS data with the Argo vertical profiles of salinity, the 3D volume of these fresh-water anomalies can be inferred and used to estimate the Congo River discharge. Reasonably good agreement is found between the Congo River discharge as observed by a stream gauge at Kinshasa and that estimated from the combined Aquarius and Argo data, indicating that Aquarius data can be used to close the fresh-water budget between the coastal ocean and the Congo River. The precipitation minus evaporation portion of the freshwater flux is found to play a secondary role in this region.

Lac Télé structure, Republic of Congo: Geological setting of a cryptozoological and biodiversity hotspot, and evidence against an impact origin

NASA Astrophysics Data System (ADS)

Master, Sharad

2010-11-01

Lac Télé is a large lake, ˜5.6 km in diameter, with an ovoid shape, situated at 17°10'E, 1°20'N, in the great tropical rain forest region of the Republic of Congo. This lake has attracted widespread attention, mainly because of the legends among the local people that it harbours a strange animal known as the Mokele-Mbembe, but also because it is situated in a region that is a hotbed of biodiversity and conservation efforts with respect to various endangered mammalian species, including gorillas and chimpanzees. Because of its appearance, Lac Télé has been regarded as a possible meteorite impact structure. Various expeditions, studying cryptozoology, conservation ecology, biodiversity, and the impact hypothesis, have visited Lac Télé in the past several decades. The Lac Télé structure is located in the NW part of the intracratonic Congo Basin, in a region dominated by Holocene alluvium, dense tropical rain forest, and swamps which form part of the basin of the Likouala aux Herbes, a multi-branched meandering river flowing over very low gradients into the Sangha river, a major tributary of the Congo river. Previous bathymetric studies have shown that the average depth of Lac Télé is only 4 m, including organic-rich silty sediments. The structure is that of a flat-bottomed dish. Modelling of the Lac Télé as an impact structure indicates a number of features which ought to be present. The absence of any of these features, coupled with the irregular ovoid shape, the palynological record, and the location of the structure at the intersection of major regional lineaments, is regarded as evidence against the impact hypothesis. Lac Télé as an isolated lake ecosystem is not unique in the Congo Basin, and there are several other similar small shallow isolated lakes surrounded by rain forest and marshes, some of which formed by damming of drainage systems by neotectonic faults. It is suggested that the formation of Lac Télé may be related to its location

Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo

PubMed Central

Taylor, Steve M.; Juliao, Patricia C.; Parobek, Christian M.; Janko, Mark; Gonzalez, Luis Demetrio; Ortiz, Lucia; Padilla, Norma; Tshefu, Antoinette K.; Emch, Michael; Udhayakumar, Venkatachalam; Lindblade, Kim; Meshnick, Steven R.

2014-01-01

Imported malaria threatens control and elimination efforts in countries that have low rates of transmission. In 2010, an outbreak of Plasmodium falciparum malaria was reported among United Nations peacekeeping soldiers from Guatemala who had recently returned from the Democratic Republic of the Congo (DRC). Epidemiologic evidence suggested that the soldiers were infected in the DRC, but local transmission could not be ruled out in all cases. We used population genetic analyses of neutral microsatellites to determine the outbreak source. Genetic relatedness was compared among parasites found in samples from the soldiers and parasite populations collected in the DRC and Guatemala; parasites identified in the soldiers were more closely related to those from the DRC. A phylogenetic clustering analysis confirms this identification with >99.9% confidence. Thus, results support the hypothesis that the soldiers likely imported malaria from the DRC. This study demonstrates the utility of molecular genotyping in outbreak investigations. PMID:24856348

[Blood transfusion in the Democratic Republic of Congo: efforts and challenges].

PubMed

Kabinda Maotela, J; Ramazani, S Y; Misingi, P; Dramaix-Wilmet, M

2015-01-01

The authors trace the history of blood transfusion in the Democratic Republic of Congo, as inherited through the colonial organization of the health system. The current configuration of transfusion system begins with the drafting of the national blood transfusion policy and the establishment of a national technical office within the Ministry of Health to coordinate transfusion activities and of its agents in each province. Despite countless difficulties, several positive points were noted. These involve essentially the drafting of all the necessary documents and standards and the integration of the blood safety system into the country's health system. Initially, the blood transfusion system applied a vertical approach, but with the reform of the country's health system, the performance of blood safety became transversal. In the 12 years from 2001 to 2012, it mobilized 112,882 volunteer blood donors; more than 80% of blood products were checked for safety and covered all blood needs; and 81,806 HIV infections were avoided by routine testing of blood products. During the same period, 7560 people were trained in blood transfusion. The prevalence of viral markers among donors has diminished sharply. Thus, HIV prevalence decreased from 4.7% to 2.1% between 2001 and 2012 that of hepatitis B dropped from 7.1% to 3.5% during the same period, and hepatitis C from 11.8% to 2.3% from 2004 to 2012. Despite this performance, enormous efforts are still required, for the organization of blood safety monitoring, the establishment of a safe supply of reagents and supplies, for sustaining the dynamics of voluntary associations of blood donors, and finally for providing stable funding for these blood safety activities.

Les granitoïdes de la couverture protérozoïque de la bordure nord du craton du Congo (Sud-Est du Cameroun et Sud-Ouest de la République centrafricaine), témoins d'une activité magmatique post-kibarienne à pré-panafricaineGranitoids of the Proterozoic cover of the Congo craton northern edge (South-East of Cameroon and South-West of the Central African Republic), witnesses of a post-Kibarian to pre-Pan-African magmatic activity

NASA Astrophysics Data System (ADS)

Vicat, Jean-Paul; Moloto-A-Kenguemba, Gaétan; Pouclet, André

2001-02-01

Granitoid bodies dated from the Late Mesoproterozoic intrude the Palaeoproterozoic cover of the northern edge of the Congo craton. They line up a north-south left-lateral shear zone related to the Late Kibaran tectonics. They originated from crustal melting, may be due to the thermal anomalies, that were responsible of the large basaltic production during the pre-Pan-African extension of the Central Africa rift system.

Sense of coherence and its association with exposure to traumatic events, posttraumatic stress disorder, and depression in eastern Democratic Republic of Congo.

PubMed

Pham, Phuong N; Vinck, Patrick; Kinkodi, Didine Kaba; Weinstein, Harvey M

2010-06-01

The Democratic Republic of Congo is the scene of some of the worst atrocities in recent history. However, in the face of traumatic experience, only a minority of people develops symptoms that impair their functioning. The sense of coherence proposed by Antonovsky (1987) is a theoretical construct reflecting an individual's overall wellbeing and ability to cope with stress. This study explores the relationships between sense of coherence, exposure to traumatic events, symptoms of posttraumatic stress disorder (PTSD), and depression. Results suggest an association between a high sense of coherence and high education levels, high income, and positive social relationships. Furthermore, the study found that sense of coherence is inversely correlated with cumulative exposure to violence and symptoms of PTSD and depression.

Stratigraphic correlations in mid- to late-Proterozoic carbonates of the Democratic Republic of Congo using magnetic susceptibility

NASA Astrophysics Data System (ADS)

Delpomdor, Franck R. A.; Devleeschouwer, Xavier; Spassov, Simo; Préat, Alain R.

2017-04-01

In this paper, we have tested the application of magnetic susceptibility measurements in Cu-Ag-Zn-Pb-(Fe)-mineralized carbonates of the BIe subgroup (Democratic Republic of Congo) as an efficient tool for regional and global high-resolution stratigraphic correlations in the Neoproterozoic marine carbonates. To achieve this goal, we integrate the low-field magnetic susceptibility (XLF) data with facies analyses, geochemistry and isotope stratigraphy. The microfacies analyses of two cores, Tshinyama#S70 and Kafuku#15, drilled in the early Neoproterozoic carbonates of the Mbuji-Mayi Supergroup reveal a deep carbonate ramp setting associated with a microbial/stromatolitic mid-ramp environment. High-resolution stratigraphic correlations using magnetic susceptibility and C-isotope curves established for both cores, 190 km apart, suggest a sedimentary hiatus at the base of the Tshinyama#S70 succession. C-O and Sr isotopes and Sr/Ca and Fe abundances show that a diagenetic meteoric overprint affected the series of the Tshinyama#S70 core and a thermal effect related to mineralizing fluids affected the Kafuku#15 core carbonates.

A model to predict when a cholera outbreak might hit the Congo

NASA Astrophysics Data System (ADS)

Schultz, Colin

2014-09-01

In 2011, as many as 600,000 people in 58 countries contracted cholera, with thousands succumbing to the disease. In most countries, cholera is rare. In others, like the Democratic Republic of the Congo, cholera is an endemic threat, always lurking in the background waiting for the right set of conditions to spark an outbreak.

Predictors of Persistent Anaemia in the First Year of Antiretroviral Therapy: A Retrospective Cohort Study from Goma, the Democratic Republic of Congo.

PubMed

Akilimali, Pierre Zalagile; Kashala-Abotnes, Espérance; Musumari, Patou Masika; Kayembe, Patrick Kalambayi; Tylleskar, Thorkild; Mapatano, Mala Ali

2015-01-01

Anaemia is associated with adverse outcomes including early death in the first year of antiretroviral therapy (ART). This study reports on the factors associated with persistent anaemia among HIV-infected patients initiating ART in the Democratic Republic of Congo (DR Congo). We conducted a retrospective cohort study and analyzed data from patients receiving HIV care between January 2004 and December 2012 at two major hospitals in Goma, DR Congo. Haemoglobin concentrations of all patients on ART regimen were obtained prior to and within one year of ART initiation. A logistic regression model was used to identify the predictors of persistent anaemia after 12 months of ART. Of 756 patients, 69% of patients were anaemic (IC95%: 65.7-72.3) at baseline. After 12 months of follow up, there was a 1.2 g/dl average increase of haemoglobin concentration (P < 0.001) with differences depending on the therapeutic regimen. Patients who received zidovudine (AZT) gained less than those who did not receive AZT (0.99 g/dl vs 1.33 g/dl; p< 0.001). Among 445 patient who had anaemia at the beginning, 33% (147/445) had the condition resolved. Among patients with anaemia at ART initiation, those who did not receive cotrimoxazole prophylaxis before starting ART(AOR 3.89; 95% CI 2.09-7.25; P < 0.001) and a AZT initial regimen (AOR 2.19; 95% CI 1.36-3.52; P < 0.001) were significantly at risk of persistent anaemia. More than two thirds of patients had anaemia at baseline. The AZT-containing regimen and absence of cotrimoxazole prophylaxis before starting ART were associated with persistent anaemia 12 months, after initiation of treatment. Considering the large proportion of patients with persistence of anaemia at 12 months, we suggest that it is necessary to conduct a large study to assess anaemia among HIV-infected patients in Goma.

[Epilepsy and its impact in northwest region of the Central African Republic].

PubMed

Bernet-Bernady, P; Tabo, A; Druet-Cabanac, M; Poumale, F; Ndoma, V; Lao, H; Bouteille, B; Dumas, M; Preux, P M

1997-01-01

In African countries, epilepsy is an important public health problem with major medical, socio-cultural, and economic implications. This study was carried out to evaluate attitudes towards epilepsy in the Central African Republic. A total of 187 epileptic patients were included. Only 20.9% of the study population were married. School attendance never exceeded the elementary level. Epilepsy was active in 98.4% of patients who continued to present attacks despite extensive treatment which was either poorly complied with or inadequate. Attitudes towards epilepsy remain rooted in belief in supernatural phenomenon and evil spirits with use of traditional therapies involving abstinence from certain foods and use of laxative agents to drive out evil forces. Epileptics are excluded from their families and not allowed to attend school but, in our study, they were not prevented from the work place since 70% held jobs. In this study, 54% of epileptics believed that the disease was contagious, 55.6% that it was incurable, and 20.9% that it was due occult or supernatural causes. While precise quantification is impossible, our experience based on interviews with patients and frequent observation of burn wounds suggests that moral and physical suffering is immense among epileptics in the Central African Republic. Epilepsy in Black Africa is a major public health problem requiring serious attention from government officials, health care specialists, and the families of patients. Better information to promote awareness of the non-contagious nature of the disease, greater support for families of patients, and improvement in treatment compliance are essential.

Lasting impact: insights from a surgical mission-based mentoring training programme in the Republic of Congo

PubMed Central

White, Michelle; Close, Kristin

2016-01-01

The global shortage of surgeons, anaesthetists and obstetricians is significant, especially in low and middle income countries (LMICs). A significant amount of LMIC surgical volume is provided by surgical missions and non-governmental organisations (NGOs) who are often well resourced, making them ideal environments for training. However, there are few publications addressing how to train in this setting, or the long-term impact of such training. Mercy Ships operates the largest non-governmental hospital ship in the world, the Africa Mercy, serving LMICs at the invitation of their President by providing free surgery and training for the surgical workforce. Mercy Ships developed and offered a comprehensive training programme across surgical specialties and disciplines in the Republic of Congo, 2013–2014. In this analysis paper, we present our experiences in developing and implementing the training portion of the programme. We also present the findings of an evaluation of the programme, which show a sustained positive impact and lasting change on personal and organisational practice 12–18 months post-training. We also make recommendations to NGOs and surgical mission organisations seeking to augment the impact of surgical missions with effective surgical training programmes. PMID:28588961

The Upper Jurassic Stanleyville Group of the eastern Congo Basin: An example of perennial lacustrine system

NASA Astrophysics Data System (ADS)

Caillaud, Alexis; Blanpied, Christian; Delvaux, Damien

2017-08-01

The intracratonic Congo Basin, located in the Democratic Republic of Congo (DRC), is the largest sedimentary basin of Africa. The Jurassic strata outcrop along its eastern margin, south of Kisangani (formerly Stanleyville). In the last century, the Upper Jurassic Stanleyville Group was described as a lacustrine series containing a thin basal marine limestone designed as the ;Lime Fine; beds. Since the proposal of this early model, the depositional environment of the Stanleyville Group, and especially the possible marine incursion, has been debated, but without re-examining the existing cores, outcrop samples and historical fossils from the type location near Kisangani that are available at the Royal Museum for Central Africa (MRAC/KMMA, Tervuren, Belgium). In order to refine the former sedimentology, a series of nine exploration cores drilled in the Kisangani sub-basin have been described. This study aims at integrating sedimentary facies in existing sedimentary models and to discuss the hypothesis of the presence of Kimmeridgian marine deposits along the Congo River near Kisangani, a region which lies in the middle of the African continent. Eight facies have been identified, which permit a reinterpretation of the depositional environment and paleogeography of the Stanleyville Group. The base of the Stanleyville Group is interpreted to represent a conglomeratic fluvial succession, which filled an inherited Triassic paleotopography. Above these conglomerates, a transition to a typically lacustrine system is interpreted, which includes: (1) a basal profundal, sublittoral (brown to dark fine-grained siltstones with microbial carbonates, i.e., the ;Lime Fine; beds) and littoral lacustrine series; covered by (2) a sublittoral to profundal interval (brown to dark organic-rich, fine-grained siltstones), which corresponds to the maximum extent of the paleo-lake; and, finally (3) a shallow lacustrine series (greenish calcareous siltstones and sandstones with red siltstones

[Environmental factors associated with textile industry in Democratic Republic of Congo: state of play].

PubMed

Kitronza, Panda Lukongo; Philippe, Mairiaux

2016-01-01

This case study aims to make an assessment of environmental health nuisances in textile industry in the Democratic Republic of Congo. We conducted a cross-sectional and analytical study. Out of 257 workers selected using systematic sampling, 229 workers were enrolled in the study. 223 workstations were subjected to measurements in order to determine the level of noise, lighting and heat. Data were collected from company documents, by means of a direct-question interview focusing on socio professional informations and through measurements. Descriptive analysis was used for sociodemographic and professional data and analytical approach was used for the measurements. In the company studied 88% of employees were workers. Weaving department included almost 68% of workers. The majority of employees worked as part of a three shift (85%). The study population was predominantly male (85%), aging (52%) over 40 years and educated (80%). In the company studied, only 12.1% of workstations met the noise standards and 18% of workstations met the lighting standards. 94% of workstations didn't meet the heat standards for heavy work. Our study highlighted the environmental health nuisances in textile industry, demonstrating the existence of significant gaps related to the prescribed standards for the measured nuisances. These results are a plea for the development of appropriate preventive measures. They should be confronted with other more detailed studies in this work environment.

Pregnancy outcomes following exposure to efavirenz-based antiretroviral therapy in the Republic of Congo.

PubMed

Bisio, Francesca; Nicco, Elena; Calzi, Anna; Giacobbe, Daniele Roberto; Mesini, Alessio; Banguissa, Hubert; Vividila, Nicole Edith; Mahoungou, Pélagie; Boumba, Jean Denis; Mboungou, Franc Astyanax Mayinda; Bruzzone, Bianca; Ratto, Sandra; Icardi, Giancarlo; Viscoli, Claudio; Bruzzi, Paolo

2015-04-01

WHO recently recommended efavirenz (EFV) use for HIV infection through pregnancy, breastfeeding and childbearing age. However the use of EFV during pregnancy remains of concern and not all national guidelines reflect WHO advice. Few data are available concerning pregnancy outcomes. The objective of our study was to evaluate pregnancy outcomes in a cohort of women who conceived on EFV. A retrospective, multicenter cohort study was conducted in Pointe Noire, Republic of Congo (September 2005- June 2012). The following adverse pregnancy outcomes were considered: births defects, low birth weight, premature delivery, stillbirth and abortion, stratified by antiretroviral exposure at the time of conception. During the study period, 188 women conceived on antiretrovirals: 35 (18.6%) on EFV-based regimens and 153 (81.4%) on nevirapine-based regimens. Adverse pregnancy outcomes were observed in 17/35 (48.6%, 95% CI 33.0-64.4%) women in the EFV group and in 43/153 (28.1%, 95% CI 21.6-35.7%) in the non-EFV group (p=0.019). No birth defect was observed in either group. An increased incidence of adverse pregnancy outcomes was observed in the EFV group. As WHO is promoting a widespread use of EFV also for women in childbearing age, our study emphasizes the importance of launching large prospective cohort studies investigating pregnancy outcomes in exposed women.

Appearance of konzo in South-Kivu, a wartorn area in the Democratic Republic of Congo.

PubMed

Chabwine, J N; Masheka, C; Balol'ebwami, Z; Maheshe, B; Balegamire, S; Rutega, B; Wa Lola, M; Mutendela, K; Bonnet, M-J; Shangalume, O; Balegamire, J M; Nemery, B

2011-03-01

Konzo is an upper motor neuron disease characterized by sudden-onset and irreversible spastic paraparesis occurring in nutritionally compromised people. It is associated with consumption of insufficiently processed cyanogenic-toxic cassava. Cassava, the main caloric source in the Democratic Republic of Congo, has been safely consumed for decades in the Eastern Province of South-Kivu. However, in the context of long-lasting war and violent conflicts, cases of spastic paraparesis resembling konzo appeared in a populous area (Burhinyi). Two field surveys (2003 and 2005) identified 41 subjects meeting clinical criteria of konzo and suffering from (chronic) malnutrition. Their urinary thiocyanate concentrations (median 129, range 20-688, SD 146 μg/L), and cyanogen levels (median 20 ppm, range 5-300 ppm, SD 73 ppm) in cassava roots from their household stocks were high. The source of cyanogenic-toxicity was unprocessed fresh cassava roots during harvest period, but probably also insufficiently processed roots. This first report of konzo in South-Kivu concludes that occurrence of konzo was triggered by food shortages because of the longstanding state of insecurity. Contributory factors included the introduction of new varieties of (bitter) cassava, but konzo may actually be caused by a combination of factors that are yet to be understood. Copyright © 2010 Elsevier Ltd. All rights reserved.

Presumptive risk factors for monkeypox in rural communities in the Democratic Republic of the Congo

PubMed Central

Moses, Cynthia; Monroe, Benjamin P.; Nakazawa, Yoshinori; Doty, Jeffrey B.; Hughes, Christine M.; McCollum, Andrea M.; Ibata, Saturnin; Malekani, Jean; Okitolonda, Emile; Carroll, Darin S.; Reynolds, Mary G.

2017-01-01

Monkeypox virus (MPXV), a close relative of Variola virus, is a zoonotic virus with an unknown reservoir. Interaction with infected wildlife, bites from peri-domestic animals, and bushmeat hunting are hypothesized routes of infection from wildlife to humans. Using a Risk Questionnaire, performed in monkeypox-affected areas of rural Democratic Republic of the Congo, we describe the lifestyles and demographics associated with presumptive risk factors for MPXV infection. We generated two indices to assess risk: Household Materials Index (HMI), a proxy for socioeconomic status of households and Risk Activity Index (RAI), which describes presumptive risk for animal-to-human transmission of MPXV. Based on participant self-reported activity patterns, we found that people in this population are more likely to visit the forest than a market to fulfill material needs, and that the reported occupation is limited in describing behavior of individuals may participate. Being bitten by rodents in the home was commonly reported, and this was significantly associated with a low HMI. The highest scoring RAI sub-groups were ‘hunters’ and males aged ≥ 18 years; however, several activities involving MPXV-implicated animals were distributed across all sub-groups. The current analysis may be useful in identifying at-risk groups and help to direct education, outreach and prevention efforts more efficiently. PMID:28192435

Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo.

PubMed

Rock, Kat S; Torr, Steve J; Lumbala, Crispin; Keeling, Matt J

2017-01-01

Two goals have been set for Gambian human African trypanosomiasis (HAT), the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction). At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT.

Predicting the Impact of Intervention Strategies for Sleeping Sickness in Two High-Endemicity Health Zones of the Democratic Republic of Congo

PubMed Central

Torr, Steve J.; Lumbala, Crispin; Keeling, Matt J.

2017-01-01

Two goals have been set for Gambian human African trypanosomiasis (HAT), the first is to achieve elimination as a public health problem in 90% of foci by 2020, and the second is to achieve zero transmission globally by 2030. It remains unclear if certain HAT hotspots could achieve elimination as a public health problem by 2020 and, of greater concern, it appears that current interventions to control HAT in these areas may not be sufficient to achieve zero transmission by 2030. A mathematical model of disease dynamics was used to assess the potential impact of changing the intervention strategy in two high-endemicity health zones of Kwilu province, Democratic Republic of Congo. Six key strategies and twelve variations were considered which covered a range of recruitment strategies for screening and vector control. It was found that effectiveness of HAT screening could be improved by increasing effort to recruit high-risk groups for screening. Furthermore, seven proposed strategies which included vector control were predicted to be sufficient to achieve an incidence of less than 1 reported case per 10,000 people by 2020 in the study region. All vector control strategies simulated reduced transmission enough to meet the 2030 goal, even if vector control was only moderately effective (60% tsetse population reduction). At this level of control the full elimination threshold was expected to be met within six years following the start of the change in strategy and over 6000 additional cases would be averted between 2017 and 2030 compared to current screening alone. It is recommended that a two-pronged strategy including both enhanced active screening and tsetse control is implemented in this region and in other persistent HAT foci to ensure the success of the control programme and meet the 2030 elimination goal for HAT. PMID:28056016

Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo.

PubMed

Ilunga-Ilunga, Félicien; Levêque, Alain; Ngongo, Léon Okenge; Laokri, Samia; Dramaix, Michèle

2015-03-01

In the Democratic Republic of Congo (DRC), few studies have focused on treatment-seeking paths selected by caretakers for the management of severe childhood malaria in an urban environment. The present study aims at describing the treatment-seeking paths according to the characteristics of households, as well as the subsequent impact on pre-hospitalisation delay and malarial fatality and on the main syndromes associated with severe childhood malaria. This descriptive study included data collected at nine hospitals in Kinshasa between January and November 2011. A total of 1,350 children, under 15 years of age and hospitalised for severe malaria, were included in the study. Regarding the management of malaria, 31.5% of households went directly to the health centre or hospital while 68.5% opted for self-medication, church and/or traditional healing therapy. The most frequent first-line option was self-medication, adopted by more than 61.5% of households. Nevertheless, rational self-medication using antimalarial drugs recommended by the WHO (artemisinin-based combinations) was reported for only 5.5% of children. Only 12.5% of households combined 2 or 3 traditional options. The following criteria influenced the choice of a modern vs. traditional path: household socioeconomic level, residential environment, maternal education level and religious beliefs. When caretakers opted for traditional healing therapy, the pre-hospitalisation delay was longer and the occurrence of respiratory distress, severe anaemia and mortality was higher. The implementation of a malaria action plan in the Democratic Republic of Congo should take into account the diversity and pluralistic character of treatment-seeking behaviours in order to promote the most appropriate options (hospital and rational self-medication) and to avoid detrimental outcomes.

[Integrated screening for HIV, syphilis, and toxoplasmosis among pregnant women in the Central African Republic].

PubMed

Gamba, E P; Nambei, W S; Kamandji, L

2013-01-01

The aim of this study was to determine the prevalence of syphilis and toxoplasmosis infection in pregnant women in the Central African Republic who were and were not HIV-infected, in the framework of HIV surveillance. This case-control study included 270 HIV(+) and 217 HIV(-) pregnant women among 4 750 women who attended prenatal-care clinics throughout the Central African Republic from November 2011 through January 2012. Blood specimens were collected and serological evidence of HIV1/2 was analyzed by ELISA1 and ELISA2. The Toxoplasma gondii antibody was detected with the Toxo-Hai Fumouze(®) diagnostic kit. A VDRL test was performed to screen for syphilis in all study participants. Of the 434 samples tested, 33 (7.60%) were positive for syphilis: 21 (9.7%) among HIV(+) and 12 (5.5%) among HIV(-) women (p = 0.1031); 221 (50.90%) were positive for toxoplasmosis: 117 (53.9%) among HIV(+) and 104 (47.9%) among HIV(-) women (p = 0, 2119). Coinfection with HIV, syphilis, and toxoplasmosis was found in 6.00%. No association was found between coinfection and age, parity, and residence area. The rate of syphilis infection was very high in pregnant women living in rural areas (ORcrude = 4.37; 95% CI = 2,11, 9.05). This study showed a high prevalence of toxoplasmosis and syphilis in pregnant women in the Central African Republic, regardless of their HIV infection status. Sexually transmitted infections (STIs) are common in pregnant women living in rural areas. It may be appropriate to include routine serological screening tests to determine of toxoplasmosis, syphilis and HIV in pregnant women in this country.

Trace metals and persistent organic pollutants in sediments from river-reservoir systems in Democratic Republic of Congo (DRC): Spatial distribution and potential ecotoxicological effects.

PubMed

Mwanamoki, Paola M; Devarajan, Naresh; Thevenon, Florian; Birane, Niane; de Alencastro, Luiz Felippe; Grandjean, Dominique; Mpiana, Pius T; Prabakar, Kandasamy; Mubedi, Josué I; Kabele, Christophe G; Wildi, Walter; Poté, John

2014-09-01

This paper discusses the occurrence and spatial distribution of metals and persistent organic pollutants (POPs: including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), Polybrominated diphenyl ethers (PBDEs), and polycyclic aromatic hydrocarbons (PAHs) in sediments from a river-reservoir system. Surface sediments were sampled from thirteen sites of the Congo River Basin and Lake Ma Vallée, both situated in the vicinity of the capital city Kinshasa (Congo Democratic Republic). Sediment qualities were evaluated using toxicity test based on exposing Ostracods to the sediment samples. The highest metal concentrations were observed in sediments subjected to anthropogenic influences, urban runoff and domestic and industrial wastewaters, discharge into the Congo River basin. Ostracods exposed to the sediments resulted in 100% mortality rates after 6d of incubation, indicating the ultimate toxicity of these sediments as well as potential environmental risks. The POPs and PAHs levels in all sediment samples were low, with maximum concentration found in the sediments (area of pool Malebo): OCP value ranged from 0.02 to 2.50 with ∑OCPs: 3.3μgkg(-1); PCB ranged from 0.07 to 0.99 with Total PCBs (∑7×4.3): 15.31μgkg(-1); PAH value ranged from 0.12 to 9.39 with ∑PAHs: 63.89μgkg(-1). Our results indicate that the deterioration of urban river-reservoir water quality result mainly from urban stormwater runoff, untreated industrial effluents which discharge into the river-reservoirs, human activities and uncontrolled urbanization. This study represents useful tools incorporated to evaluate sediment quality in river-reservoir systems which can be applied to similar aquatic environments. Copyright © 2014 Elsevier Ltd. All rights reserved.

Vaccination Coverage and Timelines Among Children 0-6 Months in Kinshasa, the Democratic Republic of Congo: A Prospective Cohort Study.

PubMed

Zivich, Paul N; Kiketa, Landry; Kawende, Bienvenu; Lapika, Bruno; Yotebieng, Marcel

2017-05-01

Objectives The Democratic Republic of Congo (DR Congo) is one of the ten countries, which accounts for 60% of unvaccinated children worldwide. The aim of this study was to assess predictors of incomplete and untimely immunization among a cohort of infants recruited at birth and followed up through 24 weeks in Kinshasa. Methods Complete immunization for each vaccine was defined as receiving all the recommended doses. Untimely immunization was defined as receiving the given dose before (early) or after (delayed) the recommended time window. Infants not immunized by the end of the follow-up time were considered missing. Multivariate hierarchical model and generalized logistic model were used to assess the independent contribution of each socio-economic and demographic factors considered to complete immunization and timeliness, respectively. Results Overall, of 975 infants from six selected clinics included in the analysis 84.7% were fully immunized the three doses of DTP or four doses of Polio by 24 weeks of age. Independently of the vaccine considered, the strongest predictor of incomplete and untimely immunization was the clinic in which the infant was enrolled. This association was strengthened after adjustment for socio-economic and demographic characteristics. Education and the socio-economic status also were predictive of completion and timeliness of immunization in our cohort. Discussion In conclusion, the strongest predictor for incomplete and untimely immunization among infants in Kinshasa was the clinics in which they were enrolled. The association was likely due to the user fee for well-baby clinic visits and its varying structure by clinic.

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity.

PubMed

Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

2015-01-01

Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

PubMed Central

Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

2015-01-01

Background Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Methods and Results Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. Conclusions The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country. PMID:25563450

Charcoal records reveal past occurrences of disturbances in the forests of the Kisangani region, Democratic Republic of the Congo

NASA Astrophysics Data System (ADS)

Tshibamba Mukendi, John; Hubau, Wannes; Ntahobavuka, Honorine; Boyemba Bosela, Faustin; De Cannière, Charles; Beeckman, Hans

2014-05-01

Past disturbances have modified local density, structure and floristic composition of Central African rainforests. As such, these perturbations represent a driving force for forest dynamics and they were presumably at the origin of present-day forest mosaics. One of the most prominent disturbances within the forest is fire, leaving behind charcoal as a witness of past forest dynamics. Quantification and identification of ancient charcoal fragments found in soil layers (= pedoanthracology) allows a detailed reconstruction of forest history, including the possible occurrence of past perturbations. The primary objective of this study is to present palaeoenvironmental evidence for the existence of past disturbances in the forests of the Kisangani region (Democratic Republic of the Congo) using a pedoanthracological approach. We quantified and identified charcoal fragments from pedoanthracological excavations in the Yangambi, Yoko, Masako and Kole forest regions. Charcoal sampling was conducted in pit intervals of 10 cm, whereby pottery fragments were also registered and quantified. Floristic identifications were conducted using former protocols based on wood anatomy, which is largely preserved after charcoalification. 14 excavations were conducted and charcoal was found in most pit intervals. Specifically, 52 out of 56 sampled intervals from the Yangambi forest contained charcoal, along with 47 pit intervals from the Yoko forest reserve, 34 pit intervals from the Masako forest and 16 from the Kole forest. Highest specific anthracomasses were recorded in Yoko (167 mg charcoal per kg soil), followed by Yangambi (133 mg/kg), Masako (71,89 mg/kg) and finally Kole (42,4 mg/kg). Charcoal identifications point at a manifest presence of the family of Fabaceae (Caesalpinioideae). This family is characteristic for the tropical humid rainforest. The presence of charcoal fragments from these taxa, associated with pottery sherds on different depths within the profiles, suggests

Dietary composition and ovarian function among Lese horticulturalist women of the Ituri Forest, Democratic Republic of Congo.

PubMed

Bentley, G R; Harrigan, A M; Ellison, P T

1998-04-01

To assess dietary composition in relation to energetic status and ovarian function. An eight-month prospective study undertaken in 1989. Ituri Forest, northeast Democratic Republic of Congo. Sixty-four female volunteers of reproductive age (16-45), with a subsample of 30 for nutritional focal follows, 39 for analysis of salivary progesterone levels, and 18 for analysis of salivary oestradiol. Regular anthropometric measurements of heights, weights, and mid-triceps skinfolds, 204 h of nutritional focal follows when all foods prepared and consumed were recorded and weighed, analysis of dietary composition using African food tables, collection of saliva samples every-other day for radioimmunoassay of salivary oestradiol and progesterone. The primary staple in the Lese diet is manioc, consumed at nearly every meal, but the diet is subject to seasonal fluctuations. Important seasonal crops are groundnuts and rice. Carbohydrates comprise 64% of the diet, protein 14% and fat 22%, but seasonal fluctuations in food items create significant differences in protein content (P = 0.007). Energy intake falls by 25% in the hunger season. Lese energy balance reflects this lack with women losing a mean 7% of total body weight. The mean BMI for Lese women at the beginning of the study was 22.8 but, during the hunger season, the BMI for 20% of women fell to < 18.5, indicative of chronic energy shortage. Mean levels of Lese salivary oestradiol and progesterone are chronically and significantly lower than healthy, Western controls (P = 0.0001 for progesterone; P = 0.03 for follicular values of oestradiol, P = 0.0001 for mid-cycle values, and P = 0.0002 for luteal values). Mean salivary progesterone levels were significantly lower for those Lese women losing weight (P = 0.03), and significantly lower for weight-loss women when comparing levels at the beginning and end of the hunger season (P = 0.03). The relatively low-fat, high-fibre diet of the Lese appears healthy, but there are

Task shifting in the management of hypertension in Kinshasa, Democratic Republic of Congo: a cross-sectional study.

PubMed

Lulebo, Aimée M; Kaba, Didine K; Atake, Silvestre E-H; Mapatano, Mala A; Mafuta, Eric M; Mampunza, Julien M; Coppieters, Yves

2017-12-04

The Democratic Republic of the Congo (DRC) is characterized by a high prevalence of hypertension (HTN) and a high proportion of uncontrolled HTN, which is indicative of poor HTN management. Effective management of HTN in the African region is challenging due to limited resources, particularly human resources for health. To address the shortage of health workers, the World Health Organization (WHO) recommends task shifting for better disease management and treatment. Although task shifting from doctors to nurses is being implemented in the DRC, there are no studies, to the best of our knowledge, that document the association between task shifting and HTN control. The aim of this study was to investigate the association between task shifting and HTN control in Kinshasa, DRC. We conducted a cross-sectional study in Kinshasa from December 2015 to January 2016 in five general referral hospitals (GRHs) and nine health centers (HCs). A total of 260 hypertensive patients participated in the study. Sociodemographic, clinical, health care costs and perceived health care quality assessment data were collected using a structured questionnaire. To examine the association between task shifting and HTN control, we assessed differences between GRH and HC patients using bivariate and multivariate analyses. Almost half the patients were female (53.1%), patients' mean age was 59.5 ± 11.4 years. Over three-fourths of patients had uncontrolled HTN. There was no significant difference in the proportion of GRH and HC patients with uncontrolled HTN (76.2% vs 77.7%, p = 0.771). Uncontrolled HTN was associated with co-morbidity (OR = 10.3; 95% CI: 3.8-28.3) and the type of antihypertensive drug used (OR = 4.6; 95% CI: 1.3-16.1). The mean healthcare costs in the GRHs were significantly higher than costs in the HCs (US$ 34.2 ± US$3.34 versus US$ 7.7 ± US$ 0.6, respectively). Uncontrolled HTN was not associated with the type of health facility. This finding suggests that the

Prevalence of Rubella Antibodies Among Children in the Democratic Republic of the Congo.

PubMed

Alfonso, Vivian H; Doshi, Reena H; Mukadi, Patrick; Higgins, Stephen G; Hoff, Nicole A; Bwaka, Ado; Mwamba, Guillaume Ngoie; Okitolonda, Emile; Muyembe, Jean-Jacques; Gerber, Sue; Rimoin, Anne W

2018-01-01

While generally mild in children, rubella infection in early pregnancy can lead to miscarriage, fetal death or congenital rubella syndrome. Rubella vaccination is not yet available as a part of routine immunization in the Democratic Republic of the Congo (DRC), and the burden of infection is unknown. In collaboration with the 2013-2014 DRC Demographic and Health Survey, a serosurvey was carried out to assess population immunity to vaccine-preventable diseases. Dry blood spot samples collected from children 6-59 months of age were processed using the Dynex Technologies Multiplier FLEX chemiluminescent immunoassay platform (Dynex Technologies, Chantilly, VA). Among the 7195 6- to 59-month-old children, 33% were positive and <1% indeterminate for rubella antibodies in weighted analyses. Seroprevalence was positively associated with age of the child and province, with seropositivity highest in Bandundu (53%) and lowest in Kasai-Oriental (20%). In multivariate analyses, serologic evidence of infection was associated with age of the mother and child, socioeconomic status and geographic location. Rubella infection is prevalent among children in the DRC, and while most seroconversion occurs in young children, a significant proportion of children remain at risk and may enter reproductive age susceptible to rubella infection. While not currently in place, implementation of a surveillance program will provide improved estimates of both rubella virus circulation and the burden of congenital rubella syndrome. Such information will play an important role in future policy decisions, vaccine delivery strategies and may provide a basis upon which the effectiveness of rubella antigen introduction may be assessed.

Pyrethroid, DDT and malathion resistance in the malaria vector Anopheles gambiae from the Democratic Republic of Congo.

PubMed

Basilua Kanza, Jean Pierre; El Fahime, Elmostafa; Alaoui, Sanaa; Essassi, El Mokhtar; Brooke, Basil; Nkebolo Malafu, André; Watsenga Tezzo, Francis

2013-01-01

Malaria remains the most important parasitic disease in sub-Saharan Africa. We investigated the extent of resistance in the malaria vector Anopheles gambiae from the Democratic Republic of Congo (DRC) to three classes of insecticide approved by WHO for indoor residual spraying. Standard WHO bioassays were performed on adult Anopheles mosquitoes reared in the laboratory from larvae collected from different sites. Molecular techniques were used for species identification and to identify knockdown resistance (kdr) and acetylcholinesterase (ace-1(R)) mutations in individual mosquitoes. Only A. gambiae s.s., the nominal member of the A. gambiae species complex, was found. Bioassays showed phenotypic resistance to the main insecticides used in the region, notably pyrethroids (deltamethrin, permethrin, lambda-cyhalothrin), an organochlorine (DDT) and an organophosphate (malathion). The L1014F kdr allele, often associated with resistance to pyrethroids and DDT, was detected in samples from all collection sites at varying frequencies. No ace-1(R) resistance alleles (associated with organophosphate and carbamate resistance) were detected. These data can be used to inform a resistance management strategy that requires comprehensive information concerning malaria vector species composition in the areas of interest, and their susceptibility to the insecticides proposed for their control.

Urinary testosterone levels of wild male bonobos (Pan paniscus) in the Lomako Forest, Democratic Republic of Congo.

PubMed

Marshall, Andrew J; Hohmann, Gottfried

2005-01-01

We collected urine samples from seven male bonobos (Pan paniscus) in the Eyengo community, Lomako Forest, Democratic Republic of Congo, and assayed them for testosterone (T). T levels averaged 525 pmol/mg Cr in adult males, and 309 pmol/mg Cr in subadult males. We collected hormonal and behavioral data during a period of relative social instability following the recent arrival of two immigrant males. In concordance with predictions derived from the challenge hypothesis [Wingfield et al., American Naturalist 136:829-846, 1990], which relates T to levels of reproductive aggression, the alpha male had the highest circulating levels of T. When we removed the two recent immigrant males from the analysis, there was a significant positive correlation between T levels and dominance rank for the long-term resident males (n=5, P=0.001, r2=0.98). These are the first data on T levels in wild bonobos, and the results suggest that further study of the relationship between T levels and social context in this species could inform current models relating hormones and aggression in wild apes. (c) 2005 Wiley-Liss, Inc.

[Change management: An analysis of actors; perceptions about technical assistance in the Democratic Republic of Congo].

PubMed

Ribesse, Nathalie; Iyeti, Alain; Macq, Jean

2015-01-01

Technical assistance (TA) is a common component of health system strengthening interventions. This type of intervention is too often designed and evaluated according to a logic that fails to take into account social complexity. Actors' perceptions are one element of this complexity. This article presents a study conducted in the Democratic Republic of Congo designed to identify perceptions concerning two types of technical support providers for health system strengthening: long-term technical assistants (agents of development agencies) and provincial technical advisors (agents of the Ministry of Health). Interviews were conducted with an innovative tool inspired by the principles of systems thinking. Interviewees were actors involved in a TA intervention in the province of Bandundu. Their expectations regarding TA providers were identified in terms of personal characteristics (knowledge, know-how and interpersonal skills), roles, and styles of interaction for capacity building ("interventionist/ prescriptive axes"). Interviewees emphasized the importance of mutual learning and the quality of interactions, which depends on TA provider's interpersonal skills and mutual willingness. Perceptions of TA provider's characteristics tend to be similar, but several differences were observed concerning the expectations about the roles of TAs, and the style that should be adopted for capacity building. Ignoring these differences in expectations may be a threat to the effectiveness of TA.

Polio immunity and the impact of mass immunization campaigns in the Democratic Republic of the Congo.

PubMed

Voorman, Arend; Hoff, Nicole A; Doshi, Reena H; Alfonso, Vivian; Mukadi, Patrick; Muyembe-Tamfum, Jean-Jacques; Wemakoy, Emile Okitolonda; Bwaka, Ado; Weldon, William; Gerber, Sue; Rimoin, Anne W

2017-10-09

In order to prevent outbreaks from wild and vaccine-derived poliovirus, maintenance of population immunity in non-endemic countries is critical. We estimated population seroprevalence using dried blood spots collected from 4893 children 6-59months olds in the 2013-2014 Demographic and Health Survey in the Democratic Republic of the Congo (DRC). Population immunity was 81%, 90%, and 70% for poliovirus types 1, 2, and 3, respectively. Among 6-59-month-old children, 78% reported at least one dose of polio in routine immunization, while only 15% had three doses documented on vaccination cards. All children in the study had been eligible for at least two trivalent oral polio vaccine campaigns at the time of enrollment; additional immunization campaigns seroconverted 5.0%, 14%, and 5.5% of non-immune children per-campaign for types 1, 2, and 3, respectively, averaged over relevant campaigns for each serotype. Overall polio immunity was high at the time of the study, though pockets of low immunity cannot be ruled out. The DRC still relies on supplementary immunization campaigns, and this report stresses the importance of the quality and coverage of those campaigns over their quantity, as well as the importance of routine immunization. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo

PubMed Central

Ilunga-Ilunga, Félicien; Levêque, Alain; Ngongo, Léon Okenge; Laokri, Samia; Dramaix, Michèle

2015-01-01

Background: In the Democratic Republic of Congo (DRC), few studies have focused on treatment-seeking paths selected by caretakers for the management of severe childhood malaria in an urban environment. The present study aims at describing the treatment-seeking paths according to the characteristics of households, as well as the subsequent impact on pre-hospitalisation delay and malarial fatality and on the main syndromes associated with severe childhood malaria. Methods: This descriptive study included data collected at nine hospitals in Kinshasa between January and November 2011. A total of 1,350 children, under 15 years of age and hospitalised for severe malaria, were included in the study. Results: Regarding the management of malaria, 31.5% of households went directly to the health centre or hospital while 68.5% opted for self-medication, church and/or traditional healing therapy. The most frequent first-line option was self-medication, adopted by more than 61.5% of households. Nevertheless, rational self-medication using antimalarial drugs recommended by the WHO (artemisinin-based combinations) was reported for only 5.5% of children. Only 12.5% of households combined 2 or 3 traditional options. The following criteria influenced the choice of a modern vs. traditional path: household socioeconomic level, residential environment, maternal education level and religious beliefs. When caretakers opted for traditional healing therapy, the pre-hospitalisation delay was longer and the occurrence of respiratory distress, severe anaemia and mortality was higher. Conclusion: The implementation of a malaria action plan in the Democratic Republic of Congo should take into account the diversity and pluralistic character of treatment-seeking behaviours in order to promote the most appropriate options (hospital and rational self-medication) and to avoid detrimental outcomes. PMID:25729313

[Determinants of survival in HIV patients receiving antiretroviral therapy in Goma, Democratic Republic of Congo].

PubMed

Akilimali, P Z; Mutombo, P B; Kayembe, P K; Kaba, D K; Mapatano, M A

2014-06-01

The study aimed to identify factors associated with the survival of patients receiving antiretroviral therapy. A historic cohort of HIV patients from two major hospitals in Goma (Democratic Republic of Congo) was followed from 2004 to 2012. The Kaplan-Meier method was used to describe the probability of survival as a function of time since inclusion into the cohort. The log-rank test was used to compare survival curves based on determinants. The Cox regression model identified the determinants of survival since treatment induction. The median follow-up time was 3.56 years (IQR=2.22-5.39). The mortality rate was 40 deaths per 1000 person-years. Male gender (RR: 2.56; 95 %CI 1.66-4.83), advanced clinical stage (RR: 2.12; 95 %CI 1.15-3.90), low CD4 count (CD4 < 50) (RR: 2.05; 95 %CI : 1.22-3.45), anemia (RR: 3.95; 95 %CI 2.60-6.01), chemoprophylaxis with cotrimoxazole (RR: 4.29, 95 % CI 2.69-6.86) and period of treatment initiation (2010-2011) (RR: 3.34; 95 %CI 1.24-8.98) were statistically associated with short survival. Initiation of treatment at an early stage of the disease with use of less toxic molecules and an increased surveillance especially of male patients are recommended to reduce mortality. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Understanding How Solidarity Groups-A Community-Based Economic and Psychosocial Support Intervention-Can Affect Mental Health for Survivors of Conflict-Related Sexual Violence in Democratic Republic of the Congo.

PubMed

Koegler, Erica; Kennedy, Caitlin; Mrindi, Janvier; Bachunguye, Richard; Winch, Peter; Ramazani, Paul; Makambo, Maphie Tosha; Glass, Nancy

2018-06-01

Solidarity groups were established in eastern Democratic Republic of Congo to provide female survivors of conflict-related sexual violence an opportunity to generate income, establish networks of support, and cope with atrocities. Qualitative data were collected from 12 members of solidarity groups to explore factors that contributed to members' mental health. All women identified some improvement (physiological, psychological, economic, or social) since joining the solidarity group, but none of the women were free from ailments. Our findings suggest that a multifaceted intervention in women's own communities has the potential to improve multiple aspects of women's lives, including mental health.

The incidence of induced abortion in Kinshasa, Democratic Republic of Congo, 2016

PubMed Central

Kayembe, Patrick K.; Philbin, Jesse; Mabika, Crispin; Bankole, Akinrinola

2017-01-01

Background In the Democratic Republic of Congo, the penal code prohibits the provision of abortion. In practice, however, it is widely accepted that the procedure can be performed to save the life of a pregnant woman. Although abortion is highly restricted, anecdotal evidence indicates that women often resort to clandestine abortions, many of which are unsafe. However, to date, there are no official statistics or reliable data to support this assertion. Objectives Our study provides the first estimates of the incidence of abortion and unintended pregnancy in Kinshasa. Methods We applied the Abortion Incidence Complications Method (AICM) to estimate the incidence of abortion and unintended pregnancy. We used data from a Health Facilities Survey and a Prospective Morbidity Survey to determine the annual number of women treated for abortion complications at health facilities. We also employed data from a Health Professionals Survey to calculate a multiplier representing the number of abortions for every induced abortion complication treated in a health facility. Results In 2016, an estimated 37,865 women obtained treatment for induced abortion complications in health facilities in Kinshasa. For every woman treated in a facility, almost four times as many abortions occurred. In total, an estimated 146,713 abortions were performed, yielding an abortion rate of 56 per 1,000 women aged 15–49. Furthermore, more than 343,000 unintended pregnancies occurred, resulting in an unintended pregnancy rate of 147 per 1,000 women aged 15–49. Conclusions Increasing contraceptive uptake can reduce the number of women who experience unintended pregnancies, and as a consequence, result in fewer women obtaining unsafe abortions, suffering abortion complications, and dying needlessly from unsafe abortion. Increasing access to safe abortion and improving post-abortion care are other measures that can be implemented to reduce unsafe abortion and/or its negative consequences, including

The incidence of induced abortion in Kinshasa, Democratic Republic of Congo, 2016.

PubMed

Chae, Sophia; Kayembe, Patrick K; Philbin, Jesse; Mabika, Crispin; Bankole, Akinrinola

2017-01-01

In the Democratic Republic of Congo, the penal code prohibits the provision of abortion. In practice, however, it is widely accepted that the procedure can be performed to save the life of a pregnant woman. Although abortion is highly restricted, anecdotal evidence indicates that women often resort to clandestine abortions, many of which are unsafe. However, to date, there are no official statistics or reliable data to support this assertion. Our study provides the first estimates of the incidence of abortion and unintended pregnancy in Kinshasa. We applied the Abortion Incidence Complications Method (AICM) to estimate the incidence of abortion and unintended pregnancy. We used data from a Health Facilities Survey and a Prospective Morbidity Survey to determine the annual number of women treated for abortion complications at health facilities. We also employed data from a Health Professionals Survey to calculate a multiplier representing the number of abortions for every induced abortion complication treated in a health facility. In 2016, an estimated 37,865 women obtained treatment for induced abortion complications in health facilities in Kinshasa. For every woman treated in a facility, almost four times as many abortions occurred. In total, an estimated 146,713 abortions were performed, yielding an abortion rate of 56 per 1,000 women aged 15-49. Furthermore, more than 343,000 unintended pregnancies occurred, resulting in an unintended pregnancy rate of 147 per 1,000 women aged 15-49. Increasing contraceptive uptake can reduce the number of women who experience unintended pregnancies, and as a consequence, result in fewer women obtaining unsafe abortions, suffering abortion complications, and dying needlessly from unsafe abortion. Increasing access to safe abortion and improving post-abortion care are other measures that can be implemented to reduce unsafe abortion and/or its negative consequences, including maternal mortality.

Virulent strain of African swine fever virus eclipses its attenuated derivative after challenge.

PubMed

Titov, Ilya; Burmakina, Galina; Morgunov, Yuriy; Morgunov, Sergey; Koltsov, Andrey; Malogolovkin, Alexander; Kolbasov, Denis

2017-10-01

African swine fever (ASF) is one of the most devastating diseases affecting the swine industry worldwide. No effective vaccine is currently available for disease prevention and control. Although live attenuated vaccines (LAV) have demonstrated great potential for immunizing against homologous strains of African swine fever virus (ASFV), adverse reactions from LAV remain a concern. Here, by using a homologous ASFV Congo strain system, we show passage-attenuated Congo LAV to induce an efficient protective immune response against challenge with the virulent parental Congo strain. Notably, only the parental challenge Congo strain was identified in blood and organs of recovered pigs through B602L gene PCR, long-range PCR, nucleotide sequencing and virus isolation. Thus, despite the great protective potential of homologous attenuated ASFV strain, the challenge Congo strain can persist for weeks in recovered pigs and a recrudescence of virulent virus at late time post-challenge may occur.

Preventing vertical transmission of HIV in Kinshasa, Democratic Republic of the Congo: a baseline survey of 18 antenatal clinics.

PubMed

Behets, Frieda Mtf; Matendo, Richard; Vaz, Lara Me; Kilese, Nick; Nanlele, Diderot; Kokolomami, Jack; Okitolando, Emile W; Van Rie, Annelies

2006-12-01

To assess the content and delivery of essential antenatal services before implementation of programmes for prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV). We assessed 18 antenatal care centres (eight public units and ten managed by nongovernmental organizations) in Kinshasa, Democratic Republic of the Congo. We used a survey to capture information about the number and type of antenatal health workers, infrastructure capacity and the delivery of basic antenatal care services such as: nutritional counselling; tetanus toxoid vaccination; prevention and management of anaemia, malaria, sexually transmitted infections, and tuberculosis; and counselling for postpartum contraception. Antenatal care units differed with respect to size, capacity, cost, service delivery systems and content. For instance, 17 of the 18 sites offered anaemia screening but only two sites included the cost in the card that gives access to antenatal care. Nine of the clinics (50%) reported providing the malaria prophyalxis sulfadoxine pyrimethamine as per national policy. Four (22%) of the sites offered syphilis screening. Scaling up PMTCT programmes in under-resourced settings requires evaluation and strengthening of existing basic antenatal care service delivery.

Beyond the hype? The response to sexual violence in the Democratic Republic of the Congo in 2011 and 2014.

PubMed

Hilhorst, Dorothea; Douma, Nynke

2018-01-01

The Democratic Republic of the Congo (DRC) has witnessed a high prevalence of sexual violence since the wars of the mid-1990s. The huge response to it commenced around the turn of the century, but turned to 'hype' towards 2010. The paper defines 'hypes' as phenomena characterised by a media frenzy, eagerness by non-governmental organisations, and pragmatic local responses. Interviews and analyses conducted in 2011 revealed misuse of services and misrepresentation at different levels. The paper goes on to review medical and legal assistance and to provide evidence of incremental improvements in the response since 2012. It has become better coordinated, with more engagement by the DRC government, more community-oriented, and has incorporated a broader notion of gender-based violence. Nonetheless, concern remains about its impact and its continued dependence on international resources. There is apprehension too about social reactions to the problems of corruption and impunity, seemingly adding to the confusion surrounding gender relations in the country. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Correlates of ever had sex and of recent sex among teenagers and young unmarried adults in the Democratic Republic of Congo.

PubMed

Kayembe, Kalambayi Patrick; Mapatano, Mala Ali; Busangu, Fatuma Alphonsine; Nyandwe, Kyloka Jean; Mashinda, Kulimba Désiré; Musema, Mulakilwa Godefroid; Kibungu, Jocelyne Pemba; Matamba, Tshingombe Léonard; Mayala, Mabasi Godefroid

2008-07-01

The future of the HIV/AIDS epidemic in the Democratic Republic of Congo will depend on the behavior that teenagers and young adults are likely to adopt. Documenting teenagers and young adults behavior can help design effective interventions. The premarital sexual activity of 13,091 teenagers and young adults aged 15-24 years was examined. Logistic regression models were used to identify the correlates of ever had sex and recent sex. Ever had sex and recent sex were associated with older individuals, males, school dropouts, those addicted to alcohol and drug use, those living alone or with friends, those involved in an income generating activity, those with low capacity to resist sex, those with low socio-economic status and those living in permissive milieu. Controlling access to alcohol and drugs, teaching teenagers skills to resist sex, getting schools involved in teaching values of abstinence and delayed sex, could impact the age at first sex and trigger the adoption of lower risk behavior.

Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo

PubMed Central

Scott, Jennifer; Rouhani, Shada; Greiner, Ashley; Albutt, Katherine; Kuwert, Philipp; Hacker, Michele R; VanRooyen, Michael; Bartels, Susan

2015-01-01

Objectives Assess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children. Design Participants were recruited using respondent-driven sampling. Setting Bukavu, Democratic Republic of Congo in 2012. Participants 757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother. Intervention Trained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent. Outcome measures Symptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed. Results 48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria. Conclusions Women raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may

Antecedent causes of a measles resurgence in the Democratic Republic of the Congo

PubMed Central

Scobie, Heather Melissa; Ilunga, Benoît Kebela; Mulumba, Audry; Shidi, Calixte; Coulibaly, Tiekoura; Obama, Ricardo; Tamfum, Jean-Jacques Muyembe; Simbu, Elisabeth Pukuta; Smit, Sheilagh Brigitte; Masresha, Balcha; Perry, Robert Tyrrell; Alleman, Mary Margaret; Kretsinger, Katrina; Goodson, James

2015-01-01

Introduction Despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes. Methods We conducted a descriptive epidemiological analysis using measles immunization and surveillance data to understand the causes of the measles resurgence and to develop recommendations for elimination efforts in DRC. Results During 2004-2012, performance indicator targets for case-based surveillance and routine measles vaccination were not met. Estimated coverage with the routine first dose of measles-containing vaccine (MCV1) increased from 57% to 73%. Phased supplementary immunization activities (SIAs) were conducted starting in 2002, in some cases with sub-optimal coverage (≤95%). In 2010, SIAs in five of 11 provinces were not implemented as planned, resulting in a prolonged interval between SIAs, and a missed birth cohort in one province. During July 1, 2010-December 30, 2012, high measles attack rates (>100 cases per 100,000 population) occurred in provinces that had estimated MCV1 coverage lower than the national estimate and did not implement planned 2010 SIAs. The majority of confirmed case-patients were aged <10 years (87%) and unvaccinated or with unknown vaccination status (75%). Surveillance detected two genotype B3 and one genotype B2 measles virus strains that were previously identified in the region. Conclusion The resurgence was likely caused by an accumulation of unvaccinated, measles-susceptible children due to low MCV1 coverage and suboptimal SIA implementation. To achieve the regional goal of measles elimination by 2020, efforts are needed in DRC to improve case-based surveillance and increase two-dose measles vaccination coverage through routine services and SIAs. PMID:26401224

Antecedent causes of a measles resurgence in the Democratic Republic of the Congo.

PubMed

Scobie, Heather Melissa; Ilunga, Benoît Kebela; Mulumba, Audry; Shidi, Calixte; Coulibaly, Tiekoura; Obama, Ricardo; Tamfum, Jean-Jacques Muyembe; Simbu, Elisabeth Pukuta; Smit, Sheilagh Brigitte; Masresha, Balcha; Perry, Robert Tyrrell; Alleman, Mary Margaret; Kretsinger, Katrina; Goodson, James

2015-01-01

Despite accelerated measles control efforts, a massive measles resurgence occurred in the Democratic Republic of the Congo (DRC) starting in mid-2010, prompting an investigation into likely causes. We conducted a descriptive epidemiological analysis using measles immunization and surveillance data to understand the causes of the measles resurgence and to develop recommendations for elimination efforts in DRC. During 2004-2012, performance indicator targets for case-based surveillance and routine measles vaccination were not met. Estimated coverage with the routine first dose of measles-containing vaccine (MCV1) increased from 57% to 73%. Phased supplementary immunization activities (SIAs) were conducted starting in 2002, in some cases with sub-optimal coverage (≤95%). In 2010, SIAs in five of 11 provinces were not implemented as planned, resulting in a prolonged interval between SIAs, and a missed birth cohort in one province. During July 1, 2010-December 30, 2012, high measles attack rates (>100 cases per 100,000 population) occurred in provinces that had estimated MCV1 coverage lower than the national estimate and did not implement planned 2010 SIAs. The majority of confirmed case-patients were aged <10 years (87%) and unvaccinated or with unknown vaccination status (75%). Surveillance detected two genotype B3 and one genotype B2 measles virus strains that were previously identified in the region. The resurgence was likely caused by an accumulation of unvaccinated, measles-susceptible children due to low MCV1 coverage and suboptimal SIA implementation. To achieve the regional goal of measles elimination by 2020, efforts are needed in DRC to improve case-based surveillance and increase two-dose measles vaccination coverage through routine services and SIAs.

Violence, selection and infant mortality in Congo.

PubMed

Dagnelie, Olivier; Luca, Giacomo Davide De; Maystadt, Jean-François

2018-05-01

This paper documents the effects of the recent civil war in the Democratic Republic of Congo on mortality both in utero and during the first year of life. It instruments for conflict intensity using a mineral price index, which exploits the exogenous variation in the potential value of mineral resources generated by changes in world mineral prices to predict the geographic distribution of the conflict. Using estimates of civil war exposure on mortality across male and female newborn to assess their relative health, it provides evidence of culling effect (in utero selection) as a consequence of in utero shocks. Copyright © 2018 Elsevier B.V. All rights reserved.

Localised transmission hotspots of a typhoid fever outbreak in the Democratic Republic of Congo.

PubMed

Ali, Engy; Bergh, Rafael Van Den; D'hondt, Rob; Kuma-Kuma, Donat; Weggheleire, Anja De; Baudot, Yves; Lambert, Vincent; Hunter, Paul; Zachariah, Rony; Maes, Peter

2017-01-01

In a semi-urban setting in the Democratic Republic of Congo, this study aims to understand the dynamic of a typhoid fever (TF) outbreak and to assess: a) the existence of hot spots for TF transmission and b) the difference between typhoid cases identified within those hot spots and the general population in relation to socio-demographic characteristics, sanitation practice, and sources of drinking water. This was a retrospective analysis of TF outbreaks in 2011 in Kikwit, DRC using microbiological analysis of water sources and a structured interview questionnaire. There were a total of 1430 reported TF cases. The outbreak's epidemic curve shows earliest and highest peak attack rates (AR) in three military camps located in Kikwit (Ebeya 3.2%; Ngubu 3.0%; and Nsinga 2.2%) compared to an average peak AR of 0.6% in other affected areas. A total 320 cases from the military camps and the high burden health areas were interviewed. Typhoid cases in the military camps shared a latrine with more than one family (P<0.02). All tap water sources in both the military camps and general population were found to be highly contaminated with faecal coliforms. The role of military camps in Kikwit as early hotspots of TF transmission was likely associated with lower sanitary and hygiene conditions. The proximity of camps to the general population might have been responsible for disseminating TF to the general population. Mapping of cases during an outbreak could be crucial to identify hot spots for transmission and institute corrective measures.

Localised transmission hotspots of a typhoid fever outbreak in the Democratic Republic of Congo

PubMed Central

Ali, Engy; Bergh, Rafael Van Den; D’hondt, Rob; Kuma-Kuma, Donat; Weggheleire, Anja De; Baudot, Yves; Lambert, Vincent; Hunter, Paul; Zachariah, Rony; Maes, Peter

2017-01-01

Introduction In a semi-urban setting in the Democratic Republic of Congo, this study aims to understand the dynamic of a typhoid fever (TF) outbreak and to assess: a) the existence of hot spots for TF transmission and b) the difference between typhoid cases identified within those hot spots and the general population in relation to socio-demographic characteristics, sanitation practice, and sources of drinking water. Methods This was a retrospective analysis of TF outbreaks in 2011 in Kikwit, DRC using microbiological analysis of water sources and a structured interview questionnaire. Results There were a total of 1430 reported TF cases. The outbreak’s epidemic curve shows earliest and highest peak attack rates (AR) in three military camps located in Kikwit (Ebeya 3.2%; Ngubu 3.0%; and Nsinga 2.2%) compared to an average peak AR of 0.6% in other affected areas. A total 320 cases from the military camps and the high burden health areas were interviewed. Typhoid cases in the military camps shared a latrine with more than one family (P<0.02). All tap water sources in both the military camps and general population were found to be highly contaminated with faecal coliforms. Conclusion The role of military camps in Kikwit as early hotspots of TF transmission was likely associated with lower sanitary and hygiene conditions. The proximity of camps to the general population might have been responsible for disseminating TF to the general population. Mapping of cases during an outbreak could be crucial to identify hot spots for transmission and institute corrective measures. PMID:29541325

Close Relationship between West Nile Virus from Turkey and Lineage 1 Strain from Central African Republic

PubMed Central

Ergunay, Koray; Bakonyi, Tamas; Nowotny, Norbert

2015-01-01

We sequenced West Nile viruses (WNVs) from Turkey and found close relationships to WNV lineage 1 strain ArB310/67 from the Central African Republic, distinct from other WNVs circulating in the Mediterranean Basin, eastern Europe, and the Middle East. These findings suggest independent introductions of WNV strains from Africa to the Middle East. PMID:25625703

Winning the battle against the scourge of poliomyelitis in the African Region.

PubMed

Moeti, Matshidiso

2016-10-10

Recently we have recorded some progress against the transmission of poliovirus in the African Region. This is attributable to a number of factors, including commitment of global partnerships against polio, improvement of existing strategies as well as a number of innovations in response to the disease in the Region. The WHO Regional Office in Africa documented these practices that led to the noticeable progress in the polio eradication initiative in the African Region, as lessons learnt and as part of polio legacy planning. The documentation exercise covered eight countries, namely Angola, Chad, Cote d'Ivoire, Democratic Republic of Congo, Ethiopia, Nigeria, Tanzania and Togo. A number of practices were identified. Some of these practices cut across countries while others were peculiar to specific countries. We have thus developed some manuscripts to capture these practices for publication in scientific journal so as to place them in the public domain for use. It is hoped that these practices will be deployed to other public health programmes in the Region and beyond. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Satellite-based primary forest degradation assessment in the Democratic Republic of the Congo, 2000-2010

NASA Astrophysics Data System (ADS)

Zhuravleva, I.; Turubanova, S.; Potapov, P.; Hansen, M.; Tyukavina, A.; Minnemeyer, S.; Laporte, N.; Goetz, S.; Verbelen, F.; Thies, C.

2013-06-01

Primary forest extent, loss and degradation within the Democratic Republic of the Congo (DRC) were quantified from 2000 to 2010 by combining directly mapped forest cover extent and loss data (CARPE) with indirectly mapped forest degradation data (intact forest landscapes, IFL). Landsat data were used to derive both map inputs, and data from the GLAS (Geoscience Laser Altimetry System) sensor were employed to validate the discrimination of primary intact and primary degraded forests. In the year 2000, primary humid tropical forests occupied 104 455 kha of the country, with 61% of these forests classified as intact. From 2000 to 2010, 1.02% of primary forest cover was lost due to clearing, and almost 2% of intact primary forests were degraded due to alteration and fragmentation. While primary forest clearing increased by a factor of two between 2000-2005 and 2005-2010, the degradation of intact forests slightly decreased. Fragmentation and selective logging were the leading causes of intact forest degradation, accounting for 91% of IFL area change. The 10 year forest degradation rate within designated logging permit areas was 3.8 times higher compared to other primary forest areas. Within protected areas the forest degradation rate was 3.7 times lower than in other primary forest areas. Forest degradation rates were high in the vicinity of major urban areas. Given the observed forest degradation rates, we infer that the degradation of intact forests could increase up to two-fold over the next decade.

Toxoplasmosis among pregnant women: High seroprevalence and risk factors in Kinshasa, Democratic Republic of Congo

PubMed Central

Yobi, Doudou; Piarroux, Renaud; L'Ollivier, Coralie; Franck, Jacqueline; Situakibanza, Hypolite; Muhindo, Hypolite; Mitashi, Patrick; Inocêncio da Luz, Raquel Andreia; Van Sprundel, Marc; Boelaert, Marleen; Van Geertruyden, Jean-Pierre; Lutumba, Pascal

2014-01-01

Objective To determine the seroprevalence of toxoplasmosis in pregnant women, as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo. Methods Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate. They were interviewed with a structured questionnaire about known risk factors (age, meat consumption, contact with soil, and presence of cat) and a venous blood sample was taken. Sera were analysed for total immunoglobulins (Ig) by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay. IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity. Results A total of 781 women were included. Median age was 28 years old (IQR: 8.5). And 627 women (80.3%; 95% CI: 77.5-83.1) were found to be positive to total Ig and 17 out of 387 (4.4%; 95% CI: 2.3-6.4) were positive to IgM. IgG avidity was low for 2 (11.8%) women, intermediate for 2 (11.8%) and high for 13 women (76.4%). There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed. Conclusion In Kinshasa, toxoplasmosis endemicity is highly prevalent. One woman out of twenty five had a recent toxoplasmosis infection and 20% were not protected against primo-infection, indicating a need for measures to prevent and control toxoplasmosis during pregnancy. PMID:24144134

Prevalence of River Epilepsy in the Orientale Province in the Democratic Republic of the Congo

PubMed Central

Colebunders, Robert; Tepage, Floribert; Rood, Ente; Mandro, Michel; Abatih, Emmanuel Nji; Musinya, Gisele; Mambandu, Germain; Kabeya, José; Komba, Michel; Levick, Bethany; Mokili, John L; Laudisoit, Anne

2016-01-01

Background An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. Objective To determine the prevalence and distribution of epilepsy in an onchocerciasis endemic region in the Democratic Republic of the Congo (DRC). Design/Methods An epilepsy prevalence study was carried out in 2014, in two localities of the Bas-Uélé district, an onchocerciasis endemic region in the Orientale Province of the DRC. Risk factors for epilepsy were identified using a random effects logistic regression model and the distribution of epilepsy cases was investigated using the Moran’s I statistic of spatial auto-correlation. Results Among the 12,776 individuals of Dingila, 373 (2.9%) individuals with epilepsy were identified. In a house-to-house survey in Titule, 68 (2.3%) of the 2,908 people who participated in the survey were found to present episodes of epilepsy. Epilepsy showed a marked spatial pattern with clustering of cases occurring within and between adjacent households. Individual risk of epilepsy was found to be associated with living close to the nearest fast flowing river where blackflies (Diptera: Simuliidae)–the vector of Onchocerca volvulus–oviposit and breed. Conclusions The prevalence of epilepsy in villages in the Bas-Uélé district in the DRC was higher than in non-onchocerciasis endemic regions in Africa. Living close to a blackflies infested river was found to be a risk factor for epilepsy. PMID:27139245

[How to optimize the efficiency of international sanitary aid in the Democratic Republic of Congo].

PubMed

Kuwekita, Joseph Manzambi; Bruyère, Olivier; Guillaume, Michèle; Gosset, Christiane; Reginster, Jean-Yves

2015-01-01

Analysis of national health insurance accounts in the Democratic Republic of Congo (DRC) clearly shows the importance of international sanitary aid, particularlyfor thefunding ofgeneral referral hospitals, the management of inpatients with AIDS, administration of health zones andfunding of preventive care providers. It The targeted changes described in this article could possibly optimize the efficiency ofinternational aidfor the DRC population, mainly for disorders considered to be a health care priority (i.e. malaria, AIDS, tuberculosis) as well as in the fight against malnutrition. Recommendations target the implementation of procedures for control offood chain security, changes in lifestyle and dietary habits of the population but also comprise extensive restructuring of the health care administration. A dramatic change of the structure in charge of drug distribution as well as eradication of the transfer of part of public health structure income to public health administrative personnel could result in the allocation of significantfunds to thefight against the most important diseases. Better collaboration between the various departments in charge of health care professional training, together with enhanced responsibility of health care personnel is essential. Independent and respected non-governmental organizations should be involved in an audit process, targeting all aspects of the current DRC health system. Eventually, in an equal opportunity perspective, taking into consideration the very high degree of poverty ofDRC inhabitants, implementation of health insurance programmes, use ofgeneric drugs and generalization ofmicro-credit initiatives should also be implemented.

Diagnosis of smear-negative pulmonary tuberculosis based on clinical signs in the Republic of Congo.

PubMed

Linguissi, Laure Stella Ghoma; Vouvoungui, Christevy Jeannhey; Poulain, Pierre; Essassa, Gaston Bango; Kwedi, Sylvie; Ntoumi, Francine

2015-12-18

The diagnosis of pulmonary tuberculosis (PTB) and smear-negative pulmonary tuberculosis (SNPT) in resource-limited countries is often solely based on clinical signs, chest X-ray radiography and sputum smear microscopy. We investigated currently used methods for the routine diagnosis of SNPT in the Republic of Congo (RoC) among TB suspected patients. The specific case of HIV positive patients was also studied. A cross-sectional study was conducted at the anti-tuberculosis center (CAT) of Brazzaville, RoC. Tuberculosis suspects were examined for physical signs of TB. Clinical signs, results from sputum smear microscopy, tuberculin skin test (TST) and chest X-ray were recorded. Of the 772 enrolled participants, 372 were diagnosed PTB. Cough was a common symptom for PTB and no PTB patients. Pale skin, positive TST, weight loss and chest X-ray with abnormalities compatible with PTB (PTB-CXR) were significant indicators of PTB. Thirty-six percent of PTB patients were diagnosed SNPT. This category of patients presented less persistent cough and less PTB-CXR. Anorexia and asthenia were significant indicators of SNPT. In the case of HIV+ patients, 57% were SNPT with anorexia, asthenia and shorter cough being strong indicators of SNPT. Chest X-ray abnormalities, weight loss, pale skin and positive TST were significant indicators of PTB. Anorexia and asthenia showed good diagnostic performance for SNPT, which deserve to be recommended as index indicators of SNPT diagnosis. Duration of cough is also a relevant indicator, especially for HIV+ patients.

Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique.

PubMed

Ho, Lara S; Labrecque, Guillaume; Batonon, Isatou; Salsi, Viviana; Ratnayake, Ruwan

2015-01-01

More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo. Between June 2012 and November 2013, 45 stories of change in the health system were collected from village development committee, health committee, community members (20 men and 18 women) and healthcare providers (n = 7) in 25 sites using the Most Significant Change technique. Stories were analyzed qualitatively for content related to the types and mechanisms of change observed. The most salient changes were related to increased transparency and community participation in health facility management, and improved quality of care. Quality of care included increased access to services, improved patient-provider relationships, improved performance of service providers, and improved maintenance of physical infrastructure. Changes occurred through many different mechanisms including provider actions in response to information, pressure from community representatives, or supervisors; and joint action and improved collaboration by health facility committees and providers. Although it is often assumed that confrontation is a primary mechanism for citizens to change state-provided services, this study demonstrates that healthcare providers may also be motivated to change through other means. Positive experiences of community scorecards can provide a structured space for interface between community members and the health system, allowing users to voice their opinions and preferences and bridge information gaps for both

Awareness and Perceptions of Emergency Contraceptive Pills Among Women in Kinshasa, Democratic Republic of the Congo.

PubMed

Hernandez, Julie H; Muanda, Mbadu; Garcia, Mélissa; Matawa, Grace

2017-09-01

Despite the commitment of the Democratic Republic of the Congo (DRC) to expand the family planning method mix and increase access to services, awareness of emergency contraception is low among women, and the method remains underused and poorly integrated in family planning programming. Data from 15 focus group discussions conducted in 2016 among women aged 15-35 were used to examine awareness and perceptions of, and attitudes toward, emergency contraceptives. After facilitators explained emergency contraceptive pills' mechanism of action and other characteristics, participants were asked about the potential benefits and risks of making the method more widely available. Transcripts were analyzed using an iterative approach. Women reported employing a wide range of postcoital contraceptive behaviors, albeit often using inappropriate products, and generally agreed that emergency contraceptive pills seemed to be a potentially effective solution to their family planning needs. Perceived benefits and limitations of the method were almost always framed in reference to other, better-known contraceptives, and women expressed strong preferences for pharmacy-based provision that aligned with their usual behaviors for obtaining contraceptives. Participants were reluctant to see the method available for free. Emergency contraceptive pills have the potential to address gaps in the family planning method mix in the DRC. Assessing whether women have incomplete or erroneous information about family planning methods can provide better understanding of women's contraceptive choices in low-income countries.

[The "health promotion" approach, a strategic alternative to teenagers' health in the Democratic Republic of Congo?].

PubMed

Nsakala, Gabriel Vodiena; Coppieters, Yves

2014-01-01

This paper describes a review of the possibilities of improving HIV/AIDS prevention and reproductive health of teenagers and adolescents in the Democratic Republic of Congo (DRC). This approach was based on compilation of institutional, political, legislative and national strategy data. The document review was completed by information collected from 15 key informants and by direct observation of the work of peer educators and community workers, allowing evaluation of the possibilities of development of the priority domains of the Ottawa Charter for Health Promotion in young adolescents. Health promotion interventions for adolescents are globally ensured institutionally by three specialized programmes of the Ministry of Health, in collaboration with numerous national and international partners. Organized operationally outside of the primary health care circuit, strategic actions are more specifically directed towards acquisition of knowledge than individual skills by means of IEC (information, education and communication) and (BCC) (behaviour change communication) approaches, but with disappointing results. Although traces of these five priority domains of the Ottawa Charter are perceptible in the national response to the health problems of adolescents, the work of the various actors is not coordinated and organized in compliance with health promotion guidelines. The training of health workers appears to be a major determinant to structure this response around a dynamic federating the actions of all stakeholders to orient them towards the options of the health promotion approach.

Investigation of elevated case-fatality rate in poliomyelitis outbreak in Pointe Noire, Republic of Congo, 2010.

PubMed

Gregory, Christopher J; Ndiaye, Serigne; Patel, Minal; Hakizamana, Elisaphan; Wannemuehler, Kathleen; Ndinga, Edouard; Chu, Susan; Talani, Pascal; Kretsinger, Katrina

2012-11-15

Multiple cases of paralysis, often resulting in death, occurred among young adults during a wild poliovirus (WPV) type 1 outbreak in Pointe Noire, Republic of Congo, in 2010. We conducted an investigation to identify factors associated with fatal outcomes among persons with poliomyelitis in Pointe Noire. Polio cases were defined as acute flaccid paralysis (AFP) cases reported from 7 October to 7 December 2010 with either a stool specimen positive for WPV or clinically classified as polio-compatible. Data were obtained from medical records, hospital databases, AFP case investigation forms and, when possible, via interviews with persons with polio or surrogates using a standard questionnaire. A total of 369 polio cases occurred in Pointe Noire between 7 October and 7 December 2010. Median age was 22 years for nonsurvivors and 18 years for survivors (P = .01). Small home size, as defined by ≤2 rooms, use of a well for drinking water during a water shortage, and age ≥15 years were risk factors for death in multivariate analysis. Consideration should be given during polio risk assessment planning and outbreak response to water/sanitation status and potential susceptibility to polio in older children and adults. Serosurveys to estimate immunity gaps in older age groups in countries at high risk of polio importation might be useful to guide preparedness and response planning.

Conventional tree height-diameter relationships significantly overestimate aboveground carbon stocks in the Central Congo Basin.

PubMed

Kearsley, Elizabeth; de Haulleville, Thales; Hufkens, Koen; Kidimbu, Alidé; Toirambe, Benjamin; Baert, Geert; Huygens, Dries; Kebede, Yodit; Defourny, Pierre; Bogaert, Jan; Beeckman, Hans; Steppe, Kathy; Boeckx, Pascal; Verbeeck, Hans

2013-01-01

Policies to reduce emissions from deforestation and forest degradation largely depend on accurate estimates of tropical forest carbon stocks. Here we present the first field-based carbon stock data for the Central Congo Basin in Yangambi, Democratic Republic of Congo. We find an average aboveground carbon stock of 162 ± 20  Mg  C  ha(-1) for intact old-growth forest, which is significantly lower than stocks recorded in the outer regions of the Congo Basin. The best available tree height-diameter relationships derived for Central Africa do not render accurate canopy height estimates for our study area. Aboveground carbon stocks would be overestimated by 24% if these inaccurate relationships were used. The studied forests have a lower stature compared with forests in the outer regions of the basin, which confirms remotely sensed patterns. Additionally, we find an average soil carbon stock of 111 ± 24  Mg  C  ha(-1), slightly influenced by the current land-use change.

The importance of education to increase the use of bed nets in villages outside of Kinshasa, Democratic Republic of the Congo.

PubMed

Ndjinga, Julie K; Minakawa, Noboru

2010-10-12

Malaria is the most prominent disease in the Democratic Republic of the Congo (DRC), and long-lasting insecticide-treated nets (LLINs) have been distributed free of charge since 2006 to combat the disease. However, the success of this bed net campaign depends on sufficient bed net use in all age groups. This study was designed to examine the factors affecting bed net use in villages outside of Kinshasa. Two villages along the Congo River, totalling 142 households with 640 residents, were surveyed using a standard questionnaire. The interview determined the number, ages, and sexes of family members; the education level of the family head; the number, colour, and type of nets owned; and the number of nets used in the previous night. The size of house was also measured, and numbers of rooms and beds were recorded. These variables were examined to reveal important factors that affect bed net use. A total of 469 nets were counted, and nearly all nets were white LLINs. Of these nets, 229 (48.8%) nets were used by 284 (44.4%) residents. Bed nets were used by over 90% of children 5 to 15 years of age, whereas less than 50% of the residents in other age groups used bed nets. The important variables affecting bed net use were numbers of beds and rooms in the house and the education level of the family head of household. Education was the most important factor affecting bed net use in the villages outside Kinshasa. Development of an educational programme, particularly one directed toward parents, is necessary to reduce misconceptions and increase prevalence of bed net use among all age groups.

High prevalence of sulphadoxine-pyrimethamine resistance-associated mutations in Plasmodium falciparum field isolates from pregnant women in Brazzaville, Republic of Congo.

PubMed

Koukouikila-Koussounda, Felix; Bakoua, Damien; Fesser, Anna; Nkombo, Michael; Vouvoungui, Christevy; Ntoumi, Francine

2015-07-01

Intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) has not been evaluated in the Republic of Congo since its implementation in 2006 and there is no published data on molecular markers of SP resistance among Plasmodium falciparum isolates from pregnant women. This first study in this country aimed to describe the prevalence of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) point mutations and haplotypes in P. falciparum isolates collected from pregnant women with asymptomatic infection. From March 2012 to December 2013, pregnant women attending Madibou health centre (in Southern Brazzaville) for antenatal visits were enrolled in this study after obtaining their written informed consent. Blood samples were collected and P. falciparum infections were characterized using PCR. A total of 363 pregnant women were enrolled. P. falciparum infection was detected in 67 (18.4%) samples as their PCR amplification of dhfr and dhps genes yielded bands and all the PCR products were successfully digested. Out of these 67 isolates, 59 (88%), 57 (85%) and 53 (79.1%) carried 51I, 59R and 108N dhfr mutant alleles, respectively. The prevalence of dhps 436A, 437G and 540E mutations were 67.1% (45/67), 98.5% (66/67) and 55.2% (37/67), respectively. More than one-half of the isolates carried quintuple mutations, with highly resistant haplotype dhfr51I/59R/108N + dhps437G/540E detected in 33% (22/67) whereas 25% (17/67) were found to carry sextuple mutations. We observed significantly higher frequencies of triple dhps mutations 436A/437G/540E and quintuple mutations dhfr51I/59R/108N+dhps437G/540E in isolates from women who received IPTp-SP than those who did not. Overall, this study shows high prevalence rates of SP-associated resistance mutations in P. falciparum isolates collected from pregnant women. The presence of the dhps mutant allele 540E and the high prevalence of isolates carrying quintuple dhfr/dhps mutations are here

Water supply interruptions and suspected cholera incidence: a time-series regression in the Democratic Republic of the Congo.

PubMed

Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H J

2015-10-01

The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54-4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile-4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%-33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91-7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%-42.5%). The analysis did not suggest any association between levels of residual

Polio Eradication Initiative (PEI) contribution in strengthening public health laboratories systems in the African region.

PubMed

Gumede, Nicksy; Coulibaly, Sheick Oumar; Yahaya, Ali Ahmed; Ndihokubwayo, Jean-Bosco; Nsubuga, Peter; Okeibunor, Joseph; Dosseh, Annick; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal; Byabamazima, Charles

2016-10-10

The laboratory has always played a very critical role in diagnosis of the diseases. The success of any disease programme is based on a functional laboratory network. Health laboratory services are an integral component of the health system. Efficiency and effectiveness of both clinical and public health functions including surveillance, diagnosis, prevention, treatment, research and health promotion are influenced by reliable laboratory services. The establishment of the African Regional polio laboratory for the Polio Eradication Initiative (PEI) has contributed in supporting countries in their efforts to strengthen laboratory capacity. On the eve of the closing of the program, we have shown through this article, examples of this contribution in two countries of the African region: Côte d'Ivoire and the Democratic Republic of Congo. Descriptive studies were carried out in Côte d'Ivoire (RCI) and Democratic Republic of Congo (DRC) from October to December 2014. Questionnaires and self-administered and in-depth interviews and group discussions as well as records and observation were used to collect information during laboratory visits and assessments. The PEI financial support allows to maintain the majority of the 14 (DRC) and 12 (RCI) staff involved in the polio laboratory as full or in part time members. Through laboratory technical staff training supported by the PEI, skills and knowledge were gained to reinforce laboratories capacity and performance in quality laboratory functioning, processes and techniques such as cell culture. In the same way, infrastructure was improved and equipment provided. General laboratory quality standards, including the entire laboratory key elements was improved through the PEI accreditation process. The Polio Eradication Initiative (PEI) is a good example of contribution in strengthening public health laboratories systems in the African region. It has established strong Polio Laboratory network that contributed to the

Identification of different trypanosome species in the mid-guts of tsetse flies of the Malanga (Kimpese) sleeping sickness focus of the Democratic Republic of Congo.

PubMed

Simo, Gustave; Silatsa, Barberine; Flobert, Njiokou; Lutumba, Pascal; Mansinsa, Philemon; Madinga, Joule; Manzambi, Emile; De Deken, Reginald; Asonganyi, Tazoacha

2012-09-19

The Malanga sleeping sickness focus of the Democratic Republic of Congo has shown an epidemic evolution of disease during the last century. However, following case detection and treatment, the prevalence of the disease decreased considerably. No active survey has been undertaken in this focus for a couple of years. To understand the current epidemiological status of sleeping sickness as well as the animal African trypanosomiasis in the Malanga focus, we undertook the identification of tsetse blood meals as well as different trypanosome species in flies trapped in this focus. Pyramidal traps were use to trap tsetse flies. All flies caught were identified and live flies were dissected and their mid-guts collected. Fly mid-gut was used for the molecular identification of the blood meal source, as well as for the presence of different trypanosome species. About 949 Glossina palpalis palpalis were trapped; 296 (31.2%) of which were dissected, 60 (20.3%) blood meals collected and 57 (19.3%) trypanosome infections identified. The infection rates were 13.4%, 5.1%, 3.5% and 0.4% for Trypanosoma congolense savannah type, Trypanosoma brucei s.l., Trypanosoma congolense forest type and Trypanosoma vivax, respectively. Three mixed infections including Trypanosoma brucei s.l. and Trypanosoma congolense savannah type, and one mixed infection of Trypanosoma vivax and Trypanosoma congolense savannah type were identified. Eleven Trypanosoma brucei gambiense infections were identified; indicating an active circulation of this trypanosome subspecies. Of all the identified blood meals, about 58.3% were identified as being taken on pigs, while 33.3% and 8.3% were from man and other mammals, respectively. The presence of Trypanosoma brucei in tsetse mid-guts associated with human blood meals is indicative of an active transmission of this parasite between tsetse and man. The considerable number of pig blood meals combined with the circulation of Trypanosoma brucei gambiense in this focus

New synonymies and new records of Afrotropical and Madagascan Pentatominae (Hemiptera: Heteroptera: Pentatomidae).

PubMed

Kment, Petr; Jindra, Zdeněk; Rider, David A

2014-09-24

The following new synonymies within the family Pentatomidae, subfamily Pentatominae, are established: Aesula Stål, 1876 = Pseudacrosternum Day, 1965, syn. nov. (Nezarini), Aesula viridissima (Signoret, 1861) = Aesula signoretiana Kirkaldy, 1909, syn. nov. = Pseudacrosternum cachani Day, 1965, syn. nov. = Pseudacrosternum cachani var. scutellatum Day, 1965, syn. nov., and Andocides vittaticeps (Stål, 1858) = Andocides vittaticeps var. viridescens Schumacher, 1913, syn. nov. Afrania brachyptera (Schaum, 1853), stat. restit., is restored as the oldest available name for that species, with Afrania wahlbergi Stål, 1854, syn. restit., being its junior synonym. Lectotype of Pentatoma viridissima Signoret, 1861 is designated, and lectotype designation of Pseudolerida incerta (Schouteden, 1909) is commented. The following new or confirmed state records are provided: Cappaeini: Leridella kenyensis Jeannel, 1913 (Cameroon), Paralerida bolivari (Schouteden, 1904) (Republic of the Congo, Uganda), P. niokana Linnavuori, 1982 (Uganda), Tripanda (Tripanda) dispar Schouteden, 1964 (Cameroon, Ghana, Liberia), T. (T.) horacekorum Kment & Jindra, 2009 (Cameroon, Guinea), T. (T.) jurickorum Kment & Jindra, 2009 (Gabon, Ivory Coast), T. (T.) longiceps (Villiers, 1967) (Democratic Republic of the Congo, Gabon), T. (T.) signitenens (Distant, 1898) (Democratic Republic of the Congo, Mozambique), T. (Tenerva) decorata (Jensen-Haarup, 1937) (Kenya, Oman, Tanzania); Carpocorini: Andocides vittaticeps (Angola); Diploxyini: Acoloba lanceolata (Fabricius, 1803) (Angola, Central African Republic, Zambia, Zimbabwe); Eysarcorini: Pseudolerida bitalensis Schouteden, 1958 (Cameroon), Pseudolerida incerta (Equatorial Guinea: Bioko Island, Tanzania, Uganda); Myrocheini: Humria bimaculicollis Linnavuori, 1975 (Botswana, Democratic Republic of the Congo, Guinea, Kenya, Mozambique, Namibia, South Africa, Zambia, Zimbabwe); Strachiini: Afrania brachyptera (Schaum, 1853) (Botswana, Democratic Republic of

Worldwide Threat Assessment of the US Intelligence Community

DTIC Science & Technology

2014-01-29

data-deletion and system- damaging attacks.  In early 2013, the US financial sector faced wide-scale network denial-of-service attacks that...South Sudan Nigeria Central African Republic Democratic Republic of the Congo Lord’s Resistance Army 19 19 19 19 19 20 20 21 21 East Asia...operations, financial activities, and personnel recruitment. Cyber criminal organizations are as ubiquitous as they are problematic on digital

Yellow Fever Outbreak - Kongo Central Province, Democratic Republic of the Congo, August 2016.

PubMed

Otshudiema, John O; Ndakala, Nestor G; Mawanda, Elande-Taty K; Tshapenda, Gaston P; Kimfuta, Jacques M; Nsibu, Loupy-Régence N; Gueye, Abdou S; Dee, Jacob; Philen, Rossanne M; Giese, Coralie; Murrill, Christopher S; Arthur, Ray R; Kebela, Benoit I

2017-03-31

On April 23, 2016, the Democratic Republic of the Congo's (DRC's) Ministry of Health declared a yellow fever outbreak. As of May 24, 2016, approximately 90% of suspected yellow fever cases (n = 459) and deaths (45) were reported in a single province, Kongo Central Province, that borders Angola, where a large yellow fever outbreak had begun in December 2015. Two yellow fever mass vaccination campaigns were conducted in Kongo Central Province during May 25-June 7, 2016 and August 17-28, 2016. In June 2016, the DRC Ministry of Health requested assistance from CDC to control the outbreak. As of August 18, 2016, a total of 410 suspected yellow fever cases and 42 deaths were reported in Kongo Central Province. Thirty seven of the 393 specimens tested in the laboratory were confirmed as positive for yellow fever virus (local outbreak threshold is one laboratory-confirmed case of yellow fever). Although not well-documented for this outbreak, malaria, viral hepatitis, and typhoid fever are common differential diagnoses among suspected yellow fever cases in this region. Other possible diagnoses include Zika, West Nile, or dengue viruses; however, no laboratory-confirmed cases of these viruses were reported. Thirty five of the 37 cases of yellow fever were imported from Angola. Two-thirds of confirmed cases occurred in persons who crossed the DRC-Angola border at one market city on the DRC side, where ≤40,000 travelers cross the border each week on market day. Strategies to improve coordination between health surveillance and cross-border trade activities at land borders and to enhance laboratory and case-based surveillance and health border screening capacity are needed to prevent and control future yellow fever outbreaks.

Mycological and aflatoxin contamination of peanuts sold at markets in Kinshasa, Democratic Republic of Congo, and Pretoria, South Africa.

PubMed

Kamika, Ilunga; Mngqawa, Pamella; Rheeder, John P; Teffo, Snow L; Katerere, David R

2014-01-01

Peanut (Arachis hypogaea L.) is an important food crop in sub-Saharan Africa. In this survey, the mycological and aflatoxin contamination of peanuts collected from Kinshasa, Democratic Republic of Congo, and Pretoria, South Africa, was assessed. Twenty peanut samples were purchased randomly at informal markets in the two cities and analysed for mycoflora and aflatoxins (AFB1, AFB2, AFG1 and AFG2) using standard methods. The results indicated that 95% of the Kinshasa samples and 100% of the Pretoria samples were contaminated with aflatoxigenic fungi in the ranges 20-49,000 and 40-21,000 CFU/g, respectively. Seventy-five per cent of the Kinshasa samples and 35% of the Pretoria samples exceeded the maximum limits of AFB1 as set by The Joint FAO/WHO Expert Committee on Food Additives. Residents of both cities are at a high risk of aflatoxin exposure despite their apparent cultural, socio-economic, geographic and climatic differences. Further work needs to be done to understand the supply chains of peanut trade in informal markets of the two countries so that interventions are well targeted on a regional rather than a national level.

Promoting children's learning and development in conflict-affected countries: Testing change process in the Democratic Republic of the Congo.

PubMed

Aber, J Lawrence; Tubbs, Carly; Torrente, Catalina; Halpin, Peter F; Johnston, Brian; Starkey, Leighann; Shivshanker, Anjuli; Annan, Jeannie; Seidman, Edward; Wolf, Sharon

2017-02-01

Improving children's learning and development in conflict-affected countries is critically important for breaking the intergenerational transmission of violence and poverty. Yet there is currently a stunning lack of rigorous evidence as to whether and how programs to improve learning and development in conflict-affected countries actually work to bolster children's academic learning and socioemotional development. This study tests a theory of change derived from the fields of developmental psychopathology and social ecology about how a school-based universal socioemotional learning program, the International Rescue Committee's Learning to Read in a Healing Classroom (LRHC), impacts children's learning and development. The study was implemented in three conflict-affected provinces of the Democratic Republic of the Congo and employed a cluster-randomized waitlist control design to estimate impact. Using multilevel structural equation modeling techniques, we found support for the central pathways in the LRHC theory of change. Specifically, we found that LRHC differentially impacted dimensions of the quality of the school and classroom environment at the end of the first year of the intervention, and that in turn these dimensions of quality were differentially associated with child academic and socioemotional outcomes. Future implications and directions are discussed.

Budget process bottlenecks for immunization financing in the Democratic Republic of the Congo (DRC).

PubMed

Le Gargasson, Jean-Bernard; Mibulumukini, Benoît; Gessner, Bradford D; Colombini, Anaïs

2014-02-19

In Democratic Republic of the Congo (DRC), the availability of domestic resources for the immunization program is limited and relies mostly on external donor support. DRC has introduced a series of reforms to move the country toward performance-based management and program budgets. The objectives of the study were to: (i) describe the budget process norm, (ii) analyze the budget process in practice and associated bottlenecks at each of its phases, and (iii) collect suggestions made by the actors involved to improve the situation. Quantitative and qualitative data were collected through: a review of published and gray literature, and individual interviews. Bottlenecks in the budget process and disbursement of funds for immunization are one of the causes of limited domestic resources for the program. Critical bottlenecks include: excessive use of off-budget procedures; limited human resources and capacity; lack of motivation; interference from ministries with the standard budget process; dependency toward the development partner's disbursements schedule; and lack of budget implementation tracking. Results show that the health sector's mobilization rate was 59% in 2011. For the credit line specific to immunization program activities, the mobilization rate for the national Expanded Program for Immunization (EPI) was 26% in 2011 and 43% for vaccines (2010). The main bottleneck for the EPI budget line (2011) and vaccine budget line (2011) occurs at the authorization phase. Budget process bottlenecks identified in the analysis lead to a low mobilization rate for the immunization program. The bottlenecks identified show that a poor flow of funds causes an insufficient percentage of already allocated resources to reach various health system levels. Copyright © 2014 Elsevier Ltd. All rights reserved.

"Reading" Central African Skies - A Case Study from Southeastern DRC

NASA Astrophysics Data System (ADS)

Roberts, Allen F.

Little is known of the local astronomies of central Africa, and because of decades of horrific civil strife, this is particularly true of the Democratic Republic of the Congo (DRC). The present case study combines archival consideration of unpublished letters by earliest European visitors with ethnographic research in the mid-1970s among Tabwa and related peoples living along the western shores of and inland from Lake Tanganyika. Early data are very sparse, and in more recent days local astronomy is little-developed; but hypotheses are nonetheless possible about how people understood the regularities of the heavens as well as astonishing events like the apparition of Sungrazer Comets of the 1880s. A mnemonic logic shared by Tabwa, Luba, and other regional groups that was sometimes given material form or realized through performance arts may have informed how central African skies were "read" in earlier times.

Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo

PubMed Central

Binanga, Arsene; Bertrand, Jane T

2016-01-01

ABSTRACT In the Democratic Republic of the Congo (DRC), the Ministry of Health authorizes only physicians and nurses to give injections, with one exception—medical and nursing students may also give injections if supervised by a clinical instructor. The emergence of the injectable contraceptive Sayana Press in some African countries prompted the DRC to test the acceptability and feasibility of distributing Sayana Press and other contraceptive methods at the community level through medical and nursing students. Sayana Press is similar in formulation to the injectable contraceptive Depo-Provera but contains a lower dose and is administered subcutaneously using a single-use syringe with a short needle called the Uniject system. The Uniject system allows Sayana Press to be administered by community health workers without clinical training or by self-injection. In this pilot, the advocacy objective was to obtain approval from the Ministry of Health to allow medical and nursing students to inject Sayana Press, as a first step toward authorization for community health workers to provide the method. The pilot described in this article documents a process whereby an innovative approach moved from concept to implementation to replication in less than 2 years. It also paved the way for testing additional progressive strategies to increase access to contraception at the community level. Because the pilot project included a research component designed to assess benefits and challenges, it provided the means to introduce the new task-shifting approach, which might not have been approved otherwise. Key pilot activities included: (1) increasing awareness of Sayana Press among family planning stakeholders at a national conference on family planning, (2) enlisting the support of key decision makers in designing the pilot, (3) obtaining marketing authorization to distribute Sayana Press in the DRC, (4) implementing the pilot from July to December 2015, (5) conducting quantitative

Pilot Research as Advocacy: The Case of Sayana Press in Kinshasa, Democratic Republic of the Congo.

PubMed

Binanga, Arsene; Bertrand, Jane T

2016-12-23

In the Democratic Republic of the Congo (DRC), the Ministry of Health authorizes only physicians and nurses to give injections, with one exception-medical and nursing students may also give injections if supervised by a clinical instructor. The emergence of the injectable contraceptive Sayana Press in some African countries prompted the DRC to test the acceptability and feasibility of distributing Sayana Press and other contraceptive methods at the community level through medical and nursing students. Sayana Press is similar in formulation to the injectable contraceptive Depo-Provera but contains a lower dose and is administered subcutaneously using a single-use syringe with a short needle called the Uniject system. The Uniject system allows Sayana Press to be administered by community health workers without clinical training or by self-injection. In this pilot, the advocacy objective was to obtain approval from the Ministry of Health to allow medical and nursing students to inject Sayana Press, as a first step toward authorization for community health workers to provide the method. The pilot described in this article documents a process whereby an innovative approach moved from concept to implementation to replication in less than 2 years. It also paved the way for testing additional progressive strategies to increase access to contraception at the community level. Because the pilot project included a research component designed to assess benefits and challenges, it provided the means to introduce the new task-shifting approach, which might not have been approved otherwise. Key pilot activities included: (1) increasing awareness of Sayana Press among family planning stakeholders at a national conference on family planning, (2) enlisting the support of key decision makers in designing the pilot, (3) obtaining marketing authorization to distribute Sayana Press in the DRC, (4) implementing the pilot from July to December 2015, (5) conducting quantitative and

Medical anthropology and Ebola in Congo: cultural models and humanistic care.

PubMed

Hewlett, B S; Epelboin, A; Hewlett, B L; Formenty, P

2005-09-01

Seldom have medical anthropologists been involved in efforts to control high mortality diseases such as Ebola hemorrhagic fever (EHF) This paper describes the results of two distinct but complementary interventions during the first phases of an outbreak in the Republic of Congo in 2003. The first approach emphasized understanding local peoples cultural models and political-economic explanations for the disease while the second approach focused on providing more humanitarian care of patients by identifying and incorporating local beliefs and practices into patient care and response efforts.

Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter?

PubMed

Kandala, Ngianga-Bakwin; Madungu, Tumwaka P; Emina, Jacques B O; Nzita, Kikhela P D; Cappuccio, Francesco P

2011-04-25

Although there are inequalities in child health and survival in the Democratic Republic of Congo (DRC), the influence of distal determinants such as geographic location on children's nutritional status is still unclear. We investigate the impact of geographic location on child nutritional status by mapping the residual net effect of malnutrition while accounting for important risk factors. We examine spatial variation in under-five malnutrition with flexible geo-additive semi-parametric mixed model while simultaneously controlling for spatial dependence and possibly nonlinear effects of covariates within a simultaneous, coherent regression framework based on Markov Chain Monte Carlo techniques. Individual data records were constructed for children. Each record represents a child and consists of nutritional status information and a list of covariates. For the 8,992 children born within the last five years before the survey, 3,663 children have information on anthropometric measures.Our novel empirical approach is able to flexibly determine to what extent the substantial spatial pattern of malnutrition is driven by detectable factors such as socioeconomic factors and can be attributable to unmeasured factors such as conflicts, political, environmental and cultural factors. Although childhood malnutrition was more pronounced in all provinces of the DRC, after accounting for the location's effects, geographic differences were significant: malnutrition was significantly higher in rural areas compared to urban centres and this difference persisted after multiple adjustments. The findings suggest that models of nutritional intervention must be carefully specified with regard to residential location. Childhood malnutrition is spatially structured and rates remain very high in the provinces that rely on the mining industry and comparable to the level seen in Eastern provinces under conflicts. Even in provinces such as Bas-Congo that produce foods, childhood malnutrition is

Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter?

PubMed Central

2011-01-01

Background Although there are inequalities in child health and survival in the Democratic Republic of Congo (DRC), the influence of distal determinants such as geographic location on children's nutritional status is still unclear. We investigate the impact of geographic location on child nutritional status by mapping the residual net effect of malnutrition while accounting for important risk factors. Methods We examine spatial variation in under-five malnutrition with flexible geo-additive semi-parametric mixed model while simultaneously controlling for spatial dependence and possibly nonlinear effects of covariates within a simultaneous, coherent regression framework based on Markov Chain Monte Carlo techniques. Individual data records were constructed for children. Each record represents a child and consists of nutritional status information and a list of covariates. For the 8,992 children born within the last five years before the survey, 3,663 children have information on anthropometric measures. Our novel empirical approach is able to flexibly determine to what extent the substantial spatial pattern of malnutrition is driven by detectable factors such as socioeconomic factors and can be attributable to unmeasured factors such as conflicts, political, environmental and cultural factors. Results Although childhood malnutrition was more pronounced in all provinces of the DRC, after accounting for the location's effects, geographic differences were significant: malnutrition was significantly higher in rural areas compared to urban centres and this difference persisted after multiple adjustments. The findings suggest that models of nutritional intervention must be carefully specified with regard to residential location. Conclusion Childhood malnutrition is spatially structured and rates remain very high in the provinces that rely on the mining industry and comparable to the level seen in Eastern provinces under conflicts. Even in provinces such as Bas-Congo that

Malunion of Long-Bone Fractures in a Conflict Zone in the Democratic Republic of Congo.

PubMed

Bauhahn, Grace; Veen, Harald; Hoencamp, Rigo; Olim, Nelson; Tan, Edward C T H

2017-09-01

Malunion is a well-recognized complication of long-bone fractures which accounts for more than 25% of injuries in conflict zones. The aim of this study was to investigate the rate of malunion sustained by casualties with penetrating gunshot wounds in an International Committee of the Red Cross (ICRC) surgical substitution project in the Democratic Republic of Congo (DRC) and compare these results with current literature. A retrospective cohort study was performed. All patients admitted to the ICRC facility between the periods of 01.10.2014 and 31.12.2015 with long-bone fractures caused by gunshot wound were included, and data were collected retrospectively from the patient's hospital notes. A total of 191 fractures caused by gunshot were treated in the DRC at the ICRC surgical substitution project during the study period. On average, the fractures were 3 days old on admission and were all open, with 62% also being comminuted. The ICRC management protocol, which emphasizes debridement, antibiotic prophylaxis and conservative fracture stabilization, was followed in all cases. Forty-eight percentage of the fractures were finally classified as 'union without complication'; however, 17% were classified as 'malunion'. This study indicates that open long-bone fractures that are managed by the ICRC surgical substitution project in DRC may have an increased likelihood of malunion as compared to long-bone fractures treated in developed countries. Patient delay and mechanism of injury may have caused increased rates of infection which are likely behind these increased rates of malunion, alongside the lack of definitive fracture treatment options made available to the surgical team.

Toxoplasmosis among pregnant women: high seroprevalence and risk factors in Kinshasa, Democratic Republic of Congo.

PubMed

Doudou, Yobi; Renaud, Piarroux; Coralie, L'Ollivier; Jacqueline, Franck; Hypolite, Situakibanza; Hypolite, Muhindo; Patrick, Mitashi; Andreia, Inocêncio da Luz Raquel; Van Sprundel, Marc; Marleen, Boelaert; Van Geertruyden, Jean-Pierre; Pascal, Lutumba

2014-01-01

To determine the seroprevalence of toxoplasmosis in pregnant women, as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo. Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate. They were interviewed with a structured questionnaire about known risk factors (age, meat consumption, contact with soil, and presence of cat) and a venous blood sample was taken. Sera were analysed for total immunoglobulins (Ig) by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay. IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity. A total of 781 women were included. Median age was 28 years old (IQR: 8.5). And 627 women (80.3%; 95% CI: 77.5-83.1) were found to be positive to total Ig and 17 out of 387 (4.4%; 95% CI: 2.3-6.4) were positive to IgM. IgG avidity was low for 2 (11.8%) women, intermediate for 2 (11.8%) and high for 13 women (76.4%). There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed. In Kinshasa, toxoplasmosis endemicity is highly prevalent. One woman out of twenty five had a recent toxoplasmosis infection and 20% were not protected against primo-infection, indicating a need for measures to prevent and control toxoplasmosis during pregnancy. Copyright © 2014 Asian Pacific Tropical Biomedical Magazine. Published by Elsevier B.V. All rights reserved.

[Risk factors for multidrug-resistant tuberculosis in the city of Kinshasa in the Democratic Republic of Congo].

PubMed

Misombo-Kalabela, André; Nguefack-Tsague, Georges; Kalla, Ginette Claude Mireille; Ze, Emmanuel Afane; Diangs, Kimpanga; Panda, Tshapenda; Kebela, Ilunga; Fueza, Serge Bisuta; Magazani, Nzanzu; Mbopi-Kéou, François-Xavier

2016-01-01

The aim of this study was to determine the risk factors for multidrug-resistant tuberculosis (TB) in the city of Kinshasa in the Democratic Republic of Congo. This was a case control study. The cases included all TB patients notified as resistant to rifampicin and isoniazid in Kinshasa from January 2012 to June 2013. The controls included TB patients treated during the same period as the cases and declared cured at the end of treatment. For this study, we obtained ethical clearance. The sample consisted of 213 participants, 132 men (62%) and 81 women (38%). The median age was 31 years (16-73 years). Factors associated with significant (p< 0,05) multidrug-resistant tuberculosis were the non-observance of the hours of taking drugs (0R = 111) (80% cases, 4% controls), the failure of treatment (0R = 20 (76% cases, 13% controls); the concept of multidrug-resistant tuberculosis in the family (0R = 6.4) (28% cases, 6% controls); a lack of knowledge of multidrug-resistant tuberculosis (0R = 3.2) (31% cases, 59% controls); a stay in prison (0R = 7.6) (10% cases, 1% controls) and the interruption of treatment (0R = 6.1) (59% cases, 19% controls). The emergence of multidrug-resistant tuberculosis can be avoided by the installation of suitable diagnosis and treatment strategies.

Female sociality during the daytime birth of a wild bonobo at Luikotale, Democratic Republic of the Congo.

PubMed

Douglas, Pamela Heidi

2014-10-01

Parturition is one of the most important yet least observed events in studies of primate life history and reproduction. Here, I report the first documented observation of a bonobo (Pan paniscus) birth event in the wild, at the Luikotale Bonobo Project field site, Democratic Republic of the Congo. The nulliparous mother's behaviour before, during and after parturition is described, along with reactions of other community members to the birth and the neonate. Data were collected through focal-animal observations, and the events postpartum were photo-documented. The behaviour and spatial distribution of party members were recorded using scan samples. Parturition occurred during the late morning in a social context, with parous females in close proximity to the parturient mother. Placentophagia occurred immediately after delivery, and the parturient shared the placenta with two of the attending females. I compare this observation with reports of parturition in captive bonobos, and highlight the observed female sociality and social support during the birth event. Plausible adaptive advantages of parturition occurring in a social context are discussed, and accrued observations of birth events in wild and free-ranging primates suggest that females may give birth within proximity of others more frequently than previously thought. This account contributes rare empirical data for examining the interface between female sociality and parturition, and the evolution of parturitional behaviours in primates.

Social support under siege: An analysis of forced migration among women from the Democratic Republic of Congo.

PubMed

Wachter, Karin; Gulbas, Lauren E

2018-07-01

In 2016, researchers conducted a qualitative study in a mid-sized town in the United States to address gaps in research and practice related to psychosocial consequences of forced migration among women. The loss of social support and its impacts on the well-being of women are rarely addressed in refugee resettlement policy or practice overwhelmingly concerned with economic self-sufficiency. The study sought to develop theory to explain how women (n = 27) who migrated from the Democratic Republic of the Congo recreate social support post-resettlement in the United States. An interpretive approach informed by postcolonial feminist perspectives guided the grounded theory methodology. A theoretical model emerged explaining pivots in the internal and relational lives of women as social support systematically constricted over time as a result of war, displacement, and resettlement. Upon arrival to the United States, women experienced partitioned lives through changing relationships to space and time, which contributed to women being alone and impacted well-being. Converging processes propelled women towards learning to stand alone, through which women could develop a sense self-reliance, but not without internal and relational consequences. The analysis contributes to the empirical literature knowledge of how resettlement is a life altering event that sets into motion psychosocial processes with implications for well-being and health. Implications for practice and future research are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Acute renal failure and severe malaria in Congolese children living in Kinshasa, Democratic Republic of Congo].

PubMed

Kunuanunua, Thomas Sengua; Nsibu, Célestin Ndosimao; Gini-Ehungu, Jean-Lambert; Bodi, Joseph Mabiala; Ekulu, Pépé Mfutu; Situakibanza, Hypolite; Nseka, Nazaire Mangani; Magoga, Kumbundu; Aloni, Michel Ntetani

2013-06-01

Data on acute renal failure in complicated malaria in children in the Democratic Republic of Congo are sparse. The objective of this study was to document the profile of acute renal failure in severe malaria in admitted patients in pediatric hospitals from Kinshasa. A prospective cohort study was conducted from January 2008 to December 2008 in children admitted in emergency units of five hospitals in Kinshasa for severe malaria. In our series, 378 children with severe malaria were included. There were 226 boys and 152 girls (sex ratio 1.49). One hundred and ninety four (194) of these patients were under 5 years old. Acute renal failure was observed in 89 children (23.6%) and 87 of them had blackwater fever (BWF). This form of severe malaria was predominant in children older than 5 years. Quinine was the commonest antimalarial drug involved in the genesis of BWF. Dialysis was indicated in 23 children (24.0%) and was effective (acute peritoneal dialysis) in 21 patients. The death rate in children with ARF was 12.6% (n=87). Recovery of renal function was obtained by conservative treatment in the remained group. This study confirmed the emergence of BWF in seemed protected autochthon children older than 5 years. BWF remained the leading cause of acute renal failure in complicated malaria among Congolese children in Kinshasa. Copyright © 2013 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Women's Education, Employment, and Fertility in Kinshasa, Congo, 1955-1990: A Descriptive Overview. Working Paper 10-97-1.

ERIC Educational Resources Information Center

Shapiro, David

This report provides a descriptive overview of women's schooling and educational attainment, employment activity, and fertility behavior in Kinshasa, the capital of the Democratic Republic of Congo. Data were used from a series of five household surveys carried out between 1955 and 1990 to see how these variables have changed during this period.…

Youth access to cigarettes in six sub-Saharan African countries.

PubMed

Chandora, Rachna; Song, Yang; Chaussard, Martine; Palipudi, Krishna Mohan; Lee, Kyung Ah; Ramanandraibe, Nivo; Asma, Samira

2016-10-01

Tobacco smoking is initiated and established mostly during adolescence. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) Article 16 outlines the obligation of parties to prohibit the sale of tobacco products to minors. This study examined where and how student smokers obtain cigarettes. We examined Global Youth Tobacco Survey (GYTS) data from 2009 to 2011 on cigarette access among students aged 13-15 in six sub-Saharan African countries. In all countries analyzed, over 20% of student smokers obtained their cigarettes in a store or shop (52.6% in South Africa, 37.7% in Republic of Congo, 28.2% in Swaziland, 27.4% in Cote d'Ivoire, 26.9% in Ghana, and 22.6% in Uganda). In Cote d'Ivoire and South Africa, 68.9% and 68.7% of student cigarette smokers, respectively, were not refused the sale of cigarettes because of age. The percentage of students who were offered free cigarettes by a tobacco company representative ranged from 4.7% in Cote d'Ivoire to 12.1% in South Africa. The method of obtaining cigarettes and access to cigarettes among students varies among sub-Saharan African countries. Adopting and enforcing interventions that prevent youth from accessing tobacco products could be an effective strategy for reducing smoking initiation among youth in sub-Saharan African countries. Copyright © 2016. Published by Elsevier Inc.

Respondent-driven sampling to assess mental health outcomes, stigma and acceptance among women raising children born from sexual violence-related pregnancies in eastern Democratic Republic of Congo.

PubMed

Scott, Jennifer; Rouhani, Shada; Greiner, Ashley; Albutt, Katherine; Kuwert, Philipp; Hacker, Michele R; VanRooyen, Michael; Bartels, Susan

2015-04-08

Assess mental health outcomes among women raising children from sexual violence-related pregnancies (SVRPs) in eastern Democratic Republic of Congo and stigma toward and acceptance of women and their children. Participants were recruited using respondent-driven sampling. Bukavu, Democratic Republic of Congo in 2012. 757 adult women raising children from SVRPs were interviewed. A woman aged 18 and older was eligible for the study if she self-identified as a sexual violence survivor since the start of the conflict (∼1996), conceived an SVRP, delivered a liveborn child and was currently raising the child. A woman was ineligible for the study if the SVRP ended with a spontaneous abortion or fetal demise or the child was not currently living or in the care of the biological mother. Trained female Congolese interviewers verbally administered a quantitative survey after obtaining verbal informed consent. Symptom criteria for major depressive disorder, post-traumatic stress disorder, anxiety and suicidality were assessed, as well as stigma toward the woman and her child. Acceptance of the woman and child from the spouse, family and community were analysed. 48.6% met symptom criteria for major depressive disorder, 57.9% for post-traumatic stress disorder, 43.3% for anxiety and 34.2% reported suicidality. Women who reported stigma from the community (38.4%) or who reported stigma toward the child from the spouse (42.9%), family (31.8%) or community (38.1%) were significantly more likely to meet symptom criteria for most mental health disorders. Although not statistically significant, participants who reported acceptance and acceptance of their children from the spouse, family and community were less likely to meet symptom criteria. Women raising children from SVRPs experience symptoms of mental health disorders. Programming addressing stigma and acceptance following sexual violence may improve mental health outcomes in this population. Published by the BMJ Publishing Group

Water Supply Interruptions and Suspected Cholera Incidence: A Time-Series Regression in the Democratic Republic of the Congo

PubMed Central

Jeandron, Aurélie; Saidi, Jaime Mufitini; Kapama, Alois; Burhole, Manu; Birembano, Freddy; Vandevelde, Thierry; Gasparrini, Antonio; Armstrong, Ben; Cairncross, Sandy; Ensink, Jeroen H. J.

2015-01-01

Background The eastern provinces of the Democratic Republic of the Congo have been identified as endemic areas for cholera transmission, and despite continuous control efforts, they continue to experience regular cholera outbreaks that occasionally spread to the rest of the country. In a region where access to improved water sources is particularly poor, the question of which improvements in water access should be prioritized to address cholera transmission remains unresolved. This study aimed at investigating the temporal association between water supply interruptions and Cholera Treatment Centre (CTC) admissions in a medium-sized town. Methods and Findings Time-series patterns of daily incidence of suspected cholera cases admitted to the Cholera Treatment Centre in Uvira in South Kivu Province between 2009 and 2014 were examined in relation to the daily variations in volume of water supplied by the town water treatment plant. Quasi-poisson regression and distributed lag nonlinear models up to 12 d were used, adjusting for daily precipitation rates, day of the week, and seasonal variations. A total of 5,745 patients over 5 y of age with acute watery diarrhoea symptoms were admitted to the CTC over the study period of 1,946 d. Following a day without tap water supply, the suspected cholera incidence rate increased on average by 155% over the next 12 d, corresponding to a rate ratio of 2.55 (95% CI: 1.54–4.24), compared to the incidence experienced after a day with optimal production (defined as the 95th percentile—4,794 m3). Suspected cholera cases attributable to a suboptimal tap water supply reached 23.2% of total admissions (95% CI 11.4%–33.2%). Although generally reporting less admissions to the CTC, neighbourhoods with a higher consumption of tap water were more affected by water supply interruptions, with a rate ratio of 3.71 (95% CI: 1.91–7.20) and an attributable fraction of cases of 31.4% (95% CI: 17.3%–42.5%). The analysis did not suggest any

Africa: A Survey of Distance Education 1991. New Papers on Higher Education: Studies and Research 4.

ERIC Educational Resources Information Center

John, Magnus

Country profiles compiled through a survey of distance education in Africa form the contents of this document. International organizations and 35 countries were surveyed: Algeria; Benin; Botswana; Burkina Faso; Burundi; Cameroon; Central African Republic; Chad; Congo (Brazzaville); Djibouti; Ethiopia; Gambia; Ghana; Guinea; Ivory Coast; Kenya;…

The nitrogen budget for different forest types in the central Congo Basin

NASA Astrophysics Data System (ADS)

Bauters, Marijn; Verbeeck, Hans; Cizungu, Landry; Boeckx, Pascal

2016-04-01

Characterization of fundamental processes in different forest types is vital to understand the interaction of forests with their changing environment. Recent data analyses, as well as modeling activities have shown that the CO2 uptake by terrestrial ecosystems strongly depends on site fertility, i.e. nutrient availability. Accurate projections of future net forest growth and terrestrial CO2 uptake thus necessitate an improved understanding on nutrient cycles and how these are coupled to the carbon (C) cycle in forests. This holds especially for tropical forests, since they represent about 40-50% of the total carbon that is stored in terrestrial vegetation, with the Amazon basin and the Congo basin being the largest two contiguous blocks. However, due to political instability and reduced accessibility in the central Africa region, there is a strong bias in scientific research towards the Amazon basin. Consequently, central African forests are poorly characterized and their role in global change interactions shows distinct knowledge gaps, which is important bottleneck for all efforts to further optimize Earth system models explicitly including this region. Research in the Congo Basin region should combine assessments of both carbon stocks and the underlying nutrient cycles which directly impact the forest productivity. We set up a monitoring network for carbon stocks and nitrogen fluxes in four different forest types in the Congo Basin, which is now operative. With the preliminary data, we can get a glimpse of the differences in nitrogen budget and biogeochemistry of African mixed lowland rainforest, monodominant lowland forest, mixed montane forest and eucalypt plantations.

The impact of hospital and urban wastewaters on the bacteriological contamination of the water resources in Kinshasa, Democratic Republic of Congo.

PubMed

Kilunga, Pitchouna I; Kayembe, John M; Laffite, Amandine; Thevenon, Florian; Devarajan, Naresh; Mulaji, Crispin K; Mubedi, Josué I; Yav, Zéphirin G; Otamonga, Jean-Paul; Mpiana, Pius T; Poté, John

2016-10-14

Although the United Nations General Assembly recognized in 2010 the right to safe and clean drinking water and sanitation as a human right that is essential to the full enjoyment of life and all other human rights, the contamination of water supplies with faecal pathogens is still a major and unsolved problem in many parts of the world. In this study, faecal indicator bacteria (FIB), including Escherichia coli (E. coli) and Enterococcus (ENT), were quantified over the period of June/July 2014 and June/July 2015 to assess the quality of hospital effluents (n = 3: H1, H2 and H3) and of rivers receiving wastewaters from the city of Kinshasa, Democratic Republic of Congo. The water and sediment samples from the river-receiving systems were collected in, upstream and downstream of the hospital outlet pipe (HOP) discharge. The analysis of E. coli and ENT in water and sediment suspension was performed using the cultural membrane filter method. The FIB characterization was performed for general E. coli, Enterococcus faecalis(E. faecalis) and human-specific Bacteroides by PCR using specific primers. The results revealed very high FIB concentration in the hospital effluent waters, with E. coli reaching the values of 4.2 × 10(5), 16.1 × 10(5) and 5.9 × 10(5) CFU 100 mL(-1), for the hospital effluents from H1, H2, and H3, respectively; and Enterococcus reaching the values of 2.3 × 10(4), 10.9 × 10(4) and 4.1 × 10(4) CFU 100 mL(-1), respectively. Interestingly, the FIB levels in the water and sediment samples from river-receiving systems are spatially and temporally highly variable and present in some samples with higher values than the hospital effluents. The PCR assays for human-specific Bacteroides HF183/HF134 further indicate that more than 98% of bacteria were from human origin. The results of this research therefore confirm the hypothesis of our previous studies, indicating that in developing countries (e.g., Democratic Republic of Congo and South India), the

Yellow fever risk assessment in the Central African Republic.

PubMed

Ramos Junior, Alberto Novaes; Heukelbach, Jorg

2015-04-01

Yellow fever still causes high burden in several areas of sub-Saharan Africa and Latin America. There are few well-designed epidemiological studies and limited data about yellow fever in Africa. Staples et al., in a recently published paper in Transactions of the Royal Society of Tropical Medicine & Hygiene, performed a nationwide study in the Central African Republic (CAR) assessing infection risk and the operational impact of preventive measures. The rapid assessment of human, non-human and mosquito data call attention to the potential risk of future yellow fever outbreaks in the CAR and elsewhere. The study reinforces the need for intensified applied and operational research to address problems and human capacity needs in the realm of neglected tropical diseases in the post-2015 agenda. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Circulation of Crimean-Congo Hemorrhagic Fever Virus in the Former Yugoslav Republic of Macedonia Revealed by Screening of Cattle Sera Using a Novel Enzyme-linked Immunosorbent Assay

PubMed Central

Mertens, Marc; Vatansever, Zati; Mrenoshki, Slavcho; Krstevski, Kiril; Stefanovska, Jovana; Djadjovski, Igor; Cvetkovikj, Iskra; Farkas, Robert; Schuster, Isolde; Donnet, Fabien; Comtet, Loic; Tordo, Noël; Ben Mechlia, Mohamed; Balkema-Buschmann, Anne; Mitrov, Dine; Groschup, Martin H.

2015-01-01

Background There are only few assays available for the detection of Crimean-Congo Hemorrhagic Fever Virus (CCHFV)-specific antibodies in animals, and data about diagnostic sensitivity and specificity are incompletely documented for most of these tests. This is unfortunate since CCHFV antibodies in animals can be used as indicator for virus circulation in a geographic area and therewith potential risk of human exposure. This paper therefore reports on a novel ELISA for the detection of CCHFV-specific antibodies in cattle and on its application for testing ruminant sera from the Former Yugoslav Republic of Macedonia. Principal Findings A highly sensitive and specific ELISA was developed to detect CCHFV-specific IgG antibodies in cattle. The assay was validated by using 503 negative serum samples from a country where CCHFV has never been detected until now, and by using 54 positive serum samples. The positive sera were verified by using two commercially available assays (for testing human serum) which we have adapted for use in animals. The sensitivity of the novel ELISA was 98% and its specificity 99%. The presence of Hyalomma ticks was demonstrated in the Former Yugoslav Republic of Macedonia and depending on the region antibody prevalence rates up to 80% were detected in the cattle population. Conclusion This article describes a fully validated, highly sensitive and specific ELISA for the detection of CCHFV-specific IgG antibodies in cattle. Using this assay, CCHFV-specific antibodies were detected for the first time in cattle in the Former Yugoslav Republic of Macedonia, giving evidence for an active circulation of this virus in the country. Supporting this conclusion, the occurrence of the main vector of CCHFV was demonstrated in the present work for the first time in Former Yugoslav Republic of Macedonia. PMID:25742017

Vaccine-Derived Poliovirus Outbreaks and Events - Three Provinces, Democratic Republic of the Congo, 2017.

PubMed

Alleman, Mary M; Chitale, Rohit; Burns, Cara C; Iber, Jane; Dybdahl-Sissoko, Naomi; Chen, Qi; Van Koko, Djo-Roy; Ewetola, Raimi; Riziki, Yogolelo; Kavunga-Membo, Hugo; Dah, Cheikh; Andriamihantanirina, Rija

2018-03-16

The last confirmed wild poliovirus (WPV) case in Democratic Republic of the Congo (DRC) had paralysis onset in December 2011 (1). DRC has had cases of vaccine-derived polioviruses (VDPVs) documented since 2004 (Table 1) (1-6). After an outbreak of 30 circulating VDPV type 2 (cVDPV2) cases during 2011-2012, only five VDPV2 cases were reported during 2013-2016 (Table 1) (1-6). VDPVs can emerge from oral poliovirus vaccine (OPV types 1, 2, or 3; Sabin) polioviruses that have genetically mutated resulting in reversion to neurovirulence. This process occurs during extensive person-to-person transmission in populations with low immunity or after extended replication in the intestines of immune-deficient persons following vaccination (1-6). During 2017 (as of March 8, 2018), 25 VDPV cases were reported in three provinces in DRC: in Tanganyika province, an emergence with one VDPV2 case (pending final classification) in Kabalo health zone and an emergence with one ambiguous VDPV type 1 (aVDPV1) case in Ankoro health zone; in Maniema province, an emergence with two cVDPV2 cases; and in Haut Lomami province, an emergence with 20 cVDPV2 cases that originated in Haut Lomami province and later spread to Tanganyika province (hereafter referred to as the Haut Lomami outbreak area) and an emergence with one aVDPV type 2 (aVDPV2) case in Lwamba health zone (Table 1) (Figure) (6). Outbreak response supplementary immunization activities (SIAs) were conducted during June-December 2017 (Table 2) (6). Because of limitations in surveillance and suboptimal SIA quality and geographic scope, cVDPV2 circulation is likely continuing in 2018, requiring additional SIAs. DRC health officials and Global Polio Eradication Initiative (GPEI) partners are increasing human and financial resources to improve all aspects of outbreak response.

Sexual Violence toward Children and Youth in War-Torn Eastern Democratic Republic of Congo

PubMed Central

Malemo Kalisya, Luc; Lussy Justin, Paluku; Kimona, Christophe; Nyavandu, Kavira; Mukekulu Eugenie, Kamabu; Jonathan, Kasereka Muhindo Lusi; Claude, Kasereka Masumbuko; Hawkes, Michael

2011-01-01

Background The epidemic of gender-based violence in the Democratic Republic of the Congo (DRC) has garnered popular media attention, but is incompletely described in the medical literature to date. In particular, the relative importance of militarized compared to civilian rape and the impact on vulnerable populations merits further study. We describe a retrospective case series of sexual abuse among children and youth in eastern DRC. Methods Medical records of patients treated for sexual assault at HEAL Africa Hospital, Goma, DRC between 2006 and 2008 were reviewed. Information extracted from the chart record was summarized using descriptive statistics, with comparative statistics to examine differences between pediatric (≤18 yrs) and adult patients. Findings 440 pediatric and 54 adult sexual abuse cases were identified. Children and youth were more often assaulted by someone known to the family (74% vs 30%, OR 6.7 [95%CI 3.6–12], p<0.001), and less frequently by military personnel (13% vs 48%, OR 0.14 [95%CI 0.075–0.26], p<0.001). Delayed presentation for medical care (>72 hours after the assault) was more common in pediatric patients (53% vs 33%, OR 2.2 [95%CI 1.2–4.0], p = 0.007). Physical signs of sexual abuse, including lesions of the posterior fourchette, hymeneal tears, and anal lesions, were more commonly observed in children and youth (84% vs 69%, OR 2.3 [95%CI 1.3–4.4], p = 0.006). Nine (2.9%) pediatrics patients were HIV-positive at presentation, compared to 5.3% of adults (p = 0.34). Interpretation World media attention has focused on violent rape as a weapon of war in the DRC. Our data highlight some neglected but important and distinct aspects of the ongoing epidemic of sexual violence: sexual abuse of children and youth. PMID:21267467

Enhancing case definitions for surveillance of human monkeypox in the Democratic Republic of Congo.

PubMed

Osadebe, Lynda; Hughes, Christine M; Shongo Lushima, Robert; Kabamba, Joelle; Nguete, Beatrice; Malekani, Jean; Pukuta, Elisabeth; Karhemere, Stomy; Muyembe Tamfum, Jean-Jacques; Wemakoy Okitolonda, Emile; Reynolds, Mary G; McCollum, Andrea M

2017-09-01

Human monkeypox (MPX) occurs at appreciable rates in the Democratic Republic of Congo (DRC). Infection with varicella zoster virus (VZV) has a similar presentation to that of MPX, and in areas where MPX is endemic these two illnesses are commonly mistaken. This study evaluated the diagnostic utility of two surveillance case definitions for MPX and specific clinical characteristics associated with laboratory-confirmed MPX cases. Data from a cohort of suspect MPX cases (identified by surveillance over the course of a 42 month period during 2009-2014) from DRC were used; real-time PCR diagnostic test results were used to establish MPX and VZV diagnoses. A total of 333 laboratory-confirmed MPX cases, 383 laboratory-confirmed VZV cases, and 36 cases that were determined to not be either MPX or VZV were included in the analyses. Significant (p<0.05) differences between laboratory-confirmed MPX and VZV cases were noted for several signs/symptoms including key rash characteristics. Both surveillance case definitions had high sensitivity and low specificities for individuals that had suspected MPX virus infections. Using 12 signs/symptoms with high sensitivity and/or specificity values, a receiver operator characteristic analysis showed that models for MPX cases that had the presence of 'fever before rash' plus at least 7 or 8 of the 12 signs/symptoms demonstrated a more balanced performance between sensitivity and specificity. Laboratory-confirmed MPX and VZV cases presented with many of the same signs and symptoms, and the analysis here emphasized the utility of including 12 specific signs/symptoms when investigating MPX cases. In order to document and detect endemic human MPX cases, a surveillance case definition with more specificity is needed for accurate case detection. In the absence of a more specific case definition, continued emphasis on confirmatory laboratory-based diagnostics is warranted.

Flexibility of mobile laboratory unit in support of patient management during the 2007 Ebola-Zaire outbreak in the Democratic Republic of Congo.

PubMed

Grolla, A; Jones, S; Kobinger, G; Sprecher, A; Girard, G; Yao, M; Roth, C; Artsob, H; Feldmann, H; Strong, J E

2012-09-01

The mobile laboratory provides a safe, rapid and flexible platform to provide effective diagnosis of Ebola virus as well as additional differential diagnostic agents in remote settings of equatorial Africa. During the 2007 Democratic Republic of Congo outbreak of Ebola-Zaire, the mobile laboratory was set up in two different locations by two separate teams within a day of equipment arriving in each location. The first location was in Mweka where our laboratory took over the diagnostic laboratory space of the local hospital, whereas the second location, approximately 50 km south near Kampungu at the epicentre of the outbreak, required local labour to fabricate a tent structure as a suitable pre-existing structure was not available. In both settings, the laboratory was able to quickly set up, providing accurate and efficient molecular diagnostics (within 3 h of receiving samples) for 67 individuals, including four cases of Ebola, seven cases of Shigella and 13 cases of malaria. This rapid turn-around time provides an important role in the support of patient management and epidemiological surveillance. © 2012 Blackwell Verlag GmbH.

Modelling nitrate pollution pressure using a multivariate statistical approach: the case of Kinshasa groundwater body, Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Mfumu Kihumba, Antoine; Ndembo Longo, Jean; Vanclooster, Marnik

2016-03-01

A multivariate statistical modelling approach was applied to explain the anthropogenic pressure of nitrate pollution on the Kinshasa groundwater body (Democratic Republic of Congo). Multiple regression and regression tree models were compared and used to identify major environmental factors that control the groundwater nitrate concentration in this region. The analyses were made in terms of physical attributes related to the topography, land use, geology and hydrogeology in the capture zone of different groundwater sampling stations. For the nitrate data, groundwater datasets from two different surveys were used. The statistical models identified the topography, the residential area, the service land (cemetery), and the surface-water land-use classes as major factors explaining nitrate occurrence in the groundwater. Also, groundwater nitrate pollution depends not on one single factor but on the combined influence of factors representing nitrogen loading sources and aquifer susceptibility characteristics. The groundwater nitrate pressure was better predicted with the regression tree model than with the multiple regression model. Furthermore, the results elucidated the sensitivity of the model performance towards the method of delineation of the capture zones. For pollution modelling at the monitoring points, therefore, it is better to identify capture-zone shapes based on a conceptual hydrogeological model rather than to adopt arbitrary circular capture zones.

HIV-1 genetic diversity and primary drug resistance mutations before large-scale access to antiretroviral therapy, Republic of Congo.

PubMed

Niama, Fabien Roch; Vidal, Nicole; Diop-Ndiaye, Halimatou; Nguimbi, Etienne; Ahombo, Gabriel; Diakabana, Philippe; Bayonne Kombo, Édith Sophie; Mayengue, Pembe Issamou; Kobawila, Simon-Charles; Parra, Henri Joseph; Toure-Kane, Coumba

2017-07-05

In this work, we investigated the genetic diversity of HIV-1 and the presence of mutations conferring antiretroviral drug resistance in 50 drug-naïve infected persons in the Republic of Congo (RoC). Samples were obtained before large-scale access to HAART in 2002 and 2004. To assess the HIV-1 genetic recombination, the sequencing of the pol gene encoding a protease and partial reverse transcriptase was performed and analyzed with updated references, including newly characterized CRFs. The assessment of drug resistance was conducted according to the WHO protocol. Among the 50 samples analyzed for the pol gene, 50% were classified as intersubtype recombinants, charring complex structures inside the pol fragment. Five samples could not be classified (noted U). The most prevalent subtypes were G with 10 isolates and D with 11 isolates. One isolate of A, J, H, CRF05, CRF18 and CRF37 were also found. Two samples (4%) harboring the mutations M230L and Y181C associated with the TAMs M41L and T215Y, respectively, were found. This first study in the RoC, based on WHO classification, shows that the threshold of transmitted drug resistance before large-scale access to antiretroviral therapy is 4%.

Assessing monkeypox virus prevalence in small mammals at the human-animal interface in the Democratic Republic of the Congo

USGS Publications Warehouse

Doty, Jeffrey B.; Malekani, Jean M.; Kalemba, Lem's N.; Stanley, William T.; Monroe, Benjamin P.; Nakazawa, Yoshinori J.; Mauldin, Matthew R.; Bakambana, Trésor L.; Liyandja Dja Liyandja , Tobit; Braden, Zachary; Wallace, Ryan; Malekani, Divin V.; McCollum, Andrea M.; Gallardo-Romero, Nadia; Kondas, Ashley; Peterson, A. Townsend; Osorio, Jorge E.; Rocke, Tonie E.; Karem, Kevin L.; Emerson, Ginny L.; Carroll, Darin S.

2017-01-01

During 2012, 2013 and 2015, we collected small mammals within 25 km of the town of Boende in Tshuapa Province, the Democratic Republic of the Congo. The prevalence of monkeypox virus (MPXV) in this area is unknown; however, cases of human infection were previously confirmed near these collection sites. Samples were collected from 353 mammals (rodents, shrews, pangolins, elephant shrews, a potamogale, and a hyrax). Some rodents and shrews were captured from houses where human monkeypox cases have recently been identified, but most were trapped in forests and agricultural areas near villages. Real-time PCR and ELISA were used to assess evidence of MPXV infection and other Orthopoxvirus (OPXV) infections in these small mammals. Seven (2.0%) of these animal samples were found to be anti-orthopoxvirus immunoglobulin G (IgG) antibody positive (six rodents: two Funisciurus spp.; one Graphiurus lorraineus; one Cricetomys emini; one Heliosciurus sp.; one Oenomys hypoxanthus, and one elephant shrew Petrodromus tetradactylus); no individuals were found positive in PCR-based assays. These results suggest that a variety of animals can be infected with OPXVs, and that epidemiology studies and educational campaigns should focus on animals that people are regularly contacting, including larger rodents used as protein sources. 

Assessing Monkeypox Virus Prevalence in Small Mammals at the Human-Animal Interface in the Democratic Republic of the Congo.

PubMed

Doty, Jeffrey B; Malekani, Jean M; Kalemba, Lem's N; Stanley, William T; Monroe, Benjamin P; Nakazawa, Yoshinori U; Mauldin, Matthew R; Bakambana, Trésor L; Liyandja Dja Liyandja, Tobit; Braden, Zachary H; Wallace, Ryan M; Malekani, Divin V; McCollum, Andrea M; Gallardo-Romero, Nadia; Kondas, Ashley; Peterson, A Townsend; Osorio, Jorge E; Rocke, Tonie E; Karem, Kevin L; Emerson, Ginny L; Carroll, Darin S

2017-10-03

During 2012, 2013 and 2015, we collected small mammals within 25 km of the town of Boende in Tshuapa Province, the Democratic Republic of the Congo. The prevalence of monkeypox virus (MPXV) in this area is unknown; however, cases of human infection were previously confirmed near these collection sites. Samples were collected from 353 mammals (rodents, shrews, pangolins, elephant shrews, a potamogale, and a hyrax). Some rodents and shrews were captured from houses where human monkeypox cases have recently been identified, but most were trapped in forests and agricultural areas near villages. Real-time PCR and ELISA were used to assess evidence of MPXV infection and other Orthopoxvirus (OPXV) infections in these small mammals. Seven (2.0%) of these animal samples were found to be anti-orthopoxvirus immunoglobulin G (IgG) antibody positive (six rodents: two Funisciurus spp.; one Graphiurus lorraineus ; one Cricetomys emini ; one Heliosciurus sp.; one Oenomys hypoxanthus , and one elephant shrew Petrodromus tetradactylus ); no individuals were found positive in PCR-based assays. These results suggest that a variety of animals can be infected with OPXVs, and that epidemiology studies and educational campaigns should focus on animals that people are regularly contacting, including larger rodents used as protein sources.

Stabilization Lessons Learned from Sierra Leone

DTIC Science & Technology

2013-12-01

Reduction Project (0704–0188) Washington, DC 20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE December 2013 3. REPORT TYPE AND DATES...Force Commander DRC Democratic Republic of the Congo ECOWAS Economic Community of West African States ECOMOG ECOWAS Monitoring Group JIC... Community of West African States (ECOWAS) tried and failed to implement cease-fires and resolve the conflict.1 After Nigeria and the ECOWAS mission

Effects of untreated hospital effluents on the accumulation of toxic metals in sediments of receiving system under tropical conditions: case of South India and Democratic Republic of Congo.

PubMed

Mubedi, Josué Ilunga; Devarajan, Naresh; Le Faucheur, Séverine; Mputu, John Kayembe; Atibu, Emmanuel K; Sivalingam, Periyasamy; Prabakar, Kandasamy; Mpiana, Pius T; Wildi, Walter; Poté, John

2013-10-01

Physicochemical and ecotoxicological analyses have been performed to assess the quality of sediments receiving untreated hospital effluents from Indian and Democratic Republic of Congo (DRC) hospitals. The sediments were collected monthly and characterized for grain size, organic matter, total organic carbon, total carbon, nitrogen, phosphorus, toxic metals and ecotoxicity. The results highlight the high concentration of toxic metals from the Indian hospital effluent receiving systems, especially for Cr, Cu, As, Zn and Hg. On the other hand, the metal concentrations in the sediment receiving system from DRC are low (e.g. maximum Hg and Zn concentration were 0.46 and 48.84 mg kg(-1) respectively). Ostracods exposed to sediment samples H2 (September month sample) and H3 (June and September month samples) were found dead after 6d of exposure whereas the higher mortality rate for Congo sediments was 23% but was accompanied with 33 ± 7% of growth inhibition. The results of this study show the variation of sediment composition on toxic metal levels as well as toxicity related to both, the type of hospitals and the sampling period. Additionally, hospital effluent disposal practices at the study sites can lead to the pollution of water resources and may generate risks for aquatic organisms and human health. Copyright © 2013 Elsevier Ltd. All rights reserved.

Geospatial Information Informs Bonobo (pan Paniscus) Conservation Efforts in the Democratic Republic of the Congo

NASA Astrophysics Data System (ADS)

Nackoney, J.; Hickey, J.; Williams, D.; Facheux, C.; Dupain, J.

2014-12-01

The bonobo (Pan paniscus), a great ape that is endemic to the Democratic Republic of the Congo (DRC), has been listed as Endangered on the IUCN Red List since 2007. Hunting and habitat loss are primary threats. Two recent wars and ongoing conflicts in the DRC have resulted in political and economic instability that hampers on-the-ground work, thereby accentuating the importance of spatial data and maps as tools for monitoring threats remotely and prioritizing locations for safeguarding bonobo habitat. Several regional and rangewide efforts have leveraged the utility of existing spatial data to help focus limited resources for effective broad-scale conservation of these great apes. At local scales, we developed spatial models to identify locations of highest hunting pressure, predict future human settlement and agricultural expansion, map areas of highest conservation value to bonobos, and identify the connective corridors linking them. We identified 42 least-disturbed wildland blocks meeting the minimum home range size needed for bonobos, and 32 potential corridors. At the range-wide scale, we developed a first range-wide spatial model of suitable conditions for the bonobo; this was a major contribution to the development of a Bonobo Conservation Strategy for 2012-2022, recently published by IUCN. The model used a forest edge density metric and other biotic and abiotic variables in conjunction with bonobo nest data collected during 2003-2010 by over 40 bonobo researchers. Approximately 28% of the range was predicted suitable; of that, about 27.5% was located in official protected areas. Highlighting these examples, this presentation will discuss the conservation status of bonobos and how spatial data and models are being utilized for the formation of strategic conservation plans.

Geological Substrates Shape Tree Species and Trait Distributions in African Moist Forests

PubMed Central

Fayolle, Adeline; Engelbrecht, Bettina; Freycon, Vincent; Mortier, Frédéric; Swaine, Michael; Réjou-Méchain, Maxime; Doucet, Jean-Louis; Fauvet, Nicolas; Cornu, Guillaume; Gourlet-Fleury, Sylvie

2012-01-01

Background Understanding the factors that shape the distribution of tropical tree species at large scales is a central issue in ecology, conservation and forest management. The aims of this study were to (i) assess the importance of environmental factors relative to historical factors for tree species distributions in the semi-evergreen forests of the northern Congo basin; and to (ii) identify potential mechanisms explaining distribution patterns through a trait-based approach. Methodology/Principal Findings We analyzed the distribution patterns of 31 common tree species in an area of more than 700,000 km2 spanning the borders of Cameroon, the Central African Republic, and the Republic of Congo using forest inventory data from 56,445 0.5-ha plots. Spatial variation of environmental (climate, topography and geology) and historical factors (human disturbance) were quantified from maps and satellite records. Four key functional traits (leaf phenology, shade tolerance, wood density, and maximum growth rate) were extracted from the literature. The geological substrate was of major importance for the distribution of the focal species, while climate and past human disturbances had a significant but lesser impact. Species distribution patterns were significantly related to functional traits. Species associated with sandy soils typical of sandstone and alluvium were characterized by slow growth rates, shade tolerance, evergreen leaves, and high wood density, traits allowing persistence on resource-poor soils. In contrast, fast-growing pioneer species rarely occurred on sandy soils, except for Lophira alata. Conclusions/Significance The results indicate strong environmental filtering due to differential soil resource availability across geological substrates. Additionally, long-term human disturbances in resource-rich areas may have accentuated the observed patterns of species and trait distributions. Trait differences across geological substrates imply pronounced

Lead exposure and early child neurodevelopment among children 12-24 months in Kinshasa, the Democratic Republic of Congo.

PubMed

Kashala-Abotnes, Espérance; Mumbere, Pépé Penghele; Mishika, Jeannette Mukanya; Ndjukendi, Ally Omba; Mpaka, Davin Beya; Bumoko, Makila-Mabe Guy; Kayembe, Tharcisse Kalula; Tshala-Katumbay, Désiré; Kazadi, Théodore Kayembe; Okitundu, Daniel Luwa E-Andjafono

2016-12-01

Childhood lead exposure remains a problem in developing countries, and little is known about its effects on early child neurodevelopment and temperament in the Democratic Republic of Congo (DRC). We, therefore, conducted this study to determine the association between lead exposure and the neurodevelopment and behaviour of children aged 12-24 months in Kinshasa, DRC. A cross-sectional study was conducted between February and June 2012, and parents of 104 children were invited to participate. Blood lead levels (BLLs) of each child were tested using the flame atomic spectrophotometry method. All children were subject to a clinical examination and assessed with two selected early child neurodevelopmental tools, the Gensini-Gavito and the baby characteristics questionnaire, to measure their neurodevelopment and temperament. Detectable BLLs ranged from 1 to 30 μg/dl with a geometric mean of 6.9 (SD 4.8) μg/dl. BLLs at 5-9 and ≥10 μg/dl were significantly associated with the child temperament (p <0.05). Perinatal and maternal factors did not seem to affect early child neurodevelopment and temperament. Children exposed to lead were reported with more temperament difficulties at even blood lead levels <10 μg/dl, suggesting the need for preventive and intervention measures to reduce lead exposure among children in Kinshasa, DRC.

Adenovirus and Herpesvirus Diversity in Free-Ranging Great Apes in the Sangha Region of the Republic of Congo

PubMed Central

Seimon, Tracie A.; Olson, Sarah H.; Lee, Kerry Jo; Rosen, Gail; Ondzie, Alain; Cameron, Kenneth; Reed, Patricia; Anthony, Simon J.; Joly, Damien O.; McAloose, Denise; Lipkin, W. Ian

2015-01-01

Infectious diseases have caused die-offs in both free-ranging gorillas and chimpanzees. Understanding pathogen diversity and disease ecology is therefore critical for conserving these endangered animals. To determine viral diversity in free-ranging, non-habituated gorillas and chimpanzees in the Republic of Congo, genetic testing was performed on great-ape fecal samples collected near Odzala-Kokoua National Park. Samples were analyzed to determine ape species, identify individuals in the population, and to test for the presence of herpesviruses, adenoviruses, poxviruses, bocaviruses, flaviviruses, paramyxoviruses, coronaviruses, filoviruses, and simian immunodeficiency virus (SIV). We identified 19 DNA viruses representing two viral families, Herpesviridae and Adenoviridae, of which three herpesviruses had not been previously described. Co-detections of multiple herpesviruses and/or adenoviruses were present in both gorillas and chimpanzees. Cytomegalovirus (CMV) and lymphocryptovirus (LCV) were found primarily in the context of co-association with each other and adenoviruses. Using viral discovery curves for herpesviruses and adenoviruses, the total viral richness in the sample population of gorillas and chimpanzees was estimated to be a minimum of 23 viruses, corresponding to a detection rate of 83%. These findings represent the first description of DNA viral diversity in feces from free-ranging gorillas and chimpanzees in or near the Odzala-Kokoua National Park and form a basis for understanding the types of viruses circulating among great apes in this region. PMID:25781992

Adenovirus and herpesvirus diversity in free-ranging great apes in the Sangha region of the Republic Of Congo.

PubMed

Seimon, Tracie A; Olson, Sarah H; Lee, Kerry Jo; Rosen, Gail; Ondzie, Alain; Cameron, Kenneth; Reed, Patricia; Anthony, Simon J; Joly, Damien O; Karesh, William B; McAloose, Denise; Lipkin, W Ian

2015-01-01

Infectious diseases have caused die-offs in both free-ranging gorillas and chimpanzees. Understanding pathogen diversity and disease ecology is therefore critical for conserving these endangered animals. To determine viral diversity in free-ranging, non-habituated gorillas and chimpanzees in the Republic of Congo, genetic testing was performed on great-ape fecal samples collected near Odzala-Kokoua National Park. Samples were analyzed to determine ape species, identify individuals in the population, and to test for the presence of herpesviruses, adenoviruses, poxviruses, bocaviruses, flaviviruses, paramyxoviruses, coronaviruses, filoviruses, and simian immunodeficiency virus (SIV). We identified 19 DNA viruses representing two viral families, Herpesviridae and Adenoviridae, of which three herpesviruses had not been previously described. Co-detections of multiple herpesviruses and/or adenoviruses were present in both gorillas and chimpanzees. Cytomegalovirus (CMV) and lymphocryptovirus (LCV) were found primarily in the context of co-association with each other and adenoviruses. Using viral discovery curves for herpesviruses and adenoviruses, the total viral richness in the sample population of gorillas and chimpanzees was estimated to be a minimum of 23 viruses, corresponding to a detection rate of 83%. These findings represent the first description of DNA viral diversity in feces from free-ranging gorillas and chimpanzees in or near the Odzala-Kokoua National Park and form a basis for understanding the types of viruses circulating among great apes in this region.

Overview of Animal Rabies in Kinshasa Province in the Democratic Republic of Congo.

PubMed

Twabela, Augustin Tshibwabwa; Mweene, Aaron Simanyengwe; Masumu, Justin Mulumbu; Muma, John Bwalya; Lombe, Boniface Pongombo; Hankanga, Careen

2016-01-01

Rabies is one of the major public health problems mostly affecting developing countries in Africa and Asia where 99.9% of all rabies related human deaths are recorded each year. In Democratic Republic of Congo, repeated outbreaks have been reported. Despite this, there is little reliable epidemiological data about rabies in the country for the development of effective control strategies. A retrospective study was carried out in Kinshasa Province during a period of five years (2009-2013) to describe the proportion of rabid animals and the species involved in rabies transmission and maintenance. The survey also aimed at describing the spatial-temporal distribution of rabies. To gather information, the daily registers of institutions involved in rabies diagnosis were reviewed and each rabies case was traced back to area of occurrence for collection of geographic coordinates. A total of 5,053 attacks were registered involving six animal species including dog, cat, monkey, rabbit, rat, and pig. Based on clinical observations, rabies was reported in dogs and cats while data obtained from the laboratory confirmed rabies cases included dogs, cats and a goat. The annual distribution showed a significant decrease of rabies cases from 2009 up to 2011 and a later increase up to 2013. There was no difference in rabies occurrence between seasons (p = 0.721). Rabies cases were three times higher in peri-urban zone than in urban zone OR = 3.4 (95% CI: 2.3-5.1). The positive proportion of rabies was 2.6% (95% CI: 2.1-3) based on clinical evidence and 65.9% (95% CI: 50-79.5) for laboratory confirmed cases. This study confirms the endemicity of rabies in Kinshasa where occurrence of rabies cases was related to human population density and lifestyle. In order to control rabies, there is need to set up a surveillance program and implement efficient mass vaccination campaigns of susceptible animals.

Overview of Animal Rabies in Kinshasa Province in the Democratic Republic of Congo

PubMed Central

Twabela, Augustin Tshibwabwa; Lombe, Boniface Pongombo; Hankanga, Careen

2016-01-01

Introduction Rabies is one of the major public health problems mostly affecting developing countries in Africa and Asia where 99.9% of all rabies related human deaths are recorded each year. In Democratic Republic of Congo, repeated outbreaks have been reported. Despite this, there is little reliable epidemiological data about rabies in the country for the development of effective control strategies. Materials and Methods A retrospective study was carried out in Kinshasa Province during a period of five years (2009–2013) to describe the proportion of rabid animals and the species involved in rabies transmission and maintenance. The survey also aimed at describing the spatial-temporal distribution of rabies. To gather information, the daily registers of institutions involved in rabies diagnosis were reviewed and each rabies case was traced back to area of occurrence for collection of geographic coordinates. Results and Discussion A total of 5,053 attacks were registered involving six animal species including dog, cat, monkey, rabbit, rat, and pig. Based on clinical observations, rabies was reported in dogs and cats while data obtained from the laboratory confirmed rabies cases included dogs, cats and a goat. The annual distribution showed a significant decrease of rabies cases from 2009 up to 2011 and a later increase up to 2013. There was no difference in rabies occurrence between seasons (p = 0.721). Rabies cases were three times higher in peri-urban zone than in urban zone OR = 3.4 (95% CI: 2.3–5.1). The positive proportion of rabies was 2.6% (95% CI: 2.1–3) based on clinical evidence and 65.9% (95% CI: 50–79.5) for laboratory confirmed cases. Conclusion and Suggestion This study confirms the endemicity of rabies in Kinshasa where occurrence of rabies cases was related to human population density and lifestyle. In order to control rabies, there is need to set up a surveillance program and implement efficient mass vaccination campaigns of susceptible

Determinants of dog owner-charged rabies vaccination in Kinshasa, Democratic Republic of Congo

PubMed Central

Tshilenge, Georges Mbuyi; Mbao, Victor; Njoumemi, Zakariaou; Masumu, Justin

2017-01-01

Rabies is a preventable fatal disease that causes about 61,000 human deaths annually around the world, mostly in developing countries. In Africa, several studies have shown that vaccination of pets is effective in controlling the disease. An annual vaccination coverage of 70% is recommended by the World Health Organization as a control threshold. The effective control of rabies requires vaccination coverage of owned dogs. Identification of the factors determining dog owners’ choice to vaccinate is necessary for evidence-based policy-making. However, for the Democratic Republic of Congo (DRC), the limited data on rabies vaccination coverage makes it difficult for its control and formulation of appropriate policies. A cross-sectional study was conducted in Kinshasa (Lemba commune) with dog-owning households and owned dogs as study populations. The association between dog vaccination and independent factors (household socio-demographics characteristics, dog characteristics, knowledge of rabies and location of veterinary offices/clinics) was performed with Epi-info 7. The Odds Ratio (OR) and p-value < 0.05 were used to determine levels of significance. A total of 166 households owning dogs and 218 owned dogs were investigated. 47% of the dogs had been vaccinated within one year preceding the survey which is higher than the critical coverage (25 to 40%) necessary to interrupt rabies transmission but below the 70% threshold recommended by WHO for control. The determinants of vaccination included socio-economic level of the household (OR = 2.9, p<0.05), formal education level of the dog owner (OR = 4, p<0.05), type of residence (OR = 4.6, p<0.05), knowledge of rabies disease (OR = 8.0, p<0.05), knowledge of location of veterinary offices/clinics (OR = 3.4, p<0.05), dog gender (OR = 1.6, p<0.05) and dog breed (OR = 2.1, p<0.05). This study shows that the vaccination coverage in this area can easily reach the WHO threshold if supplemented by mass vaccination campaigns

Determinants of dog owner-charged rabies vaccination in Kinshasa, Democratic Republic of Congo.

PubMed

Kazadi, Eric Kawaya; Tshilenge, Georges Mbuyi; Mbao, Victor; Njoumemi, Zakariaou; Masumu, Justin

2017-01-01

Rabies is a preventable fatal disease that causes about 61,000 human deaths annually around the world, mostly in developing countries. In Africa, several studies have shown that vaccination of pets is effective in controlling the disease. An annual vaccination coverage of 70% is recommended by the World Health Organization as a control threshold. The effective control of rabies requires vaccination coverage of owned dogs. Identification of the factors determining dog owners' choice to vaccinate is necessary for evidence-based policy-making. However, for the Democratic Republic of Congo (DRC), the limited data on rabies vaccination coverage makes it difficult for its control and formulation of appropriate policies. A cross-sectional study was conducted in Kinshasa (Lemba commune) with dog-owning households and owned dogs as study populations. The association between dog vaccination and independent factors (household socio-demographics characteristics, dog characteristics, knowledge of rabies and location of veterinary offices/clinics) was performed with Epi-info 7. The Odds Ratio (OR) and p-value < 0.05 were used to determine levels of significance. A total of 166 households owning dogs and 218 owned dogs were investigated. 47% of the dogs had been vaccinated within one year preceding the survey which is higher than the critical coverage (25 to 40%) necessary to interrupt rabies transmission but below the 70% threshold recommended by WHO for control. The determinants of vaccination included socio-economic level of the household (OR = 2.9, p<0.05), formal education level of the dog owner (OR = 4, p<0.05), type of residence (OR = 4.6, p<0.05), knowledge of rabies disease (OR = 8.0, p<0.05), knowledge of location of veterinary offices/clinics (OR = 3.4, p<0.05), dog gender (OR = 1.6, p<0.05) and dog breed (OR = 2.1, p<0.05). This study shows that the vaccination coverage in this area can easily reach the WHO threshold if supplemented by mass vaccination campaigns.

Ethics of mandatory premarital HIV testing in Africa: the case of Goma, Democratic Republic of Congo.

PubMed

Rennie, Stuart; Mupenda, Bavon

2008-08-01

Despite decades of prevention efforts, millions of persons worldwide continue to become infected by the human immunodeficiency virus (HIV) every year. This urgent problem of global epidemic control has recently lead to significant changes in HIV testing policies. Provider-initiated approaches to HIV testing have been embraced by the Centers for Disease Control and Prevention and the World Health Organization, such as those that routinely inform persons that they will be tested for HIV unless they explicitly refuse ('opt out'). While these policies appear to increase uptake of testing, they raise a number of ethical concerns that have been debated in journals and at international AIDS conferences. However, one special form of 'provider-initiated' testing is being practiced and promoted in various parts of the world, and has advocates within international health agencies, but has received little attention in the bioethical literature: mandatory premarital HIV testing. This article analyses some of the key ethical issues related to mandatory premarital HIV testing in resource-poor settings with generalized HIV epidemics. We will first briefly mention some mandatory HIV premarital testing proposals, policies and practices worldwide, and offer a number of conceptual and factual distinctions to help distinguish different types of mandatory testing policies. Using premarital testing in Goma (Democratic Republic of Congo) as a point of departure, we will use influential public health ethics principles to evaluate different forms of mandatory testing. We conclude by making concrete recommendations concerning the place of mandatory premarital testing in the struggle against HIV/AIDS.

ETHICS OF MANDATORY PREMARITAL HIV TESTING IN AFRICA: THE CASE OF GOMA, DEMOCRATIC REPUBLIC OF CONGO

PubMed Central

RENNIE, STUART; MUPENDA, BAVON

2015-01-01

Despite decades of prevention efforts, millions of persons worldwide continue to become infected by the human immunodeficiency virus (HIV) every year. This urgent problem of global epidemic control has recently lead to significant changes in HIV testing policies. Provider-initiated approaches to HIV testing have been embraced by the Centers for Disease Control and Prevention and the World Health Organization, such as those that routinely inform persons that they will be tested for HIV unless they explicitly refuse (‘opt out’). While these policies appear to increase uptake of testing, they raise a number of ethical concerns that have been debated in journals and at international AIDS conferences. However, one special form of ‘provider-initiated’ testing is being practiced and promoted in various parts of the world, and has advocates within international health agencies, but has received little attention in the bioethical literature: mandatory premarital HIV testing. This article analyses some of the key ethical issues related to mandatory premarital HIV testing in resource-poor settings with generalized HIV epidemics. We will first briefly mention some mandatory HIV premarital testing proposals, policies and practices worldwide, and offer a number of conceptual and factual distinctions to help distinguish different types of mandatory testing policies. Using premarital testing in Goma (Democratic Republic of Congo) as a point of departure, we will use influential public health ethics principles to evaluate different forms of mandatory testing. We conclude by making concrete recommendations concerning the place of mandatory premarital testing in the struggle against HIV/AIDS. PMID:19143089

[Knowledge of the general population about hypertension and diabetes mellitus in South Kivu, Democratic Republic of Congo].

PubMed

Katchunga, P B; Malanda, B; Mweze, M C; Dupont, B; M'Buyamba-Kabangu, J R; Kashongwe, Z; Kabinda, J M; Buysschaert, M

2012-04-01

In the Democratic Republic of Congo (DRC), a country in a post-conflict period, high priority cannot be given to non-communicable diseases other than to emergencies. This certainly involves inadequacy in raising awareness for prevention of these diseases. To evaluate the level of knowledge of the Congolese general population on hypertension and diabetes mellitus. Responses to a questionnaire from 3% of the general population aged 15 and older in the city of Bukavu and two rural areas: Hombo and Walungu (South Kivu, eastern DRC), recruited after stratification by ward in the city of Bukavu and a group of prone villages were expected. The questions focused on identification, testing, causes, complications and treatment of hypertension and diabetes mellitus. Of the 7770 respondents, screening for hypertension and diabetes mellitus affected only 14.9% and 7.3% of subjects respectively. Knowledge of these two conditions was generally low in the general population, although better in the subgroups of patients and those with higher socioeconomic level (P<0.05). Use of the medias was also associated with better knowledge (P<0.05). This study shows that knowledge about hypertension and diabetes mellitus and their testing in South Kivu is low. It is imperative that the Congolese government includes non-communicable diseases in its priorities of the millennium. Similarly, the WHO should actively contribute to screening for them in low-income countries. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context.

PubMed

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

PubMed Central

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness. PMID:25136358

Entomological profile of yellow fever epidemics in the Central African Republic, 2006-2010.

PubMed

Ngoagouni, Carine; Kamgang, Basile; Manirakiza, Alexandre; Nangouma, Auguste; Paupy, Christophe; Nakoune, Emmanuel; Kazanji, Mirdad

2012-08-16

The causative agent of yellow fever is an arbovirus of the Flaviviridae family transmitted by infected Aedes mosquitoes, particularly in Africa. In the Central African Republic since 2006, cases have been notified in the provinces of Ombella-Mpoko, Ouham-Pende, Basse-Kotto, Haute-Kotto and in Bangui the capital. As the presence of a vector of yellow fever virus (YFV) represents a risk for spread of the disease, we undertook entomological investigations at these sites to identify potential vectors of YFV and their abundance. Between 2006 and 2010, 5066 mosquitoes belonging to six genera and 43 species were identified. The 20 species of the Aedes genus identified included Ae. aegypti, the main vector of YFV in urban settings, and species found in tropical forests, such as Ae. africanus, Ae. simpsoni, Ae. luteocephalus, Ae. vittatus and Ae. opok. These species were not distributed uniformly in the various sites studied. Thus, the predominant Aedes species was Ae. aegypti in Bangui (90.7 %) and Basse-Kotto (42.2 %), Ae. africanus in Ombella-Mpoko (67.4 %) and Haute-Kotto (77.8 %) and Ae. vittatus in Ouham-Pende (62.2 %). Ae. albopictus was also found in Bangui. The distribution of these dominant species differed significantly according to study site (P < 0.0001). None of the pooled homogenates of Aedes mosquitoes analysed by polymerase chain reaction contained the YFV genome. The results indicate a wide diversity of vector species for YFV in the Central African Republic. The establishment of surveillance and vector control programs should take into account the ecological specificity of each species.

Forest Elephant Crisis in the Congo Basin

PubMed Central

Blake, Stephen; Strindberg, Samantha; Boudjan, Patrick; Makombo, Calixte; Bila-Isia, Inogwabini; Ilambu, Omari; Grossmann, Falk; Bene-Bene, Lambert; de Semboli, Bruno; Mbenzo, Valentin; S'hwa, Dino; Bayogo, Rosine; Williamson, Liz; Fay, Mike; Hart, John; Maisels, Fiona

2007-01-01

Debate over repealing the ivory trade ban dominates conferences of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Resolving this controversy requires accurate estimates of elephant population trends and rates of illegal killing. Most African savannah elephant populations are well known; however, the status of forest elephants, perhaps a distinct species, in the vast Congo Basin is unclear. We assessed population status and incidence of poaching from line-transect and reconnaissance surveys conducted on foot in sites throughout the Congo Basin. Results indicate that the abundance and range of forest elephants are threatened from poaching that is most intense close to roads. The probability of elephant presence increased with distance to roads, whereas that of human signs declined. At all distances from roads, the probability of elephant occurrence was always higher inside, compared to outside, protected areas, whereas that of humans was always lower. Inside protected areas, forest elephant density was correlated with the size of remote forest core, but not with size of protected area. Forest elephants must be prioritised in elephant management planning at the continental scale. PMID:17407383

Forest elephant crisis in the Congo Basin.

PubMed

Blake, Stephen; Strindberg, Samantha; Boudjan, Patrick; Makombo, Calixte; Bila-Isia, Inogwabini; Ilambu, Omari; Grossmann, Falk; Bene-Bene, Lambert; de Semboli, Bruno; Mbenzo, Valentin; S'hwa, Dino; Bayogo, Rosine; Williamson, Liz; Fay, Mike; Hart, John; Maisels, Fiona

2007-04-01

Debate over repealing the ivory trade ban dominates conferences of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Resolving this controversy requires accurate estimates of elephant population trends and rates of illegal killing. Most African savannah elephant populations are well known; however, the status of forest elephants, perhaps a distinct species, in the vast Congo Basin is unclear. We assessed population status and incidence of poaching from line-transect and reconnaissance surveys conducted on foot in sites throughout the Congo Basin. Results indicate that the abundance and range of forest elephants are threatened from poaching that is most intense close to roads. The probability of elephant presence increased with distance to roads, whereas that of human signs declined. At all distances from roads, the probability of elephant occurrence was always higher inside, compared to outside, protected areas, whereas that of humans was always lower. Inside protected areas, forest elephant density was correlated with the size of remote forest core, but not with size of protected area. Forest elephants must be prioritised in elephant management planning at the continental scale.

Current use of smokeless tobacco among adolescents in the Republic of Congo.

PubMed

Rudatsikira, Emmanuel; Muula, Adamson S; Siziya, Seter

2010-01-14

Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT). Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations. Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]). Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and

75 FR 79443 - Unblocking of Specially Designated National Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

... the Democratic Republic of Congo'' and who has been removed from OFAC's list of Specially Designated... imposed sanctions relating to the situation in the Democratic Republic of the Congo. Section 1 of the... Congo, Democratic Republic of the; Passport C0323172 (Congo, Democratic Republic of the) (individual...

Discovery of a leptospirosis cluster amidst a pneumonic plague outbreak in a miners' camp in the Democratic Republic of the Congo.

PubMed

Bertherat, Eric; Mueller, Melissa J; Shako, Jean-Christophe; Picardeau, Mathieu

2014-02-07

Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing 57 of them. Clinical signs, fast disease spread, and initial laboratory investigations suggested pneumonic plague. While leptospirosis had not recently been described in the region, it was considered as a differential diagnosis. Anti-Leptospira antibodies were detected by microscopic agglutination test (MAT). A confirmed case of leptospirosis was defined as having consistent clinical signs and any one of the following: seroconversion or four-fold increase in MAT titre for paired serum samples, or a MAT titre ≥ 1:400 for acute-phase serum samples. Twenty-nine of the 54 patients or convalescents tested for leptospirosis were seropositive. Two cases showed a confirmed infection for both plague and leptospirosis. While evidence supports the plague nature of this outbreak, the results suggest that some of the suspected plague cases might be due to leptospirosis. In any case, this diagnosis will have to be evoked in the future if a similar outbreak occurs in this region of Africa.

[Exploratory study of road safety in Brazzaville and Pointe-Noire in Republic of the Congo].

PubMed

Batala Mpondo, Georges; Bouanga, Marianne; Saya, Yvette Marie Clarisse; Maurice, Pierre; Burigusa, Guillaume

2014-01-01

Although road accidents in the Congo are reaching alarming levels (2,720 accidents in 2010 and 3,126 accidents in 2011), especially with the massive arrival of "Jakarta" mopeds, no evaluation has been conducted to identify and understand the factors responsible for this problem. This article reports the results of an exploratory study conducted in Brazzaville and Pointe-Noire based on information collected from existing documents and by semidirective questionnaire of people from various sectors able to elucidate the problem of road safety. Using William Haddon's matrix, the parameters investigated were : road user behaviour ; environmental and technological factors ; characteristics of road accident victims ; quality of care ; intervention times and organization of prevention. This study demonstrated the absence of a road safety policy in Congo. It also showed that the main factors responsible for road accidents are behavioural (failure to wear safety belts, failure to comply with road signs, fatigue, use of a telephone while driving, etc.), followed by environmental and technological factors (insufficient traffic lights, absence of sidewalks, disorganized occupation of roads, general state of vehicles). This study shows that, in order to improve road safety in the Congo, it is essential to promote the development of national road safety policies and an action plan, intervention on the determinants of road accidents, and a change of road user behaviours (compulsory use of safety belts, ban on the use of a telephone and smoking while driving, etc.). Effective organization of the management of road accident victims and allocation of a budget to implement a road safety policy are also necessary.

Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC).

PubMed

Nkanga, Mireille Solange Nganga; Longo-Mbenza, Benjamin; Adeniyi, Oladele Vincent; Ngwidiwo, Jacques Bikaula; Katawandja, Antoine Lufimbo; Kazadi, Paul Roger Beia; Nzonzila, Alain Nganga

2017-08-23

The global burden of hematologic malignancy (HM) is rapidly rising with aging, exposure to polluted environments, and global and local climate variability all being well-established conditions of oxidative stress. However, there is currently no information on the extent and predictors of HM at Kinshasa University Clinics (KUC), DR Congo (DRC). This study evaluated the impact of bio-clinical factors, exposure to polluted environments, and interactions between global climate changes (EL Nino and La Nina) and local climate (dry and rainy seasons) on the incidence of HM. This hospital-based prospective cohort study was conducted at Kinshasa University Clinics in DR Congo. A total of 105 black African adult patients with anaemia between 2009 and 2016 were included. HM was confirmed by morphological typing according to the French-American-British (FAB) Classification System. Gender, age, exposure to traffic pollution and garages/stations, global climate variability (El Nino and La Nina), and local climate (dry and rainy seasons) were potential independent variables to predict incident HM using Cox regression analysis and Kaplan Meier curves. Out of the total 105 patients, 63 experienced incident HM, with an incidence rate of 60%. After adjusting for gender, HIV/AIDS, and other bio-clinical factors, the most significant independent predictors of HM were age ≥ 55 years (HR = 2.4; 95% CI 1.4-4.3; P = 0.003), exposure to pollution and garages or stations (HR = 4.9; 95% CI 2-12.1; P < 0.001), combined local dry season + La Nina (HR = 4.6; 95%CI 1.8-11.8; P < 0.001), and combined local dry season + El Nino (HR = 4; 95% CI 1.6-9.7; P = 0.004). HM types included acute myeloid leukaemia (28.6% n = 18), multiple myeloma (22.2% n = 14), myelodysplastic syndromes (15.9% n = 10), chronic myeloid leukaemia (15.9% n = 10), chronic lymphoid leukaemia (9.5% n = 6), and acute lymphoid leukaemia (7.9% n = 5). After adjusting for confounders using Cox

Low prevalence of HIV and other selected sexually transmitted infections in 2004 in pregnant women from Kinshasa, the Democratic Republic of the Congo

PubMed Central

KINOSHITA-MOLEKA, R.; SMITH, J. S.; ATIBU, J.; TSHEFU, A.; HEMINGWAY-FODAY, J.; HOBBS, M.; BARTZ, J.; KOCH, M. A.; RIMOIN, A. W.; RYDER, R. W.

2008-01-01

SUMMARY This study examined the prevalence of HIV and other sexually transmitted infections (STIs) in pregnant women in Kinshasa, the Democratic Republic of the Congo (DRC). Between April and July 2004, antenatal attendees at two of the largest maternity clinics in Kinshasa were tested to identify HIV status, syphilis, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). HIV seroprevalence was 1·9% in 2082 women. With PCR techniques, CT and NG infections were also uncommon in the first 529 women (1·7% and 0·4%, respectively). No active syphilis infection case was identified by Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin test (RPR). A woman's risk of HIV infection was significantly associated with her reporting a male partner having had other female sexual partners (OR 2·7, 95% CI 1·2–6·2). The continuing low seroprevalence of HIV in pregnant women from Kinshasa was confirmed. Understanding factors associated with this phenomenon could help prevent a future HIV epidemic in low HIV transmission areas in Africa. PMID:18028581

Paleoenvironments, δ13C and δ18O signatures in the Neoproterozoic carbonates of the Comba Basin, Republic of Congo: Implications for regional correlations and Marinoan event

NASA Astrophysics Data System (ADS)

Préat, Alain; Delpomdor, Franck; Ackouala Mfere, Anna Perla; Callec, Yannick

2018-01-01

The Ediacaran Schisto-Calcaire Group is a ∼1300 m-thick succession belonging to the West Congo Supergroup in Central Africa. In the Comba Basin, it consists of three carbonate-dominated units defined as formations (SCI to SCIII) that are unconformably overlain by clastic deposits (Mpioka Group) interpreted as a molassic formation associated with the Panafrican Orogen. The underlying Upper Tillite and Cap Carbonate (SCIa) units, considered as markers of the Snowball Earth event were studied in three sections. We investigated the carbonates of the Schisto-Calcaire Group by defining new microfacies (MF1-MF7) and we performed C and O isotopic analyses in order to constraint the depositional and diagenetic events directly after the Marinoan interval. Stratigraphic variations of the stable isotopes are important in the series with lighter δ18O values (>1.5‰) than those of the Neoproterozoic ocean in the SCIc unit. According to regional stratigraphy a temperature effect can be dismissed and a freshwater surface layer is the origin of such negative δ18O values in this unit. The negative δ13C anomaly (-3.5‰ on average) of the Cap Carbonate is similarly to the δ18O values (-6.4‰ on average) in the range of the marine domain during postglacial sea level rise. The sample suite as a whole (SCII and SCIII formations) displays heavier δ18O and δ13C than those of the lower part (SCI unit) of the Schisto-Calcaire Group. The comparison with the Lower Congo (Democratic Republic of Congo) and Nyanga (Gabon) basins shows that the meteoric flushing in SCIc unit of the Schisto-Calcaire Group was regional and not local, and could be derived from a climatic evolution. Although an overall overprint is present, our isotopic relationships argue against overall diagenetic resetting of primary compositions and suggest that with careful examination combined with detailed petrographic analysis general depositional and diagenetic controls can be discerned in oxygen and carbon

[Preliminary results of an herpetology investigation in sugar cane plantation in Democratic Republic of Congo].

PubMed

Malukisa, J; Collet, M; Bokata, S; Odio, W

2005-11-01

Out of the 3,000 species of snakes described in the world, 163 are currently known from D.R. of Congo. We performed a systematic survey in sugar-cane plantations of the Sugar Company of Kwilu-Ngongo (Bas-Congo), located at 160 km South-West from Kinshasa and exploiting nearly 10,000 ha. The plantation is divided into 3 sectors in the middle of which we deposited barrels filled of formaldehyde. All the employees of the Sugar Company of Kwilu-Ngongo were requested to collect encountered snakes and put them in the nearest barrel. Between August 9th and September 21st, 2004, we collected 36 snakes in two different sites, revealing the presence of 3 families and 12 species. The most abundant species in Causus maculatus (47% in the first site--Point 8--and 29% in the second site--Point 13). The most poisonous and dangerous species were captured only in the first site--point 8, and were Dendroaspis jamesoni and Naja melanoleuca, both young.

[A case of tuberculous otitis media associated with meningoencephalitis in the Bangui paediatric institution (Central African Republic)].

PubMed

Gody, J-C; Kassa-Kelembho, E; Bobossi-Serengbe, G; Beyam, E-N; Bercion, R

2006-03-01

The authors report a case of fatal tuberculous meningoencephalitis following chronic bilateral otitis media in a child. Mycobacterium tuberculosis was identified in the CSF and in the otitis secretions. There were no pulmonary tuberculosis signs, thus the tuberculous otitis was considered as primary. In high tuberculosis endemic areas like Central African Republic it is important to consider tuberculosis, in chronic otitis media resistant to non specific therapy, and to reinforce the immunization programs for children.

[Sexual violence in Congo-Kinshasa: necessity of decriminalizing abortion].

PubMed

Kalonda, J C Omba

2012-01-01

The sexual violence's committed in the Democratic Republic of Congo (DRC) are from their scales and consequences on women, real public health, politico-legal, and socio-economical challenges. More than a million of women have been victims of sexual violence on a period of less than fifteen years. Systematic rapes of women were used as war weapon by different groups involved in the Congolese war. Sexual violence against women has impacted public health by spreading sexually transmissible diseases including HIV/AIDS, causing unwanted pregnancies, leading to the gynaecological complications of rape-related injuries, and inflicting psychological trauma on the victims. Despite high level of unwanted pregnancies observed, the Congolese law is very restrictive and interdict induced abortion. This paper presents three arguments which plead in favour of legalizing abortion in DRC: 1) a restrictive law on abortion forces women to use unsafe abortion and increase incidence of injuries and maternal mortality ; 2) DRC has ratified the universal Declaration of human rights, the African union charter, and has than to promote equality between sexes, in this is included women reproductive rights; 3) an unwanted birth is an additional financial charge for a woman, a factor increasing poverty and psychologically unacceptable in case of rape. From the politico-legal point of view, ending rape impunity and decriminalizing abortion are recommended. Decriminalizing abortion give women choice and save victims and pregnant women from risks related to the pregnancy, a childbirth, or an eventual unsafe abortion. These risks increase the maternal mortality already high in DRC (between 950 and 3000 for 100000 live births).

Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013.

PubMed

Carrel, Margaret; Janko, Mark; Mwandagalirwa, Melchior Kashamuka; Morgan, Camille; Fwamba, Franck; Muwonga, Jérémie; Tshefu, Antoinette K; Meshnick, Steven; Emch, Michael

2016-05-01

The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9-1.3] of adults aged 15-49 in 2013 (UNAIDS). Within the 2 million km(2) country, however, there exists spatial variation in HIV prevalence, with the highest HIV prevalence observed in the large cities of Kinshasa and Lubumbashi. Globally, HIV is an increasingly rural disease, diffusing outwards from urban centers of high HIV prevalence to places where HIV was previously absent or present at very low levels. Utilizing data collected during Demographic and Health Surveillance (DHS) in 2007 and 2013 in the DRC, we sought to update the map of HIV prevalence in the DRC as well as to explore whether HIV in the DRC is an increasingly rural disease or remains confined to urban areas. Bayesian kriging and regression indicate that HIV prevalence in rural areas of the DRC is higher in 2013 than in 2007 and that increased distance to an urban area is no longer protective against HIV as it was in 2007. These findings suggest that HIV education, testing and prevention efforts need to diffuse from urban to rural areas just as HIV is doing. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Human African trypanosomiasis in an urban area: an emerging problem?].

PubMed

Louis, F J; Bilenge, C M; Simarro, P P; Meso, V Kande; Lucas, P; Jannin, J

2003-08-01

The human African trypanosomiasis is essentially a rural disease. The notification of cases in urban area has always been incidental; either a diagnosis made in town revealed a disease contracted in rural environment or it meant the preservation of a complete epidemiological cycle in a remaining urban micro-focus. In Kinshasa, in Democratic Republic of Congo, about forty cases have been notified each year. All of them came from the nearby foci of Bandundu, Lower Congo and Kasaï. In 1996 the number of cases reached suddenly 254 and today the average annual number comes up to 500 in spite of all the efforts undertaken to fight the disease. A study of cases in 1998 and 1999 shows that patients are essentially distributed in suburbs and that the most affected by the disease are the 15-49 year old ones whose job is related with agricultural or fishing activities. Two phenomena seem to explain this sudden increase: the massive inflow of refugees in outskirts of town coming from provinces where trypanosomiasis is endemic and a major economic crisis throwing out urban population in suburbs living on a subsistence micro-agriculture. These concomitant factors have contributed to the setting up of a trypanosomiasis belt around the capital. Today a strategy has to be reconsidered in order to fight against the disease in the capital itself and to make the medical staff aware of the diagnosis of a disease still unknown in their sanitary district.

Radio and Television in Literacy. A Survey of the Use of the Broadcasting Media in Combating Illiteracy among Adults.

ERIC Educational Resources Information Center

Maddison, John

Information obtained in a survey of the uses of radio and television in connection with literacy work in 40 countries of the world is presented. Much of the information consists of replies to Unesco questionnaires on the subject. The countries surveyed were: Algeria, Cameroon, Central African Republic, Chad, Congo (Brazzaville), Ethiopia, Gabon,…

The Dilemmas of Explaining Africa

ERIC Educational Resources Information Center

Ochonu, Moses

2008-01-01

African professors are often asked by Americans at academic gatherings, campus events, and informal social gatherings what they think of the never-ending civil war in the Democratic Republic of the Congo, the genocide in Sudan, anarchy in Somalia, last year's disastrous elections in Nigeria, the Kenyan political crisis, and other problems. Whether…

Proceedings of the African Field Epidemiology Network (AFENET) Scientific Conference 17-22 November 2013 Addis Ababa, Ethiopia: plenaries and oral presentations.

PubMed

Gitta, Sheba Nakacubo; Mwesiga, Allan; Kamadjeu, Raoul

2015-01-01

Biennially, trainees and graduates of Field Epidemiology and Laboratory Training Programs (FELTPs) are presented with a platform to share investigations and projects undertaken during their two-year training in Applied Epidemiology. The African Field Epidemiology Network (AFENET) Scientific Conference, is a perfect opportunity for public health professionals from various sectors and organizations to come together to discuss issues that impact on public health in Africa. This year's conference was organized by the Ethiopian Health and Nutrition Research Institute in collaboration with the Ethiopia Ministry of Health, Ethiopian Public Health Association (EPHA), Ethiopia Field Epidemiology Training Program (EFETP), Addis Ababa University (AAU), Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) and AFENET. Participants at this year's conference numbered 400 from over 20 countries including; Angola, Burkina Faso, Cameroon, Central African Republic, Democratic Republic of the Congo, Ethiopia, Ghana, Indonesia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Sudan, Tanzania, Uganda, Yemen and Zimbabwe. The topics covered in the 144 oral presentations included: global health security, emergency response, public health informatics, vaccine preventable diseases, immunization, outbreak investigation, Millennium Development Goals, Non-Communicable Diseases, and public health surveillance. The theme for the 5th AFENET Scientific Conference was; "Addressing Public Health Priorities in Africa through FELTPs." Previous AFENET Scientific conferences have been held in: Accra, Ghana (2005), Kampala, Uganda (2007), Mombasa, Kenya (2009) and Dar es Salaam, Tanzania (2011).

How did bonobos come to range south of the congo river? Reconsideration of the divergence of Pan paniscus from other Pan populations.

PubMed

Takemoto, Hiroyuki; Kawamoto, Yoshi; Furuichi, Takeshi

2015-01-01

While investigating the genetic structure in wild bonobos,(1) we realized that the widely accepted scenario positing that the Pleistocene appearance of the Congo River separated the common ancestor of chimpanzees (Pan troglodytes) and bonobos (P. paniscus) into two species is not supported by recent geographical knowledge about the formation of the Congo River. We explored the origin of bonobos using a broader biogeographical perspective by examining local faunas in the central African region. The submarine Congo River sediments and paleotopography of central Africa show that the Congo River has functioned as a geographical barrier for the last 34 million years. This evidence allows us to hypothesize that when the river was first formed, the ancestor of bonobos did not inhabit the current range of the species on the left bank of the Congo River but that, during rare times when the Congo River discharge decreased during the Pleistocene, one or more founder populations of ancestral Pan paniscus crossed the river to its left bank. The proposed scenario for formation of the Congo River and the corridor hypothesis for an ancestral bonobo population is key to understanding the distribution of great apes and their evolution. © 2015 Wiley Periodicals, Inc.

Assessment of hypertension management in primary health care settings in Kinshasa, Democratic Republic of Congo.

PubMed

Lulebo, Aimée M; Mapatano, Mala A; Kayembe, Patrick K; Mafuta, Eric M; Mutombo, Paulin B; Coppieters, Yves

2015-12-24

Hypertension-related complications have become more diagnosed at secondary and tertiary care levels, in the Democratic Republic of the Congo (DRC), probably indicative of poor management of hypertensive patients at primary health care level. This study aimed to assess the management of hypertension in primary health care settings by using guidelines of the International Forum for Prevention and Control of HTN in Africa (IFHA). A multi-center cross-sectional study was carried out in primary health care settings. A total of 102 nurses were surveyed using a structured interview. Mean and proportion comparisons were performed using the t Student test and the Chi-square test respectively. The Kinshasa Primary Health Care network facilities were compared with non-Kinshasa Primary Health Care network facilities. From the 102 nurses surveyed; 52.9% were female with a mean age of 41.1, (SD = 10) years, merely 9.5% benefited from in-job training on cardiovascular diseases or their risk factors, and 51.7% had guidelines on the management of hypertension. Less than a quarter of the nurses knew the cut-off values of hypertension, diabetes and obesity. Merely 14.7% knew the therapeutic goals for uncomplicated hypertension. Several of the indicators for immediate referral recommended by IFHA were unmentioned. The content of patient education was lacking, avoiding stress being the best advice provided to hypertensive patients. The antihypertensive most used were unlikely to be recommended by the IFHA. This study showed a considerable gap of knowledge and practices in the management of hypertensive patients at primary health care facilities in Kinshasa pertaining to the IFHA guidelines. We think that task-shifting for management of hypertension is feasible if appropriate guidelines are provided and nurses trained.

Sensibility analysis of VORIS lava-flow simulations: application to Nyamulagira volcano, Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Syavulisembo, A. M.; Havenith, H.-B.; Smets, B.; d'Oreye, N.; Marti, J.

2015-03-01

Assessment and management of volcanic risk are important scientific, economic, and political issues, especially in densely populated areas threatened by volcanoes. The Virunga area in the Democratic Republic of Congo, with over 1 million inhabitants, has to cope permanently with the threat posed by the active Nyamulagira and Nyiragongo volcanoes. During the past century, Nyamulagira erupted at intervals of 1-4 years - mostly in the form of lava flows - at least 30 times. Its summit and flank eruptions lasted for periods of a few days up to more than two years, and produced lava flows sometimes reaching distances of over 20 km from the volcano, thereby affecting very large areas and having a serious impact on the region of Virunga. In order to identify a useful tool for lava flow hazard assessment at the Goma Volcano Observatory (GVO), we tested VORIS 2.0.1 (Felpeto et al., 2007), a freely available software (http://www.gvb-csic.es) based on a probabilistic model that considers topography as the main parameter controlling lava flow propagation. We tested different Digital Elevation Models (DEM) - SRTM1, SRTM3, and ASTER GDEM - to analyze the sensibility of the input parameters of VORIS 2.0.1 in simulation of recent historical lava-flow for which the pre-eruption topography is known. The results obtained show that VORIS 2.0.1 is a quick, easy-to-use tool for simulating lava-flow eruptions and replicates to a high degree of accuracy the eruptions tested. In practice, these results will be used by GVO to calibrate VORIS model for lava flow path forecasting during new eruptions, hence contributing to a better volcanic crisis management.

Acceptability of the community-level provision of Sayana® Press by medical and nursing students in Kinshasa, Democratic Republic of the Congo.

PubMed

Bertrand, Jane T; Makani, Paul Bukutuvwidi; Hernandez, Julie; Akilimali, Pierre; Mukengeshayi, Bitshi; Babazadeh, Saleh; Binanga, Arsene

2017-09-01

The objectives were to assess acceptors' attitudes toward Sayana® Press as a method and toward the mechanism of community-based distribution by medical and nursing (M/N) students, known locally as "DBCs," in Kinshasa, Democratic Republic of the Congo, and to evaluate the experience of these DBCs. In 2015, surveys were conducted among (1) acceptors of Sayana® Press on the day of the initial injection, (2) these same acceptors 3 months later and (3) the DBCs providing community-based services. The analysis was descriptive and involved no significance testing. Acceptors of Sayana® Press expressed high levels of satisfaction with the method, despite some pain experienced at injection and subsequent side effects. Although most were satisfied with the counseling and services received from the DBCs, less than one third realized that the providers were M/N students. The DBCs expressed satisfaction in serving as community-based distributors; more than 95% would recommend it to others. Their primary complaints were lack of remuneration, stockouts and need for greater supervision. Consistent with results from previous pilot introductions of Sayana® Press in three African countries, clients were highly satisfied with Sayana® Press as a method. The reported preference for resupply at health centers may reflect a lack of client awareness that the DBCs administering methods near the health center were not in fact staff from the health center. The pilot served to gain acceptance for the use of M/N students in community-based distribution, paving the way for additional task-shifting pilots in Kinshasa. Sayana® Press represents a promising new method for increasing access to modern contraception in low-income countries. The Kinshasa experience is the first to test the use of medical and nursing students as providers at the community level. The study reports high levels of satisfaction on three counts: acceptors of the contraceptive method, acceptors of the mode of service

Genomics of an emerging clone of Salmonella serovar Typhimurium ST313 from Nigeria and the Democratic Republic of Congo.

PubMed

Leekitcharoenphon, Pimlapas; Friis, Carsten; Zankari, Ea; Svendsen, Christina Aaby; Price, Lance B; Rahmani, Maral; Herrero-Fresno, Ana; Fashae, Kayode; Vandenberg, Olivier; Aarestrup, Frank M; Hendriksen, Rene S

2013-10-15

Salmonella enterica serovar Typhimurium ST313 is an invasive and phylogenetically distinct lineage present in sub-Saharan Africa. We report the presence of S. Typhimurium ST313 from patients in the Democratic Republic of Congo and Nigeria. Eighteen S. Typhimurium ST313 isolates were characterized by antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). Additionally, six of the isolates were characterized by whole genome sequence typing (WGST). The presence of a putative virulence determinant was examined in 177 Salmonella isolates belonging to 57 different serovars. All S. Typhimurium ST313 isolates harbored resistant genes encoded by blaTEM1b, catA1, strA/B, sul1, and dfrA1. Additionally, aac(6')1aa gene was detected. Phylogenetic analyses revealed close genetic relationships among Congolese and Nigerian isolates from both blood and stool. Comparative genomic analyses identified a putative virulence fragment (ST313-TD) unique to S. Typhimurium ST313 and S. Dublin. We showed in a limited number of isolates that S. Typhimurium ST313 is a prevalent sequence-type causing gastrointestinal diseases and septicemia in patients from Nigeria and DRC. We found three distinct phylogenetic clusters based on the origin of isolation suggesting some spatial evolution. Comparative genomics showed an interesting putative virulence fragment (ST313-TD) unique to S. Typhimurium ST313 and invasive S. Dublin.

Investigation of pregnancy-associated malaria by microscopy, rapid diagnostic test and PCR in Bandundu, the Democratic Republic of Congo.

PubMed

Ruh, Emrah; Bateko, Jean Paul; Imir, Turgut; Taylan-Ozkan, Aysegul

2018-01-01

The study was conducted to investigate malaria prevalence among a group of women in the Democratic Republic of Congo (DRC) who received intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). A total of 250 women from Bandundu city who received two doses of IPTp-SP were enrolled in the survey. Blood samples were collected at the time of delivery and malaria prevalence was determined using microscopy, rapid diagnostic test (RDT), and nested polymerase chain reaction (PCR). Malaria infection was detected in 81 (32.4%), 93 (37.2%), and 92 (36.8%) samples by microscopy, RDT, and PCR, respectively. Among 92 samples, P. falciparum mono-infection (n=87; 94.5%), P. falciparum+P. vivax (n=2; 2.2%) and P. falciparum+P. malariae (n=1; 1.1%) mixed infections, and P. vivax mono-infection (n=2; 2.2%) were detected. Prevalence of malaria was not affected by age and number of pregnancies (p>0.05). Microscopy and RDT, either alone (κ=0.29; p<0.001) or in combination (κ=0.33; p<0.001) showed a fair agreement with PCR. Our findings indicate that two doses of IPTp-SP did not protect the women against malaria in the DRC, and support the World Health Organization (WHO) guidelines that ensure a minimum of three doses of SP in pregnancy.

Country watch: Central African Republic (CAR).

PubMed

Aubel, J; Sobela, F; Voga, P

1997-01-01

This article describes the activities of the Community Peer AIDS Education Project, initiated in 1995 in the Central African Republic (CAR). The CAR project was created by the National AIDS Committee (NAC) and the US Peace Corps. A 4-day workshop was held at the onset for project staff and consultants. Staff developed a simple monitoring and evaluation (M&E) system that emphasizes "learning." M&E schemes measure project outputs, expenditures, and other measures of program implementation in order to help staff gradually improve implementation. M&E helps staff document activities, share information, and learn from the implementation process. Project activities are documented by maintaining community logbooks, taking photos of significant aspects of the educational activities, and leading informal discussion groups. The CAR project engaged in sharing and learning activities by holding meetings with peer leaders, team meetings, meetings with project managers, and meetings with the NAC. Once a month, peer field coordinators conducted a structured exercise with peer leaders. One aim was to gain their feedback on the successes and constraints of activities. Another was to make suggestions on how to improve activities. These structured exercises are recorded as lessons learned in a project book. Team meetings are held periodically. During meetings, staff review project books and photos and discuss successes and problems encountered. Project manager meetings provide time to share lessons learned and to suggest project strengthening options. NAC meetings between the project manager and field coordinators allow for a bottom-up learning process. CAR project staff were receptive to M&E efforts.

75 FR 61239 - Request for Public Comments on Annual Review of Country Eligibility for Benefits Under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... Verde, Republic of Cameroon, Republic of Chad, Federal Islamic Republic of Comoros, Republic of Congo, Democratic Republic of Congo, Republic of Djibouti, Ethiopia, Gabonese Republic, The Gambia, Republic of...

Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo.

PubMed

Bartels, Susan A; Scott, Jennifer A; Leaning, Jennifer; Kelly, Jocelyn T; Joyce, Nina R; Mukwege, Denis; Vanrooyen, Michael J

2012-12-01

One of the most striking features of the ongoing conflict in the Democratic Republic of Congo (DRC) is the use of sexual violence. In spite of the brutality of these crimes, the experiences of women affected by sexual violence in Eastern DRC remain poorly characterized. This analysis aimed to (1) provide detailed demographics of sexual violence survivors presenting to Panzi Hospital; (2) examine how demographic factors might impact patterns of sexual violence; and (3) describe care-seeking behavior among sexual violence survivors. The demographics and care-seeking behavior of sexual violence survivors in South Kivu Province were described from a retrospective registry-based study of sexual violence survivors presenting to Panzi Hospital (2004-2008). A total of 4311 records were reviewed. The mean age of survivors was 35 years. Most women (53%) were married, self-identified with the Bashi tribe (65%), and reported agriculture as their livelihood (74%). The mean time delay between sexual assault and seeking care was 10.4 months. Five reasons were identified to help explain the lengthy delays to seeking care: waiting for physical symptoms to develop or worsen before seeking medical attention, lack of means to access medical care, concerns that family would find out about the sexual assault, stigma surrounding sexual violence, and being abducted into sexual slavery for prolonged periods of time. Many sexual assault survivors have very delayed presentations to medical attention. Promoting timely access of medical care may best be facilitated by reducing stigma and by educating women about the benefits of early medical care, even in the absence of injuries or symptoms.

Importation of chloroquine-resistant Plasmodium falciparum by Guatemalan peacekeepers returning from the Democratic Republic of the Congo

PubMed Central

2013-01-01

Background Malaria elimination is being pursued in five of seven Central American countries. Military personnel returning from peacekeeping missions in sub-Saharan Africa could import chloroquine-resistant Plasmodium falciparum, posing a threat to elimination and to the continued efficacy of first-line chloroquine (CQ) treatment in these countries. This report describes the importation of P. falciparum from among 150 Guatemalan army special forces and support staff who spent ten months on a United Nations’ peacekeeping mission in the Democratic Republic of the Congo (DRC) in 2010. Methods Investigators reviewed patients’ medical charts and interviewed members of the contingent to identify malaria cases and risk factors for malaria acquisition. Clinical specimens were tested for malaria; isolated parasites were characterized molecularly for CQ resistance. Results Investigators identified 12 cases (8%) of laboratory-confirmed P. falciparum infection within the contingent; one case was from a soldier infected with a CQ-resistant pfcrt genotype resulting in his death. None of the contingent used an insecticide-treated bed net (ITN) or completely adhered to malaria chemoprophylaxis while in the DRC. Conclusion This report highlights the need to promote use of malaria prevention measures, in particular ITNs and chemoprophylaxis, among peacekeepers stationed in malaria-endemic areas. Countries attempting to eliminate malaria should consider appropriate methods to screen peacekeepers returning from endemic areas for malaria infections. Cases of malaria in travellers, immigrants and soldiers returning to Central America from countries with CQ-resistant malaria should be assumed to be carry resistant parasites and receive appropriate anti-malarial therapy to prevent severe disease and death. PMID:24060234

Quality of the antimalarial medicine artemether - lumefantrine in eight cities of the Democratic Republic of the Congo.

PubMed

Mufusama, Jean-Pierre; Ioset, Karine Ndjoko; Feineis, Doris; Hoellein, Ludwig; Holzgrabe, Ulrike; Bringmann, Gerhard

2018-06-12

In the context of post-marketing surveillance supporting public-health authorities to take evidence-based decisions to fight the spread of poor-quality medicines, the quality of antimalarial artemether-lumefantrine (AL) medicines was assessed in the Democratic Republic of the Congo (DRC). A total of 150 samples of AL containing products was collected from private pharmaceutical outlets in eight main cities: Goma, Kikwit, Kinshasa, Kisangani, Lubumbashi, Matadi, Mbandaka, and Mbuji-Mayi. All drug samples were successively analyzed by visual inspection, thin-layer chromatography (TLC), and high-performance liquid chromatography (HPLC) following The International Pharmacopoeia. Out of the 150 collected drug samples, three (2%) failed the visual inspection as they had shelf lives different from those of other samples with the same brand name. Four samples (2.7%) did not pass the TLC test as they contained only one or even none of the two declared active pharmaceutical ingredients (APIs). HPLC assays showed that 46 (30.7%) samples had artemether contents below 90% and 17 (11.3%) above 110% of the content claimed on the label. For lumefantrine, 32 (21.7%) samples had contents below 90%, and eight (5.3%) had contents above 110%. This survey in DRC gives evidence that poor-quality antimalarial medicines are widely present. Based on three detection techniques, the study shows the necessity to equip developing countries with modern techniques such as HPLC, which, if combined with affordable techniques like TLC, could provide a pertinent analytical strategy to combat drug counterfeiting and poor manufacturing. This article is protected by copyright. All rights reserved.

Palenque de San Basilio in Colombia: genetic data support an oral history of a paternal ancestry in Congo

PubMed Central

Ansari-Pour, Naser; Moñino, Yves; Duque, Constanza; Gallego, Natalia; Bedoya, Gabriel; Thomas, Mark G.; Bradman, Neil

2016-01-01

The Palenque, a black community in rural Colombia, have an oral history of fugitive African slaves founding a free village near Cartagena in the seventeenth century. Recently, linguists have identified some 200 words in regular use that originate in a Kikongo language, with Yombe, mainly spoken in the Congo region, being the most likely source. The non-recombining portion of the Y chromosome (NRY) and mitochondrial DNA were analysed to establish whether there was greater similarity between present-day members of the Palenque and Yombe than between the Palenque and 42 other African groups (for all individuals, n = 2799) from which forced slaves might have been taken. NRY data are consistent with the linguistic evidence that Yombe is the most likely group from which the original male settlers of Palenque came. Mitochondrial DNA data suggested substantial maternal sub-Saharan African ancestry and a strong founder effect but did not associate Palenque with any particular African group. In addition, based on cultural data including inhabitants' claims of linguistic differences, it has been hypothesized that the two districts of the village (Abajo and Arriba) have different origins, with Arriba founded by men originating in Congo and Abajo by those born in Colombia. Although significant genetic structuring distinguished the two from each other, no supporting evidence for this hypothesis was found. PMID:27030413

Palenque de San Basilio in Colombia: genetic data support an oral history of a paternal ancestry in Congo.

PubMed

Ansari-Pour, Naser; Moñino, Yves; Duque, Constanza; Gallego, Natalia; Bedoya, Gabriel; Thomas, Mark G; Bradman, Neil

2016-03-30

The Palenque, a black community in rural Colombia, have an oral history of fugitive African slaves founding a free village near Cartagena in the seventeenth century. Recently, linguists have identified some 200 words in regular use that originate in a Kikongo language, with Yombe, mainly spoken in the Congo region, being the most likely source. The non-recombining portion of the Y chromosome (NRY) and mitochondrial DNA were analysed to establish whether there was greater similarity between present-day members of the Palenque and Yombe than between the Palenque and 42 other African groups (for all individuals,n= 2799) from which forced slaves might have been taken. NRY data are consistent with the linguistic evidence that Yombe is the most likely group from which the original male settlers of Palenque came. Mitochondrial DNA data suggested substantial maternal sub-Saharan African ancestry and a strong founder effect but did not associate Palenque with any particular African group. In addition, based on cultural data including inhabitants' claims of linguistic differences, it has been hypothesized that the two districts of the village (Abajo and Arriba) have different origins, with Arriba founded by men originating in Congo and Abajo by those born in Colombia. Although significant genetic structuring distinguished the two from each other, no supporting evidence for this hypothesis was found. © 2016 The Author(s).

Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013

PubMed Central

Polonsky, Jonathan; Ciglenecki, Iza; Bichet, Mathieu; Coldiron, Matthew; Thuambe Lwiyo, Enoch; Akonda, Innocent; Serafini, Micaela; Porten, Klaudia

2018-01-01

In 2013, a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage, retrospective cluster survey to estimate the attack rate, the case fatality rate, and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0%, (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children, those who did not receive care, and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measles related death. Vaccination coverage prior to the outbreak was low (76%), and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural, inaccessible resource-poor setting. PMID:29538437

Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013.

PubMed

Gignoux, Etienne; Polonsky, Jonathan; Ciglenecki, Iza; Bichet, Mathieu; Coldiron, Matthew; Thuambe Lwiyo, Enoch; Akonda, Innocent; Serafini, Micaela; Porten, Klaudia

2018-01-01

In 2013, a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage, retrospective cluster survey to estimate the attack rate, the case fatality rate, and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0%, (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children, those who did not receive care, and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measles related death. Vaccination coverage prior to the outbreak was low (76%), and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural, inaccessible resource-poor setting.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Le Fournier, J.

The Congo basin, in Equatorial Africa, is an enormous topographic depression, roughly coinciding with the drainage system of the Congo (or Zaire) River and its tributaries. It covers nearly 2 million sq km, mostly in the Republic of Zaire, the Republic of Congo, and the Central African Republic. With only 2,900 km of seismic profiling and two exploration wells, it can be considered almost unexplored. No exploration work is in progress. Data derived from wells, seismic profiles, and some field reconnaissance surveys have been reviewed in initial articles by Lawrence et al. and Daly et al. Based on the availablemore » data, these authors have proposed a model of the basin, which is summarized. Based on the same data complemented by more-elaborate sedimentological interpretations, focusing on paleoenvironmental reconstruction, this author proposes a significantly different model concluding in the nonexistence of the Galamboge play, at least in the central part of the basin. He counters with the alternative of the probable existence of a variety of other plays located at different stratigraphic intervals and distributed in different sectors of the basin. While this alternative model certainly downgrades the Galamboge sandstones play, in return it considerably upgrades the global estimate of the petroleum potential of the Congo basin. Indeed, it shows that this basin displays most of the characteristics generally attached to major intracratonic petroleum provinces.« less

A case study of risk factors for lymphatic filariasis in the Republic of Congo.

PubMed

Chesnais, Cédric B; Missamou, François; Pion, Sébastien D; Bopda, Jean; Louya, Frédéric; Majewski, Andrew C; Fischer, Peter U; Weil, Gary J; Boussinesq, Michel

2014-07-01

Little is known regarding risk factors for lymphatic filariasis (LF) in Central Africa. We studied the epidemiology of LF in an endemic village in the Republic of Congo. Dependent variables were Wuchereria bancrofti antigenemia (ICT card test) and microfilaremia (night blood smears). The following factors were investigated: sex, age, bed net, latrines, source of water, uptake of anthelmintic drugs, hunting/fishing activities, and occasionally sleeping in the bush. Mixed multivariate logistic regression models were used. 134 of 774 subjects aged ≥ 5 years (17.3%) had W. bancrofti antigenemia and 41 (5.3%) had microfilaremia (mf). Infection rates increased with age up to roughly 20 years and remained stable thereafter. Multivariate analysis of antigenemia demonstrated an increased risk for males (OR = 2.0 [1.3-3.0]) and for people who hunt or fish (OR = 1.5 [1.0-2.4]) and a protective effect of latrines (OR = 0.5 [0.4-0.8]). Among males, those hunting or fishing at night had an increased risk for antigenemia (OR = 1.9 [1.1-3.5]), and use of latrines was protective (OR = 0.5 [0.3-0.9]). For females, bed nets were protective (OR = 0.4 [0.1-0.9]), and there was a strong household effect (intraclass correlation coefficient [ICC]: 0.24). When mf was used as the dependent variable, males had a higher risk for infection (OR = 5.4 [2.1-13.4]), latrines had a protective effect (OR = 0.4 [0.1-0.9]) and there was a marked household effect (ICC = 0.49). Age, sex, and occupation-dependent exposure to mosquitoes were important risk factors for infection with W. bancrofti in this study. It is likely that men often acquire infection in high transmission areas outside of the village, while children and women are infected in areas with lower transmission inside or near the village. Additional studies are needed to determine whether these findings apply to other areas in Central Africa.

Heath Sector Network Governance and State-building in South Kivu, Democratic Republic of Congo.

PubMed

Bwimana, Aembe

2017-12-01

Longstanding patterns of interaction exist between state and non-state actors seeking to improve public health in Democratic Republic of Congo (DRC). DRC is a weak state, and, in many cases, private actors have stepped in to fill the void created by the lack of state health care provision. However, the role of these interactions in creating a governance network in the health sector has been underexplored. Using data from 18 months of qualitative field research, this study aimed to explore governance networks in DRC's health sector, examining how multiple stakeholders work to manage the health system and how the resulting governance network has been relevant for the state-building process. The findings demonstrate that the health sector in South Kivu is emerging as an arena of networked governance based on active partnerships between state institutions and non-state actors. Interactions between state and non-state actors account for the persistence of the health sector in a setting characterized by state weakness. However, networked governance does not function optimally, because, although non-state interventions fill the void where the state falls short, the DRC state has faced the challenge of interacting with partners with fragmented and horizontally competing agendas. Although weak, the shadow of state authority is present in the arena of stakeholders' interactions, as the state plays a determining role by providing a regulatory framework. Overall, the findings show that the interactive engagement of non-state actors contributes to improving institutional capacity through these actors' engagement with state institutions for health system management and institutional development. However, although networked health sector governance does contribute to state capacity, it is difficult to assess the real influence of these interactions on the state-building process in a context of critical fragility, where coordination and alignment have been problematic. © The

[Circulating vaccine-derived poliovirus type 2 outbreak in Democratic Republic of Congo 2011-2012].

PubMed

Bazira, L; Coulibaly, T; Mayenga, M; Ncharre, C; Yogolelo, R; Mbule, A; Moudzeo, H; Lwamba, P; Mulumba, A W; Cabore, J

2015-10-01

According to the WHO records of 2013, the incidence of poliomyelitis was reduced by more than 99%, the number of endemic countries decreased from 125 in 1988 to 3 in 2013 and over 10 million cases were prevented from poliomyelitis thanks to the intensive use of Oral polio vaccine (OPV). However, the emergence of circulating vaccine-derived poliovirus strains (cVDPV), causing serious epidemics like the wild poliovirus, is a major challenge on the final straight towards the goal of eradication and OPV cessation. This paper describes the cVDPVoutbreak that occurred in the Democratic Republic of Congo (DRC) from November 2011 to April 2012. All children under 15 years of age with acute flaccid paralysis (AFP) and confirmed presence of cVDPV in the stool samples were included. Thirty (30) children, all from the administrative territories of Bukama and Malemba Nkulu in the Katanga Province (south-east DRC), were reported. The virus responsible was the cVDPV type 2 (0.7% -3.5% divergent from the reference Sabin 2 strain) in 29 children (97%) and the ambiguous vaccine-derived poliovirus strain (0.7% divergent) was confirmed in one case (3%), a boy seventeen months old and already vaccinated four times with OPV. Twentyfive children (83%) were protected by any of the routine EPI vaccines and 3 children (10%) had never received any dose of OPV. In reaction, DRC has conducted five local campaigns over a period of 10 months (from January to October 2012) and the epidemic was stopped after the second round performed in March 2012. As elsewhere in similar conditions, low immunization coverage, poor sanitation conditions and the stop of the use of OPV2 have favoured the emergence of the third cVDPV epidemic in DRC. The implementation of the Strategic Plan for Polio eradication and endgame strategic plan 2013-2018 will prevent the emergence of cVDPV and set up the conditions for a coordinated OPV phase out.

Sociocultural determinants of anticipated oral cholera vaccine acceptance in three African settings: a meta-analytic approach.

PubMed

Sundaram, Neisha; Schaetti, Christian; Merten, Sonja; Schindler, Christian; Ali, Said M; Nyambedha, Erick O; Lapika, Bruno; Chaignat, Claire-Lise; Hutubessy, Raymond; Weiss, Mitchell G

2016-01-14

Controlling cholera remains a significant challenge in Sub-Saharan Africa. In areas where access to safe water and sanitation are limited, oral cholera vaccine (OCV) can save lives. Establishment of a global stockpile for OCV reflects increasing priority for use of cholera vaccines in endemic settings. Community acceptance of vaccines, however, is critical and sociocultural features of acceptance require attention for effective implementation. This study identifies and compares sociocultural determinants of anticipated OCV acceptance across populations in Southeastern Democratic Republic of Congo, Western Kenya and Zanzibar. Cross-sectional studies were conducted using similar but locally-adapted semistructured interviews among 1095 respondents in three African settings. Logistic regression models identified sociocultural determinants of OCV acceptance from these studies in endemic areas of Southeastern Democratic Republic of Congo (SE-DRC), Western Kenya (W-Kenya) and Zanzibar. Meta-analytic techniques highlighted common and distinctive determinants in the three settings. Anticipated OCV acceptance was high in all settings. More than 93% of community respondents overall indicated interest in a no-cost vaccine. Higher anticipated acceptance was observed in areas with less access to public health facilities. In all settings awareness of cholera prevention methods (safe food consumption and garbage disposal) and relating ingestion to cholera causation were associated with greater acceptance. Higher age, larger households, lack of education, social vulnerability and knowledge of oral rehydration solution for self-treatment were negatively associated with anticipated OCV acceptance. Setting-specific determinants of acceptance included reporting a reliable income (W-Kenya and Zanzibar, not SE-DRC). In SE-DRC, intention to purchase an OCV appeared unrelated to ability to pay. Rural residents were less likely than urban counterparts to accept an OCV in W-Kenya, but more

2.5D change detection from satellite imagery to monitor small-scale mining activities in the Democratic Republic of the Congo

NASA Astrophysics Data System (ADS)

Kranz, Olaf; Lang, Stefan; Schoepfer, Elisabeth

2017-09-01

Mining natural resources serve fundamental societal needs or commercial interests, but it may well turn into a driver of violence and regional instability. In this study, very high resolution (VHR) optical stereo satellite data are analysed to monitor processes and changes in one of the largest artisanal and small-scale mining sites in the Democratic Republic of the Congo, which is among the world's wealthiest countries in exploitable minerals To identify the subtle structural changes, the applied methodological framework employs object-based change detection (OBCD) based on optical VHR data and generated digital surface models (DSM). Results prove the DSM-based change detection approach enhances the assessment gained from sole 2D analyses by providing valuable information about changes in surface structure or volume. Land cover changes as analysed by OBCD reveal an increase in bare soil area by a rate of 47% between April 2010 and September 2010, followed by a significant decrease of 47.5% until March 2015. Beyond that, DSM differencing enabled the characterisation of small-scale features such as pits and excavations. The presented Earth observation (EO)-based monitoring of mineral exploitation aims at a better understanding of the relations between resource extraction and conflict, and thus providing relevant information for potential mitigation strategies and peace building.

Discovery of a Leptospirosis Cluster Amidst a Pneumonic Plague Outbreak in a Miners’ Camp in the Democratic Republic of the Congo

PubMed Central

Bertherat, Eric; Mueller, Melissa J.; Shako, Jean-Christophe; Picardeau, Mathieu

2014-01-01

Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing 57 of them. Clinical signs, fast disease spread, and initial laboratory investigations suggested pneumonic plague. While leptospirosis had not recently been described in the region, it was considered as a differential diagnosis. Anti-Leptospira antibodies were detected by microscopic agglutination test (MAT). A confirmed case of leptospirosis was defined as having consistent clinical signs and any one of the following: seroconversion or four-fold increase in MAT titre for paired serum samples, or a MAT titre ≥ 1:400 for acute-phase serum samples. Twenty-nine of the 54 patients or convalescents tested for leptospirosis were seropositive. Two cases showed a confirmed infection for both plague and leptospirosis. While evidence supports the plague nature of this outbreak, the results suggest that some of the suspected plague cases might be due to leptospirosis. In any case, this diagnosis will have to be evoked in the future if a similar outbreak occurs in this region of Africa. PMID:24514425

External quality assessment of malaria microscopy in the Democratic Republic of the Congo

PubMed Central

2011-01-01

Background External quality assessments (EQA) are an alternative to cross-checking of blood slides in the quality control of malaria microscopy. This study reports the findings of an EQA of malaria microscopy in the Democratic Republic of the Congo (DRC). Methods After validation, an EQA slide panel and a questionnaire were delivered to diagnostic laboratories in four provinces of DRC. The panel included three samples for diagnosis (sample 1: Plasmodium falciparum, 177,000/μl, sample 2: P. falciparum, 2,500/μl, sample 3: no parasites seen), one didactic sample (Howell-Jolly bodies) and one sample for assessing the quality of staining. Participating laboratories were addressed and selected through the network of the National Tuberculosis Control Programme. Participants were asked to return the responses together with a stained thin and thick blood film for evaluation of Giemsa stain quality. Results Among 174 participants (response rate 95.1%), 26.2% scored samples 1, 2 and 3 correctly and 34.3%, 21.5% and 5.8% of participants reported major errors in one, two or three samples respectively. Major errors included reporting "no malaria" or "non-falciparum malaria" for Plasmodium falciparum-positive samples 1 and 2 (16.1% and 34.9% of participants respectively) and "P. falciparum" for Plasmodium negative sample 3 (24.0%). Howell-Jolly bodies (didactic sample) were not recognized by any of the participants but reported as "P. falciparum" by 16.7% of participants. With parasite density expressed according to the "plus system", 16.1% and 21.5% of participants scored one "+" different from the reference score for samples 1 and 2 respectively and 9.7% and 2.9% participants scored more than two "+" different. When expressed as counts of asexual parasites/μl, more than two-thirds of results were outside the mean ± 2SD reference values. The quality of the Giemsa stain was poor, with less than 20% slides complying with all criteria assessed. Only one quarter of participants

The effect of war on infant mortality in the Democratic Republic of Congo.

PubMed

Lindskog, Elina Elveborg

2016-10-06

The Democratic Republic of Congo (DRC) has suffered from war and lingering conflicts in East DRC and has one of the highest infant mortality rates in the world. Prior research has documented increases in infant and child mortality associated with war, but the empirical evidence is limited in several respects. Measures of conflict are quite crude or conflict is not tightly linked to periods of exposure to infant death. Few studies have distinguished between the effects of war on neonatal versus post-neonatal infants. No study has considered possible differences between women who give birth during wartime and those who do not that may be related to greater infant mortality. The analysis used the nationally representative sample of 15,103 mothers and 53,768 children from the 2007 and 2013/2014 Demographic Health Survey in the DRC and indicators of conflict events and conflict deaths from the 2013 Uppsala Conflict Data. To account for unobserved heterogeneity across women, a multi-level modeling approach was followed by grouping all births for each woman and estimating random intercepts in discrete time event history models. Post-neonatal mortality increased during the Congolese wars, and was highest where conflict events and deaths were extreme. Neonatal mortality was not associated with conflict levels. Infant mortality was not higher in East DRC, where conflicts continued during the post Congolese war period. Models specifying unobserved differences between mothers who give birth during war and those who have children in peacetime did not reduce the estimated effect of war, i.e., no support was found for selectivity in the sample of births during war. Differences in effects of the Congolese war on neonatal versus post-neonatal mortality suggest that conflict influences the conditions of infants' lives more than the aspects of mothers' pregnancy conditions and delivery that are relevant for infant mortality. These differences may, however, be specific to the nature

On Intensive Late Holocene Iron Mining and Production in the Northern Congo Basin and the Environmental Consequences Associated with Metallurgy in Central Africa.

PubMed

Lupo, Karen D; Schmitt, Dave N; Kiahtipes, Christopher A; Ndanga, Jean-Paul; Young, D Craig; Simiti, Bernard

2015-01-01

An ongoing question in paleoenvironmental reconstructions of the central African rainforest concerns the role that prehistoric metallurgy played in shaping forest vegetation. Here we report evidence of intensive iron-ore mining and smelting in forested regions of the northern Congo Basin dating to the late Holocene. Volumetric estimates on extracted iron-ore and associated slag mounds from prehistoric sites in the southern Central African Republic suggest large-scale iron production on par with other archaeological and historically-known iron fabrication areas. These data document the first evidence of intensive iron mining and production spanning approximately 90 years prior to colonial occupation (circa AD 1889) and during an interval of time that is poorly represented in the archaeological record. Additional site areas pre-dating these remains by 3-4 centuries reflect an earlier period of iron production on a smaller scale. Microbotanical evidence from a sediment core collected from an adjacent riparian trap shows a reduction in shade-demanding trees in concert with an increase in light-demanding species spanning the time interval associated with iron intensification. This shift occurs during the same time interval when many portions of the Central African witnessed forest transgressions associated with a return to moister and more humid conditions beginning 500-100 years ago. Although data presented here do not demonstrate that iron smelting activities caused widespread vegetation change in Central Africa, we argue that intense mining and smelting can have localized and potentially regional impacts on vegetation communities. These data further demonstrate the high value of pairing archeological and paleoenvironmental analyses to reconstruct regional-scale forest histories.

Polymorphisms of Estrogen Metabolism-Related Genes and Prostate Cancer Risk in Two Populations of African Ancestry

PubMed Central

Emeville, Elise; Ferdinand, Séverine; Punga, Augustin; Lufuma, Simon; Blanchet, Pascal; Romana, Marc; Multigner, Luc

2016-01-01

Background Estrogens are thought to play a critical role in prostate carcinogenesis. It has been suggested that polymorphisms of genes encoding enzymes involved in estrogen metabolism are risk factors for prostate cancer. However, few studies have been performed on populations of African ancestry, which are known to have a high risk of prostate cancer. Objective We investigated whether functional polymorphisms of CYP17, CYP19, CYP1B1, COMT and UGT1A1 affected the risk of prostate cancer in two different populations of African ancestry. Methods In Guadeloupe (French West Indies), we compared 498 prostate cancer patients and 565 control subjects. In Kinshasa (Democratic Republic of Congo), 162 prostate cancer patients were compared with 144 controls. Gene polymorphisms were determined by the SNaPshot technique or short tandem repeat PCR analysis. Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results The AA genotype and the A allele of rs4680 (COMT) appeared to be inversely associated with the risk of prostate cancer in adjusted models for both Afro-Caribbean and native African men. For the A allele, a significant inverse association was observed among cases with low-grade Gleason scores and localized clinical stage, in both populations. Conclusions These preliminary results support the hypothesis that polymorphisms of genes encoding enzymes involved in estrogen metabolism may modulate the risk of prostate cancer in populations of African ancestry. PMID:27074016

Group Trauma-Focused Cognitive-Behavioural Therapy with Former Child Soldiers and Other War-Affected Boys in the DR Congo: A Randomised Controlled Trial

ERIC Educational Resources Information Center

McMullen, John; O'Callaghan, Paul; Shannon, Ciaran; Black, Alastair; Eakin, John

2013-01-01

Background: The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled…

Child soldiers as zones of violence in The Democratic Republic of Congo: three cases of medico-legal evidence of torture.

PubMed

Guy, Kitwe Mulunda

2009-01-01

This article sets medico legal light on torture of three former child soldiers by comparing torture methods, consequences of torture and medical observations. It is focused on these child soldiers as representatives of the many abuses of children as soldiers in armed groups. The three persons were child soldiers during 12 years in The Democratic Republic of Congo (DRC) as members of three different armed groups. They were exposed to armed conflict events, experienced torture, and participated in atrocities, sexual abuse and traditional rituals during their role in armed conflict. They were psychologically distressed with unhealthy physical and mental states. The principles for working with child soldiers are described. The model addresses basic items: The confluence of the dimensions of the items will determine the specifics of medico legal evidence of torture in child soldiers, taking into consideration inputs that are required at the macro, community and individual levels. A primary goal is to prevent violence from occurring in child soldiers. Thus, much more deliberate effort is made to address the underlying causes of recruitment of children in armed groups in DRC and to invest more resources in conflict resolution before there is an outbreak of violence. Peace education tends to be introduced too late and does little to alleviate the use of children in armed conflict in DRC.

Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

PubMed

Ashbaugh, Hayley R; Kuang, Brandon; Gadoth, Adva; Alfonso, Vivian H; Mukadi, Patrick; Doshi, Reena H; Hoff, Nicole A; Sinai, Cyrus; Mossoko, Mathias; Kebela, Benoit Ilunga; Muyembe, Jean-Jacques; Wemakoy, Emile Okitolonda; Rimoin, Anne W

2017-09-01

Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.

Serologic Evidence of Ebolavirus Infection in a Population With No History of Outbreaks in the Democratic Republic of the Congo.

PubMed

Mulangu, Sabue; Alfonso, Vivian H; Hoff, Nicole A; Doshi, Reena H; Mulembakani, Prime; Kisalu, Neville K; Okitolonda-Wemakoy, Emile; Kebela, Benoit Ilunga; Marcus, Hadar; Shiloach, Joseph; Phue, Je-Nie; Wright, Linda L; Muyembe-Tamfum, Jean-Jacques; Sullivan, Nancy J; Rimoin, Anne W

2018-01-30

Previous studies suggest that cases of Ebola virus disease (EVD) may go unreported because they are asymptomatic or unrecognized, but evidence is limited by study designs and sample size. A large population-based survey was conducted (n = 3415) to assess animal exposures and behaviors associated with Ebolavirus antibody prevalence in rural Kasai Oriental province of the Democratic Republic of Congo (DRC). Fourteen villages were randomly selected and all healthy individuals ≥1 year of age were eligible. Overall, 11% of subjects tested positive for Zaire Ebolavirus (EBOV) immunoglobulin G antibodies. Odds of seropositivity were higher for study participants older than 15 years of age and for males. Those residing in Kole (closer to the outbreak site) tested positive at a rate 1.6× higher than Lomela, with seropositivity peaking at a site located between Kole and Lomela. Multivariate analyses of behaviors and animal exposures showed that visits to the forest or hunting and exposure to rodents or duikers predicted a higher likelihood of EBOV seropositivity. These results provide serologic evidence of Ebolavirus exposure in a population residing in non-EBOV outbreak locations in the DRC and define statistically significant activities and animal exposures that associate with EBOV seropositivity. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.

Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice.

PubMed

Wachter, Karin; Murray, Sarah M; Hall, Brian J; Annan, Jeannie; Bolton, Paul; Bass, Judy

2018-07-01

The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC). Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD). Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t = -2.49, p = .013), anxiety (t = -3.08, p = .002), and PTSD (t = -2.94, p = .003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma. Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.

Petroleum geology of Cretaceous-Tertiary rift basins in Niger, Chad, and Central African Republic

DOE Office of Scientific and Technical Information (OSTI.GOV)

Genik, G.J.

1993-08-01

This overview of the petroleum geology of rift basins in Niger, Chad, and Central African Republic (CAR) is based on exploration work by Exxon and partners in the years 1969-1991. The work included 50,000 km of modern reflection seismic, 53 exploration wells, 1,000,000 km[sup 2] of aeromagnetic coverage, and about 10,500 km of gravity profiles. The results outline ten Cretaceous and Tertiary rift basins, which constitute a major part of the West and Central African rift system (WCARS). The rift basins derive from a multiphased geologic history dating from the Pan-African (approximately 750-550 Ma) to the Holocene. WCARS in themore » study area is divided into the West African rift subsystem (WAS) and the Central African rift subsystem (WAS) and the Central African rift subsystem (CAS). WAS basins in Niger and Chad are chiefly extensional, and are filled by up to 13,000 m of Lower Cretaceous to Holocene continental and marine clastics. The basins contain five oil (19-43[degrees]API) and two oil and gas accumulations in Upper Cretaceous and Eocene sandstone reservoirs. The hydrocarbons are sourced and sealed by Upper Cretaceous and Eocene marine and lacustrine shales. The most common structural styles and hydrocarbon traps usually are associated with normal fault blocks. CAS rift basins in Chad and CAR are extensional and transtensional, and are filled by up to 7500 m of chiefly Lower Cretaceous continental clastics. The basins contain eight oil (15-39[degrees]API) and one oil and gas discovery in Lower and Upper Cretaceous sandstone reservoirs. The hydrocarbons are sourced by Lower Cretaceous shales and sealed by interbedded lacustrine and flood-plain shales. Structural styles range from simple fault blocks through complex flower structures. The main hydrocarbon traps are in contractional anticlines. Geological conditions favor the discovery of potentially commercial volumes of oil in WCARS basins, of Niger, Chad and CAR. 108 refs., 24 figs., 4 tabs.« less

Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo.

PubMed

Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

2016-01-01

Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief.

Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo

PubMed Central

Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

2016-01-01

Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief. PMID:27583088

Uncontrolled hypertension among patients managed in primary healthcare facilities in Kinshasa, Democratic Republic of the Congo.

PubMed

Kika, T M; Lepira, F B; Kayembe, P K; Makulo, J R; Sumaili, E K; Kintoki, E V; M'Buyamba-Kabangu, J R

Uncontrolled hypertension remains an important issue in daily clinical practice worldwide. Although the majority of patients are treated in primary care, most of the data on blood pressure control originate from population-based studies or secondary healthcare. The aim of this study was to evaluate the frequency of uncontrolled hypertension and associated risk factors among hypertensive patients followed at primary care facilities in Kinshasa, the capital city of Democratic Republic of the Congo. A sample of 298 hypertensive patients seen at primary healthcare facilities, 90 men and 208 women, aged ≥ 18 years, were consecutively included in this cross-sectional study. The majority (66%) was receiving monotherapy, and diuretics (43%) were the most used drugs. According to 2007 European Society of Hypertension/European Society of Cardiology hypertension guidelines, uncontrolled hypertension was defined as blood pressure ≥ 140/90 or ≥ 130/80 mmHg (diabetes or chronic kidney disease). Logistic regression analysis was used to identify the determinants of uncontrolled hypertension. Uncontrolled hypertension was observed in 231 patients (77.5%), 72 men and 159 women. Uncontrolled systolic blood pressure (SBP) was more frequent than uncontrolled diastolic blood pressure (DBP) and increased significantly with advancing age (p = 0.002). The proportion of uncontrolled SBP and DBP was significantly higher in patients with renal failure (p = 0.01) and those with high (p = 0.03) to very high (p = 0.02) absolute cardiovascular risk. The metabolic syndrome (OR 2.40; 95% CI 1.01-5.74; p = 0.04) emerged as the main risk factor associated with uncontrolled hypertension. Uncontrolled hypertension was common in this case series and was associated with factors related to lifestyle and diet, which interact with blood pressure control.

Heterogeneous and decreasing HIV prevalence among women seeking antenatal care in Kinshasa, Democratic Republic of Congo

PubMed Central

Behets, Frieda; Edmonds, Andrew; Kitenge, François; Crabbé, François; Laga, Marie

2010-01-01

Background We examined HIV prevalence trends over 4.5 years among women receiving antenatal care in Kinshasa, Democratic Republic of Congo, by geographic location, clinic management and urbanicity. Methods Quarterly proportions and 95% confidence intervals (CIs) of pregnant women with HIV positive results were determined using aggregate service provision and uptake data from 22 maternity units that provided vertical HIV prevention services from October 2004 to March 2009. Assuming linearity, proportions were assessed for trend via the Cochran–Armitage test. Multivariable binomial regression was used to describe detailed prevalence trends. Results HIV testing was offered to 220 006 pregnant women; 210 348 (95.6%) agreed to be tested and 191 216 (90.9%) received their results. A total of 3999 women were found to be HIV positive, a prevalence of 1.90% (95% CI: 1.84–1.96%). The median quarterly proportion of women testing positive for HIV was 1.94% (range: 1.44–2.44%). Prevalence was heterogeneous in terms of maternity management, urbanicity and geographic location. Modeling suggested that the overall prevalence dropped from 2.04% (95% CI: 1.92–2.16%) to 1.77% (95% CI: 1.66–1.88%) over 4.5 years, a relative decrease of 13.2% (95% CI: 3.53–22.9%). Trend testing corroborated this decline (P < 0.01). Conclusions The decreasing HIV prevalence among Kinshasa antenatal care seekers is robust and encouraging. The relatively low prevalence and the weak existing healthcare system require prevention of mother-to-child transmission interventions that strengthen maternal and child healthcare service delivery. Complacency would be unwarranted: assuming a uniform national crude birth rate of 50/1000 and 1.8% antenatal HIV prevalence, approximately 7000 pregnant HIV infected women in Kinshasa, and 60 000 nationwide, are in need of care and prevention services yearly. PMID:20453017

The geography of malaria genetics in the Democratic Republic of Congo: A complex and fragmented landscape

PubMed Central

Carrel, Margaret; Patel, Jaymin; Taylor, Steve M.; Janko, Mark; Mwandagalirwa, Melchior Kashamuka; Tshefu, Antoinette K.; Escalante, Ananias A.; McCollum, Andrea; Alam, Md Tauqeer; Udhayakumar, Venkatachalam; Meshnick, Steven; Emch, Michael

2014-01-01

Understanding how malaria parasites move between populations is important, particularly given the potential for malaria to be reintroduced into areas where it was previously eliminated. We examine the distribution of malaria genetics across seven sites within the Democratic Republic of Congo (DRC) and two nearby countries, Ghana and Kenya, in order to understand how the relatedness of malaria parasites varies across space, and whether there are barriers to the flow of malaria parasites within the DRC or across borders. Parasite DNA was retrieved from dried blood spots from 7 Demographic and Health Survey sample clusters in the DRC. Malaria genetic characteristics of parasites from Ghana and Kenya were also obtained. For each of 9 geographic sites (7 DRC, 1 Ghana and 1 Kenya), a pair-wise RST statistic was calculated, indicating the genetic distance between malaria parasites found in those locations. Mapping genetics across the spatial extent of the study area indicates a complex genetic landscape, where relatedness between two proximal sites may be relatively high (RST > 0.64) or low (RST < 0.05), and where distal sites also exhibit both high and low genetic similarity. Mantel’s tests suggest that malaria genetics differ as geographic distances increase. Principal Coordinate Analysis suggests that genetically related samples are not co-located. Barrier analysis reveals no significant barriers to gene flow between locations. Malaria genetics in the DRC have a complex and fragmented landscape. Limited exchange of genes across space is reflected in greater genetic distance between malaria parasites isolated at greater geographic distances. There is, however, evidence for close genetic ties between distally located sample locations, indicating that movement of malaria parasites and flow of genes is being driven by factors other than distance decay. This research demonstrates the contributions that spatial disease ecology and landscape genetics can make to

[Socioeconomic impact of armed conflict on the health of women and children in the Democratic Republic of the Congo].

PubMed

Omba Kalonda, J C

2011-04-01

Since 1996, the Democratic Republic of Congo (DRC) has been the theatre of armed conflict. More than 5.4 millions have died and 500,000 to 1,000,000 women have been raped. As a result of permanent insecurity including frequent massacres, burning of villages and plundering of personal property and crops, millions of Congolese people especially in eastern regions have been displaced with around 1.3 million in internal refugee camps. Rural populations have abandoned farming that was the main source of employment, food, and income. The purpose of this paper is to describe the socioeconomic impact of this armed conflict particularly on the health of women and children. Consequences include i) decreased food production, ii) worsening food insecurity and malnutrition, iii) reduced household income, and iv) inadequate health care leading to epidemic outbreaks of diseases such as cholera, measles, and meningitis. Food insecurity and poverty affect around 70% of the population. Chronic malnutrition and growth retardation affect 38% of children. The mortality rate for children under 5 has reached 205 per 1000 live births. Other than achieving lasting peace that is a prerequisite for development in the DRC, the main priority must be to provide victims with multiform assistance aimed at restarting the economy and ensuring food self-sufficiency, thereby reducing both malnutrition and child mortality. Better access to healthcare and to psychosocial, medical, and legal services is also needed for rape victims.

Prevalence Study of Yaws in the Democratic Republic of Congo Using the Lot Quality Assurance Sampling Method

PubMed Central

Gerstl, Sibylle; Kiwila, Gédeon; Dhorda, Mehul; Lonlas, Sylvaine; Myatt, Mark; Ilunga, Benoît Kebela; Lemasson, Denis; Szumilin, Elisabeth; Guerin, Philippe J.; Ferradini, Laurent

2009-01-01

Background Until the 1970s the prevalence of non-venereal trepanomatosis, including yaws, was greatly reduced after worldwide mass treatment. In 2005, cases were again reported in the Democratic Republic of the Congo. We carried out a survey to estimate the village-level prevalence of yaws in the region of Equator in the north of the country in order to define appropriate strategies to effectively treat the affected population. Methodology/Principal Findings We designed a community-based survey using the Lot Quality Assurance Sampling method to classify the prevalence of active yaws in 14 groups of villages (lots). The classification into high, moderate, or low yaws prevalence corresponded to World Health Organization prevalence thresholds for identifying appropriate operational treatment strategies. Active yaws cases were defined by suggestive clinical signs and positive rapid plasma reagin and Treponema pallidum hemagglutination serological tests. The overall prevalence in the study area was 4.7% (95% confidence interval: 3.4–6.0). Two of 14 lots had high prevalence (>10%), three moderate prevalence (5–10%) and nine low prevalence (<5%.). Conclusions/Significance Although yaws is no longer a World Health Organization priority disease, the presence of yaws in a region where it was supposed to be eradicated demonstrates the importance of continued surveillance and control efforts. Yaws should remain a public health priority in countries where previously it was known to be endemic. The integration of sensitive surveillance systems together with free access to effective treatment is recommended. As a consequence of our study results, more than 16,000 people received free treatment against yaws. PMID:19623266

Pfhrp2-Deleted Plasmodium falciparum Parasites in the Democratic Republic of the Congo: A National Cross-sectional Survey.

PubMed

Parr, Jonathan B; Verity, Robert; Doctor, Stephanie M; Janko, Mark; Carey-Ewend, Kelly; Turman, Breanna J; Keeler, Corinna; Slater, Hannah C; Whitesell, Amy N; Mwandagalirwa, Kashamuka; Ghani, Azra C; Likwela, Joris L; Tshefu, Antoinette K; Emch, Michael; Juliano, Jonathan J; Meshnick, Steven R

2017-07-01

Rapid diagnostic tests (RDTs) account for more than two-thirds of malaria diagnoses in Africa. Deletions of the Plasmodium falciparum hrp2 (pfhrp2) gene cause false-negative RDT results and have never been investigated on a national level. Spread of pfhrp2-deleted P. falciparum mutants, resistant to detection by HRP2-based RDTs, would represent a serious threat to malaria elimination efforts. Using a nationally representative cross-sectional study of 7,137 children under five years of age from the Democratic Republic of Congo (DRC), we tested 783 subjects with RDT-/PCR+ results using PCR assays to detect and confirm deletions of the pfhrp2 gene. Spatial and population genetic analyses were employed to examine the distribution and evolution of these parasites. We identified 149 pfhrp2-deleted parasites, representing 6.4% of all P. falciparum infections country-wide (95% confidence interval 5.1-8.0%). Bayesian spatial analyses identified statistically significant clustering of pfhrp2 deletions near Kinshasa and Kivu. Population genetic analysis revealed significant genetic differentiation between wild-type and pfhrp2-deleted parasite populations (GST = .046, p ≤ .00001). Pfhrp2-deleted P. falciparum is a common cause of RDT-/PCR+ malaria among asymptomatic children in the DRC and appears to be clustered within select communities. Surveillance for these deletions is needed, and alternatives to HRP2-specific RDTs may be necessary. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo

PubMed Central

Labat, Francoise; Sharma, Anjali

2016-01-01

Objective To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). Design In-depth interviews were conducted and analysed using qualitative content analysis. Setting Governmental referral teaching hospital in Eastern DRC. Participants We purposively selected 2–4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Results Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs’ reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. Conclusions The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. PMID:27113232

Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study

PubMed Central

2011-01-01

Background The conflict in eastern Democratic Republic of the Congo (DRC) is the deadliest since World War II. Over a decade of fighting amongst an array of armed groups has resulted in extensive human rights abuses, particularly the widespread use of sexual violence against women. Methods Using a mixed-methods approach, we surveyed a non-random sample of 255 women attending a referral hospital and two local non-governmental organizations to characterize their experiences of sexual and gender-based violence (SGBV). We then conducted focus groups of 48 women survivors of SGBV to elaborate on survey findings. Quantitative and qualitative data underwent thematic and statistical analysis respectively. Findings Of the women surveyed, 193 (75.7%) experienced rape. Twenty-nine percent of raped women were rejected by their families and 6% by their communities. Thirteen percent of women had a child from rape. Widowhood, husband abandonment, gang rape, and having a child from rape were significant risk factors for social rejection. Mixed methods findings show rape survivors were seen as "contaminated" with HIV, contributing to their isolation and over 95% could not access prophylactic care in time. Receiving support from their husbands after rape was protective against survivors' feelings of shame and social isolation. Interpretation Rape results not only in physical and psychological trauma, but can destroy family and community structures. Women face significant obstacles in seeking services after rape. Interventions offering long-term solutions for hyper-vulnerable women are vital, but lacking; reintegration programs on SGBV for women, men, and communities are also needed. PMID:22047181

A new species of Pseudocrenilabrus (Perciformes: Cichlidae) from Lake Mweru in the Upper Congo River System.

PubMed

Katongo, Cyprian; Seehausen, Ole; Snoeks, Jos

2017-02-26

Pseudocrenilabrus pyrrhocaudalis sp. nov. is described from Lake Mweru in the upper Congo River drainage, on the border of the Democratic Republic of Congo and Zambia. This species, which appears to be endemic to the lake, lives in sympatry with P. philander. Pseudocrenilabrus pyrrhocaudalis sp. nov. is distinguished from P. philander in nuptial males by the presence of an orange colour on the ventral part of the body and the proximal parts of the anal and caudal fins, a broad band of bright white on the distal edge of anal and caudal fins, a uniform grey head and dorsum, and a subtruncate caudal fin. In addition, P. pyrrhocaudalis has a shorter snout, a narrower head, a smaller interorbital distance, a smaller pre-anal distance, a more slender caudal peduncle and fewer scales around the caudal peduncle in both sexes.

Autochthonous Crimean-Congo Hemorrhagic Fever in Spain.

PubMed

Negredo, Anabel; de la Calle-Prieto, Fernando; Palencia-Herrejón, Eduardo; Mora-Rillo, Marta; Astray-Mochales, Jenaro; Sánchez-Seco, María P; Bermejo Lopez, Esther; Menárguez, Javier; Fernández-Cruz, Ana; Sánchez-Artola, Beatriz; Keough-Delgado, Elena; Ramírez de Arellano, Eva; Lasala, Fátima; Milla, Jakob; Fraile, Jose L; Ordobás Gavín, Maria; Martinez de la Gándara, Amalia; López Perez, Lorenzo; Diaz-Diaz, Domingo; López-García, M Aurora; Delgado-Jimenez, Pilar; Martín-Quirós, Alejandro; Trigo, Elena; Figueira, Juan C; Manzanares, Jesús; Rodriguez-Baena, Elena; Garcia-Comas, Luis; Rodríguez-Fraga, Olaia; García-Arenzana, Nicolás; Fernández-Díaz, Maria V; Cornejo, Victor M; Emmerich, Petra; Schmidt-Chanasit, Jonas; Arribas, Jose R

2017-07-13

Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].).

New Species of the Spider Genus Cheiracanthium from Continental Africa
(Araneae: Eutichuridae).

PubMed

Lotz, L N

2015-06-17

Eleven new species of Cheiracanthium, C. boendense sp. nov. (Democratic Republic of Congo), C. falcis sp. nov. (Gabon), C. foordi sp. nov. (South Africa), C. ghanaense sp. nov. (Ghana), C. kabalense sp. nov. (Uganda), C. kakamega sp. nov. (Kenya), C. kakumense sp. nov. (Democratic Republic of Congo, Ivory Coast, Ghana), C. lukiense sp. nov. (Democratic Republic of Congo), C. mayombense sp. nov. (Democratic Republic of Congo), C. shilabira sp. nov. (Democratic Republic of Congo, Kenya) and C. tanzanense sp. nov. (Tanzania) are described. Males of C. punctipedellum Caporiacco, 1949, C. sansibaricum Strand, 1907 and C. schenkeli Caporiacco, 1949 are described for the first time.

[Preliminary results about loiasis in the district of Likouala in the Republic of the Congo].

PubMed

Akiana, J; Bokilo Dzia Lepfoundzou, A; Mokondjimobe, E; Parra, H J; Sokhna, C S; Faye, O

2013-05-01

The authors report results of a prospective study to assess the prevalence of loiasis in populations older than 18 years in two villages of the Likouala district in the Congo: the study took place during a visit to Lopola in 2012 and to Lopola and Lombo in 2013. The prevalence rate was 20%. Loa loa carriers were treated with diethylcarbamazine citrate and celestamine.

Prenatal alcohol exposure in the Republic of the Congo: prevalence and screening strategies.

PubMed

Williams, Andrew D; Nkombo, Yannick; Nkodia, Gery; Leonardson, Gary; Burd, Larry

2013-07-01

To determine prevalence of prenatal alcohol use in Brazzaville, Congo and to evaluate a prenatal screening tool for use in this population. A prospective population screening program of 3099 women at 10 prenatal care clinics in Brazzaville, Congo using the 1-Question screen. To validate the 1-Question screen in this population we screened 764 of these women again using the T-ACE as a gold standard for comparison study. The study outcomes were as follows: prevalence of self-reported prenatal alcohol use in Brazzaville using the 1-Question screen, estimation of number of drinking days, drinks per drinking day, most drinks on any one occasion. We also estimated the epidemiologic performance criteria for the 1-Question screen. The 3099 women screened were classified as follows: no risk 77% (n=2,384); at risk 3.7% (n=115); and as high risk 19.3% (n=600). Of the women reporting drinking during pregnancy, 87.4% reported drinking 4 or more drinks on any occasion. The agreement for detection of alcohol use during pregnancy by the 1-Question Screen and a positive T-ACE score was 94.7%. 23.3% of women attending prenatal care in Brazzaville reported alcohol use during pregnancy and 83% of them continued to drink after recognition of pregnancy. Prenatal alcohol exposure should be the focus of efforts to improve identification of alcohol use prior to and during pregnancy to improve maternal and child health. Birth Defects Research (Part A) 97:489-496, 2013. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.

Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health.

PubMed

Andze, Gervais Ondobo; Namsenmo, Abel; Illunga, Benoit Kebella; Kazambu, Ditu; Delissaint, Dieula; Kuaban, Christopher; Mbopi-Kéou, Francois-Xavier; Gabsa, Wilfred; Mulumba, Leopold; Bangamingo, Jean Pierre; Ngulefac, John; Dahlke, Melissa; Mukanga, David; Nsubuga, Peter

2011-01-01

The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries.

Central African Field Epidemiology and Laboratory Training Program: building and strengthening regional workforce capacity in public health

PubMed Central

Ondobo Andze, Gervais; Namsenmo, Abel; Kebella Illunga, Benoit; Kazambu, Ditu; Delissaint, Dieula; Kuaban, Christopher; Mbopi-Kéou, Francois-Xavier; Gabsa, Wilfred; Mulumba, Leopold; Pierre Bangamingo, Jean; Ngulefac, John; Dahlke, Melissa; Mukanga, David; Nsubuga, Peter

2011-01-01

The Central African Field Epidemiology and Laboratory Training Program (CAFELTP) is a 2-year public health leadership capacity building training program. It was established in October 2010 to enhance capacity for applied epidemiology and public health laboratory services in three countries: Cameroon, Central African Republic, and the Democratic Republic of Congo. The aim of the program is to develop a trained public health workforce to assure that acute public health events are detected, investigated, and responded to quickly and effectively. The program consists of 25% didactic and 75% practical training (field based activities). Although the program is still in its infancy, the residents have already responded to six outbreak investigations in the region, evaluated 18 public health surveillance systems and public health programs, and completed 18 management projects. Through these various activities, information is shared to understand similarities and differences in the region leading to new and innovative approaches in public health. The program provides opportunities for regional and international networking in field epidemiology and laboratory activities, and is particularly beneficial for countries that may not have the immediate resources to host an individual country program. Several of the trainees from the first cohort already hold leadership positions within the ministries of health and national laboratories, and will return to their assignments better equipped to face the public health challenges in the region. They bring with them knowledge, practical training, and experiences gained through the program to shape the future of the public health landscape in their countries. PMID:22359692

[Street children in Bukavu, Democratic Republic of the Congo: causes for leaving home].

PubMed

Witumbula Katambwe, V; Kizanda, F; Wabatinga Kyalemaninwa, G

2009-06-01

The purpose of this report is to describe the results of a survey conducted in 2004 among a cohort of 310 street children in Bukavu DR Congo to determine sociodemographic features and the reasons that led them to leave the homes of their parents. The causes were school dropout due either to the inability of the parents to pay or refusal to study, death or separation of parents, family dispute, feelings of injustice or discrimination within the family, and a desire for freedom. Street life depersonalizes children, subjects them to the law of the strongest, and exposes them to drugs and prostitution.

Nyiragongo Volcano Erupts in the Congo

NASA Technical Reports Server (NTRS)

2002-01-01

Mount Nyiragongo, located in the Democratic Republic of the Congo, erupted today (January 17, 2002), ejecting a large cloud of smoke and ash high into the sky and spewing lava down three sides of the volcano. Mount Nyiragongo is located roughly 10 km (6 miles) north of the town of Goma, near the Congo's border with Rwanda. According to news reports, one river of lava is headed straight toward Goma, where international aid teams are evacuating residents. Already, the lava flows have burned through large swaths of the surrounding jungle and have destroyed dozens of homes. This false-color image was acquired today (January 17) by the Moderate-resolution Imaging Spectroradiometer (MODIS) roughly 5 hours after the eruption began. Notice Mount Nyiragongo's large plume (bright white) can be seen streaming westward in this scene. The plume appears to be higher than the immediately adjacent clouds and so it is colder in temperature, making it easy for MODIS to distinguish the volcanic plume from the clouds by using image bands sensitive to thermal radiation. Images of the eruption using other band combinations are located on the MODIS Rapid Response System. Nyiragongo eruptions are extremely hazardous because the lava tends to be very fluid and travels down the slopes of the volcano quickly. Eruptions can be large and spectacular, and flows can reach up to 10s of kilometers from the volcano very quickly. Also, biomass burned from Nyriagongo, and nearby Mount Nyamuragira, eruptions tends to create clouds of smoke that adversely affect the Mountain Gorillas living in the adjacent mountain chain. Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC

A proposed drainage evolution model for Central Africa—Did the Congo flow east?

NASA Astrophysics Data System (ADS)

Stankiewicz, Jacek; de Wit, Maarten J.

2006-01-01

Understanding the origin of Sub-Saharan biodiversity requires knowing the history of the region's paleo-ecosystems. As water is essential for sustaining of life, the evolving geometry of river basins often have influence on local speciation. With this in mind, we analyse drainage patterns in Central and East Africa. Evidence from marine fossils suggests the Congo Basin was submerged for much of the Cretaceous, and after being uplifted drained eastwards through a paleo-Congo river towards the Indian Ocean. Two remnant peneplains in the Congo Basin are interpreted as evidence that this basin was tectonically stable on at least two occasions in the past. The lower peneplain is interpreted as the base level of the drainage pattern that had its outlet in Tanzania, at the present Rufiji Delta that was once over 500 km wide. The Luangwa, today a tributary of the Zambezi river, was a part of this drainage network. This pattern was subsequently disrupted by uplift associated with the East African Rifting in the Oligocene-Eocene (30-40 Ma). The resulting landlocked system was captured in the Miocene (5-15 Ma) by short rivers draining into the Atlantic Ocean, producing the drainage pattern of Central Africa seen today.

Assessing out-of-pocket expenditures for primary health care: how responsive is the Democratic Republic of Congo health system to providing financial risk protection?

PubMed

Laokri, Samia; Soelaeman, Rieza; Hotchkiss, David R

2018-06-15

The goal of universal health coverage is challenging for chronically under-resourced health systems. Although household out-of-pocket payments are the most important source of health financing in low-income countries, relatively little is known about the drivers of primary health care expenditure and the predictability of the burden associated with high fee-for-service payments. This study describes out-of-pocket health expenditure and investigates demand- and supply-side drivers of excessive costs in the Democratic Republic of Congo (DRC), a central African country in the midst of a process of reforming its health financing system towards universal health coverage. A population-based household survey was conducted in four provinces of the DRC in 2014. Data included type, level and utilization of health care services, accessibility to care, patient satisfaction and disaggregated health care expenditure. Multivariate logistic regressions of excessive expenditure for outpatient care using alternative thresholds were performed to explore the incidence and predictors of atypically high expenditure incurred by individuals. Over 17% (17.5%) of individuals living in sample households reported an illness or injury without being hospitalized. Of 3341 individuals reporting an event in the four-week period prior to the survey, 65.6% sought outpatient care with an average of one visit (SD = 0.0). The overall mean expenditure per visit was US$ 6.7 (SD = 10.4) with 29.4% incurring excessive expenditure. The main predictors of a financial risk burden included utilizing public services offering the complementary benefit package, dissatisfaction with care received, being a member of a large household, expenditure composition, severity of illness, residence and wealth (p < .05). The insured status influenced the expenditure level, with no association with catastrophe. Those who did not seek care when needed reported financial constraints as the major reason for

Local perceptions of cholera and anticipated vaccine acceptance in Katanga province, Democratic Republic of Congo

PubMed Central

2013-01-01

Background In regions where access to clean water and the provision of a sanitary infrastructure has not been sustainable, cholera continues to pose an important public health burden. Although oral cholera vaccines (OCV) are effective means to complement classical cholera control efforts, still relatively little is known about their acceptability in targeted communities. Clarification of vaccine acceptability prior to the introduction of a new vaccine provides important information for future policy and planning. Methods In a cross-sectional study in Katanga province, Democratic Republic of Congo (DRC), local perceptions of cholera and anticipated acceptance of an OCV were investigated. A random sample of 360 unaffected adults from a rural town and a remote fishing island was interviewed in 2010. In-depth interviews with a purposive sample of key informants and focus-group discussions provided contextual information. Socio-cultural determinants of anticipated OCV acceptance were assessed with logistic regression. Results Most respondents perceived contaminated water (63%) and food (61%) as main causes of cholera. Vaccines (28%), health education (18%) and the provision of clean water (15%) were considered the most effective measures of cholera control. Anticipated vaccine acceptance reached 97% if an OCV would be provided for free. Cholera-specific knowledge of hygiene and self-help in form of praying for healing were positively associated with anticipated OCV acceptance if costs of USD 5 were assumed. Conversely, respondents who feared negative social implications of cholera were less likely to anticipate acceptance of OCVs. These fears were especially prominent among respondents who generated their income through fishing. With an increase of assumed costs to USD 10.5, fear of financial constraints was negatively associated with anticipated vaccine acceptance as well. Conclusions Results suggest a high motivation to use an OCV as long as it seems affordable. The

Democratic Republic of Congo A Fertile Ground for Instability in the Great Lakes Region States

DTIC Science & Technology

2017-06-09

International 2007, 3). Non-state Armed Groups Involved in the Congo Conflict There have been a number of non-state actors from the four countries herein...insurgent groups from neighboring countries: Uganda, Rwanda, and Burundi. These non-state actors have their own interests and goals; namely, wrestling...chaos in the Great Lakes Region. These are insurgent groups from neighboring countries: Uganda, Rwanda, and Burundi. These non-state actors have

Biological and clinical responses of west African sheep to Crimean-Congo haemorrhagic fever virus experimental infection.

PubMed

Gonzalez, J P; Camicas, J L; Cornet, J P; Wilson, M L

1998-01-01

West African sheep appear to play a central role as virus hosts in the maintenance cycle of Crimean-Congo haemorrhagic fever (CCHF) virus in endemic areas and also because of their role as a principal host of the CCHF virus tick vector. In an effort to clarify CCHF epidemiological significance in sheep, we studied the biological and clinical aspects of sheep experimentally infected with CCHF virus. West African sheep breeds were infected either by intraperitoneal inoculation or by infestation with experimentally CCHF-virus-infected ticks (Hyalomma truncatum). A total of 17 sheep including controls as well as 5 lambs from their progeny were monitored. A moderate but constant fever was observed (39.7 degrees C +/- 0.3) which correlates with the viraemia. Virus was reisolated from blood samples taken from day 3 to day 9 postinfection (p.i.) at a mean titre of 3.3 log LD50/ml. The virus was detected for a period of time of 7 days in non-immune sheep and for less than 4 days in previously immunized sheep. In non-immune sheep, antibody detected by ELISA showed an IgM response on day 7 p.i., followed by an IgG response one day later. Five infected sheep, surveyed for liver and kidney biological markers, showed hepatic dysfunction with a moderate serum aspartate transferase rise to 210 U/l. Out of four sheep tested for blood markers, two showed an abnormal blood cell count, with marked neutrophilia of up to 63% lasting for two weeks. Infected pregnant ewes produced antibodies in their milk at a significant titre (1:1,000), and antibodies were recovered in the sera of nursing lambs from their first meal to 50 days after birth. These findings are discussed; they demonstrate that, in spite of a high turnover of local sheep herds (median age of 3 years) and long-term CCHF antibody persistence (> 3 years), sheep can be infected and efficiently transmit the virus at least once in a lifetime.

The Effect of Cognitive Therapy on Structural Social Capital: Results From a Randomized Controlled Trial Among Sexual Violence Survivors in the Democratic Republic of the Congo

PubMed Central

Bolton, Paul A.; Annan, Jeannie; Kaysen, Debra; Robinette, Katie; Cetinoglu, Talita; Wachter, Karin; Bass, Judith K.

2014-01-01

Objectives. We evaluated changes in social capital following group-based cognitive processing therapy (CPT) for female survivors of sexual violence. Methods. We compared CPT with individual support in a cluster-randomized trial in villages in South Kivu province, Democratic Republic of the Congo. Local psychosocial assistants delivered the interventions from April through July 2011. We evaluated differences between CPT and individual support conditions for structural social capital (i.e., time spent with nonkin social network, group membership and participation, and the size of financial and instrumental support networks) and emotional support seeking. We analyzed intervention effects with longitudinal random effects models. Results. We obtained small to medium effect size differences for 2 study outcomes. Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages. Conclusions. Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context. PMID:25033113

A case study of risk factors for lymphatic filariasis in the Republic of Congo

PubMed Central

2014-01-01

Background Little is known regarding risk factors for lymphatic filariasis (LF) in Central Africa. We studied the epidemiology of LF in an endemic village in the Republic of Congo. Methods Dependent variables were Wuchereria bancrofti antigenemia (ICT card test) and microfilaremia (night blood smears). The following factors were investigated: sex, age, bed net, latrines, source of water, uptake of anthelmintic drugs, hunting/fishing activities, and occasionally sleeping in the bush. Mixed multivariate logistic regression models were used. Results 134 of 774 subjects aged ≥ 5 years (17.3%) had W. bancrofti antigenemia and 41 (5.3%) had microfilaremia (mf). Infection rates increased with age up to roughly 20 years and remained stable thereafter. Multivariate analysis of antigenemia demonstrated an increased risk for males (OR = 2.0 [1.3-3.0]) and for people who hunt or fish (OR = 1.5 [1.0-2.4]) and a protective effect of latrines (OR = 0.5 [0.4-0.8]). Among males, those hunting or fishing at night had an increased risk for antigenemia (OR = 1.9 [1.1-3.5]), and use of latrines was protective (OR = 0.5 [0.3-0.9]). For females, bed nets were protective (OR = 0.4 [0.1-0.9]), and there was a strong household effect (intraclass correlation coefficient [ICC]: 0.24). When mf was used as the dependent variable, males had a higher risk for infection (OR = 5.4 [2.1-13.4]), latrines had a protective effect (OR = 0.4 [0.1-0.9]) and there was a marked household effect (ICC = 0.49). Conclusions Age, sex, and occupation-dependent exposure to mosquitoes were important risk factors for infection with W. bancrofti in this study. It is likely that men often acquire infection in high transmission areas outside of the village, while children and women are infected in areas with lower transmission inside or near the village. Additional studies are needed to determine whether these findings apply to other areas in Central Africa. PMID:24984769

Lightning climatology in the Congo Basin: methodology and first results

NASA Astrophysics Data System (ADS)

Kigotsi, Jean; Soula, Serge; Georgis, Jean-François; Barthe, Christelle

2016-04-01

The global climatology of lightning issued from space observations (OTD and LIS) clearly showed the maximum of the thunderstorm activity is located in a large area of the Congo Basin, especially in the Democratic Republic of Congo (DRC). The first goal of the present study is to compare observations from the World Wide Lightning Location Network (WWLLN) from the Lightning Imaging Sensor (LIS) over a 9-year period (2005-2013) in this 2750 km × 2750 km area. The second goal is to analyse the lightning activity in terms of time and space variability. The detection efficiency (DE) of the WWLLN relative to LIS has increased between 2005 and 2013, typically from about 1.70 % to 5.90 %, in agreement with previous results for other regions of the world. The mean monthly flash rate describes an annual cycle with a maximum between November and March and a minimum between June and August, associated with the ICTZ migration but not exactly symmetrical on both sides of the equator. The diurnal evolution of the flash rate has a maximum between 1400 and 1700 UTC, depending on the reference year, in agreement with previous works in other regions of the world. The annual flash density shows a sharp maximum localized in eastern DRC regardless of the reference year and the period of the year. This annual maximum systematically located west of Kivu Lake corresponds to that previously identified by many authors as the worldwide maximum which Christian et al. (2013) falsely attributed to Rwanda. Another more extended region within the Congo Basin exhibits moderately large values, especially during the beginning of the period analyzed. A comparison of both patterns of lightning density from the WWLLN and from LIS allows to validate the representativeness of this world network and to restitute the total lightning activity in terms of lightning density and rate.

On Intensive Late Holocene Iron Mining and Production in the Northern Congo Basin and the Environmental Consequences Associated with Metallurgy in Central Africa

PubMed Central

Lupo, Karen D.; Schmitt, Dave N.; Kiahtipes, Christopher A.; Ndanga, Jean-Paul; Young, D. Craig; Simiti, Bernard

2015-01-01

An ongoing question in paleoenvironmental reconstructions of the central African rainforest concerns the role that prehistoric metallurgy played in shaping forest vegetation. Here we report evidence of intensive iron-ore mining and smelting in forested regions of the northern Congo Basin dating to the late Holocene. Volumetric estimates on extracted iron-ore and associated slag mounds from prehistoric sites in the southern Central African Republic suggest large-scale iron production on par with other archaeological and historically-known iron fabrication areas. These data document the first evidence of intensive iron mining and production spanning approximately 90 years prior to colonial occupation (circa AD 1889) and during an interval of time that is poorly represented in the archaeological record. Additional site areas pre-dating these remains by 3-4 centuries reflect an earlier period of iron production on a smaller scale. Microbotanical evidence from a sediment core collected from an adjacent riparian trap shows a reduction in shade-demanding trees in concert with an increase in light-demanding species spanning the time interval associated with iron intensification. This shift occurs during the same time interval when many portions of the Central African witnessed forest transgressions associated with a return to moister and more humid conditions beginning 500-100 years ago. Although data presented here do not demonstrate that iron smelting activities caused widespread vegetation change in Central Africa, we argue that intense mining and smelting can have localized and potentially regional impacts on vegetation communities. These data further demonstrate the high value of pairing archeological and paleoenvironmental analyses to reconstruct regional-scale forest histories. PMID:26161540

Identification of a New Genotype of African Swine Fever Virus in Domestic Pigs from Ethiopia.

PubMed

Achenbach, J E; Gallardo, C; Nieto-Pelegrín, E; Rivera-Arroyo, B; Degefa-Negi, T; Arias, M; Jenberie, S; Mulisa, D D; Gizaw, D; Gelaye, E; Chibssa, T R; Belaye, A; Loitsch, A; Forsa, M; Yami, M; Diallo, A; Soler, A; Lamien, C E; Sánchez-Vizcaíno, J M

2017-10-01

African swine fever (ASF) is an important emerging transboundary animal disease (TAD), which currently has an impact on many countries in Africa, Eastern Europe, the Caucasus and the Russian Federation. The current situation in Europe shows the ability of the virus to rapidly spread, which stands to threaten the global swine industry. At present, there is no viable vaccine to minimize spread of the disease and stamping out is the main source of control. In February 2011, Ethiopia had reported its first suspected outbreaks of ASF. Genomic analyses of the collected ASF virus (ASFV) strains were undertaken using 23 tissue samples collected from domestic swine in Ethiopia from 2011 to 2014. The analysis of Ethiopian ASFVs partial p72 gene sequence showed the identification of a new genotype, genotype XXIII, that shares a common ancestor with genotypes IX and X, which comprise isolates circulating in Eastern African countries and the Republic of Congo. Analysis of the p54 gene also followed the p72 pattern and the deduced amino acid sequence of the central variable region (CVR) of the B602L gene showed novel tetramer repeats not previously characterized. © 2016 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.

Geospatial and age-related patterns of Taenia solium taeniasis in the rural health zone of Kimpese, Democratic Republic of Congo.

PubMed

Madinga, Joule; Kanobana, Kirezi; Lukanu, Philippe; Abatih, Emmanuel; Baloji, Sylvain; Linsuke, Sylvie; Praet, Nicolas; Kapinga, Serge; Polman, Katja; Lutumba, Pascal; Speybroeck, Niko; Dorny, Pierre; Harrison, Wendy; Gabriel, Sarah

2017-01-01

Taenia solium infections are mostly endemic in less developed countries where poor hygiene conditions and free-range pig management favor their transmission. Knowledge on patterns of infections in both human and pig is crucial to design effective control strategies. The aim of this study was to assess the prevalence, risk factors and spatial distribution of taeniasis in a rural area of the Democratic Republic of Congo (DRC), in the prospect of upcoming control activities. A cross-sectional study was conducted in 24 villages of the health zone of Kimpese, Bas Congo Province. Individual and household characteristics, including geographical coordinates were recorded. Stool samples were collected from willing participants and analyzed using the copro-antigen enzyme-linked immunosorbent assay (copro-Ag ELISA) for the detection of taeniasis. Blood samples were collected from pigs and analyzed using the B158/B60 monoclonal antibody-based antigen ELISA (sero-Ag ELISA) to detect porcine cysticercosis. Logistic regression and multilevel analysis were applied to identify risk factors. Global clustering and spatial correlation of taeniasis and porcine cysticercosis were assessed using K functions. Local clusters of both infections were identified using the Kulldorff's scan statistic. A total of 4751 participants above 5 years of age (median: 23 years; IQR: 11-41) were included. The overall proportion of taeniasis positivity was 23.4% (95% CI: 22.2-24.6), ranging from 1 to 60% between villages, with a significant between-household variance of 2.43 (SE=0.29, p<0.05). Taeniasis was significantly associated with age (p<0.05) and the highest positivity was found in the 5-10 years age group (27.0% (95% CI: 24.4-29.7)). Overall, 45.6% (95% CI: 40.2-51) of sampled pigs were sero-positive. The K functions revealed a significant overall clustering of human and pig infections but no spatial dependence between them. Two significant clusters of taeniasis (p<0.001; n=276 and n=9) and one

Yellow fever risk assessment in the Central African Republic

PubMed Central

Staples, J. Erin; Diallo, Mawlouth; Janusz, Kristen B.; Manengu, Casimir; Lewis, Rosamund F.; Perea, William; Yactayo, Sergio; Sall, Amadou A.

2015-01-01

Background Starting in 2008, the Central African Republic (CAR) experienced an unprecedented number of reported yellow fever (YF) cases. A risk assessment of YF virus (YFV) activity was conducted to estimate potential disease risk and vaccine needs. Methods A multistage cluster sampling design was used to sample humans, non-human primates, and mosquitoes in distinct ecologic zones. Humans and non-human primates were tested for YFV-specific antibodies; mosquitoes were tested for YFV RNA. Results Overall, 13.3% (125/938) of humans were found to have naturally-acquired YFV antibodies. Antibody levels were higher in zones in the southern and south central regions of CAR. All sampled non-human primates (n=56) were known YFV reservoirs; one tested positive for YFV antibodies. Several known YF vectors were identified including Aedes africanus, Ae. aegypti, Ae. luteocephalus, and Ae. simpsoni. Several more urban locations were found to have elevated Breateau and Container indices for Ae. aegypti. Conclusions A country-wide assessment of YF risk found YFV to be endemic in CAR. The potential for future YF cases and outbreaks, however, varied by ecologic zone. Improved vaccination coverage through mass campaign and childhood immunization was recommended to mitigate the YF risk. PMID:24947520

Characterizing Congo Basin rainfall and climate using Tropical Rainfall Measuring Mission (TRMM) satellite data and limited rain gauge ground observations

USGS Publications Warehouse

Munzimi, Yolande A.; Hansen, Matthew C.; Adusei, Bernard; Senay, Gabriel B.

2015-01-01

Quantitative understanding of Congo River basin hydrological behavior is poor because of the basin’s limited hydrometeorological observation network. In cases such as the Congo basin where ground data are scarce, satellite-based estimates of rainfall, such as those from the joint NASA/JAXA Tropical Rainfall Measuring Mission (TRMM), can be used to quantify rainfall patterns. This study tests and reports the use of limited rainfall gauge data within the Democratic Republic of Congo (DRC) to recalibrate a TRMM science product (TRMM 3B42, version 6) in characterizing precipitation and climate in the Congo basin. Rainfall estimates from TRMM 3B42, version 6, are compared and adjusted using ground precipitation data from 12 DRC meteorological stations from 1998 to 2007. Adjustment is achieved on a monthly scale by using a regression-tree algorithm. The output is a new, basin-specific estimate of monthly and annual rainfall and climate types across the Congo basin. This new product and the latest version-7 TRMM 3B43 science product are validated by using an independent long-term dataset of historical isohyets. Standard errors of the estimate, root-mean-square errors, and regression coefficients r were slightly and uniformly better with the recalibration from this study when compared with the 3B43 product (mean monthly standard errors of 31 and 40 mm of precipitation and mean r2 of 0.85 and 0.82, respectively), but the 3B43 product was slightly better in terms of bias estimation (1.02 and 1.00). Despite reasonable doubts that have been expressed in studies of other tropical regions, within the Congo basin the TRMM science product (3B43) performed in a manner that is comparable to the performance of the recalibrated product that is described in this study.

Congo (Brazzaville) Country Analysis Brief

EIA Publications

2014-01-01

Congo (Brazzaville) is among the top five oil producers in Sub-Saharan Africa. Oil production comes almost entirely from offshore oil fields. Congo exports almost all of its oil production, and the largest recipients are China and the European Union.

78 FR 2722 - Designation of Individuals Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... Republic of Congo.'' DATES: The designation by the Director of OFAC of the two individuals identified in... relation to the Democratic Republic of the Congo constitutes an unusual and extraordinary threat to the... 1978; POB Bunagana, Rutshuru territory, Democratic Republic of the Congo; Colonel (individual) [DRCONGO...

Nurses’ compliance with prevention of mother-to-child transmission national guidelines in selected sites in Kinshasa, Democratic Republic of Congo.

PubMed

Amboko, Augustin R M; Brysiewicz, Petra

2015-01-01

The Democratic Republic of Congo (DRC) implemented a prevention of mother-to-child transmission (PMTCT) of HIV infection programme in maternal, newborn and child health (MNCH) services in 2001 with nurses as key personnel. To date there is no information in the DRC and specifically in Kinshasa with respect to compliance with PMTCT national guidelines. The study aimed at describing nurses’ compliance with the PMTCT national guidelines in selected PMTCT sites of Kinshasa. A descriptive cross-sectional study was conducted in Kinshasa with 76 nurses in 18 selected PMTCT sites. The nurses’ compliance with PMTCT national guidelines was assessed using a healthcare provider self-reporting questionnaire developed by the researchers. The study showed that the mean score of nurses’ compliance with PMTCT national guidelines was 74% (95% CI: 69%-78%) which progressively decreased and was significantly different across different MNCH services (p = 0.025). With respect to categories of PMTCT recommendations, nurses were compliant with those related to education in labour and delivery, and antenatal services. Sociodemographic characteristics such as training, length of service and category of nurses did not influence nurses’ compliance score. These findings showed that nurses were noncompliant with PMTCT national guidelines, with the score level being 80% or more in the three MNCH services/units. Improvement of nurses’ ‘compliance with the PMTCT national guidelines requires effective monitoring of full integration of PMTCT as routine activities in MNCH care.

Reasons for non-compliance among patients with hypertension at Vanga Hospital, Bandundu Province, Democratic Republic of Congo: A qualitative study

PubMed Central

Mabuza, Langalibalele; Malete, Nomsa; Maduna, Patrick; Ndimande, John V.

2009-01-01

ABSTRACT Background Hypertension is a serious public health challenge in both economically developing and developed countries. Patients on outpatient medication for hypertension at Vanga Hospital in the Democratic Republic of Congo (DRC) often present with uncontrolled hypertension and some with hypertension emergencies. On enquiry, the problem appeared to revolve around compliance. Method The study was a qualitative, descriptive study using the focus group interview technique for data collection. Subjects were purposely selected. Interviews were conducted from 23 March to 19 July 2006. Three focus groups were formed: The first was heterogeneous in terms of gender (five males and three females), the second homogeneous (six males) and the last also homogeneous (six females). The group members varied with respect to characteristics such as place of residence, occupation and educational standard. The data collected were analysed using the thematic analysis method within grounded theory. Results Five themes emerged as possible explanations for non-compliance: Side effects discouraged patients from taking medication; patients took medication only when they experienced perceived symptoms of hypertension; poor knowledge of the disease and the medication used; lack of support by family members; and difficulty in obtaining antihypertensive medication. Conclusion Side effects of the medication, lack of information and support, difficulty in obtaining the medication and the fact that the disease is mainly silent played a major role in the poor adherence to hypertension medication. Sustained health promotion and education should be undertaken at all levels of patient contact to ensure good compliance.

The infant feeding choices and experiences of women living with HIV in Kinshasa, Democratic Republic of Congo.

PubMed

Maman, Suzanne; Cathcart, Rebecca; Burkhardt, Gillian; Omba, Serge; Thompson, Deidre; Behets, Frieda

2012-01-01

HIV transmission through breastfeeding is a significant public health challenge. While breastfeeding provides important nutrition, and results in reduced morbidity and mortality, there is a risk of HIV transmission through breastfeeding. International prevention of mother-to-child transmission (PMTCT) guidelines recommend exclusive breastfeeding for six months among HIV-infected women on antiretroviral therapy. Promoting exclusive feeding has proved difficult in settings where mixed feeding is a cultural norm. Understanding the factors that influence HIV infected women's infant feeding choices and practices is critical to promoting adherence to PMTCT guidelines. We conducted in-depth interviews with 40 HIV+ pregnant and post-partum women in Kinshasa, Democratic Republic of Congo to understand their infant feeding experiences. Interviews were conducted in Lingala, and transcribed and translated into French for analysis. Deductive and inductive codes were applied, and matrices were created to facilitate cross-case analysis. Women had limited understanding of the specific mechanisms through which their infant feeding practices influenced HIV transmission risk. Clinical staff was the primary source of women's knowledge of HIV mother-to-child-transmission. Among the 24 post-partum women in the sample, seven women adhered to exclusive breastfeeding and two women to exclusive formula feeding for at least six months. Women's beliefs and awareness about HIV transmission through breastfeeding, as well as the information and support from clinical staff and other members of their support networks positively influenced their exclusive feeding. Common barriers to exclusive feeding included financial constraints, breast health problems, misinformation about HIV transmission, local norms, and prior feeding experiences. Health care workers play a key role in providing correct information on PMTCT and supporting women's infant feeding choices to adhere to guidelines of exclusive

Health care seeking and financial behaviours of the elderly during wartime in Goma, Democratic Republic of Congo

PubMed Central

Kwalya, Timothée M.; Kasagila, Eric K.; Watongoka, L. Hubert; Mupenda, Bavon W.

2010-01-01

ABSTRACT Background Health and social services utilisation is seen to be more closely related to age than to other socio-demographic characteristics. Many health problems are known to increase with age and this demographic trend may lead to an increase in the absolute number of health conditions in this population. However, questions are still emerging as to how the elderly seek care in response to their needs in the context of a war-torn region. Objectives The aim of this study was to determine the behaviour of the elderly in seeking care during a time of conflict. Method A descriptive cross-sectional study was carried out in the health district Goma, in the Democratic Republic of the Congo (DRC), using a multistage sampling of 500 senior citizens. Eight trained field-workers were deployed in the field where they administered a structured questionnaire. Results The public health sector was well known and preferred by 186 participants (37.2%), but only used by 16 (3.2%) participants. Financial support received by the elderly came from their own relatives and fellow believers in 33.5% and 20.2% of cases, respectively. Almost 71% of monetary support is the result of begging and unknown sources – there is no government involvement whatsoever. Much of the external support that the elderly receive involves support in the form of food. Disease expenses remain a main concern of the elderly themselves. Conclusion Government support for the elderly in the DRC is non-existent. There is an overuse of private sector and traditional medicine, despite the preference indicated for the public health sector. As a recommendation, a general increase in income-related activities could contribute to alleviating the health state of the elderly in a war situation. Further studies might explore in future the contribution of those results on the health of elders.

Surgical care for the direct and indirect victims of violence in the eastern Democratic Republic of Congo.

PubMed

Chu, Kathryn; Havet, Philippe; Ford, Nathan; Trelles, Miguel

2010-04-14

The provision of surgical assistance in conflict is often associated with care for victims of violence. However, there is an increasing appreciation that surgical care is needed for non-traumatic morbidities. In this paper we report on surgical interventions carried out by Médecins sans Frontières in Masisi, North Kivu, Democratic Republic of Congo to contribute to the scarce evidence base on surgical needs in conflict. We analysed data on all surgical interventions done at Masisi district hospital between September 2007 and December 2009. Types of interventions are described, and logistic regression used to model associations with violence-related injury. 2869 operations were performed on 2441 patients. Obstetric emergencies accounted for over half (675, 57%) of all surgical pathology and infections for another quarter (160, 14%). Trauma-related injuries accounted for only one quarter (681, 24%) of all interventions; among these, 363 (13%) were violence-related. Male gender (adjusted odds ratio (AOR) = 20.0, p < 0.001), military status (AOR = 4.1, p < 0.001), and age less than 20 years (AOR = 2.1, p < 0.001) were associated with violence-related injury. Immediate peri-operative mortality was 0.2%. In this study, most surgical interventions were unrelated to violent trauma and rather reflected the general surgical needs of a low-income tropical country. Programs in conflict zones in low-income countries need to be prepared to treat both the war-wounded and non-trauma related life-threatening surgical needs of the general population. Given the limited surgical workforce in these areas, training of local staff and task shifting is recommended to support broad availability of essential surgical care. Further studies into the surgical needs of the population are warranted, including population-based surveys, to improve program planning and resource allocation and the effectiveness of the humanitarian response.

Investigating the effect of fire dynamics on aboveground carbon storage in the Bateke landscape, Republic of Congo

NASA Astrophysics Data System (ADS)

Nieto Quintano, P.; Mitchard, E. T.; Ryan, C.; Tim, R.

2016-12-01

It is estimated that 68% of Africa's surface area burns every year (Roy et al. 2008), being the savanna biome the most continuously affected by burning with strong environmental and social impacts (Romero-Ruiz et al., 2010). Most fires in Africa are anthropogenic and occur during the Late Dry Season, but their dynamics and effects remain understudied. Sankaran et al. (2005) suggested that if disturbances by fire, browsers and humans were absent, then large areas of Africa would become forests. The main objective of this research is to understand the woody cover, productivity, carbon storage and fire regime of the complex forest/savanna system of the Bateke Plateau. The Bateke Plateau is a landscape composed of frequently burned grassland savanna surrounded by tropical forest, situated in the centre of the Republic of Congo. This study combines two approaches: firstly experimental, with long term field experiments where the fire regime is manipulated, and then observational, using remote sensing to study the past history of fire regime in the region. Field experiments suggest that late dry season fires are more intense and have higher mortality rates. We also investigated aboveground biomass, fire occurrence and intensity, using Landsat, ALOS PALSAR and the fire products of MODIS. We found that most savanna areas burnt at least once every 4 years, with more frequent fires occurring in the late dry season and around roads and settlements. This two approaches will be then combined to create a novel model of vegetation-fire-climate interactions in order to predict the vegetation response to different future scenarios. The results will be used to promote better management of this area to enhance carbon storage, as well as increase our understanding of vegetation dynamics in this understudied ecosystem and help orient policy and conservation.

Quantification of land cover and land use within the rural complex of the Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Molinario, G.; Hansen, M. C.; Potapov, P. V.; Tyukavina, A.; Stehman, S.; Barker, B.; Humber, M.

2017-10-01

The rural complex is the inhabited agricultural land cover mosaic found along the network of rivers and roads in the forest of the Democratic Republic of Congo. It is a product of traditional small-holder shifting cultivation. To date, thanks to its distinction from primary forest, this area has been mapped as relatively homogenous, leaving the proportions of land cover heterogeneity within it unknown. However, the success of strategies for sustainable development, including land use planning and payment for ecosystem services, such as Reduced Emissions from Deforestation and Degradation, depends on the accurate characterization of the impacts of land use on natural resources, including within the rural complex. We photo-interpreted a simple random sample of 1000 points in the established rural complex, using 3106 high resolution satellite images obtained from the National Geospatial-Intelligence Agency, together with 406 images from Google Earth, spanning the period 2008-2016. Results indicate that nationally the established rural complex includes 5% clearings, 10% active fields, 26% fallows, 34% secondary forest, 2% wetland forest, 11% primary forest, 6% grasslands, 3% roads and settlements and 2% commercial plantations. Only a small proportion of sample points were plantations, while other commercial dynamics, such as logging and mining, were not detected in the sample. The area of current shifting cultivation accounts for 76% of the established rural complex. Added to primary forest (11%), this means that 87% of the rural complex is available for shifting cultivation. At the current clearing rate, it would take ~18 years for a complete rotation of the rural complex to occur. Additional pressure on land results in either the cultivation of non-preferred land types within the rural complex (such as wetland forest), or expansion of agriculture into nearby primary forests, with attendant impacts on emissions, habitat loss and other ecosystems services.

Identification of Dengue and Chikungunya Cases Among Suspected Cases of Yellow Fever in the Democratic Republic of the Congo.

PubMed

Makiala-Mandanda, Sheila; Ahuka-Mundeke, Steve; Abbate, Jessica L; Pukuta-Simbu, Elisabeth; Nsio-Mbeta, Justus; Berthet, Nicolas; Leroy, Eric Maurice; Becquart, Pierre; Muyembe-Tamfum, Jean-Jacques

2018-05-16

For more than 95% of acute febrile jaundice cases identified through surveillance for yellow fever, a reemerging arthropod-borne viral disease, no etiological exploration is ever done. The aim of this study was to test for other arthropod-borne viruses that can induce the same symptoms in patients enrolled in the yellow fever surveillance in the Democratic Republic of the Congo (DRC). Of 652 patients included in the surveillance of yellow fever in DRC from January 2003 to January 2012, 453 patients that tested negative for yellow fever virus (YFV) immunoglobulin M (IgM) antibodies were selected for the study. Real-time polymerase chain reaction was performed for the detection of dengue, West Nile, Chikungunya, O'nyong-nyong, Rift Valley fever, Zika, and YFV. The average age of patients was 22.1 years. We reported 16 cases (3.5%; confidence interval [CI]: 0.8-5.2) of dengue (serotypes 1 and 2) and 2 cases (0.4%; CI: 0.0-1.0) of Chikungunya. Three patients were co-infected with the two serotypes of dengue virus. Three cases of dengue were found in early July 2010 from the city of Titule (Oriental province) during a laboratory-confirmed outbreak of yellow fever, suggesting simultaneous circulation of dengue and yellow fever viruses. This study showed that dengue and Chikungunya viruses are potential causes of acute febrile jaundice in the DRC and highlights the need to consider dengue and Chikungunya diagnosis in the integrated disease surveillance and response program in the DRC. A prospective study is necessary to establish the epidemiology of these diseases.

Effect of removing the barrier of transportation costs on surgical utilisation in Guinea, Madagascar and the Republic of Congo.

PubMed

Shrime, Mark G; Hamer, Mirjam; Mukhopadhyay, Swagoto; Kunz, Lauren M; Claus, Nathan H; Randall, Kirsten; Jean-Baptiste, Joannita H; Maevatombo, Pierre H; Toh, Melissa P S; Biddell, Jasmin R; Bos, Ria; White, Michelle

2017-01-01

81 million people face impoverishment from surgical costs every year. The majority of this impoverishment is attributable to the non-medical costs of care-for transportation, for food and for lodging. Of these, transportation is the largest, but because it is not viewed as an actual medical cost, it is frequently unaddressed. This paper examines the effect on surgical utilisation of paying for transportation. A hierarchical logistic regression was performed on 2692 patients presenting for surgical care to a non-governmental organisation operating in the Republic of the Congo, Guinea and Madagascar. Controlling for distance from the hospital, age, gender, the need for air travel and time between appointments, the effect of payment for transportation on the surgical no-show rate was evaluated. After adjustment for observed confounders, paying for transportation drops the surgical no-show rate by 45% (OR 0.55; 95% CI 0.40 to 0.77; p<0.001). Age, delay between appointments and the number of hours travelled for surgery also predict surgical no-show. For 28% of no-show patients, the cost of transportation from their homes to a nearby predetermined pick-up point remained a barrier, even when transportation from the pick-up point to the hospital was free. Transportation costs are a significant barrier to surgical care in low-resource settings, and paying for it halves the no-show rate. This finding highlights that decreasing demand-side barriers to surgical care cannot be limited only to the removal of user fees.

Wealth and under-nourishment among married women in two impoverished nations: evidence from Burkina Faso and Congo Democratic Republic.

PubMed

Adebowale, Ayo Stephen; Palamuleni, Martin Enoch; Odimegwu, Clifford Obby

2015-02-08

Burkina Faso (BF) and Congo Democratic Republic (CDR) are among the top-ten poverty and hunger stricken countries globally. The influence of poverty and hunger on health is enormous. The objectives of the study are to; examine the association between poverty and nutritional status, it also identified socio-demographic and health related mediating factors that contribute to the relationship between poverty and poor nutritional status. The study focused on married or cohabiting women aged 15-49 years and utilized 2010 and 2007 DHS dataset from BF and CDR respectively. Mean age of the women in BF and CDR were 34.4 ± 9.3 and 34.7 ± 9.0 years respectively. About 19.4% and 18.4% of the poor were malnourished as against 7.7% and 9.7% of the rich women in BF and CDR respectively. Obesity and overweight were more prominent among the rich than the poor. Higher prevalence of under-nourish women was found among the older than the younger women in BF. In the countries, the prevalence of malnutrition was significantly higher among women; in the rural areas, with no formal education, anaemic and those who are not working. Multivariate analysis revealed that in the countries, the risk of under-nourishment was significantly higher among poor and middle class than the rich women despite controlling for confounding variables. Undernourished women were more common among the poor and those with no formal education. Programs that target nutrition of women of reproductive age should be strengthened in BF and CDR.

High human exposure to pyrene (polycyclic aromatic hydrocarbon) in Kinshasa, a capital of the Democratic Republic of Congo.

PubMed

Tuakuila, Joel; Kabamba, Martin; Mata, Honoré

2013-01-01

Data on human exposure to chemicals in Africa are scarce. A biomonitoring study was conducted in a representative sample of the population in Kinshasa (Democratic Republic of Congo) to document exposure to polycyclic aromatics hydrocarbons. 1-hydroxypyrene (1-OHP) was measured by HPLC fluorescence in spot urine samples from 220 individuals (50.5% women), aged 6-70 years living in the urban area and from 50 additional subjects from the sub-rural area of Kinshasa. Data were compiled as geometric means and selected percentiles, expressed without (μg/L) or with creatinine adjustment (μg/g cr). Multiple regression analyses were applied to factors (creatinine, grilled meat habits and smoking habits) influencing 1-OHP (stepwise procedure, criteria: probability F to enter ≤ 0.05 and probability F to remove ≥ 0.10). According to the regression models, creatinine, grilled meat habits and smoking habits contribute to explain 45% of the variation in population's urinary 1-OHP by the environmental exposure. Overall, living in urban area of Kinshasa was associated with increased levels of 1-OHP in urine as compared to a population living in the sub-rural area [GM: 1.8 μg/L (n = 220) versus 1.4 μg/L (n = 50), p < 0.01] as well as compared to the reference values from databases involving American or German populations. This study reveals the high pyrene (PAH) exposure of the Kinshasa population. However, more work, with a rigorous design in the exposed population (monitoring of air concentrations and identifying other sources of pyrene -PAH exposure), is needed to establish further documentation.

High human exposure to pyrene (polycyclic aromatic hydrocarbon) in Kinshasa, a capital of the Democratic Republic of Congo

PubMed Central

2013-01-01

Background Data on human exposure to chemicals in Africa are scarce. A biomonitoring study was conducted in a representative sample of the population in Kinshasa (Democratic Republic of Congo) to document exposure to polycyclic aromatics hydrocarbons. Methods 1-hydroxypyrene (1-OHP) was measured by HPLC fluorescence in spot urine samples from 220 individuals (50.5% women), aged 6–70 years living in the urban area and from 50 additional subjects from the sub-rural area of Kinshasa. Data were compiled as geometric means and selected percentiles, expressed without (μg/L) or with creatinine adjustment (μg/g cr). Multiple regression analyses were applied to factors (creatinine, grilled meat habits and smoking habits) influencing 1-OHP (stepwise procedure, criteria: probability F to enter ≤ 0.05 and probability F to remove ≥ 0.10). Results According to the regression models, creatinine, grilled meat habits and smoking habits contribute to explain 45% of the variation in population’s urinary 1-OHP by the environmental exposure. Overall, living in urban area of Kinshasa was associated with increased levels of 1-OHP in urine as compared to a population living in the sub-rural area [GM: 1.8 μg/L (n = 220) versus 1.4 μg/L (n = 50), p < 0.01] as well as compared to the reference values from databases involving American or German populations. Conclusion This study reveals the high pyrene (PAH) exposure of the Kinshasa population. However, more work, with a rigorous design in the exposed population (monitoring of air concentrations and identifying other sources of pyrene –PAH exposure), is needed to establish further documentation. PMID:23782930

Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo.

PubMed

Labat, Francoise; Sharma, Anjali

2016-04-25

To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). In-depth interviews were conducted and analysed using qualitative content analysis. Governmental referral teaching hospital in Eastern DRC. We purposively selected 2-4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs' reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Lateralization and performance asymmetries in the termite fishing of wild chimpanzees in the goualougo triangle, republic of Congo.

PubMed

Sanz, Crickette M; Morgan, David B; Hopkins, William D

2016-11-01

The nearly universal right hand preference manifested by human populations is one of the most pronounced manifestations of population-level lateralization. Morphological and archeological evidence indicate that this behavioral specialization may have emerged among our hominin ancestors. Whether population-level behavioral asymmetries are evident in non-human animals remains a topic of considerable scientific debate, with the most consistent evidence of population-level trends emerging from studies of chimpanzees (Pan troglodytes). However, previous studies of population-level lateralization in wild apes have relied upon data sets pooled across populations to reach adequate sample sizes. Our aim was to test for population-level handedness within a single wild chimpanzee population, and also to determine if performance asymmetries were associated with handedness. To address these questions, we coded handedness and duration of fishing probe insertions from remote video footage of chimpanzee visitation to termite nests (totaling 119 hr) in the Goualougo Triangle, Republic of Congo. Similar to reports from other populations, chimpanzees in the Goualougo Triangle showed robust individual hand preferences for termite fishing. There were 46 right-handed, 39 left-handed, and 4 ambiguously-handed individuals. Though we did not detect an overall significant population-level handedness (t(88) = 0.83, n.s.) in this study, males showed a greater right hand preference than females. Further, we found that average dipping latencies were significantly faster for right- compared to left-handed chimpanzees. Possible explanations and evolutionary implications of taxa- and task-specific patterns of population-level laterality are discussed. Am. J. Primatol. 78:1190-1200, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Assessment of Breast Cancer Knowledge among Health Workers in Bangui, Central African Republic: a Cross-sectional Study.

PubMed

Balekouzou, Augustin; Yin, Ping; Pamatika, Christian Maucler; Nambei, Sylvain Wilfrid; Djeintote, Marceline; Doromandji, Eric; Gouaye, Andre Richard; Yamba, Pascal Gastien; Guessy, Elysee Ephraim; Ba-Mpoutou, Bertrand; Mandjiza, Dieubeni Rawago; Shu, Chang; Yin, Minghui; Fu, Zhen; Qing, Tingting; Yan, Mingming; Mella, Grace; Koffi, Boniface

2016-01-01

Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's χ 2 test and ANOVA were applied to examine associations between variables with <0.05 being considered significant. Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in the Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.

Adaptation of a U.S. evidence-based Positive Prevention intervention for youth living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

PubMed Central

Parker, L.; Maman, S.; Pettifor, A.; Chalachala, J.L.; Edmonds, A.; Golin, C.E.; Moracco, K.; Behets, F.

2013-01-01

Effective HIV prevention programs for people living with HIV/AIDS (PLWH) are important to reduce new infections and to ensure PLWH remain healthy. This paper describes the systematic adaptation of a U.S.-developed Evidence Based Intervention (EBI) using the Centers for Disease Control and Prevention (CDC) Map of Adaption Process for use at a Pediatric Hospital in Kinshasa, Democratic Republic of the Congo (DRC). The adapted intervention, Supporting Youth and Motivating Positive Action or SYMPA, a six-session risk reduction intervention targeted for youth living with HIV/AIDS (YLWH) in Kinshasa was adapted from the Healthy Living Project and guided by the Social Action Theory. This paper describes the process of implementing the first four steps of the ADAPT framework (Assess, Select, Prepare, and Pilot). Our study has shown that an EBI developed and implemented in the U.S. can be adapted successfully for a different target population in a low-resource context through an iterative process following the CDC ADAPT framework. This process included reviewing existing literature, adapting and adding components, and focusing on increasing staff capacity. This paper provides a rare, detailed description of the adaptation process and may aid organizations seeking to adapt and implement HIV prevention EBIs in sub-Saharan Africa and beyond. PMID:23063699

Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

PubMed

Mwandagalirwa, Melchior Kashamuka; Levitz, Lauren; Thwai, Kyaw L; Parr, Jonathan B; Goel, Varun; Janko, Mark; Tshefu, Antoinette; Emch, Michael; Meshnick, Steven R; Carrel, Margaret

2017-11-09

The Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with malaria are needed, as is an understanding of how these characteristics vary spatiotemporally and across different community-level malaria endemicities. An ongoing study in Kinshasa Province is designed to address gaps in prior malaria surveillance in the DRC by monitoring malaria across seasons, age groups and in high and low malaria sites. Across seven sites, 242 households and 1591 individuals are participating in the study. Results of the enrollment questionnaire, rapid diagnostic tests and PCR testing of dried blood spots are presented. Overall malaria prevalence in the study cohort is high, 27% by rapid diagnostic test and 31% by polymerase chain reaction, and malaria prevalence is highly varied across very small geographic distances. Malaria prevalence is highest in children aged 6-15. While the majority of households own bed nets, bed net usage is less than 50%. The study cohort will provide an understanding of how malaria persists in populations that have varying environmental exposures, varying community-level malaria, and varying access to malaria control efforts.

77 FR 69547 - Designation of an Individual Pursuant to Executive Order 13413

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2012-11-19

... Republic of Congo.'' DATES: The designation by the Director of OFAC of the one individual identified in... relation to the Democratic Republic of the Congo constitutes an unusual and extraordinary threat to the... Sultani); DOB 25 Dec 1973; POB Rutshuru, Democratic Republic of the Congo; Colonel (individual) [DRCONGO...

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2013-01-29

... Republic of Congo.'' DATES: The designation by the Director of OFAC of the two individuals identified in... relation to the Democratic Republic of the Congo constitutes an unusual and extraordinary threat to the...-Marie Lugerero); DOB September 17, 1966; POB Democratic Republic of the Congo (individual) [DRCONGO] 2...

[African community empowerment approach to diagnosis in Health Care in two countries: Guinea Conakry and Congo Brazzaville].

PubMed

Vieira, Gildas; Courtois, Robert; Rusch, Emmanuel

2017-01-01

After immigration to France, the populations of Sub-Saharan Africa have often maintained their traditional lifestyles, this is why housing policies have been promoting their clustering in priority neighborhoods. Discussing issues about health promotion, requires to investigate health policies in their countries of origin. For this, we (i) organized brainstorming sessions with a group of 16 persons resident in France who were involved in a process of empowerment strengthening of community health programs in order to make them understood the incentives and the obstacles in health care in their countries of origin. We also (ii) collected literature data prior to undertake several trips to Guinea and Congo, in order to compare literature data with those of these countries. The result concerning health promotion in these countries allowed the identification of measures to be put in place. Among them, the facilitation of accessing to community health programs, basing on successful experiences, with the prospect of transferring them to France for migrants. These measures are based on the involvement of the institutional actors and of the populations in educational approaches to health behavior change. "Territorial" diagnosis allows to emphasize the importance of the influence of health environment in the country of origin on subsequent behaviours. Moreover, it allows to highlight solutions that can promote harmonization of African community health in France.

Sensitive Next-Generation Sequencing Method Reveals Deep Genetic Diversity of HIV-1 in the Democratic Republic of the Congo.

PubMed

Rodgers, Mary A; Wilkinson, Eduan; Vallari, Ana; McArthur, Carole; Sthreshley, Larry; Brennan, Catherine A; Cloherty, Gavin; de Oliveira, Tulio

2017-03-15

As the epidemiological epicenter of the human immunodeficiency virus (HIV) pandemic, the Democratic Republic of the Congo (DRC) is a reservoir of circulating HIV strains exhibiting high levels of diversity and recombination. In this study, we characterized HIV specimens collected in two rural areas of the DRC between 2001 and 2003 to identify rare strains of HIV. The env gp41 region was sequenced and characterized for 172 HIV-positive specimens. The env sequences were predominantly subtype A (43.02%), but 7 other subtypes (33.14%), 20 circulating recombinant forms (CRFs; 11.63%), and 20 unclassified (11.63%) sequences were also found. Of the rare and unclassified subtypes, 18 specimens were selected for next-generation sequencing (NGS) by a modified HIV-switching mechanism at the 5' end of the RNA template (SMART) method to obtain full-genome sequences. NGS produced 14 new complete genomes, which included pure subtype C ( n = 2), D ( n = 1), F1 ( n = 1), H ( n = 3), and J ( n = 1) genomes. The two subtype C genomes and one of the subtype H genomes branched basal to their respective subtype branches but had no evidence of recombination. The remaining 6 genomes were complex recombinants of 2 or more subtypes, including subtypes A1, F, G, H, J, and K and unclassified fragments, including one subtype CRF25 isolate, which branched basal to all CRF25 references. Notably, all recombinant subtype H fragments branched basal to the H clade. Spatial-geographical analysis indicated that the diverse sequences identified here did not expand globally. The full-genome and subgenomic sequences identified in our study population significantly increase the documented diversity of the strains involved in the continually evolving HIV-1 pandemic. IMPORTANCE Very little is known about the ancestral HIV-1 strains that founded the global pandemic, and very few complete genome sequences are available from patients in the Congo Basin, where HIV-1 expanded early in the global pandemic. By

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3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

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2013-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...

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3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

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2014-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...

31 CFR 547.301 - Arms or any related materiel.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO SANCTIONS... use by units of the army and police of the Democratic Republic of the Congo, provided that said units... the Congo; (3) Are in the process of their integration in the territory of the Democratic Republic of...

31 CFR 547.301 - Arms or any related materiel.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO SANCTIONS... use by units of the army and police of the Democratic Republic of the Congo, provided that said units... the Congo; (3) Are in the process of their integration in the territory of the Democratic Republic of...

Intestinal Helminths of Wild Bonobos in Forest-Savanna Mosaic: Risk Assessment of Cross-Species Transmission with Local People in the Democratic Republic of the Congo.

PubMed

Narat, Victor; Guillot, Jacques; Pennec, Flora; Lafosse, Sophie; Grüner, Anne Charlotte; Simmen, Bruno; Bokika Ngawolo, Jean Christophe; Krief, Sabrina

2015-12-01

Phylogenetic and geographic proximities between humans and apes pose a risk of zoonotic transmission of pathogens. Bonobos (Pan paniscus) of the Bolobo Territory, Democratic Republic of the Congo, live in a fragmented forest-savanna mosaic setting, a marginal habitat for this species used to living in dense forests. Human activities in the forest have increased the risk of contacts between humans and bonobos. Over 21 months (September 2010-October 2013), we monitored intestinal parasites in bonobo (n = 273) and in human (n = 79) fecal samples to acquire data on bonobo parasitology and to assess the risk of intestinal helminth transmission between these hosts. Coproscopy, DNA amplification, and sequencing of stored dried feces and larvae were performed to identify helminths. Little difference was observed in intestinal parasites of bonobos in this dryer habitat compared to those living in dense forests. Although Strongylids, Enterobius sp., and Capillaria sp. were found in both humans and bonobos, the species were different between the hosts according to egg size or molecular data. Thus, no evidence of helminth transmission between humans and bonobos was found. However, because humans and this threatened species share the same habitat, it is essential to continue to monitor this risk.

Review and three new species of the flat bug genus Neochelonoderus Hoberlandt, 1967 from East Africa (Hemiptera: Heteroptera: Aradidae).

PubMed

Heiss, Ernst; Grebennikov, Vasily

2015-04-17

The apterous East African Mezirinae flat bug genus Neochelonoderus Hoberlandt 1967 is revised. In addition to known species from Burundi (N. basilewskyi) and Democratic Republic of the Congo (N. straeleni), two new species from Tanzania (N. talaus n. sp. and N. areius n. sp.) and one from Zambia (N. hoberlandti n. sp.) are described and illustrated. A key to the species of Neochelonoderus is presented.

African Peace and Security Architecture: A Strategic Analysis

DTIC Science & Technology

2011-12-16

In effect, it seems that the PW is operating 27There are innumerous proverbs in all African regions espousing the wisdom of elders. “The Ikwerre...African proverb , “What old people see seated at the base of the tree young people cannot see from the branches.” The Loa people of Congo have a... proverb which states that “Those who do not listen to the voice of the elderly are like trees without roots” (ACCORD 2009, 21). 50 in a “contemporary

Technical Education and Vocational Training in Central Africa. Feasibility Survey of the Regional Development of Rapid Vocational Training: Cameroon, Central African Republic, Chad, and Gabon.

ERIC Educational Resources Information Center

Organization for Rehabilitation through Training, Geneva (Switzerland).

This final report is the result of a survey requested by the United States Agency for International Development (USAID) and undertaken by the Organization for Rehabilitation through Training (ORT) of four countries (Cameroon, Chad, Central African Republic, and Gabon) and a conference on vocational training sponsored by the Economic and Customs…

76 FR 76219 - Designation of Additional Individual Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

... Democratic Republic of Congo.'' DATES: The designation by the Director of OFAC of the individual identified... the Congo constitutes and unusual and extraordinary threat to the foreign policy of the United States... Ntaberi; DOB 4 Apr 1976; POB Walikale Territory, Democratic Republic of the Congo; nationality Congo...

Is Congo red an amyloid-specific dye?

PubMed

Khurana, R; Uversky, V N; Nielsen, L; Fink, A L

2001-06-22

Congo red (CR) binding, monitored by characteristic yellow-green birefringence under crossed polarization has been used as a diagnostic test for the presence of amyloid in tissue sections for several decades. This assay is also widely used for the characterization of in vitro amyloid fibrils. In order to probe the structural specificity of Congo red binding to amyloid fibrils we have used an induced circular dichroism (CD) assay. Amyloid fibrils from insulin and the variable domain of Ig light chain demonstrate induced CD spectra upon binding to Congo red. Surprisingly, the native conformations of insulin and Ig light chain also induced Congo red circular dichroism, but with different spectral shapes than those from fibrils. In fact, a wide variety of native proteins exhibited induced CR circular dichroism indicating that CR bound to representative proteins from different classes of secondary structure such as alpha (citrate synthase), alpha + beta (lysozyme), beta (concavalin A), and parallel beta-helical proteins (pectate lyase). Partially folded intermediates of apomyoglobin induced different Congo red CD bands than the corresponding native conformation, however, no induced CD bands were observed with unfolded protein. Congo red was also found to induce oligomerization of native proteins, as demonstrated by covalent cross-linking and small angle x-ray scattering. Our data suggest that Congo red is sandwiched between two protein molecules causing protein oligomerization. The fact that Congo red binds to native, partially folded conformations and amyloid fibrils of several proteins shows that it must be used with caution as a diagnostic test for the presence of amyloid fibrils in vitro.

75 FR 65933 - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-26

... Respect to the Situation in or in Relation to the Democratic Republic of the Congo #0; #0; #0... Republic of the Congo On October 27, 2006, by Executive Order 13413, the President declared a national emergency with respect to the situation in or in relation to the Democratic Republic of the Congo and...

75 FR 77044 - Blocking of Specially Designated National Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... Conflict in the Democratic Republic of Congo.'' DATES: The designation by the Director of OFAC of the four... States Code. In the Order, the President found that the situation in the Democratic Republic of the Congo.... DOB 1975; POB Ngungu, Masisi Territory, North Kivu province, Democratic Republic of the Congo; Lt. Col...

New Mycobacterium tuberculosis Complex Sublineage, Brazzaville, Congo

PubMed Central

Malm, Sven; Linguissi, Laure S. Ghoma; Tekwu, Emmanuel M.; Vouvoungui, Jeannhey C.; Kohl, Thomas A.; Beckert, Patrick; Sidibe, Anissa; Rüsch-Gerdes, Sabine; Madzou-Laboum, Igor K.; Kwedi, Sylvie; Penlap Beng, Véronique; Frank, Matthias; Ntoumi, Francine

2017-01-01

Tuberculosis is a leading cause of illness and death in Congo. No data are available about the population structure and transmission dynamics of the Mycobacterium tuberculosis complex strains prevalent in this central Africa country. On the basis of single-nucleotide polymorphisms detected by whole-genome sequencing, we phylogenetically characterized 74 MTBC isolates from Brazzaville, the capital of Congo. The diversity of the study population was high; most strains belonged to the Euro-American lineage, which split into Latin American Mediterranean, Uganda I, Uganda II, Haarlem, X type, and a new dominant sublineage named Congo type (n = 26). Thirty strains were grouped in 5 clusters (each within 12 single-nucleotide polymorphisms), from which 23 belonged to the Congo type. High cluster rates and low genomic diversity indicate recent emergence and transmission of the Congo type, a new Euro-American sublineage of MTBC. PMID:28221129

New Mycobacterium tuberculosis Complex Sublineage, Brazzaville, Congo.

PubMed

Malm, Sven; Linguissi, Laure S Ghoma; Tekwu, Emmanuel M; Vouvoungui, Jeannhey C; Kohl, Thomas A; Beckert, Patrick; Sidibe, Anissa; Rüsch-Gerdes, Sabine; Madzou-Laboum, Igor K; Kwedi, Sylvie; Penlap Beng, Véronique; Frank, Matthias; Ntoumi, Francine; Niemann, Stefan

2017-03-01

Tuberculosis is a leading cause of illness and death in Congo. No data are available about the population structure and transmission dynamics of the Mycobacterium tuberculosis complex strains prevalent in this central Africa country. On the basis of single-nucleotide polymorphisms detected by whole-genome sequencing, we phylogenetically characterized 74 MTBC isolates from Brazzaville, the capital of Congo. The diversity of the study population was high; most strains belonged to the Euro-American lineage, which split into Latin American Mediterranean, Uganda I, Uganda II, Haarlem, X type, and a new dominant sublineage named Congo type (n = 26). Thirty strains were grouped in 5 clusters (each within 12 single-nucleotide polymorphisms), from which 23 belonged to the Congo type. High cluster rates and low genomic diversity indicate recent emergence and transmission of the Congo type, a new Euro-American sublineage of MTBC.

Combining satellite, aerial and ground measurements to assess forest carbon stocks in Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

Beaumont, Benjamin; Bouvy, Alban; Stephenne, Nathalie; Mathoux, Pierre; Bastin, Jean-François; Baudot, Yves; Akkermans, Tom

2015-04-01

Monitoring tropical forest carbon stocks changes has been a rising topic in the recent years as a result of REDD+ mechanisms negotiations. Such monitoring will be mandatory for each project/country willing to benefit from these financial incentives in the future. Aerial and satellite remote sensing technologies offer cost advantages in implementing large scale forest inventories. Despite the recent progress made in the use of airborne LiDAR for carbon stocks estimation, no widely operational and cost effective method has yet been delivered for central Africa forest monitoring. Within the Maï Ndombe region of Democratic Republic of Congo, the EO4REDD project develops a method combining satellite, aerial and ground measurements. This combination is done in three steps: [1] mapping and quantifying forest cover changes using an object-based semi-automatic change detection (deforestation and forest degradation) methodology based on very high resolution satellite imagery (RapidEye), [2] developing an allometric linear model for above ground biomass measurements based on dendrometric parameters (tree crown areas and heights) extracted from airborne stereoscopic image pairs and calibrated using ground measurements of individual trees on a data set of 18 one hectare plots and [3] relating these two products to assess carbon stocks changes at a regional scale. Given the high accuracies obtained in [1] (> 80% for deforestation and 77% for forest degradation) and the suitable, but still to be improved with a larger calibrating sample, model (R² of 0.7) obtained in [2], EO4REDD products can be seen as a valid and replicable option for carbon stocks monitoring in tropical forests. Further improvements are planned to strengthen the cost effectiveness value and the REDD+ suitability in the second phase of EO4REDD. This second phase will include [A] specific model developments per forest type; [B] measurements of afforestation, reforestation and natural regeneration processes and

Global Health Observatory (GHO): Life Expectancy

MedlinePlus

... Overview Statistics Cooperation strategies Democratic Republic of the Congo » Emergencies Focus on » Bangladesh Rohingya Democratic Republic of the Congo Iraq Nigeria Somalia South Sudan Syrian Arab Republic ...

Frequently Asked Questions and Answers on Smallpox

MedlinePlus

... Overview Statistics Cooperation strategies Democratic Republic of the Congo » Emergencies Focus on » Bangladesh Rohingya Democratic Republic of the Congo Iraq Nigeria Somalia South Sudan Syrian Arab Republic ...

Acute Arthritis in Crimean-Congo Hemorrhagic Fever

PubMed Central

Ahmeti, Salih; Ajazaj-Berisha, Lindita; Halili, Bahrije; Shala, Anita

2014-01-01

Crimean-Congo hemorrhagic fever is a severe viral disease caused by a Nairovirus. An atypical manifestation in the form of acute arthritis was found in a confirmed Crimean-Congo hemorrhagic fever virus Kosova-Hoti strain positive patient. Acute arthritis in Crimean-Congo hemorrhagic fever (CCHF) may be as a result of immune mechanisms or the bleeding disorder underlying CCHF. PMID:24926169

76 FR 66597 - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-26

... Republic of the Congo #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 76, No. 207... Relation to the Democratic Republic of the Congo On October 27, 2006, by Executive Order 13413, the... Republic of the Congo and, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706...

78 FR 64149 - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-25

... Republic of the Congo #0; #0; #0; Presidential Documents #0; #0; #0;#0;Federal Register / Vol. 78 , No. 207... Relation to the Democratic Republic of the Congo On October 27, 2006, by Executive Order 13413, the... Republic of the Congo and, pursuant to the International Emergency Economic Powers Act (50 U.S.C. 1701-1706...

Conflict minerals from the Democratic Republic of the Congo: global tungsten processing plants, a critical part of the tungsten supply chain

USGS Publications Warehouse

Bermúdez-Lugo, Omayra

2014-01-01

The U.S. Geological Survey (USGS) analyzes supply chains to identify and define major components of mineral and material flows from ore extraction, through intermediate forms, to a final product. Two major reasons necessitate these analyses: (1) to identify risks associated with the supply of critical and strategic minerals to the United States and (2) to provide greater supply chain transparency so that policymakers have the information necessary to ensure domestic legislation compliance. This fact sheet focuses on the latter. The USGS National Minerals Information Center has been asked by governmental and non-governmental organizations to provide information on tin, tantalum, tungsten, and gold (collectively known as “3TG minerals”) processing facilities worldwide in response to U.S. legislation aimed at removing the link between the trade in these minerals and civil unrest in the Democratic Republic of the Congo. Post beneficiation processing plants (smelters and refineries) of 3TG mineral ores and concentrates were identified by company and industry association representatives as being the link in the 3TG mineral supply chain through which these minerals can be traced to their source of origin (mine); determining the point of origin is critical to establishing a transparent conflict mineral supply chain. This fact sheet, the first in a series of 3TG mineral fact sheets, focuses on the tungsten supply chain by listing plants that consume tungsten concentrates to produce ammonium paratungstate and ferrotungsten worldwide.

Trachoma in the Democratic Republic of the Congo: Results of 46 Baseline Prevalence Surveys Conducted with the Global Trachoma Mapping Project.

PubMed

Kilangalanga, Janvier; Ndjemba, Jean Marie; Uvon, Pitchouna A; Kibangala, Felix M; Mwandulo, Jean-Lebone Safari B; Mavula, Nicaise; Ndombe, Martin; Kazadi, Junior; Limbaka, Henry; Cohn, Daniel; Tougoue, Jean-Jacques; Kabore, Achille; Rotondo, Lisa; Willis, Rebecca; Bio, Amadou Alfa; Kadri, Boubacar; Bakhtiari, Ana; Ngondi, Jeremiah M; Solomon, Anthony W

2017-08-29

Trachoma was suspected to be endemic in parts of the Democratic Republic of the Congo (DRC). We aimed to estimate prevalences of trachomatous inflammation-follicular (TF), trichiasis, and water and sanitation (WASH) indicators in suspected-endemic Health Zones. A population-based prevalence survey was undertaken in each of 46 Health Zones across nine provinces of DRC, using Global Trachoma Mapping Project methods. A two-stage cluster random sampling design was used in each Health Zone, whereby 25 villages (clusters) and 30 households per cluster were sampled. Consenting eligible participants (children aged 1-9 years and adults aged ≥15 years) were examined for trachoma by GTMP-certified graders; households were assessed for access to WASH. A total of 32,758 households were surveyed, and 141,853 participants (98.2% of those enumerated) were examined for trachoma. Health Zone-level TF prevalence in 1-9-year-olds ranged from 1.9-41.6%. Among people aged ≥15 years, trichiasis prevalences ranged from 0.02-5.1% (95% CI 3.3-6.8). TF prevalence in 1-9-year-olds was ≥5% in 30 Health Zones, while trichiasis prevalence was ≥0.2% in 37 Health Zones. Trachoma is a public health problem in 39 of 46 Health Zones surveyed. To meet elimination targets, 37 Health Zones require expanded trichiasis surgery services while 30 health zones require antibiotics, facial cleanliness and environmental improvement interventions. Survey data suggest that trachoma is widespread: further surveys are warranted.

Pediatric Acute Severe Neurologic Illness and Injury in an Urban and a Rural Hospital in the Democratic Republic of the Congo.

PubMed

Tshimangani, Taty; Pongo, Jean; Bodi Mabiala, Joseph; Yotebieng, Marcel; O'Brien, Nicole F

2018-05-01

Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions. Two hundred and seventy-two children had clinical findings consistent with central nervous system infection but lacked complete diagnostic evaluation for definitive classification. Another 151 children were confirmed to have cerebral malaria ( N = 109, 23% of admissions), bacterial meningitis ( N = 38, 8% of admissions), tuberculous meningitis ( N = 3, 0.6% of admissions), or herpes encephalitis ( N = 1, 0.21% of admissions). Febrile convulsions, traumatic brain injury, and epilepsy contributed less significantly to overall hospital prevalence of ANI (3.19/1,000, 1.37/1,000, and 1.06/1,000, respectively). Overall mortality for the cohort was 21% (97/471). Neurologic sequelae were seen in another 31% of participants, with only 45% completing the study with a normal neurologic examination. This type of data is imperative to help plan effective strategies for illness and injury prevention and control, and to allow optimal use of limited resources in terms of provision of acute care and rehabilitation for these children.

Yellow fever risk assessment in the Central African Republic.

PubMed

Staples, J Erin; Diallo, Mawlouth; Janusz, Kristen B; Manengu, Casimir; Lewis, Rosamund F; Perea, William; Yactayo, Sergio; Sall, Amadou A

2014-10-01

Starting in 2008, the Central African Republic (CAR) experienced an unprecedented number of reported yellow fever (YF) cases. A risk assessment of YF virus (YFV) activity was conducted to estimate potential disease risk and vaccine needs. A multistage cluster sampling design was used to sample humans, non-human primates, and mosquitoes in distinct ecologic zones. Humans and non-human primates were tested for YFV-specific antibodies; mosquitoes were tested for YFV RNA. Overall, 13.3% (125/938) of humans were found to have naturally-acquired YFV antibodies. Antibody levels were higher in zones in the southern and south central regions of CAR. All sampled non-human primates (n=56) were known YFV reservoirs; one tested positive for YFV antibodies. Several known YF vectors were identified including Aedes africanus, Ae. aegypti, Ae. luteocephalus, and Ae. simpsoni. Several more urban locations were found to have elevated Breateau and Container indices for Ae. aegypti. A country-wide assessment of YF risk found YFV to be endemic in CAR. The potential for future YF cases and outbreaks, however, varied by ecologic zone. Improved vaccination coverage through mass campaign and childhood immunization was recommended to mitigate the YF risk. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Food Security Monitoring via Mobile Data Collection and Remote Sensing: Results from the Central African Republic

PubMed Central

Enenkel, Markus; See, Linda; Karner, Mathias; Álvarez, Mònica; Rogenhofer, Edith; Baraldès-Vallverdú, Carme; Lanusse, Candela; Salse, Núria

2015-01-01

The Central African Republic is one of the world’s most vulnerable countries, suffering from chronic poverty, violent conflicts and weak disaster resilience. In collaboration with Doctors without Borders/Médecins Sans Frontières (MSF), this study presents a novel approach to collect information about socio-economic vulnerabilities related to malnutrition, access to resources and coping capacities. The first technical test was carried out in the North of the country (sub-prefecture Kabo) in May 2015. All activities were aimed at the investigation of technical feasibility, not at operational data collection, which requires a random sampling strategy. At the core of the study is an open-source Android application named SATIDA COLLECT that facilitates rapid and simple data collection. All assessments were carried out by local MSF staff after they had been trained for one day. Once a mobile network is available, all assessments can easily be uploaded to a database for further processing and trend analysis via MSF in-house software. On one hand, regularly updated food security assessments can complement traditional large-scale surveys, whose completion can take up to eight months. Ideally, this leads to a gain in time for disaster logistics. On the other hand, recording the location of every assessment via the smart phones’ GPS receiver helps to analyze and display the coupling between drought risk and impacts over many years. Although the current situation in the Central African Republic is mostly related to violent conflict it is necessary to consider information about drought risk, because climatic shocks can further disrupt the already vulnerable system. SATIDA COLLECT can easily be adapted to local conditions or other applications, such as the evaluation of vaccination campaigns. Most importantly, it facilitates the standardized collection of information without pen and paper, as well as straightforward sharing of collected data with the MSF headquarters or

Food Security Monitoring via Mobile Data Collection and Remote Sensing: Results from the Central African Republic.

PubMed

Enenkel, Markus; See, Linda; Karner, Mathias; Álvarez, Mònica; Rogenhofer, Edith; Baraldès-Vallverdú, Carme; Lanusse, Candela; Salse, Núria

2015-01-01

The Central African Republic is one of the world's most vulnerable countries, suffering from chronic poverty, violent conflicts and weak disaster resilience. In collaboration with Doctors without Borders/Médecins Sans Frontières (MSF), this study presents a novel approach to collect information about socio-economic vulnerabilities related to malnutrition, access to resources and coping capacities. The first technical test was carried out in the North of the country (sub-prefecture Kabo) in May 2015. All activities were aimed at the investigation of technical feasibility, not at operational data collection, which requires a random sampling strategy. At the core of the study is an open-source Android application named SATIDA COLLECT that facilitates rapid and simple data collection. All assessments were carried out by local MSF staff after they had been trained for one day. Once a mobile network is available, all assessments can easily be uploaded to a database for further processing and trend analysis via MSF in-house software. On one hand, regularly updated food security assessments can complement traditional large-scale surveys, whose completion can take up to eight months. Ideally, this leads to a gain in time for disaster logistics. On the other hand, recording the location of every assessment via the smart phones' GPS receiver helps to analyze and display the coupling between drought risk and impacts over many years. Although the current situation in the Central African Republic is mostly related to violent conflict it is necessary to consider information about drought risk, because climatic shocks can further disrupt the already vulnerable system. SATIDA COLLECT can easily be adapted to local conditions or other applications, such as the evaluation of vaccination campaigns. Most importantly, it facilitates the standardized collection of information without pen and paper, as well as straightforward sharing of collected data with the MSF headquarters or other

Crimean-Congo Hemorrhagic Fever Virus in Pakistan.

PubMed

Ijaz, Muhammad; Rahim, Afaq; Ali, Iftikhar

2017-01-01

The Crimean-Congo hemorrhagic fever is a zoonotic disease transmitted by ticks and is characterized by fever and bleeding. It was seen for the first time in the south of present day Ukraine and thus named, Crimean fever. 1 In 1956, the virus was isolated in a patient with similar symptoms residing in Congo, Kenya and the virus was named Congo virus. The viruses causing these two diseases were the same and hence was termed Crimean-Congo hemorrhagic fever virus (CCHFV). Humans are the only known host that develops disease. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

First Detection of an Enterovirus C99 in a Captive Chimpanzee with Acute Flaccid Paralysis, from the Tchimpounga Chimpanzee Rehabilitation Center, Republic of Congo.

PubMed

Mombo, Illich Manfred; Berthet, Nicolas; Lukashev, Alexander N; Bleicker, Tobias; Brünink, Sebastian; Léger, Lucas; Atencia, Rebeca; Cox, Debby; Bouchier, Christiane; Durand, Patrick; Arnathau, Céline; Brazier, Lionel; Fair, Joseph N; Schneider, Bradley S; Drexler, Jan Felix; Prugnolle, Franck; Drosten, Christian; Renaud, François; Leroy, Eric M; Rougeron, Virginie

2015-01-01

Enteroviruses, members of the Picornaviridae family, are ubiquitous viruses responsible for mild to severe infections in human populations around the world. In 2010 Pointe-Noire, Republic of Congo recorded an outbreak of acute flaccid paralysis (AFP) in the humans, caused by wild poliovirus type 1 (WPV1). One month later, in the Tchimpounga sanctuary near Pointe-Noire, a chimpanzee developed signs similar to AFP, with paralysis of the lower limbs. In the present work, we sought to identify the pathogen, including viral and bacterial agents, responsible for this illness. In order to identify the causative agent, we evaluated a fecal specimen by PCR and sequencing. A Human enterovirus C, specifically of the EV-C99 type was potentially responsible for the illness in this chimpanzee. To rule out other possible causative agents, we also investigated the bacteriome and the virome using next generation sequencing. The majority of bacterial reads obtained belonged to commensal bacteria (95%), and the mammalian virus reads matched mainly with viruses of the Picornaviridae family (99%), in which enteroviruses were the most abundant (99.6%). This study thus reports the first identification of a chimpanzee presenting AFP most likely caused by an enterovirus and demonstrates once again the cross-species transmission of a human pathogen to an ape.

Understanding the Cultural Meaning of Selected African Ndop Statues: The Use of Art History Constructivist Inquiry Methods.

ERIC Educational Resources Information Center

Chanda, Jacqueline; Basinger, Ashlee M.

2000-01-01

Describes a case study in which third-grade children (n=19) examined a series of images of Ndop statues and visual information from the Kuba people of the Democratic Republic of the Congo using art history constructivist inquiry methods. Presents the results in detail. Includes references. (CMK)

High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo

PubMed Central

Tepage, Floribert; Ensoy-Musoro, Chellafe; Mandro, Michel; Bonareri Osoro, Caroline; Suykerbuyk, Patrick; Kashama, Jean Marie; Komba, Michel; Tagoto, Alliance; Falay, Dadi; Begon, Michael

2017-01-01

Background An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. The objective of this study was to determine the prevalence of epilepsy in onchocerciasis endemic areas in the Democratic Republic of the Congo (DRC) and investigate whether a higher annual intake of Ivermectin was associated with a lower prevalence of epilepsy. Methodology/Principle findings Between July 2014 and February 2016, house-to-house epilepsy prevalence surveys were carried out in areas with a high level of onchocerciasis endemicity: 3 localities in the Bas-Uele, 24 in the Tshopo and 21 in the Ituri province. Ivermectin uptake was recorded for every household member. This database allowed a matched case-control pair subset to be created that enabled putative risk factors for epilepsy to be tested using univariate logistic regression models. Risk factors relating to onchocerciasis were tested using a multivariate random effects model. To identify presence of clusters of epilepsy cases, the Kulldorff's scan statistic was used. Of 12, 408 people examined in the different health areas 407 (3.3%) were found to have a history of epilepsy. A high prevalence of epilepsy was observed in health areas in the 3 provinces: 6.8–8.5% in Bas-Uele, 0.8–7.4% in Tshopo and 3.6–6.2% in Ituri. Median age of epilepsy onset was 9 years, and the modal age 12 years. The case control analysis demonstrated that before the appearance of epilepsy, compared to the same life period in controls, persons with epilepsy were around two times less likely (OR: 0.52; 95%CI: (0.28, 0.98)) to have taken Ivermectin than controls. After the appearance of epilepsy, there was no difference of Ivermectin intake between cases and controls. Only in Ituri, a significant cluster (p-value = 0.0001) was identified located around the Draju sample site area. Conclusions The prevalence of epilepsy in health areas in onchocerciasis endemic regions in the DRC was 2–10 times higher than in non

Genotypes of Rubella Virus and the Epidemiology of Rubella Infections in the Democratic Republic of the Congo, 2004–2013

PubMed Central

Pukuta, Elizabeth; Waku-Kouomou, Diane; Abernathy, Emily; Illunga, Benoit Kebela; Obama, Ricardo; Mondonge, Vital; Dahl, Benjamin A.; Maresha, Balcha G.; Icenogle, Joseph; Muyembe, Jean-Jacques

2017-01-01

Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of rubella virus circulating in the DRC. These data contribute to a better understanding of rubella burden and the dynamics of rubella virus circulation in Africa. Efforts to establish rubella surveillance in the DRC are needed to support rubella elimination in Africa. PMID:27479298

Post-partum depression in Kinshasa, Democratic Republic of Congo: validation of a concept using a mixed-methods cross-cultural approach.

PubMed

Bass, Judith K; Ryder, Robert W; Lammers, Marie-Christine; Mukaba, Thibaut N; Bolton, Paul A

2008-12-01

To determine if a post-partum depression syndrome exists among mothers in Kinshasa, Democratic Republic of Congo, by adapting and validating standard screening instruments. Using qualitative interviewing techniques, we interviewed a convenience sample of 80 women living in a large peri-urban community to better understand local conceptions of mental illness. We used this information to adapt two standard depression screeners, the Edinburgh Post-partum Depression Scale and the Hopkins Symptom Checklist. In a subsequent quantitative study, we identified another 133 women with and without the local depression syndrome and used this information to validate the adapted screening instruments. Based on the qualitative data, we found a local syndrome that closely approximates the Western model of major depressive disorder. The women we interviewed, representative of the local populace, considered this an important syndrome among new mothers because it negatively affects women and their young children. Women (n = 41) identified as suffering from this syndrome had statistically significantly higher depression severity scores on both adapted screeners than women identified as not having this syndrome (n = 20; P < 0.0001). When it is unclear or unknown if Western models of psychopathology are appropriate for use in the local context, these models must be validated to ensure cross-cultural applicability. Using a mixed-methods approach we found a local syndrome similar to depression and validated instruments to screen for this disorder. As the importance of compromised mental health in developing world populations becomes recognized, the methods described in this report will be useful more widely.

Relationship between Distinct African Cholera Epidemics Revealed via MLVA Haplotyping of 337 Vibrio cholerae Isolates.

PubMed

Moore, Sandra; Miwanda, Berthe; Sadji, Adodo Yao; Thefenne, Hélène; Jeddi, Fakhri; Rebaudet, Stanislas; de Boeck, Hilde; Bidjada, Bawimodom; Depina, Jean-Jacques; Bompangue, Didier; Abedi, Aaron Aruna; Koivogui, Lamine; Keita, Sakoba; Garnotel, Eric; Plisnier, Pierre-Denis; Ruimy, Raymond; Thomson, Nicholas; Muyembe, Jean-Jacques; Piarroux, Renaud

2015-01-01

Since cholera appeared in Africa during the 1970s, cases have been reported on the continent every year. In Sub-Saharan Africa, cholera outbreaks primarily cluster at certain hotspots including the African Great Lakes Region and West Africa. In this study, we applied MLVA (Multi-Locus Variable Number Tandem Repeat Analysis) typing of 337 Vibrio cholerae isolates from recent cholera epidemics in the Democratic Republic of the Congo (DRC), Zambia, Guinea and Togo. We aimed to assess the relationship between outbreaks. Applying this method, we identified 89 unique MLVA haplotypes across our isolate collection. MLVA typing revealed the short-term divergence and microevolution of these Vibrio cholerae populations to provide insight into the dynamics of cholera outbreaks in each country. Our analyses also revealed strong geographical clustering. Isolates from the African Great Lakes Region (DRC and Zambia) formed a closely related group, while West African isolates (Togo and Guinea) constituted a separate cluster. At a country-level scale our analyses revealed several distinct MLVA groups, most notably DRC 2011/2012, DRC 2009, Zambia 2012 and Guinea 2012. We also found that certain MLVA types collected in the DRC persisted in the country for several years, occasionally giving rise to expansive epidemics. Finally, we found that the six environmental isolates in our panel were unrelated to the epidemic isolates. To effectively combat the disease, it is critical to understand the mechanisms of cholera emergence and diffusion in a region-specific manner. Overall, these findings demonstrate the relationship between distinct epidemics in West Africa and the African Great Lakes Region. This study also highlights the importance of monitoring and analyzing Vibrio cholerae isolates.

Presence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in waste waters, Kinshasa, the Democratic Republic of the Congo.

PubMed

De Boeck, H; Lunguya, O; Muyembe, J-J; Glupczynski, Y; Jacobs, J

2012-11-01

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a major public health concern. We previously demonstrated the presence of ESBL-producing Enterobacteriaceae in sachet-packaged water bags sold in Kinshasa, the Democratic Republic of the Congo. In complement to the previous study, we aimed to assess the presence of ESBL-producing Enterobacteriaceae in waste waters in Kinshasa.Enterobacteriaceae isolates recovered from environmental water samples were screened and phenotypically confirmed as ESBL-producers by disk diffusion according to Clinical and Laboratory Standards Institute (CLSI) guidelines (CLSI M100-S21). Final identification to the species level and further antimicrobial susceptibility testing were carried out with MicroScan® NBC42 panels and the identification of bla (ESBL) coding genes was performed by a commercial multiplex ligation polymerase chain reaction (PCR) microarray (Check-Points CT 101, Wageningen, the Netherlands). Overall, 194 non-duplicate Enterobacteriaceae were recovered from several sewer and river sites in nine out of 24 municipalities of Kinshasa. Fourteen isolates (7.4 %) were confirmed as ESBL-producers, the main species being Enterobacter cloacae (46.6 %) and Klebsiella pneumoniae (40.0 %). Associated resistance to both aminoglycoside and fluoroquinolone antibiotics was observed in ten isolates; the remaining isolates showed co-resistance to either fluoroquinolone (n = 3) or to aminoglycoside (n = 1) alone. All but one isolate carried bla (CTX-M) genes belonging to the CTX-M-1 group. ESBL-producing Enterobacteriaceae are increasingly being reported from various sources in the community. The present results suggest that ESBL-producing Enterobacteriaceae are widespread in the environment in the community of Kinshasa. Cities in Central Africa should be added to the map of potentially ESBL-contaminated environments and highlight the need to reinforce safe water supply and public sanitation.

Highly targeted cholera vaccination campaigns in urban setting are feasible: The experience in Kalemie, Democratic Republic of Congo

PubMed Central

Massing, Louis Albert; Aboubakar, Soumah; Page, Anne-Laure; Cohuet, Sandra; Ngandwe, Adalbert; Mukomena Sompwe, Eric; Ramazani, Romain; Allheimen, Marcela; Levaillant, Philippe; Lechevalier, Pauline; Kashimi, Marie; de la Motte, Axelle; Calmejane, Arielle; Bouhenia, Malika; Dabire, Ernest; Bompangue, Didier; Kebela, Benoit; Porten, Klaudia

2018-01-01

Introduction Oral cholera vaccines are primarily recommended by the World Health Organization for cholera control in endemic countries. However, the number of cholera vaccines currently produced is very limited and examples of OCV use in endemic countries, and especially in urban settings, are scarce. A vaccination campaign was organized by Médecins Sans Frontières and the Ministry of Health in a highly endemic area in the Democratic Republic of Congo. This study aims to describe the vaccine coverage achieved with this highly targeted vaccination campaign and the acceptability among the vaccinated communities. Methods and findings We performed a cross-sectional survey using random spatial sampling. The study population included individuals one year old and above, eligible for vaccination, and residing in the areas targeted for vaccination in the city of Kalemie. Data sources were household interviews with verification by vaccination card. In total 2,488 people were included in the survey. Overall, 81.9% (95%CI: 77.9–85.3) of the target population received at least one dose of vaccine. The vaccine coverage with two doses was 67.2% (95%CI: 61.9–72.0) among the target population. The vaccine coverage was higher during the first round (74.0, 95%CI: 69.3–78.3) than during the second round of vaccination (69.1%, 95%CI: 63.9–74.0). Vaccination coverage was lower in male adults. The main reason for non-vaccination was to be absent during the campaign. No severe adverse events were notified during the interviews. Conclusions Cholera vaccination campaigns using highly targeted strategies are feasible in urban settings. High vaccination coverage can be obtained using door to door vaccination. However, alternative strategies should be considered to reach non-vaccinated populations like male adults and also in order to improve the efficiency of the interventions. PMID:29734337

Factors associated with behavioral problems and cognitive impairment in children with epilepsy of Kinshasa, Democratic Republic of the Congo.

PubMed

Matonda-Ma-Nzuzi, Thierry; Mampunza Ma Miezi, Samuel; Mpembi, Magloire Nkosi; Mvumbi, Diane Muanza; Aloni, Michel Ntentani; Malendakana, Fanny; Mpaka Mbeya, Davin; Lelo, Gilbert Mananga; Charlier-Mikolajczak, Dominique

2018-01-01

Behavioral problems and cognitive impairment are common in children with epilepsy (CWE). In sub-Saharan Africa, little is known about these comorbidities particularly their relationships with socioeconomic features. The goal of this study was to identify clinical and socioeconomic factors associated with behavioral problems and cognitive impairment in CWE of Kinshasa (Democratic Republic of the Congo). This cross-sectional hospital-based study had included 104 CWE aged 6 to 17years. Behavioral problems were assessed by the child behavior checklist. The Wechsler nonverbal scale of ability was used to assess cognitive impairment. At least one behavioral problem was found in 34.6% of CWE. Internalized problems were increasing with father's age (p=0.034). Externalized problems were increasing with the decreased of mother's age (p=0.009) and with a previous antiepileptic treatment (p=0.032). Total behavioral problems were increasing with a previous antiepileptic treatment (p=0.029). Cognitive impairment was present in 73.3% of CWE. It was more common in boys (p=0.013), and it was increasing with a low household daily expenses (p=0.034), with a previous antiepileptic treatment (p=0.041), with an early onset of epileptic seizures (p=0.042), and with a high frequency of epileptic seizures (p=0.011). Behavioral problems and cognitive impairment are common in CWE. Multivariate analysis has shown that behavioral problems were associated with socioeconomic features only. Contrariwise, cognitive impairment was associated with both socioeconomic factors and clinical features. There is a need of more studies to improve knowledge of these comorbidities in the sub-Saharan Africa context. Copyright © 2017 Elsevier Inc. All rights reserved.

Genotypes of rubella virus and the epidemiology of rubella infections in the Democratic Republic of the Congo, 2004-2013.

PubMed

Pukuta, Elizabeth; Waku-Kouomou, Diane; Abernathy, Emily; Illunga, Benoit Kebela; Obama, Ricardo; Mondonge, Vital; Dahl, Benjamin A; Maresha, Balcha G; Icenogle, Joseph; Muyembe, Jean-Jacques

2016-10-01

Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of rubella virus circulating in the DRC. These data contribute to a better understanding of rubella burden and the dynamics of rubella virus circulation in Africa. Efforts to establish rubella surveillance in the DRC are needed to support rubella elimination in Africa. J. Med. Virol. 88:1677-1684, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Dry gas vents (“mazuku”) in Goma region (North-Kivu, Democratic Republic of Congo): Formation and risk assessment

NASA Astrophysics Data System (ADS)

Smets, Benoît; Tedesco, Dario; Kervyn, François; Kies, Antoine; Vaselli, Orlando; Yalire, Mathieu Mapendano

2010-12-01

The word " mazuku" in Swahili means "evil wind". It corresponds to lowland (depressions) where carbon dioxide is released and, being heavier than air, accumulates at high - often lethal - concentrations (10 vol.% of CO 2 in atmosphere can be considered as the deadly threshold, even for a short time exposure). Mazuku are abundant in Goma and surrounding areas and particularly in the area south of the large volcanic edifices of Nyiragongo and Nyamulagira volcanoes located in the most eastern part of DR Congo, W branch of the East African Rift System (EARS). Our extensive field surveys have indicated that mazuku are concentrated within to and around the densely populated city of Goma close to the N shores of Lake Kivu, mainly near fault or fissure networks. At a more local scale, depressions allowing CO 2-rich gas accumulation are created by lava flow superposition, lava tunnels or cavity collapses, or directly associated with open fractures. People are killed by mazuku every year. Given political and social unrest coupled with the current important demographic and urban growths around Goma, the risks associated to mazuku are increasing accordingly. Mazuku are currently the most important natural risk in terms of human loss for the area and there is an urgent need for further research, more systematic mapping and monitoring of mazuku and for appropriate risk management to be implemented. This paper summarizes the current scientific knowledge on mazuku as well as new advances and a preliminary risk assessment performed recently in the frame of the GORISK project.

Malaria burden and anti-malarial drug efficacy in Owando, northern Congo.

PubMed

Singana, Brice P; Bogreau, Hervé; Matondo, Brunelle D; Dossou-Yovo, Louis R; Casimiro, Prisca N; Mbouka, Rigobert; Ha Nguyen, Kim Yen; Pradines, Bruno; Basco, Leonardo K; Ndounga, Mathieu

2016-01-08

In the Republic of Congo, previous epidemiological studies have only been conducted in the south of the country where it is most accessible. Nationally representative data on the efficacy of new anti-malarial tools are lacking in the country. As an initial step to close the gap, clinical efficacy of two artemisinin-based combinations, artesunate-amodiaquine (ASAQ) and artemether-lumefantrine (AL), was assessed in Owando, a city in equatorial flooded forest in northern Republic of Congo. Under 12 years old febrile children attending public health facilities were screened for malaria parasites using lactate dehydrogenase (LDH)-based rapid diagnostic test (RDT) for malaria and microscopic examination of thick blood films. Patients with at least 1,000 asexual Plasmodium falciparum parasites/µl of blood were clinically examined, included after informed consent, and followed up for 28 days, according to the 2009 World Health Organization protocol. Patients were randomly assigned to co-formulated ASAQ (Coarsucam(®)) or AL (Coartem(®)) treatment groups. Plasmodium falciparum recrudescent isolates were compared to pre-treatment isolates by polymerase chain reaction (PCR) using msp1, msp2, and glurp genes to distinguish between re-infection and recrudescence. Between November 2012 and February 2013, 857 under 12 years old febrile children were screened, of whom 198 (23.1%) had positive RDT and 167 (19.5%) positive thick films. ASAQ and AL efficacies were 92.7 and 94.2% before PCR correction, respectively. After genotyping, the overall efficacy was 100% for ASAQ and 98.0% for AL. The data reported here represent partially the burden of malaria in 0-11 years old febrile children examined in public health centres of Owando city and serve as reference for further studies. Both artemisinin-based combinations were highly efficacious in patients under 12 years old with acute uncomplicated malaria. ASAQ was associated with more adverse events, which may reduce compliance in

The malaria testing and treatment market in Kinshasa, Democratic Republic of the Congo, 2013.

PubMed

Mpanya, Godéfroid; Tshefu, Antoinette; Likwela, Joris Losimba

2017-02-28

The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation's capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector. A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and private sector were screened for eligibility. Among outlets with anti-malarials or malaria rapid diagnostic tests (RDT) in stock, a full audit of all available products was conducted. Information collected included product information (e.g. active ingredients, brand name), amount reportedly distributed to patients in the past week, and retail price. In total, 3364 outlets were screened for inclusion across Kinshasa and 1118 outlets were eligible for the study. Among all screened outlets in the private sector only about one in ten (12.1%) were stocking quality-assured Artemisinin-based Combination Therapy (ACT) medicines. Among all screened public sector facilities, 24.5% had both confirmatory testing and quality-assured ACT available, and 20.2% had sulfadoxine-pyrimethamine (SP) available for intermittent preventive therapy during pregnancy (IPTp). The private sector distributed the majority of anti-malarials in Kinshasa (96.7%), typically through drug stores (89.1% of the total anti-malarial market). Non-artemisinin therapies were the most commonly distributed anti-malarial (50.1% of the total market), followed by non quality-assured ACT medicines (38.5%). The median price of an adult quality-assured ACT was $6.59, and more expensive than non quality-assured ACT ($3.71) and SP ($0.44). Confirmatory testing was largely not available in the private

Prioritizing Healthcare Delivery in a Conflict Zone Comment on "TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo".

PubMed

Wood, Robin; Richardson, Eugene T

2013-09-01

Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.

Rethinking Insurgency

DTIC Science & Technology

2007-06-01

insurgents access to money and resources out of proportion to what they would have in peacetime. As Paul Collier , one of the pioneers of this idea...competition. This, too, can work to the advantage of elites, including those in the government or security services. Collier continues: . . . various...Conflict Trends, June 2000, p. 28. 60 28. Henry Boshoff and Thierry Vircoulon, “Democratic Republic of the Congo: Update on Ituri,” African

Characterization of the Bas-Congo virus glycoprotein and its function in pseudotyped viruses.

PubMed

Steffen, Imke; Liss, Nathan M; Schneider, Bradley S; Fair, Joseph N; Chiu, Charles Y; Simmons, Graham

2013-09-01

Bas-Congo virus (BASV) is a novel rhabdovirus recently identified from a patient with acute hemorrhagic fever in the Bas-Congo province of the Democratic Republic of Congo (DRC). Here we show that the BASV glycoprotein (BASV-G) can be successfully used to pseudotype glycoprotein-deficient vesicular stomatitis virus (VSV), allowing studies of BASV-G-driven membrane fusion and viral entry into target cells without replication-competent virus. BASV-G displayed broad tissue and species tropism in vitro, and BASV-G-mediated membrane fusion was pH dependent. The conformational changes induced in BASV-G by acidification were fully reversible and did not lead to inactivation of the viral fusion protein. Our data combined with comparative sequence similarity analyses suggest that BASV-G shares structural and functional features with other rhabdovirus glycoproteins and falls into the group of class III viral fusion proteins. However, activation of BASV-G-driven fusion required a lower pH and higher temperatures than did VSV-G-mediated fusion. Moreover, in contrast to VSV-G, mature BASV-G in VSV pseudotypes consists of a mixture of high-mannose and complex glycans that enables it to bind to certain C-type lectins, thereby enhancing its attachment to target cells. Taken together, the results presented in this study will facilitate future investigations of BASV-G-mediated cell entry and its inhibition in the absence of an infectious cell culture assay for BASV and at lower biosafety levels. Moreover, serology testing based on BASV-G pseudotype neutralization can be used to uncover the prevalence and importance of BASV as a potential novel human pathogen in the DRC and throughout Central Africa.

[Use of modern contraceptive methods in the Democratic Republic of the Congo: prevalence and barriers in the health zone of Dibindi, Mbuji-Mayi].

PubMed

Ntambue, Abel Mukengeshayi; Tshiala, Rachel Ngalula; Malonga, Françoise Kaj; Ilunga, Tabitha Mpoyi; Kamonayi, Josaphat Mulumba; Kazadi, Simon Tshimankinda; Matungulu, Charles Matungu; Musau, Angel Nkola; Mulamba, Diese; Dramaix-Wilmet, Michèle; Donnen, Philippe

2017-01-01

This study aimed to determine modern contraceptive prevalence and the barriers to using modern contraceptive methods among the couples in Dibindi health zone, Mbuji-Mayi, in the Democratic Republic of the Congo. We conducted a cross-sectional descriptive study from May to June 2015. Nonpregnant married women aged 15-49 years old at the time of the investigation, living in Dibindi health zone for two years and having freely consented to participate in the study were included. Data were collected by open-ended interview of these women. Modern contraceptive prevalence was referred to women who were currently using, at the time of the investigation, modern contraceptives. The comparison between proportions was performed at the significance threshold of 5%. Bonferroni's test was used to compare, two by two, the proportions of barriers to using modern contraceptive methods. Modern contraceptive prevalence in Dibindi was 18.4% in 2015. It was low with regard to family planning services available in this health zone. Several women refused to use modern contraceptive methods despite available information because of their desire for motherhood, religious prohibition, opposition on the part of their husband and fear of side effects. Sufficient client-centered or couple-centered information and family planning information should be strengthened in order to eliminate the false beliefs and to increase the use of modern contraceptive methods.

Three new endemic Aphyosemion species (Cyprinodontiformes: Nothobranchiidae) from the Massif du Chaillu in the upper Louessé River system, Republic of the Congo.

PubMed

Zee, Jouke R van der; Walsh, Gina; Mikembi, Valdie N Boukaka; Jonker, Michiel N; Alexandre, Marco P; Sonnenberg, Rainer

2018-01-02

Three new 'Aphyosemion' species are described from the upper Louessé River in the Massif du Chaillu, Republic of the Congo, based on a combination of DNA, habitat preference, male colour pattern, and morphological data. 'Aphyosemion' cyanoflavum, new species, is a member of the 'A'. ogoense group. It differs from its congeners by a unique colour pattern and cephalic sensory system which contains a wide supra-orbital groove with large, densely pigmented anterior neuromasts and dark frontal neuromasts housed in one pit with one central anterior lobe. 'Aphyosemion' mandoroense, new species, and 'A'. cryptum, new species, are members of the 'A'. coeleste group. 'Aphyosemion' cryptum, new species, is in appearance very similar to 'A'. coeleste, but lacks the typical post opercular metallic green blotch and is generally larger in body size. Initial DNA analyses demonstrate that 'A'. cryptum, new species, is more closely related to 'A'. mandoroense, new species, than to 'A'. coeleste, despite similarity in appearance. 'Aphyosemion' cryptum, new species, and 'A'. coeleste occur syntopic in several locations in a sub-catchment of the upper Louessé system, however differ in microhabitat preference. 'Aphyosemion' mandoroense, new species, differs by male body and fin colour pattern from all species of the 'A'. coeleste group except 'A'. citrineipinnis. From the latter, it can be distinguished by the absence of red pigmentation and a dark grey to black margin in the unpaired fins.

Hydrological trends in Congo basin (Central Africa)

NASA Astrophysics Data System (ADS)

Laraque, A.

2015-12-01

The last studies concerning some main Congo basin rivers allowed to subdivide their multi-annual flows into several homogeneous phases. As in West Africa, 1970 was the year of the major hydroclimatic event announcing a weaker flowing period. In the absence of long, reliable and available flow series in the whole Congo basin of 3,8 106km2 area, the present study concerns only the Congo River at Brazzaville/Kinshasa and two of the main tributaries of its right bank, Ubangui at Bangui and Sangha at Ouesso, with hydrologic data available from the first half of the 20th century. For Congo River, in comparison with its secular average, after an excess flow noted during the sixties, a significant drop of 10% occurs in the eighties. However, a return to normal conditions is recorded from 1995. For Ubangui and Sangha, the flows remain weaker since 1970. Within the bi-modal hydrological regimes of Sangha and Congo river, because they are equatorial, we also observe since many years a small decline of the secondary flood of april-june. This phenomenon was emphasized especially these last years and is founded in others rivers of Central Africa, where it reflects the variations of de rainfall patterns and the surfaces features. For the Congo basin, the situation is worrying because that affects the inland waterway transport. Moreover that wakes also the project of junction by a canal of the Congo and Chari basins for fighting against the hydrological decline of Lake Chad.

Relative Abundance and Diversity of Bacterial Methanotrophs at the Oxic–Anoxic Interface of the Congo Deep-Sea Fan

PubMed Central

Bessette, Sandrine; Moalic, Yann; Gautey, Sébastien; Lesongeur, Françoise; Godfroy, Anne; Toffin, Laurent

2017-01-01

Sitting at ∼5,000 m water depth on the Congo-Angola margin and ∼760 km offshore of the West African coast, the recent lobe complex of the Congo deep-sea fan receives large amounts of fluvial sediments (3–5% organic carbon). This organic-rich sedimentation area harbors habitats with chemosynthetic communities similar to those of cold seeps. In this study, we investigated relative abundance, diversity and distribution of aerobic methane-oxidizing bacteria (MOB) communities at the oxic–anoxic interface of sedimentary habitats by using fluorescence in situ hybridization and comparative sequence analysis of particulate mono-oxygenase (pmoA) genes. Our findings revealed that sedimentary habitats of the recent lobe complex hosted type I and type II MOB cells and comparisons of pmoA community compositions showed variations among the different organic-rich habitats. Furthermore, the pmoA lineages were taxonomically more diverse compared to methane seep environments and were related to those found at cold seeps. Surprisingly, MOB phylogenetic lineages typical of terrestrial environments were observed at such water depth. In contrast, MOB cells or pmoA sequences were not detected at the previous lobe complex that is disconnected from the Congo River inputs. PMID:28487684

Relative Abundance and Diversity of Bacterial Methanotrophs at the Oxic-Anoxic Interface of the Congo Deep-Sea Fan.

PubMed

Bessette, Sandrine; Moalic, Yann; Gautey, Sébastien; Lesongeur, Françoise; Godfroy, Anne; Toffin, Laurent

2017-01-01

Sitting at ∼5,000 m water depth on the Congo-Angola margin and ∼760 km offshore of the West African coast, the recent lobe complex of the Congo deep-sea fan receives large amounts of fluvial sediments (3-5% organic carbon). This organic-rich sedimentation area harbors habitats with chemosynthetic communities similar to those of cold seeps. In this study, we investigated relative abundance, diversity and distribution of aerobic methane-oxidizing bacteria (MOB) communities at the oxic-anoxic interface of sedimentary habitats by using fluorescence in situ hybridization and comparative sequence analysis of particulate mono-oxygenase ( pmoA ) genes. Our findings revealed that sedimentary habitats of the recent lobe complex hosted type I and type II MOB cells and comparisons of pmoA community compositions showed variations among the different organic-rich habitats. Furthermore, the pmoA lineages were taxonomically more diverse compared to methane seep environments and were related to those found at cold seeps. Surprisingly, MOB phylogenetic lineages typical of terrestrial environments were observed at such water depth. In contrast, MOB cells or pmoA sequences were not detected at the previous lobe complex that is disconnected from the Congo River inputs.

Effect of 3 years of biannual mass drug administration with albendazole on lymphatic filariasis and soil-transmitted helminth infections: a community-based study in Republic of the Congo.

PubMed

Pion, Sébastien D S; Chesnais, Cédric B; Weil, Gary J; Fischer, Peter U; Missamou, François; Boussinesq, Michel

2017-07-01

The standard treatment strategy of mass drug administration with ivermectin plus albendazole for lymphatic filariasis cannot be applied in central Africa, because of the risk of serious adverse events in people with high Loa loa microfilaraemia. Thus, alternative strategies are needed. We investigated one such alternative strategy for mass drug administration for elimination of lymphatic filariasis and soil-transmitted helminth infections in Republic of the Congo. In 2012, we started a 3 year community trial of biannual mass administration of albendazole in a village in Republic of the Congo. All volunteering inhabitants aged 2 years or older were offered albendazole (400 mg) every 6 months. Infection with Wuchereria bancrofti was diagnosed with a rapid card immunochromatographic test for antigenaemia. People with antigenaemia were tested for microfilaraemia by night blood smears. Individuals were also tested for soil-transmitted helminth infections (ie, hookworm, Ascaris lumbricoides, Trichuris trichiura) with the Kato-Katz method. Assessment surveys were done at 12, 24, and 36 months. The main outcome measure was change in infection rates from baseline to year 3. Therapeutic coverage was more than 80% in all six rounds of mass administration of albendazole. Between 2012 and 2015, W bancrofti antigenaemia and microfilaraemia rates in the community fell significantly, from 17·3% (95% CI 14·7-20·0) to 4·7% (3·3-6·6; p<0·0001) and from 5·3% (3·9-7·1) to 0·3% (0·1-1·2; p<0·0001), respectively. The geometric mean microfilaria count in microfilaraemic people fell from 199·4 (120·4-330·5) per mL in 2012 to 39·1 (95% CIs not computed) per mL in 2015 (p=0·0095). Hookworm infection was undetectable after 1 year. Between 2012 and 2015, the number of A lumbricoides eggs expelled per g of faeces fell from 9844·6 (8209·0-11 480·0) to 724·4 (340·7-1114·2; p<0·0001), and of T trichiura eggs from 1107·4 (878·5-1336·3) to 366·0 (255·7-476·2; p<0�

31 CFR 547.201 - Prohibited transactions involving blocked property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... THE CONGO SANCTIONS REGULATIONS Prohibitions § 547.201 Prohibited transactions involving blocked... the Democratic Republic of the Congo that impedes the disarmament, repatriation, or resettlement of... children in armed conflict in the Democratic Republic of the Congo in violation of applicable international...

31 CFR 547.201 - Prohibited transactions involving blocked property.

Code of Federal Regulations, 2014 CFR

2014-07-01

... THE CONGO SANCTIONS REGULATIONS Prohibitions § 547.201 Prohibited transactions involving blocked... the Democratic Republic of the Congo that impedes the disarmament, repatriation, or resettlement of... children in armed conflict in the Democratic Republic of the Congo in violation of applicable international...

31 CFR 547.201 - Prohibited transactions involving blocked property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... THE CONGO SANCTIONS REGULATIONS Prohibitions § 547.201 Prohibited transactions involving blocked... the Democratic Republic of the Congo that impedes the disarmament, repatriation, or resettlement of... children in armed conflict in the Democratic Republic of the Congo in violation of applicable international...

31 CFR 547.201 - Prohibited transactions involving blocked property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... THE CONGO SANCTIONS REGULATIONS Prohibitions § 547.201 Prohibited transactions involving blocked... the Democratic Republic of the Congo that impedes the disarmament, repatriation, or resettlement of... children in armed conflict in the Democratic Republic of the Congo in violation of applicable international...

31 CFR 547.201 - Prohibited transactions involving blocked property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... THE CONGO SANCTIONS REGULATIONS Prohibitions § 547.201 Prohibited transactions involving blocked... the Democratic Republic of the Congo that impedes the disarmament, repatriation, or resettlement of... children in armed conflict in the Democratic Republic of the Congo in violation of applicable international...

Mitochondrial, Y-chromosomal and autosomal variation in Mbenzele Pygmies from the Central African Republic.

PubMed

Anagnostou, Paolo; Coia, Valentina; Spedini, Gabriella; Destro-Bisol, Giovanni

2010-06-01

In this paper, we carry out a combined analysis of autosomal (ten microsatellites and an Alu insertion), mitochondrial (HVR-1 sequence, 360 nucleotides) and Y-chromosomal (seven microsatellites) variation in the Mbenzele Pygmies from the Central African Republic. This study focuses on two important questions concerning the admixture and origin of African Pygmies. Ethnographic observations suggest a sex-biased gene flow between the Bantus and Pygmies, an issue which could be clarified through genetic analyses may shed light. A study of intrapopulational variation of mtDNA and Y-chromosome produces results in accordance with the hypothesized matrimonial behaviour. In fact, while shared mitochondrial haplotypes belonging to the L1c5 (or L1c1a1 clade) sub-haplogroup provides evidence of a Pygmy-to-Bantu female biased gene flow, a male biased gene flow from Bantu to Pygmies is supported by the distribution of the Y-chromosomes bearing M2 mutation. The second part of our study regards the question of the genetic relationships between Western and Eastern Pygmies. Our results favour the pre-Bantu hypothesis which suggests that the two Pygmy groups separated in ancient times (at least 18,000 years ago), whereas they do not support the recent divergence and differential admixture hypothesis which posits their separation as a consequence of the Bantu expansion (2,000-3,000 years ago).

[The distribution of the tsetse fly (Diptera: Glossinidae) in the humid savanna zone (Central African Republic). Evaluation of prospective entomological techniques].

PubMed

Blanc, F; Gouteux, J P; Cuisance, D; Pounekrozou, E; N'Dokoué, F; Le Gall, F

1991-06-01

Two trapping methods were compared during a survey of the distribution of tsetse flies in the Mbororo cattle breeding area of the Central African Republic: (a) several traps dispersed throughout the riverine forest galleries and remaining only one day at each site: (b) one sentinel trap placed at the cattle drinking point and remaining for several days. The latter method was more reliable and is therefore recommended. The concentration of tsetse flies at the drinking points was negligible during the rainy season.

Roadless Wilderness Area Determines Forest Elephant Movements in the Congo Basin

PubMed Central

Blake, Stephen; Deem, Sharon L.; Strindberg, Samantha; Maisels, Fiona; Momont, Ludovic; Isia, Inogwabini-Bila; Douglas-Hamilton, Iain; Karesh, William B.; Kock, Michael D.

2008-01-01

A dramatic expansion of road building is underway in the Congo Basin fuelled by private enterprise, international aid, and government aspirations. Among the great wilderness areas on earth, the Congo Basin is outstanding for its high biodiversity, particularly mobile megafauna including forest elephants (Loxodonta africana cyclotis). The abundance of many mammal species in the Basin increases with distance from roads due to hunting pressure, but the impacts of road proliferation on the movements of individuals are unknown. We investigated the ranging behaviour of forest elephants in relation to roads and roadless wilderness by fitting GPS telemetry collars onto a sample of 28 forest elephants living in six priority conservation areas. We show that the size of roadless wilderness is a strong determinant of home range size in this species. Though our study sites included the largest wilderness areas in central African forests, none of 4 home range metrics we calculated, including core area, tended toward an asymptote with increasing wilderness size, suggesting that uninhibited ranging in forest elephants no longer exists. Furthermore we show that roads outside protected areas which are not protected from hunting are a formidable barrier to movement while roads inside protected areas are not. Only 1 elephant from our sample crossed an unprotected road. During crossings her mean speed increased 14-fold compared to normal movements. Forest elephants are increasingly confined and constrained by roads across the Congo Basin which is reducing effective habitat availability and isolating populations, significantly threatening long term conservation efforts. If the current road development trajectory continues, forest wildernesses and the forest elephants they contain will collapse. PMID:18958284

The misuse of Cyproheptadine: a non-communicable disease risk behaviour in Kinshasa population, Democratic Republic of Congo.

PubMed

Lulebo, Aimée M; Bavuidibo, Carine D; Mafuta, Eric M; Ndelo, Josaphat D; Mputu, Lievin's Corneille M; Kabundji, Dalton M; Mutombo, Paulin B

2016-02-09

Obesity is one of the main risk factors of non-communicable diseases (NCDs) worldwide, especially in sub-Saharan Africa. The use of Cyproheptadine increases body weight and the risk of becoming obese. The aim of this study is to determine the prevalence of Cyproheptadine misuse in the Kinshasa population and to describe its characteristics. A cross-sectional study was conducted in two town sectors of Kinshasa, Democratic Republic of Congo (DRC), over a 4 month period (May 2011 to August 2011). Data from 499 participants, aged between 13 and 55 years were collected and analyzed. Mean and standard deviation were used for quantitative variables and frequency and percentage for categorical variables. In order to determine the relationship between socio-demographic status and Cyproheptadine use the Chi-square test was conducted. Student's t-test was used to compare means age of Cyproheptadine users and non-users. Logistic regression was used to determine predictors of Cyproheptadine use. A p-value of <0.05 was considered statistically significant. Overall, 499 participants were enrolled (352 females, 147 males, mean age ± standard deviation 24.9 ± 9.7 years) in the study. The majority of the study participants (72.9 %) had used Cyproheptadine as an appetite stimulant. Females were 11 times more likely to use Cryproheptadine (OR = 11.9; 95 % CI: 7.1-20.1) than males. People aged between 36 and 55 were three times less likely to use Cryproheptadine (OR = 0.3; 95 % CI: 0.2-0.8) compared to teenagers. More than half of the participants (69.0 %) declared to take daily Cyproheptadine. Half of the study participants (50.0 %) used Cyproheptadine for more than a year and also declared to combine it with Dexamethasone (87.6 %). This study shows that the Kinshasa population is significantly misusing Cyproheptadine and is highly exposed to its risk, including obesity.

Assessing the cost-effectiveness of different measles vaccination strategies for children in the Democratic Republic of Congo.

PubMed

Doshi, Reena H; Eckhoff, Philip; Cheng, Alvan; Hoff, Nicole A; Mukadi, Patrick; Shidi, Calixte; Gerber, Sue; Wemakoy, Emile Okitolonda; Muyembe-Tafum, Jean-Jacques; Kominski, Gerald F; Rimoin, Anne W

2017-10-27

One of the goals of the Global Measles and Rubella Strategic Plan is the reduction in global measles mortality, with high measles vaccination coverage as one of its core components. While measles mortality has been reduced more than 79%, the disease remains a major cause of childhood vaccine preventable disease burden globally. Measles immunization requires a two-dose schedule and only countries with strong, stable immunization programs can rely on routine services to deliver the second dose. In the Democratic Republic of Congo (DRC), weak health infrastructure and lack of provision of the second dose of measles vaccine necessitates the use of supplementary immunization activities (SIAs) to administer the second dose. We modeled three vaccination strategies using an age-structured SIR (Susceptible-Infectious-Recovered) model to simulate natural measles dynamics along with the effect of immunization. We compared the cost-effectiveness of two different strategies for the second dose of Measles Containing Vaccine (MCV) to one dose of MCV through routine immunization services over a 15-year time period for a hypothetical birth cohort of 3 million children. Compared to strategy 1 (MCV1 only), strategy 2 (MCV2 by SIA) would prevent a total of 5,808,750 measles cases, 156,836 measles-related deaths and save U.S. $199 million. Compared to strategy 1, strategy 3 (MCV2 by RI) would prevent a total of 13,232,250 measles cases, 166,475 measles-related deaths and save U.S. $408 million. Vaccination recommendations should be tailored to each country, offering a framework where countries can adapt to local epidemiological and economical circumstances in the context of other health priorities. Our results reflect the synergistic effect of two doses of MCV and demonstrate that the most cost-effective approach to measles vaccination in DRC is to incorporate the second dose of MCV in the RI schedule provided that high enough coverage can be achieved. Published by Elsevier Ltd.

Linking plant functional traits and forest carbon stocks in the Congo Basin

NASA Astrophysics Data System (ADS)

Kearsley, Elizabeth; Verbeeck, Hans; Hufkens, Koen; Lewis, Simon; Huygens, Dries; Beeckman, Hans; Steppe, Kathy; Boeckx, Pascal

2013-04-01

Accurate estimates of the amount of carbon stored in tropical forests represent crucial baseline data for recent climate change mitigation policies. Such data are needed to quantify possible emissions due to deforestation and forest degradation, and to evaluate the potential of these forests to act as carbon sinks. Currently, only rough estimates of the carbon stocks for Central African tropical forests are available due to a lack of field data, and little is known about the response of these stocks to climate change. We present the first ground-based carbon stock data for the central Congo Basin in Yangambi, D. R. Congo, based on data of 20 inventory plots of 1 ha covering different forest types. We found an average aboveground carbon stock of 163 ± 19 Mg C ha-1 for intact old-growth forest, which is significantly lower than the stocks recorded in the outer regions of the Congo Basin. Commonly studied drivers for variations of carbon stocks include climatic and edaphic factors, but detailed trait-based studies are lacking. We identified a significant difference in height-diameter relations across the Congo Basin as a driver for spatial differences in carbon stocks. The study of a more detailed interaction of the environment and the available tree species pool as drivers for differences in carbon storage could have large implications. The effect of the species pool on carbon storage can be large since species differ in their ability to sequester carbon, and the collective functional characteristics of plant communities could be a major driver of carbon accumulation. The use of a trait-based approach shows high potential for identifying and quantifying carbon stocks as an ecosystem service. We test for associations between functional trait values and carbon storage across multiple regrowth and old-growth forests types in the Yangambi study area, with soil properties and climate similar for all plots. A selection of traits associated with carbon dynamics is made

Group size of a permanent large group of agile mangabeys (Cercocebus agilis) at Bai Hokou, Central African Republic.

PubMed

Devreese, Lieven; Huynen, Marie-Claude; Stevens, Jeroen M G; Todd, Angelique

2013-01-01

White-eyelid mangabeys (genus Cercocebus) live in groups of highly variable size. Because of their semi-terrestrial behaviour and preference for dense forest habitats, re-liable data on group size are scarce. During a 5-month study, we collected 17 group counts on a habituated group of agile mangabeys (C. agilis) at Bai Hokou in the Central African Republic. We found a stable group size of approximately 135 individuals. This permanent large grouping pattern is known to occur among several populations of white-eyelid mangabeys and is congruent with extreme group sizes reported in mandrills at Lopé in Gabon. Copyright © 2013 S. Karger AG, Basel.

Workplace violence towards Congolese health care workers: a survey of 436 healthcare facilities in Katanga province, Democratic Republic of Congo.

PubMed

Muzembo, Basilua Andre; Mbutshu, Lukuke Hendrick; Ngatu, Nlandu Roger; Malonga, Kaj Francoise; Eitoku, Masamitsu; Hirota, Ryoji; Suganuma, Narufumi

2015-01-01

The aim of this study was to investigate workplace violence by patients or their relatives towards health-care workers in Congolese hospitals. Through the autumn of 2012, a cross-sectional survey on workplace violence was conducted in a sample of 2,210 registered health-care workers (989 males and 1,221 females, aged 33 ± 8 years) from 436 hospitals located in the province of Katanga, Democratic Republic of the Congo. Verbal aggression, harassment and physical violence perpetrated by patients or their relatives within the previous year along with factors contributing to violence, were recorded, and the response rate was 99%. About 80.1% of the health-care workers had experienced one or more types of workplace violence. Overall, the severity of workplace violence varied from verbal aggression (57.4%) and harassment (15.2%) to physical violence (7.5%). Patients were the major perpetrators of verbal aggression and harassment, whereas patients' relatives were mainly involved in physical violence. The frequency of workplace violence was similar across hospitals. Male health-care workers were more likely to be victims of physical violence, whereas female health-care workers were the prime target for harassment. Only 34.3% of the violent episodes were reported to a supervisor. Furthermore, disrespect for medical deontology was the main cause of workplace violence perceived by 68.8% of the health-care workers. Although it has not been officially recognized, there has been workplace violence towards health-care workers perpetrated by patients or their relatives despite the fact that health-care workers have traditionally been highly respected in Congolese society. Further studies on this issue may suggest opportunities for combating violence in Congolese hospitals.

Predictors of measles vaccination coverage among children 6-59 months of age in the Democratic Republic of the Congo.

PubMed

Ashbaugh, Hayley R; Hoff, Nicole A; Doshi, Reena H; Alfonso, Vivian H; Gadoth, Adva; Mukadi, Patrick; Okitolonda-Wemakoy, Emile; Muyembe-Tamfum, Jean Jacques; Gerber, Sue K; Cherry, James D; Rimoin, Anne W

2018-01-25

Measles is a significant contributor to child mortality in the Democratic Republic of the Congo (DRC), despite routine immunization programs and supplementary immunization activities (SIA). Further, national immunization coverage levels may hide disparities among certain groups of children, making effective measles control even more challenging. This study describes measles vaccination coverage and reporting methods and identifies predictors of vaccination among children participating in the 2013-2014 DRC Demographic and Health Survey (DHS). We examined vaccination coverage of 6947 children aged 6-59 months. A multivariate logistic regression model was used to identify predictors of vaccination among children reporting vaccination via dated card in order to identify least reached children. We also assessed spatial distribution of vaccination report type by rural versus urban residence. Urban children with educated mothers were more likely to be vaccinated (OR = 4.1, 95% CI: 1.6, 10.7) versus children of mothers with no education, as were children in wealthier rural families (OR = 2.9, 95% CI: 1.9, 4.4). At the provincial level, urban areas more frequently reported vaccination via dated card than rural areas. Results indicate that, while the overall coverage level of 70% is too low, socioeconomic and geographic disparities also exist which could make some children even less likely to be vaccinated. Dated records of measles vaccination must be increased, and groups of children with the greatest need should be targeted. As access to routine vaccination services is limited in DRC, identifying and targeting under-reached children should be a strategic means of increasing country-wide effective measles control. Published by Elsevier Ltd.

High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo

PubMed Central

Le Gal, Frédéric; Ngwaka-Matsung, Nadine; Ahuka-Mundeke, Steve; Onanga, Richard; Pukuta-Simbu, Elisabeth; Gerber, Athenaïs; Abbate, Jessica L.; Mwamba, Dieudonné; Berthet, Nicolas; Leroy, Eric Maurice; Muyembe-Tamfum, Jean-Jacques

2017-01-01

ABSTRACT The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 105 IU/ml for HBV (range, 769 to 9.82 × 109 IU/ml) and 1.4 × 106 IU/ml for HDV (range, 3.1 × 102 to 2.9 × 108 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC. PMID:28202798

High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo.

PubMed

Makiala-Mandanda, Sheila; Le Gal, Frédéric; Ngwaka-Matsung, Nadine; Ahuka-Mundeke, Steve; Onanga, Richard; Bivigou-Mboumba, Berthold; Pukuta-Simbu, Elisabeth; Gerber, Athenaïs; Abbate, Jessica L; Mwamba, Dieudonné; Berthet, Nicolas; Leroy, Eric Maurice; Muyembe-Tamfum, Jean-Jacques; Becquart, Pierre

2017-05-01

The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 10 5 IU/ml for HBV (range, 769 to 9.82 × 10 9 IU/ml) and 1.4 × 10 6 IU/ml for HDV (range, 3.1 × 10 2 to 2.9 × 10 8 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC. Copyright © 2017 Makiala-Mandanda et al.

[Prevalence and factors associated with renal disease among patients with newly diagnoses of HIV in Brazzaville, Republic of Congo].

PubMed

Ekat, M H; Courpotin, C; Diafouka, M; Akolbout, M; Mahambou-Nsonde, D; Bitsindou, P R; Nzounza, P; Simon, B

2013-05-01

The aim of this study was to determine the prevalence of kidney disease in patients newly diagnosed as HIV-positive in Brazzaville and to identify the associated risk factors. Descriptive and analytical study of patients diagnosed with HIV infection at the Ambulatory Treatment Center in Brazzaville, Republic of Congo, from January 1, 2009, through December 31, 2010. Estimated glomerular filtration rate (eGFR) was assessed with the Modification of Diet in Renal Disease equation (MDRD-GFR), and kidney disease was defined by an eGFR less than 60 mL/min/1.73 m(2). We conducted a univariate and then a multivariate logistic regression analysis to determine the factors associated with kidney disease in this population. The study included 562 patients newly identified as HIV-infected, 66.13% of whom were women. Their median age was 38.84 years interquartile range (IQR): 33.18-46.23) and their median body mass index (BMI) 20.31 kg/m(2) (IQR: 17.97-22.89). Their median CD4 count was 192 cells/mm(3) (IQR: 81-350), and 70.8% were at WHO stage III/IV. Finally, the median MDRD-GFR was 95.59 (IQR: 78.76-114.92) mL/min/1.73 m(2) and 8.5% had a GFR less than 60 mL/min/1.73 m(2), that is, moderate impairment of kidney function. The only factor associated with kidney disease in the multivariate analysis was a BMI less than 18.5 kg/m(2) (adjusted odds ratio: 2.54, 95% confidence interval: 1.25-5.15, p = 0.01). The prevalence of kidney disease in patients newly diagnosed with HIV in Brazzaville is relatively high. The only factor associated with it in the multivariate analysis was a BMI less than 18.5 kg/m(2).

Malaria burden and case management in the Republic of Congo: limited use and application of rapid diagnostic tests results

PubMed Central

2013-01-01

Background There have been few investigations evaluating the burden of malaria disease at district level in the Republic of Congo since the introduction of artemisinin-based combination therapies (ACTs). The main objective of this study was to document laboratory-confirmed cases of malaria using microscopy and/or rapid diagnostic tests (RDTs) in children and pregnant women attending selected health facilities in Brazzaville and Pointe Noire, the two main cities of the country. Secondly, P. falciparum genetic diversity and multiplicity of infection during the malaria transmission season of October 2011 to February 2012 in these areas were described. Methods Three and one health facilities were selected in Brazzaville and Pointe-Noire as sentinel sites for malaria surveillance. Children under 15 years of age and pregnant women were enrolled if study criteria were met and lab technicians used RDT and/or microscopy to diagnose malaria. In order to determine the multiplicity of infection, parasite DNA was extracted from RDT cassette and msp2 P.falciparum genotyped. Results Malaria prevalence among more than 3,000 children and 700 pregnant women ranged from 8 to 29%, and 8 to 24% respectively depending on health center locality. While health workers did not optimize use of RDTs, microscopy remained a reference diagnostic tool. Quality control of malaria diagnosis at the reference laboratory showed acceptable health centre performances. P. falciparum genetic diversity determination using msp2 gene marker ranged from 9 to 20 alleles and remains stable while multiplicity of infection (mean of 1.7clone/infected individual) and parasite densities in clinical isolates were lower than previously reported. Conclusions These findings are consistent with a reduction of malaria transmission in the two areas. This study raises the issue of targeted training for health workers and sustained availability of RDTs in order to improve quality of care through optimal use of RDTs. PMID

[Socio-entomologic survey in human trypanosomiasis focus of Yamba (Peoples Republic of Congo)].

PubMed

Gouteux, J P; Malonga, J R

1985-01-01

A study carried out at villagers level in a focus infected by human trypanosomiasis (Yamba, Bouenza region, Congo, Mikengue ethnic group) revealed that modern medicin is recognized by them as the sole possibility to treat the sleeping sickness. The witch doctor, if he cannot transmit the sickness, is perfectly able to aggravate it. He is considered as the responsible for any fatal issue. Tsetse flies are charged of transmitting the sickness as well as other biting insects (black flies, ceratopogonidae). The elders give an historical role to pigs in spreading the sickness. Villagers seem very determined to assume themselves fighting against the tsetse fly by trapping, but impregnation of traps by an insecticide got some problems (technical know-how, equipment) which have been solved by a new model of trap designed by the ORSTOM Center in Brazzaville.

Lightning climatology in the Congo Basin

NASA Astrophysics Data System (ADS)

Soula, S.; Kasereka, J. Kigotsi; Georgis, J. F.; Barthe, C.

2016-09-01

The lightning climatology of the Congo Basin including several countries of Central Africa is analysed in detail for the first time. It is based on data from the World Wide Lightning Location Network (WWLLN), for the period from 2005 to 2013. A comparison of these data with Lightning Imaging Sensor (LIS) data for the same period shows the relative detection efficiency of the WWLLN (DE) in the 2500 km × 2500 km region increases from about 1.70% in the beginning of the period to 5.90% in 2013, and it is in agreement with previous results for other regions of the world. However, the increase of DE is not uniform over the whole region. The average monthly flash rate describes an annual cycle with a strong activity from October to March and a low one from June to August, associated with the ITCZ migration but not exactly symmetrical on both sides of the equator. The zonal distribution of the lightning flashes exhibits a maximum between 1°S and 2°S and about 56% of the flashes are located south of the equator in the 10°S-10°N interval. The diurnal evolution of the flash rate has a maximum between 1400 and 1700 UTC, according to the reference year. The annual flash density and number of stormy days show a sharp maximum localized in the eastern part of Democratic Republic of Congo (DRC) regardless of the reference year and the period of the year. These maxima reach 12.86 fl km- 2 and 189 days, respectively, in 2013, and correspond to a very active region located at the rear of the Virunga mountain range at altitudes that exceed 3000 m. The presence of these mountains plays a role in the thunderstorm development along the year. The estimation of this local maximum of the lightning density by taking into account the DE, leads to a value consistent with that of the global climatology by Christian et al. (2003).

Antimicrobial resistance in human and animal pathogens in Zambia, Democratic Republic of Congo, Mozambique and Tanzania: an urgent need of a sustainable surveillance system.

PubMed

Mshana, Stephen E; Matee, Mecky; Rweyemamu, Mark

2013-10-12

A review of the published and unpublished literature on bacterial resistance in human and animals was performed. Sixty-eight articles/reports from the Democratic Republic of Congo (DRC), Mozambique, Tanzania and Zambia were reviewed. The majority of these articles were from Tanzania. There is an increasing trend in the incidence of antibiotic resistance; of major concern is the increase in multidrug- resistant Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Vibrio cholera, non-typhoid Salmonella and other pathogens responsible for nosocomial infections. The increase in methicillin- resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) producers in the countries under review confirms the spread of these clones worldwide. Clinical microbiology services in these countries need to be strengthened in order to allow a coordinated surveillance for antimicrobial resistance and provide data for local treatment guidelines and for national policies to control antimicrobial resistance. While the present study does not provide conclusive evidence to associate the increasing trend in antibiotic resistance in humans with the use of antibiotics in animals, either as feed additives or veterinary prescription, we strongly recommend a one-health approach of systematic surveillance across the public and animal health sectors, as well as the adherence to the FAO (Food and Agriculture Organization)-OIE (World Organization of animal Health) -WHO(World Health Organization) recommendations for non-human antimicrobial usage.

Accuracy of malaria rapid diagnosis test Optimal-IT(®) in Kinshasa, the Democratic Republic of Congo.

PubMed

Muhindo, Hypolite Mavoko; Ilombe, Gillon; Meya, Ruth; Mitashi, Patrick M; Kutekemeni, Albert; Gasigwa, Didier; Lutumba, Pascal; Van Geertruyden, Jean-Pierre

2012-07-06

Despite some problems related to accuracy and applicability, malaria rapid diagnostic tests (RDTs), are currently considered the best option in areas with limited laboratory services for improving case management and reducing over-treatment. However, their performance must be established taking into the account the particularities of each endemic area. In the Democratic Republic of Congo, the validity of Optimal-IT(®) and Paracheck-Pf(®), respectively based on the detection of lactate dehydrogenase and histidine-rich protein-2, was assessed at primary health care level (PHC). This was a two-stage cluster randomized survey, conducted in one health centre in 12 health zones in Kinshasa city. All patients with malaria presumptive diagnosis were eligible. Gold standard was microscopy performed by experts from the parasitology unit, Kinshasa University. 624 patients were enrolled. 53.4% (95% CI: 49.4-57.3) owed a bed net, obtained in 74.5% of cases (95% CI: 69.4-79.1) through community-based distribution by the National Malaria Control Programme. Microscopy expert reading confirmed 123 malaria cases (19.7%; 95% CI: 16.7-23.1). Overall sensitivity were 79.7% (95% CI: 72.4-86.8), 87.8% (95% CI: 81.9-93.6) and 86.2% (95% CI: 79.9-92.3), respectively, for Optimal-IT(®), Paracheck-Pf(®) and microscopy performed at PHC. Specificity was 97.0% (95% CI: 95.5-98.5), 91.6% (95% CI: 89.1-94.0) and 49.1% (95% CI: 44.7-53.4). The proportion of confirmed cases seemed similar in under-fives compared to others. Any treatment prior to the current visit was a predictor for malaria (AOR: 2.3; 95% CI: 1.5-3.5), but not malaria treatment (AOR: 0.87; 95% CI: 0.4-1.8). Bed net ownership tended to protect against malaria (AOR: 0.67; 95% CI: 0.45-0.99). Although microscopy is considered as the "gold standard" for malaria diagnosis at point of care level, this study showed that its accuracy may not always be satisfactory when performed in health centres.

Role of faith-based and nongovernment organizations in the provision of obstetric services in 3 African countries.

PubMed

Vogel, Joshua Peter; Betrán, Ana Pilar; Widmer, Mariana; Souza, João Paulo; Gülmezoglu, Ahmet Metin; Seuc, Armando; Torloni, Maria Regina; Mengestu, Tigest Ketsela; Merialdi, Mario

2012-12-01

We sought to describe obstetric care capacity of nongovernment organization (NGO)-/faith-based organization (FBO)-run institutions compared to government-run institutions in 3 African countries using the World Health Organization Global Survey. We also compared delivery characteristics and outcomes. This is a descriptive analysis of the 22 NGO-/FBO-run institutions in Uganda, Kenya and Democratic Republic of Congo delivering 11,594 women, compared to 20 government-run institutions delivering 25,825 women in the same countries and period. Infrastructure, obstetric services, diagnostic facilities, and anesthesiology at NGO/FBO institutions were comparable to government institutions. Women delivering at NGO/FBO institutions had more antenatal care, antenatal complications, and cesarean delivery. NGO/FBO institutions had higher obstetrician attendance and lower rates of eclampsia, preterm birth, stillbirth, Apgar <7, and neonatal near miss. NGO/FBO institutions are comparable to government institutions in capacity to deliver obstetric care. NGO/FBOs have been found effective in providing delivery care in developing countries and should be appropriately recognized by stakeholders in their efforts to assist nations achieve international goals. Copyright © 2012 Mosby, Inc. All rights reserved.

75 FR 37880 - Blocking of Specially Designated National Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... the Democratic Republic of Congo''. DATES: The designation by the Director of OFAC of the one... President found that the situation in the Democratic Republic of the Congo constitutes and unusual and... BAKONDE, Jerome; a.k.a. GAKWAVU BOKANDE, Jerome; a.k.a. GAGAKWAVU, Jerome); Kinshasa, Aru, Congo...

Antemortem diagnosis of hydrocephalus in two Congo African grey parrots (Psittacus erithacus erithacus) by means of computed tomography.

PubMed

Thurber, Mary I; Mans, Christoph; Fazio, Constance; Waller, Ken; Rylander, Helena; Pinkerton, Marie E

2015-04-01

A 7-year-old and a 10-year-old Congo African grey parrot (Psittacus erithacus erithacus; parrots 1 and 2, respectively) were evaluated because of neurologic deficits. Parrot 1 had an 8- to 9-month history of lethargy and anorexia, with a recent history of a suspected seizure. Parrot 2 had a 6-month history of decreased activity and vocalizing, with an extended history of excessive water intake; a water deprivation test ruled out diabetes insipidus, and psychogenic polydipsia was suspected. Both birds had ophthalmologic asymmetry, with anisocoria detected in parrot 1 and unilateral blindness in parrot 2. Metal gastrointestinal foreign bodies were observed on whole-body radiographs of both birds, but blood lead concentrations were below the range indicated for lead toxicosis. Findings on CT of the head were consistent with hydrocephalus in both cases. Parrot 1 received supportive care and died 3 months after the diagnosis of hydrocephalus. Parrot 2 was treated with omeprazole and prednisolone for 10 days without any improvement in neurologic deficits; euthanasia was elected, and hydrocephalus was confirmed on necropsy. No underlying or concurrent disease was identified. Hydrocephalus should be considered a differential diagnosis for parrots evaluated because of CNS signs. Computed tomography was an excellent screening tool to diagnose hydrocephalus in these patients. Compared with MRI, CT is more frequently available and offers reduced scanning times, reduced cost, and less concern for interference from metallic foreign bodies.

Shaded Relief with Height as Color, Virunga and Nyiragongo Volcanoes and the East African Rift Valley

NASA Image and Video Library

2002-07-11

Volcanic, tectonic, erosional and sedimentary landforms are all evident in this comparison of two elevation models of a region along the East African Rift at Lake Kivu. The area shown covers parts of Congo, Rwanda and Uganda.

The Impact of Two Semiannual Treatments with Albendazole Alone on Lymphatic Filariasis and Soil-Transmitted Helminth Infections: A Community-Based Study in the Republic of Congo

PubMed Central

Pion, Sébastien D. S.; Chesnais, Cédric B.; Bopda, Jean; Louya, Frédéric; Fischer, Peter U.; Majewski, Andrew C.; Weil, Gary J.; Boussinesq, Michel; Missamou, François

2015-01-01

Implementation of mass drug administration (MDA) with ivermectin plus albendazole (ALB) for lymphatic filariasis (LF) has been delayed in central Africa because of the risk of serious adverse events in subjects with high Loa loa microfilaremia. We conducted a community trial to assess the impact of semiannual MDA with ALB (400 mg) alone on LF and soil-transmitted helminth (STH) infections in the Republic of Congo. Evaluation at 12 months showed that ALB MDA had not significantly reduced Wuchereria bancrofti antigenemia or microfilaria (mf) rates in the community (from 17.3% to 16.6% and from 5.3% to 4.2%, respectively). However, the geometric mean mf count in mf-positive subjects was reduced from 202.2 to 80.9 mf/mL (60% reduction, P = 0.01). The effect of ALB was impressive in 38 subjects who were mf-positive at baseline and retested at 12 months: 37% had total mf clearance, and individual mf densities were reduced by 73.0%. MDA also dramatically reduced the hookworm infection rate in the community from 6.5% to 0.6% (91% reduction), with less impressive effects on Ascaris and Trichuris. These preliminary results suggest that semiannual community MDA with ALB is a promising strategy for controlling LF and STH in areas with coendemic loiasis. PMID:25758650

Prevalence of HIV-1 Subtypes and Drug Resistance-Associated Mutations in HIV-1-Positive Treatment-Naive Pregnant Women in Pointe Noire, Republic of the Congo (Kento-Mwana Project).

PubMed

Bruzzone, Bianca; Saladini, Francesco; Sticchi, Laura; Mayinda Mboungou, Franc A; Barresi, Renata; Caligiuri, Patrizia; Calzi, Anna; Zazzi, Maurizio; Icardi, Giancarlo; Viscoli, Claudio; Bisio, Francesca

2015-08-01

The Kento-Mwana project was carried out in Pointe Noire, Republic of the Congo, to prevent mother-to-child HIV-1 transmission. To determine the prevalence of different subtypes and transmitted drug resistance-associated mutations, 95 plasma samples were collected at baseline from HIV-1-positive naive pregnant women enrolled in the project during the years 2005-2008. Full protease and partial reverse transcriptase sequencing was performed and 68/95 (71.6%) samples were successfully sequenced. Major mutations to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors were detected in 4/68 (5.9%), 3/68 (4.4%), and 2/68 (2.9%) samples, respectively. Phylogenetic analysis of HIV-1 isolates showed a high prevalence of unique recombinant forms (24/68, 35%), followed by CRF45_cpx (7/68, 10.3%) and subsubtype A3 and subtype G (6/68 each, 8.8%). Although the prevalence of transmitted drug resistance mutations appears to be currently limited, baseline HIV-1 genotyping is highly advisable in conjunction with antiretroviral therapy scale-up in resource-limited settings to optimize treatment and prevent perinatal transmission.

Object-based image analysis for the assessment of mineral extraction in conflict regions - a case study in the Democratic Republic of the Congo

NASA Astrophysics Data System (ADS)

Kranz, Olaf; Schoepfer, Elisabeth; Spröhnle, Kristin; Lang, Stefan

2016-06-01

In this study object-based image analysis (OBIA) techniques were applied to assess land cover changes related to mineral extraction in a conflict-affected area of the eastern Democratic Republic of the Congo (DRC) over a period of five years based on very high resolution (VHR) satellite data of different sensors. Object-based approaches explicitly consider spatio-temporal aspects which allow extracting important information to document mining activities. The use of remote sensing data as an independent, up-to-date and reliable data source provided hints on the general development of the mining sector in relation to socio-economic and political decisions. While in early 2010, the situation was still characterised by an intensification of mineral extraction, a mining ban between autumn 2010 and spring 2011 marked the starting point for a continuous decrease of mining activities. The latter can be substantiated through a decrease in the extend of the mining area as well as of the number of dwellings in the nearby settlement. A following demilitarisation and the mentioned need for accountability with respect to the origin of certain minerals led to organised, more industrialized exploitation. This development is likewise visible on satellite imagery as typical clearings within forested areas. The results of the continuous monitoring in turn facilitate non-governmental organisations (NGOs) to further foster the mentioned establishment of responsible supply chains by the mining industry throughout the entire period of investigation.

78 FR 2721 - Designation of Entities Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-14

... Democratic Republic of Congo.'' DATES: The designation by the Director of OFAC of the two entities identified... relation to the Democratic Republic of the Congo constitutes an unusual and extraordinary threat to the.... FDLR; a.k.a. ``FOCA''; a.k.a. FORCE COMBATTANTE ABACUNGUZI), North and South Kivu, Congo, Democratic...

Coupling between tectonics and surface processes in the Congo Basin: Cretaceous-Cenozoic sedimentation and erosion triggered by climatic and tectonic factors

NASA Astrophysics Data System (ADS)

de Putter, Thierry; Mees, Florias; Bayon, Germain; Ruffet, Gilles; Smith, Thierry; Delvaux, Damien

2017-04-01

Cretaceous to Recent evolution of the Congo Basin in Central Africa is still poorly documented although its history over the last 75 Myr has potentially recorded global and major regional events, including the Paleocene-Eocene Thermal Maximum at 56 Ma and the Miocene aperture of the Western branch of the East African Rift System along its eastern border at 25 Ma. Available data for associated off-shore deposits show that in parallel, the Congo River delta experienced a starvation period during the Mid- to Late Cretaceous and Paleogene, with endorheic lacustrine to desert environments in the upstream basin, followed by a period marked by high rates of drainage and sediment supply in the Neogene. Here, we combine new observations on the recent tectonic evolution with newly obtained 39Ar-40Ar ages for cryptomelane from Katanga (Kasekelesa) and Kasaï (Mt Mwatshimwa) and the preliminary results of the Landana condensed section ( 45 m) Paleogene-Neogene sequence. The maximum burial in the Congo Basin is estimated at 80 Ma and was followed by the removal of at least 900-1500 m of sediments (Sachse et al., 2012). Soon after the 39Ar-40Ar ages reveal that a major (Campanian or older) surface formed in the Kasai and Katanga before 76 Ma, followed by at least two younger Eocene denudation episodes, during the Lutetian ( 45 Ma) and the Priabonian ( 35 Ma) and more Mio-Pliocene denudation surfaces during the Mio-Pliocene (De Putter et al., 2016). The older surface likely belongs to the subcontinental 'African Surface' that had previously not been identified for Central Africa. During this long-lasting erosional history of the central part of the Congo Basin, the Landana section along the Atlantic coast recorded a condensed ( 45 m) sequence of Paleogene-Neogene sediments. The first 25m are shallow marine carbonates with little detrital input, recording slightly increasing weathering from the Danian to the Lutetian (Bayon et al., 2016). Whether this section had a physical

Sedimentary processes in the Carnot Formation (Central African Republic) related to the palaeogeographic framework of Central Africa

NASA Astrophysics Data System (ADS)

Censier, Claude; Lang, Jacques

1999-08-01

The depositional environment, provenance and processes of emplacement of the detrital material of the Mesozoic Carnot Formation are defined, by bedding and sedimentological analysis of its main facies, and are reconstructed within the palaeogeographic framework of Central Africa. The clastic material was laid down between probably the Albian and the end of the Cretaceous, in a NNW-oriented braided stream fluvial system that drained into the Doba Trough (Chad) and probably also into the Touboro Basin (Cameroon). The material was derived from weathering of the underlying Devonian-Carboniferous Mambéré Glacial Formation and of the Precambrian schist-quartzite complex located to the south of the Carnot Formation. These results provide useful indications as to the provenance of diamonds mined in the southwest Central African Republic.

Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

PubMed Central

Ogbo, Felix A.; Agho, Kingsley; Ogeleka, Pascal; Woolfenden, Sue; Page, Andrew; Eastwood, John

2017-01-01

Background The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children’s Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. Method The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries. Results Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77–0.85, P<0.001 and OR = 0.50; 95%CI: 0.43–0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14–1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05–1.55) were significantly associated with a higher risk of diarrhoea. Conclusion Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each