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Sample records for kinshasa

  1. Poverty among widows of Kinshasa, Congo.

    PubMed

    D'Souza, S

    2000-09-01

    The linkages between poverty and death in the family in a sector of the city of Kinshasa, capital of the Democratic Republic of Congo (previously Zaire) were studied. The poor people have been identified using 3 convergent norms, described in the Methods of Materials section, based on total expenditure, calorie consumption in food, and proportion of expenditure for food. Family histories were recorded to understand the difficult situation of widow-headed households identified within the sample area. The relationship between death in the family and poverty was bi-directional: on the one hand, death of the breadwinner can accelerate the level of poverty; and on the other, poverty conditions can result in further deaths in the family. PMID:11057062

  2. Human African Trypanosomiasis Transmission, Kinshasa, Democratic Republic of Congo

    PubMed Central

    Diabakana, Philemon Mansinsa; Mesu, Victor Kande Betu Ku; Manzambi, Emile Zola; Ollivier, Gaelle; Asonganyi, Tazoacha; Cuny, Gerard; Grébaut, Pascal

    2006-01-01

    To investigate the epidemiology of human African trypanosomiasis (sleeping sickness) in Kinshasa, Democratic Republic of Congo, 2 entomologic surveys were conducted in 2005. Trypanosoma brucei gambiense and human-blood meals were found in tsetse fly midguts, which suggested active disease transmission. Vector control should be used to improve human African trypanosomiasis control efforts. PMID:17326955

  3. Differential correlates of nutritional status in Kinshasa, Zaire.

    PubMed

    Bertrand, W E; Mock, N B; Franklin, R R

    1988-09-01

    In an effort to search for causes of malnutrition in the urban environment to guide intervention efforts, a study of more than 2000 mother/child pairs was conducted in Kinshasa, Zaire. Under the auspices of the Zairian National Nutrition Planning Center a representative sample of a large lower class urban population was interviewed at two points in time. One phase covered morbidity and nutritional status measurements for all children under five years of age. A second phase examined a complex set of socioeconomic and behavioural variables possibly linked to nutritional outcomes for a 20% sample of the households. After merging the data sets bivariate and multivariate regression analyses were performed twice, using the youngest child and the household as the unit of analysis respectively. Results showed that different complexes of variables predicted malnutrition as measured by three separate anthropometric measures. For so-called acute malnutrition (weight-for-height) morbidity, migration, and diarrhoeal knowledge, all emerged as significant predictors. Chronic malnutrition (height-for-age), however, was only significantly predicted by zone of residence, a level of living score, and recent morbidity when all major variables were considered in the regression model. Factors that were significant predictors of each of these two indices also were predictors of the third nutritional indicator, weight-for-age. Birth interval also was associated with this index. The findings here suggest more careful scrutiny of the nature, causes, interpretation and use of these widely accepted measures of nutritional status. PMID:3145250

  4. Gender, Poverty, Family Structure, and Investments in Children's Education in Kinshasa, Congo.

    ERIC Educational Resources Information Center

    Shapiro, David; Tambashe, B. Oleko

    2001-01-01

    Examines school enrollment and educational attainment in Kinshasa, Congo, focusing on how poverty, household structure, gender, and economic well-being affect investments in children's education. Increased economic well-being translates into greater attainment for both females and males, but does not necessarily reduce gender differences in school…

  5. [African mobilization against AIDS. After the Kinshasa Conference].

    PubMed

    Poissonnier, A

    The AIDS epidemic in Africa has become too massive to ignore. A sign of increasing awareness of the AIDS threat was the attendance of some 1200 participants at the 5th international conference on AIDS in Africa held in Kinshasa, Zaire, in October 1990. An African society to combat AIDS has been formed and is based in Nairobi. The new association will be responsible for organization of coming conferences to be held in Africa rather than in Europe. Sub-Saharan Africa contains less than 10% of the world's population but 2/3 of adult AIDS cases and almost 90% of maternal and child cases. The epidemic is even more worrisome because it has brought with it a recrudescence of other illnesses such as tuberculosis. The World Health Organization estimates that 5 million Africans were seropositive in 1990 vs 2.5 million in 1987. Predictions are necessary and allow planning to begin for the care of the 10 million orphans who will be found in Africa by the year 2000 and for other serious problems created by the disease. But the situation is already very dire. There has been a certain stabilization in the number of cases in countries such as that Congo, Zaire, or the Central African Republic. As yet the stabilization cannot be explained. The pessimistic view is that the pause results from a purely statistical phenomenon due to increased mortality. The optimistic view is that sexual behavior is responding to health information campaigns. Although the experts had expected the AIDS epidemic to be limited to urban zones in Africa, rural rates already approach urban rates in several countries such as the Ivory Coast, Tanzania, Uganda, and Rwanda. Mother-infant contamination is the greatest worry of health officials. The number of infants infected during pregnancy or birth is expected to double to 1 million by 1992 and reach nearly 10 million in 2000. Some 20-25 million Africans will be seropositive by 2000. A cure for AIDS is unlikely in the near future. Products delaying the onset of

  6. Explaining nitrate pollution pressure on the groundwater resource in Kinshasa using a multivariate statistical modelling approach

    NASA Astrophysics Data System (ADS)

    Mfumu Kihumba, Antoine; Vanclooster, Marnik

    2013-04-01

    Drinking water in Kinshasa, the capital of the Democratic Republic of Congo, is provided by extracting groundwater from the local aquifer, particularly in peripheral areas. The exploited groundwater body is mainly unconfined and located within a continuous detrital aquifer, primarily composed of sedimentary formations. However, the aquifer is subjected to an increasing threat of anthropogenic pollution pressure. Understanding the detailed origin of this pollution pressure is important for sustainable drinking water management in Kinshasa. The present study aims to explain the observed nitrate pollution problem, nitrate being considered as a good tracer for other pollution threats. The analysis is made in terms of physical attributes that are readily available using a statistical modelling approach. For the nitrate data, use was made of a historical groundwater quality assessment study, for which the data were re-analysed. The physical attributes are related to the topography, land use, geology and hydrogeology of the region. Prior to the statistical modelling, intrinsic and specific vulnerability for nitrate pollution was assessed. This vulnerability assessment showed that the alluvium area in the northern part of the region is the most vulnerable area. This area consists of urban land use with poor sanitation. Re-analysis of the nitrate pollution data demonstrated that the spatial variability of nitrate concentrations in the groundwater body is high, and coherent with the fragmented land use of the region and the intrinsic and specific vulnerability maps. For the statistical modeling use was made of multiple regression and regression tree analysis. The results demonstrated the significant impact of land use variables on the Kinshasa groundwater nitrate pollution and the need for a detailed delineation of groundwater capture zones around the monitoring stations. Key words: Groundwater , Isotopic, Kinshasa, Modelling, Pollution, Physico-chemical.

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

    PubMed Central

    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

    2014-01-01

    Objectives: 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. Methods: 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. Results: 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%. Conclusions: 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. PMID:25417907

  8. 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

  9. Complications of childbirth and maternal deaths in Kinshasa hospitals: testimonies from women and their families

    PubMed Central

    2011-01-01

    Background Maternal mortality in Kinshasa is high despite near universal availability of antenatal care and hospital delivery. Possible explanations are poor-quality care and by delays in the uptake of care. There is, however, little information on the circumstances surrounding maternal deaths. This study describes and compares the circumstances of survivors and non survivors of severe obstetric complications. Method Semi structured interviews with 208 women who survived their obstetric complication and with the families of 110 women who died were conducted at home by three experienced nurses under the supervision of EK. All the cases were identified from twelve referral hospitals in Kinshasa after admission for a serious acute obstetric complication. Transcriptions of interviews were analysed with N-Vivo 2.0 and some categories were exported to SPSS 14.0 for further quantitative analysis. Results Testimonies showed that despite attendance at antenatal care, some women were not aware of or minimized danger signs and did not seek appropriate care. Cost was a problem; 5 deceased and 4 surviving women tried to avoid an expensive caesarean section by delivering in a health centre, although they knew the risk. The majority of surviving mothers (for whom the length of stay was known) had the caesarean section on the day of admission while only about a third of those who died did so. Ten women died before the required caesarean section or blood transfusion could take place because they did not bring the money in time. Negligence and lack of staff competence contributed to the poor quality of care. Interviews revealed that patients and their families were aware of the problem, but often powerless to do anything about it. Conclusion Our findings suggest that women with serious obstetric complications have a greater chance of survival in Kinshasa if they have cash, go directly to a functioning referral hospital and have some leverage when dealing with health care staff PMID

  10. Cholera ante portas – The re-emergence of cholera in Kinshasa after a ten-year hiatus

    PubMed Central

    Bompangue, Didier; Vesenbeckh, Silvan Manuel; Giraudoux, Patrick; Castro, Marcia; Muyembe, Jean-Jacques; Kebela Ilunga, Benoît; Murray, Megan

    2012-01-01

    Background: Cholera is an endemic disease in certain well-defined areas in the east of the Democratic Republic of Congo (DRC). The west of the country, including the mega-city Kinshasa, has been free of cases since mid 2001 when the last outbreak ended. Methods and Findings: We used routinely collected passive surveillance data to construct epidemic curves of the cholera cases and map the spatio-temporal progress of the disease during the first 47 weeks of 2011. We compared the spatial distribution of disease spread to that which occurred in the last cholera epidemic in Kinshasa between 1996 and 2001. To better understand previous determinants of cholera spread in this region, we conducted a correlation analysis to assess the impact of rainfall on weekly health zone cholera case counts between December 1998 and March 2001 and a Generalized Linear Model (GLM) regression analysis to identify factors that have been associated with the most vulnerable health zones within Kinshasa between October 1998 and June 1999. In February 2011, cholera reemerged in a region surrounding Kisangani and gradually spread westwards following the course of the Congo River to Kinshasa, home to 10 million people. Ten sampled isolates were confirmed to be Vibrio cholerae O1, biotype El Tor, serotype Inaba, resistant to trimethoprim-sulfa, furazolidone, nalidixic acid, sulfisoxaole, and streptomycin, and intermediate resistant to Chloramphenicol. An analysis of a previous outbreak in Kinshasa shows that rainfall was correlated with case counts and that health zone population densities as well as fishing and trade activities were predictors of case counts. Conclusion: Cholera is particularly difficult to tackle in the DRC. Given the duration of the rainy season and increased riverine traffic from the eastern provinces in late 2011, we expect further increases in cholera in the coming months and especially within the mega-city Kinshasa. We urge all partners involved in the response to remain

  11. The value of spatial analysis for tracking supply for family planning: the case of Kinshasa, DRC.

    PubMed

    Hernandez, Julie H; Akilimali, Pierre; Kayembe, Patrick; Dikamba, Nelly; Bertrand, Jane

    2016-10-01

    While geographic information systems (GIS) are frequently used to research accessibility issues for healthcare services around the world, sophisticated spatial analysis protocols and outputs often prove inappropriate and unsustainable to support evidence-based programme strategies in resource-constrained environments. This article examines how simple, open-source and interactive GIS tools have been used to locate family planning (FP) services delivery points in Kinshasa (Democratic Republic of Congo) and to identify underserved areas, determining the potential location of new service points, and to support advocacy for FP programmes. Using smartphone-based data collection applications (OpenDataKit), we conducted two surveys of FP facilities supported by partner organizations in 2012 and 2013 and used the results to assess gaps in FP services coverage, using both ratio of facilities per population and distance-based accessibility criteria. The cartographic outputs included both static analysis maps and interactive Google Earth displays, and sought to support advocacy and evidence-based planning for the placement of new service points. These maps, at the scale of Kinshasa or for each of the 35 health zones that cover the city, garnered a wide interest from the operational level of the health zones' Chief Medical Officers, who were consulted to contribute field knowledge on potential new service delivery points, to the FP programmes officers at the Ministry of Health, who could use the map to inform resources allocation decisions throughout the city. PMID:27084735

  12. 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

  13. ENDURING ECONOMIC HARDSHIP, WOMEN'S EDUCATION, MARRIAGE AND FERTILITY TRANSITION IN KINSHASA.

    PubMed

    Shapiro, David

    2015-03-01

    This paper examines fertility transition in Kinshasa, capital of the Democratic Republic of the Congo (DRC) and second-largest city in sub-Saharan Africa. Shapiro (1996) documented the onset of fertility transition in the city, using data from 1990. Women's education was strongly inversely related to fertility, beginning with secondary schooling, and increases in women's education were important in initiating fertility transition in the city. The paper uses data from the 2007 Demographic and Health Survey in the DRC to examine fertility in Kinshasa and assess fertility transition since 1990, a period characterized by severe adverse economic conditions in the DRC. Fertility transition has continued at a strong pace. In part this reflects increased educational attainment of women, but it appears also to be largely a consequence of enduring economic hardship. The ongoing fertility decline has been accompanied by substantial delays in entry to marriage and childbearing, reflecting adverse economic conditions, which in turn have contributed to continuing declines in fertility. PMID:24650711

  14. Baseline assessment of collaborative tuberculosis/HIV activities in Kinshasa, the Democratic Republic of Congo.

    PubMed

    Martinot, Amanda; Van Rie, Annelies; Mulangu, Sabue; Mbulula, Marie; Jarrett, Nikki; Behets, Frieda; Bola, Valentin; Bahati, Etienne

    2008-07-01

    Ninety-two clinics were surveyed in 2005 as part of a baseline assessment of HIV activities in Tuberculosis (TB) clinics in Kinshasa, Democratic Republic of Congo. Some HIV activities were implemented in 58% of TB clinics. The majority of health had > or = 1 health care worker (HCW) trained in either HIV counseling or testing (71%). Fifty-three clinics offered counseling and testing to TB patients; twenty-two (42%) routinely offered HIV CT to all patients, while others used selective criteria. While most offered on-site counseling (92%) and testing (77%), not all 53 clinics had a HCW trained in counseling and only 31 had access to a counseling room. Cotrimoxazole prophylaxis was offered in 51% of clinics; antiretroviral treatment in 17%. Shortcomings in human resources, infrastructure and quality of services were revealed. Strengthening those clinics already implementing HIV activities could be prioritized to achieve the goals set forward by the Global Plan to Stop TB. PMID:18628533

  15. [Type of employment and occupational health in urban public transport in the city of Kinshasa].

    PubMed

    Shadi, Jemina Wangata; De Brouwer, Christophe

    2010-01-01

    The objective of this work was to highlight the impact of job type on the health of public transportation workers in the informal sector in Kinshasa. An exploratory cross-sectional study was conducted in a population of workers (n=390) with two types of jobs and employment status: permanent employment, the drivers (n=130) and precarious employment, receivers (n=130) and shippers (n=130). A health questionnaire was used for data collection. Odds ratios and confidence intervals at 95% were estimated by logistic regression. Adjusted odds ratios were higher respectively for receivers and shippers regarding complaints of weight loss, abnormal fatigue, headache and insomnia. These results suggest an association between the type of employment and the health of these workers. This differential impact could reflect the outcome associated with either the insecurity of the employment status or an increased level of harmful exposures. PMID:21491745

  16. Social capital and premarital sexual activity in Africa: the case of Kinshasa, Democratic Republic of Congo.

    PubMed

    Djamba, Yanyi K

    2003-08-01

    Prior research has pointed to several factors that may affect sexual behavior in Africa, but much of the work has been atheoretical or descriptive, thus reducing the explanatory value of some findings. In this study, the influence of individual characteristics and family background were examined in a sample of 2,000 women aged 14-24 interviewed in Kinshasa in 1995. The analysis was guided by the social capital framework and the discussion focused on three theoretical perspectives: rational adaptation, social disorganization, and patrilineal bias. The results from the event history analysis showed that poverty, exposure to mass media, patrilinearity, and AIDS awareness greatly reduce the risk of premarital sexual activity. In contrast, social capital, as measured by the number of siblings, was positively associated with sexual permissiveness, suggesting a dilution of adults' attention to children in larger families. PMID:12856894

  17. Topographic and road control of mega-gullies in Kinshasa (DR Congo)

    NASA Astrophysics Data System (ADS)

    Makanzu Imwangana, Fils; Dewitte, Olivier; Ntombi, Médard; Moeyersons, Jan

    2014-07-01

    Diachronic mapping (1957, 1967, 2007 and 2010) shows an exponentially growing mega-gully network since roads were constructed through in the forests and plantations which occupied the sandy soils of the high town of Kinshasa. We found that the spatial occurrence of the mega-gullies (width ≥ 5 m) in this newly urbanized environment is controlled by two factors. First, there is a topographic control, given by the relation S = 0.00008A- 1.459, with S being the slope gradient (m m- 1) of the soil surface at the gully head and A the drainage area (ha) above the head. There is also a ‘road’ control, expressed by S = 22.991Lc- 1.999, with Lc being the cumulated length of roads in the basin above the gully head. The co-existence of both controls reflects the fact that the local sands are highly permeable and hence roads are more important generators of continuous runoff. The S-A relation noted above should not be applied outside the town where the road network is less dense. In contrast, the S-Lc relation may be used in both the town and rural areas underlain by porous soils where roads are the only generators of continuous runoff. We further conclude that the high town of Kinshasa is one of the most vulnerable places for gullying, and gullying can potentially transform the town into a badland. ‘Artisanal’ gully treatment is more successful than generally believed and the S-Lc relation can be a tool for mega-gully prevention.

  18. 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. PMID:24914597

  19. Survey of abdominal obesities in an adult urban population of Kinshasa, Democratic Republic of Congo

    PubMed Central

    Kasiam Lasi On’kin, JB; Longo-Mbenza, B; Okwe, A Nge; Kabangu, N Kangola

    2007-01-01

    Summary Background The prevalence of overweight/obesity, which is an important cardiovascular risk factor, is rapidly increasing worldwide. Abdominal obesity, a fundamental component of the metabolic syndrome, is not defined by appropriate cutoff points for sub-Saharan Africa. Objective To provide baseline and reference data on the anthropometry/body composition and the prevalence rates of obesity types and levels in the adult urban population of Kinshasa, DRC, Central Africa. Methods During this cross-sectional study carried out within a random sample of adults in Kinshasa town, body mass index, waist circumference and fatty mass were measured using standard methods. Their reference and local thresholds (cut-off points) were compared with those of WHO, NCEP and IFD to define the types and levels of obesity in the population. Results From this sample of 11 511 subjects (5 676 men and 5 835 women), the men presented with similar body mass index and fatty mass values to those of the women, but higher waist measurements. The international thresholds overestimated the prevalence of denutrition, but underscored that of general and abdominal obesity. The two types of obesity were more prevalent among women than men when using both international and local thresholds. Body mass index was negatively associated with age; but abdominal obesity was more frequent before 20 years of age and between 40 and 60 years old. Local thresholds of body mass index (≥ 23, ≥ 27 and ≥ 30 kg/m2) and waist measurement (≥ 80, ≥ 90 and ≥ 94 cm) defined epidemic rates of overweight/general obesity (52%) and abdominal obesity (40.9%). The threshold of waist circumference ≥ 94 cm (90th percentile) corresponding to the threshold of the body mass index ≥ 30 kg/m2 (90th percentile) was proposed as the specific threshold of definition of the metabolic syndrome, without reference to gender, for the cities of sub-Saharan Africa. Conclusion Further studies are required to define the

  20. 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

  1. Investigation et riposte à une épidémie de poliovirus sauvage à Kinshasa

    PubMed Central

    Nsambu, Muriel Nzazi; Bazira, Léodegal; Coulibaly, Tiekoura; Mbule, Albert; Wilmet, Michèle Dramaix; Likwela, Joris Losimba

    2013-01-01

    Introduction La République Démocratique du Congo a été considérée comme un pays à circulation rétablie de poliovirus sauvage (PVS). Cet article décrit l’épidémie de PVS qui a sévit dans la province de Kinshasa de 2010 à 2011. Méthodes Les analyses ont porté sur les cas de paralysie flasque aigüe (PFA) enregistrés de décembre 2010 à décembre 2011, les données de surveillance des PFA, les données de couverture vaccinale et celles du monitorage indépendant des activités de vaccination supplémentaires. Résultats Entre décembre 2010 à décembre 2011, 298 cas de PFA ont été enregistrés par les zones de santé parmi lesquels 34 cas de PVS confirmés. 58% des cas de PVS avaient plus de 15 ans avec plus d'hommes que de femmes. 10 passages d'activités de vaccination supplémentaires ont été mis en œuvre dont 4 avaient ciblé toute la population de Kinshasa. Il n'y a plus eu de cas de PVS après le 3e passage. Le monitorage des activités de vaccination a montré une proportion de sujets non vaccinés allant de 4 à 13%. La performance du système de surveillance était globalement bonne. Conclusion La prédominance des adultes parmi les cas notifiés traduit leur susceptibilité alors qu'ils ne sont généralement pas concernés lors des campagnes de vaccination supplémentaires. Ceci devrait engager les autorités sanitaires à envisager des activités vaccinales supplémentaires ciblant les adultes afin de casser plus rapidement la chaîne de transmission. Les faiblesses subsistant dans le système de surveillance pourraient être jugulées par le renforcement de la surveillance à base communautaire. PMID:24062866

  2. 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. PMID:25957436

  3. 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 Central

    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. PMID:27340411

  4. 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:…

  5. 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. PMID:27340411

  6. Black water fever associated with acute renal failure among Congolese children in Kinshasa.

    PubMed

    Bodi, Joseph M; Nsibu, Célestin N; Aloni, Michel N; Lukute, Guy N; Kunuanuna, Thomas S; Tshibassu, Pierre M; Pakasa, Nestor

    2014-11-01

    Acute renal failure (ARF) is reported in some severe forms of malaria such as black water fever (BWF). It is associated with a high mortality rate and can be managed effectively with adequate renal replacement. A prospective survey of children with dark urine after a malarial infection with Plasmodium falciparum was coupled with a chart review study of patients managed in the past 11 years in the Pediatrics' Kinshasa University Hospital. Eighty-nine cases of ARF were identified, but data from only 63 patients were available, of whom 44 (69.8%) had severe malaria (39 with BWF and 5 with cerebral malaria). The mean age of the patients was 8.2±1.73 years. Of the 39 cases of BWF, an association with quinine ingestion was observed in 32 children (82%). Urea and creatinine levels were elevated in all cases (135.4±88.2 and 3.83±2.81 mg/dL, respectively). Oligo-anuria was observed in 44.4%, severe metabolic acidosis (bicarbonate<15 mEq/L) in 61.5% and hyponatremia (<130 mEq/L) in 33.3%. Peritoneal dialysis was required in 36 patients, including 20 with BWF. The remaining patients were managed with conservative treatment. Twenty-eight children (44.4%), including 20 on dialysis, fully recovered and 14 died (22.2%), including eight cases of BWF. Our study suggests that ARF is commonly associated with BWF in Congolese children. Elevated urea and creatinine and severe metabolic acidosis were observed more often than other clinical/metabolic disturbances. Severe renal impairment remains a significant complication with a high mortality rate in low-resource settings. PMID:25394465

  7. High prevalence of methicillin resistant staphylococci strains isolated from surgical site infections in Kinshasa

    PubMed Central

    Iyamba, Jean-Marie Liesse; Wambale, José Mulwahali; Lukukula, Cyprien Mbundu; Takaisi-Kikuni, Ntondo za Balega

    2014-01-01

    Introduction Surgical site infections (SSIs) after surgery are usually caused by Staphylococcus aureus and coagulase-negative staphylococci (CNS). In low income countries, methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase-negative staphylococci (MR-CNS) surgical site infections are particularly associated with high treatment cost and remain a source of mortality and morbidity. This study aimed to determine the prevalence and the sensitivity to antibiotics of MRSA and MR-CNS isolated from SSIs. Methods Wound swabs were collected from 130 hospitalized surgical patients in two major hospitals of Kinshasa. S. aureus and CNS strains were identified by standard microbiological methods and latex agglutination test (Pastorex Staph-Plus). The antibiotic susceptibility of all staphylococcal strains was carried out using disk-diffusion method. Results Eighty nine staphylococcal strains were isolated. Out of 74 S. aureus and 15 CNS isolated, 47 (63.5%) and 9 (60%) were identified as MRSA and MR-CNS respectively. Among the MRSA strains, 47 strains (100%) were sensitive to imipenem, 39 strains (89%) to amoxycillin-clavulanic acid and 38 strains (81%) to vancomycin. All MR-CNS were sensitive to imipenem, amoxycillin-clavulanic acid and vancomycin. The isolated MRSA and MR-CNS strains showed multidrug resistance. They were both resistant to ampicillin, cotrimoxazole, erythromycin, clindamycin, ciprofloxacin, cefotaxime and ceftazidime. Conclusion The results of the present study showed a high prevalence of MRSA and MR-CNS. Imipenem, amoxycillin-clavulanic acid and vancomycin were the most active antibiotics. This study suggests that antibiotic surveillance policy should become national priority as MRSA and MR-CNS were found to be multidrug resistant. PMID:25478043

  8. Nurses’ compliance with prevention of mother-to-child transmission national guidelines in selected sites in Kinshasa, Democratic Republic of Congo

    PubMed Central

    Brysiewicz, Petra

    2015-01-01

    Background 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. Aim The study aimed at describing nurses’ compliance with the PMTCT national guidelines in selected PMTCT sites of Kinshasa. Methods 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. Results 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. Conclusion 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.

  9. 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.

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

    PubMed Central

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

    2006-01-01

    OBJECTIVE: 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). METHODS: 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. FINDINGS: 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. CONCLUSION: Scaling up PMTCT programmes in under-resourced settings requires evaluation and strengthening of existing basic antenatal care service delivery. PMID:17242833

  11. 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. PMID:19136188

  12. [Stab wounds of the hand and forearm due to Kuluna in Kinshasa (Democratic Republic of Congo): types of injuries and treatment].

    PubMed

    Kibadi, K; Portaels, F; Pichot, Y; Kapinga, M; Moutet, F

    2015-01-01

    Democratic Republic of Congo (DRC), a particular form of juvenile delinquency and insecurity intensifies in the city of Kinshasa. This is the phenomenon Kuluna. It is organized gangs equipped with machetes and other weapons. The main objective of this study is to know the phenomenon Kuluna and describe the upper limb injuries caused by machetes, while insisting on the specifics of the management of these lesions in our communities. This retrospective descriptive study examines 14 cases of wounds of the hand and forearm due to stab phenomenon Kuluna, in Kinshasa. It covers the period from 1 November 2010 to 1 November 2013. Among the 14 patients with lesions in the hand and forearm admitted and treated at the Unit of Plastic Reconstructive and Aesthetic Surgery, Hand Surgery and Burns, University Clinics of Kinshasa to attacks due to the phenomenon Kuluna. We have 11 men and 3 women. The average age was 33, 5 years (extremes of 21 and 56 years). The right upper limb is reached that the left upper limb, respectively 12 patients and 2 patients. The lesions are localized to the wrist in the majority of cases (10 patients) in the palm of hand and in 3 patients in the fingers in 1 patient. The palmar surface is reached (10 cases) and the dorsal (4 cases). Zone 5 of the International Classification of flexor and Zone 8 topographic classification extensors at hand are the predilection sites of lesions respectively the palmar surface (6 out of 10) and the dorsal (2 case 4). The median nerve at the wrist is cut in half the cases. On bone lesions localized to the forearm, we observed a high incidence of fracture of the ulna (62.5%). The treatment begins with the stabilization of bone pieces, gestures revascularization and nerve sutures and suture tendon and finally skin coverage. Rehabilitation was mandatory, she supervises the actions of repair and it continues until the recovery of function. PMID:26837110

  13. Family Planning Supply Environment in Kinshasa, DRC: Survey Findings and Their Value in Advancing Family Planning Programming

    PubMed Central

    Kayembe, Patrick; Babazadeh, Saleh; Dikamba, Nelly; Akilimali, Pierre; Hernandez, Julie; Binanga, Arsene; Bertrand, Jane T

    2015-01-01

    Background: Modern contraceptive prevalence was 14.1% in 2007 in Kinshasa, the capital city of the Democratic Republic of the Congo (DRC). Yet virtually nothing was known about the family planning supply environment. Methods: Three surveys of health facilities were conducted in 2012, 2013, and 2014 to determine the number, spatial distribution, and attributes of sites providing family planning services. The 2012 and 2013 surveys aimed to identify the universe of family planning facilities while obtaining a limited set of data on “readiness” to provide family planning services (defined as having at least 3 modern methods, at least 1 person training in family planning in the last 3 years, and an information system to track distribution of products to clients) and output (measured by couple-years of protection, or CYP). In contrast, the 2014 survey, conducted under the umbrella of the Performance Monitoring and Accountability 2020 (PMA2020) project, was based on 2-stage cluster sampling. This article provides detailed analysis of the 2012 and 2013 surveys, including bivariate and multivariate analysis of correlates of readiness to provide services and of output. Results: We identified 184 health facilities that reported providing at least 1 contraceptive method in 2012 and 395 facilities in 2013. The percentage of sites defined as “ready” to provide services increased from 44.1% in 2012 to 63.3% in 2013. For the 3-month period between January and March 2013, facilities distributed between 0 and 879.2 CYP (mean, 39.7). Nearly half (49%) of the CYP was attributable to implants, followed by IUDs (24%), CycleBeads (11%), and injectables (8%). In 2013, facilities supported by PEPFAR (n = 121) were more likely than other facilities to be rated as ready to provide services (P<.0001); however, PEPFAR-supported sites generated less CYP on average than sites supported by family planning implementing agencies (P<.0001). Multivariate analysis showed 3 variables were

  14. Conflicting discourses of church youths on masculinity and sexuality in the context of HIV in Kinshasa, Democratic Republic of Congo

    PubMed Central

    Lusey, Hendrew; San Sebastian, Miguel; Christianson, Monica; Dahlgren, Lars; Edin, Kerstin E.

    2014-01-01

    Abstract Masculinity studies are fairly new and young churchgoers are an under-researched group in the current Congolese church context. In response to this knowledge gap, this paper attempts to explore discourses of young churchgoers from deprived areas of Kinshasa regarding masculinity and sexuality in the era of HIV. A series of 16 semi-structured interviews were conducted with unmarried young churchgoers from the Salvation Army, Protestant and Revival churches. The interviews were tape-recorded, transcribed verbatim and analysed using discourse analysis. Five main discourses emerged: ‘we are aware of the church message on sex’, ‘young men need sex’, ‘young women need money’, ‘to use or not to use condoms’ and ‘we trust in the church message’. Although all informants knew and heard church messages against premarital sex, many of them were sexually active. The perception was that young men were engaged in sexual activities with multiple partners as a result of sexual motivations surrounding masculinity and sexual potency, while young women sought multiple partners through transactional and intergenerational sex for economic reasons. These sexual practices of young people conflicted with church messages on sexual abstinence and faithfulness. However, a small number of participants challenged current gender norms and suggested alternative ways of being a man or a woman. To elucidate these alternatives, we suggest that church youths and church leaders might take concrete actions to deconstruct misconceptions about being men. In this way, they can possibly enhance a frank and fruitful dialogue on sex, sexuality and gender to promote positive masculinities and constructive partnerships to prevent HIV. PMID:25000272

  15. Conflicting discourses of church youths on masculinity and sexuality in the context of HIV in Kinshasa, Democratic Republic of Congo.

    PubMed

    Lusey, Hendrew; San Sebastian, Miguel; Christianson, Monica; Dahlgren, Lars; Edin, Kerstin E

    2014-01-01

    Masculinity studies are fairly new and young churchgoers are an under-researched group in the current Congolese church context. In response to this knowledge gap, this paper attempts to explore discourses of young churchgoers from deprived areas of Kinshasa regarding masculinity and sexuality in the era of HIV. A series of 16 semi-structured interviews were conducted with unmarried young churchgoers from the Salvation Army, Protestant and Revival churches. The interviews were tape-recorded, transcribed verbatim and analysed using discourse analysis. Five main discourses emerged: 'we are aware of the church message on sex', 'young men need sex', 'young women need money', 'to use or not to use condoms' and 'we trust in the church message'. Although all informants knew and heard church messages against premarital sex, many of them were sexually active. The perception was that young men were engaged in sexual activities with multiple partners as a result of sexual motivations surrounding masculinity and sexual potency, while young women sought multiple partners through transactional and intergenerational sex for economic reasons. These sexual practices of young people conflicted with church messages on sexual abstinence and faithfulness. However, a small number of participants challenged current gender norms and suggested alternative ways of being a man or a woman. To elucidate these alternatives, we suggest that church youths and church leaders might take concrete actions to deconstruct misconceptions about being men. In this way, they can possibly enhance a frank and fruitful dialogue on sex, sexuality and gender to promote positive masculinities and constructive partnerships to prevent HIV. PMID:25000272

  16. HIV knowledge and sexual risk behavior among street adolescents in rehabilitation centres in Kinshasa; DRC: gender differences

    PubMed Central

    Mudingayi, Albert; Lutala, Prosper; Mupenda, Bavon

    2011-01-01

    Background Street children, common in Africa, are increasingly vulnerable to alcohol and drugs of abuse and lack access to both healthcare and knowledge about HIV and AIDS. Hence, this study assessed the level of knowledge about sexually transmitted infections (STIs), including HIV, among street adolescents in the Democratic Republic of the Congo (DRC). Methods A random sampling of 200 street children (10-25 years of age) were selected from 17 rehabilitation centres in Kinshasa, and a structured questionnaire was administered to all participants in their respective centres. High knowledge, knowledge or awareness of condom was defined when a participant gave more than 67% of correct responses. Chi square analysis was used to test differences between sexes. Results The knowledge level of respondents was high. 54.3% of males and 45.7% of girls have heard about HIV), and few participants cited unprotected sex as mode of transmission (42.9% for males and 57.1% for females). A high number of children reported a previous sexual experience. Satisfying a natural bodily need was the main reason for having sex. However, the use of condoms is still low in both genders (26.2 versus 59.3%, p<0.01). Neither gender reported a reason why they are not using a condom. Conclusion This study highlights the high knowledge about HIV, which contrasts with low condom use and high past sexual experiences with the high number of sexual partners and sexual contacts. Policies targeting these findings are warranted to reverse such trends. PMID:22187605

  17. [Epidemiology of chronic kidney disease in the Democratic Republic of Congo: review of cross-sectional studies from Kinshasa, the capital].

    PubMed

    Sumaili, Ernest K; Krzesinski, Jean-Marie; Cohen, Eric P; Nseka, Nazaire M

    2010-07-01

    Chronic kidney disease (CKD) is a worldwide public health problem. Little is known about its burden in Africa. This paper reviews the knowledge of CKD in Kinshasa, summarizing four studies undertaken in the general population and traditional health system of Kinshasa. CKD was defined by either kidney damage (proteinuria> or =300 mg/day) or reduced kidney function (eGFR<60 ml/min/1.73 m(2)). In the general population, the prevalence of CKD all stage is 12.4 %. Our work shows also the high prevalence of proteinuria among subjects who do not have diabetes or hypertension, the lack of early detection and management of CKD risk factors in the traditional health care system leading to late referral or premature deaths, and the limits of renal replacement treatment. CKD affects young people in the DRC, in contrast to the United States, where CKD is more prevalent in older people. Major determinants of CKD in our studies were hypertension, diabetes, overweight, age, lower socioeconomic status, and Human immunodeficiency virus (HIV) infection. Glomerular nephropathy (mainly focal segmental glomerulosclerosis) remains the leading cause of end stage renal disease. An annual screening of the population for proteinuria and CKD risk factors is feasible and will, it is hoped, provide the basis for building a nationwide prevention strategy. PMID:20409770

  18. Elevated blood lead levels and sources of exposure in the population of Kinshasa, the capital of the Democratic Republic of Congo.

    PubMed

    Tuakuila, Joel; Lison, Dominique; Mbuyi, Francois; Haufroid, Vincent; Hoet, Perrine

    2013-01-01

    The objective of this study was to determine blood lead levels (BLLs) and the possible sources of exposure in the population of Kinshasa, the capital of the Democratic Republic of Congo. A cross-sectional survey was carried out from January to May 2008 in a representative sample of the Kinshasan population. BLL was measured in 275 individuals (53.4% women) aged 1-70 years in the urban area of Kinshasa and from 60 additional subjects in the rural area. Pb was also determined in environmental specimens (air and soil, indoor and outdoor). BLL in the study population ranged from 2.9 to 49.3 μg/dl (median, 9.9 μg/dl). The median BLL among children aged <6 years was 11.5 μg/dl (range: 3.0-37.8 μg/dl). Of these children, 71% had elevated BLL (≥10 μg/dl) and 22% had BLL ≥20 μg/dl. The proportion of elevated BLL (≥10 μg/dl) was higher for children aged <3 years than for children aged 3 to 5 years (97% vs 56%). A higher prevalence of elevated BLL was observed in urban compared with rural children (71% vs 20%). Significantly higher BLLs were also found in children whose mother consumed fired clay during pregnancy. Residential informal activities in the recycling of car batteries also contributed to elevated BLL in children. The elevated background of Pb exposure in the Kinshasan population indicates a public health issue that requires corrective actions. Pb-contaminated dust and air in children's home is an issue of public health concern. The use of leaded gasoline and the activities of car battery recycling in certain residences appear to constitute the main sources of exposure in the city of Kinshasa. The traditional use of fired clay for the treatment of gastritis by pregnant women is another significant contributor for elevated BLL in children. PMID:22617721

  19. FEASIBILITY ANALYSIS OF AN 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

    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: acceptability, implementation, adaptation, and limited-efficacy. The adapted intervention was suitable, satisfying, and attractive to program facilitators and participants and able to be implemented effectively. It performed well with a new population and showed preliminary efficacy. However, we identified certain aspects of the intervention that must be addressed prior to wider implementation such as: (1) including more content on navigating marriage while living with HIV and disclosure; (2) adjusting intervention timing and session length; and (3) simplifying the more complicated content. An adapted evidence-based intervention was found to be feasible and lessons learned can be applied to YLWH in other low-resource settings. PMID:23514081

  20. Perceptions of Health, Health Care and Community-Oriented Health Interventions in Poor Urban Communities of Kinshasa, Democratic Republic of Congo

    PubMed Central

    Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal

    2013-01-01

    In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city’s major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and

  1. Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo.

    PubMed

    Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal

    2013-01-01

    In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and

  2. Carence en fer, anémie et anémie ferriprive chez les donneurs de sang à Kinshasa, République Démocratique du Congo

    PubMed Central

    Nzengu-Lukusa, Franck; Yuma-Ramazani, Sylvain; Sokolua-Mvika, Eddy; Dilu-Keti, Angèle; Malenga-Nkanga, Blanchard; Shuli, Jean Baptiste; Nzongola-Nkasu, Donatien Kayembe; Mbayo-Kalumbu, Ferdinand; Ahuka-Mundeke, Steve

    2016-01-01

    Introduction En République Démocratique du Congo (RDC), plus d'un million de don de sang ont été réalisés entre 2007 et 2011. Cependant, aucun bilan portant sur la carence en fer et l'anémie ferriprive, conséquence d'un don de sang chez les donneurs de sang (DS), n'est disponible dans ce pays. L'objectif de cette étude était d'estimer la prévalence de la carence en fer, de l'anémie et de l'anémie ferriprive chezles DS au Centre National de Transfusion Sanguine (CNTS) à Kinshasa en RDC. Méthodes Entre Décembre 2012 et Août 2013, une étude transversale a été menée au CNTS où des DS éligibles au don de sang ont été inclus. Les informations socio démographiques et des prélèvements sanguins ont été collectés de manière simultanée au don de sang. La ferritine sérique a été dosée pour évaluer la carence en fer en utilisant la technique ELISA. L'hémogramme a été réalisé en vue d’évaluer et mettre au point l'anémie. Résultats Au total 386 DS ont été inclus dans cette étude. La prévalence de la carence en fer et de l'anémie ferriprive étaient respectivement de 63,2% (244/386) et 25,9% (100/386) des DS. Une anémie a été trouvée chez 36.5% (141/386) au moment du don de sang. Conclusion La carence en fer, l'anémie et l'anémie ferriprive demeurent très fréquentes chez les DS à Kinshasa. Ces résultats suggèrent la révision des tests biologiques utilisés dans le recrutement des DS au CNTS. Par ailleurs le dosage de la ferritine s'impose en routine chez les DS rég PMID:27303590

  3. Facteurs de risque de la tuberculose multi-résistante dans la ville de Kinshasa en République Démocratique du Congo

    PubMed Central

    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

    Introduction L'objectif de cette étude était de déterminer les facteurs de risque associés à la tuberculose multi résistance à Kinshasa en République Démocratique du Congo. Méthodes Il s'agissait d'une étude cas témoins. Les cas comprenaient tous les patients tuberculeux résistants à la rifampicine et à l'isoniazide notifiés à Kinshasa de janvier 2012 à juin 2013. Les témoins étaient les patients tuberculeux traités durant la même période que les cas et qui à la fin du traitement étaient déclarés guéris. Pour cette étude, nous avons obtenu une clairance éthique. Résultats L’échantillon était constitué de 213 participants dont 132 hommes (62%) et 81 femmes (38%). L’âge médian était de 31ans (16-73 ans). Les facteurs associés significatifs (p< 0,05) à la tuberculose multi résistante étaient le non-respect des heures de prise de médicaments (0R = 111) (80% chez les cas et 4% chez les témoins), l’échec au traitement (0R = 20) (76% chez les cas et 13% chez les témoins); la notion de tuberculose multi résistante dans la famille (0R = 6.4) (28% chez les cas et 6% chez les témoins); la méconnaissance de la tuberculose multi résistante (0R = 3.2) (31% chez les cas et 59% chez les témoins); un séjour en prison (0R = 7.6) (10% chez les cas et 1% chez les témoins) et l'interruption du traitement (0R = 6.1) ( 59% chez les cas et 19% chez les témoins). Conclusion L’émergence de la tuberculose multi résistante peut être évitée par la mise en place des stratégies de diagnostic et de traitement appropriées. PMID:27516818

  4. [The behavioral determinants for health centers in health districts of urban Africa: results of a survey of households in Kinshasa, Congo].

    PubMed

    Manzambi, J K; Tellier, V; Bertrand, F; Albert, A; Reginster, J Y; Van Balen, E H

    2000-08-01

    This study analyses the choice determinants of the population for health centres through a survey of the behaviour of families in a representative sample of 1,000 households in the health districts of Kinshasa, Congo in 1997. For the most recent episode of illness, the respondents turned to seven types of care: the health centre (37%), private dispensaries (26.5%), self-medication through a pharmacy (23.9%), traditional practitioner (21%), traditional self-medication (16.9%), private outpatients' clinic (16.7%) and a reference hospital (10.4%). Past logistics have shown that patients resort to a health centre rather than another type of care structure (P = 0.05) when looking for quality care, reasonable prices and the availability of varied services. On the other hand, concern about the geographical proximity in relation to the family's residence calls for using the private dispensary. When looking for a doctor or the existence of a 'convention', families are more inclined to choose a private officially recognized outpatients' clinic. Those who had been looking for a solution to a special type of illness opted primarily for a traditional practitioner. In conclusion, the results of this study show that if people choose the care offered by health centres, it is because they judge it to be of good quality. The integrated care offered by the same technician, with a required training, is a major asset in the acceptability of the first line of primary health care in Kinshasa. This study suggests that it would no doubt be beneficial to integrate non-official private care structures into the primary health care system, as far as it is possible for them to achieve a level of quality comparable to that of the health centres. In order that the traditional practitioner might play an important complementary role in the realization of primary health care, even in urban areas, the possibility of promoting sites of communication should be studied. Moreover, considering the weak

  5. Assessment of attitudes towards adverse events following immunization with oral poliovirus vaccine: a pilot study among high school students of Kinshasa, the Democratic Republic of Congo

    PubMed Central

    Kinuani, Léon; Nzolo, Didier Bomene; Aloni, Michel Ntetani; Makolo, Pavel; Ntamabyaliro, Nsengi; Ntamba, Yves Lula; Kazadi, Crispin; Nyembwe, Michel; Ekila, Mathilde Bothale; Mesia, Gauthier Kahunu

    2014-01-01

    Objective: The aim of this study is to evaluate the reaction of students to adverse events following immunization in order to offer a baseline for developing a communication and risk management plan. Method: This is a cross-sectional study conducted in Kinshasa. A survey was conducted between the third and the fourth rounds of Supplementary Immunization Activity. Nine hundred and fifty questionnaires were used and addressed students who attended this university from 1 to 10 June 2011. Results: Completed questionnaires were received from 848 students, with 485 females (57.2%), 343 males (40.4%), and 20 unknown (2.4%); 46.9% of students were from the faculty of medicine and 24.7% was from the third graduate degree. From those who completed the questionnaire, 136 (16.4%) reported experiencing an adverse events following immunization. Concerning the attitude of students towards adverse events following immunization, 79 students (58.5%) did nothing; 54 (40.0%) opted for self-medication; 2 (1.5%) went to the hospital. Conclusion: The main finding of our study is the low rate of people referring to health-care providers for vaccine-related problems, more specially for adverse events following immunization. A risk management plan should be focused in strategies to increase communication between population and health-care providers. PMID:25237792

  6. An innovative approach to using both cellphones and the radio to identify young people’s sexual concerns in Kinshasa, Democratic Republic of Congo

    PubMed Central

    2014-01-01

    Background As teenagers have easy access to both radio programs and cell phones, the current study used these tools so that young people could anonymously identify questions about sex and other related concerns in the urban environment of the Democratic Republic of Congo. The purpose of this healthcare intervention was to identify and address concerns raised by young people, which are related to sexual health, and which promote youth health. Methods This healthcare intervention was conducted over a six month period and consisted of a survey carried out in Kinshasa. This focused on 14 to 24 old young people using phone calls on a radio program raising concerns related to sexuality. The radio program was jointly run by a journalist and a health professional who were required to reply immediately to questions from young people. All sexual health concerns were recorded and analyzed. Results Forty programs were broadcast in six months and 1,250 messages and calls were recorded: 880 (70%) from girls and 370 (30%) from boys, which represents an average of 32 interventions (of which 10 calls and 22 messages) per broadcast. Most questions came from 15-19- and 20-24-year-old girls and boys. Focus of girls’ questions: menstrual cycle calculation and related concerns accounted for the majority (24%); sexual practices (16%), love relationships (15%) and virginity (14%). Boys’ concerns are masturbation (and its consequences) (22%), sexual practices (19%), love relationships (18%) and worries about penis size (10%). Infections (genital and STI) and topics regarding HIV represent 9% and 4% of the questions asked by girls against 7% and 10% by boys. Concerns were mainly related to knowledge, attitudes and competences to be developed. Conclusions Concerns and sexual practices raised by teens about their sexual and emotional life have inspired the design of a practical guide for youth self-training and have steered the second phase of this interactive program towards supporting

  7. The use of hybrid fractures in paleostress determinations: test case with the the Palygorskite-bearing fractures in the Kinshasa area, DR Congo

    NASA Astrophysics Data System (ADS)

    Delvaux, Damien; Gloire, Ganza; Mees, Florias; Lahogue, Pascale

    2014-05-01

    Hybrid fractures represent the transition from extension fracture to shear fracture (Ramsey and Chester, 2004, Nature 428, 63-66). Although hybrid fractures have long been hypothesized to represent brittle fracture types between the extension and shear fractures end-members, it was only in 2004 that these authors succeeded to demonstrate their existence experimentally. As a consequence, observation of hybrid fractures in naturally deformed rocks remained ambiguous for a long time and only few studies reported their natural existence. Hybrid fractures have also not been considered so far as brittle element in paleostress reconstructions as their kinematic understanding was unclear. The Paleozoic Inkisi red sandstones of the West-Congo Supergroup in the region of Kinshasa and Brazzaville (Congo) are affected by prominent fracture sets, the most prominent of which are filled by palygorskite veins. They were formed in a strike-slip setting related to intraplate stress field generated by the mid Atlantic ridge push since that became efficient in late Cretaceous. We found an almost continuous range of fracture types, from plume joints to open fractures filled with calcite-palygorskite but without slip striae, and slickensided fractures with only thin films of redeposited palygorskite. The structural data have been analyzed with the Win-Tensor program (version 5.0.1) which has been adapted to consider hybrid fractures. Those are characterized by extension and shear, as opposed to tension fractures, on which no shear movement occurs, and to shear fractures, on which contraction occurs instead of extension. The results obtained suggest that the fractures have been initiated locally as plume joint and developed laterally under hybrid conditions. Later, some of them have been reactivated as strike-slip shear fractures and a new conjugated set appeared. Overall, this illustrates the progressive development with time of the stress state corresponding to an increase in the sigma

  8. Fertility desires, unmet need for family planning, and unwanted pregnancies among HIV-infected women in care in Kinshasa, DR Congo

    PubMed Central

    Yotebieng, Marcel; Norris, Alison; Chalachala, Jean Lambert; Matumona, Yori; Ramadhani, Habib Omari; Behets, Frieda

    2015-01-01

    Introduction We assessed the fertility desires, utilization of family planning (FP) methods, and incidence of pregnancies among HIV-infected women receiving care in an HIV clinic with an onsite FP services in Kinshasa, Democratic Republic of Congo. Methods Between November 2011 and May 2012, all HIV-infected women who attended a routine visit at the clinic were interviewed about their fertility desires and utilization of contraceptive methods using a structured questionnaire. Routine follow-up visit data were used to identify pregnancies recorded between the interview and June 2013. Results Overall, of the 699 HIV-infected women interviewed. 249 (35.7%) reported not wanting another child. Of the 499 (72.2%) participants who were sexually active at the time of interview, 177 (35.5%) were using an effective contraceptive method, including 70 (14.0%) women who reported using condoms consistently and 104 (20.8%) who were using injectable contraception. Overall, 88 (17.6%) sexually active participants who did not want another child were not using an effective FP method, and thus are considered to have had unmet need. During the median follow-up time of 22.2 (IQR: 20.2, 23.6) months, among all women interviewed, 96 (14.1%) became newly pregnant [pregnancy rate 9.3 (95%CI: 7.6, 11.4) per 100 women-years] including 21 (8.7%) among women who initially reported not wanting another child [unwanted pregnancy rate 5.8 (95%CI: 3.6, 9.3) per 100 women-years]. Conclusion The persistence of relatively high unmet need among women receiving HIV care in a clinic with onsite FP services suggests the existence of barriers that must be identified and addressed.

  9. 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

  10. [Combining microcredit, microinsurance, and the provision of health care can improve access to quality care in urban areas of Africa: Results of an experiment in the Bandalungwa health zone in Kinshasa, the Congo].

    PubMed

    Manzambi Kuwekita, J; Gosset, C; Guillaume, M; Balula Semutsari, M-P; Tshiama Kabongo, E; Bruyere, O; Reginster, J-Y

    2015-01-01

    This study, based on a survey conducted in 2008, examines how combining microcredit, microinsurance, and health care provision can improve access to quality care in the health zone of Bandalungwa, in Kinshasa. The bivariate analysis showed a significant association between increased purchasing power and earnings (p = 0.001), between earnings and savings (p = 0.000), and between health insurance and improved access to health care. These results show that 68.8% of borrowers reported an increase in their purchasing power, of whom 82% reported profits. Those with savings were 24.7 times more likely to purchase health insurance than those without; and 72% of those who regularly made health insurance payments improved their access to care. Combining microcredit, health microinsurance, and health care can improve access to quality health care at lower cost. This suggests that health insurance could usefully be integrated into the primary health-care system. PMID:26643890

  11. Les accidents du travail dans le transport urbain en commun de la ville province de Kinshasa, République Démocratique du Congo: une étude transversale descriptive

    PubMed Central

    Wangata, Jemima; Elenge, Myriam; De Brouwer, Christophe

    2014-01-01

    Introduction Le transport en commun urbain constitue un secteur où les travailleurs sont très exposés aux accidents du travail. Cette étude visait une description épidémiologique des accidents du travail dans le secteur informel du transport en commun à Kinshasa en vue d'apporter les pistes d'amélioration de la sécurité des travailleurs dans cette activité. Méthodes Un questionnaire sur les accidents du travail, administré en Décembre 2012 a permis d'explorer les tendances significatives entre les accidents et leurs circonstances, leurs facteurs associés, leurs conséquences au sein d'une population des travailleurs (n = 472) du transport en commun à Kinshasa. Résultats Durant les 12 derniers précédant l’étude 76.5% des travailleurs ont connu au moins un accident du travail, 54,8% ont connu un arrêt d'au moins 1jour. Les accidents liés à la circulation routière étaient plus important suivis des chutes. Les facteurs ayant montré des différences significatives étaient le travail sous l'influence de l'alcool et le port des équipements de protection individuelle. Les plaies (46,3%) et les contusions (39,4%) étaient les lésions les plus courantes. Les membres supérieurs (51,3%) et inférieurs (30,7%) étaient les plus atteints. 76,6% des travailleurs ont assumé seuls leur prise en charge médicale. Conclusion L'incidence des accidents du travail dans ce secteur est très élevée. La mise en place d'une politique de prévention et gestion de différents facteurs associés ainsi qu'un système de déclaration d'accidents est nécessaire dans ce secteur. Les patrons ainsi que les politiques devraient veiller à une prise en charge médicale correcte pour des travailleurs accidentés. PMID:25667703

  12. Pseudo-outbreak of pre-extensively drug-resistant (Pre-XDR) tuberculosis in Kinshasa: collateral damage caused by false detection of fluoroquinolone resistance by GenoType MTBDRsl.

    PubMed

    Kaswa, Michel K; Aloni, Muriel; Nkuku, Léontine; Bakoko, Brian; Lebeke, Rossin; Nzita, Albert; Muyembe, Jean Jacques; de Jong, Bouke C; de Rijk, Pim; Verhaegen, Jan; Boelaert, Marleen; Ieven, Margareta; Van Deun, Armand

    2014-08-01

    Fluoroquinolones are the core drugs for the management of multidrug-resistant tuberculosis (MDR-TB). Molecular drug susceptibility testing methods provide considerable advantages for scaling up programmatic management and surveillance of drug-resistant TB. We describe here the misidentification of fluoroquinolone resistance by the GenoType MTBDRsl (MTBDRsl) (Hain Lifescience GmbH, Nehren, Germany) line probe assay (LPA) encountered during a feasibility and validation study for the introduction of this rapid drug susceptibility test in Kinshasa, Democratic Republic of Congo. The double gyrA mutation 80Ala and 90Gly represented 57% of all fluoroquinolone mutations identified from MDR-TB patient sputum samples, as confirmed by DNA sequencing. This double mutation was previously found to be associated with susceptibility to fluoroquinolones, yet it leads to absent hybridization of a wild-type band in the MTBDRsl and is thus falsely scored as resistance. Our findings suggest that MTBDRsl results must be interpreted with caution when the interpretation is based solely on the absence of a wild-type band without confirmation by visualization of a mutant band. Performance of the MTBDRsl LPA might be improved by replacing the gyrA wild-type probes by additional probes specific for well-documented gyrA mutations that confer clinically relevant resistance. PMID:24871222

  13. Une étude cas-témoins pour déterminer les facteurs de non-observance du suivi médical chez les patients diabétiques à Kinshasa, en 2010

    PubMed Central

    Mense, Kennedy; Mapatano, Mala Ali; Mutombo, Paulin Beya; Muyer, Marie Claire

    2014-01-01

    Introduction Le diabète est un problème majeur de santé publique et un fardeau économique mondial qui n’épargne pas la RD-Congo. Bien que sa prise en charge soit codifiée, la plupart des diabétiques n'arrivent pas à respecter les rendez-vous de suivi. Cette étude vise principalement à identifier les déterminants de la non-observance du suivi médical chez les diabétiques à Kinshasa. Méthodes Il s'agit d'une étude cas-témoins où les cas sont les patients diabétiques non observant le suivi médical et les témoins, ceux répondant régulièrement au suivi médical. Couvrant la période du 1erjanvier au 31 décembre 2010, l’étude a porté sur un échantillon aléatoire de 154 sujets répartis entre 77 cas et 77 témoins. Résultats Les données indiquent une association entre la non-observance du suivi médical et le revenu (niveau de vie) des ménages. Les cas provenant des ménages à faible revenu courent six fois plus le risque d’être non-observants. Par contre, entre le niveau de connaissance et la non-observance l'association notée n’était pas statistiquement significative. Le respect des rendez-vous pourrait être amélioré de 77% si le revenu des ménages des diabétiques était augmenté. Le coût total mensuel du suivi médical est estimé à 27,2 USD, alors que le revenu permanant des ménages se situe à 306,6 USD. Conclusion Le bas niveau de vie mais pas celui de l'ignorance est un déterminant de la non-observance des visites de suivi du malade diabétique. PMID:25309658

  14. Profil clinique de la dépression post- accident vasculaire cérébral étude transversale descriptive menée au centre de réhabilitation des personnes handicapées de Kinshasa (RD Congo)

    PubMed Central

    Mpembi, Magloire Nkosi; Ma Miezi, Samuel Mampunza; Nzuzi, Thierry Matonda Ma; Massamba, Victoria Kubuta; Henrard, Sévérine; Partz, Marie-Pierre De; Peeters, André; Macq, Jean; Dubois, Vincent; Constant, Eric

    2014-01-01

    Introduction L'objectif général poursuivi dans cette étude est de décrire le tableau clinique de la dépression post-accident vasculaire cérébral (DPAVC) à Kinshasa. Méthodes Il s'agit d'une étude transversale descriptive portant sur 56 patients suivis pour hémiplégie post-accident vasculaire cérébral au Centre de réhabilitation pour personnes handicapées de Kinshasa (CRPHK) du 1er au 31 août 2011. Résultats Au Patient Health Questionnaire (PHQ9), 21. 40 % des patients présentaient une dépression modérée à sévère. A l’échelle de Rankin, 63. 8% des patients étaient capables de marcher sans aide. L'apathie modérée à sévère était présente chez 44. 64%; à l’échelle de sévérité de la fatigue, le score de 12. 7 % des sujets était compatible avec un état dépressif. La dépression était associée à la sévérité des troubles neurologiques, à l'incapacité évaluée avec l’échelle de Rankin, à l'apathie et à une appréciation mauvaise de son propre état de santé par le patient. Conclusion La DPAVC est fréquente à Kinshasa parmi les patients en réhabilitation. La fréquence observée est comparable à celles retrouvées dans des travaux antérieurs dans le monde et aux rares travaux publiés en Afrique. La DPAVC est associée de manière significative à la sévérité des troubles neurologiques, au degré d'handicap, à la fatigue, à l'apathie et à la mauvaise perception de son état de santé. PMID:25018844

  15. Profil comparatif et évolutif des personnes infectées par le virus de l'immunodéficience humaine traitées aux antirétroviraux à Kinshasa, République Démocratique du Congo

    PubMed Central

    Koy, Tshingani; Mukumbi, Henri; Malandala, Ghislain Lubangi Muteba; Donnen, Philippe; Wilmet–Dramaix, Michèle

    2014-01-01

    Introduction A trithérapie (ARV) introduite en R.D.Congo en 1996, a permis l′amélioration substantielle de la qualité de vie des PVVIH et a réduit la morbimortalité liée au sida en R.D. Congo. L'objectif de cette étude est de présenter le profil épidémiologique comparatif, clinique, ainsi que l’évolution anthropométrique des PVVIH sous ARV à Kinshasa. Méthodes Etude de cohorte sur 438 PVVIH, de 18 ans et plus, suivies entre mai 2010 à 2011 à Amo Congo à Kinshasa. Une comparaison a été faite entre les patients suivis pendant un an et ceux perdus de vue. Le Chi carré de Mc Nemar et l'analyse de variance pour mesures répétées ont été appliqués pour étudier l’évolution. Résultats Près 12 mois de suivi, 11,4% de patients ont été perdus de vue. Parmi eux, on observait des proportions significativement plus élevées de personnes de niveau socioéconomique bas, d'indice de masse corporelle (IMC) bas, présentant de l'anorexie, des affections opportunistes. Les proportions de patients aux stades OMS 3 & 4 et naïfs étaient également significativement plus élevées et la durée sous ARV plus courte. Les gains moyens des paramètres anthropométriques au 12ème mois, étaient importants: de 3,6 [3,2 - 4,0] kg pour le poids, 1,8 (1,4 - 2,3) cm pour le périmètre abdominal, 0,9 (0,8 - 1,2) cm pour le périmètre brachial, 1,4 (1,2 - 1,5) kg/m2 pour l'IMC. La proportion de patients avec un IMC <18,5 kg/m2 a significativement plus baissé entre l'admission et le 12ème mois parmi les patients sans stomatite que parmi ceux avec stomatite. L'IMC moyen évoluait significativement différemment entre l'admission et le 12ème mois selon l’âge et la taille de ménage. Conclusion Les facteurs fragilisant la rétention des patients sous antirétroviraux et une évolution progressive de l’état nutritionnel ont été observés. PMID:25995784

  16. AIDS action-research with women in Kinshasa, Zaire.

    PubMed

    Schoepf, B G

    1993-12-01

    AIDS has assumed epidemic proportions in Central Africa. Knowledge of culturally constructed gender relations and sexual meanings is crucial to developing prevention strategies and reducing the impact of AIDS. CONNAISSIDA, a transdisciplinary medical anthropology research project, developed culturally appropriate community-based empowerment workshops. These used cognitive, emotional and social stimulants to provoke critical reflection and action. Collaborative relationships developed in workshops were used to study sexual relations in many contexts. Significant changes in knowledge and action were observed. Nevertheless, economic necessity and inequality limited the ability of many women to avoid sexual risk. Economic crisis, structural adjustment and debt reimbursement policies have exacerbated poverty, particularly among women. Linking macrolevel political economy to microlevel sociocultural analysis shows how strategies adopted for survival contribute to sexual risk. Therefore broader socioeconomic changes that reduce poverty and gender subordination are necessary to control the HIV/AIDS epidemic. Findings from Zaire are widely applicable in the region. PMID:8284707

  17. [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). PMID:23167138

  18. Antimalarial activity of 20 crude extracts from nine African medicinal plants used in Kinshasa, Congo.

    PubMed

    Tona, L; Ngimbi, N P; Tsakala, M; Mesia, K; Cimanga, K; Apers, S; De Bruyne, T; Pieters, L; Totté, J; Vlietinck, A J

    1999-12-15

    Twenty extracts including ten EtOH and ten CH2Cl2 from different parts of nine African medicinal plants used in Congolese traditional medicine for the treatment of malaria, were submitted to a pharmacological test in order to evaluate their effect on P. falciparum growth in vitro. Of these plant species, 14 (70%) extracts including EtOH and CH2Cl2 from Cassia occidentalis leaves, Cryptolepis sanguinolenta root bark, Euphorbia hirta whole plant, Garcinia kola stem bark and seeds, Morinda lucida leaves and Phyllanthus niruri whole plant produced more than 60% inhibition of the parasite growth in vitro at a test concentration of 6 microg/ml. Extracts from E. hirta, C. sanguinolenta and M. morindoides showed a significant chemosuppression of parasitaemia in mice infected with P. berghei berghei at orally given doses of 100-400 mg/kg per day. PMID:10624878

  19. Antiamoebic and spasmolytic activities of extracts from some antidiarrhoeal traditional preparations used in Kinshasa, Congo.

    PubMed

    Tona, L; Kambu, K; Ngimbi, N; Mesia, K; Penge, O; Lusakibanza, M; Cimanga, K; De Bruyne, T; Apers, S; Totte, J; Pieters, L; Vlietinck, A J

    2000-03-01

    Three major extracts from some traditional preparations, based on medicinal plants, used as antidiarrhoeal agents were investigated for their putative antiamoebic and spasmolytic activities in vitro. Results indicated that both biological activities are concentrated in the polyphenolic fraction, and not in the saponin or alkaloid containing fractions. The most active polyphenolic extracts were those from Euphorbia hirta whole plant, leaves of Alchornea cordifolia, Crossopteryx febrifuga, Nauclea latifolia, Psidium guajava, Tithonia diversifolia, stem bark of Harungana madagascariensis, Mangifera indica, Maprounea africana and Psidium guajava, inhibiting Entamoeba histolytica growth with MAC < 10 micrograms/ml. The same extracts, at a concentration of 80 micrograms/ml in an organ bath, also exhibited more than 70% inhibition of acetylcholine and/or KCl solution-induced contractions on isolated guinea-pig ileum. PMID:10782488

  20. The Utility of Case-Control Methods for Health Policy and Planning Analysis: An Illustration from Kinshasa, Zaire.

    ERIC Educational Resources Information Center

    Mock, Nancy B.; And Others

    1993-01-01

    The use of case-control methodology as an applied policy/planning research tool in assessing the potential effectiveness of behavioral interventions is studied in connection with diarrhea control in Zaire. Results with 107 matched pairs of children demonstrate the importance of hygiene-related knowledge and the utility of the research approach.…

  1. Malaria, Schistosomiasis and Soil Transmitted Helminth Burden and Their Correlation with Anemia in Children Attending Primary Schools in Kinshasa, Democratic Republic of Congo

    PubMed Central

    Matangila, Junior R.; Doua, Joachim Yorokpa; Linsuke, Sylvie; Madinga, Joule; Inocêncio da Luz, Raquel; Van Geertruyden, Jean-Pierre; Lutumba, Pascal

    2014-01-01

    Background Anaemia reduces cognitive potential in school children, retards their growth and predisposes them to other diseases. As there is a paucity of data on the current burden of P. falciparum, S. mansoni and soil transmitted helminths (STH) infections and their correlation with schoolchildren’s anemia in the Democratic Republic of Congo (DRC), we collect these data. Methods This study reports baseline data collected from a randomized controlled trial investigating the impact of IPT with SP and SP-PQ on anemia and malaria morbidity in Congolese schoolchildren (Trial registration: NCT01722539; PACTR201211000449323). S. mansoni and STH infections were assessed using kato-katz technique. Malaria infection and hemoglobin concentration were assessed using Blood smear and Hemocontrol device, respectively. Results A total of 616 primary schoolchildren from 4 to 13 years old were enrolled in the study. The prevalence of Plasmodium spp. infection was 18.5% (95%CI:15.6–21.9). Amongst those infected, 24 (21%), 40 (35.1%), 40 (35.1%), 10 (8.8%), had light, moderate, heavy, very high malaria parasite density, respectively. Above 9 years of age (p = 0.02), male and history of fever (p = 0.04) were both associated with malaria infection. The overall prevalence of S. mansoni infection was 6.4% (95%CI:4.4–9.1). Girls were associated with S. mansoni infection (p = 0.04). T. trichiura was the most prevalent STH infection (26.3%), followed by A. lumbricoides (20.1%). Co-infection with malaria-S. mansoni and malaria-STH was, respectively, 1.5% (CI95%:0.7–3.3) and 6.4% (CI95% 4.4–9.1). The prevalence of anemia was found to be 41.6% (95%CI:37.7–45.6) and anemia was strongly related with Plasmodium ssp infection (aOR:4.1; CI95%:2.6–6.5;p<0.001) and S. mansoni infection (aOR:3.3;CI95%:1.4–7.8;p<0.01). Conclusion Malaria and S. mansoni infection were strongly associated with high prevalence of anemia in schoolchildren. Therefore, specific school-based interventions, such as intermittent preventive treatment or prophylaxis, LLITN distribution, anthelminthic mass treatment and micronutrient supplementation are needed to improve school children’s health. PMID:25372029

  2. Répercussions psychosociales de la drépanocytose sur les parents d'enfants vivant à Kinshasa, République Démocratique du Congo: une étude qualitative

    PubMed Central

    Luboya, Evariste; Tshilonda, Jean-Christophe Bukasa; Ekila, Mathilde Bothale; Aloni, Michel Ntetani

    2014-01-01

    Introduction L'insuffisance des moyens de base pour le dépistage et la prise en charge de la socioculturel Africain. D'où la nécessité de réaliser un travail de mise en sens du vécu et des émotions en vue d'information et de soutien psychologique des familles des drépanocytaires. Cette étude a eu pour objectif d'identifier la nature des répercussions psychosociales de la drépanocytose chez les parents et chez les malades. Méthodes Une approche qualitative a été utilisée. Des entretiens ont été menés auprès des parents et des patients drépanocytaires. Nos résultats ont fait l'objet d'une analyse thématique articulée sur les circonstances de découvertes de la maladie, les répercussions de la maladie et la perception de la prise en charge. Résultats Nos interviews ont montré des répercussions psychosociales importantes chez les parents d'enfants drépanocytaires et de stigmatisation des difficultés d'insertion sociale et scolaire pour les enfants drépanocytaires. Ces derniers sont les grands oubliés des récits de parents. La prise en charge est uniquement médicale avec des ressources très limitées et aucun accompagnement psychologique de la famille n'est assuré. Conclusion La prise en charge de cette maladie nécessite la mise en place d'une politique de prise en charge basée sur une approche globale de la maladie. PMID:25574334

  3. Langage, normes et repertoire en milieu urbain africain: L'indoubill (Language, Norms, and Repertoire in the African Urban Milieu: Indoubill).

    ERIC Educational Resources Information Center

    Sesep, N'Sial Bal-Nsien

    A study explored, from a sociolinguistic perspective, the phenomenon of indoubill, patterns and usage of a special variety of Lingala, among a group of delinquent urban youth in Kinshasa (Zaire). It is proposed that: (1) at a particular moment in its social history, the community experienced sociocultural change that brought with it a special…

  4. On the early dynamics and spread of HIV-1.

    PubMed

    Rife, Brittany; Salemi, Marco

    2015-01-01

    Until recently, the origin of the HIV-1 group M pandemic largely remained a scientific mystery. The use of comprehensive evolutionary analyses has revealed a unique story regarding viral migration, starting in the 1920s in Kinshasa, and the social and infrastructural changes associated with the early spread of this deadly virus. PMID:25465351

  5. HIV epidemiology. The early spread and epidemic ignition of HIV-1 in human populations.

    PubMed

    Faria, Nuno R; Rambaut, Andrew; Suchard, Marc A; Baele, Guy; Bedford, Trevor; Ward, Melissa J; Tatem, Andrew J; Sousa, João D; Arinaminpathy, Nimalan; Pépin, Jacques; Posada, David; Peeters, Martine; Pybus, Oliver G; Lemey, Philippe

    2014-10-01

    Thirty years after the discovery of HIV-1, the early transmission, dissemination, and establishment of the virus in human populations remain unclear. Using statistical approaches applied to HIV-1 sequence data from central Africa, we show that from the 1920s Kinshasa (in what is now the Democratic Republic of Congo) was the focus of early transmission and the source of pre-1960 pandemic viruses elsewhere. Location and dating estimates were validated using the earliest HIV-1 archival sample, also from Kinshasa. The epidemic histories of HIV-1 group M and nonpandemic group O were similar until ~1960, after which group M underwent an epidemiological transition and outpaced regional population growth. Our results reconstruct the early dynamics of HIV-1 and emphasize the role of social changes and transport networks in the establishment of this virus in human populations. PMID:25278604

  6. The early spread and epidemic ignition of HIV-1 in human populations

    PubMed Central

    Faria, Nuno R.; Rambaut, Andrew; Suchard, Marc A.; Baele, Guy; Bedford, Trevor; Ward, Melissa J.; Tatem, Andrew J.; Sousa, João D.; Arinaminpathy, Nimalan; Pépin, Jacques; Posada, David; Peeters, Martine; Pybus, Oliver G.; Lemey, Philippe

    2014-01-01

    Thirty years after the discovery of HIV-1, the early transmission, dissemination, and establishment of the virus in human populations remain unclear. Using statistical approaches applied to HIV-1 sequence data from central Africa, we show that from the 1920s Kinshasa (in what is now the Democratic Republic of Congo) was the focus of early transmission and the source of pre-1960 pandemic viruses elsewhere. Location and dating estimates were validated using the earliest HIV-1 archival sample, also from Kinshasa. The epidemic histories of HIV-1 group M and nonpandemic group O were similar until ~1960, after which group M underwent an epidemiological transition and outpaced regional population growth. Our results reconstruct the early dynamics of HIV-1 and emphasize the role of social changes and transport networks in the establishment of this virus in human populations. PMID:25278604

  7. Spontaneous intracerebral hemorrhage: Clinical and computed tomography findings in predicting in-hospital mortality in Central Africans

    PubMed Central

    Tshikwela, Michel Lelo; Longo-Mbenza, Benjamin

    2012-01-01

    Background and Purpose: Intracerebral hemorrhage (ICH) constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score) by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis. Materials and Methods: Age, sex, hypertension, type 2 diabetes mellitus (T2DM), smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift) of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models. Results: A total of 185 adults and known hypertensive patients (140 men and 45 women) were examined. 30-day mortality rate was 35% (n=65). ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P<0.0001), presence of coma (OR=6.8 95% CI 2.6-17.4; P<0.0001) and left hemispheric site of ICH (OR 2.6 95% CI: 1.1-6; P=0.027) were identified as significant and independent predictors of 30-day mortality. Midline shift > 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 × 2 = 4), absence of coma coded 1 (1 × 2 = 2), ICH volume>25 mL coded 2 (2 × 2=4), ICH volume of ≤25 mL coded 1(1 × 2=2), left hemispheric site of ICH coded 2 (2 × 1=2), and right hemispheric site of hemorrhage coded 1(1 × 1 = 1). All patients with Kinshasa ICH score ≤7 survived and the patients with a score >7 died. In considering sex influence (Model 3), points were allowed as follows: Presence of coma (2 × 3 = 6), absence of coma (1 × 3 = 3), men (2 × 2 = 4), women (1 × 2 = 2), midline shift ≤7 mm (1 × 3 = 3), and midline shift >7 mm (2 × 3

  8. Impact of WHO 2010 Guidelines on Antiretroviral Therapy Initiation among Patients with HIV-Associated Tuberculosis in Clinics with and without Onsite HIV Services in the Democratic Republic of Congo

    PubMed Central

    Tabala, Martine; Batumbula, Marie Louise; Wenzi, Landry; Basaki, Emmanuel; Mungoyo, Eugenie; Mangala, Richard; Behets, Frieda

    2016-01-01

    Background. We assessed the impact of WHO's 2010 guidelines that removed the requirement of CD4 count before ART, on timely initiation of ART among HIV/TB patients in the Democratic Republic of Congo (DRC). Methods. Data collected to monitor implementation of provider initiated HIV testing and counseling (PITC) and linkage to HIV care from 65 and 13 TB clinics in Kinshasa and Kisangani, respectively, between November 2010 and June 2013. Results. Prior to the WHO's 2010 guidelines, in Kinshasa, 79.1% (401/507) of HIV/TB patients referred for HIV services were initiated on ART in clinics with onsite ART services compared to 50.0% (63/123) in clinics without. Following the implementation of the new guidelines, 89.8% (714/795) and 93.0% (345/371) of HIV/TB patients referred for HIV services were initiated on ART, respectively, in clinics with onsite and without onsite ART services. Similarly, in Kisangani, 69.7% (53/120) and 36.4% (16/44) in clinics with and without onsite ART service, respectively, were initiated on ART prior to the 2010 guidelines and 88.8% (135/152) and 72.6% (106/146), respectively, after the new guidelines. Conclusion. Though implementation of the 2010 guidelines increased the proportion of HIV/TB patients initiated on ART substantially, it remained below the 100% target, particularly in clinics without onsite ART services. PMID:27595020

  9. Impact of WHO 2010 Guidelines on Antiretroviral Therapy Initiation among Patients with HIV-Associated Tuberculosis in Clinics with and without Onsite HIV Services in the Democratic Republic of Congo.

    PubMed

    Yotebieng, Marcel; Tabala, Martine; Batumbula, Marie Louise; Wenzi, Landry; Basaki, Emmanuel; Mungoyo, Eugenie; Mangala, Richard; Behets, Frieda

    2016-01-01

    Background. We assessed the impact of WHO's 2010 guidelines that removed the requirement of CD4 count before ART, on timely initiation of ART among HIV/TB patients in the Democratic Republic of Congo (DRC). Methods. Data collected to monitor implementation of provider initiated HIV testing and counseling (PITC) and linkage to HIV care from 65 and 13 TB clinics in Kinshasa and Kisangani, respectively, between November 2010 and June 2013. Results. Prior to the WHO's 2010 guidelines, in Kinshasa, 79.1% (401/507) of HIV/TB patients referred for HIV services were initiated on ART in clinics with onsite ART services compared to 50.0% (63/123) in clinics without. Following the implementation of the new guidelines, 89.8% (714/795) and 93.0% (345/371) of HIV/TB patients referred for HIV services were initiated on ART, respectively, in clinics with onsite and without onsite ART services. Similarly, in Kisangani, 69.7% (53/120) and 36.4% (16/44) in clinics with and without onsite ART service, respectively, were initiated on ART prior to the 2010 guidelines and 88.8% (135/152) and 72.6% (106/146), respectively, after the new guidelines. Conclusion. Though implementation of the 2010 guidelines increased the proportion of HIV/TB patients initiated on ART substantially, it remained below the 100% target, particularly in clinics without onsite ART services. PMID:27595020

  10. Antimicrobial susceptibility of Neisseria gonorrhoeae in Zaire: high level plasmid-mediated tetracycline resistance in central Africa.

    PubMed Central

    Van Dyck, E; Rossau, R; Duhamel, M; Behets, F; Laga, M; Nzila, M; Bygdeman, S; Van Heuverswijn, H; Piot, P

    1992-01-01

    OBJECTIVE--To determine the in vitro antimicrobial susceptibility of gonococcal strains isolated in 1988 among female prostitutes in Kinshasa, Zaire and to characterise strains with high level tetracycline resistance. METHODS--Minimal inhibitory concentrations of 8 antimicrobials were measured by agar dilution technique. Plasmid-profiles and serovars were determined. RESULTS--Two hundred and thirteen strains of Neisseria gonorrhoeae were tested of which 59% were beta-lactamase producers and an additional 21% showed intermediate or chromosomal resistance to penicillin (MIC = 0.5-8 mg/l). Eleven percent of the strains were resistant to the combination sulfamethoxazole-trimethoprim (MIC greater than 8 mg/l) and 57% of the isolates showed decreased susceptibility to thiamphenicol (MIC = 1-4 mg/l). All strains were sensitive to spectinomycin, norfloxacin and ceftriaxone and moderately sensitive to kanamycin. Chromosomal resistance to tetracycline was observed in 45% of strains (MIC = 2-8 mg/l). Ten percent were highly resistant to tetracycline (TRNG, MIC = 16-128 mg/l) and were shown to carry a plasmid borne Tet M determinant; such strains were not found in Kinshasa in 1985. TRNG belonged to 4 different serovars, which were also the dominant serovars in non-TRNG. CONCLUSION--These findings illustrate the high frequency of multiresistant gonococci in Zaire and suggest that high level tetracycline resistant strains of N. gonorrhoeae have become endemic in Central Africa. Images PMID:1582653

  11. The deforestation of rural areas in the Lower Congo Province.

    PubMed

    Iloweka, Ernest Manganda

    2004-12-01

    The Lower Congo is one of eleven provinces in the Democratic Republic of Congo, and is located southwest of Kinshasa Town Province. It has an area of approximately 53.947 km2 with a population of 1,504,361 at an estimated 237 persons per km2. The Province comprises five districts, including Lukaya and Cataracts where rural poverty is severe and the population struggle to make a living through agriculture and woodcutting. These activities result in excessive resource exploitation. The high demand for foodstuffs and the high consumption of wood (for energy, construction and export) in Kinshasa, the capital city of the Democratic Republic of Congo and the expanding towns of Matadi and Boma in the Lower Congo Province, are speeding the deforestation rate and unbalancing forest ecosystems. In addition there is the stress resulting from reduced josher (the rest period for agriculture ground), plus climate change and erosion. The phenomena that that we need to address in these two districts include deforestation, reduced josher, excessive agriculture, erosion, burning and climate change which taken together largely explain the current soil degradation. These areas are marked by excessive post deforestation savannah formation and extended areas of sandy soil, distributed throughout grass and shrub savannahs. This desertification, which is rampant in Lukaya and Cataracts, risks imprisoning the rural population in a vicious cycle of poverty if adequate solutions are not found. PMID:15641386

  12. Education

    NASA Astrophysics Data System (ADS)

    Lundja, J. O.; Decrosta, J. T.; Lechuga, P.

    2009-05-01

    Government schools in Congo kinshasa are not providing quality education to the masses since many years, and this phenomenon has not escaped the eyes of experts, activists, and policy makers. However, there seems to be a general perception that the main, and sometimes even the sole, source of this problem are the low levels of government expenditure of education. And to prove their case supports of this view cite educational expenditure to GDP ratios in Congo kinshasa in comparison with that of some other nations. Though there may be reasonable arguments to increase the level of government expenditure on education, such hijacking of public debate to focus on - the level of expenditure - often overlooks more important issues. Contrary to common perception the level of per student expenditure on government schools in Delhi is reasonable, ranging from Fc.6000 to Fc.12000 p.a. There are a number of organisational deficiencies which do not create checks and balances for appropriate utilization of fund. Moreover, the division of these funds among social groups and for different purposes is also questionable. Though, female literacy lags significantly behind male literacy, about 15% points, extra resources provided for female education are insignificant. And in some schemes such as the one run for 'street children' and 'child labourers', large amounts are budgeted year after year without a single French congolese being spent. Also government schools catering to richer regions of Kinshasa seem to be spending more per child as compared to the poorer counterparts. The paper also proposes an education voucher model, which may have the potential to address some of the issues raised in the paper. Trends in expenditure under some schemes have been studied in relation to the purpose of expenditure. The issue of government expenditure on education is a complex one, and public space should be utilized to discuss them as they are, rather than reducing discussion to dogmatic wars

  13. Interventions to control virus transmission during an outbreak of Ebola hemorrhagic fever: experience from Kikwit, Democratic Republic of the Congo, 1995.

    PubMed

    Kerstiëns, B; Matthys, F

    1999-02-01

    On 6 May 1995, the Médecins sans Frontières (MSF) coordinator in Kinshasa, Democratic Republic of the Congo (DRC), received a request for assistance for what was believed to be a concurrent outbreak of bacillary dysentery and viral hemorrhagic fever (suspected Ebola hemorrhagic fever [EHF]) in the town of Kikwit, DRC. On 11 May, the MSF intervention team assessed Kikwit General Hospital. This initial assessment revealed a nonfunctional isolation ward for suspected EHF cases; a lack of water and electricity; no waste disposal system; and no protective gear for medical staff. The priorities set by MSF were to establish a functional isolation ward to deal with EHF and to distribute protective supplies to individuals who were involved with patient care. Before the intervention, 67 health workers contracted EHF; after the initiation of control measures, just 3 cases were reported among health staff and none among Red Cross volunteers involved in body burial. PMID:9988193

  14. AIDS, sex and condoms: African healers and the reinvention of tradition in Zaire.

    PubMed

    Schoepf, B G

    1992-05-01

    Condoms offer considerable protection against sexual transmission of AIDS. Yet many Africans who are at risk of infection reject condoms as "unnatural." Data from Zaire have been used to examine this culturally constructed category in relation to sexuality, procreation, gender roles, class formation and international health and development policy. Much more than a simple transfer of biomedical technology is involved. Condom use with regular partners raises issues of cultural politics at many levels. "Traditional" African healers represent important social networks with considerable authority in poor urban communities. They are able to reinterpret cultural categories and endow behavior with new meanings. Action-research in Kinshasa was used to explore roles that healers might play in promoting change to safer sex practices. PMID:1297899

  15. Barriers to Provider-Delivered Sexual Behavior Counseling for Youth Living with HIV/AIDS in the 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

    Aims The study aimed to understand providers’ role in delivering HIV transmission prevention counseling to youth living with HIV (YLWH). Methods We conducted 14 in-depth interviews with providers in Kinshasa, DRC. Results Providers’ lack of knowledge and comfort in talking to youth about sex because of cultural and religious beliefs about sexuality, coupled with confusion about legal issues related to youth and contraception, made it difficult for them to effectively counsel youth. Implications for practice and policy In order for providers to deliver effective prevention counseling to YLWH, clinics should follow adolescent-friendly clinic standards, provide counseling in an adolescent-friendly style, and institute an effective referral system for additional prevention services. Conclusion HIV prevention services can be improved through the creation of an adolescent-friendly environment and by providing “values clarification” and skill-based trainings so that providers are able to assess the role of their own beliefs and learn new skills. PMID:24409092

  16. Chordodes ferox, a new record of horsehair worms (Nematomorpha, Gordiida) from South Africa

    PubMed Central

    Schmidt-Rhaesa, Andreas; Perissinotto, Renzo

    2016-01-01

    Abstract Three females and one male specimen of a previously unconfirmed species of horsehair worms (Nematomorpha) from South Africa are described using Scanning Electron Microscopy. The females correspond to the description of Chordodes ferox Camerano, 1897, a species previously described from the Democratic Republic of the Congo (Congo-Kinshasa) and an adjacent, not further specified region of the Republic of Congo (Congo-Brazzaville). Characteristic is the presence of enlarged and elevated simple areoles around the base of a thorn areole, in combination with further cuticular characters. This is the latest of a total of six species of horsehair worms reported from South Africa so far. Two species of praying mantids, Polyspilota aeruginosa (Goeze, 1778) and Sphodromantis gastrica Stål, 1858, have been identified as hosts of Chordodes ferox, while its distribution range in the region and the period of adult emergence from the host remain largely unknown. PMID:27047243

  17. The therapist and the source of healing among the Yaka of Zaire.

    PubMed

    Devisch, R

    1990-06-01

    The Yaka of southwestern Zaire and the capital, Kinshasa, practise some ten major healing cults with initiatory treatments. These follow the model of rites de passage and lead the patient to resituate him/herself in the group, while partially redramatizing the cosmology and the fundamental values of the society. The body-self is the source and scene of the healing. The therapeutic drama offers a space-time stage upon which metaphoric correspondents of organs, affects, energies and bodily functions are constituted and manipulated. Acting as the patient's maternal uncle, as trapper-hunter, and as demiurge and weaver, the healer aims at fighting the illness by turning it back against itself autodestructively. The initiate is 'reborn' thanks to the emergence of the vital flow, particularly through trance, leading her or him to take up a transformed presence in the world and the group: this is "the weaving of the vital flow." PMID:1698134

  18. Terms Used for People Living With HIV in the Democratic Republic of the Congo

    PubMed Central

    Mupenda, Bavon; Duvall, Sandra; Maman, Suzanne; Pettifor, Audrey; Holub, Christina; Taylor, Eboni; Rennie, Stuart; Kashosi, Mujalambo; Lema, Mamie; Behets, Frieda

    2015-01-01

    For this study we conducted in-depth interviews with 29 youth living with HIV (YLWH) and key informant interviews with 8 HIV care/support providers. We describe terms used to portray people living with HIV (PLWH) in Kinshasa, Democratic Republic of the Congo. Labels commonly used, mostly derogatory, described PLWH as walking corpses, dangers to others, or people deserving to die before others get infected. Blame and other accusations were directed at PLWH through anchoring or objectification. Being labeled sometimes made these youth suffer in silence, afraid to disclose their status, or avoid performing actions in public, preferring to let others do them. YLWH need psychosocial support to mitigate the harmful effects of these labels and strengthen their coping skills, whereas community, institutional, and national efforts are needed for stigma reduction. PMID:24463633

  19. The Finnish forward surgical team: lessons from the European Union Forces Operation République Démocratique du Congo.

    PubMed

    Lauri, Handolin; Olli, Kiviluoto

    2008-05-01

    The European Union Forces Operation République Démocratique du Congo in the Democratic Republic of the Congo in 2006 was the first operation planned and conducted solely by the European Union Forces. The Finnish forward surgical team (FST) was deployed for 4 months in Kinshasa, the capital of the Democratic Republic of the Congo. Because of the peacekeeping nature of the operation, the surgical workload was light and the total number of patients treated by the FST was 12. However, there is an obvious need to establish similar surgical assets in future operations. The lessons and experiences regarding the variables in the composition of the FST (mobility, surgical ability, staffing, patient care, physical stability, environmental adaptation, and independence) are discussed in the present article. The major future challenges are to resource the FST units optimally to remain light and easily deployable and to maintain the effectiveness of the unit during nonclinical periods. PMID:18543567

  20. Engaging with research ethics in central Francophone Africa: reflections on a workshop about ancillary care

    PubMed Central

    2012-01-01

    Research ethics is predominantly taught and practiced in Anglophone countries, particularly those in North America and Western Europe. Initiatives to build research ethics capacity in developing countries must attempt to avoid imposing foreign frameworks and engage with ethical issues in research that are locally relevant. This article describes the process and outcomes of a capacity-building workshop that took place in Kinshasa, Democratic Republic of Congo in the summer of 2011. Although the workshop focused on a specific ethical theme – the responsibilities of researchers to provide health-related care to their research participants – we argue that the structure of the workshop offers a useful method for engaging with research ethics in general, and the theme of ancillary care encourages a broad perspective on research ethics that is highly pertinent in low-income countries. The workshop follows an interactive, locally driven model that could be fruitfully replicated in similar settings. PMID:22866822

  1. Childhood Tuberculosis in a Sub-Saharan Tertiary Facility: Epidemiology and Factors Associated with Treatment Outcome

    PubMed Central

    Kinsiona, Christian; Fueza, Serge Bisuta; Kokolomami, Jack; Bolie, Grace; Lumbala, Paul

    2016-01-01

    Childhood tuberculosis (TB) is a diagnostic challenge in developing countries, and patient outcome can be influenced by certain factors. We report the disease course, clinical profile and factors associated with treatment outcome in a tertiary facility of Kinshasa. Documentary and analytical studies were conducted using clinical and exploratory data for children aged up to 15 years who were admitted to the University Clinics of Kinshasa for TB. Data are presented as frequencies and averages, and binary and logistic regression analyses were performed. Of 283 children with TB, 82 (29.0%) had smear-negative TB, 40 (14.1%) had smear-positive TB, 159 (56.1%) had extra-pulmonary TB (EPTB), 2 (0.7%) had multidrug-resistant TB (MDR-TB), 167 (59.0%) completed treatment, 30 (10.6%) were cured, 7 (2.5%) failed treatment, 4 (1.4%) died, 55 (19.4%) were transferred to health centers nearest their home, and 20 (7.0%) were defaulters. In the binary analysis, reported TB contacts (p = 0.048), type of TB (p = 0.000), HIV status (p = 0.050), Ziehl-Nielsen test result (p = 0.000), Lowenstein culture (p = 0.004) and chest X-ray (p = 0.057) were associated with outcome. In the logistic regression, none of these factors was a significant predictor of outcome. Tertiary level care facilities must improve the diagnosis and care of patients with childhood TB, which justifies the development of alternative diagnostic techniques and the assessment of other factors that potentially affect outcome. PMID:27101146

  2. Childhood Tuberculosis in a Sub-Saharan Tertiary Facility: Epidemiology and Factors Associated with Treatment Outcome.

    PubMed

    Aketi, Loukia; Kashongwe, Zacharie; Kinsiona, Christian; Fueza, Serge Bisuta; Kokolomami, Jack; Bolie, Grace; Lumbala, Paul; Diayisu, Joseph Shiku

    2016-01-01

    Childhood tuberculosis (TB) is a diagnostic challenge in developing countries, and patient outcome can be influenced by certain factors. We report the disease course, clinical profile and factors associated with treatment outcome in a tertiary facility of Kinshasa. Documentary and analytical studies were conducted using clinical and exploratory data for children aged up to 15 years who were admitted to the University Clinics of Kinshasa for TB. Data are presented as frequencies and averages, and binary and logistic regression analyses were performed. Of 283 children with TB, 82 (29.0%) had smear-negative TB, 40 (14.1%) had smear-positive TB, 159 (56.1%) had extra-pulmonary TB (EPTB), 2 (0.7%) had multidrug-resistant TB (MDR-TB), 167 (59.0%) completed treatment, 30 (10.6%) were cured, 7 (2.5%) failed treatment, 4 (1.4%) died, 55 (19.4%) were transferred to health centers nearest their home, and 20 (7.0%) were defaulters. In the binary analysis, reported TB contacts (p = 0.048), type of TB (p = 0.000), HIV status (p = 0.050), Ziehl-Nielsen test result (p = 0.000), Lowenstein culture (p = 0.004) and chest X-ray (p = 0.057) were associated with outcome. In the logistic regression, none of these factors was a significant predictor of outcome. Tertiary level care facilities must improve the diagnosis and care of patients with childhood TB, which justifies the development of alternative diagnostic techniques and the assessment of other factors that potentially affect outcome. PMID:27101146

  3. Geographical factors affecting bed net ownership, a tool for the elimination of Anopheles-transmitted lymphatic filariasis in hard-to-reach communities.

    PubMed

    Stanton, Michelle C; Bockarie, Moses J; Kelly-Hope, Louise A

    2013-01-01

    Vector control, including the use of bed nets, is recommended as a possible strategy for eliminating lymphatic filariasis (LF) in post-conflict countries such as the Democratic Republic of Congo (DRC). This study examined the geographical factors that influence bed net ownership in DRC in order to identify hard-to-reach communities that need to be better targeted. In particular, urban/rural differences and the influence of population density, proximity to cities and health facilities, plus access to major transport networks were investigated. Demographic and Health Survey geo-referenced cluster level data were used to map bed net coverage (proportion of households with at least one of any type of bed net or at least one insecticide-treated net (ITN)), and ITN density (ITNs per person) for 260 clusters. Bivariate and multiple logistic or Poisson regression analyses were used to determine significant relationships. Overall, bed net (30%) and ITN (9%) coverage were very low with significant differences found between urban and rural clusters. In rural clusters, ITN coverage/density was positively correlated with population density (r = 0.25, 0.27 respectively, p<0.01), and negatively with the distance to the two largest cities, Kinshasa or Lubumbashi (r = -0.28, -0.30 respectively, p<0.0001). Further, ownership was significantly negatively correlated with distance to primary national roads and railways (all three measures), distance to main rivers (any bed net only) and distance to the nearest health facility (ITNs only). Logistic and Poisson regression models fitted to the rural cluster data indicated that, after controlling for measured covariates, ownership levels in the Bas-Congo province close to Kinshasa were much larger than that of other provinces. This was most noticeable when considering ITN coverage (odds ratio: 5.3, 95% CI: 3.67-7.70). This analysis provides key insights into the barriers of bed net ownership, which will help inform both LF and

  4. Classification of very high resolution satellite remote sensing data in a pilot phase of the forest cover classification of the Democratic Republic of Congo, Forêts d'Afrique Central Evaluées par Télédetection (FACET) product

    NASA Astrophysics Data System (ADS)

    Singa Monga Lowengo, C.

    2012-12-01

    The Observatoire Satellital des Forêts d'Afrique Centrale (OSFAC) based in Kinshasa, serves as the focal point of the GOFC-GOLD network for Central Africa. OSFAC's long term objective is building regional capacity to use remotely sensed data to map forest cover and forest cover change across Central Africa. OSFAC archives and disseminates satellite data, offers training in geospatial data applications in coordination with the University of Kinshasa, and provides technical support to CARPE partners. Forêts d'Afrique Centrale Évaluées par Télédétection (FACET) is an OSFAC initiative that implements the UMD/SDSU methodology at the national level and quantitatively evaluates the spatiotemporal dynamics of forest cover in Central Africa. The multi-temporal series of FACET data is a useful contribution to many projects, such as biodiversity monitoring, climate modeling, conservation, natural resource management, land use planning, agriculture and REDD+. I am working as Remote Sensing and GIS Officer in various projects of OSFAC. My activities include forest cover and lands dynamics monitoring in Congo Basin. I am familiar with the use of digital mapping software, GIS and RS (Arc GIS, ENVI and PCI Geomatica etc.), classification and spatial Analysis of satellite images, 3D modeling, etc. I started as an intern at OSFAC, Assistant Trainer (Professional Training) and Consultant than permanent employee since October 2009. To assist in the OSFAC activities regarding the monitoring of forest cover and the CARPE program in the context of natural resources management, I participated in the development of the FACET Atlas (Republic of Congo). I received data from Matt Hansen (map.img), WRI and Brazzaville (shapefiles). With all these data I draw maps of the ROC Atlas and statistics of forest cover and forest loss. We organize field work on land to collect data to validate the FACET product. Therefore, to assess forest cover in the region of Kwamouth and Kahuzi-Maiko Biega

  5. Geographical Factors Affecting Bed Net Ownership, a Tool for the Elimination of Anopheles-Transmitted Lymphatic Filariasis in Hard-to-Reach Communities

    PubMed Central

    Stanton, Michelle C.; Bockarie, Moses J.; Kelly-Hope, Louise A.

    2013-01-01

    Vector control, including the use of bed nets, is recommended as a possible strategy for eliminating lymphatic filariasis (LF) in post-conflict countries such as the Democratic Republic of Congo (DRC). This study examined the geographical factors that influence bed net ownership in DRC in order to identify hard-to-reach communities that need to be better targeted. In particular, urban/rural differences and the influence of population density, proximity to cities and health facilities, plus access to major transport networks were investigated. Demographic and Health Survey geo-referenced cluster level data were used to map bed net coverage (proportion of households with at least one of any type of bed net or at least one insecticide-treated net (ITN)), and ITN density (ITNs per person) for 260 clusters. Bivariate and multiple logistic or Poisson regression analyses were used to determine significant relationships. Overall, bed net (30%) and ITN (9%) coverage were very low with significant differences found between urban and rural clusters. In rural clusters, ITN coverage/density was positively correlated with population density (r = 0.25, 0.27 respectively, p<0.01), and negatively with the distance to the two largest cities, Kinshasa or Lubumbashi (r = −0.28, −0.30 respectively, p<0.0001). Further, ownership was significantly negatively correlated with distance to primary national roads and railways (all three measures), distance to main rivers (any bed net only) and distance to the nearest health facility (ITNs only). Logistic and Poisson regression models fitted to the rural cluster data indicated that, after controlling for measured covariates, ownership levels in the Bas-Congo province close to Kinshasa were much larger than that of other provinces. This was most noticeable when considering ITN coverage (odds ratio: 5.3, 95% CI: 3.67–7.70). This analysis provides key insights into the barriers of bed net ownership, which will help inform both LF

  6. Opportunities for Hydrologic Research in the Congo Basin

    NASA Astrophysics Data System (ADS)

    Alsdorf, D. E.; Beighley, E., II; Lee, H.; Tshimanga, R.; Spencer, R. G.; O'Loughlin, F.

    2014-12-01

    We review the published results on the Congo Basin hydrology and find that there are historic data, ongoing measurement recording efforts, and important model results. Annual rainfall is ~2000 mm/yr along an east-west trend, decreasing northward and southward to ~1100 mm/yr. While some studies show rain gauges at specific locations with declines in P greater than 10% from 1960 to 1990, other studies suggest that basin wide decreases from 1951 to 1993 are modest at 4.5% or that the trend is minimal. Studies during the 1950s using lysimeters, pans, and models suggest that the annual potential ET varies little across the basin at a 1100 mm/yr to 1200 mm/yr. Over the past century, river discharge data has been collected at 100s of stream gauges with historic and recent data at 96 locations now publicly available. Discharge of the Congo River at Kinshasa-Brazzaville experienced an increase of 21% during 1960-1970 in comparison to background values of the previous decades and of today. There does not appear to be a long-term discharge trend over the century of record. Satellite altimetry measurements collected during high and low flows show that the Cuvette Centrale wetland water levels are consistently 0.5m to 3m higher in elevation than the immediately adjacent Congo River levels. Wetland water depths are shallow at about 1m whereas the Congo is typically less than 15m deep everywhere upstream of Kinshasa. The wetlands do not appear to be marked by sizable channels such that the flows are diffusive. CO2 and CH4 evasion from the Congo waters directly to the atmosphere are estimated at 1.6 to 3.2 Tg/yr for CH4 from the Cuvette wetland waters and 105 to 204 g C/m2/yr for CO2 from waters of the Oubangui River. Using these published results, we suggest seven hypotheses that may lead to important water and carbon cycle discoveries. These hypotheses focus on the source of the Cuvette waters and how those waters leave the wetland; on river discharge generated by historic

  7. [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. PMID:14582296

  8. NASA LCLUC Program: An Integrated Forest Monitoring System for Central Africa

    NASA Technical Reports Server (NTRS)

    Laporte, Nadine; LeMoigne, Jacqueline; Elkan, Paul; Desmet, Olivier; Paget, Dominique; Pumptre, Andrew; Gouala, Patrice; Honzack, Miro; Maisels, Fiona

    2004-01-01

    Central Africa has the second largest unfragmented block of tropical rain forest in the world; it is also one of the largest carbon and biodiversity reservoirs. With nearly one-third of the forest currently allocated for logging, the region is poised to undergo extensive land-use change. Through the mapping of the forests, our Integrated Forest Monitoring System for Central Africa (INFORMS) project aims to monitor habitat alteration, support biodiversity conservation, and promote better land-use planning and forest management. Designed as an interdisciplinary project, its goal is to integrate data acquired from satellites with field observations from forest inventories, wildlife surveys, and socio-economic studies to map and monitor forest resources. This project also emphasizes on collaboration and coordination with international, regional, national, and local partners-including non-profit, governmental, and commercial sectors. This project has been focused on developing remote sensing products for the needs of forest conservation and management, insuring that research findings are incorporated in forest management plans at the national level. The societal impact of INFORMS can be also appreciated through the development of a regional remote sensing network in central Africa. With a regional office in Kinshasa, (www.OSFAC.org), the contribution to the development of forest management plans for 1.5 million hectares of forests in northern Republic of Congo (www.tt-timber.com), and the monitoring of park encroachments in the Albertine region (Uganda and DRC) (www.albertinerift.org).

  9. 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.

  10. 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

  11. Telling Children They Have HIV: Lessons Learned from Findings of a Qualitative Study in Sub-Saharan Africa

    PubMed Central

    Eng, Eugenia; Maman, Suzanne; Tshikandu, Tomi; Behets, Frieda

    2010-01-01

    Abstract HIV-infected children in developing countries are living longer lives as they gain access to antiretroviral treatment programs. As they grow older, their parents/guardians are faced with the difficult decision of if, when, and how to inform their child of his/her HIV status. Both negative and positive social, psychological, and behavioral impacts of disclosure to children have been reported, including improved adherence to medication regimens. Understanding the disclosure process from the perspective of HIV positive children, therefore, is critical to developing these interventions. Through children's experiences we can learn about what works well, what needs to be strengthened, and what is missing in current disclosure practices. We conducted in-depth interviews with eight caregiver–child dyads in Kinshasa, Democratic Republic of the Congo. The children were in a comprehensive HIV pediatric care and treatment program and had already been told their HIV diagnosis. For the analysis we placed particular emphasis on children's reports of communication with their caregivers and health care providers about their illness. Patterns emerged of limited communication between children and their caregivers as well as their providers, before, during, and after disclosure. From the perspective of children in this study, disclosure was largely a discrete event rather than a process. Sociocultural contexts surrounding HIV/AIDS, as well as health status, variations in parent–child communication and the relationships between health providers and children under their care, should inform psychosocial interventions delivered alongside treatment programs. PMID:20397899

  12. Review of the genera Anelaphinis Kolbe, 1892 and Atrichelaphinis Kraatz, 1898 (Coleoptera, Scarabaeidae, Cetoniinae)

    PubMed Central

    Rojkoff, Sébastien; Perissinotto, Renzo

    2015-01-01

    Abstract New material collected recently throughout the Afrotropical region has led to a major reassessment of taxa within the genera Anelaphinis Kolbe, 1892, Atrichelaphinis Kraatz, 1898 and other closely related genera. As a result, the name Megalleucosma Antoine, 1989 is here synonymised with Anelaphinis and a lectotype is designated for the type species, Cetonia dominula Harold, 1879. The genus Atrichelaphinis is redefined and a new subgenus, Atrichelaphinis (Eugeaphinis), is proposed for Elaphinis simillima Ancey, 1883, Elaphinis vermiculata Fairmaire, 1894, Niphetophora rhodesiana Péringuey, 1907, Atrichelaphinis deplanata Moser, 1907 (with Anelaphinis kwangensis Burgeon, 1931 as junior synonym) and Anelaphinis sternalis Moser, 1914. Additionally, three new species and one new subspecies are recognised and described in this new subgenus: Atrichelaphinis (Eugeaphinis) bomboesbergica sp. n. from South Africa; Atrichelaphinis (Eugeaphinis) bjornstadi sp. n. from Tanzania; Atrichelaphinis (Eugeaphinis) garnieri sp. n. from south–east Africa (Tanzania, Zimbabwe); and Atrichelaphinis (Eugeaphinis) deplanata minettii ssp. n. from central Africa (Malawi, Mozambique, Congo-Kinshasa, Congo-Brazzaville, South Africa, Rwanda, Zambia, Zimbabwe). The genus Atrichelaphinis is compared to its closest relatives and two separate keys are proposed, one for Atrichelaphinis and one for the sub-Saharan genera exhibiting completely or partially fused parameres. PMID:25709532

  13. 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. PMID:26974234

  14. Development, validation and comparison of NIR and Raman methods for the identification and assay of poor-quality oral quinine drops.

    PubMed

    Mbinze, J K; Sacré, P-Y; Yemoa, A; Mavar Tayey Mbay, J; Habyalimana, V; Kalenda, N; Hubert, Ph; Marini, R D; Ziemons, E

    2015-01-01

    Poor quality antimalarial drugs are one of the public's major health problems in Africa. The depth of this problem may be explained in part by the lack of effective enforcement and the lack of efficient local drug analysis laboratories. To tackle part of this issue, two spectroscopic methods with the ability to detect and to quantify quinine dihydrochloride in children's oral drops formulations were developed and validated. Raman and near infrared (NIR) spectroscopy were selected for the drug analysis due to their low cost, non-destructive and rapid characteristics. Both of the methods developed were successfully validated using the total error approach in the range of 50-150% of the target concentration (20%W/V) within the 10% acceptance limits. Samples collected on the Congolese pharmaceutical market were analyzed by both techniques to detect potentially substandard drugs. After a comparison of the analytical performance of both methods, it has been decided to implement the method based on NIR spectroscopy to perform the routine analysis of quinine oral drop samples in the Quality Control Laboratory of Drugs at the University of Kinshasa (DRC). PMID:25828509

  15. Role of Mediterranean diet, tropical vegetables rich in antioxidants, and sunlight exposure in blindness, cataract and glaucoma among African type 2 diabetics

    PubMed Central

    Moïse, Mvitu Muaka; Benjamin, Longo-Mbenza; Doris, Tulomba Mona; Dalida, Kibokela Ndembe; Augustin, Nge Okwe

    2012-01-01

    AIM To assess whether regular Mediterranean diet and regular intake of vegetables may reduce the risk of blindness, cataract, and glaucoma in these type 2 diabetics. METHODS A cross-sectional design was carried out among known black diabetics admitted at the diabetic clinics of Kinshasa, between October 2008 and March 2009. The Mediterranean-style dietary score (MSDPS) was used to characterize a Mediterranean-style dietary pattern in the study population using the Harvard semi quantitative FFQ adapted for Africa. RESULTS Five hundred Type 2 diabetic patients were included in this study (48% of males; 40% aged ≥60 years). There was a significant association between blindness, cataract and aging; between blindness (P<0.05), cataract (P<0.05), glaucoma (P<0.05), and physical inactivity; between blindness (P<0.05), cataract (P<0.0001), glaucoma (P<0.01) and high SES, and a very significant association between blindness (P<0.0001), cataract (P<0.0001), glaucoma (P<0.0001) and exposure to sunlight. There was also a significant association between blindness, glaucoma, and male sex. Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, Musa acuminata reduced significantly the risk of blindness, cataract and glaucoma. CONCLUSION Regular intake of Mediterranean diet, Brassica Rapa, beans, Abelmoschus, and Musa acuminata may significantly reduce the risk of blindness or its major causes among type 2 diabetes mellitus in Africa. PMID:22762057

  16. Spatial reference in a bonobo gesture.

    PubMed

    Genty, Emilie; Zuberbühler, Klaus

    2014-07-21

    Great apes frequently produce gestures during social interactions to communicate in flexible, goal-directed ways [1-3], a feature with considerable relevance for the ongoing debate over the evolutionary origins of human language [1, 4]. But despite this shared feature with language, there has been a lack of evidence for semantic content in ape gestures. According to one authoritative view, ape gestures thus do not have any specific referential, iconic, or deictic content, a fundamental difference versus human gestures and spoken language [1, 5] that suggests these features have a more recent origin in human evolution, perhaps caused by a fundamental transition from ape-like individual intentionality to human-like shared intentionality [6]. Here, we revisit this human uniqueness claim with a study of a previously undescribed human-like beckoning gesture in bonobos that has potentially both deictic and iconic character. We analyzed beckoning in two groups of bonobos, kept under near natural environmental and social conditions at the Lola Ya Bonobo sanctuary near Kinshasa, Democratic Republic of Congo, in terms of its linguistic content and underlying communicative intention. PMID:24998531

  17. Human African Trypanosomiasis in a Rural Community, Democratic Republic of Congo

    PubMed Central

    Lutumba, Pascal; Makieya, Eric; Shaw, Alexandra; Meheus, Filip

    2007-01-01

    According to the World Health Organization, human African trypanosomiasis (HAT) (sleeping sickness) caused the loss of ≈1.5 million disability-adjusted life years (DALYs) in 2002. We describe the effect of HAT during 2000–2002 in Buma, a rural community near Kinshasa in the Democratic Republic of Congo. We used retrospective questionnaire surveys to estimate HAT-related household costs and DALYs. The HAT outbreak in Buma involved 57 patients and affected 47 (21%) households. The cost to each household was equivalent to 5 months’ income for that household. The total number of HAT-related DALYs was 2,145, and interventions to control HAT averted 1,408 DALYs. The cost per DALY averted was US $17. Because HAT has a serious economic effect on households and control interventions are cost-effective, considering only global burden of disease rankings for resource allocation could lead to misguided priority setting if applied without caution in HAT-affected countries. PMID:17479887

  18. Intake of Gnetum Africanum and Dacryodes Edulis, Imbalance of Oxidant/Antioxidant Status and Prevalence of Diabetic Retinopathy in Central Africans

    PubMed Central

    Moise, Mvitu-Muaka; Benjamin, Longo-Mbenza; Etienne, Mokondjimobe; Thierry, Gombet; Ndembe Dalida, Kibokela; Doris, Tulomba Mona; Samy, Wayiza Masamba

    2012-01-01

    Objective To estimate the prevalence of DR and to correlate cardiometabolic, sociodemographic, and oxidant/antioxidant imbalance data to the prevalence of DR. Design This case-control study included type 2 DM (T2 DM) patients with DR (n = 66), T2 DM patients without DR (N = 84), and healthy controls (n = 45) without DR, in Kinshasa town. Diet, albuminemia, serum vitamins, and 8-isoprostane were examined. Results No intake of safou (OR = 2.7 95% CI 1.2–5.8; P = 0.014), low serum albumin <4.5 g/dL (OR-2.9 95% CI 1.4–5.9; P = 0.003), no intake of fumbwa (OR = 2.8 95% CI 1.2–6.5; P = 0.014), high 8-isoprostane (OR = 14.3 95% CI 4.5–46; P<0.0001), DM duration ≥5 years (OR = 3.8 95% CI 1.6–9.1; P = 0.003), and low serum vitamin C (OR = 4.5 95% CI 1.3–15.5; P = 0.016) were identified as the significant independent determinants of DR. Conclusion The important role of oxidant/antioxidant status imbalance and diet is demonstrated in DR. PMID:23226496

  19. 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

  20. [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. PMID:16402584

  1. Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings.

    PubMed

    Van Rie, A; Fitzgerald, D; Kabuya, G; Van Deun, A; Tabala, M; Jarret, N; Behets, F; Bahati, E

    2008-03-01

    Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories. PMID:18174302

  2. [Not Available].

    PubMed

    Kibadi, K; Moutet, F

    2015-03-31

    Burn injuries to the hand are still common in low-income countries. Between December 1st 2010 and May 1st 2014, 32 patients, representing 38 hands, were admitted and treated at the University Clinics of Kinshasa in the Democratic Republic of Congo (DRC). We observed 22 patients (69%) in the juvenile age group (under 18 years old) and 10 patients (31%) in the adult age group (18-59 years). We did not observe any patients in the senior age group (60 years and over). In the juvenile age group, those aged from 1 to 5 years old were the most affected, comprising 13 patients (40%). Accidents occurred mainly at home (72%). The most common burn etiologies were thermal injuries caused by flame (51%) and scalds (34%). Contractures were the most frequently occurring lesions (84%). Overall dorsal retraction, known as "claw hand", was found in 40% of patients, and was associated with keloid and hypertrophic scars in 84% of cases. Excision and grafting were performed in 43.7%, local flaps in 43.7% and distant flaps in 12.5% of cases. On discharge from hospital, 84% "good" results were observed. Follow-up lasted 18 months. This study demonstrates the feasibility of reconstructive surgery in sequelae of hand burns, despite limited resources. However, the challenges in low income countries with limited resources are numerous: poor access to current techniques of plastic surgery, inadequate initial burns management, and poverty. PMID:26668560

  3. HIV-1 subtype B: Traces of a pandemic.

    PubMed

    Junqueira, Dennis Maletich; Almeida, Sabrina Esteves de Matos

    2016-08-01

    Human migration is a major process that shaped the origin and dissemination of HIV. Within HIV-1, subtype B (HIV-1B) is the most disseminated variant and it is assumed to be the causative agent in approximately 11% of all cases of HIV worldwide. Phylogenetic studies have revealed that HIV-1B emerged in Kinshasa (Africa) and was introduced into the Caribbean region via Haiti in or around 1966 by human migration. After localized dispersion, the virus was brought to the United States of America via homosexual/bisexual contact around 1969. Inside USA, the incidence of HIV-1B infection increased exponentially and it became established in the population, affecting not only homosexual individuals but also heterosexual individuals and injecting drug users. Soon after, the virus was disseminated and became established in other regions, including Europe, Asia, Latin America, and Australia. Recent studies suggest that, in addition to this pandemic clade, several lineages have emerged from Haiti and reached other Caribbean and Latin American countries via short-distance dissemination. Different subtype B genetic variants have also been detected in these epidemics. Four genetic variants have been described to date: subtype B', which mainly circulates in Thailand and other Asian countries; a specific variant mainly found in Trinidad and Tobago; the GPGS variant, which is primarily detected in Korea; and the GWGR variant, which is mainly detected in Brazil. This paper reviews the evolution of HIV-1B and its impact on the human population. PMID:27228177

  4. Development and deployment of a Desktop and Mobile application on grid for GPS studie

    NASA Astrophysics Data System (ADS)

    Ntumba, Patient; Lotoy, Vianney; Djungu, Saint Jean; Fleury, Rolland; Petitdidier, Monique; Gemünd, André; Schwichtenberg, Horst

    2013-04-01

    GPS networks for scientific studies are developed all other the world and large databases, regularly updated, like IGS are also available. Many GPS have been installed in West and Central Africa during AMMA (African Monsoon Multiplidisciplinary Analysis), IHY (International heliophysical Year)and many other projects since 2005. African scientists have been educated to use those data especially for meteorological and ionospheric studies. The annual variations of ionospheric parameters for a given station or map of a given region are very intensive computing. Then grid or cloud computing may be a solution to obtain results in a relatively short time. Real time At the University of Kinshasa the chosen solution is a grid of several PCs. It has been deployed by using Globus Toolkit on a Condor pool in order to support the processing of GPS data for ionospheric studies. To be user-friendly, graphical user interfaces(GUI) have been developed to help the user to prepare and submit jobs. One is a java GUI for desktop client, the other is an Android GUI for mobile client. The interest of a grid is the possibility to send a bunch of jobs with an adequate agent control in order to survey the job execution and result storage. After the feasibility study the grid will be extended to a larger number of PCs. Other solutions will be in parallel explored.

  5. Enhanced Heterosexual Transmission Hypothesis for the Origin of Pandemic HIV-1

    PubMed Central

    de Sousa, João Dinis; Alvarez, Carolina; Vandamme, Anne-Mieke; Müller, Viktor

    2012-01-01

    HIV-1 M originated from SIVcpz endemic in chimpanzees from southeast Cameroon or neighboring areas, and it started to spread in the early 20th century. Here we examine the factors that may have contributed to simian-to-human transmission, local transmission between humans, and export to a city. The region had intense ape hunting, social disruption, commercial sex work, STDs, and traffic to/from Kinshasa in the period 1899–1923. Injection treatments increased sharply around 1930; however, their frequency among local patients was far lower than among modern groups experiencing parenteral HIV-1 outbreaks. Recent molecular datings of HIV-1 M fit better the period of maximal resource exploitation and trade links than the period of high injection intensity. We conclude that although local parenteral outbreaks might have occurred, these are unlikely to have caused massive transmission. World War I led to additional, and hitherto unrecognized, risks of HIV-1 emergence. We propose an Enhanced Heterosexual Transmission Hypothesis for the origin of HIV-1 M, featuring at the time and place of its origin a coincidence of favorable co-factors (ape hunting, social disruption, STDs, and mobility) for both cross-species transmission and heterosexual spread. Our hypothesis does not exclude a role for parenteral transmission in the initial viral adaptation. PMID:23202448

  6. Mayombian ethnic, vegetables low intake, insulin treatment, diabetic nephropathy and severe diabetic retinopathy are determinants of blindness in diabetic Africans

    PubMed Central

    Moise, Mvitu Muaka; Benjamin, Longo-Mbenza; Enoch, Cibanda Yokobo; Igor, Longo Phemba

    2013-01-01

    AIM To determine the frequency and causes of blindness in diabetic Africans. METHODS The study was a cross-sectional survey carried out among known black diabetics consecutively admitted at the Teaching Hospital, University of Kinshasa, between 2005 and 2007. Examination methods included interviewer-administered structured questionnaire, eye examinations (visual acuity, tonometry, funduscopy), and fasting plasma glycaemia test. RESULTS Of the 227 patients examined, 15.9% had blindness. Univariate analyses showed significant association between female, severity of diabetic retinopathy, Mayombian ethnic group, use of insulin treatment, low intake of vegetables, diabetic nephropathy, open angle glaucoma and blindness in all diabetics. After logistic regression, only diabetic nephropathy, use of insulin treatment, macular oedema, Mayombian ethnic group and vegetables low intake were the independent risk factors of blindness in all diabetics. However, after logistic regression in the sub-group with diabetic retinopathy, only open angle glaucoma and proliferative diabetic retinopathy were the independent determinants of blindness. CONCLUSION The majority of the causes of blindness in these diabetic Africans are avoidable. It is recommended that appropriate diabetes care, nutrition education, periodic eye examination and laser photocoagulation facilities should be provided for treating diabetics in sub-Saharan Africa. PMID:24195057

  7. La formation de l'inkisi (Supergroupe ouest-congolien) en Afrique centrale (Congo et Bas-Zaïre): un delta d'âge Paléozoïque comblant un bassin en extension

    NASA Astrophysics Data System (ADS)

    Alvarez, Philippe; Maurin, Jean-Christophe; Vicat, Jean-Paul

    1995-02-01

    The Inkisi Formation (West Congolian Supergroup) corresponds to a large deltaic body, which extends through Congo, Lower Zaire and Angola. In the Congo and Lower Zaire areas, the lower part of this formation is characterized by a fluvial conglomerate with elliptic pebbles. The red arkosic, channelized series from the Brazzaville-Kinshasa area involves delta plain distributary channels and delta front sequences. The transport direction of continental material is from north to south and the source area is the Chaillu basement. Glacial quartzitic pebbles are probably reworked from the fluvio-lacustrine Upper Diamictite Formation. The classical subdivisions of the Inkisi Formation - basal conglomerate (I 0), Lower part (I 1) and Upper part (I 2) - are not used. These subdivisions correspond to a fluvial conglomerate and to delta front and delta plain facies. The coastal onlap progressively covered the conglomerate and the distributary channels in the delta plain was prograding onto the delta front. The prodelta sequence could correspond to the Upper level of the Mpioka molassic Formation. The Inkisi delta was on the northern edge of an extensional basin controlled by NE-SW normal faults. The extension phase is dearly post Pan-African and occurred during the Palaeozoic, probably in relation to the Permian Karoo phase, and is also known in Angola.

  8. Recombinant Viruses and Early Global HIV-1 Epidemic

    PubMed Central

    Robbins, Kenneth E.; Pieniazek, Danuta; Schaefer, Amanda; Nzilambi, Nzila; Quinn, Thomas C.; St. Louis, Michael E.; Youngpairoj, Ae S.; Phillips, Jonathan; Jaffe, Harold W.; Folks, Thomas M.

    2004-01-01

    Central Africa was the epicenter of the HIV type 1 (HIV-1) pandemic. Understanding the early epidemic in the Democratic Republic of the Congo, formerly Zaire, could provide insight into how HIV evolved and assist vaccine design and intervention efforts. Using enzyme immunosorbent assays, we tested 3,988 serum samples collected in Kinshasa in the mid-1980s and confirmed seroreactivity by Western blot. Polymerase chain reaction of gag p17, env C2V3C3, and/or gp41; DNA sequencing; and genetic analyses were performed. Gene regions representing all the HIV-1 group M clades and unclassifiable sequences were found. From two or three short gene regions, 37% of the strains represented recombinant viruses, multiple infections, or both, which suggests that if whole genome sequences were available, most of these strains would have mosaic genomes. We propose that the HIV epidemic was well established in central Africa by the early 1980s and that some recombinant viruses most likely seeded the early global epidemic. PMID:15324542

  9. Cobalt mineral exploration and supply from 1995 through 2013

    USGS Publications Warehouse

    Wilburn, David R.

    2011-01-01

    The global mining industry has invested a large amount of capital in mineral exploration and development over the past 15 years in an effort to ensure that sufficient resources are available to meet future increases in demand for minerals. Exploration data have been used to identify specific sites where this investment has led to a significant contribution in global mineral supply of cobalt or where a significant increase in cobalt production capacity is anticipated in the next 5 years. This report provides an overview of the cobalt industry, factors affecting mineral supply, and circumstances surrounding the development, or lack thereof, of key mineral properties with the potential to affect mineral supply. Of the 48 sites with an effective production capacity of at least 1,000 metric tons per year of cobalt considered for this study, 3 producing sites underwent significant expansion during the study period, 10 exploration sites commenced production from 1995 through 2008, and 16 sites were expected to begin production by 2013 if planned development schedules are met. Cobalt supply is influenced by economic, environmental, political, and technological factors affecting exploration for and production of copper, nickel, and other metals as well as factors affecting the cobalt industry. Cobalt-rich nickel laterite deposits were discovered and developed in Australia and the South Pacific and improvements in laterite processing technology took place during the 1990s and early in the first decade of the 21st century when mining of copper-cobalt deposits in Congo (Kinshasa) was restricted because of regional conflict and lack of investment in that country's mining sector. There was also increased exploration for and greater importance placed on cobalt as a byproduct of nickel mining in Australia and Canada. The emergence of China as a major refined cobalt producer and consumer since 2007 has changed the pattern of demand for cobalt, particularly from Africa and

  10. Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients

    PubMed Central

    Wumba, Roger; Longo-Mbenza, Benjamin; Menotti, Jean; Mandina, Madone; Kintoki, Fabien; Situakibanza, Nani Hippolyte; Kakicha, Marie Kapepela; Zanga, Josue; Mbanzulu-Makola, Kennedy; Nseka, Tommy; Mukendi, Jean Pierre; Kendjo, Eric; Sala, Jean; Thellier, Marc

    2012-01-01

    Background The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. Methods In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Results Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of <100 cells/mm3, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of <100 cells/mm3, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal

  11. Comparative study of the methane production based on the chemical compositions of Mangifera Indica and Manihot Utilissima leaves.

    PubMed

    Mambanzulua Ngoma, Philippe; Hiligsmann, Serge; Sumbu Zola, Eric; Culot, Marc; Fievez, Thierry; Thonart, Philippe

    2015-01-01

    Leaves of Mangifera Indica (MI, mango leaves) and Manihot Utilissima (MU, cassava leaves) are available in tropical regions and are the most accessible vegetal wastes of Kinshasa, capital of Democratic Republic of Congo. These wastes are not suitably managed and are not rationally valorized. They are abandoned in full air, on the soil and in the rivers. They thus pollute environment. By contrast, they can be recuperated and treated in order to produce methane (energy source), organic fertilizer and clean up the environment simultaneously. The main objective of this study was to investigate methane production from MI and MU leaves by BMP tests at 30°C. The yields achieved from the anaerobic digestion of up to 61.3 g raw matter in 1 l medium were 0.001 l/g and 0.100 l CH4/g volatile solids of MI and MU leaves, respectively. The yield of MU leaves was in the range mentioned in the literature for other leaves because of a poor presence of bioactive substrates, and low C/N ratio. This methane yield corresponded to 7% of calorific power of wood. By contrast, the methane yield from MI leaves was almost nil suggesting some metabolism inhibition because of their rich composition in carbon and bioactive substrates. Whereas classical acidogenesis and acetogenesis were recorded. Therefore, methane production from the sole MI leaves seems unfavorable by comparison to MU leaves at the ambient temperature in tropical regions. Their solid and liquid residues obtained after anaerobic digestion would be efficient fertilizers. However, the methane productivity of both leaves could be improved by anaerobic co-digestion. PMID:25825684

  12. Inorganic and organic carbon spatial variability in the Congo River during high waters (December 2013)

    NASA Astrophysics Data System (ADS)

    Borges, Alberto V.; Bouillon, Steven; Teodoru, Cristian; Leporcq, Bruno; Descy, Jean-Pïerre; Darchambeau, François

    2014-05-01

    Rivers are important components of the global carbon cycle, as they transport terrestrial organic matter from the land to the sea, and emit CO2 to the atmosphere. In particular, tropical systems that account for 60% of global freshwater discharge to the oceans. In contrast with south American rivers, very little information is available for African rivers on their carbon flows and stocks, in particular the Congo river, the second largest river in the World in terms of freshwater discharge (1457 km3 yr-1) and in terms of drainage basin (3.75 106 km2) located the second largest tropical forest in the World. Here, we report a data-set of continuous (every minute) records of the partial pressure of CO2 (pCO2) (total of 10,000 records), and discrete samples of particulate (POC) and dissolved (DOC) organic carbon (total of 75 samples) in the mainstem and major tributaries of the Congo river, along the 1700 km stretch from Kisangani to Kinshasa (total river length = 4374 km), during the high water period (December 2013). The pCO2 dynamic range was high ranging from minimum values of 2000 ppm in white waters tributaries (higher turbidity, conductivity and O2, lower DOC), up to maximal values of 18,000 ppm in blackwaters tributaries (lower turbidity, conductivity and O2, higher DOC). In the mainstem, very strong horizontal (cross-section) gradients were imposed by the presence of blackwaters close to the riverbanks and the presence of whitewaters in the middle of the river. In the mainstem, a distinct horizontal (longitudinal) pattern was observed with pCO2 increasing, and conductivity and turbidity decreasing downstream.

  13. Passive optical remote sensing of Congo River bathymetry using Landsat

    NASA Astrophysics Data System (ADS)

    Ache Rocha Lopes, V.; Trigg, M. A.; O'Loughlin, F.; Laraque, A.

    2014-12-01

    While there have been notable advances in deriving river characteristics such as width, using satellite remote sensing datasets, deriving river bathymetry remains a significant challenge. Bathymetry is fundamental to hydrodynamic modelling of river systems and being able to estimate this parameter remotely would be of great benefit, especially when attempting to model hard to access areas where the collection of field data is difficult. One such region is the Congo Basin, where due to past political instability and large scale there are few studies that characterise river bathymetry. In this study we test whether it is possible to use passive optical remote sensing to estimate the depth of the Congo River using Landsat 8 imagery in the region around Malebo Pool, located just upstream of the Kinshasa gauging station. Methods of estimating bathymetry using remotely sensed datasets have been used extensively for coastal regions and now more recently have been demonstrated as feasible for optically shallow rivers. Previous river bathymetry studies have focused on shallow rivers and have generally used aerial imagery with a finer spatial resolution than Landsat. While the Congo River has relatively low suspended sediment concentration values the application of passive bathymetry estimation to a river of this scale has not been attempted before. Three different analysis methods are tested in this study: 1) a single band algorithm; 2) a log ratio method; and 3) a linear transform method. All three methods require depth data for calibration and in this study area bathymetry measurements are available for three cross-sections resulting in approximately 300 in-situ measurements of depth, which are used in the calibration and validation. The performance of each method is assessed, allowing the feasibility of passive depth measurement in the Congo River to be determined. Considering the scarcity of in-situ bathymetry measurements on the Congo River, even an approximate

  14. Mass media entertainment for AIDS communication in Zaire.

    PubMed

    Convisser, J

    1992-01-01

    Health communicators use entertainment and mass media to prevent HIV transmission. Population Services International operates an AIDS Mass Media Project as an adjunct to its Condom Social Marketing Project. It collaborates with the Government of Zaire's National AIDS Program. Its 1st target is urban youth because most AIDS cases in Zaire were infected as teenagers, urban youth have access to television (TV), and they take part in high risk sexual behavior. The project uses various AIDS songs to reach this group. A 6-month posttest shows that the 1st song was so effective that 65% heard it and that 93% of them recalled the major AIDS messages and 85% said that they changed their behavior. The project distributes a video of the 1990 World AIDS Day concert. Research in Zaire and other African countries shows that the threat AIDS poses to children's health strongly motivates parents' behavior. Thus the 2nd target is the 20-30 year old group--young and prospective parents. The project boasts a 4-part TV series about a groom who does not reveal his AIDS status to his young bride until after their wedding night. 2 scenes stress the benefits of condoms. After its 1st airing, 66% of the 20-30 year old group in Kinshasa watched all 4 parts of the series. Of these, about 75% said they would change their behavior. Most people in Zaire change behavior by using condoms. Indeed, during the mass media campaign, condom sales grew 1000% which saved almost 7200 lives. The project also features comic strips informing working men and women and teenagers about AIDS and distributes an inexpensive notebook listening AIDS facts and myths for school children. The project uses regional radio stations to broadcast 28 AIDS feature programs, 22 radio spots, 8 AIDS radio dramas, and 2 songs to high priority rural areas. These AIDS radio efforts have indeed influenced AIDS knowledge and attitudes. PMID:12285440

  15. High GUD Incidence in the Early 20th Century Created a Particularly Permissive Time Window for the Origin and Initial Spread of Epidemic HIV Strains

    PubMed Central

    de Sousa, João Dinis; Müller, Viktor; Lemey, Philippe; Vandamme, Anne-Mieke

    2010-01-01

    The processes that permitted a few SIV strains to emerge epidemically as HIV groups remain elusive. Paradigmatic theories propose factors that may have facilitated adaptation to the human host (e.g., unsafe injections), none of which provide a coherent explanation for the timing, geographical origin, and scarcity of epidemic HIV strains. Our updated molecular clock analyses established relatively narrow time intervals (roughly 1880–1940) for major SIV transfers to humans. Factors that could favor HIV emergence in this time frame may have been genital ulcer disease (GUD), resulting in high HIV-1 transmissibility (4–43%), largely exceeding parenteral transmissibility; lack of male circumcision increasing male HIV infection risk; and gender-skewed city growth increasing sexual promiscuity. We surveyed colonial medical literature reporting incidences of GUD for the relevant regions, concentrating on cities, suffering less reporting biases than rural areas. Coinciding in time with the origin of the major HIV groups, colonial cities showed intense GUD outbreaks with incidences 1.5–2.5 orders of magnitude higher than in mid 20th century. We surveyed ethnographic literature, and concluded that male circumcision frequencies were lower in early 20th century than nowadays, with low rates correlating spatially with the emergence of HIV groups. We developed computer simulations to model the early spread of HIV-1 group M in Kinshasa before, during and after the estimated origin of the virus, using parameters derived from the colonial literature. These confirmed that the early 20th century was particularly permissive for the emergence of HIV by heterosexual transmission. The strongest potential facilitating factor was high GUD levels. Remarkably, the direct effects of city population size and circumcision frequency seemed relatively small. Our results suggest that intense GUD in promiscuous urban communities was the main factor driving HIV emergence. Low circumcision rates

  16. The Impact of Implementation Fidelity on Mortality Under a CD4-Stratified Timing Strategy for Antiretroviral Therapy in Patients With Tuberculosis

    PubMed Central

    Patel, Monita R.; Westreich, Daniel; Yotebieng, Marcel; Nana, Mbonze; Eron, Joseph J.; Behets, Frieda; Van Rie, Annelies

    2015-01-01

    Among patients with tuberculosis and human immunodeficiency virus type 1, CD4-stratified initiation of antiretroviral therapy (ART) is recommended, with earlier ART in those with low CD4 counts. However, the impact of implementation fidelity to this recommendation is unknown. We examined a prospective cohort study of 395 adult patients diagnosed with tuberculosis and human immunodeficiency virus between August 2007 and November 2009 in Kinshasa, Democratic Republic of the Congo. ART was to be initiated after 1 month of tuberculosis treatment at a CD4 count of <100 cells/mm3 or World Health Organization stage 4 (other than extrapulmonary tuberculosis) and after 2 months of tuberculosis treatment at a CD4 count of 100–350 cells/mm3. We used the parametric g-formula to estimate the impact of implementation fidelity on 6-month mortality. Observed implementation fidelity was low (46%); 54% of patients either experienced delays in ART initiation or did not initiate ART, which could be avoided under perfect implementation fidelity. The observed mortality risk was 12.0% (95% confidence interval (CI): 8.2, 15.7); under complete (counterfactual) implementation fidelity, the mortality risk was 7.8% (95% CI: 2.4, 12.3), corresponding to a risk reduction of 4.2% (95% CI: 0.3, 8.1) and a preventable fraction of 35.1% (95% CI: 2.9, 67.9). Strategies to achieve high implementation fidelity to CD4-stratified ART timing are needed to maximize survival benefit. PMID:25787266

  17. Renewed UN drive against AIDS.

    PubMed

    McGregor, A

    1994-12-17

    After a 1-day meeting of agency directors on December 12 in New York, UN Secretary-General Boutros Boutros-Ghali announced the appointment of Dr. Peter Piot as director of a renewed UN program against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), provisionally entitled "UN Joint and Co-sponsored Programme on AIDS." The 6 UN agencies already involved (UNICEF, UNDP, UNESCO, UN Population Fund, the World Bank, and WHO) will be more tightly coordinated; the World Health Organization (WHO) will remain in charge. Dr. Piot, a 45-year-old Belgian physician and co-discoverer of the Ebola virus (1976), assisted and effectively succeeds Dr. Michael Merson, the director of the World Health Organizations's global program on AIDS. While professor of microbiology at the Institute of Tropical Medicine in Antwerp, Dr. Piot launched a series of collaborative projects in Africa, including "Project SIDA" in Kinshasa in 1984. The new program will not be fully operational until 1996. The World Bank is expected to provide additional money. Dr. Merson's predecessor, Dr. Jonathan Mann (now director of the International Center at the Harvard School Of Public Health) expressed hopefulness about the new leadership and concern that what has been learned about AIDS in the last decade will be applied in the new program. A transition team has been working on a provisional program blueprint that provides for a resident coordinator and the full integration of local staff in each country. Additional emphasis will be given to education. An estimated 17 million people are infected with HIV, 3 million more since June of last year. 20-40 million are expected to be infected by 1999. PMID:7996968

  18. Opportunities for hydrologic research in the Congo Basin

    NASA Astrophysics Data System (ADS)

    Alsdorf, Douglas; Beighley, Ed; Laraque, Alain; Lee, Hyongki; Tshimanga, Raphael; O'Loughlin, Fiachra; Mahé, Gil; Dinga, Bienvenu; Moukandi, Guy; Spencer, Robert G. M.

    2016-06-01

    We review the published results on the Congo Basin hydrology and summarize the historic and ongoing research. Annual rainfall is ~1900 mm/yr along an east-west trend across the basin, decreasing northward and southward to ~1100 mm/yr. Historic studies using lysimeters, pans, and models suggest that the annual potential evapotranspiration varies little across the basin at 1100 to 1200 mm/yr. Over the past century, river discharge data have been collected at hundreds of stream gauges with historic and recent data at 96 locations now publicly available. Congo River discharge at Kinshasa-Brazzaville experienced an increase of 21% during the 1960-1970 decade in comparison to most other decades. Satellite altimetry measurements of high and low flows show that water levels in the "Cuvette Centrale" wetland are 0.5 m to 3.0 m higher in elevation than the immediately adjacent Congo River levels. Wetland water depths are shallow at about a meter and there does not appear to be many sizable channels across the "Cuvette"; thus, wetland flows are diffusive. Cuvette waters alone are estimated to emit about 0.5 Pg CH4 and CO2 equivalents/yr, an amount that is significant compared to global carbon evasions. Using these results, we suggest seven hypotheses that focus on the source of the Cuvette waters and how these leave the wetland, on the river discharge generated by historic rainfall, on the connection between climate change and the rainfall-runoff generated by the migrating "tropical rainbelt," on deforestation and hydroelectric power generation, and on the amount of carbon emitted from Congo waters.

  19. SD Bioline malaria antigen Pf (HRP-2/pLHD) for assessing efficacy of artemisinin combination therapy against Plasmodium falciparum in pediatric patients in the Democratic Republic of the Congo

    PubMed Central

    Kilauzi, Albert Lukuka; Mulumba, Jose Gaby Tshikuka; Magafu, Mgaywa Gilbert Mjungu Damas; Matchaba-Hove, Reginald; Tapera, Roy; Magafu, Naoko Shimizu; Tamfum, Jean Jacques Muyembe

    2015-01-01

    Introduction The emergence of Plasmodium falciparum resistance to artemisinin combination therapy (ACT) is a worrying development. It calls for close surveillance to monitor the efficacy of the drugs. The objectives of this study were to determine the performance of SD Bioline malaria AgPf(HRP-2/pLDH) 3 band Rapid Diagnostic Test (RDT) against Giemsa-stained blood smear and evaluate the suitability of this test in assessing the therapeutic efficacy of ACT in pediatric malaria patients in the Democratic Republic of the Congo (DRC). Methods Five hundred and one patients with malaria symptoms were screened for P. falciparum in Kinshasa, DRC. Of the 166 patients who tested positive for P. falciparum at recruitment (day 0), 103 consented to participate in this study and were followed up and retested for P. falciparum on day 3, day 7, day 14, day 21 and day 28. Results Sensitivity and specificity of the test were significantly high on day 0 and so were their positive and negative predictive values. Higher proportions of false positive cases were observed on the HRP-2 band irrespective of patient parasite densities during the follow up but these were barely seen on the pLDH band. Some patients turned positive during follow up but pLDH readings remained consistent with blood smear readings. Conclusion SD Bioline malaria AgPf(HRP-2/pLDH) RDT demonstrated high performance in DRC. Thus, the test can be employed to assess the efficacy of ACT in pediatric malaria patients and prioritize areas that require the deployment of advanced testing like polymerase chain reaction (PCR). PMID:26966500

  20. 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.

  1. Unprecedented Degree of Human Immunodeficiency Virus Type 1 (HIV-1) Group M Genetic Diversity in the Democratic Republic of Congo Suggests that the HIV-1 Pandemic Originated in Central Africa

    PubMed Central

    Vidal, Nicole; Peeters, Martine; Mulanga-Kabeya, Claire; Nzilambi, Nzila; Robertson, David; Ilunga, Wantabala; Sema, Hurogo; Tshimanga, Kazadi; Bongo, Beni; Delaporte, Eric

    2000-01-01

    The purpose of this study was to document the genetic diversity of human immunodeficiency virus type 1 (HIV-1) in the Democratic Republic of Congo (DRC; formerly Zaire). A total of 247 HIV-1-positive samples, collected during an epidemiologic survey conducted in 1997 in three regions (Kinshasa [the capital], Bwamanda [in the north], and Mbuyi-Maya [in the south]), were genetically characterized in the env V3-V5 region. All known subtypes were found to cocirculate, and for 6% of the samples the subtype could not be identified. Subtype A is predominant, with prevalences decreasing from north to south (69% in the north, 53% in the capital city, and 46% in the south). Subtype C, D, G, and H prevalences range from 7 to 9%, whereas subtype F, J, K, and CRF01-AE strains represent 2 to 4% of the samples; only one subtype B strain was identified. The highest prevalence (25%) of subtype C was in the south, and CRF01-AE was seen mainly in the north. The high intersubtype variability among the V3-V5 sequences is the most probable reason for the low (45%) efficiency of subtype A-specific PCR and HMA (heteroduplex mobility assay). Eighteen (29%) of 62 samples had discordant subtype designations between env and gag. Sequence analysis of the entire envelope from 13 samples confirmed the high degree of diversity and complexity of HIV-1 strains in the DRC; 9 had a complex recombinant structure in gp160, involving fragments of known and unknown subtypes. Interestingly, the unknown fragments from the different strains did not cluster together. Overall, the high number of HIV-1 subtypes cocirculating, the high intrasubtype diversity, and the high numbers of possible recombinant viruses as well as different unclassified strains are all in agreement with an old and mature epidemic in the DRC, suggesting that this region is the epicenter of HIV-1 group M. PMID:11044094

  2. [AIDS in Africa].

    PubMed

    Bolin, H

    1987-12-01

    Acquired immunodeficiency syndrome (AIDS) is believed to have begun in Rwanda with the transmission of green monkey virus to humans; the virus spread among prostitutes and truck drivers along the highways and then to the cities. In the most threatened areas, for example, Kinshasa in Zaire, 20% of the inhabitants are infected. 8% of pregnant women are human immunodeficiency virus (HIV)-positive. Social conditions are important. In Kenya prostitutes who work along the highways are carriers of socially transmitted diseases and genital sores. They are 60-80% HIV-positive. The better-off prostitutes at bars and hotels enjoy better health and fewer contacts and are 30% HIV-positive. It should be possible to develop a vaccine against the AIDS virus, but only a few virologists believe that this can be done within 10 years. Because HIV virus mutates rapidly, many different vaccines would have to be prepared. About 80 countries are cooperating with the World Health Organization to combat HIV and AIDS in Africa. Traveling and working abroad is beginning to be a problem. 15 countries have introduced restrictions on foreign visitors. Swedish midwives have an important role to play in fighting HIV. Their youth counseling activities can spread information about HIV and AIDS. Children who are in early stages of sexuality are probably the most important group to be influenced. It is already too late to begin informing 15-17 year olds about the disease. Midwives should probably be starting much sooner, perhaps even with 10-year olds. PMID:3692943

  3. The Finnish Forward Surgical Team Experience During EUFOR Operation RD Congo in 2006.

    PubMed

    Handolin, Lauri; Elomaa, Teemu

    2007-06-01

    The army Forward Surgical Team (FST) is a mobile surgical asset designed to provide life- and limbsaving combat surgery in remote and austere terrains. Operation EUFOR RDC in Democratic Republic of the Congo (DRC) in 2006 was the first one planned and conducted solely by the European Union Forces (EUFOR). The first two European FSTs reported in the present article were established by the Finnish Defence Forces.The Finnish FSTs were deployed for 4 months in Kinshasa. Three different deployment scenarios were trained; the equipments loaded on two trucks and carried by two C-130 aircrafts, the equipments loaded on two aircraft pallets (no trucks) and carried by one C-130 aircraft, and the equipments loaded on and carried by two CH-53 helicopters. The FSTs were deployed in three tactical and four reconnaissance operations. Due to the peacekeeping nature of the Operation, the surgical medical workload was light. The total number of patients treated by FSTs was 12,5 of them being due to trauma and 7 to medical condition. All trauma cases were of noncombat origin, and only one of them was severe.The European FST concept should be developed for future missions regarding the experiences gained during the reported deployment, the main goals being the mobility and the lightness of the unit. This kind of special trauma surgical asset, designed for remote theatres, will possibly be useful also in other emergency operations taking place in non-conventional circumstances; a concept of FST could easily be deployed in short notice to various accidental and natural disasters. PMID:26814487

  4. Leachates draining from controlled municipal solid waste landfill: Detailed geochemical characterization and toxicity tests.

    PubMed

    Mavakala, Bienvenu K; Le Faucheur, Séverine; Mulaji, Crispin K; Laffite, Amandine; Devarajan, Naresh; Biey, Emmanuel M; Giuliani, Gregory; Otamonga, Jean-Paul; Kabatusuila, Prosper; Mpiana, Pius T; Poté, John

    2016-09-01

    Management of municipal solid wastes in many countries consists of waste disposal into landfill without treatment or selective collection of solid waste fractions including plastics, paper, glass, metals, electronic waste, and organic fraction leading to the unsolved problem of contamination of numerous ecosystems such as air, soil, surface, and ground water. Knowledge of leachate composition is critical in risk assessment of long-term impact of landfills on human health and the environment as well as for prevention of negative outcomes. The research presented in this paper investigates the seasonal variation of draining leachate composition and resulting toxicity as well as the contamination status of soil/sediment from lagoon basins receiving leachates from landfill in Mpasa, a suburb of Kinshasa in the Democratic Republic of the Congo. Samples were collected during the dry and rainy seasons and analyzed for pH, electrical conductivity, dissolved oxygen, soluble ions, toxic metals, and were then subjected to toxicity tests. Results highlight the significant seasonal difference in leachate physicochemical composition. Affected soil/sediment showed higher values for toxic metals than leachates, indicating the possibility of using lagoon system for the purification of landfill leachates, especially for organic matter and heavy metal sedimentation. However, the ecotoxicity tests demonstrated that leachates are still a significant source of toxicity for terrestrial and benthic organisms. Therefore, landfill leachates should not be discarded into the environment (soil or surface water) without prior treatment. Interest in the use of macrophytes in lagoon system is growing and toxic metal retention in lagoon basin receiving systems needs to be fully investigated in the future. This study presents useful tools for evaluating landfill leachate quality and risk in lagoon systems which can be applied to similar environmental compartments. PMID:27177465

  5. Antiretroviral Treatment Program Retention among HIV-Infected Children in the Democratic Republic of Congo

    PubMed Central

    Ditekemena, John; Luhata, Christophe; Bonane, William; Kiumbu, Modeste; Tshefu, Antoinette; Colebunders, Robert; Koole, Olivier

    2014-01-01

    Background Retaining patients with HIV infection in care is still a major challenge in sub- Saharan Africa, particularly in the Democratic Republic of Congo (DRC) where the antiretroviral treatment (ART) coverage is low. Monitoring retention is an important tool for evaluating the quality of care. Methods and Findings A review of medical records of HIV -infected children was performed in three health facilities in the DRC: the Amo-Congo Health center, the Monkole Clinic in Kinshasa, and the HEAL Africa Clinic in Goma. Medical records of 720 children were included. Kaplan Meier curves were constructed with the probability of retention at 6 months, 1 year, 2 years and 3 years. Retention rates were: 88.2% (95% CI: 85.1%–90.8%) at 6 months; 85% (95% CI: 81.5%–87.6%) at one year; 79.4% (95%CI: 75.5%–82.8%) at two years and 74.7% (95% CI: 70.5%–78.5%) at 3 years. The retention varied across study sites: 88.2%, 66.6% and 92.5% at 6 months; 84%, 59% and 90% at 12 months and 75.7%, 56.3% and 85.8% at 24 months respectively for Amo-Congo/Kasavubu, Monkole facility and HEAL Africa. After multivariable Cox regression four variables remained independently associated with attrition: study site, CD4 cell count <350 cells/µL, children younger than 2 years and children whose caregivers were member of an independent church. Conclusions Attrition remains a challenge for pediatric HIV positive patients in ART programs in DRC. In addition, the low coverage of pediatric treatment exacerbates the situation of pediatric HIV/AIDS. PMID:25541707

  6. 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. PMID:24997956

  7. What Controls the Hydrodynamics of the Central Congo River?

    NASA Astrophysics Data System (ADS)

    O'Loughlin, F.; Bates, P. D.

    2014-12-01

    Despite being the second largest river basin in the world, with a drainage area greater than 3.7 million square kilometres, little is known about the hydraulics of the Congo River. This lack of knowledge is mainly due to a mixture of conflicts and the difficulty of accessing existing data. We present results of studies which have focused primarily on the middle reach of the Congo River, located between Kisangani and Kinshasa, and its six main tributaries (Kasai, Ubangai, Sangha, Ruki, Lulonga and Lomami rivers). Through a combination of remotely sensed datasets and a hydrodynamic model we investigated what factors control the hydrodynamics of the middle reach. From the analysis of the remotely sensed datasets, we discover that variability in river width of the middle reach of the Congo is large and cannot be represented by empirical equations which relate channel geometry to basin area and discharge. Water surface slopes vary from 3.5 cm/km to 9 cm/km, which is far more than previous studies suggest. The remote datasets indicate that there exist 5 large constrictions in the river width which may result in backwater affecting between 11 and 33 percent of middle reach at low and high water respectively. These results were corroborated by the hydrodynamic model. In fact, when all constrictions caused by a narrowing in width of 1 km or more are considered, water levels along 43 percent of the middle reach change by at least 0.5 m. Using the hydrodynamic model we also investigated the importance of the wetlands to the attenuation of the flood wave through the system. Initial results suggest that for the Congo River, floodplains have far more impact on the peak magnitude than the timing of the flood wave. When the model was run with no floodplain interactions an increase in the magnitude of flood peak was observed, with the timing of the waves being consistent with observed measurements.

  8. External Quality Assessment of Reading and Interpretation of Malaria Rapid Diagnostic Tests among 1849 End-Users in the Democratic Republic of the Congo through Short Message Service (SMS)

    PubMed Central

    Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Mbatshi, Joêl; Otshudiema, John; Muyembe, Jean-Jacques; Buyze, Jozefien; Jacobs, Jan; Lejon, Veerle

    2013-01-01

    Background Although malaria rapid diagnostic tests (RDT) are simple to perform, they remain subject to errors, mainly related to the post-analytical phase. We organized the first large scale SMS based external quality assessment (EQA) on correct reading and interpretation of photographs of a three-band malaria RDT among laboratory health workers in the Democratic Republic of the Congo (DR Congo). Methods and Findings High resolution EQA photographs of 10 RDT results together with a questionnaire were distributed to health facilities in 9 out of 11 provinces in DR Congo. Each laboratory health worker answered the EQA by Short Message Service (SMS). Filled-in questionnaires from each health facility were sent back to Kinshasa. A total of 1849 laboratory health workers in 1014 health facilities participated. Most frequent errors in RDT reading were i) failure to recognize invalid (13.2–32.5% ) or negative test results (9.8–12.8%), (ii) overlooking faint test lines (4.1–31.2%) and (iii) incorrect identification of the malaria species (12.1–17.4%). No uniform strategy for diagnosis of malaria at the health facility was present. Stock outs of RDTs occurred frequently. Half of the health facilities had not received an RDT training. Only two thirds used the RDT recommended by the National Malaria Control Program. Performance of RDT reading was positively associated with training and the technical level of health facility. Facilities with RDT positivity rates >50% and located in Eastern DR Congo performed worse. Conclusions Our study confirmed that errors in reading and interpretation of malaria RDTs are widespread and highlighted the problem of stock outs of RDTs. Adequate training of end-users in the application of malaria RDTs associated with regular EQAs is recommended. PMID:23967211

  9. 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.

  10. Advancing and retreating in the AIDS battle in Zaire.

    PubMed

    Shiner, C

    1992-07-01

    Unemployment and inflation stand at 70% and 5000%/year, respectively, in Zaire. Thus many women turn to prostitution to survive. About 50% are HIV positive. Yet HIV seroprevalence rates in prostitutes in other sub=Saharan African countries can be as high as 90%. 5-10% of women of reproductive age in Kinshasa are HIV positive, but the HIV infection rate as stabilized. Health workers may not learn why this has occurred, however, since the US Centers for Disease Control (CDC) stopped providing personnel and funds to Zaire's AIDS Program (Project SIDA). It is the continent's largest and most reputable and significant effort to fight AIDS. Its Zairian researchers are international level scientists. Project SIDA had 8 sites which tracked HIV infection in prostitutes and treated tuberculosis in AIDS patients and sexually transmitted diseases since they foster the spread of HIV. It also carried on a successful education and condom distribution campaign. Other countries use Project SIDA as a model to control AIDS. The most obvious effect of CDC withdrawal will be the reduced services to prostitutes according to a US pathologist. The project can no longer follow about 2000 mothers and children infected with HIV. CDC's withdrawal also negates any planned clinical trials of an AIDS vaccine. CDC claims it is no longer supporting Project SIDA because the government of Zaire can no longer guarantee the safety of CDC employees after the looting spree of unpaid soldiers in September-October 1991. Tensions have grown since December 1991 when the President, who gained power in a US Central Intelligence Agency backed coup in 1960, did not relinquish power at the end of his 46th term. Some US State Department officials are happy the disorder occurred since it allows the US to cut back on diplomats in Africa and to strengthen US representation in Eastern Europe. PMID:12286486

  11. Hospital Effluents Are One of Several Sources of Metal, Antibiotic Resistance Genes, and Bacterial Markers Disseminated in Sub-Saharan Urban Rivers.

    PubMed

    Laffite, Amandine; Kilunga, Pitchouna I; Kayembe, John M; Devarajan, Naresh; Mulaji, Crispin K; Giuliani, Gregory; Slaveykova, Vera I; Poté, John

    2016-01-01

    Data concerning the occurrence of emerging biological contaminants such as antibiotic resistance genes (ARGs) and fecal indicator bacteria (FIB) in aquatic environments in Sub-Saharan African countries is limited. On the other hand, antibiotic resistance remains a worldwide problem which may pose serious potential risks to human and animal health. Consequently, there is a growing number of reports concerning the prevalence and dissemination of these contaminants into various environmental compartments. Sediments provide the opportunity to reconstruct the pollution history and evaluate impacts so this study investigates the abundance and distribution of toxic metals, FIB, and ARGs released from hospital effluent wastewaters and their presence in river sediments receiving systems. ARGs (bla TEM, bla CTX-M, bla SHV, and aadA), total bacterial load, and selected bacterial species FIB [Escherichia coli, Enterococcus (ENT)] and species (Psd) were quantified by targeting species specific genes using quantitative PCR (qPCR) in total DNA extracted from the sediments recovered from 4 hospital outlet pipes (HOP) and their river receiving systems in the City of Kinshasa in the Democratic Republic of the Congo. The results highlight the great concentration of toxic metals in HOP, reaching the values (in mg kg(-1)) of 47.9 (Cr), 213.6 (Cu), 1434.4 (Zn), 2.6 (Cd), 281.5 (Pb), and 13.6 (Hg). The results also highlight the highest (P < 0.05) values of 16S rRNA, FIB, and ARGs copy numbers in all sampling sites including upstream (control site), discharge point, and downstream of receiving rivers, indicating that the hospital effluent water is not an exclusive source of the biological contaminants entering the urban rivers. Significant correlation were observed between (i) all analyzed ARGs and total bacterial load (16S rRNA) 0.51 to 0.72 (p < 0.001, n = 65); (ii) ARGs (except bla TEM) and FIB and Psd 0.57 < r < 0.82 (p < 0.001, n = 65); and (iii) ARGs (except bla TEM) and toxic

  12. Decentralization Does Not Assure Optimal Delivery of PMTCT and HIV-Exposed Infant Services in a Low Prevalence Setting

    PubMed Central

    Edmonds, Andrew; Feinstein, Lydia; Okitolonda, Vitus; Thompson, Deidre; Kawende, Bienvenu; Behets, Frieda

    2016-01-01

    Background The consequences of decentralizing prevention of mother-to-child HIV transmission and HIV-exposed infant services to antenatal care (ANC)/labor and delivery (L&D) sites from dedicated HIV care and treatment (C&T) centers remain unknown, particularly in low prevalence settings. Methods In a cohort of mother–infant pairs, we compared delivery of routine services at ANC/L&D and C&T facilities in Kinshasa, Democratic Republic of Congo from 2010–2013, using methods accounting for competing risks (eg, death). Women could opt to receive interventions at 90 decentralized ANC/L&D sites, or 2 affiliated C&T centers. Additionally, we assessed decentralization’s population-level impacts by comparing proportions of women and infants receiving interventions before (2009–2010) and after (2011–2013) decentralization. Results Among newly HIV-diagnosed women (N = 1482), the 14-week cumulative incidence of receiving the package of CD4 testing and zidovudine or antiretroviral therapy was less at ANC/L&D [66%; 95% confidence interval (CI): 63% to 69%] than at C&T (88%; 95% CI: 83% to 92%) sites (subdistribution hazard ratio, 0.62; 95% CI: 0.55 to 0.69). Delivery of cotrimoxazole and DNA polymerase chain reaction testing to HIV-exposed infants (N = 1182) was inferior at ANC/L&D sites (subdistribution hazard ratio, 0.84; 95% CI: 0.76 to 0.92); the 10-month cumulative incidence of the package at ANC/L&D sites was 89% (95% CI: 82% to 93%) versus 97% (95% CI: 93% to 99%) at C&T centers. Receipt of the pregnancy (20% of 1518, to 64% of 1405) and infant (16%–31%) packages improved post decentralization. Conclusions Services were delivered less efficiently at ANC/L&D sites than C&T centers. Although access improved with decentralization, its potential cannot be realized without sufficient and sustained support. PMID:26262776

  13. Schistosomiasis in the Democratic Republic of Congo: a literature review.

    PubMed

    Madinga, Joule; Linsuke, Sylvie; Mpabanzi, Liliane; Meurs, Lynn; Kanobana, Kirezi; Speybroeck, Niko; Lutumba, Pascal; Polman, Katja

    2015-01-01

    Schistosomiasis is a poverty-related parasitic infection, leading to chronic ill-health. For more than a century, schistosomiasis has been known to be endemic in certain provinces of the Democratic Republic of Congo (DRC). However, a clear overview on the status of the disease within the country is currently lacking, which is seriously hampering control. Here, we review the available information on schistosomiasis in DRC of the past 60 years. Findings and data gaps are discussed in the perspective of upcoming control activities.An electronic literature search via PubMed complemented by manual search of non-peer-reviewed articles was conducted up to January 2015. The search concerned all relevant records related to schistosomiasis in the DRC from January 1955 onwards. A total of 155 records were found, of which 30 met the inclusion criteria. Results were summarized by geographical region, mapped, and compared with those reported sixty years ago. The available data reported schistosomiasis in some areas located in 10 of the 11 provinces of DRC. Three species of Schistosoma were found: S. mansoni, S. haematobium and S. intercalatum. The prevalence of schistosomiasis varied greatly between regions and between villages, with high values of up to 95 % observed in some communities. The overall trend over 60 years points to the spread of schistosomiasis to formerly non-endemic areas. The prevalence of schistosomiasis has increased in rural endemic areas and decreased in urban/peri-urban endemic areas of Kinshasa. Hepatosplenomegaly, urinary tract lesions and anaemia were commonly reported in schistosomiasis endemic areas but not always associated with infection status.The present review confirms that schistosomiasis is still endemic in DRC. However, available data are scattered across time and space and studies lack methodological uniformity, hampering a reliable estimation of the current status of schistosomiasis in DRC. There is a clear need for updated prevalence data

  14. An initial investigation into the organic matter biogeochemistry of the Congo River

    USGS Publications Warehouse

    Spencer, Robert G.M.; Hernes, Peter J.; Aufdenkampe, Anthony K.; Baker, Andy; Gulliver, Pauline; Stubbins, Aron; Aiken, George R.; Dyda, Rachael Y.; Butler, Kenna D.; Mwamba, Vincent L.; Mangangu, Arthur M.; Wabakanghanzi, Jose N.; Six, Johan

    2012-01-01

    The Congo River, which drains pristine tropical forest and savannah and is the second largest exporter of terrestrial carbon to the ocean, was sampled in early 2008 to investigate organic matter (OM) dynamics in this historically understudied river basin. We examined the elemental (%OC, %N, C:N), isotopic (δ13C, Δ14C, δ15N) and biochemical composition (lignin phenols) of coarse particulate (>63 μm; CPOM) and fine particulate (0.7–63 μm; FPOM) OM and DOC, δ13C, Δ14C and lignin phenol composition with respect to dissolved OM (14C = -62.2 ± -13.2‰, n = 5) compared to CPOM and DOM (mean Δ14C = 55.7 ± 30.6‰, n = 4 and 73.4 ± 16.1‰, n = 5 respectively). The modern radiocarbon ages for DOM belie a degraded lignin compositional signature (i.e. elevated acid:aldehyde ratios (Ad:Al) relative to CPOM and FPOM), and indicate that the application of OM degradation patterns derived from particulate phase studies to dissolved samples needs to be reassessed: these elevated ratios are likely attributable to fractionation processes during solubilization of plant material. The relatively low DOM carbon-normalized lignin yields (Λ8; 0.67–1.12 (mg(100 mg OC)-1)) could also reflect fractionation processes, however, they have also been interpreted as an indication of significant microbial or algal sources of DOM. CPOM appears to be well preserved higher vascular plant material as evidenced by its modern radiocarbon age, elevated C:N (17.2–27.1) and Λ8 values (4.56–7.59 (mg(100 mg OC)-1)). In relation to CPOM, the aged FPOM fraction (320–580 ybp 14C ages) was comparatively degraded, as demonstrated by its nitrogen enrichment (C:N 11.4–14.3), lower Λ8 (2.80–4.31 (mg(100 mg OC)-1)) and elevated lignin Ad:Al values similar to soil derived OM. In this study we observed little modification of the OM signature from sample sites near the cities of Brazzaville and Kinshasa to the head of the estuary (~350 km) highlighting the potential for future studies to

  15. Hospital Effluents Are One of Several Sources of Metal, Antibiotic Resistance Genes, and Bacterial Markers Disseminated in Sub-Saharan Urban Rivers

    PubMed Central

    Laffite, Amandine; Kilunga, Pitchouna I.; Kayembe, John M.; Devarajan, Naresh; Mulaji, Crispin K.; Giuliani, Gregory; Slaveykova, Vera I.; Poté, John

    2016-01-01

    Data concerning the occurrence of emerging biological contaminants such as antibiotic resistance genes (ARGs) and fecal indicator bacteria (FIB) in aquatic environments in Sub-Saharan African countries is limited. On the other hand, antibiotic resistance remains a worldwide problem which may pose serious potential risks to human and animal health. Consequently, there is a growing number of reports concerning the prevalence and dissemination of these contaminants into various environmental compartments. Sediments provide the opportunity to reconstruct the pollution history and evaluate impacts so this study investigates the abundance and distribution of toxic metals, FIB, and ARGs released from hospital effluent wastewaters and their presence in river sediments receiving systems. ARGs (blaTEM, blaCTX-M, blaSHV, and aadA), total bacterial load, and selected bacterial species FIB [Escherichia coli, Enterococcus (ENT)] and species (Psd) were quantified by targeting species specific genes using quantitative PCR (qPCR) in total DNA extracted from the sediments recovered from 4 hospital outlet pipes (HOP) and their river receiving systems in the City of Kinshasa in the Democratic Republic of the Congo. The results highlight the great concentration of toxic metals in HOP, reaching the values (in mg kg−1) of 47.9 (Cr), 213.6 (Cu), 1434.4 (Zn), 2.6 (Cd), 281.5 (Pb), and 13.6 (Hg). The results also highlight the highest (P < 0.05) values of 16S rRNA, FIB, and ARGs copy numbers in all sampling sites including upstream (control site), discharge point, and downstream of receiving rivers, indicating that the hospital effluent water is not an exclusive source of the biological contaminants entering the urban rivers. Significant correlation were observed between (i) all analyzed ARGs and total bacterial load (16S rRNA) 0.51 to 0.72 (p < 0.001, n = 65); (ii) ARGs (except blaTEM) and FIB and Psd 0.57 < r < 0.82 (p < 0.001, n = 65); and (iii) ARGs (except blaTEM) and toxic metals

  16. Traitement des séquelles de brûlures de la main dans les pays à ressources limitées ; notre expérience en république démocratique du Congo

    PubMed Central

    Kibadi, K.; Moutet, F.

    2015-01-01

    Summary Les séquelles de brûlures de la main sont encore fréquentes dans les pays à ressources limitées. Trente-deux patients, représentant 38 mains, ont été admis et traités, entre le 1er décembre 2010 et le 1er mai 2014 aux Cliniques Universitaires de Kinshasa en République Démocratique du Congo (RDC). nous avons observé 22 patients (69 %) dans le groupe de jeunes (patients âgés de moins de 18 ans), et 10 patients (31 %) chez les adultes (18 à 59 ans). Aucun patient dans le groupe de seniors (60 ans et plus) n’a été observé. Dans le groupe de jeunes, la tranche d’âge de 1 à 5 ans a été la plus atteinte avec 13 malades (40 %). l’accident à la maison était le plus fréquent (72 %). le mécanisme de la brûlure était le plus souvent thermique par flammes (51 %) ou par liquide chaud (34 %). les rétractions et brides sont les lésions le plus observées (84 %). la rétraction dorsale globale « main en griffe» est observée chez 40 % de patients traités, associée à des cicatrices hypertrophiques et chéloïdiennes dans 84 % de cas. Chez les 32 mains traitées chirurgicalement, des excision-greffes ont été réalisées dans 43,7 %, des lambeaux locaux dans 43,7 % et des lambeaux à distance dans 12,5 % de cas. A la sortie de l’hôpital, 84 % de « bons » résultats ont été observés. le suivi a été de 18 mois. le traitement des séquelles de brûlures de la main est possible dans ces pays, exemple de la rDC. Mais les défis à surmonter dans ces pays sont nombreux : la faible accessibilité aux techniques actuelles de la chirurgie plastique, la prise en charge initiale inadéquate des brûlures, la pauvreté. PMID:26668560

  17. Detection of Rickettsia felis, Rickettsia typhi, Bartonella Species and Yersinia pestis in Fleas (Siphonaptera) from Africa

    PubMed Central

    Leulmi, Hamza; Socolovschi, Cristina; Laudisoit, Anne; Houemenou, Gualbert; Davoust, Bernard; Bitam, Idir; Raoult, Didier; Parola, Philippe

    2014-01-01

    Little is known about the presence/absence and prevalence of Rickettsia spp, Bartonella spp. and Yersinia pestis in domestic and urban flea populations in tropical and subtropical African countries. Methodology/Principal findings Fleas collected in Benin, the United Republic of Tanzania and the Democratic Republic of the Congo were investigated for the presence and identity of Rickettsia spp., Bartonella spp. and Yersinia pestis using two qPCR systems or qPCR and standard PCR. In Xenopsylla cheopis fleas collected from Cotonou (Benin), Rickettsia typhi was detected in 1% (2/199), and an uncultured Bartonella sp. was detected in 34.7% (69/199). In the Lushoto district (United Republic of Tanzania), R. typhi DNA was detected in 10% (2/20) of Xenopsylla brasiliensis, and Rickettsia felis was detected in 65% (13/20) of Ctenocephalides felis strongylus, 71.4% (5/7) of Ctenocephalides canis and 25% (5/20) of Ctenophthalmus calceatus calceatus. In the Democratic Republic of the Congo, R. felis was detected in 56.5% (13/23) of Ct. f. felis from Kinshasa, in 26.3% (10/38) of Ct. f. felis and 9% (1/11) of Leptopsylla aethiopica aethiopica from Ituri district and in 19.2% (5/26) of Ct. f. strongylus and 4.7% (1/21) of Echidnophaga gallinacea. Bartonella sp. was also detected in 36.3% (4/11) of L. a. aethiopica. Finally, in Ituri, Y. pestis DNA was detected in 3.8% (1/26) of Ct. f. strongylus and 10% (3/30) of Pulex irritans from the villages of Wanyale and Zaa. Conclusion Most flea-borne infections are neglected diseases which should be monitored systematically in domestic rural and urban human populations to assess their epidemiological and clinical relevance. Finally, the presence of Y. pestis DNA in fleas captured in households was unexpected and raises a series of questions regarding the role of free fleas in the transmission of plague in rural Africa, especially in remote areas where the flea density in houses is high. PMID:25299702

  18. Treatment of rheumatoid arthritis with methotrexate in Congolese patients.

    PubMed

    Malemba, J J; Mbuyi Muamba, J M; Mukaya, J; Bossuyt, X; Verschueren, P; Westhovens, R

    2013-09-01

    Methotrexate (MTX) is the anchor drug in the treatment of rheumatoid arthritis (RA) but data concerning the effectiveness of treatment with this compound are lacking in the Congolese population. In the present study, the evolution of RA in Congolese patients on MTX treatment is reported from before disease-modifying antirheumatic drug (DMARD) initiation till 20 months later. All consecutive DMARD-naïve RA patients (ACR 1987 criteria) attending the rheumatology unit of the University Hospital of Kinshasa from January 2008 to September 2010 were included. All were treated with MTX (started at 7.5 mg/week) and bridging steroids (started at 30mg/day). Treatment adaptations of MTX and concomitant drugs are reported as well as evolution of disease activity (DAS28-ESR), functionality (Health Assessment Questionnaire), radiological damage, and safety over 20 months. Of 98 patients recruited, more than one third were lost at follow-up. A follow-up visit at 20 months was available for 51 patients. These 48 women and 3 men had a mean age of 51.2 ± 13 years and a mean delay from symptom onset till their first visit of 3.2 years. At 20 months, the average MTX dose was 9.7 mg weekly. A second DMARD was added in three patients. The average dose of prednisone at 20 months was 7.5 mg daily. A significant improvement of DAS28 and functional disability was observed and 35.3 % of patients entered remission (DAS28 <2.6). A progression of X-ray damage was observed in one third of patients. Two patients had to stop MTX because of severe side effects and two patients developed diabetes. Methotrexate and bridging steroids therapy is effective also in sub-Saharan Africa but the average weekly MTX dose remains low. Implementation of a regular follow-up is a major issue. PMID:23649482

  19. Uncomplicated Clinical Malaria Features, the Efficacy of Artesunate-Amodiaquine and Their Relation with Multiplicity of Infection in the Democratic Republic of Congo

    PubMed Central

    Muhindo Mavoko, Hypolite; Kalabuanga, Marion; Delgado-Ratto, Christopher; Maketa, Vivi; Mukele, Rodin; Fungula, Blaise; Inocêncio da Luz, Raquel; Rosanas-Urgell, Anna; Lutumba, Pascal; Van geertruyden, Jean-Pierre

    2016-01-01

    Background In the Democratic Republic of Congo, artesunate-amodiaquine (ASAQ) is the first-line medication recommended for uncomplicated malaria treatment. We conducted a study in Kinshasa to describe the clinical features of the disease and assess the efficacy of ASAQ and its impact on the multiplicity of infection in children with uncomplicated malaria. Methods Children aged 12 to 59 months with uncomplicated P. falciparum malaria were treated with ASAQ and followed up passively for 42 days. To distinguish new infections from recrudescent parasites, samples were genotyped using a stepwise strategy with three molecular markers (GLURP, MSP2 and MSP1). We then assessed PCR-corrected and -uncorrected day-42 cure rates and multiplicity of infection (MOI). Results In total, 2,796 patients were screened and 865 enrolled in the study. Clinical features were characterized by history of fever (100%), coryza (59.9%) and weakness (59.4%). The crude and PCR-corrected efficacies of ASAQ were 55.3% (95%CI: 51.8–58.8) and 92.8% (95%CI: 91.0–94.6) respectively, as 83.6% (95%CI: 79.1–87.2) of the recurrences were new infections. Compared to monoclonal infections, polyclonal infections were more frequent at enrollment (88.1%) and in recurrences (80.1%; p = 0.005; OR: 1.8, 95%CI: 1.20–2.8). The median MOI at enrollment (MOI = 3.7; IQR: 0.7–6.7) decreased to 3 (IQR: 1–5) in the recurrent samples (p<0.001). Patients infected with a single haplotype on day 0 had no recrudescence; the risk of recrudescence increased by 28% with each additional haplotype (HR: 1.3, 95%CI: 1.24–1.44). Conclusion The PCR-corrected efficacy of ASAQ at day 42 was 92.8%, but crude efficacy was relatively poor due to high reinfection rates. Treatment outcomes were positively correlated with MOI. Continued monitoring of the efficacy of ACTs—ASAQ, in this case—is paramount. Trial Registration ClinicalTrials.gov NCT01374581 PMID:27280792

  20. Intraplate compressional deformation in West-Congo and the Congo basin: related to ridge-puch from the South Atlantic spreading ridge?

    NASA Astrophysics Data System (ADS)

    Delvaux, Damien; Everaerts, Michel; Kongota Isasi, Elvis; Ganza Bamulezi, Gloire

    2016-04-01

    After the break-up and separation of South America from Africa and the initiation of the South-Atlantic mid-oceanic ridge in the Albian, at about 120 Ma, ridge-push forces started to build-up in the oceanic lithosphere and were transmitted to the adjacent continental plates. This is particularly well expressed in the passive margin and continental interior of Central Africa. According to the relations of Wiens and Stein (1985) between ridge-push forces and basal drag in function of the lithospheric age of oceanic plates, the deviatoric stress reaches a compressional maximum between 50 and 100, Ma after the initiation of the spreading ridge, so broadly corresponding to the Paleocene in this case (~70-20 Ma). Earthquake focal mechanism data show that the West-Congo margin and a large part of the Congo basin are still currently under compressional stresses with an horizontal compression parallel to the direction of the active transform fracture zones. We studied the fracture network along the Congo River in Kinshasa and Brazzaville which affect Cambrian sandstones and probably also the late Cretaceous-Paleocene sediments. Their brittle tectonic evolution is compatible with the buildup of ridge-push forces related to the South-Atlantic opening. Further inland, low-angle reverse faults are found affecting Jurassic to Middle Cretaceous cores from the Samba borehole in the Congo basin and strike-slip movements are recorded as a second brittle phase in the Permian cores of the Dekese well, at the southern margin of the Congo basin. An analysis of the topography and river network of the Congo basin show the development of low-amplitude (50-100 m) long wavelengths (100-300 km) undulations that can be interpreted as lithospheric buckling in response to the compressional intraplate stress field generated by the Mid-Atlantic ridge-push. Wiens, D.A., Stein, S., 1985. Implications of oceanic intraplate seismicity for plate stresses, driving forces and theology. Tectonophysics

  1. An initial investigation into the organic matter biogeochemistry of the Congo River

    NASA Astrophysics Data System (ADS)

    Spencer, Robert G. M.; Hernes, Peter J.; Aufdenkampe, Anthony K.; Baker, Andy; Gulliver, Pauline; Stubbins, Aron; Aiken, George R.; Dyda, Rachael Y.; Butler, Kenna D.; Mwamba, Vincent L.; Mangangu, Arthur M.; Wabakanghanzi, Jose N.; Six, Johan

    2012-05-01

    radiocarbon age, elevated C:N (17.2-27.1) and Λ8 values (4.56-7.59 (mg(100 mg OC)-1)). In relation to CPOM, the aged FPOM fraction (320-580 ybp 14C ages) was comparatively degraded, as demonstrated by its nitrogen enrichment (C:N 11.4-14.3), lower Λ8 (2.80-4.31 (mg(100 mg OC)-1)) and elevated lignin Ad:Al values similar to soil derived OM. In this study we observed little modification of the OM signature from sample sites near the cities of Brazzaville and Kinshasa to the head of the estuary (˜350 km) highlighting the potential for future studies to assess seasonal and long-term OM dynamics from this logistically feasible location and derive relevant information with respect to OM exported to the Atlantic Ocean. The relative lack of OM data for the Congo River Basin highlights the importance of studies such as this for establishing baselines upon which to gauge future change.

  2. Ebola haemorrhagic fever in Zaire, 1976

    PubMed Central

    1978-01-01

    Between 1 September and 24 October 1976, 318 cases of acute viral haemorrhagic fever occurred in northern Zaire. The outbreak was centred in the Bumba Zone of the Equateur Region and most of the cases were recorded within a radius of 70 km of Yambuku, although a few patients sought medical attention in Bumba, Abumombazi, and the capital city of Kinshasa, where individual secondary and tertiary cases occurred. There were 280 deaths, and only 38 serologically confirmed survivors. The index case in this outbreak had onset of symptoms on 1 September 1976, five days after receiving an injection of chloroquine for presumptive malaria at the outpatient clinic at Yambuku Mission Hospital (YMH). He had a clinical remission of his malaria symptoms. Within one week several other persons who had received injections at YMH also suffered from Ebola haemorrhagic fever, and almost all subsequent cases had either received injections at the hospital or had had close contact with another case. Most of these occurred during the first four weeks of the epidemic, after which time the hospital was closed, 11 of the 17 staff members having died of the disease. All ages and both sexes were affected, but women 15-29 years of age had the highest incidence of disease, a phenomenon strongly related to attendance at prenatal and outpatient clinics at the hospital where they received injections. The overall secondary attack rate was about 5%, although it ranged to 20% among close relatives such as spouses, parent or child, and brother or sister. Active surveillance disclosed that cases occurred in 55 of some 550 villages which were examined house-by-house. The disease was hitherto unknown to the people of the affected region. Intensive search for cases in the area of north-eastern Zaire between the Bumba Zone and the Sudan frontier near Nzara and Maridi failed to detect definite evidence of a link between an epidemic of the disease in that country and the outbreak near Bumba. Nevertheless it was

  3. [Heterosexual transmission of HIV infection

    PubMed

    Coulaud, J P

    1993-02-01

    The AIDS epidemic has spread rapidly in Africa among the urban impoverished where multiple sexual partners and sexually transmitted diseases are common. Over 80% of the 9 million Africans who will develop AIDS before the year 2000 will have been contaminated sexually. Poverty, multiple sexual partners in the framework of prostitution, and drug addiction are responsible for rapid spread of HIV infection in Southeast Asia, the West India, and Brazil. Drug addiction has played a major role in diffusion of HIV into the general population of Europe and the US. Prevalence rates are much higher in sexually transmitted disease centers in France and the US than among blood donors or pregnant women. Sexually transmitted diseases and heterosexual transmission have been studied in Africas since diagnostic tests became available. Several studies, the majority conducted among prostitutes in Nairobi or Kinshasa and their clients, allow establishment of a list of sexually transmitted diseases associated with increased risk of seroconversion. Genital ulcers within the past 6 months presented a relative risk of 2-4 depending on the series. Urethral or cervical gonorrhea has a lower relative risk of 1.2 in most studies. Absence of circumcision was also a risk factor. Studies were subsequently conducted in Europe on factors favoring sexual transmission. 513 heterosexual couples together for a minimum duration of 18 months and an average of 38 months were included in the Multicenter European Study conducted in 10 centers in 9 countries. The "index" subject was male in 400 cases and female in 113. At entry into the study, 73 of 400 males (18.2%) and 10 of 113 females (8.8%) had already infected their partners. Duration of union, frequency of intercourse, mode of transmission of the index subject, and oral contraceptive use had no effect on risk of transmission. Factors increasing risk of infection included the severity of immunosuppression of the index subject, whether judged by