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Sample records for democratic republic civil

  1. Resource Wars and Conflict Ivory: The Impact of Civil Conflict on Elephants in the Democratic Republic of Congo - The Case of the Okapi Reserve

    PubMed Central

    Beyers, Rene L.; Hart, John A.; Sinclair, Anthony R. E.; Grossmann, Falk; Klinkenberg, Brian; Dino, Simeon

    2011-01-01

    Human conflict generally has substantial negative impacts on wildlife and conservation. The recent civil war (1995-2006) in the Democratic Republic of Congo (DRC) resulted in a significant loss of wildlife, including elephants, due to institutional collapse, lawlessness and unbridled exploitation of natural resources such as minerals, wood, ivory and bushmeat. We used data from distance sampling surveys conducted before and after the war in a protected forest, the Okapi Faunal Reserve, to document changes in elephant abundance and distribution. We employed Generalized Additive Models to relate changes in elephant distribution to human and environmental factors. Populations declined by nearly fifty percent coinciding with a major increase in elephant poaching as indicated by reports of ivory trade during the war. Our results suggest that humans influenced elephant distribution far more than habitat, both before and after the war, but post-war models explained more of the variation. Elephant abundance declined more, closer to the park boundary and to areas of intense human activity. After the war, elephant densities were relatively higher in the centre of the park where they were better protected, suggesting that this area may have acted as a refuge. In other sites in Eastern DRC, where no protection was provided, elephants were even more decimated. Post-war dynamics, such as weakened institutions, human movements and availability of weapons, continue to affect elephants. Survival of remaining populations and recovery will be determined by these persistent factors and by new threats associated with growing human populations and exploitation of natural resources. Prioritizing wildlife protection, curbing illegal trade in ivory and bushmeat, and strengthening national institutions and organizations in charge of conservation will be crucial to counter these threats. PMID:22096529

  2. Resource wars and conflict ivory: the impact of civil conflict on elephants in the Democratic Republic of Congo--the case of the Okapi Reserve.

    PubMed

    Beyers, Rene L; Hart, John A; Sinclair, Anthony R E; Grossmann, Falk; Klinkenberg, Brian; Dino, Simeon

    2011-01-01

    Human conflict generally has substantial negative impacts on wildlife and conservation. The recent civil war (1995-2006) in the Democratic Republic of Congo (DRC) resulted in a significant loss of wildlife, including elephants, due to institutional collapse, lawlessness and unbridled exploitation of natural resources such as minerals, wood, ivory and bushmeat. We used data from distance sampling surveys conducted before and after the war in a protected forest, the Okapi Faunal Reserve, to document changes in elephant abundance and distribution. We employed Generalized Additive Models to relate changes in elephant distribution to human and environmental factors. Populations declined by nearly fifty percent coinciding with a major increase in elephant poaching as indicated by reports of ivory trade during the war. Our results suggest that humans influenced elephant distribution far more than habitat, both before and after the war, but post-war models explained more of the variation. Elephant abundance declined more, closer to the park boundary and to areas of intense human activity. After the war, elephant densities were relatively higher in the centre of the park where they were better protected, suggesting that this area may have acted as a refuge. In other sites in Eastern DRC, where no protection was provided, elephants were even more decimated. Post-war dynamics, such as weakened institutions, human movements and availability of weapons, continue to affect elephants. Survival of remaining populations and recovery will be determined by these persistent factors and by new threats associated with growing human populations and exploitation of natural resources. Prioritizing wildlife protection, curbing illegal trade in ivory and bushmeat, and strengthening national institutions and organizations in charge of conservation will be crucial to counter these threats.

  3. Medical ethics in the German Democratic Republic.

    PubMed

    Luther, E

    1989-06-01

    Medical ethics has been developing in the German Democratic Republic (GDR) since the 1970's on the basis of the traditional ethics of physicians and the socio-economic fundamentals of our socialist state. Medical care provided in the framework of Marxist-Leninist medical ethics is based on rationality and humanity.

  4. Forensic medicine in the German Democratic Republic.

    PubMed

    Strauch, H; Wirth, I; Geserick, G

    2004-09-10

    Forensic medicine services were resumed in the territory of the Soviet occupation zone in early summer 1945. One coherent legal system was established, following the foundation of the German Democratic Republic (GDR), 7 October 1949. Forensic medicine was subject of teaching and examinations from the very outset. Sub-specialisation (fellowship) was introduced in 1955. The Gesellschaft für Gerichtliche Medizin der DDR (GDR Society of Forensic Medicine) was established in 1967 and began to organise with high continuity a wide-ranging variety of scientific events. Almost all administrative districts had their own institute of forensic medicine by 1990.

  5. Democratic Republic of the Congo: undoing government by predation.

    PubMed

    Rackley, Edward B

    2006-12-01

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

  6. The Democratic Republic of Afghanistan, 1979.

    PubMed

    Dupree, L

    1979-01-01

    4 struggles currently dominate Afghan politics: 1) the war being fought by regionally and religously oriented guerrillas to overthrow the Soviet-leaning Amin regime; 2) the competition between conservative and religious leaders in the Pushtun area to monopolize funds from friendly Arabs; 3) the attempts by guerrilla forces to establish localized bases of power, so that any new regime in Kabul must grant the various ethno-linguistic groups some type of regional autonomy; and 4) the internal struggle for power within the Khalq leadership. 2 factions of Khalquis are involved: the liberal nationalists, led by Panjsheri and most military members of the Cabinet and Revolutionary Council; and the pro-Soviet opportunists led by Amin. The author lists these points after recounting the events leading to the coup d'etat against the Daoud regime on April 17, 1978 and the subsequent, but not markedly successful, attempts by leaders of the newly proclaimed Democratic Republic of Afghanistan to gain stability and implement land reform. More often, the struggle for security and legitimacy has led to rhetoric and repression--and growing opposition. The Soviet Union, which is currently facing an Islamic revival within its own borders, will only intervene physically against its better judgment, in the opinion of the author; the United States is terminating all aid, including the Peace Corps.

  7. [Democratic Republic of the Congo: between civil war and the Marburg virus. International Committee of Technical and Scientific Coordination of the Durba Epidemic].

    PubMed

    Bertherat, E; Talarmin, A; Zeller, H

    1999-01-01

    Because the epidemiology of viral hemorrhagic fever is unclear, each outbreak is a spectacular event that focuses the attention of the international scientific community. When an epidemic of Marburg virus disease occurred in the Durba region located in the northeastern part of the People's Republic of the Congo, 23 scientists were sent from 12 different countries. Sixty of the 73 people infected died. The first case was observed in December 1998 and the last in May 1999. Because of political unrest in the country, the outbreak was not reported immediately and most data was collected by observers retrospectively. However Marburg virus infection was confirmed in 5 of 16 patients in whom testing was performed and person-to-person transmission was demonstrated. Thus the Durba outbreak was the first epidemic of Marburg virus disease not involving laboratory contamination. Initial epidemiologic findings suggest that the first cases involved miners who were probably infected by contact with an animal reservoir such as bats. Further studies to determine seroprevalence in the general population and virologic testing on animals captured in the zone should provide answers to these questions.

  8. Situation Reports--Afghanistan, Cyprus, Iran, Kenya, Lebanese Republic, Malagasy Republic, Malaysia (West), People's Democratic Republic of Yemen.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in eight foreign countries are presented in these situation reports. Countries included are Afghanistan, Cyprus, Iran, Kenya, Lebanese Republic, Malagasy Republic (Madagascar), Malaysia (West), and People's Democratic Republic of Yemen. Information is provided under two topics, general background and…

  9. Democratic Republic of Congo: Status of women in physics

    NASA Astrophysics Data System (ADS)

    Banza, Elvire Nzeba

    2015-12-01

    There is one physics department in the Democratic Republic of Congo, at the University of Kinshasa. Since 2001, one woman graduate continued her studies in England, where she received a PhD, and currently two master's degree graduates from this program have joined the faculty as assistant professors.

  10. Student Activism and Democratic Quality in Ghana's Fourth Republic

    ERIC Educational Resources Information Center

    Van Gyampo, Ransford Edward

    2013-01-01

    Student activism has been pivotal in Ghana's political and democratic history. Prior to Ghana's Fourth Republic, student activism was highly confrontational and entailed student support or opposition to the various regimes depending on the extent to which the regimes were accepted by all as being rightful or legitimate. After 23 years of…

  11. Care-seeking behavior by survivors of sexual assault in the Democratic Republic of the Congo.

    PubMed

    Casey, Sara E; Gallagher, Meghan C; Makanda, Babou Rukengeza; Meyers, Janet L; Vinas, Mereia Cano; Austin, Judy

    2011-06-01

    In February 2008, trained female interviewers collected data on sexual violence and use of medical services following sexual assault from 607 women in the Democratic Republic of the Congo (DRC). Exposure to sexual violence during the DRC's civil war was reported by 17.8% of the women; 4.8% of the women reported exposure to sexual violence after the war. Few sexual-assault survivors accessed timely medical care. Facility assessments showed that this care was rarely available. Clinical care for sexual-assault survivors must be integrated into primary health care for DRC women.

  12. Vaccine introduction in the Democratic People's Republic of Korea.

    PubMed

    Marks, Florian; Nyambat, Batmunkh; Xu, Zhi-Yi; von Kalckreuth, Vera; Kilgore, Paul E; Seo, Hye Jin; Du, Yuping; Park, Se Eun; Im, Justin; Konings, Frank; Meyer, Christian G; Wierzba, Thomas F; Clemens, John D

    2015-05-11

    The feasibility of mass vaccination campaigns for Japanese encephalitis and Haemophilus influenzae type b infections was explored in the Democratic People's Republic of Korea using pilot vaccination studies. The experiences from these initial studies were then used to support larger vaccination campaigns in children at risk of these infections. We discuss the challenges and requirements for the inclusion of additional vaccines into the existing expanded program on immunization in the country.

  13. Trypanosomiasis Control, Democratic Republic of Congo, 1993–2003

    PubMed Central

    Lutumba, Pascal; Robays, Jo; Bilenge, Constantin Miaka mia; Mesu, Victor Kande Betu Ku; Molisho, Didier; Declercq, Johan; Van der Veken, Wim; Meheus, Filip; Jannin, Jean

    2005-01-01

    In the Democratic Republic of Congo (DRC), human African trypanosomiasis (HAT) reached unprecedented levels in the 1990s. To assess recent trends and evaluate control efforts, we analyzed epidemiologic and financial data collected by all agencies involved in HAT control in DRC from 1993 to 2003. Funds allocated to control populations, as well as to the population screened, doubled from 1993 to 1997 and from 1998 to 2003. The number of cases detected decreased from 26,000 new cases per year in 1998 to 11,000 in 2003. Our analysis shows that HAT control in DRC is almost completely dependent on international aid and that sudden withdrawal of such aid in 1990 had a long-lasting effect. Since 1998, control efforts intensified because of renewed donor interest, including a public-private partnership, and this effort led to a major reduction in HAT incidence. To avoid reemergence of this disease, such efforts should be sustained. PMID:16229766

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

    PubMed Central

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

    2016-01-01

    During July–November 2014, the Democratic Republic of the Congo underwent its seventh Ebola virus disease (EVD) outbreak. The etiologic agent was Zaire Ebola virus; 66 cases were reported (overall case-fatality rate 74.2%). Through a retrospective observational study of confirmed EVD in 25 patients admitted to either of 2 Ebola treatment centers, we described clinical features and investigated correlates associated with death. Clinical features were mainly generic. At admission, 76% of patients had >1 gastrointestinal symptom and 28% >1 hemorrhagic symptom. The case-fatality rate in this group was 48% and was higher for female patients (67%). Cox regression analysis correlated death with initial low cycle threshold, indicating high viral load. Cycle threshold was a robust predictor of death, as were fever, hiccups, diarrhea, dyspnea, dehydration, disorientation, hematemesis, bloody feces during hospitalization, and anorexia in recent medical history. Differences from other outbreaks could suggest guidance for optimizing clinical management and disease control. PMID:27533284

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

    PubMed

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

    2016-09-01

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

  16. Current status of human taeniasis in Lao People's Democratic Republic.

    PubMed

    Jeon, Hyeong-Kyu; Yong, Tai-Soon; Sohn, Woon-Mok; Chai, Jong-Yil; Min, Duk-Young; Yun, Cheong-Ha; Rim, Han-Jong; Pongvongsa, Tiengkham; Banouvong, Virasack; Insisiengmay, Bounnaloth; Phommasack, Bounlay; Eom, Keeseon S

    2013-04-01

    Human taeniasis was investigated in Lao People's Democratic Republic (Lao PDR) between 2000 and 2011 as part of the nation's helminthiasis survey. A total of 55,038 inhabitants, including 29,846 school children, were examined using the Kato-Katz and scotch-tape anal swab method, and morphological observation of adult worms. Molecular identification of Taenia tapeworms was performed by multiplex PCR or DNA sequence analysis of the mitochondrial cox1 gene. Taenia eggs were present at a rate of 1.5% (845/55,038) in the subject population. Adult tapeworms were identified as T. solium or T. saginata by analyzing the collectable stool specimens (n=126). Three specimens identified as T. solium were found in Luang Prabang, while the remaining 123 specimens, which were T. saginata, were found in Bokeo, Bolikhamxay, Champasak, Houaphan, Khammouane, Luang Namta, Luang Prabang, Oudomxay, Phongsaly, Saysomboune, Saravane, Savannakhet, Xayaboury, Xekong, Xieng Khouang Province, and Vientiane Municipality.

  17. History of Neurosurgery in Democratic People's Republic of Korea.

    PubMed

    Park, Kee B; Roh, Young Han; Lee-Park, Owen; Park, Sophie

    2015-09-01

    Neurosurgery in Democratic People's Republic of Korea (DPRK) has undergone remarkable progress since its beginning in the 1950s. With the initial support from socialist countries of the Soviet bloc, especially Professor Constantin Arseni of Romania, the nation has consistently produced a number of its own neurosurgeons each year and fostered further advancement by establishing the Korean Neurosurgery Association (DPRK). Despite the recent international collaborative activity for North Korean neurosurgery-namely with Foundation for International Education in Neurological Surgery, World Federation of Neurological Surgeons, and Korean American Medical Association-the sparse exchange of information, knowledge, and surgical skills still remains largely inadequate. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Situation Report--Barbados, Finland, German Democratic Republic, Italy, Lesotho, Luxembourg, Malagasy Republic (Madagascar), Malaysia (West), Netherlands, Poland, Portugal, Singapore, Sweden, Syrian Arab Republic, and Yugoslavia.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in 15 foreign countries are presented in these situation reports. Countries included are Barbados, Finland, German Democratic Republic, Italy, Lesotho, Luxembourg, Malagasy Republic, Malaysia (West), Netherlands, Poland, Portugal, Singapore, Sweden, Syrian Arab Republic, and Yogoslavia. Information…

  19. Ocular Pentastomiasis in the Democratic Republic of the Congo

    PubMed Central

    Sulyok, Mihály; Rózsa, Lajos; Bodó, Imre

    2014-01-01

    Ocular pentastomiasis is a rare infection caused by the larval stage of pentastomids, an unusual group of crustacean-related parasites. Zoonotic pentastomids have a distinct geographical distribution and utilize reptiles or canids as final hosts. Recently, an increasing number of human abdominal infections have been reported in Africa, where pentastomiasis is an emerging, though severely neglected, tropical disease. Here we describe four ocular infections caused by pentastomids from the Democratic Republic of the Congo. Two cases underwent surgery and an Armillifer grandis infection was detected by morphological and molecular approaches. Thus far, 15 other cases of ocular pentastomiasis have been reported worldwide. Twelve cases were caused by Armillifer sp., recorded almost exclusively in Africa, where such infections occur as a consequence of hunting and consuming snakes, their final hosts. Seven further cases were caused by Linguatula serrata, a cosmopolitan pentastomid whose final hosts are usually canids. Intraocular infections caused permanent visual damage in 69% and a total loss of vision in 31% of reported cases. In contrast, ocular adnexal cases had a benign clinical course. Further research is required to estimate the burden, therapeutic options and pathogenesis of this neglected disease. PMID:25058608

  20. [History of Medical Mycology in the former German Democratic Republic].

    PubMed

    Seebacher, C; Blaschke-Hellmessen, Renate; Kielstein, P

    2002-01-01

    After the Second World War the development of medical mycology in Germany had taken a very different course in the east and west parts depending on the political division. In this respect our contribution deals with the situation in the former German Democratic Republic. Efficient mycological centres were founded step by step almost in all medical universities on the basis of the mycological laboratories in dermatological hospitals competent for diagnostic work, but also for teaching and scientific research. In this context biologists were the main stay of mycology, they finally were integrated to the same degree in the universities like physicians. The effectiveness of the Gesellschaft für Medizinische Mykologie der DDR (GMM), its board of directors and its working groups as well as the topics of human and animal mycology during this period are described. Especially the merger of the GMM with the Deutschsprachige Mykologische Gesellschaft after the reunification of Germany without problems and the kind co-operation of Prof. Dr. Johannes Müller during this procedure are emphasized.

  1. The Role of Civil Society in Shaping Democratic Civil-Military Relations During Political Transition in Nepal

    DTIC Science & Technology

    2015-03-01

    opposition to patrimonial state[ s ].”148 In other words, the political affiliation of Nepal’s civil society originated in its historical development and...REPORT DATE I 3. REPORT TYPE AND DATES COVERED March 2015 Master ’ s Thesis 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS THE ROLE OF CIVIL SOCIETY IN...SHAPING DEMOCRATIC CIVIL- MILITARY RELATIONS DURING POLITICAL TRANSITION IN NEPAL 6. AUTHOR( S ) Bhuwan Pwna Satya! 7. PERFORMING ORGANIZATION NA:i\\tiE( S

  2. Background Report on Eastern Democratic Republic of the Congo

    SciTech Connect

    Warren, Tracy A

    2011-05-01

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

  3. Ebola virus disease in the Democratic Republic of Congo.

    PubMed

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

    2014-11-27

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

  4. High prevalence of mumps in Lao People's Democratic Republic.

    PubMed

    Hübschen, J M; Vilivong, K; Souvannaso, C; Black, A P; Lütteke, N; Samountry, B; Phongsavath, V; Khamphaphongphane, B; Denny, J; Sayyavong, C; Woo, G K S; Sengsaya, K; Sausy, A; Vongphrachanh, P; Jutavijittum, P; Phonekeo, D; Muller, C P

    2014-10-01

    In the Lao People's Democratic Republic (PDR), mumps is not a notifiable disease and mumps vaccine is currently not included in the routine childhood immunization programme. In order to assess the burden of disease, we investigated the seroprevalence of mumps-specific IgG antibodies across four provinces. In addition, we genetically characterized mumps viruses from the past 3 years from several outbreaks and single cases. Blood and/or throat swabs from suspected cases were investigated for specific IgM antibodies or viral RNA. Mumps cases occurred between March and November in 2011-2013 and 5- to 15-year-olds were most affected. Four sequences from an outbreak in the north of Lao PDR in 2011 were identical and belonged to genotype G. Eight sequences from two outbreaks and two individual cases from 2012 and 2013 belonged to genotype J. In addition, sera collected from 2379 healthy infants and school pupils aged between 9 months and 19 years and from pregnant women aged between 16 and 46 years were investigated for mumps-specific IgG. Overall, 58.2% were positive, 39.5% were negative and the remaining 2.3% were equivocal. The seropositivity increased with age, with the lowest percentage found in <1-year-old infants (9.1%) and the highest in the cohort of pregnant women (69.2%). More female subjects than male subjects were seropositive (60.4 vs. 54.9%). There were some differences between the locations. Mumps should be a notifiable disease in Lao PDR in order to get more accurate case numbers and cost estimates for public health-care, and vaccination of children and high-risk groups should be considered. © 2014 The Authors Clinical Microbiology and Infection © 2014 European Society of Clinical Microbiology and Infectious Diseases.

  5. 76 FR 61134 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... waive the requirements of Section 7086(c)(1) of the Act with respect to the Democratic Republic of the... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

  6. 78 FR 76698 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-18

    ... of Restriction on Assistance to the Central Government of the Democratic Republic of the Congo... requirements of Section 7031(b)(1) of the Act and similar provisions of law in prior year Acts with respect to the Democratic Republic of the Congo and I hereby waive this restriction. This determination and...

  7. 78 FR 16028 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of Congo

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... waive the requirements of Section 7031(b)(1-2) of the Act with respect to the Democratic Republic of... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF STATE Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of Congo...

  8. 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

    2015-11-19

    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

  9. [Health problems in textile industry in Democratic Republic of Congo].

    PubMed

    Panda Lukongo Kitronza, J; de Brouwer, C

    2010-01-01

    The objective of this work was to highlight the influence of the occupational conditions on the textile sector workers' health in Democratic Republic of Congo (DRC). We conduct an exploratory cross-sectional study of two populations within a plant located at the North of the DRC: workers (N=114) and executive or employees (N=96). Our total sample data (N=210) were collected by a questionnaire focused on the procedures, the exposures and the effects on health. Odds ratio (OR) and confidence interval at 95% were estimated. For each significant diseases symptom, a regression model has been achieved in order to estimate OR adjusted for association of disease symptoms and occupational statute. Workers compared to employees present high frequencies and exposure rates for many diseases symptoms. These OR are respectively for cough (OR = 5.1; IC: 2.93-10.68); respiratory difficulty (OR = 2.9; IC: 1.42-6.42) thoracic pain (OR = 2.6; IC: 1.31-5.24); fever (OR = 2.4; IC: 1.27-4.50); upper limbs pain (OR = 4.8; IC: 2.55-8.80); neck-shoulder pain (OR = 3.8; IC: 2.02-7.31); ocular diseases (OR = 2.2; IC: 1.17-3.89) and cutaneous diseases (OR = 2.5; IC: 1.18-5.46). The OR related to the libido loss is highest (OR = 5.5; IC: 2.84-10.71). In the other hand, the OR of the neuropsychics disorders are lower than 1 in this comparison and are respectively of 0.5 (0.28-0.95) for tiredness; 0.2 (0.08-0.28) for the lack of concentration and 0.07 (0.04-0.18) for the stress. In conclusion, the frequencies and high OR observed attest differences of the health issues between the workers and employees whose causes could be under the live and work conditions. These results should be confronted with those of other studies in health at the work.

  10. Diphtheria outbreak in Lao People's Democratic Republic, 2012-2013.

    PubMed

    Sein, Carolyn; Tiwari, Tejpratap; Macneil, Adam; Wannemuehler, Kathleen; Soulaphy, Chanthavy; Souliphone, Phouthone; Reyburn, Rita; Ramirez Gonzalez, Alejandro; Watkins, Margaret; Goodson, James L

    2016-08-05

    Diphtheria is a vaccine-preventable disease. When vaccination coverage and population immunity are low, outbreaks can occur. We investigated a diphtheria outbreak in Lao People's Democratic Republic that occurred during 2012-2013 and highlighted challenges in immunization services delivery to children in the country. We reviewed diphtheria surveillance data from April 1, 2012-May 31, 2013. A diphtheria case was defined as a respiratory illness consisting of pharyngitis, tonsillitis, or laryngitis, and an adherent tonsillar or nasopharyngeal pseudomembrane. To identify potential risk factors for diphtheria, we conducted a retrospective case-control study with two aged-matched neighborhood controls per case-patient in Houaphan Province, using bivariate analysis to calculate matched odds ratio (mOR) with 95% confidence intervals (CI). Reasons for non-vaccination among unvaccinated persons were assessed. Sixty-two clinical cases of diphtheria and 12 diphtheria-related deaths were reported in seven of 17 provinces. Among case-patients, 43 (69%) were <15years old, five (8%) reported receiving three DTP doses (DTP3), 21 (34%) had received no DTP doses, and 35 (56%) had unknown vaccination status. For the case-control study, 42 of 52 diphtheria case-patients from Houaphan province and 79 matched-controls were enrolled. Five (12%) case-patients and 20 (25%) controls had received DTP3 (mOR=0.4, CI=0.1-1.7). No diphtheria toxoid-containing vaccine was received by 20 (48%) case-patients and 38 (46%) controls. Among case-patients and controls with no DTP dose, 43% of case-patients and 40% of controls lacked access to routine immunization services. Suboptimal DTP3 coverage likely caused the outbreak. To prevent continued outbreaks, access to routine immunization services should be strengthened, outreach visits need to be increased, and missed opportunities need to be minimized. In the short term, to rapidly increase population immunity, three rounds of DTP immunization

  11. Smallpox and its eradication in the Democratic Republic of Congo: lessons learned.

    PubMed

    Muyembe-Tamfum, Jean-Jacques; Mulembakani, Prime; Lekie, René Botee; Szczeniowski, Mark; Ježek, Zdeněk; Doshi, Reena; Hoff, Nicole; Rimoin, Anne W

    2011-12-30

    Smallpox eradication is considered to be one of the most remarkable accomplishments of the 20th century. Lessons learned from the campaign during the 1960s and 1970s in the Democratic Republic of Congo (DRC) can provide important information for the development of other eradication programs including polio. The DRC is the third largest country in Africa; the population suffers from extreme poverty, deteriorating infrastructure and health systems, and long periods of civil strife. Despite these challenges, DRC's smallpox eradication campaign was successful, eradicating smallpox only 41 months after initiation. DRC had been polio free since 2001; however, in 2006, imported cases were identified in the country. Polio transmission has since been re-established and DRC now has the second greatest number of reported polio cases in the world. Challenges which existed during the smallpox campaign in DRC are still present today; additionally, the polio vaccine itself poses unique challenges which include requiring multiple doses to confer immunity. In the fight against polio in DRC, it will be important to draw from the smallpox eradication experience. A number of important themes emerged during the campaign that could be beneficial to eradicating polio and future eradication programs that may follow. During the smallpox campaign, a standard vaccination program was implemented, surveillance was intensified, and there were strong collaborative programs with community involvement. These successful elements of the smallpox campaign should be adapted and applied in DRC in polio eradication programs. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    ERIC Educational Resources Information Center

    Banza, Nsomwe-a-Nfunkwa

    2006-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  14. Spare Time of People Working in Socialist Agriculture in the German Democratic Republic.

    ERIC Educational Resources Information Center

    Fleischer, K.; Muller, I.

    The German Democratic Republic's (GDR) Constitution says that "members of cooperative farms are responsible for the creation, on the basis of existing laws, of their own working and living conditions". This also applies to regulations of working hours, holidays, and paid leaves. The total time available per day to members of cooperative…

  15. First Report of Rust Caused by Phakopsora pachyrhizi on soybean in Democratic Republic of Congo

    USDA-ARS?s Scientific Manuscript database

    Soybean rust caused by Phakopsora pachyrhizi has not been reported to occur in the Democratic Republic of Congo (DRC) in Central Africa. Nigeria (1) and Uganda (3) are the closest countries to DRC in the west and east, respectively, where the disease has been reported. In February 2007 during a dis...

  16. Malaria in Children Adopted from the Democratic Republic of the Congo

    PubMed Central

    Sollai, Sara; de Martino, Maurizio; Galli, Luisa

    2017-01-01

    Data are lacking regarding asymptomatic and symptomatic malaria prevalence in internationally adopted children. Among 20 children from Democratic Republic of the Congo evaluated in Florence, Italy, in April 2016, malaria prevalence was 80%; 50% of infected children had symptomatic malaria. Adopted children from areas of high malaria endemicity should be screened for malaria. PMID:28322706

  17. Historical Development of Media Systems. II. German Democratic Republic. Communication and Society 2.

    ERIC Educational Resources Information Center

    Dusiska, Emil

    This report summarizes a study of the systems of mass communication in the German Democratic Republic (GDR) that concentrated on the ideological and political bases of mass media as they developed after the Second World War. Topics discussed include (1) the history of journalism in the GDR, (2) the roles of the various media in that country, (3)…

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

    ERIC Educational Resources Information Center

    Cosandey, Olivier

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

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

    PubMed

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

    2017-02-02

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

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

    PubMed Central

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  2. Vocational Education and Training in the German Democratic Republic. Comparative Papers in Further Education. Number Eleven.

    ERIC Educational Resources Information Center

    Further Education Staff Coll., Blagdon (England).

    These five papers describe the educational system of the German Democratic Republic (GDR). An introduction by Derek Marsh overviews the climate for and aims of education in the GDR. "A Brief Introduction to the GDR" (Jean Finlayson) summarizes the economic background, standard of living, role of women, politics, religion, sports and…

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

    ERIC Educational Resources Information Center

    Nsomwe-a-nfunkwa, Banza

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  5. Higher Education in the German Democratic Republic. Monographs on Higher Education.

    ERIC Educational Resources Information Center

    Schulz, H. J.

    The system of higher education of the German Democratic Republic is described. Information on the different kinds of colleges--universities, university colleges, and engineering and technical colleges--is provided, including admission procedures, course objectives, course content and structure, further education, paths leading to the award of…

  6. Unique songs of African wood-owls (Strix woodfordii) in the Democratic Republic of Congo.

    Treesearch

    B.G. Marcot

    2007-01-01

    Statistical analysis of African wood-owl (Strix woodfordii) song spectrograms suggest a significantly different song type in Democratic Republic of Congo (DRC), central Africa, than elsewhere in eastern or southern Africa. Songs of DRC owls tend to be consistently shorter in duration and more monotone in overall frequency range. The first note is...

  7. Outbreak of cholera in the Republic of Congo and the Democratic Republic of Congo, and cholera worldwide.

    PubMed

    Kelvin, Alyson Ann

    2011-10-13

    Cholera is an acute intestinal disease caused by infection of the Vibrio cholerae bacterium.  Often manifested as a constant diarrhoeal disease, Cholera is associated with significant mortality as well as economic loss due to the strain on health care.  Cholera often affects nations with lower economic status.  The recent outbreak of cholera in the Republic of Congo and the Democratic Republic of Congo has affected thousands of people.  Here we review the past cholera epidemiology, molecular mechanisms of the bacterium, and the political and environmental aspects that affect the treatment and eradication of this disease.

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

    DTIC Science & Technology

    2014-02-24

    for last place on the 2013 U.N. Human Development Index and has the world’s lowest per-capita gross domestic product ( GDP ).6 Given that it is the 11th...1 Definitions of the Great Lakes region vary, but it centers on DRC, Rwanda, Burundi , and Uganda. The International Conference on the Great Lakes...Region (ICGLR), an inter-governmental body, includes as member-states Angola, Burundi , Central African Republic, Republic of Congo (Brazzaville), DRC

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

    PubMed

    Wembonyama, S; Mpaka, S; Tshilolo, L

    2007-10-01

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

  10. The Democratic Republic of Congo: Background and Current Developments

    DTIC Science & Technology

    2010-07-23

    began in the city of Goma in the mid-1990s. The second rebellion in the late 1990s began also in eastern Congo. The root causes of the current crisis...Democratic Rally (RCD- Goma ), the Movement for the Congolese Liberation (MLC), and representatives of the unarmed political groups. The agreement called for a...dozen rebel groups and the DRC government signed the Goma Accord, primarily focused on ending the violence in Eastern Congo. Since the signing of the

  11. The Democratic Republic of Congo: Background and Current Developments

    DTIC Science & Technology

    2010-10-08

    Seko began in the city of Goma in the mid-1990s. The second rebellion in the late 1990s began also in eastern Congo. The root causes of the current...government. The All-Inclusive Agreement was signed in Pretoria, South Africa, by the DRC government, Congolese Democratic Rally (RCD- Goma ), the Movement...the Goma Accord, primarily focused on ending the violence in Eastern Congo. Since the signing of the agreement, while progress has been made, there

  12. Mai-Mai militia and sexual violence in Democratic Republic of the Congo.

    PubMed

    Guy, Kitwe Mulunda

    2014-01-01

    This article sets the reasons for the brutal violence against women. It focuses on three field sites providing insight into Mai-Mai motivations and their attitudes toward sexual violence. According to most sources, 5.5 million people have died since the beginning of the war in the Democratic Republic of the Congo (DRC) in 1994, and rape is used as a weapon of destruction. More than 15,000 rapes were reported in the DRC in the last year--accounts of these rapes include descriptions of horrific acts, such as mutilation and the killing of unborn children. The sexual violence is so severe in the DRC that some have described rape in the country as the worst in the world. Sexual violence has long lasting consequences and far-reaching impacts on individual survivors, their families, and their communities in the Democratic Republic of the Congo.

  13. Rape as a weapon of war in the Democratic Republic of the Congo.

    PubMed

    Brown, Carly

    2012-01-01

    The Democratic Republic of the Congo has been appropriately acknowledged as "the rape capital of the world." While the country has been trapped in conflict, the use of rape as a weapon of war has been rampant and unyielding. The sexual violence inflicted upon women has been nothing less than brutal and destructive, physically, socially, and psychologically. This paper analyzes the use of rape as a weapon of war in the Congo, taking into context the ongoing war, cultural and social situations that facilitate its existence, and the many consequences the victims are forced to endure. Drawing information from various academic journals, articles, and field research from international organizations, this paper paints a concise picture of the sexual atrocities occurring in the Democratic Republic of the Congo.

  14. A Qualitative Analysis of Disclosure Patterns among Women with Sexual Violence-Related Pregnancies in Eastern Democratic Republic of Congo.

    PubMed

    Onyango, Monica Adhiambo; Burkhardt, Gillian; Scott, Jennifer; Rouhani, Shada; Haider, Sadia; Greiner, Ashley; Albutt, Katherine; Mullen, Colleen; VanRooyen, Michael; Bartels, Susan

    2016-01-01

    The Democratic Republic of the Congo (DRC) has experienced nearly two decades of civil conflict in the Eastern regions of North and South Kivu. This conflict has been notorious for the use of sexual violence as a weapon of war, leading in many cases to pregnancy after rape. The objectives of this analysis were: 1) to describe patterns of sexual violence-related pregnancy (SVRP) disclosure; 2) to consider why survivors chose to disclose to particular individuals; and 3) to examine the dialogue around SVRPs between women with SVRPs and their confidants. In South Kivu Province, Democratic Republic of Congo, two sub-groups of sexual violence survivors completed qualitative interviews, those currently raising a child from an SVRP (parenting group, N = 38) and those who had terminated an SVRP (termination group, N = 17). The findings show that a majority of SVRPs were conceived when participants were held in sexual captivity for prolonged periods of time. The SVRPs were disclosed to friends, family members, other sexual violence survivors, community members, spouses, health care providers, or perpetrators. The confidants were most often chosen because they were perceived by the participants as being discreet, trusted, and supportive. The confidants often provided advice about continuing or terminating the SVRP. Trust and discretion are the most important factors determining to whom women with SVRPs disclose their pregnancies. The vital role of confidants in giving support after disclosure cannot be overlooked. Providing opportunities for survivors to safely disclose their SVRPs, including to health care providers, is a necessary first step in allowing them to access safe and comprehensive post-assault care and services.

  15. A Qualitative Analysis of Disclosure Patterns among Women with Sexual Violence-Related Pregnancies in Eastern Democratic Republic of Congo

    PubMed Central

    Onyango, Monica Adhiambo

    2016-01-01

    The Democratic Republic of the Congo (DRC) has experienced nearly two decades of civil conflict in the Eastern regions of North and South Kivu. This conflict has been notorious for the use of sexual violence as a weapon of war, leading in many cases to pregnancy after rape. The objectives of this analysis were: 1) to describe patterns of sexual violence-related pregnancy (SVRP) disclosure; 2) to consider why survivors chose to disclose to particular individuals; and 3) to examine the dialogue around SVRPs between women with SVRPs and their confidants. In South Kivu Province, Democratic Republic of Congo, two sub-groups of sexual violence survivors completed qualitative interviews, those currently raising a child from an SVRP (parenting group, N = 38) and those who had terminated an SVRP (termination group, N = 17). The findings show that a majority of SVRPs were conceived when participants were held in sexual captivity for prolonged periods of time. The SVRPs were disclosed to friends, family members, other sexual violence survivors, community members, spouses, health care providers, or perpetrators. The confidants were most often chosen because they were perceived by the participants as being discreet, trusted, and supportive. The confidants often provided advice about continuing or terminating the SVRP. Trust and discretion are the most important factors determining to whom women with SVRPs disclose their pregnancies. The vital role of confidants in giving support after disclosure cannot be overlooked. Providing opportunities for survivors to safely disclose their SVRPs, including to health care providers, is a necessary first step in allowing them to access safe and comprehensive post-assault care and services. PMID:27741262

  16. Dorstenialuamensis (Moraceae), a new species from eastern Democratic Republic of Congo.

    PubMed

    Leal, Miguel E

    2014-01-01

    A new species of Dorstenia L. (Moraceae), Dorstenialuamensis M.E.Leal, is described from the Luama Wildlife Reserve, west of Lake Tanganyika and north of the town of Kalemie in the eastern part of the Democratic Republic of Congo (DRC). This species is endemic to the region and differs from any of the other species by its fernlike lithophytic habit and lack of latex. A description and illustration of this species is presented here. Dorstenialuamensis M.E.Leal inhabits moist and shady vertical rock faces close to small waterfalls in the forest; the species is distributed in small populations within the type locality, and merits the conservation status of endangered (EN).

  17. [Malaria in the United Nations troops in the Democratic Republic of the Congo during 2005].

    PubMed

    Ennibi, K; Rabhi, M; Boudlal, M; Sbai Idrissi, K; Chaari, J; Toloune, F

    2012-01-01

    This prospective study examined malaria among United Nations troops participating in Operation MONUC in the town of Bunia in the Democratic Republic of Congo from April through October, 2005. Of 245 soldiers hospitalized, 105 were diagnosed with malaria, 93.6% with Plasmodium falciparum. All but one were men, and their median age was 43.5 years (range:29-52 years). South African (40/105) and Moroccan (22/105) soldiers accounted for the majority. Cases were collected mainly from May through July.

  18. Rape as a strategy of war in the Democratic Republic of the Congo.

    PubMed

    Mukwege, Denis Mukengere; Mohamed-Ahmed, Olaa; Fitchett, Joseph R

    2010-09-01

    The Democratic Republic of the Congo (DRC) is tremendously wealthy. Abundant in gold, diamonds, tantalum, tin, copper, zinc and cobalt, the natural resources in Africa's third largest country are not equally benefiting the people. The DRC should sustainably be making use of their natural resources to develop the country, whose health, education and transport systems all suffer to this day from the effects of conflict. Instead, the DRC is divided with rebels, corrupt governments and foreign investors all fighting in one way or another for control over the country's wealth. The following article focuses on the emergence of rape as a strategy of war in the DRC.

  19. First Order Dominance Analysis: Child Wellbeing in the Democratic Republic of Congo.

    PubMed

    Nanivazo, Malokele

    This paper performs a multidimensional first order dominance analysis of child wellbeing in the Democratic Republic of Congo (DRC). This methodology allows the ordinal ranking of the 11 provinces of the DRC in terms of their wellbeing based upon the probability of their domination. This empirical application obviates the need to adopt a weighting scheme for the deprivation indicators or to rely on the signs of other cross-derivatives for comparison. We execute a bootstrap linear programming algorithm on seven deprivation indicators for three age groups of children derived from the DRC 2007 Standard Demographic and Health Survey. The results reveal widespread disparities in child wellbeing in the DRC.

  20. [Shock therapy and psychosurgery in the early German Democratic Republic (GDR)].

    PubMed

    Rzesnitzek, L

    2015-11-01

    Patient files, textbooks and published articles of the time show that the wide range of psychiatric therapies of the 1950s and 1960s was also used in the early German Democratic Republic (GDR). The use of insulin coma therapy, cardiazol and electroconvulsive therapies and especially of leucotomy in the GDR must not only be seen in the context of the international development and debate concerning these therapies up to the introduction of psychopharmaceutic therapy but also, in a similar way as in the Federal Republic of Germany, in relation to the locally sometimes different availability of insulin and cardiazol in the post-war period, different schools of academic thought and scientific research interest and priorities of the clinics concerned.

  1. [Company centredness in the rehabilitation system of the German Democratic Republic, GDR].

    PubMed

    Höhne, A; Behrens, J; Schaepe, C; Schubert, M; Zimmermann, M

    2007-08-01

    This article describes major aspects of the rehabilitation system of the former German Democratic Republic, GDR. Based on presentation of the actors in the medical and occupational rehabilitation system, differences are pointed out in comparison to the notion of rehabilitation in the former Federal Republic of Germany, FRG. The article focuses on the system of rehabilitation after stroke, which is outlined with relevant scientific literature. The health and rehabilitation system of the GDR was company-centred. Patients in rehabilitation received comprehensive care and guidance, and especially the companies played an integrative part and adjusted the occupational activity of the patients in rehabilitation to their physical and mental abilities in order to avoid early retirement. On account of the political and social transformation process as well as transfer of the health and rehabilitation legislation of the old FRG, the company-centred rehabilitation system of the GDR was replaced, implementing West German rehabilitation structures in East Germany as well.

  2. National dengue surveillance in the Lao People's Democratic Republic, 2006-2012: epidemiological and laboratory findings.

    PubMed

    Khampapongpane, Bouaphanh; Lewis, Hannah C; Ketmayoon, Pakapak; Phonekeo, Darouny; Somoulay, Virasack; Khamsing, Amphai; Phengxay, Manilay; Sisouk, Thongchanh; Vongphrachanh, Phengta; Bryant, Juliet E

    2014-01-01

    Although dengue has been a public health problem for several decades in the Lao People's Democratic Republic, the magnitude of the disease burden and epidemiological trends remain poorly understood. We analysed national dengue surveillance and laboratory data from 2006 to 2012 by person, place and time. Between 2006 and 2012, the annual dengue notification rate ranged between 62 and 367 cases per 100 000 population with an apparent geographical expansion of transmission throughout the country in recent years and concurrent co-circulation of all four dengue virus subtypes. An electronic database, called Lao People's Democratic Republic Early Warning Alert and Response Network, was introduced in 2008 to provide automated early warning for outbreaks and epidemics. Village outbreaks continue to be notified primarily through event-based surveillance, whereas the weekly indicator-based system provides systematic assessment of annual epidemic cycles. The dengue case data indicate a high and increasing burden of disease. Efforts now need to focus on using available data to prompt more effective outbreak response and to guide the design and implementation of intervention strategies.

  3. National dengue surveillance in the Lao People's Democratic Republic, 2006–2012: epidemiological and laboratory findings

    PubMed Central

    Khampapongpane, Bouaphanh; Ketmayoon, Pakapak; Phonekeo, Darouny; Somoulay, Virasack; Khamsing, Amphai; Phengxay, Manilay; Sisouk, Thongchanh; Vongphrachanh, Phengta; Bryant, Juliet E

    2014-01-01

    Although dengue has been a public health problem for several decades in the Lao People's Democratic Republic, the magnitude of the disease burden and epidemiological trends remain poorly understood. We analysed national dengue surveillance and laboratory data from 2006 to 2012 by person, place and time. Between 2006 and 2012, the annual dengue notification rate ranged between 62 and 367 cases per 100 000 population with an apparent geographical expansion of transmission throughout the country in recent years and concurrent co-circulation of all four dengue virus subtypes. An electronic database, called Lao People's Democratic Republic Early Warning Alert and Response Network, was introduced in 2008 to provide automated early warning for outbreaks and epidemics. Village outbreaks continue to be notified primarily through event-based surveillance, whereas the weekly indicator-based system provides systematic assessment of annual epidemic cycles. The dengue case data indicate a high and increasing burden of disease. Efforts now need to focus on using available data to prompt more effective outbreak response and to guide the design and implementation of intervention strategies. PMID:24734212

  4. Antibiotic prescription behaviours in Lao People's Democratic Republic: a knowledge, attitude and practice survey.

    PubMed

    Quet, Fabrice; Vlieghe, Erika; Leyer, Caroline; Buisson, Yves; Newton, Paul N; Naphayvong, Philaysak; Keoluangkhot, Valy; Chomarat, Monique; Longuet, Christophe; Steenkeste, Nicolas; Jacobs, Jan

    2015-04-01

    To assess the antibiotic prescribing practices of doctors working in the Lao People's Democratic Republic and their knowledge of local antibiotic resistance patterns. Doctors attending morning meetings in 25 public hospitals in four provinces were asked to complete a knowledge, attitude and practice survey. The questionnaire contained 43 multiple choice questions that the doctor answered at the time of the meeting. The response rate was 83.4% (386/463). Two hundred and seventy doctors (59.8%) declared that they had insufficient information about antibiotics. Only 14.0% (54/386) recognized the possibility of cephalosporin cross-resistance in methicillin-resistant Staphylococcus aureus. Most participants had no information about local antibiotic resistance for Salmonella Typhi (211/385, 54.8%) and hospital-acquired pneumonia (253/384, 65.9%). Unnecessary antibiotic prescriptions were considered as harmless by 115 participants and 148 considered locally-available generic antibiotics to be of poor quality. Nearly three-quarters (280/386) of participants agreed that it was difficult to select the correct antibiotics. Most participants (373/386) welcomed educational programmes on antibiotic prescribing and 65.0% (249/383) preferred local over international antibiotic guidelines. Doctors in the Lao People's Democratic Republic seem to favour antibiotic prescribing interventions. Health authorities should consider a capacity building programme that incorporates antibiotic prescribing and hospital infection control.

  5. Ordinance of 30 November 1988 on travel abroad by citizens of the German Democratic Republic.

    PubMed

    1989-01-01

    This Ordinance sets forth new rules with respect to travel abroad by citizens of the German Democratic Republic. Its major provisions are as follows: 1) the occasions when relatives may travel abroad to other than socialist countries have been increased; 2) travel abroad by pensioners may be undertaken without giving any special reason; 3) travel abroad to socialist countries can be made for any reason; 4) persons may now leave the German Democratic Republic permanently for humanitarian reasons, including the desire of an invalid or old person to receive care or spend his or her days elsewhere and family reunification; 5) requests for permanent departure can be denied on the grounds of national security or defense, because a person has not performed his or her military service, to protect the public order or state interests, and to protect the rights of citizens or socialist morale and social requirements; 6) requests to go abroad temporarily are generally to be handled within 30 days and requests to leave permanently usually within 3 months; 7) adverse decisions may now be appealed both administratively and then through the courts, although in a court the only argument that can be made is that the decision was unlawful; 8) a request that has been denied can be resubmitted if the reason for denial is no longer present; and 9) in the case of a request to leave permanently, 6 months must pass before resubmission.

  6. Situation Report--Burma, Chile, German Democratic Republic, Indonesia, Jamaica, Poland, Singapore, St. Christopher/Nevis, Trinidad & Tobago, Venezuela.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in ten foreign countries are presented in these situation reports. Countries included are Burma, Chile, German Democratic Republic, Indonesia, Jamaica, Poland, Singapore, St. Christopher/Nevis, Trinidad and Tobago, and Venezuela. Information is provided, where appropriate and available, under two…

  7. 3 CFR - Presidential Determination for the Lao People's Democratic Republic Under Section 2(b)(2) of the...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false Presidential Determination for the Lao People's Democratic Republic Under Section 2(b)(2) of the Export-Import Bank Act of 1945, as amended Presidential Documents Other Presidential Documents Presidential Determination No. 2009-21 of June 12, 2009 Presidential Determination for the Lao...

  8. The Development of the National Library System on the Basis of the German Democratic Republic's Social Development.

    ERIC Educational Resources Information Center

    Schumann, Wolfgang; Schwarz, Gerhard

    This historical review considers the rise of the German Democratic Republic's (GDR) system of libraries since its inception in 1945. Sections detail the following: (1) background; (2) tasks of the state organs in the development of the library network, with attention to legislation, planning, and management of the system; (3) role of the GDR…

  9. The 1984 Literacy Campaign in the People's Democratic Republic of Yemen. A Case Study. Notes, Comments...No. 183.

    ERIC Educational Resources Information Center

    Fara, Mohammed Saeed; Fisher, Nigel

    In 1984, the People's Democratic Republic of Yemen undertook a nationwide literacy campaign, which mobilized the entire nation in an effort to reach an estimated 194,000 illiterate people, 77 percent of them women. The campaign plan demanded the full and active participation of formal school teachers and students at secondary level and above as…

  10. The 1984 Literacy Campaign in the People's Democratic Republic of Yemen. A Case Study. Notes, Comments...No. 183.

    ERIC Educational Resources Information Center

    Fara, Mohammed Saeed; Fisher, Nigel

    In 1984, the People's Democratic Republic of Yemen undertook a nationwide literacy campaign, which mobilized the entire nation in an effort to reach an estimated 194,000 illiterate people, 77 percent of them women. The campaign plan demanded the full and active participation of formal school teachers and students at secondary level and above as…

  11. On the Social Status and Career Prospects of Youth in Agriculture in the GDR (German Democratic Republic).

    ERIC Educational Resources Information Center

    Tittel, Guenter

    The new Youth Act passed by the People's Chamber of the German Democratic Republic (GDR) in 1974 assumes that the interests of young people concur with the interests of their socialist society and state, for it reforms the rights and conditions for the further development of young people and defines their duties and responsibilities in terms of…

  12. Redescriptions of three species of freshwater crabs from the Democratic Republic of Congo, Central Africa (Brachyura: Potamoidea: Potamonautidae).

    PubMed

    Cumberlidge, Neil

    2015-06-16

    The taxonomy of three species of freshwater crabs from the Upper Congo River in the Democratic Republic of Congo, Potamonautes congoensis (Rathbun, 1921), P. langi (Rathbun, 1921), and P. stanleyensis (Rathbun, 1921), is revised based on examination of the holotypes. Updated diagnoses, illustrations, and distribution maps are provided for these species, and their conservation status is discussed.

  13. Civil society advocacy in Nigeria: promoting democratic norms or donor demands?

    PubMed

    Williamson, R Taylor; Rodd, Joshua

    2016-07-11

    Civil society organizations (CSOs) are often assumed to be institutions that facilitate communication between citizens and policymakers. However, CSO advocacy is only as effective as the space allowed by government, the resources available from funders, and their own internal capacity. This article presents findings from a study in Nigeria that explores the advocacy and service delivery roles of CSOs working in Human Immunodeficiency Virus (HIV) prevention and mitigation. We will argue that donor and government treatment of civil society as service delivery organizations, rather than as organizations that participate in democratic norms, have shaped how civil society organizations work to mitigate and prevent HIV. From February to April 2012, a team of Health Systems 20/20 staff and one consultant conducted 48 in-depth interviews with civil society organizations, State AIDS Control Agencies (SACAs), donors, international organizations, and networks of people living with HIV to examine a wide range of advocacy efforts by CSOs. For quantitative data collection, sampling frames were assembled from lists of HIV-oriented or involved CSOs. This sampling frame consisted of 2548 CSOs from all 36 states and the Federal Capital Territory. A random sample was then taken from the sampling frame, and we contacted 665 CSOs to arrange interviews. With a response rate of 80.2 %, the project conducted 533 surveys in February 2012. These surveys showed that CSOs advocacy efforts focused on community mobilization related to behavior change, such as peer education (54.9 % of CSOs) and rallies (58.2 % of CSOs), and not on changing government policies. In-depth interviews highlighted the role of donors and government in shaping a purely apolitical role for most CSOs through funding constraints, regulations, and capacity development choices. In light of these findings, we present key points for considering the influence of donors and government on civil society advocacy for HIV services

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

    PubMed

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

    2015-07-01

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

  15. Dorstenia luamensis (Moraceae), a new species from eastern Democratic Republic of Congo

    PubMed Central

    Leal, Miguel E.

    2014-01-01

    Abstract A new species of Dorstenia L. (Moraceae), Dorstenia luamensis M.E.Leal, is described from the Luama Wildlife Reserve, west of Lake Tanganyika and north of the town of Kalemie in the eastern part of the Democratic Republic of Congo (DRC). This species is endemic to the region and differs from any of the other species by its fernlike lithophytic habit and lack of latex. A description and illustration of this species is presented here. Dorstenia luamensis M.E.Leal inhabits moist and shady vertical rock faces close to small waterfalls in the forest; the species is distributed in small populations within the type locality, and merits the conservation status of endangered (EN). PMID:25383011

  16. Diagnosis of Opisthorchis viverrini Infection with Handheld Microscopy in Lao People's Democratic Republic

    PubMed Central

    Bogoch, Isaac I.; Sayasone, Somphou; Vonghachack, Youthanavanh; Meister, Isabel; Utzinger, Jürg; Odermatt, Peter; Andrews, Jason R.; Keiser, Jennifer

    2016-01-01

    Opisthorchiasis is a neglected tropical disease, yet it is of considerable public health importance in Southeast Asia given the predilection for chronically infected persons to develop cholangiocarcinoma. We evaluated a handheld microscope for the diagnosis of Opisthorchis viverrini in a community-based setting in Lao People's Democratic Republic in comparison with conventional light microscopy. In stool samples collected from 104 individuals, handheld microscopy revealed a sensitivity of 70.6% and a specificity of 89.5% for O. viverrini infection. Pearson's correlation for quantitative fecal egg counts between the two devices was 0.98 (95% confidence interval: 0.98–0.99). With small adjustments to further increase diagnostic sensitivity, a handheld microscope may become a helpful tool to screen for O. viverrini and other helminth infections in public health settings. PMID:26526923

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

    PubMed

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

    2017-04-01

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

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

    PubMed

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

    2015-11-03

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

  19. Isolated case of Ebola hemorrhagic fever with mucormycosis complications, Kinshasa, Democratic Republic of the Congo.

    PubMed

    Kalongi, Y; Mwanza, K; Tshisuaka, M; Lusiama, N; Ntando, E; Kanzake, L; Shieh, W J; Zaki, S R; Lloyd, E S; Ksiazek, T G; Rollin, P E

    1999-02-01

    A patient with undiagnosed Ebola (EBO) hemorrhagic fever (EHF) was transferred from Kikwit to a private clinic in Kinshasa, Democratic Republic of the Congo. A diagnosis of EHF was suspected on clinical grounds and was confirmed by detection of EBO virus-specific IgM and IgG in serum of the patient. During the course of the disease, although she had no known predisposing factors, the patient developed a periorbital mucormycosis abscess on eyelid tissue that was biopsied during surgical drainage; the abscess was histologically confirmed. Presence of EBO antigen was also detected by specific immunohistochemistry on the biopsied tissue. The patient survived the EBO infection but had severe sequelae associated with the mucormycosis. Standard barrier-nursing precautions were taken upon admission and upgraded when EHF was suspected; there was no secondary transmission of the disease.

  20. Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients.

    PubMed

    Bwaka, M A; Bonnet, M J; Calain, P; Colebunders, R; De Roo, A; Guimard, Y; Katwiki, K R; Kibadi, K; Kipasa, M A; Kuvula, K J; Mapanda, B B; Massamba, M; Mupapa, K D; Muyembe-Tamfum, J J; Ndaberey, E; Peters, C J; Rollin, P E; Van den Enden, E; Van den Enden, E

    1999-02-01

    During the 1995 outbreak of Ebola hemorrhagic fever in the Democratic Republic of the Congo, a series of 103 cases (one-third of the total number of cases) had clinical symptoms and signs accurately recorded by medical workers, mainly in the setting of the urban hospital in Kikwit. Clinical diagnosis was confirmed retrospectively in cases for which serum samples were available (n = 63, 61% of the cases). The disease began unspecifically with fever, asthenia, diarrhea, headaches, myalgia, arthralgia, vomiting, and abdominal pain. Early inconsistent signs and symptoms included conjunctival injection, sore throat, and rash. Overall, bleeding signs were observed in <45% of the cases. Typically, terminally ill patients presented with obtundation, anuria, shock, tachypnea, and normothermia. Late manifestations, most frequently arthralgia and ocular diseases, occurred in convalescent patients. This series is the most extensive number of cases of Ebola hemorrhagic fever observed during an outbreak.

  1. Human monkeypox -- Kasai Oriental, Democratic Republic of Congo, February 1996-October 1997.

    PubMed

    1997-12-12

    Human monkeypox is a severe smallpox-like illness caused by monkeypox virus (MPV); monkeypox occurs in sporadic outbreaks, and infection is enzootic among squirrels and monkeys in the rainforests of western and central Africa. In 1996, cases of monkeypox were reported from villages in the Katako-Kombe Health Zone, Kasai Oriental, Zaire (i.e., Democratic Republic of Congo). The World Health Organization (WHO), in collaboration with CDC, investigated this outbreak and identified 92 suspected cases with onset during February 1996-February 1997, and isolated MPV from lesions of active cases. Cases continued to be reported, and a new investigation was initiated by WHO and CDC in October 1997. This report summarizes the results of the field investigation, which indicate that this is the largest human monkeypox outbreak ever recorded.

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

    PubMed

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

    2013-11-01

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

  3. Varicella Coinfection in Patients with Active Monkeypox in the Democratic Republic of the Congo.

    PubMed

    Hoff, Nicole A; Morier, Douglas S; Kisalu, Neville K; Johnston, Sara C; Doshi, Reena H; Hensley, Lisa E; Okitolonda-Wemakoy, Emile; Muyembe-Tamfum, Jean Jacques; Lloyd-Smith, James O; Rimoin, Anne W

    2017-09-11

    From 2006 to 2007, an active surveillance program for human monkeypox (MPX) in the Democratic Republic of the Congo identified 151 cases of coinfection with monkeypox virus and varicella zoster virus from 1158 suspected cases of human MPX (13%). Using clinical and socio-demographic data collected with standardized instruments by trained, local nurse supervisors, we examined a variety of hypotheses to explain the unexpectedly high proportion of coinfections among the sample, including the hypothesis that the two viruses occur independently. The probabilities of disease incidence and selection necessary to yield the observed sample proportion of coinfections under an assumption of independence are plausible given what is known and assumed about human MPX incidence. Cases of human MPX are expected to be underreported, and more coinfections are expected with improved surveillance.

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

    PubMed

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

    2011-01-01

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

  5. Diagnosis of Opisthorchis viverrini Infection with Handheld Microscopy in Lao People's Democratic Republic.

    PubMed

    Bogoch, Isaac I; Sayasone, Somphou; Vonghachack, Youthanavanh; Meister, Isabel; Utzinger, Jürg; Odermatt, Peter; Andrews, Jason R; Keiser, Jennifer

    2016-01-01

    Opisthorchiasis is a neglected tropical disease, yet it is of considerable public health importance in Southeast Asia given the predilection for chronically infected persons to develop cholangiocarcinoma. We evaluated a handheld microscope for the diagnosis of Opisthorchis viverrini in a community-based setting in Lao People's Democratic Republic in comparison with conventional light microscopy. In stool samples collected from 104 individuals, handheld microscopy revealed a sensitivity of 70.6% and a specificity of 89.5% for O. viverrini infection. Pearson's correlation for quantitative fecal egg counts between the two devices was 0.98 (95% confidence interval: 0.98-0.99). With small adjustments to further increase diagnostic sensitivity, a handheld microscope may become a helpful tool to screen for O. viverrini and other helminth infections in public health settings.

  6. Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo.

    PubMed

    Tappe, Dennis; Sulyok, Mihály; Riu, Therese; Rózsa, Lajos; Bodó, Imre; Schoen, Christoph; Muntau, Birgit; Babocsay, Gergely; Hardi, Richard

    2016-08-01

    Snakeborne Armillifer pentastomiasis is an emerging human parasitic infection in rural tropical areas where snake meat is eaten. After a series of severe ocular A. grandis larval infections and anecdotal abdominal infection in Sankuru District, Democratic Republic of the Congo, during 2014-2015, we systematically investigated possible pentastomid etiology in patients who underwent surgery in the region. Histologic and molecular analyses by established pentastomid 18S rDNA- and newly developed Armillifer-specific cytochrome oxidase PCRs revealed larval pentastomid lesions in 3.7% of patients. Some persons had A. armillatus and A. grandis co-infections. Another pentastomid larva, Raillietiella sp., was molecularly detected in 1 patient who had concomitant A. grandis and A. armillatus infection. The PCRs used were suitable for detecting pentastomid species even in highly necrotic tissues. Phylogenetic analyses of Armillifer cytochrome oxidase genes detected multiple local strains.

  7. Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo

    PubMed Central

    Sulyok, Mihály; Riu, Therese; Rózsa, Lajos; Bodó, Imre; Schoen, Christoph; Muntau, Birgit; Babocsay, Gergely; Hardi, Richard

    2016-01-01

    Snakeborne Armillifer pentastomiasis is an emerging human parasitic infection in rural tropical areas where snake meat is eaten. After a series of severe ocular A. grandis larval infections and anecdotal abdominal infection in Sankuru District, Democratic Republic of the Congo, during 2014–2015, we systematically investigated possible pentastomid etiology in patients who underwent surgery in the region. Histologic and molecular analyses by established pentastomid 18S rDNA- and newly developed Armillifer-specific cytochrome oxidase PCRs revealed larval pentastomid lesions in 3.7% of patients. Some persons had A. armillatus and A. grandis co-infections. Another pentastomid larva, Raillietiella sp., was molecularly detected in 1 patient who had concomitant A. grandis and A. armillatus infection. The PCRs used were suitable for detecting pentastomid species even in highly necrotic tissues. Phylogenetic analyses of Armillifer cytochrome oxidase genes detected multiple local strains. PMID:27434739

  8. 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

  9. Persistence of high fertility in tropical Africa: the case of the Democratic Republic of the Congo.

    PubMed

    Romaniuk, Anatole

    2011-01-01

    The article explores how geography, history, and society have shaped childbearing behaviors over the last half-century, and how they are now being reshaped by modernity and the exigencies of urban life, in the democratic Republic of the Congo. The decline of prolonged postpartum abstinence and involuntary childlessness initially raised fertility to high levels (6–7 children per woman). More recently, socioeconomic differentials in fertility have emerged, suggesting that the country may be entering a phase of fertility decline. A full-blown transition, however, seems still a remote prospect. Supported both by cultural traditions and by economic rationality, Congo's people remain largely convinced of the benefits of many children for their own and their kin's security. While an eventual fertility transition may be taken for granted, the article examines the many hurdles, contradictions, and tensions that will have to be overcome to achieve that outcome.

  10. [Triple malaria infection in twin sisters from the Democratic Republic of Congo].

    PubMed

    Galeazzi, G; Ardoin, F; Petithory, J C; Laurent, C

    2003-05-01

    Infections with 3 species of malaria parasites are rarely encountered and observed in less than 0.05% of cases. We came across such an infection in four year-old, monozygote twin sisters, coming from Kinshasa (Democratic Republic of Congo). In both of them, parasitemia was low or very low for P. falciparum and P. ovale and of 0.1-0.2% for P. malariae. The twin sisters presented with an iron deficiency anaemia, associated with an heterozygous sickle-cell anaemia and a moderate splenomegaly. The biological tests results were similar. They responded well to treatment. We point out the difficulty in recognizing the concomitant presence of several species of hematozoaire on blood smear.

  11. Iodine and iron status of pregnant women in Lubumbashi, Democratic Republic of Congo.

    PubMed

    Habimana, Laurence; Twite, Kabange E; Wallemacq, Pierre; De Nayer, Philippe; Daumerie, Chantal; Donnen, Philippe; Kalenga, Muenze K; Robert, Annie

    2013-08-01

    Adequate iodine and Fe intakes are imperative during pregnancy to prevent fetal defects, but such data are not available in the Democratic Republic of Congo. We aimed to assess iodine and Fe status in pregnant women from Lubumbashi. Cross-sectional study. We measured urinary iodine concentration (UIC) in random urine samples using a modified Sandell–Kolthoff digestion method; the WHO reference medians were used to classify iodine intake as deficient, adequate, more than adequate or excessive. Serum ferritin concentrations were measured by immunoenzymatic assay and considered insufficient when ,12 ng/ml. Maternity units from rural, semi-urban and urban areas of Lubumbashi, Democratic Republic of Congo. Two hundred and twenty-five randomly selected pregnant women attending prenatal consultation, seventy-five postpartum women and seventy-five non-pregnant women as controls. Overall median UIC in pregnant women was 138 (interquartile range: 105–172) mg/l, indicating iodine deficiency, whereas postpartum and nonpregnant women had adequate iodine intake: median UIC5144mg/l and 204mg/l,respectively. Median UIC values were lower in late pregnancy than in early pregnancy: in the first, second and third trimester respectively 255mg/l, 70mg/l and 88mg/l in the rural area; 306mg/l, 166mg/l and 68mg/l in the semi-urban area; and 203mg/l, 174mg/l and 99mg/l in the urban area. Fe was insufficient in 39% of pregnant women compared with 21% of non-pregnant and postpartum women. In the third trimester, deficiencies in both iodine and Fe were high: 40%, 12% and 18% in the rural, semi-urban and urban areas, respectively. Our data suggest that pregnant women are at risk of iodine and Fe deficiencies in Lubumbashi. Country policies fighting against iodine and Fe deficiencies during pregnancy should be reinforced.

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

    PubMed

    Mukwege, Denis; Berg, Marie

    2016-10-01

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

  13. A clash of civilizations? Examining liberal-democratic values in Turkey and the European Union.

    PubMed

    Dixon, Jeffrey C

    2008-12-01

    Turkey's proposed entry into the European Union (EU) has been undermined by Europeans' perceptions of Turkish-European cultural differences, particularly regarding the liberal-democratic values that the EU promotes (democracy, rule of law, and respect for and appreciation of minority/human rights). Yet, cross-national research on values has not focused on Turkey, the EU, and these liberal-democratic values, leaving assumptions of cultural differences and their explanations untested. Through analyses of World and European Values Survey data (1999-2002), this article asks whether people in Turkey have the same values regarding democracy, rule of law (versus religious and authoritarian rule), and minority/human rights as people in EU member and candidate states (as of 2000)? What factors explain these values? I find that people in Turkey support democracy to the same extent as people in EU member and candidate states, but people in Turkey are more supportive of religious and authoritarian rule and are less tolerant of minorities. Although the 'clash of civilizations' thesis expects liberal values to be ordered according to countries' religious traditions, with western Christian the most supportive and Islamic the least, only for tolerance of minorities values is this pattern found. Instead, economic development most consistently explains differences between Turkey and EU member and candidate states in support for these values. I conclude with calls for theoretical refinement, particularly of the clash of civilizations thesis, along with suggestions for future research to examine more Muslim and Orthodox countries; I discuss the debate over Turkey's EU entry.

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

    PubMed

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

    2014-06-01

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

  15. Description and consequences of sexual violence in Ituri province, Democratic Republic of Congo

    PubMed Central

    2011-01-01

    Background The war in eastern Democratic Republic of Congo has been the subject of numerous studies related to the problem of sexual violence. Historically, such violence is known to be part of strategic war plans to conquer and destroy communities, but it is now unfortunately prevalent in times of relative calm. Methods We describe the characteristics and consequences of sexual violence in Ituri province of Democratic Republic of Congo through the retrospective analysis of 2,565 patients who received medical care in the Médecins Sans Frontières sexual violence clinic in the capital of Ituri province, Bunia, between September 2005 and December 2006. Using a standardised questionnaire, we report patients' demographics, number and status of aggressor(s), forced detention and violent threats among other variables for all patients presenting for medical consultation after a sexually violent event during this period. Results Ninety-six percent of our cohort were female and 29.3% minors, 18-29 years was the most represented age group. Acts of sexual violence (n = 2,565) were reported to be mainly perpetrated by men with military affiliations (73%), although civilians were implicated in 21% of crimes. The attack was perpetrated by two or more persons in over 74% of cases and most commonly perpetrators were unknown armed males, (87.2%). Male victims accounted for 4% (n = 103) of our cohort. Forty-eight percent of our patients reported being attacked whilst performing daily domestic duties outside the home and 18% of victims being detained by their perpetrators, the majority of whom were held for less than 2 weeks (61.6%). Conclusions The characteristics of sexually violent acts in Ituri province during this period cannot be simply explained as a 'weapon of war' as described in the literature, meaning the use of sexual violence within a military strategy where it is employed under the orders of a commander to harm a particular community. Whilst the majority of aggressions

  16. Description and consequences of sexual violence in Ituri province, Democratic Republic of Congo.

    PubMed

    Duroch, Françoise; McRae, Melissa; Grais, Rebecca F

    2011-04-19

    The war in eastern Democratic Republic of Congo has been the subject of numerous studies related to the problem of sexual violence. Historically, such violence is known to be part of strategic war plans to conquer and destroy communities, but it is now unfortunately prevalent in times of relative calm. We describe the characteristics and consequences of sexual violence in Ituri province of Democratic Republic of Congo through the retrospective analysis of 2,565 patients who received medical care in the Médecins Sans Frontières sexual violence clinic in the capital of Ituri province, Bunia, between September 2005 and December 2006. Using a standardised questionnaire, we report patients' demographics, number and status of aggressor(s), forced detention and violent threats among other variables for all patients presenting for medical consultation after a sexually violent event during this period. Ninety-six percent of our cohort were female and 29.3% minors, 18-29 years was the most represented age group. Acts of sexual violence (n = 2,565) were reported to be mainly perpetrated by men with military affiliations (73%), although civilians were implicated in 21% of crimes. The attack was perpetrated by two or more persons in over 74% of cases and most commonly perpetrators were unknown armed males, (87.2%). Male victims accounted for 4% (n = 103) of our cohort. Forty-eight percent of our patients reported being attacked whilst performing daily domestic duties outside the home and 18% of victims being detained by their perpetrators, the majority of whom were held for less than 2 weeks (61.6%). The characteristics of sexually violent acts in Ituri province during this period cannot be simply explained as a 'weapon of war' as described in the literature, meaning the use of sexual violence within a military strategy where it is employed under the orders of a commander to harm a particular community. Whilst the majority of aggressions were by armed men there was an

  17. A review of tuberculosis prevention, diagnosis and treatment system in the Democratic People's Republic of Korea (DPRK).

    PubMed

    Linton, John A; Tan, Bernard; Casey, Michael

    2008-10-01

    This paper describes the current prevalence of tuberculosis and its management in the Democratic People's Republic of Korea. A review of technical reports of NGOs' experience working in North Korea with Democratic People's Republic of Korea officials, tuberculosis healthcare personnel and tuberculosis patients. Site visits, observations and experiences are also included. Until 2001, the Democratic People's Republic of Korea, was predominately isolated with an unknown healthcare system but has since allowed NGOs, WHO and international agencies to rehabilitate the healthcare infrastructure involving 200 people's Country Hospitals, 13 Prophylactic Hospitals, 62 Sanitariums and 4 Special Hospitals. The mid 1990s witnessed a resurgence of tuberculosis in North Korea with 100,000 new cases reported yearly. Preliminary analysis revealed that poverty, neglect, lack of resources and isolation resulted in the overall deterioration of public health services. Present estimates suggest a prevalence of 220 per 100,000 with 45,000 new cases. Tuberculosis is a major public health problem in North Korea that will require increased efforts by the national government and international agencies to control

  18. The role of major donors in health aid to the Democratic People's Republic of Korea.

    PubMed

    Lee, Haewon; Ahn, Deborah Y; Choi, Soyoung; Kim, Youngchan; Choi, Hyunju; Park, Sang Min

    2013-05-01

    We investigated the major trends in health aid financing in the Democratic People's Republic of Korea (DPRK) by identifying the primary donor organizations and examining several data sources to track overall health aid trends. We collected gross disbursements from bilateral donor countries and international organizations toward the DPRK according to specific health sectors by using the Organization for Economic Cooperation and Development creditor reporting system database and the United Nations Office for the Coordination of Humanitarian Affairs financial tracking service database. We analyzed sources of health aid to the DPRK from the Republic of Korea (ROK) using the official records from the ROK's Ministry of Unification. We identified the ROK, United Nations Children's Fund (UNICEF), World Health Organization (WHO), United Nations Population Fund (UNFPA), and The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) as the major donor entities not only according to their level of health aid expenditures but also their growing roles within the health sector of the DPRK. We found that health aid from the ROK is comprised of funding from the Inter-Korean Cooperation Fund, private organizations, local governments, and South Korean branches of international organizations such as WHO and UNICEF. We also distinguished medical equipment aid from developmental aid to show that the majority of health aid from the ROK was developmental aid. This study highlights the valuable role of the ROK in the flow of health aid to the DPRK, especially in light of the DPRK's precarious international status. Although global health aid from many international organizations has decreased, organizations such as GFATM and UNFPA continue to maintain their focus on reproductive health and infectious diseases.

  19. The Role of Major Donors in Health Aid to the Democratic People's Republic of Korea

    PubMed Central

    Lee, Haewon; Ahn, Deborah Y.; Choi, Soyoung; Kim, Youngchan; Choi, Hyunju

    2013-01-01

    We investigated the major trends in health aid financing in the Democratic People's Republic of Korea (DPRK) by identifying the primary donor organizations and examining several data sources to track overall health aid trends. We collected gross disbursements from bilateral donor countries and international organizations toward the DPRK according to specific health sectors by using the Organization for Economic Cooperation and Development creditor reporting system database and the United Nations Office for the Coordination of Humanitarian Affairs financial tracking service database. We analyzed sources of health aid to the DPRK from the Republic of Korea (ROK) using the official records from the ROK's Ministry of Unification. We identified the ROK, United Nations Children's Fund (UNICEF), World Health Organization (WHO), United Nations Population Fund (UNFPA), and The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) as the major donor entities not only according to their level of health aid expenditures but also their growing roles within the health sector of the DPRK. We found that health aid from the ROK is comprised of funding from the Inter-Korean Cooperation Fund, private organizations, local governments, and South Korean branches of international organizations such as WHO and UNICEF. We also distinguished medical equipment aid from developmental aid to show that the majority of health aid from the ROK was developmental aid. This study highlights the valuable role of the ROK in the flow of health aid to the DPRK, especially in light of the DPRK's precarious international status. Although global health aid from many international organizations has decreased, organizations such as GFATM and UNFPA continue to maintain their focus on reproductive health and infectious diseases. PMID:23766869

  20. An assessment of caprine tuberculosis prevalence in Lubumbashi slaughterhouse, Democratic Republic of Congo.

    PubMed

    Luboya, Luboya Wa; Malangu, Mposhy; Kaleka, Mwenyi; Ngulu, Nsasi; Nkokele, Bimwala; Maryabo, Kazembe; Pourrut, Xavier; Vincent, Tom; Gonzalez, Jean-Paul

    2017-04-01

    Caprine tuberculosis is a major health problem for goats and a major zoonosis of veterinary public health interest. In order to prepare a response to and control of caprine tuberculosis, to evaluate the potential risks to public health, and to assess the prevalence of the disease in Katanga province, Democratic Republic of Congo, 656 goats that were slaughtered at the Kabasele abattoir of Mzee Laurent-Desire Kabila Market in Lubumbashi were subjected to rigorous veterinary inspection during June to August 2012. All goat specimens came from the Kasumbalesa, Kasenga, and Kipushi areas of Katanga province. Consequently, suspected organs presenting signs of tuberculosis were collected and examined using Ziehl-Neelsen stains for diagnosis. Through this investigative inspection in the province, we found an overall prevalence of caprine tuberculosis of 1.68%. Although females showed higher prevalence of caprine tuberculosis (1.07%) compared to males (0.61%), and adults showed higher prevalence (1.22%) than juveniles (0.45%), these comparisons were not statically significant. However, lung and intestine infection by tuberculosis showed significantly higher prevalence of positive cases (1.21 and 0.46%, respectively) (p < 0.05). Goats from Kasumbalesa had the highest prevalence of caprine tuberculosis (1.22%) compared to goats from Kipushi (0.31%) and Kasenga (0.18%). These findings show the risk of caprine tuberculosis in the province for the first time, and we therefore recommend the implementation of strict animal biosecurity and tuberculosis controlling protocols.

  1. Salmonella Typhi in the Democratic Republic of the Congo: Fluoroquinolone Decreased Susceptibility on the Rise

    PubMed Central

    Lunguya, Octavie; Lejon, Veerle; Phoba, Marie-France; Bertrand, Sophie; Vanhoof, Raymond; Verhaegen, Jan; Smith, Anthony Marius; Keddy, Karen Helena; Muyembe-Tamfum, Jean-Jacques; Jacobs, Jan

    2012-01-01

    Background Drug resistance of Salmonella enterica serovar Typhi (Salmonella Typhi) to first-line antibiotics is emerging in Central Africa. Although increased use of fluoroquinolones is associated with spread of resistance, Salmonella Typhi with decreased ciprofloxacin susceptibility (DCS) has rarely been reported in Central Africa. Methodology/Principal Findings As part of a microbiological surveillance study in the Democratic Republic of the Congo (DR Congo), Salmonella Typhi isolates from bloodstream infections were collected prospectively between 2007 and 2011. The genetic relationship of the Salmonella Typhi isolates was assessed by pulsed-field gel electrophoresis (PFGE). The antimicrobial resistance profile of the isolates was determined and mutations associated with DCS were studied. In total, 201 Salmonella Typhi isolates were collected. More than half of the Salmonella Typhi isolates originated from children and young adults aged 5–19. Thirty different PFGE profiles were identified, with 72% of the isolates showing a single profile. Multidrug resistance, DCS and azithromycin resistance were 30.3%, 15.4% and 1.0%, respectively. DCS was associated with point mutations in the gyrA gene at codons 83 and 87. Conclusions/Significance Our study describes the first report of widespread multidrug resistance and DCS among Salmonella Typhi isolates from DR Congo. Our findings highlight the need for increased microbiological diagnosis and surveillance in DR Congo, being a prerequisite for rational use of antimicrobials and the development of standard treatment guidelines. PMID:23166855

  2. [Coexistence of mass hysteria, konzo and HTLV-1 virus in the Democratic Republic of the Congo].

    PubMed

    Tshala, K; Nunga, M; Pukuta, S; Mutombo, L; Beya, E; Tshoko, K; Mampunza, M

    1999-01-01

    A cross-sectional study was carried out in Pindi located 115 kilometers from Kikwit, Democratic Republic of the Congo to characterize a local school epidemic involving paralysis of the lower extremities, identify risk factors, and establish differential diagnosis with konzo and spastic paralysis related to human T-lymphotropic virus type 1 (HTLV-1). Data was obtained using a qualitative approach based on records, interviews, focus group technique, and neurological examination. Blood tests using the ELISA and western blot tests were performed to detect HTLV-1 and HIV 1 and 2. A total of 41 cases of paralysis were observed between 1994 and 1998. All patients were female and most (n = 28) were between the ages of 16 and 20 at the time of the study. The majority of cases were recorded in 1998 (31 prevalent cases and 16 incidents). Epidemiological data, clinical findings, and laboratory tests suggested that the etiology was mass hysteria with somatic conversion rather than toxic or viral causes in most cases. The psychosocial environment played an important role in the spread of the epidemic. These findings demonstrate the crucial role of the psychosocial environment in the occurrence of mass hysteria and support use of integrated health programs in developing countries.

  3. Occupational radiation exposures of artisans mining columbite-tantalite in the eastern Democratic Republic of Congo.

    PubMed

    Mustapha, A O; Mbuzukongira, P; Mangala, M J

    2007-06-01

    Artisans in Masisi and other parts of the North Kivu province in the eastern Democratic Republic of Congo (DRC) mine columbite-tantalite mineral ores (also called 'coltan') for the tantalum content. The potential occupational radiation exposures in the course of this operation, due to the presence of naturally occurring radioactive material (NORM), have been investigated in this screening survey. Activity concentrations of the naturally occurring radionuclides in samples of coltan were measured using gamma-ray spectrometry. The average values in Bq g(-1) are 10.75 +/- 5.11 for (238)U, 7.06 +/- 3.39 for (226)Ra, 1.75 +/- 0.85 for (232)Th, and 1.63 +/- 0.52 for (40)K. Based on these values and the working scenarios involved in artisanal coltan mining, the occupational doses that may accrue from a variety of exposure pathways were determined by model calculations. The results, assuming conservative dust load and dilution factors, indicate that grinding and sieving coltan can give rise to high occupational doses, up to 18 mSv per annum on average.

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

    PubMed

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

    2017-04-26

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

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

    PubMed

    Kitronza, Panda Lukongo; Philippe, Mairiaux

    2016-01-01

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

  6. Malnutrition of children in the Democratic People's Republic of North Korea.

    PubMed

    Katona-Apte, J; Mokdad, A

    1998-08-01

    Natural disasters have caused extensive damage to crops and to infrastructure in the Democratic People's Republic of North Korea (DPRK). The international community has responded by providing emergency food aid. To improve understanding of the magnitude of food deficiency in the DPRK. The World Food Programme (WFP) conducted a nutritional assessment survey in August 1997. The survey measured the height and weight of a total of 3984 children <7 y of age in 40 government-selected institutions. Additional information was obtained on institutional access to food and on the care, treatment and parental support of a subsample of severely malnourished and nonmalnourished children. The prevalence of acute malnutrition (wasting), based on weight-for-height Z-score < -2, varied from 0 to 32.7% among institutions, and the prevalence of chronic malnutrition (stunting), based on height-for-age < -2 Z-score varied from 0.6 to 74.1%. The findings from this survey indicate the presence of areas with severe acute or chronic malnutrition in the DPRK.

  7. The prevalence of wasting, but not stunting, has improved in the Democratic People's Republic of Korea.

    PubMed

    Hoffman, Daniel J; Lee, Soo-Kyung

    2005-03-01

    The Democratic People's Republic of Korea (DPRK) is one of the nutritionally vulnerable countries of the world. The objectives of this paper were to determine the current prevalence of undernutrition among children using data from the latest national survey and to compare the findings with those from the previous national survey in 1997. In 2002 with cooperation from UNICEF and the World Food Program (WFP), the government of the DPRK conducted a survey of 6000 households with children < 7 y old using multiple-stage sampling methods. Data were collected for sociodemographic variables, use of WFP food aid, and anthropometric measures of the youngest child in the household. The prevalence of stunting (height for age Z-score less than -2.0) in all children was 39.4% (40.2 and 38.5% for boys and girls, respectively). The prevalence of wasting (weight for height Z-score less than -2.0) was 8.2% in all children (9.1 and 7.3% for boys and girls, respectively). Although the prevalence of wasting has decreased from 1997 (16.5%) to 2002 (8.2%), the prevalence of stunting has not changed between those years, 38.2 vs. 39.4%. Thus, we conclude that acute undernutrition is decreasing in the DPRK, but chronic undernutrition that results in stunting is still highly prevalent. Continued surveillance of nutritional status of children in the DPRK is warranted given the continued state of undernutrition in that country.

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

    PubMed Central

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

    2017-01-01

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

  9. Growing healthy children and communities: Children's insights in Lao People's Democratic Republic.

    PubMed

    Ruiz-Casares, Mónica

    2016-01-01

    A diverse group of 103 children aged 7-11 years old living in family and residential care in rural and urban settings in two northern provinces in Lao People's Democratic Republic participated in group discussions using images and community mapping. Children's identified sources of risk and protection illustrate primary public health and protection concerns and resources. Young children worried about lack of hygiene, unintentional injuries, corporal punishment, and domestic violence. They also expressed concern about gambling and children sleeping in the streets, even if they had never seen any of the latter in their communities. In contrast, food and shelter; artistic, religious, and cultural practices; supportive interpersonal relationships; and schooling largely evoked feelings of safety and belonging. Images that prompted conflicting interpretations surfaced individual and contextual considerations that nuanced analysis. Researchers and decision-makers will benefit from using this developmentally appropriate, context-sensitive child-centred visual method to elicit young children's views of risk and protection. It may also serve as a tool for public health education. Involving young children in the initial selection of images would further enhance the efficiency of the method.

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  11. [Health impact of working conditions at the Ruashi mine in the Democratic Republic of Congo].

    PubMed

    Elenge Molayi, M; Aubry, J C; De Brouwer, C

    2009-10-01

    The purpose of this study was to evaluate the health impact of working conditions at the Ruashi mine in the Katanga Province in the Democratic Republic of Congo. A cross-sectional etiological study was conducted in two cohorts including 100 miners and 109 students. Data necessary to allow comparison disease symptoms in the two cohorts were collected using a questionnaire. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated. A secondary analysis was performed to compare different mine workstations, i.e., diggers (n=61) versus non-diggers (n=39). Two logistical regression models were used to estimate adjusted OR and 95% CI for the association between occupation/workstation and disease symptoms. In comparison with students, miners exhibited higher frequencies for all symptoms even after adjustment. The highest ORs were observed for musculoskeletal disorders, i.e., low back pain (OR=36.5) and upper (OR = 20.7) or lower (OR = 18.3)] extremity pain. They were followed by respiratory disorders (OR = 5.91) and headache (OR = 5.34). The high exposure frequencies and OR's observed in this study underline the negative health impact of mine working conditions. Further occupational study will be needed to obtain and compare more data.

  12. Clostridium difficile infection in the Lao People's Democratic Republic: first isolation and review of the literature.

    PubMed

    Cheong, Elaine; Roberts, Tamalee; Rattanavong, Sayaphet; Riley, Thomas V; Newton, Paul N; Dance, David A B

    2017-09-21

    Current knowledge of the epidemiology of Clostridium difficile infection in Asia, and in particular the Greater Mekong Subregion, is very limited. Only a few studies from Thailand and Vietnam have been reported from the region with variable testing methods and results, and no studies from Lao People's Democratic Republic (PDR). Therefore we investigated the presence of C. difficile in a single centre in the Lao PDR and determined the ribotypes present. Seventy unformed stool samples from hospital inpatients at Mahosot Hospital, Vientiane, were tested for the presence of C. difficile using selective differential agar and confirmed by latex agglutination. C. difficile isolates were further characterised by ribotyping and toxin gene detection. C. difficile was isolated from five of the 70 patients, and five different ribotypes were identified (014, 017, 020, QX 107 and QX 574). This is the first isolation of C. difficile from human stool samples in the Lao PDR. These results will add to the limited amount of data on C. difficile in the region. In addition, we hope this information will alert clinicians to the presence of C. difficile in the country and will help inform future investigations into the epidemiology and diagnosis of C. difficile in Lao PDR.

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

    PubMed Central

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

    2015-01-01

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

  14. Risk Factors for Marburg Hemorrhagic Fever, Democratic Republic of the Congo

    PubMed Central

    Borchert, Matthias; Grein, Thomas; Roth, Cathy; Swanepoel, Robert; Libande, Modeste L.; Talarmin, Antoine; Bertherat, Eric; Muyembe-Tamfum, Jean-Jacques; Tugume, Ben; Colebunders, Robert; Kondé, Kader M.; Pirard, Patricia; Olinda, Loku L.; Rodier, Guénaël R.; Campbell, Patricia; Tomori, Oyewale; Ksiazek, Thomas G.; Rollin, Pierre E.

    2003-01-01

    We conducted two antibody surveys to assess risk factors for Marburg hemorrhagic fever in an area of confirmed Marburg virus transmission in the Democratic Republic of the Congo. Questionnaires were administered and serum samples tested for Marburg-specific antibodies by enzyme-linked immunosorbent assay. Fifteen (2%) of 912 participants in a general village cross-sectional antibody survey were positive for Marburg immunoglobulin G antibody. Thirteen (87%) of these 15 were men who worked in the local gold mines. Working as a miner (odds ratio [OR] 13.9, 95% confidence interval [CI] 3.1 to 62.1) and receiving injections (OR 7.4, 95% CI 1.6 to 33.2) were associated with a positive antibody result. All 103 participants in a targeted antibody survey of healthcare workers were antibody negative. Primary transmission of Marburg virus to humans likely occurred via exposure to a still unidentified reservoir in the local mines. Secondary transmission appears to be less common with Marburg virus than with Ebola virus, the other known filovirus. PMID:14720391

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

    PubMed Central

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

    2016-01-01

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

  16. Spotted fever group rickettsiae in ticks and fleas from the Democratic Republic of the Congo.

    PubMed

    Mediannikov, Oleg; Davoust, Bernard; Socolovschi, Cristina; Tshilolo, Léon; Raoult, Didier; Parola, Philippe

    2012-12-01

    Little is known about the prevalence of spotted fever group (SFG) rickettsiae in ticks and fleas in the Democratic Republic of the Congo. In 2008, 12 Amblyomma compressum ticks were collected from 3 pangolins (Manis gigantea). Two Haemaphysalis punctaleachi ticks were collected from 2 African civets (Civettictis civetta congica), and one was collected from an antelope (Onotragus leche). A total of 111 Rhipicephalus sanguineus ticks, 23 Ctenocephalides canis fleas, 39 C. felis fleas, and 5 Trichodectes canis lice were sampled from 19 dogs. One C. canis flea was collected from a human. Six of the 12 A. compressum ticks were positive for rickettsial DNA, as determined by genus-specific qPCR. The ompA gene sequences amplified from positive samples showed 100% homology with Rickettsia africae (GenBank accession number CP001612). The detection of Ri. africae in A. compressum ticks, which are highly specialized parasites of pangolins, is consistent with our previous data showing the presence of Ri. africae in A. compressum ticks from Liberia. No other ticks contained rickettsial DNA. A total of 9 C. canis fleas (39%, 9/23) and 37 C. felis fleas (95%, 37/39) that was collected from dogs and one C. canis flea collected from a human harbored Ri. felis.

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

    PubMed

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

    2015-01-01

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

  18. Intimate partner violence, modern contraceptive use and conflict in the Democratic Republic of the Congo.

    PubMed

    Kidman, Rachel; Palermo, Tia; Bertrand, Jane

    2015-05-01

    Intimate partner violence (IPV) has been found to be negatively associated with contraceptive use in developing countries, but evidence from Africa is mixed. This study examines whether the above association differs in conflict settings, which have the potential for both higher levels of violence and more limited access to family planning. We use nationally representative data from the Democratic Republic of the Congo to examine the relationship between individual- and community-level IPV and modern contraceptive use, and to explore whether conflict modifies the relationship between IPV and contraceptive use. Nationally, only 6% of women reported current modern contraceptive use, while 53% reported experiencing physical IPV and 32% reported experiencing sexual IPV. In multivariate models, we found that individual-level sexual IPV was positively associated with current using modern contraceptive use, but that a combined measure of physical and sexual IPV did not demonstrate a similar association. Community-level IPV was not associated with individual-level contraceptive use. Conflict exposure was neither an independent predictor nor modifier of contraceptive use. Results suggest improved access to family planning should be a priority for programming in DRC, and efforts should ensure that sufficient resources are allocated towards the reproductive health needs of women in both conflict and non-conflict regions.

  19. Seroprevalence of Q fever, Brucellosis, and Bluetongue in Selected Provinces in Lao People's Democratic Republic

    PubMed Central

    Douangngeun, Bounlom; Theppangna, Watthana; Soukvilay, Vilayvahn; Senaphanh, Chanthana; Phithacthep, Kamphok; Phomhaksa, Souk; Yingst, Samuel; Lombardini, Eric; Hansson, Eric; Selleck, Paul W.; Blacksell, Stuart D.

    2016-01-01

    This study has determined the proportional seropositivity of two zoonotic diseases, Q fever and brucellosis, and bluetongue virus (BTV) which is nonzoonotic, in five provinces of Lao People's Democratic Republic (PDR) (Loungphabang, Luangnumtha, Xayaboury, Xiengkhouang, and Champasak, and Vientiane Province and Vientiane capital). A total of 1,089 samples from buffalo, cattle, pigs, and goats were tested, with seropositivity of BTV (96.7%), Q fever (1.2%), and brucellosis (0.3%). The results of this survey indicated that Q fever seropositivity is not widely distributed in Lao PDR; however, Xayaboury Province had a cluster of seropositive cattle in seven villages in four districts (Botan, Kenthao, Paklaiy, and Phiang) that share a border with Thailand. Further studies are required to determine if Xayaboury Province is indeed an epidemiological hot spot of Q fever activity. There is an urgent need to determine the levels of economic loss and human health-related issues caused by Q fever, brucellosis, and BTV in Lao PDR. PMID:27430548

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2011-10-01

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

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

    PubMed

    Rennie, Stuart; Mupenda, Bavon

    2008-08-01

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

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

    PubMed

    Ribesse, Nathalie; Iyeti, Alain; Macq, Jean

    2015-01-01

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

  4. Aedes aegypti control in the Lao People's Democratic Republic, with reference to copepods.

    PubMed

    Jennings, C D; Phommasack, B; Sourignadeth, B; Kay, B H

    1995-10-01

    An evaluation of the Lao Aedes aegypti control program and of the predatory abilities of copepods from Vientiane, Lao People's Democratic Republic was undertaken before a field release of copepods in Thongkankam village, Vientiane. Copepods were transported to Australia for evaluation of predatory abilities and their survival under various nutrient and pH conditions. Mesocyclops guangxiensis was chosen for release over M. aspericornis due to its higher reproduction rate and its ability to survive in lower nutrient environments. Mesocyclops guangxiensis was released into 142 containers and 20 wells in a village in Vientiane. Copepods were present in 7% of the containers after one month and were absent six months postinoculation. In comparison, 100% of wells were still positive after six months, with average numbers of Ae. aegypti in the wells decreasing from 59.5 +/- 18.5 (+/- SEM) to 0 after six months. Numbers of Culex quinquefasciatus and Anopheles maculatus also decreased to 0 after six months. This study indicates that predacious copepods will be accepted by the community and could be integrated as a low-cost, persistent control agent into new strategies for improving surveillance and control of dengue vectors.

  5. 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.

  6. A review of taeniasis and cysticercosis in the Lao People's Democratic Republic.

    PubMed

    Conlan, James; Khounsy, Syseng; Inthavong, Phouth; Fenwick, Stanley; Blacksell, Stuart; Thompson, R C Andrew

    2008-09-01

    Taeniasis and cysticercosis are important but underreported parasitic zoonoses in the Lao People's Democratic Republic (Lao PDR). Reports of human and pig cysticercosis are rather limited and based largely on anecdotal evidence. To date, no structured surveys of disease prevalence or incidence have been reported. However, one unpublished pilot survey of pig cysticercosis in a slaughterhouse in northern Laos estimated prevalence to be 1.7%, without speciation of parasite cysts. Over the past 20 years, nine surveys of intestinal helminthic infection have been conducted; the prevalence of human taeniasis ranged from 0 to 14.0%. The study designs and sample sizes varied greatly, however a high degree of spatial and age variation in taeniasis prevalence was evident. These results are however inconclusive as the species of tapeworm infecting the people was not determined. To further our knowledge of taeniasis and cysticercosis in Lao PDR, structured community-based surveys in high-risk areas are required in combination with the use of sensitive and specific diagnostic tests capable of identifying the pork tapeworm, Taenia solium. This will enable the development and implementation of control measures that are both appropriate and sustainable if T. solium is shown to be a public health threat.

  7. Subtype identification of human Blastocystis spp. isolated from Lao People's Democratic Republic.

    PubMed

    Sanpool, Oranuch; Laymanivong, Sakhone; Thanchomnang, Tongjit; Rodpai, Rutchanee; Sadaow, Lakkhana; Phosuk, Issarapong; Maleewong, Wanchai; Intapan, Pewpan M

    2017-04-01

    Blastocystis sp. is the most common protist found in the intestinal tract of humans and animals. Blastocystis subtypes (STs) are classified based on the molecular phylogeny of the small subunit rRNA gene (SSU rDNA). At least 17 Blastocystis STs have been reported and, of these, STs 1-9 have been found in humans. This study revealed the presence of human Blastocystis STs in Lao People's Democratic Republic (Lao PDR). Fecal samples were collected from apparently healthy people from the central province of Khammouane and the southern province of Champasak. Fresh fecal samples, found to be positive for Blastocystis using microscopy, were individually cultured in Jones' medium and each sample was used for the amplification and sequencing of a fragment of SSU rDNA. BLAST searches and phylogenetic analysis confirmed the distribution of four Blastocystis STs: ST1 (64%), ST2 (8%), ST3 (24%) and ST7 (4%). This is the first report to provide molecular data revealing the prevalence of Blastocystis STs in apparently healthy people from Lao PDR.

  8. A cholera epidemic in Sekong Province, Lao People's Democratic Republic, December 2007-January 2008.

    PubMed

    Lenglet, Annick; Khamphaphongphane, Bouaphanh; Thebvongsa, Phetsamay; Vongprachanh, Phengta; Sithivong, Noikaseumsy; Chantavisouk, Chitsavang; Tsuyuoka, Reiko

    2010-05-01

    Recent large-scale outbreaks in the Lao People's Democratic Republic (Lao PDR) were reported in 1993 and 1994 and from 2000 to 2002. On December 23, 2007, a drastic increase in acute watery diarrhea patients at a health center in Sekong Province was reported to the provincial health office. An outbreak investigation was initiated to understand the magnitude of the outbreak, identify new cases, identify the suspected causal agent, implement control measures, and prevent new cases. Through active village based surveillance, 370 cases and 3 deaths were reported from 31 villages between December 15, 2007 and January 29, 2008. Of these reported cases, 29% were under the age of 5. From 28 fresh stool samples taken, 17 (58.6%) were positive for Vibrio cholerae O1 Ogawa strain. Two water sources close to affected villages were found to be contaminated with the same strain of V. cholerae. Control measures implemented included health education for safe household water consumption and early identification and treatment of suspected cholera patients at village level. The cause of the outbreak was suspected to be a combination of contaminated drinking water and person-to-person transmission.

  9. Progress toward poliomyelitis eradication--Democratic Republic of Congo, 1996-1999.

    PubMed

    2000-03-31

    In 1988, the World Health Assembly resolved to eradicate poliomyelitis by December 31, 2000 (1). Although progress has been extraordinary (2), full implementation of polio eradication strategies has been delayed in several countries affected by war. The Democratic Republic of Congo (DRC) has experienced continual armed conflict since October 1996. As a result, DRC is the last country in the African Region of the World Health Organization (WHO) to implement National Immunization Days (NIDs*). DRC is an important global reservoir for wild poliovirus and shares more than 5580 miles (9000 km) of border with nine countries; in at least seven of these countries polio is endemic. The large area of DRC, substantial amount of poverty, weak health-care infrastructure, poor transportation and communication, and competing demands for resources present considerable challenges to polio eradication. This report summarizes information on the existing health-care infrastructure and routine coverage, information from NIDs carried out in 1999, and results from the recently established surveillance system for acute flaccid paralysis (AFP).

  10. Genetic diversification and recombination of HIV type 1 group M in Kinshasa, Democratic Republic of Congo.

    PubMed

    Yang, Chunfu; Li, Ming; Mokili, John L K; Winter, Jorn; Lubaki, Ndongala M; Mwandagalirwa, Kashamuka M; Kasali, Mwamba J; Losoma, Atibu J; Quinn, Thomas C; Bollinger, Robert C; Lal, Renu B

    2005-07-01

    As the HIV-1 pandemic becomes increasingly complex, the genetic characterization of HIV strains bears important implications for vaccine research. To better understand the molecular evolution of HIV-1 viral diversity, we performed a comparative molecular analysis of HIV strains collected from high-risk persons in Kinshasa, Democratic Republic of Congo (DRC). Analysis of the gag-p24, env-C2V3 and -gp41 regions from 83 specimens collected in 1999-2000 revealed that 44 (53%) had concordant subtypes in the three regions (14 subsubtype A1, 10 subtype G, 8 subtype D, 5 subtype C, 2 each subsubtype F1 and CRF01_AE, and one each of subtypes H and J, and subsubtype A2, while the remaining 39 (47%) had mosaic genomes comprising multiple subtype combinations. Similar multisubtype patterns were also observed in 24 specimens collected in 1985. Sequence analysis of the gag-pol region (2.1 kb) from 21 discordant specimens in the gag-p24, env-C2V3 and -gp41 regions in 1985 and 1999-2000 further confirmed the complex recombinant patterns. Despite the remarkable similarity in overall subtype distribution, the intra- and intersubtype distances of major subtypes A1 and G increased significantly from 1985 to 1999-2000 (p=0.018 and p=0.0016, respectively). Given the complexity of HIV-1 viruses circulating in DRC, efforts should focus on the development of vaccines that result in cross-clade immunity.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2017-04-01

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

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

    PubMed

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

    2017-08-09

    The United Nations' Monitoring and Reporting Mechanism is charged with documenting six grave violations against children in a time of conflict, including attacks on schools. Many of these incidents, however, remain unreported across the globe. This study explores whether or not a local knowledge base of education and child protection actors in North and South Kivu Provinces, Democratic Republic of the Congo, and in Mogadishu, Somalia, could contribute to a more complete record of attacks on education in those areas. Hundreds of semi-structured interviews were conducted with key informants across the three settings, and in total 432 attacks on education were documented. Purposive samples of these reports were verified and a large majority was confirmed. Local non-governmental organisations and education institutions were most knowledgeable about these incidents, but most never reported them to a monitoring authority. The study concludes that attack surveillance and response were largely insufficient, and recommends investing in mechanisms that utilise local knowledge to address these shortcomings. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

  14. Estimates and determinants of sexual violence against women in the Democratic Republic of Congo.

    PubMed

    Peterman, Amber; Palermo, Tia; Bredenkamp, Caryn

    2011-06-01

    We sought to provide data-based estimates of sexual violence in the Democratic Republic of Congo (DRC) and describe risk factors for such violence. 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. 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. 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.

  15. Ethno-entomological observations from North Korea (officially known as the "Democratic People's Republic of Korea").

    PubMed

    Meyer-Rochow, V Benno

    2013-01-16

    In terms of scientific activities generally and ethnobiological pursuits in particular, North Korea, officially known as the Democratic People's Republic of Korea, is an almost blank entity on the quilt of global research. During a sabbatical semester at Pyongyang University of Science and Technology the author used this opportunity to gather some information on the uses of insect and other terrestrial arthropods as human food and components of traditional healing methods in that country. Despite the widely publicised shortcomings in the supply of food stuffs to the population of North Korea, insects are not generally seen as a source of food worthy of exploitation. However, the therapeutic use of insects, centipedes and scorpions to treat illnesses as diverse as the common cold, skin rashes, constipation, dysentery, nervous prostration, whooping cough, osteomyelitis, tetanus, and various forms of cancer is apparently still popular. The arthropods used therapeutically are credited with anti-inflammatory, immunological and other health-promoting effects, because they are said to contain hormones, steroids, lipids and plant-derived alkaloids, all of which capable of exerting their effects on the human body.

  16. 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

  17. Mortality, violence and lack of access to healthcare in the Democratic Republic of Congo.

    PubMed

    Van Herp, Michel; Parqué, Veronique; Rackley, Edward; Ford, Nathan

    2003-06-01

    The people of the Democratic Republic of Congo for decades have been living in a situation of chronic crisis. Violence, population displacement and the destruction of infrastructure and health services have devastated the health of the population. In 2001, Médicins Sans Frontières conducted a survey in five areas of western and central DRC to assess mortality, access to health-care, vaccination coverage and exposure to violence. High mortality rates were found in front-line zones, mainly due to malnutrition and infectious diseases. In Basankusu approximately 10 per cent of the total population and 25 per cent of the under-five population had perished in the year before the survey. Humanitarian needs remain acute across the country, particularly near the front line. Infectious-disease control and treatment are a priority, as is increasing access to health-care. Humanitarian assistance must be increased considerably, especially in rural areas and zones that have been affected directly by conflict.

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

    PubMed

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

    2017-05-01

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

  19. Crystal structure study of a cobaltoan dolomite from Kolwezi, Democratic Republic of Congo.

    PubMed

    Perchiazzi, Natale

    2015-03-01

    A structural study has been undertaken on a cobaltoan dolomite, with chemical formula CaMg0.83Co0.17(CO3)2 (cal-cium magnesium cobalt dicarbonate), from Kolwezi, Democratic Republic of Congo. Pale-pink euhedral cobaltoan dolomite was associated with kolwezite [(Cu1.33Co0.67)(CO3)(OH)2] and cobaltoan malachite [(Cu,Co)2(CO3)(OH)2]. A crystal with a Co:Mg ratio of 1:5.6 (SEM/EDAX measurement), twinned on (11 -2 0) was used for crystal structural refinement. The refinement of the structural model of Reeder & Wenk [Am. Mineral. (1983 ▶), 68, 769-776; Ca at site 3a with site symmetry -3; Mg site at site 3b with site symmetry -3; C at site 6c with site symmetry 3; O at site 18f with site symmetry 1] showed that Co is totally incorporated in the Mg site, with refined occupancy Mg0.83Co0.17, which compares with Mg0.85Co0.15 from chemical data. The Co substitution reflects in the expansion of the cell volume, with a pronounced increasing of the c cell parameter.

  20. New Republic to Civil War: Booklet 2. Critical Thinking in American History. [Student Manual

    ERIC Educational Resources Information Center

    O'Reilly, Kevin

    One of a series of curriculum materials in U.S. history designed to teach critical thinking skills systematically, this student booklet presents high school students with supplementary lessons on the new Republic, the Jacksonian era, slavery and the Civil War. The student booklet begins with a guide to critical thinking which offers an explanation…

  1. New Republic to Civil War: Booklet 2. Critical Thinking in American History. [Student Manual

    ERIC Educational Resources Information Center

    O'Reilly, Kevin

    One of a series of curriculum materials in U.S. history designed to teach critical thinking skills systematically, this student booklet presents high school students with supplementary lessons on the new Republic, the Jacksonian era, slavery and the Civil War. The student booklet begins with a guide to critical thinking which offers an explanation…

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

    PubMed Central

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

    2015-01-01

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

  3. Sensibility analysis of VORIS lava-flow simulations: application to Nyamulagira volcano, Democratic Republic of Congo

    NASA Astrophysics Data System (ADS)

    Syavulisembo, A. M.; Havenith, H.-B.; Smets, B.; d'Oreye, N.; Marti, J.

    2015-03-01

    Assessment and management of volcanic risk are important scientific, economic, and political issues, especially in densely populated areas threatened by volcanoes. The Virunga area in the Democratic Republic of Congo, with over 1 million inhabitants, has to cope permanently with the threat posed by the active Nyamulagira and Nyiragongo volcanoes. During the past century, Nyamulagira erupted at intervals of 1-4 years - mostly in the form of lava flows - at least 30 times. Its summit and flank eruptions lasted for periods of a few days up to more than two years, and produced lava flows sometimes reaching distances of over 20 km from the volcano, thereby affecting very large areas and having a serious impact on the region of Virunga. In order to identify a useful tool for lava flow hazard assessment at the Goma Volcano Observatory (GVO), we tested VORIS 2.0.1 (Felpeto et al., 2007), a freely available software (http://www.gvb-csic.es) based on a probabilistic model that considers topography as the main parameter controlling lava flow propagation. We tested different Digital Elevation Models (DEM) - SRTM1, SRTM3, and ASTER GDEM - to analyze the sensibility of the input parameters of VORIS 2.0.1 in simulation of recent historical lava-flow for which the pre-eruption topography is known. The results obtained show that VORIS 2.0.1 is a quick, easy-to-use tool for simulating lava-flow eruptions and replicates to a high degree of accuracy the eruptions tested. In practice, these results will be used by GVO to calibrate VORIS model for lava flow path forecasting during new eruptions, hence contributing to a better volcanic crisis management.

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

    PubMed

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

    2017-03-31

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

  5. Occupational Stress among Textile Workers in the Democratic Republic of Congo

    PubMed Central

    Kitronza, Panda Lukongo; Mairiaux, Philippe

    2015-01-01

    Context: In the Democratic Republic of Congo (DRC), scientific studies on occupational health are scarce. The present study aims at estimating the level of occupational stress, as well as associated factors, in a textile company. Methods: We performed a cross-sectional survey among textile workers in DRC. Data (N = 192 subjects) were collected through a self-questionnaire validated for the assessment of stress (Karasek and Siegrist’s scale); supplemented by a medical examination. Frequencies and odds ratios (ORs) were estimated for descriptive analyses. Adjusted ORs were calculated through a logistic regression model to investigate associations between socio-demographic and organisational variables and stress. Results: Our study highlighted a high level of stress among individuals: 28% of them were suffering from stress, according to Karasek, and 22%, when applying Siegrist’s model. A 14%-isostrain was calculated when considering all workers. A statistically significant association was observed between stress and age, seniority and perceived non-adaptation to work, considering both approaches. Furthermore, when job strain was determined according to Karasek, it was related to the worker status, the poor perception of organisation and alcohol consumption, while stress estimated by applying Siegrist’s model showed an association with education level and the occurrence of cardiac symptoms. Conclusion: The present study provides of stress among individuals through both models. Several socio-professional factors are associated with stress, which determines populations at risk. The results revealed that both stress models offer complementary information, thus increasing the probability to model workers’ health more exactly and to make recommendations on prevention and management. PMID:26865824

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

    PubMed

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

    2014-02-19

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2017-01-01

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

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

    PubMed

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

    2015-01-01

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

  10. Health policy evolution in Lao People’s Democratic Republic: context, processes and agency

    PubMed Central

    Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

    2015-01-01

    During the last 20 years Lao People’s Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. PMID:24740710

  11. The geography of malaria genetics in the Democratic Republic of Congo: A complex and fragmented landscape

    PubMed Central

    Carrel, Margaret; Patel, Jaymin; Taylor, Steve M.; Janko, Mark; Mwandagalirwa, Melchior Kashamuka; Tshefu, Antoinette K.; Escalante, Ananias A.; McCollum, Andrea; Alam, Md Tauqeer; Udhayakumar, Venkatachalam; Meshnick, Steven; Emch, Michael

    2014-01-01

    Understanding how malaria parasites move between populations is important, particularly given the potential for malaria to be reintroduced into areas where it was previously eliminated. We examine the distribution of malaria genetics across seven sites within the Democratic Republic of Congo (DRC) and two nearby countries, Ghana and Kenya, in order to understand how the relatedness of malaria parasites varies across space, and whether there are barriers to the flow of malaria parasites within the DRC or across borders. Parasite DNA was retrieved from dried blood spots from 7 Demographic and Health Survey sample clusters in the DRC. Malaria genetic characteristics of parasites from Ghana and Kenya were also obtained. For each of 9 geographic sites (7 DRC, 1 Ghana and 1 Kenya), a pair-wise RST statistic was calculated, indicating the genetic distance between malaria parasites found in those locations. Mapping genetics across the spatial extent of the study area indicates a complex genetic landscape, where relatedness between two proximal sites may be relatively high (RST > 0.64) or low (RST < 0.05), and where distal sites also exhibit both high and low genetic similarity. Mantel’s tests suggest that malaria genetics differ as geographic distances increase. Principal Coordinate Analysis suggests that genetically related samples are not co-located. Barrier analysis reveals no significant barriers to gene flow between locations. Malaria genetics in the DRC have a complex and fragmented landscape. Limited exchange of genes across space is reflected in greater genetic distance between malaria parasites isolated at greater geographic distances. There is, however, evidence for close genetic ties between distally located sample locations, indicating that movement of malaria parasites and flow of genes is being driven by factors other than distance decay. This research demonstrates the contributions that spatial disease ecology and landscape genetics can make to

  12. Validation of the rapid assessment procedure for loiasis (RAPLOA) in the democratic republic of Congo

    PubMed Central

    2012-01-01

    Background A simple method called RAPLOA, to rapidly assess what proportion of people in a community are infected with L. loa and hence which communities are at high risk of severe adverse reactions following ivermectin treatment, was developed in Cameroon and Nigeria. The method needed further validation in other geographical and cultural contexts before its application in all endemic countries. The present study was designed to validate RAPLOA in two regions in the North East and South West of the Democratic Republic of Congo. Methods In each study region, villages were selected from different bio-ecological zones in order to cover a wide range of loiasis endemicity. In each selected community, 80 people above the age of 15 years were interviewed for a history of eye worm (migration of adult L. loa under the conjunctiva of the eye) and parasitologically examined for the presence and intensity of L. loa infection. In total, 8100 individuals from 99 villages were enrolled into the study. Results The results confirmed the findings of the original RAPLOA study: i) the eye worm phenomenon was well-known in all endemic areas, ii) there was a clear relationship between the prevalence of eye worm history and the prevalence and intensity of L. loa microfilaraemia, and iii) using a threshold of 40%, the prevalence of eye worm history was a sensitive and specific indicator of high-risk communities. Conclusion Following this successful validation, RAPLOA was recommended for the assessment of loiasis endemicity in areas targeted for ivermectin treatment by lymphatic filariasis and onchocerciasis control programmes. PMID:22300872

  13. Local perceptions of cholera and anticipated vaccine acceptance in Katanga province, Democratic Republic of Congo

    PubMed Central

    2013-01-01

    Background In regions where access to clean water and the provision of a sanitary infrastructure has not been sustainable, cholera continues to pose an important public health burden. Although oral cholera vaccines (OCV) are effective means to complement classical cholera control efforts, still relatively little is known about their acceptability in targeted communities. Clarification of vaccine acceptability prior to the introduction of a new vaccine provides important information for future policy and planning. Methods In a cross-sectional study in Katanga province, Democratic Republic of Congo (DRC), local perceptions of cholera and anticipated acceptance of an OCV were investigated. A random sample of 360 unaffected adults from a rural town and a remote fishing island was interviewed in 2010. In-depth interviews with a purposive sample of key informants and focus-group discussions provided contextual information. Socio-cultural determinants of anticipated OCV acceptance were assessed with logistic regression. Results Most respondents perceived contaminated water (63%) and food (61%) as main causes of cholera. Vaccines (28%), health education (18%) and the provision of clean water (15%) were considered the most effective measures of cholera control. Anticipated vaccine acceptance reached 97% if an OCV would be provided for free. Cholera-specific knowledge of hygiene and self-help in form of praying for healing were positively associated with anticipated OCV acceptance if costs of USD 5 were assumed. Conversely, respondents who feared negative social implications of cholera were less likely to anticipate acceptance of OCVs. These fears were especially prominent among respondents who generated their income through fishing. With an increase of assumed costs to USD 10.5, fear of financial constraints was negatively associated with anticipated vaccine acceptance as well. Conclusions Results suggest a high motivation to use an OCV as long as it seems affordable. The

  14. Health policy evolution in Lao People's Democratic Republic: context, processes and agency.

    PubMed

    Jönsson, Kristina; Phoummalaysith, Bounfeng; Wahlström, Rolf; Tomson, Göran

    2015-05-01

    During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective implementation by contextualizing the policy evolution over time and by focusing particularly on the National Drug Policy and the Health Care Law. Special attention is given to the role of research in policymaking. The analysis was guided by the conceptual framework of policy context, process, content and actors, combined with an institutional perspective, and showed that effective implementation of a health policy is highly dependent on both structures and agency of those involved in the policy process. The National Drug Policy was formulated and adopted in a short period of time in a resource-scarce setting, but with dedicated policy entrepreneurs and support of concerned international collaborators. Timely introduction of operational health systems research played a crucial role to support the implementation, as well as the subsequent revision of the policy. The development of the Health Care Law took several years and once adopted, the implementation was delayed by institutional legacies and issues concerning the choice of institutional design and financing, despite strong support of the law among the policymakers. Among many factors, timing of the implementation appeared to be of crucial importance, in combination with strong leadership. These two examples show that more research, that problematizes the complex policy environment in combination with improved communication between researchers and policymakers, is necessary to inform about measures for effective implementation. A way forward can be to strengthen the domestic research capacity and the international research collaboration regionally as well as globally. Published by Oxford University Press

  15. Combining satellite, aerial and ground measurements to assess forest carbon stocks in Democratic Republic of Congo

    NASA Astrophysics Data System (ADS)

    Beaumont, Benjamin; Bouvy, Alban; Stephenne, Nathalie; Mathoux, Pierre; Bastin, Jean-François; Baudot, Yves; Akkermans, Tom

    2015-04-01

    Monitoring tropical forest carbon stocks changes has been a rising topic in the recent years as a result of REDD+ mechanisms negotiations. Such monitoring will be mandatory for each project/country willing to benefit from these financial incentives in the future. Aerial and satellite remote sensing technologies offer cost advantages in implementing large scale forest inventories. Despite the recent progress made in the use of airborne LiDAR for carbon stocks estimation, no widely operational and cost effective method has yet been delivered for central Africa forest monitoring. Within the Maï Ndombe region of Democratic Republic of Congo, the EO4REDD project develops a method combining satellite, aerial and ground measurements. This combination is done in three steps: [1] mapping and quantifying forest cover changes using an object-based semi-automatic change detection (deforestation and forest degradation) methodology based on very high resolution satellite imagery (RapidEye), [2] developing an allometric linear model for above ground biomass measurements based on dendrometric parameters (tree crown areas and heights) extracted from airborne stereoscopic image pairs and calibrated using ground measurements of individual trees on a data set of 18 one hectare plots and [3] relating these two products to assess carbon stocks changes at a regional scale. Given the high accuracies obtained in [1] (> 80% for deforestation and 77% for forest degradation) and the suitable, but still to be improved with a larger calibrating sample, model (R² of 0.7) obtained in [2], EO4REDD products can be seen as a valid and replicable option for carbon stocks monitoring in tropical forests. Further improvements are planned to strengthen the cost effectiveness value and the REDD+ suitability in the second phase of EO4REDD. This second phase will include [A] specific model developments per forest type; [B] measurements of afforestation, reforestation and natural regeneration processes and

  16. Uncontrolled hypertension among patients managed in primary healthcare facilities in Kinshasa, Democratic Republic of the Congo

    PubMed Central

    Kika, TM; Kintoki, EV; M’Buyamba-Kabangu, JR; Lepira, FB; Makulo, JR; Sumaili, EK; Kayembe, PK

    2016-01-01

    Summary Background Uncontrolled hypertension remains an important issue in daily clinical practice worldwide. Although the majority of patients are treated in primary care, most of the data on blood pressure control originate from populationbased studies or secondary healthcare. Objective The aim of this study was to evaluate the frequency of uncontrolled hypertension and associated risk factors among hypertensive patients followed at primary care facilities in Kinshasa, the capital city of Democratic Republic of the Congo. Methods A sample of 298 hypertensive patients seen at primary healthcare facilities, 90 men and 208 women, aged ≥ 18 years, were consecutively included in this cross-sectional study. The majority (66%) was receiving monotherapy, and diuretics (43%) were the most used drugs. According to 2007 European Society of Hypertension/European Society of Cardiology hypertension guidelines, uncontrolled hypertension was defined as blood pressure ≥ 140/90 or ≥ 130/80 mmHg (diabetes or chronic kidney disease). Logistic regression analysis was used to identify the determinants of uncontrolled hypertension. Results Uncontrolled hypertension was observed in 231 patients (77.5%), 72 men and 159 women. Uncontrolled systolic blood pressure (SBP) was more frequent than uncontrolled diastolic blood pressure (DBP) and increased significantly with advancing age (p = 0.002). The proportion of uncontrolled SBP and DBP was significantly higher in patients with renal failure (p = 0.01) and those with high (p = 0.03) to very high (p = 0.02) absolute cardiovascular risk. The metabolic syndrome (OR 2.40; 95% CI 1.01–5.74; p = 0.04) emerged as the main risk factor associated with uncontrolled hypertension. Conclusion Uncontrolled hypertension was common in this case series and was associated with factors related to lifestyle and diet, which interact with blood pressure control. PMID:27965999

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

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

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

    PubMed Central

    RENNIE, STUART; MUPENDA, BAVON

    2015-01-01

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

  19. Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo

    PubMed Central

    Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

    2016-01-01

    Introduction Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. Methods We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. Results A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Conclusion Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief. PMID:27583088

  20. Sexual violence toward children and youth in war-torn eastern Democratic Republic of Congo.

    PubMed

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

    2011-01-18

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

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

    PubMed

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

    2015-01-01

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

  2. Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo.

    PubMed

    Joe, Katabwa Kabongo; Mapatano, Mala Ali; Manyonga, Tshibangu; Mwadianvita, Costa Kazadi; Valérien, Mutombo; Stanis, Wembonyama; Kavulu, Mukendi; Espérance, Kashala

    2016-01-01

    Grief is a universal experience faced at one time or another by most people during their lives. Response to grief and bereavement losses can lead to psychiatric disorders such as mood disorders, post traumatic responses, insomnia loss of appetite, anxiety, and depression. The aim of our study is to value in our community the physical and psychological complications of a normal grief. We conducted a cross-sectional study from March 2012 to September 2012 in Lubumbashi, Democratic Republic of Congo. Two questionnaires, the Hamilton Anxiety Scale and the Beck Depression Inventory scale were used as screening tool. A snow ball sampling method was performed and the questionnaires were administered only to those who consented to participate in the study. A total of 78 subjects were included in the study of which 87.2% were aged between 14-50 years old. The majority of the subjects were female 65.4%, and about a quarter (28%) was unemployed. The main correlates of the grief reported in the present study were being treated as witchcraft or accused to be responsible of a death (68%), being rejected by family and not being allowed to inherit (32%). Being homeless was reported in 26%. The main psychological symptoms reported were psychological distress after 1 year (65%) and related physical health problems after the death (72%). Depression and mild anxiety were the most reported disorders, with respectively 92.3% and 74.4% of the subjects. Grief in Lubumbashi is associated with a large number of psychological, social and health problems. Health problems such as gastric is, high blood pressure were often reported. Being accused of witchcraft remains the main social impact. Depression and anxiety were the most psychological problem associated with grief.

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

    PubMed

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

    2014-01-01

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

  4. [Taking charge of street children in the Democratic Republic of the Congo: an ethical alternative].

    PubMed

    Leyka, Mukandu Basua Babintu; Baum, Mylène Botbol

    2009-01-01

    The goal of this study carried out on street children and care providers was to determine the opinions of the staff of these institutions--foster homes--and their degree of satisfaction. Out of twenty homes of the zone or healthcare district of Kasavubu in the city of Kinshasa in the Democratic Republic of the Congo (DRC), ten were chosen at random (50%). In them, we selected one hundred street children--the beneficiaries--, ten care providers and ten protocol programs--of guardianship. The players--beneficiaries and providers--answered questions on their perceptions and expectations regarding to following: the range of activities provided, its organization, its quality and their degree of satisfaction of the site and on the development of skills. The results obtained demonstrated the predominance on useful activities ("welfarism") and on charity. The respondents declared they sometimes commit antisocial actions (theft) to access education, which is similar to a form of obtaining independence. The protocols for guardianship are often the conceived by experts. However, in a general way for young respondents, it is relatively difficult for experts alone (assistants and social educators or others) to provide precise and exhaustive data on the needs felt by street children. In view of these results, it is thus ethically acceptable to resort to the ability-based approach in the conception, the setting up and the evaluation of guardianship protocols for street children. What the youth think, the range of activities provided, the conception and the quality of the guardianship protocols is an important stake in the development of the skills. It is highly probable that the emergence of such protocols cannot be undertaken except if street children have a degree of independence in relation to experts and can assert a specific point of view.

  5. Characterisation of Staphylococcus aureus isolates from bloodstream infections, Democratic Republic of the Congo.

    PubMed

    Vandendriessche, S; De Boeck, H; Deplano, A; Phoba, M-F; Lunguya, O; Falay, D; Dauly, N; Verhaegen, J; Denis, O; Jacobs, J

    2017-01-23

    Staphylococcus aureus is known worldwide as an invasive pathogen, but information on S. aureus from bloodstream infections in Central Africa remains scarce. A collection of S. aureus blood culture isolates recovered from hospitals in four provinces in the Democratic Republic of the Congo (2009-2013) was assessed. A total of 27/108 isolates were methicillin-resistant S. aureus (MRSA), of which >70% were co-resistant to aminoglycosides, tetracyclines, macrolides and lincosamides. For MRSA and methicillin-susceptible S. aureus (MSSA) isolates, resistance to chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) was <10%. However, 66.7% (72/108) of all isolates harboured the trimethoprim resistance gene dfrG. More than three-quarters (84/108, 77.8%) of isolates belonged to CC5, CC8, CC121 or CC152. Genetic diversity was higher among MSSA (31 spa types) compared to MRSA (four spa types). Most MRSA (23/27, 85.2%) belonged to CC8-spa t1476-SCCmec V and 17/23 (73.9%) MRSA ST8 were oxacillin susceptible but cefoxitin resistant. Among MRSA and MSSA combined, 49.1% (53/108) and 19.4% (21/108) contained the genes encoding for Panton-Valentine leucocidin (lukS-lukF PV, PVL) and toxic shock syndrome toxin-1 (tst, TSST-1), respectively. PVL was mainly detected among MSSA (51/53 isolates harbouring PVL were MSSA, 96.2%) and associated with CC121, CC152, CC1 and CC5. TSST-1 was associated with CC8-spa t1476-SCCmec V. The immune evasion cluster (IEC) genes scn, sak and chp were detected in 81.5% of isolates (88/108, equally represented among MSSA and MRSA). The present study confirms the occurrence of MRSA with high levels of multidrug co-resistance and PVL-positive MSSA among invasive S. aureus isolates in Central Africa.

  6. Impact of sexual violence on children in the Eastern Democratic Republic of Congo.

    PubMed

    Nelson, Brett D; Collins, Lisa; VanRooyen, Michael J; Joyce, Nina; Mukwege, Denis; Bartels, Susan

    2011-01-01

    The conflict in the Eastern Democratic Republic of Congo (DRC) has been particularly devastating for children and has been typified by high levels of sexual and gender-based violence (SGBV). In this study, we seek to characterize the patterns and impact of sexual violence on children in the Eastern DRC. Semi-structured questionnaires were administered among a convenience sample of women <18 years of age presenting for post-sexual-violence care at Panzi Hospital in South Kivu, DRC. Analysis included quantitative and qualitative methods to describe the characteristics of the violence, perpetrators, and survivors and to illuminate common themes within the narratives. A total of 389 survivors of SGBV under the age of 18 were interviewed between 2004 and 2008. These paediatric survivors were more likely than adult survivors to have experienced gang rape, been attacked by a civilian perpetrator, and been assaulted during the day. Survivor and perpetrator characteristics were further stratified by type of attack. Reports of violence perpetrated by civilians increased 39-fold while reports of violence perpetrated by armed combatants decreased by 70% between 2004 and 2008. Qualitative analysis of the narratives revealed common themes, such as physical signs and symptoms among SGBV survivors (23.9%), pregnancy resulting from rape (19.3%), perpetrators being brought to justice (18.3%), and neighbourhood men as perpetrators (17.7%). Children in the Eastern DRC continue to face significant threats of sexual violence. By understanding the patterns of this violence, local and international approaches could be more effectively implemented to protect these vulnerable children.

  7. Seroprevalence of major bovine-associated zoonotic infectious diseases in the Lao People's Democratic Republic.

    PubMed

    Vongxay, Khamphouth; Conlan, James V; Khounsy, Syseng; Dorny, Pierre; Fenwick, Stanley; Thompson, R C Andrew; Blacksell, Stuart D

    2012-10-01

    Bovine-associated zoonotic infectious diseases pose a significant threat to human health in the Lao People's Democratic Republic (Lao PDR). In all, 905 cattle and buffalo serum samples collected in northern Lao PDR in 2006 were used to determine seroprevalence of five major bovine zoonotic infectious diseases that included Taenia saginata cysticercosis, bovine tuberculosis, Q-fever, bovine brucellosis, and bovine leptospirosis. Five enzyme-linked immunosorbent assays (ELISAs) were used to test for the presence of antibodies to the diseases, except Taenia saginata, for which we tested for the presence of Taenia metacestode circulating antigens. The overall highest prevalence was for T. saginata (46.4%), with lower prevalence for Q-fever (4%), leptospirosis (3%), tuberculosis (1%), and brucellosis (0.2%). Although there were no significant differences in the proportion of seroprevalence between sex and age of the animals sampled, there were significant differences between the provincial distributions. Further studies are required to determine the seroprevalence of these infections in other locations in Lao PDR, as well as other animal species including humans, in order to develop effective prevention and control strategies. This is the first study to investigate the prevalence of bovine zoonotic infectious agents in the Lao PDR. Positivity was demonstrated for all diseases investigated, with the highest prevalence for T. saginata antigen and Coxiella burnetti antibodies. For T. saginata, there were significant differences in the provincial distribution. Approximately 16% seroprevalence of Coxiella burnetti was noted in Xayabuly Province; however, there are no clear reasons why this was the case, and further studies are required to determine risk factors associated with this observation.

  8. Risk profiling of hookworm infection and intensity in southern Lao People's Democratic Republic using Bayesian models.

    PubMed

    Forrer, Armelle; Vounatsou, Penelope; Sayasone, Somphou; Vonghachack, Youthanavanh; Bouakhasith, Dalouny; Utzinger, Jürg; Akkhavong, Kongsap; Odermatt, Peter

    2015-03-01

    Among the common soil-transmitted helminth infections, hookworm causes the highest burden. Previous research in the southern part of Lao People's Democratic Republic (Lao PDR) revealed high prevalence rates of hookworm infection. The purpose of this study was to predict the spatial distribution of hookworm infection and intensity, and to investigate risk factors in the Champasack province, southern Lao PDR. A cross-sectional parasitological and questionnaire survey was conducted in 51 villages. Data on demography, socioeconomic status, water, sanitation, and behavior were combined with remotely sensed environmental data. Bayesian mixed effects logistic and negative binomial models were utilized to investigate risk factors and spatial distribution of hookworm infection and intensity, and to make predictions for non-surveyed locations. A total of 3,371 individuals were examined with duplicate Kato-Katz thick smears and revealed a hookworm prevalence of 48.8%. Most infections (91.7%) were of light intensity (1-1,999 eggs/g of stool). Lower hookworm infection levels were associated with higher socioeconomic status. The lowest infection levels were found in preschool-aged children. Overall, females were at lower risk of infection, but women aged 50 years and above harbored the heaviest hookworm infection intensities. Hookworm was widespread in Champasack province with little evidence for spatial clustering. Infection risk was somewhat lower in the lowlands, mostly along the western bank of the Mekong River, while infection intensity was homogeneous across the Champasack province. Hookworm transmission seems to occur within, rather than between villages in Champasack province. We present spatial risk maps of hookworm infection and intensity, which suggest that control efforts should be intensified in the Champasack province, particularly in mountainous areas.

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

    PubMed

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

    2017-09-01

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

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

    NASA Astrophysics Data System (ADS)

    Shapiro, Aurelie; Saatchi, Sassan

    2014-05-01

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

  11. District health programmes and health-sector reform: case study in the Lao People's Democratic Republic.

    PubMed Central

    Perks, Carol; Toole, Michael J.; Phouthonsy, Khamla

    2006-01-01

    The Lao People's Democratic Republic (Lao PDR) is classified by the World Bank as a low-income country under stress. Development partners have sought to utilize effective aid instruments to help countries classified in this way achieve the Millennium Development Goals; these aid instruments include sector-wide approaches (SWAps) that support decentralized district health systems and seek to avoid fragmentation and duplication. In Asia and the Pacific, only Bangladesh, Papua New Guinea and the Solomon Islands have adopted SWAps. Since 1991, a comprehensive primary health care programme in the remote Sayaboury Province of Lao PDR has focused on strengthening district health management, improving access to health facilities and responding to the most common causes of mortality and morbidity among women and children. Between 1996 and 2003, health-facility utilization tripled, and the proportion of households that have access to a facility increased to 92% compared with only 61% nationally. By 2003, infant and child mortality rates were less than one-third of the national rates. The maternal mortality ratio decreased by 50% despite comprehensive emergency obstetric care not being available in most district hospitals. These trends were achieved with an investment of approximately 4 million US dollars over 12 years (equivalent to US 1.00 US dollars per person per year). However, this project did not overcome weaknesses in some national disease-control programmes, especially the expanded programme on immunization, that require strong central management. In Lao PDR, which is not yet committed to using SWAps, tools developed in Sayaboury could help other district health offices assume greater planning responsibilities in the recently decentralized system. Development partners should balance their support for centrally managed disease-specific programmes with assistance to horizontally integrated primary health care at the district level. PMID:16501731

  12. Using fragmentation to assess degradation of forest edges in Democratic Republic of Congo.

    PubMed

    Shapiro, Aurélie C; Aguilar-Amuchastegui, Naikoa; Hostert, Patrick; Bastin, Jean-François

    2016-12-01

    Recent studies have shown that fragmentation is an increasing threat to global forests, which has major impacts on biodiversity and the important ecosystem services provided by forested landscapes. Several tools have been developed to evaluate global patterns of fragmentation, which have potential applications for REDD+. We study how canopy height and above ground biomass (AGB) change across several categories of forest edges determined by fragmentation analysis. We use Democratic Republic of Congo (DRC) as an example. An analysis of variance of different edge widths and airborne estimated canopy height found that canopy heights were significantly different in forest edges at a distance of 100 m from the nonforest edge. Biomass was significantly different between fragmentation classes at an edge distance of 300 m. Core forest types were found to have significantly higher canopy height and greater AGB than forest edges and patches, where height and biomass decrease significantly as the level of fragmentation increases. A change analysis shows that deforestation and degradation are increasing over time and biomass loss associated with degradation account for at least one quarter of total loss. We estimate that about 80 % of primary forests are intact, which decreases 3.5 % over the 15 year study period, as primary forest is either deforested or transitioned to forest edge. While the carbon loss per hectare is lower than that of deforestation, degradation potentially affects up to three times more area than deforestation alone. When defining forest degradation by decreased biomass without any loss in forest area, assessing transitions of core forest to edges over time can contribute an important element to REDD+MRV systems. The estimation of changes between different forest fragmentation types and their associated biomass loss can provide an estimate of degradation carbon emission factors. Forest degradation and emissions due to fragmentation are often

  13. The spread of drug abuse in rapidly urbanizing communities in Vientiane, Lao People's Democratic Republic.

    PubMed

    Fujiwara, Takeo; Takano, Takehito; Nakamura, Keiko

    2005-03-01

    To determine the prevalence of drug abuse in city neighborhoods in a developing country undergoing rapid urbanization, we performed a household survey on the spread of drug abuse in Vientiane, Lao People's Democratic Republic. A total of 1497 households from 17 villages were selected by the stratified random sampling method from urban districts in the city of Vientiane. Participatory style research was employed to increase both the sensitivity of detection and the reliability of information gathered. Local key players shared in the participatory process in this study. We worked with national and city officers and community leaders, as well as with neighborhood leaders who had received previous training for this survey, and conducted household surveys using face-to-face interviews. We inquired about the spread of drug abuse by asking if the families interviewed recognized drug abuse problems in their community. To examine the extent of urbanization of individual villages, the urban index was calculated by principle component analysis from the following eight indicators: income, occupation, parents' educational histories, diffusion of telephones, ownership of livestock, diffusion of plumbing for running water and distance from the Vientiane city center to the village. Distance was calculated by the Geographic Information System. Among the 17 villages included in the study, the average percentage of recognition of drug abuse in the community was 63.2%. The relationship between recognition of cases of drug abuse in the community and the urban index showed a significant correlation, with a Spearman coefficient of 0.650 (p < 0.01). The high reliability of participatory style surveys is also discussed. In conclusion, city neighborhoods in a developing country undergoing rapid urbanization showed evidence of the spread of drug abuse, which was associated with the urban index. Participatory style research activity was recommended to help raise awareness of community

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-06-16

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

  16. A cross-sectional community study of post-traumatic stress disorder and social support in Lao People's Democratic Republic.

    PubMed

    Southivong, Bouavanh; Ichikawa, Masao; Nakahara, Shinji; Southivong, Chanhpheng

    2013-10-01

    To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People's Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity. A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People's Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD. The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD. The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People's Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured.

  17. A cross-sectional community study of post-traumatic stress disorder and social support in Lao People's Democratic Republic

    PubMed Central

    Southivong, Bouavanh; Nakahara, Shinji; Southivong, Chanhpheng

    2013-01-01

    Abstract Objective To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People's Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity. Methods A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People's Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD. Findings The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD. Conclusion The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People's Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured. PMID:24115800

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

    PubMed Central

    Binanga, Arsene; Bertrand, Jane T

    2016-01-01

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

  19. A Resource Planning Analysis of District Hospital Surgical Services in the Democratic Republic of the Congo

    PubMed Central

    Sion, Melanie; Rajan, Dheepa; Kalambay, Hyppolite; Lokonga, Jean-Pierre; Bulakali, Joseph; Mossoko, Mathias; Kwete, Dieudonne; Schmets, Gerard; Kelley, Edward; Elongo, Tarcisse; Sambo, Luis; Cherian, Meena

    2015-01-01

    Abstract Background: The impact of surgical conditions on global health, particularly on vulnerable populations, is gaining recognition. However, only 3.5% of the 234.2 million cases per year of major surgery are performed in countries where the world's poorest third reside, such as the Democratic Republic of the Congo (DRC). Methods: Data on the availability of anesthesia and surgical services were gathered from 12 DRC district hospitals using the World Health Organization's (WHO's) Emergency and Essential Surgical Care Situation Analysis Tool. We complemented these data with an analysis of the costs of surgical services in a Congolese norms-based district hospital as well as in 2 of the 12 hospitals in which we conducted the situational analysis (Demba and Kabare District Hospitals). For the cost analysis, we used WHO's integrated Healthcare Technology Package tool. Results: Of the 32 surgical interventions surveyed, only 2 of the 12 hospitals provided all essential services. The deficits in procedures varied from no deficits to 17 services that could not be provided, with an average of 7 essential procedures unavailable. Many of the hospitals did not have basic infrastructure such as running water and electricity; 9 of 12 had no or interrupted water and 7 of 12 had no or interrupted electricity. On average, 21% of lifesaving surgical interventions were absent from the facilities, compared with the model normative hospital. According to the normative hospital, all surgical services would cost US$2.17 per inhabitant per year, representing 33.3% of the total patient caseload but only 18.3% of the total district hospital operating budget. At Demba Hospital, the operating budget required for surgical interventions was US$0.08 per inhabitant per year, and at Kabare Hospital, US$0.69 per inhabitant per year. Conclusion: A significant portion of the health problems addressed at Congolese district hospitals is surgical in nature, but there is a current inability to meet

  20. High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo.

    PubMed

    Levick, Bethany; Laudisoit, Anne; Tepage, Floribert; Ensoy-Musoro, Chellafe; Mandro, Michel; Bonareri Osoro, Caroline; Suykerbuyk, Patrick; Kashama, Jean Marie; Komba, Michel; Tagoto, Alliance; Falay, Dadi; Begon, Michael; Colebunders, Robert

    2017-07-01

    An increased prevalence of epilepsy has been reported in many onchocerciasis endemic areas. The objective of this study was to determine the prevalence of epilepsy in onchocerciasis endemic areas in the Democratic Republic of the Congo (DRC) and investigate whether a higher annual intake of Ivermectin was associated with a lower prevalence of epilepsy. Between July 2014 and February 2016, house-to-house epilepsy prevalence surveys were carried out in areas with a high level of onchocerciasis endemicity: 3 localities in the Bas-Uele, 24 in the Tshopo and 21 in the Ituri province. Ivermectin uptake was recorded for every household member. This database allowed a matched case-control pair subset to be created that enabled putative risk factors for epilepsy to be tested using univariate logistic regression models. Risk factors relating to onchocerciasis were tested using a multivariate random effects model. To identify presence of clusters of epilepsy cases, the Kulldorff's scan statistic was used. Of 12, 408 people examined in the different health areas 407 (3.3%) were found to have a history of epilepsy. A high prevalence of epilepsy was observed in health areas in the 3 provinces: 6.8-8.5% in Bas-Uele, 0.8-7.4% in Tshopo and 3.6-6.2% in Ituri. Median age of epilepsy onset was 9 years, and the modal age 12 years. The case control analysis demonstrated that before the appearance of epilepsy, compared to the same life period in controls, persons with epilepsy were around two times less likely (OR: 0.52; 95%CI: (0.28, 0.98)) to have taken Ivermectin than controls. After the appearance of epilepsy, there was no difference of Ivermectin intake between cases and controls. Only in Ituri, a significant cluster (p-value = 0.0001) was identified located around the Draju sample site area. The prevalence of epilepsy in health areas in onchocerciasis endemic regions in the DRC was 2-10 times higher than in non-onchocerciasis endemic regions in Africa. Our data suggests that

  1. Demographic Health Survey: Xay Thani district of Vientiane prefecture, Lao People's Democratic Republic.

    PubMed

    Foley, P J; Vongsak, D

    1991-12-01

    This article describes a demographic and health survey of 1608 married women of reproductive age, 15-44 years, from a sample of 30 villages in Xay Thani within 30-60 km of Vientiene, Lao People's Democratic Republic. It is expected that the social, economic and health conditions would be higher given the proximity to the capital city with bus service and paved roads. The physician to patient ratio is 1/1400 persons compared to rest of the country at 1/12,600. The physical conditions in the 60% farming community show that 85% are without motor transport and 40% without electricity. The mean age of respondent was 29 years. 81% could read a newspaper and 19% had no formal education and were unable to read. 87% of those 35-39 years and 48% of those 40-44 years had no formal education. The UN estimated Laotian female literacy to be 35% in 1989. It is possible the higher literacy is due to radio, television, and newspaper accessibility. 55% owned radios and 25% had televisions. 85% accepted the idea of family planning messages on television. The mean number of living children ranged from a high of 6.86 for those 40-44 to low of 1.09 for those 19 and 2.0 for those 20-24. The average was 3.82. Corresponding mean live births were 7.91 and 1.25 and 2.25. The infant mortality rate can not be determined from the data but is expected to be high. Knowledge of reproductive fertility and contraceptives was low. 86% were unaware of the timing of ovulation for most ages. 25% were aware of IUDs, condoms, tubectomy, vasectomy, periodic abstinence, or withdrawal, and 35% were aware of pills. Only 16% knew where to obtain contraceptives. The contraceptive prevalence rate (CPR) was 17.6% for modern methods. 17% were pregnant and 3% were unsure. Only 3.6% of those 19 have used any method and 1.8 a modern method. The CPR for 20-24 years old was 12.1% and increased with age. 70% of those 30 years did not want to be pregnant. Desired number of children was 3 or more, and mean desired was 5

  2. [Circulating vaccine-derived poliovirus type 2 outbreak in Democratic Republic of Congo 2011-2012].

    PubMed

    Bazira, L; Coulibaly, T; Mayenga, M; Ncharre, C; Yogolelo, R; Mbule, A; Moudzeo, H; Lwamba, P; Mulumba, A W; Cabore, J

    2015-10-01

    According to the WHO records of 2013, the incidence of poliomyelitis was reduced by more than 99%, the number of endemic countries decreased from 125 in 1988 to 3 in 2013 and over 10 million cases were prevented from poliomyelitis thanks to the intensive use of Oral polio vaccine (OPV). However, the emergence of circulating vaccine-derived poliovirus strains (cVDPV), causing serious epidemics like the wild poliovirus, is a major challenge on the final straight towards the goal of eradication and OPV cessation. This paper describes the cVDPVoutbreak that occurred in the Democratic Republic of Congo (DRC) from November 2011 to April 2012. All children under 15 years of age with acute flaccid paralysis (AFP) and confirmed presence of cVDPV in the stool samples were included. Thirty (30) children, all from the administrative territories of Bukama and Malemba Nkulu in the Katanga Province (south-east DRC), were reported. The virus responsible was the cVDPV type 2 (0.7% -3.5% divergent from the reference Sabin 2 strain) in 29 children (97%) and the ambiguous vaccine-derived poliovirus strain (0.7% divergent) was confirmed in one case (3%), a boy seventeen months old and already vaccinated four times with OPV. Twentyfive children (83%) were protected by any of the routine EPI vaccines and 3 children (10%) had never received any dose of OPV. In reaction, DRC has conducted five local campaigns over a period of 10 months (from January to October 2012) and the epidemic was stopped after the second round performed in March 2012. As elsewhere in similar conditions, low immunization coverage, poor sanitation conditions and the stop of the use of OPV2 have favoured the emergence of the third cVDPV epidemic in DRC. The implementation of the Strategic Plan for Polio eradication and endgame strategic plan 2013-2018 will prevent the emergence of cVDPV and set up the conditions for a coordinated OPV phase out.

  3. The malaria testing and treatment market in Kinshasa, Democratic Republic of the Congo, 2013.

    PubMed

    Mpanya, Godéfroid; Tshefu, Antoinette; Likwela, Joris Losimba

    2017-02-28

    The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation's capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector. A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and private sector were screened for eligibility. Among outlets with anti-malarials or malaria rapid diagnostic tests (RDT) in stock, a full audit of all available products was conducted. Information collected included product information (e.g. active ingredients, brand name), amount reportedly distributed to patients in the past week, and retail price. In total, 3364 outlets were screened for inclusion across Kinshasa and 1118 outlets were eligible for the study. Among all screened outlets in the private sector only about one in ten (12.1%) were stocking quality-assured Artemisinin-based Combination Therapy (ACT) medicines. Among all screened public sector facilities, 24.5% had both confirmatory testing and quality-assured ACT available, and 20.2% had sulfadoxine-pyrimethamine (SP) available for intermittent preventive therapy during pregnancy (IPTp). The private sector distributed the majority of anti-malarials in Kinshasa (96.7%), typically through drug stores (89.1% of the total anti-malarial market). Non-artemisinin therapies were the most commonly distributed anti-malarial (50.1% of the total market), followed by non quality-assured ACT medicines (38.5%). The median price of an adult quality-assured ACT was $6.59, and more expensive than non quality-assured ACT ($3.71) and SP ($0.44). Confirmatory testing was largely not available in the private

  4. Patterns of Congenital Malformations and Barriers to Care in Eastern Democratic Republic of Congo

    PubMed Central

    Malemo Kalisya, Luc; Nyavandu, Kavira; Machumu, Bahati; Kwiratuwe, Sylvain; Rej, Peter H.

    2015-01-01

    Background An increase of congenital anomalies in the eastern Democratic Republic of the Congo (DRC) has been reported. Congenital malformations (CMs) are not uncommon among newborns and, if left untreated, can contribute to increased neonate morbidity and mortality. Methods Medical records of all individuals admitted with a diagnosed CM to HEAL Africa Teaching Hospital (Goma, DRC) from 2002 to 2014 (n=1301) were reviewed. Data were analysed using descriptive statistics to summarize chart records, and inferential statistics to investigate significant barriers to earlier treatment. Results Since 2012, the number of patients treated each year for CMs has increased by over 200% compared to the average annual number of cases treated from 2002-2011. Though delayed presentation of patients to HEAL Hospital was very obvious, with an average age of 8.2 years. We find that patient age has been significantly decreasing (p=0.037) over time. The average distance separating patients from HEAL Hospital was 178 km, with approximately one third living 350 km or further from the treatment center. Distance is the most significant (p=3.33x10-6) barrier to earlier treatment. When controlling for an interaction between gender and the use of mercy funds, we also find that female patients are at a significant (p=1.04x10-3) disadvantage to undergo earlier corrective surgery. This disadvantage is further illustrated by our finding that 89% of women and girls, and over 81% of all patients, required mercy funds to cover the cost of surgery in 2014. Lastly, the mortality rate for surgery was low and averaged less than 1.0%. Conclusion Despite a formal end to the war in 2009, and an overall increase in individuals undergoing corrective surgery, distance, poverty, and gender are still massive barriers to CM care at HEAL Hospital, Goma, DRC. We find that patients have been successfully treated earlier by HEAL, although the average age of CM correction in 2014 (4.9 years) is still above average

  5. Patterns of Congenital Malformations and Barriers to Care in Eastern Democratic Republic of Congo.

    PubMed

    Malemo Kalisya, Luc; Nyavandu, Kavira; Machumu, Bahati; Kwiratuwe, Sylvain; Rej, Peter H

    2015-01-01

    An increase of congenital anomalies in the eastern Democratic Republic of the Congo (DRC) has been reported. Congenital malformations (CMs) are not uncommon among newborns and, if left untreated, can contribute to increased neonate morbidity and mortality. Medical records of all individuals admitted with a diagnosed CM to HEAL Africa Teaching Hospital (Goma, DRC) from 2002 to 2014 (n=1301) were reviewed. Data were analysed using descriptive statistics to summarize chart records, and inferential statistics to investigate significant barriers to earlier treatment. Since 2012, the number of patients treated each year for CMs has increased by over 200% compared to the average annual number of cases treated from 2002-2011. Though delayed presentation of patients to HEAL Hospital was very obvious, with an average age of 8.2 years. We find that patient age has been significantly decreasing (p=0.037) over time. The average distance separating patients from HEAL Hospital was 178 km, with approximately one third living 350 km or further from the treatment center. Distance is the most significant (p=3.33x10(-6)) barrier to earlier treatment. When controlling for an interaction between gender and the use of mercy funds, we also find that female patients are at a significant (p=1.04x10(-3)) disadvantage to undergo earlier corrective surgery. This disadvantage is further illustrated by our finding that 89% of women and girls, and over 81% of all patients, required mercy funds to cover the cost of surgery in 2014. Lastly, the mortality rate for surgery was low and averaged less than 1.0%. Despite a formal end to the war in 2009, and an overall increase in individuals undergoing corrective surgery, distance, poverty, and gender are still massive barriers to CM care at HEAL Hospital, Goma, DRC. We find that patients have been successfully treated earlier by HEAL, although the average age of CM correction in 2014 (4.9 years) is still above average for Sub-Saharan Africa. Thus, we

  6. 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

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

    PubMed

    Binanga, Arsene; Bertrand, Jane T

    2016-12-23

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

  8. High Prevalence of Thyroid Dysfunction Among Pregnant Women in Lubumbashi, Democratic Republic of Congo

    PubMed Central

    Twite, Kabange E.; Daumerie, Chantal; Wallemacq, Pierre; Donnen, Philippe; Kalenga, Muenze K.; Robert, Annie

    2014-01-01

    Background: Despite notable progress in the fight against iodine deficiency disorders in the Democratic Republic of Congo, a recent study has shown that pregnant women in Lubumbashi were still iodine deficient. Our objective was to assess thyroid function in this population. Methods: In a cross-sectional study conducted in maternity units from three different socioeconomic areas in Lubumbashi, serum thyrotropin, free thyroxine, thyroglobulin, and thyroperoxidase antibodies were measured in 225 pregnant women attending antenatal visits, in 75 women who recently delivered, and in 75 nonpregnant controls. The outcome was the prevalence of thyroid dysfunction. Results: Median values in pregnant women, women who recently delivered, and nonpregnant women were 1.80, 2.80, and 1.54 mIU/L for thyrotropin (p<0.001); 0.85, 1.11, and 1.16 ng/dL for free thyroxine (p<0.001); and 13.3, 9.5, and 10.4 ng/mL for thyroglobulin (p=0.01), respectively. The prevalence of thyroid dysfunction in pregnant women, in women who recently delivered, and in nonpregnant women was 31%, 8%, and 20% for isolated hypothyroxinemia (p<0.001); 12%, 24%, and 5% for subclinical hypothyroidism (p=0.002); 8%, 3%, and 3%, for overt hypothyroidism (p=0.09); and 5%, 13%, and 4%, for positive thyroperoxidase antibodies (p=0.03), respectively. In multiple logistic regression, women who were pregnant or who recently delivered, who lived in a poor socioeconomic area, and who had low urinary iodine concentration were more likely to have an increased serum thyrotropin: odds ratio (OR)=3.43 (95% confidence interval [CI] 1.23–9.53) for pregnancy, OR=4.49 [CI 1.66–15.01] for postpartum period, OR=3.68 [CI 1.85–7.35] for semiurban area, and OR=0.44 [CI 0.19–0.96] for urinary iodine concentration ≥250 μg/L. Conclusions: Our results show that there is a high prevalence of thyroid dysfunction in pregnant women of Lubumbashi, and this high prevalence is associated with iodine deficiency. To prevent

  9. The effect of war on infant mortality in the Democratic Republic of Congo.

    PubMed

    Lindskog, Elina Elveborg

    2016-10-06

    The Democratic Republic of Congo (DRC) has suffered from war and lingering conflicts in East DRC and has one of the highest infant mortality rates in the world. Prior research has documented increases in infant and child mortality associated with war, but the empirical evidence is limited in several respects. Measures of conflict are quite crude or conflict is not tightly linked to periods of exposure to infant death. Few studies have distinguished between the effects of war on neonatal versus post-neonatal infants. No study has considered possible differences between women who give birth during wartime and those who do not that may be related to greater infant mortality. The analysis used the nationally representative sample of 15,103 mothers and 53,768 children from the 2007 and 2013/2014 Demographic Health Survey in the DRC and indicators of conflict events and conflict deaths from the 2013 Uppsala Conflict Data. To account for unobserved heterogeneity across women, a multi-level modeling approach was followed by grouping all births for each woman and estimating random intercepts in discrete time event history models. Post-neonatal mortality increased during the Congolese wars, and was highest where conflict events and deaths were extreme. Neonatal mortality was not associated with conflict levels. Infant mortality was not higher in East DRC, where conflicts continued during the post Congolese war period. Models specifying unobserved differences between mothers who give birth during war and those who have children in peacetime did not reduce the estimated effect of war, i.e., no support was found for selectivity in the sample of births during war. Differences in effects of the Congolese war on neonatal versus post-neonatal mortality suggest that conflict influences the conditions of infants' lives more than the aspects of mothers' pregnancy conditions and delivery that are relevant for infant mortality. These differences may, however, be specific to the nature

  10. HIV infection and risk factors among the armed forces personnel stationed in Kinshasa, Democratic Republic of Congo.

    PubMed

    Rimoin, A W; Hoff, N A; Djoko, C F; Kisalu, N K; Kashamuka, M; Tamoufe, U; LeBreton, M; Kayembe, P K; Muyembe, J J; Kitchen, C R; Saylors, K; Fair, J; Doshi, R; Papworth, E; Mpoudi-Ngole, E; Grillo, M P; Tshala, F; Peeters, M; Wolfe, N D

    2015-03-01

    Despite recent declines in HIV incidence, sub-Saharan Africa remains the most heavily affected region in the global HIV/AIDS epidemic. Estimates of HIV prevalence in African military personnel are scarce and inconsistent. We conducted a serosurvey between June and September 2007 among 4043 Armed Forces personnel of the Democratic Republic of Congo (FARDC) stationed in Kinshasa, Democratic Republic of Congo (DRC) to determine the prevalence of HIV and syphilis infections and describe associated risk behaviours. Participants provided blood for HIV and syphilis testing and responded to a demographic and risk factor questionnaire. The prevalence of HIV was 3.8% and the prevalence of syphilis was 11.9%. Women were more likely than men to be HIV positive, (7.5% vs. 3.6% respectively, aOR: 1.66, 95% C.I: 1.21-2.28, p < 0.05). Factors significantly associated with HIV infection included gender and self-reported genital ulcers in the 12 months before date of enrollment. The prevalence of HIV in the military appears to be higher than the general population in DRC (3.8% vs. 1.3%, respectively), with women at increased risk of infection.

  11. Screening for traumatic exposure and posttraumatic stress symptoms in adolescents in the war-affected eastern Democratic Republic of Congo.

    PubMed

    Mels, Cindy; Derluyn, Ilse; Broekaert, Eric; Rosseel, Yves

    2009-06-01

    To explore adolescent mental health in the eastern Democratic Republic of Congo, scene of a complex emergency since 1996. Community cross-sectional data obtained using a cluster sample approach. From November 5, 2007, through February 5, 2008, we assessed 13 secondary schools in 4 selected health zones in the Ituri district. One thousand forty-six adolescents and young adults aged 13 to 21 years completed a self-report questionnaire. War-related traumatic events, posttraumatic stress symptoms, and sociodemographic variables. The Adolescent Complex Emergency Exposure Scale, specifically designed for this region, screened for exposure to potentially traumatic events, and the Impact of Event Scale-Revised measured symptoms of posttraumatic stress consistent with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. Among the 477 girls (45.6%) and 569 boys (54.4%) in the study, 95.0% reported at least 1 traumatic event. On average, adolescents were exposed to 4.71 traumatic events, with higher exposure rates reported in boys, older groups, rural and urban areas, and respondents whose mother or father was dead. Of 990 respondents, 52.2% met symptom criteria for posttraumatic stress disorder. Symptom scores were strongly related to cumulative trauma exposure; however, the strength of this relationship differed slightly across living area groups for girls. Adolescents in the eastern Democratic Republic of Congo are highly exposed to political violence, putting them at a considerable risk--mediated by living area and sex--to develop posttraumatic stress symptoms.

  12. Studies of crustal structure, seismic precursors to volcanic eruptions and earthquake hazard in the eastern provinces of the Democratic Republic of Congo

    NASA Astrophysics Data System (ADS)

    Mavonga, T.; Zana, N.; Durrheim, R. J.

    2010-11-01

    In recent decades, civil wars in the eastern provinces of the Democratic Republic of Congo have caused massive social disruptions, which have been exacerbated by volcanic and earthquake disasters. Seismic data were gathered and analysed as part of an effort to monitor the volcanoes and quantitatively assess the earthquake hazard. This information can be used to regulate the settlement of displaced people and to "build back better". In order to investigate volcanic processes in the Virunga area, a local seismic velocity model was derived and used to relocate earthquake hypocenters. It was found that swarm-type seismicity, composed mainly of long-period earthquakes, preceded both the 2004 and 2006 eruptions of Nyamuragira. A steady increase in seismicity was observed to commence ten or eleven months prior to the eruption, which is attributed to the movement of magma in a deep conduit. In the last stage (1 or 2 months) before the eruption, the hypocenters of long-period earthquakes became shallower. Seismic hazard maps were prepared for the DRC using a 90-year catalogue compiled for homogeneous Mw magnitudes, various published attenuation relations, and the EZ-Frisk software package. The highest levels of seismic hazard were found in the Lake Tanganyika Rift seismic zone, where peak ground accelerations (PGA) in excess of 0.32 g, 0.22 g and 0.16 g are expected to occur with 2%, 5% and 10% chance of exceedance in 50 years, respectively.

  13. Conflict minerals from the Democratic Republic of the Congo: global tungsten processing plants, a critical part of the tungsten supply chain

    USGS Publications Warehouse

    Bermúdez-Lugo, Omayra

    2014-01-01

    The U.S. Geological Survey (USGS) analyzes supply chains to identify and define major components of mineral and material flows from ore extraction, through intermediate forms, to a final product. Two major reasons necessitate these analyses: (1) to identify risks associated with the supply of critical and strategic minerals to the United States and (2) to provide greater supply chain transparency so that policymakers have the information necessary to ensure domestic legislation compliance. This fact sheet focuses on the latter. The USGS National Minerals Information Center has been asked by governmental and non-governmental organizations to provide information on tin, tantalum, tungsten, and gold (collectively known as “3TG minerals”) processing facilities worldwide in response to U.S. legislation aimed at removing the link between the trade in these minerals and civil unrest in the Democratic Republic of the Congo. Post beneficiation processing plants (smelters and refineries) of 3TG mineral ores and concentrates were identified by company and industry association representatives as being the link in the 3TG mineral supply chain through which these minerals can be traced to their source of origin (mine); determining the point of origin is critical to establishing a transparent conflict mineral supply chain. This fact sheet, the first in a series of 3TG mineral fact sheets, focuses on the tungsten supply chain by listing plants that consume tungsten concentrates to produce ammonium paratungstate and ferrotungsten worldwide.

  14. 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:…

  15. Mosquito Fauna of Lao People's Democratic Republic, with Special Emphasis on the Adult and Larval Surveillance at Nakai District, Khammuane Province.

    PubMed

    Rueda, Leopoldo M; Vongphayloth, Khamsing; Pecor, James E; Sutherland, Ian W; Hii, Jeffrey; Debboun, Mustapha; Brey, Paul T

    2015-01-01

    This article includes the distribution records and updated checklist of mosquitoes (Culicidae, Diptera) from the Lao People's Democratic Republic (PDR), based on the literature, specimens deposited at the US National Museum of Natural History mosquito collections, and our recent field collections from the Nakai District, Khammuane Province. Ten of 101 species in the updated checklist of mosquitoes are new records for the Lao PDR.

  16. A Survey of Teacher Attitudes of the German Democratic Republic to War and Peace and Their Perceptions and Misperceptions of Canadian Students.

    ERIC Educational Resources Information Center

    Weiss, Alan Z.

    Forty teachers attending a summer institute in East Germany in August of 1987 were given a questionnaire concerning their attitudes towards the German Democratic Republic and their opinions, perceptions, and misperceptions of Canadian students. The questionnaire was applied in Zwickau, East Germany at a small pedagogical college. Teachers were…

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

    ERIC Educational Resources Information Center

    Bollag, Burton, Ed.

    2015-01-01

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

  18. Cooperation of Libraries to Ensure the Satisfaction of Requirements in Information and Literature by the Broad Masses of People: Development and Experiences in the German Democratic Republic.

    ERIC Educational Resources Information Center

    Plotz, Klaus

    This overview of the situation in library cooperation in the German Democratic Republic with regard to the legal fundamentals for library work emphasizes the role of the head offices of librarianship, which are responsible for the coordination and direction of development. The existing structure and networks (territorial and special) are also…

  19. A resource planning analysis of district hospital surgical services in the Democratic Republic of the Congo.

    PubMed

    Sion, Melanie; Rajan, Dheepa; Kalambay, Hyppolite; Lokonga, Jean-Pierre; Bulakali, Joseph; Mossoko, Mathias; Kwete, Dieudonne; Schmets, Gerard; Kelley, Edward; Elongo, Tarcisse; Sambo, Luis; Cherian, Meena

    2015-03-01

    The impact of surgical conditions on global health, particularly on vulnerable populations, is gaining recognition. However, only 3.5% of the 234.2 million cases per year of major surgery are performed in countries where the world's poorest third reside, such as the Democratic Republic of the Congo (DRC). Data on the availability of anesthesia and surgical services were gathered from 12 DRC district hospitals using the World Health Organization's (WHO's) Emergency and Essential Surgical Care Situation Analysis Tool. We complemented these data with an analysis of the costs of surgical services in a Congolese norms-based district hospital as well as in 2 of the 12 hospitals in which we conducted the situational analysis (Demba and Kabare District Hospitals). For the cost analysis, we used WHO's integrated Healthcare Technology Package tool. Of the 32 surgical interventions surveyed, only 2 of the 12 hospitals provided all essential services. The deficits in procedures varied from no deficits to 17 services that could not be provided, with an average of 7 essential procedures unavailable. Many of the hospitals did not have basic infrastructure such as running water and electricity; 9 of 12 had no or interrupted water and 7 of 12 had no or interrupted electricity. On average, 21% of lifesaving surgical interventions were absent from the facilities, compared with the model normative hospital. According to the normative hospital, all surgical services would cost US$2.17 per inhabitant per year, representing 33.3% of the total patient caseload but only 18.3% of the total district hospital operating budget. At Demba Hospital, the operating budget required for surgical interventions was US$0.08 per inhabitant per year, and at Kabare Hospital, US$0.69 per inhabitant per year. A significant portion of the health problems addressed at Congolese district hospitals is surgical in nature, but there is a current inability to meet this surgical need. The deficient services and

  20. Micropaleontology and chemostratigraphy of the Neoproterozoic Mbuji-Mayi Supergroup, Democratic Republic of Congo.

    NASA Astrophysics Data System (ADS)

    Baludikay, Blaise; Bekker, Andrey; Baudet, Daniel; Asael, Dan; Storme, Jean-Yves; Javaux, Emmanuelle

    2014-05-01

    The Mbuji-Mayi Supergroup, deposited between 1170 ± 22 Ma and ca. 800 Ma [1], outcrops in the eastern Oriental Kasai Province and western Katanga Province of the Democratic Republic of Congo. It is the youngest Precambrian unit of the Kasai block and was deposited in the SE-NW trending failed-rift Sankuru-Mbuji-Mayi-Lomami-Lovoy basin filled with siliciclastic and carbonate sediments. In the northern part of this basin (Oriental Kasai Province), the Mbuji-Mayi Supergroup rests unconformably upon the Archean Dibaya Granite Complex, but in the southern part (northeastern Katanga Province), it overlies the Mesoproterozoic Kibaran Supergroup. The Supergroup is divided into two groups: the lower, ~ 500-m thick siliciclastics-rich BI Group and the upper, ~ 1000-m thick carbonate-rich BII Group. Our own and previous sedimentological observations [2] indicate facies ranging from subtidal, low-energy stromatolitic environments to overlying intertidal to supratidal evaporitic settings of lagoon and sabkha. In order to characterize the diversity of microfossil assemblages, their paleobiology and paleoecology as well as redox conditions in their depositional setting, we have sampled three drill cores (KAFUKU 15, B13 KANSHI, and S70 LUBI) from the collections of the Royal Museum for Central Africa (RMAC). Our biostratigraphic and chemostratigraphic data also provide further constraints on the age of the Mbuji-Mayi Supergroup. Here we present preliminary data on microfossil diversity from the Kanshi drill core and carbon isotope chemostratigraphy for all three drill cores. The well-preserved and diverse assemblage of acritarchs and filamentous forms includes prokaryotes and eukaryotes, and is similar to other coeval assemblages described worldwide outside of Africa. The presence of the acanthomorph acritarch Trachyhystrichosphaera aimika is significant as it is indicative of the late Meso- to early Neoproterozoic age elsewhere, and is reported for the first time in Central

  1. Situation Reports--Afghanistan, Bahrein, Brazil, Ecuador, Indonesia, Iraq, Morocco, Paraguay, People's Democratic Republic of Yemen, Peru, Qatar, Saudi Arabia, Sri Lanka, St. Christopher/Nevis, Sudan, United Arab Emirates, Yemen Arab Republic.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in 17 foreign countries are presented in these situation reports. Countries included are Afghanistan, Bahrein, Brazil, Ecuador, Indonesia, Iraq, Morocco, Paraguay, People's Democratic Republic of Yemen, Peru, Qatar, Saudi Arabia, Sri Lanka, St. Christopher/Nevis, Sudan, United Arab Emirates, and…

  2. Measles in the Democratic Republic of Congo: an urgent wake-up call to adapt vaccination implementation strategies.

    PubMed

    Gerard, S P; Kyrousis, E; Zachariah, R

    2014-03-21

    All countries in Africa have made a commitment to eliminate measles by 2020. This is laudable, as measles elimination will have a crucial impact on reducing childhood mortality. An important operational challenge is the resurgence of measles outbreaks in a number of countries; one of the main reasons for this is that many children are being missed by vaccination programmes. In the Democratic Republic of Congo (DRC), outbreaks continue unabated despite repeated vaccination campaigns and high reported coverage by the Ministry of Health. This paper brings into question the effectiveness of the current approach and the need for better reflection on bottlenecks and strategies that can address this issue. If we are to eliminate measles by 2020, there will be a need for impetus, a need for decisive action to reach that goal and prevent unnecessary childhood deaths in countries such as the DRC.

  3. High prevalence of Rickettsia typhi and Bartonella species in rats and fleas, Kisangani, Democratic Republic of the Congo.

    PubMed

    Laudisoit, Anne; Falay, Dadi; Amundala, Nicaise; Akaibe, Dudu; de Bellocq, Joëlle Goüy; Van Houtte, Natalie; Breno, Matteo; Verheyen, Erik; Wilschut, Liesbeth; Parola, Philippe; Raoult, Didier; Socolovschi, Cristina

    2014-03-01

    The prevalence and identity of Rickettsia and Bartonella in urban rat and flea populations were evaluated in Kisangani, Democratic Republic of the Congo (DRC) by molecular tools. An overall prevalence of 17% Bartonella species and 13% Rickettsia typhi, the agent of murine typhus, was found in the cosmopolitan rat species, Rattus rattus and Rattus norvegicus that were infested by a majority of Xenopsylla cheopis fleas. Bartonella queenslandensis, Bartonella elizabethae, and three Bartonella genotypes were identified by sequencing in rat specimens, mostly in R. rattus. Rickettsia typhi was detected in 72% of X. cheopis pools, the main vector and reservoir of this zoonotic pathogen. Co-infections were observed in rodents, suggesting a common mammalian host shared by R. typhi and Bartonella spp. Thus, both infections are endemic in DRC and the medical staffs need to be aware knowing the high prevalence of impoverished populations or immunocompromised inhabitants in this area.

  4. Is it better not to talk? Group polarization, extended contact, and perspective taking in Eastern Democratic Republic of Congo.

    PubMed

    Paluck, Elizabeth Levy

    2010-09-01

    Mass media are often used to generate discussion for the purpose of conflict reduction. A yearlong field experiment in eastern Democratic Republic of Congo (DRC) tested the impact of one such media program, a talk show designed to promote listener discussion about intergroup conflict and cooperation. A stratified random half of all nonoverlapping broadcast regions in eastern DRC aired the talk show, which encouraged listeners to consider tolerant opinions and outgroup perspectives, and promoted extended intergroup contact using a related soap opera. The other regions aired the soap opera only. Compared to individuals exposed to the soap opera only, talk show listeners discussed more but were more intolerant, more mindful of grievances, and less likely to aid disliked community members. These results point to some of the limits of discussion and suggest further research on ideas connecting theoretical recommendations for discussion and conflict reduction.

  5. Treatment of multidrug-resistant tuberculosis in a remote, conflict-affected area of the Democratic Republic of Congo.

    PubMed

    Shanks, L; Masumbuko, E W; Ngoy, N M; Maneno, M; Bartlett, S; Thi, S S; Shah, T

    2012-08-01

    The Democratic Republic of Congo is a high-burden country for multidrug-resistant tuberculosis. Médecins Sans Frontières has supported the Ministry of Health in the conflict-affected region of Shabunda since 1997. In 2006, three patients were diagnosed with drug-resistant TB (DR-TB) and had no options for further treatment. An innovative model was developed to treat these patients despite the remote setting. Key innovations were the devolving of responsibility for treatment to non-TB clinicians remotely supported by a TB specialist, use of simplified monitoring protocols, and a strong focus on addressing stigma to support adherence. Treatment was successfully completed after a median of 24 months. This pilot programme demonstrates that successful treatment for DR-TB is possible on a small scale in remote settings.

  6. Farming the battlefield: the meanings of war, cattle and soil in South Kivu, Democratic Republic of the Congo.

    PubMed

    Cox, T Paul

    2012-04-01

    Prior to 1996 and the Congolese wars, exploitative land policies pushed farmers in the eastern highlands of the Democratic Republic of the Congo (DRC) into a vulnerable position, with cattle manure sustaining intensive cultivation. This exposed households to a complete breakdown in mixed farming as cattle became targets of war. This study of villages in South Kivu offers an inside understanding of continuity and change in farming practices in a region where there are no easy solutions, and it assesses how the province lost its present and where farmers look when they glance to the future. For farmers, who hold a broad view of soil fertility, the casualties of war were not only people and cattle but also the land itself, which has enduring scars. Perceiving a rupture in tradition, South Kivu farmers are searching desperately for new livelihoods that are built on education instead of livestock, setting aside old ethnic signifiers to seek a future beyond protracted conflict.

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

    PubMed

    Sakamaki, Tetsuya

    2010-01-01

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

  8. Field investigations of an outbreak of Ebola hemorrhagic fever, Kikwit, Democratic Republic of the Congo, 1995: arthropod studies.

    PubMed

    Reiter, P; Turell, M; Coleman, R; Miller, B; Maupin, G; Liz, J; Kuehne, A; Barth, J; Geisbert, J; Dohm, D; Glick, J; Pecor, J; Robbins, R; Jahrling, P; Peters, C; Ksiazek, T

    1999-02-01

    During the final weeks of a 6-month epidemic of Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo, an extensive collection of arthropods was made in an attempt to learn more of the natural history of the disease. A reconstruction of the activities of the likely primary case, a 42-year-old man who lived in the city, indicated that he probably acquired his infection in a partly forested area 15 km from his home. Collections were made throughout this area, along the route he followed from the city, and at various sites in the city itself. No Ebola virus was isolated, but a description of the collections and the ecotopes involved is given for comparison with future studies of other outbreaks.

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

    PubMed Central

    Morffe, Jans; García, Nayla

    2013-01-01

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

  10. Sociocultural Determinants of Anticipated Vaccine Acceptance for Acute Watery Diarrhea in Early Childhood in Katanga Province, Democratic Republic of Congo

    PubMed Central

    Merten, Sonja; Schaetti, Christian; Manianga, Cele; Lapika, Bruno; Hutubessy, Raymond; Chaignat, Claire-Lise; Weiss, Mitchell

    2013-01-01

    Rotavirus and oral cholera vaccines have the potential to reduce diarrhea-related child mortality in low-income settings and are recommended by the World Health Organization. Uptake of vaccination depends on community support, and is based on local priorities. This study investigates local perceptions of acute watery diarrhea in childhood and anticipated vaccine acceptance in two sites in the Democratic Republic of Congo. In 2010, 360 randomly selected non-affected adults were interviewed by using a semi-structured questionnaire. Witchcraft and breastfeeding were perceived as potential cause of acute watery diarrhea by 51% and 48% of respondents. Despite misperceptions, anticipated vaccine acceptance at no cost was 99%. The strongest predictor of anticipated vaccine acceptance if costs were assumed was the educational level of the respondents. Results suggest that the introduction of vaccines is a local priority and local (mis)perceptions of illness do not compromise vaccine acceptability if the vaccine is affordable. PMID:23878187

  11. Measles in the Democratic Republic of Congo: an urgent wake-up call to adapt vaccination implementation strategies

    PubMed Central

    Kyrousis, E.; Zachariah, R.

    2014-01-01

    All countries in Africa have made a commitment to eliminate measles by 2020. This is laudable, as measles elimination will have a crucial impact on reducing childhood mortality. An important operational challenge is the resurgence of measles outbreaks in a number of countries; one of the main reasons for this is that many children are being missed by vaccination programmes. In the Democratic Republic of Congo (DRC), outbreaks continue unabated despite repeated vaccination campaigns and high reported coverage by the Ministry of Health. This paper brings into question the effectiveness of the current approach and the need for better reflection on bottlenecks and strategies that can address this issue. If we are to eliminate measles by 2020, there will be a need for impetus, a need for decisive action to reach that goal and prevent unnecessary childhood deaths in countries such as the DRC. PMID:26423753

  12. High Prevalence of Rickettsia typhi and Bartonella Species in Rats and Fleas, Kisangani, Democratic Republic of the Congo

    PubMed Central

    Laudisoit, Anne; Falay, Dadi; Amundala, Nicaise; Akaibe, Dudu; de Bellocq, Joëlle Goüy; Van Houtte, Natalie; Breno, Matteo; Verheyen, Erik; Wilschut, Liesbeth; Parola, Philippe; Raoult, Didier; Socolovschi, Cristina

    2014-01-01

    The prevalence and identity of Rickettsia and Bartonella in urban rat and flea populations were evaluated in Kisangani, Democratic Republic of the Congo (DRC) by molecular tools. An overall prevalence of 17% Bartonella species and 13% Rickettsia typhi, the agent of murine typhus, was found in the cosmopolitan rat species, Rattus rattus and Rattus norvegicus that were infested by a majority of Xenopsylla cheopis fleas. Bartonella queenslandensis, Bartonella elizabethae, and three Bartonella genotypes were identified by sequencing in rat specimens, mostly in R. rattus. Rickettsia typhi was detected in 72% of X. cheopis pools, the main vector and reservoir of this zoonotic pathogen. Co-infections were observed in rodents, suggesting a common mammalian host shared by R. typhi and Bartonella spp. Thus, both infections are endemic in DRC and the medical staffs need to be aware knowing the high prevalence of impoverished populations or immunocompromised inhabitants in this area. PMID:24445202

  13. Risk of Sexual Violence: Perspectives and Experiences of Women in a Hospital in the Democratic Republic of Congo.

    PubMed

    Zihindula, Ganzamungu; Maharaj, Pranitha

    2015-08-01

    Sexual violence in conflict situations is gaining worldwide recognition as a human rights issue. There is growing awareness and concern about the risks associated with sexual violence against women. This study was conducted in order to explore the perceptions and experiences of the risk of sexual violence in the Democratic Republic of Congo. The study draws on qualitative, in-depth interviews with women at a hospital in Bukavu. The findings show that women suffered humiliation, torture and beatings during their rape. Most women were raped by a number of men and others were forced to have sex with close family members. The rapist often used extreme brutality against the women which had major long-term consequences for women including unwanted pregnancies and/or HIV/AIDS. Many of the women experienced great uncertainty about their future and that of their children.

  14. Kitona 2013: A Medical Readiness Training Exercise in the Democratic Republic of the Congo Leading to Lion Rouge.

    PubMed

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

    2015-01-01

    Health initiatives support regional stability and are a priority for US and African partners. We present data and experience from the Democratic Republic of Congo (DRC), a strategically and epidemiologically ideal location for collaborative medical engagement (CME). Our objectives included relationship building, exposure of US military medical personnel to uncommon tropical diseases, bolstering a referral hospital, and updating Congolese physicians on new treatment or preventive standards of care. We conducted a CME-styled medical readiness training exercise (MEDRETE) at the Military Referral Hospital of Kitona in June 2013. US and Congolese healthcare providers presented 20 lectures and evaluated 158 patients collaboratively; 132 for infections. The CME led to Lion Rouge, the first joint military, multidisciplinary engagement between the respective militaries. Equally noteworthy is that some of the same participants returned to the same location for the follow-on exercise, providing continuity. These outcomes suggest the MEDRETE and CME approaches were successful. 2015.

  15. HIV prevalence and risk behaviour among men who have sex with men in Vientiane Capital, Lao People's Democratic Republic, 2007.

    PubMed

    Sheridan, Sarah; Phimphachanh, Chansy; Chanlivong, Niramonh; Manivong, Sisavath; Khamsyvolsvong, Sod; Lattanavong, Phonesay; Sisouk, Thongchanh; Toledo, Carlos; Scherzer, Martha; Toole, Mike; van Griensven, Frits

    2009-01-28

    Men who have sex with men are at high risk for HIV infection. Here we report the results of the first assessment of HIV prevalence and risk behaviour in this group in Vientiane, Lao People's Democratic Republic. Between August and September 2007, 540 men were enrolled from venues around Vientiane, using venue-day-time sampling. Men of Lao nationality, 15 years and over, reporting oral or anal sex with a man in the previous 6 months were eligible for participation. Demographic and socio-behavioural information was self-collected using hand-held computers. Oral fluid was tested for HIV infection. Logistic regression was used to evaluate risk factors for prevalent HIV infection. The median age of participants was 21 years; the HIV prevalence was 5.6%. Of participants, 39.6% reported exclusive attraction to men and 57.6% reported sex with women. Of those who reported having regular and nonregular sexual partner(s) in the past 3 months, consistent condom use with these partners was 14.4 and 24.2%, respectively. A total of 42.2% self-reported any sexually transmitted infection symptoms and 6.3% had previously been tested for HIV. Suicidal ideation was reported by 17.0%, which was the only variable significantly and independently associated with HIV infection in multivariate analysis. Although the HIV prevalence is low compared with neighbouring countries in the region, men who have sex with men in Lao People's Democratic Republic are at high behavioural risk for HIV infection. To prevent a larger HIV epidemic occurrence and transmission into the broader community, higher coverage of HIV prevention interventions is required.

  16. Military and Security Developments Involving the Democratic People’s Republic of Korea

    DTIC Science & Technology

    2012-01-01

    Korea 2012 A Report to Congress Pursuant to the National Defense Authorization Act for Fiscal Year 2012 Section 1236 of the...by these commitments, the Department of Defense will continue to manage the North Korean security challenge through close coordination and... Korea 3 CHAPTER ONE: ASSESSMENT OF THE SECURITY SITUATION KEY DEVELOPMENTS IN NORTH KOREAN AND PENINSULAR SECURITY The Democratic People’s

  17. [Role of the "Marriage and Family" Section in the field of family planning in the German Democratic Republic].

    PubMed

    Dolberg, G; Krause, S; Wegner, B

    1976-07-01

    Founded in 1963, the marriage and family planning department under the leadership of its chairman, K.H. Mehlan has grown in its number of members (220) and in its sphere of activities. With the help of the Health Department it has increasingly taken on the responsibility of implementing family planning programs in the German Democratic Republic. Laws concerning abortion and sterilization were liberalized to women's advantage and a serious attempt was made to provide new, effective mechanical, chemical, and hormonal contraceptives. Marriage and Sexual Counseling centers were set up throughout the country. From 1965 on development conferences were held annually in Rostock. A major propaganda compaign for family planning was initiated with national and local press specials, television and radio programs, and lectures and conferences throughout the republic. In 1967 the department was accepted in the IPPF. In 1968 the department was given status as a separate and independent one. In 1971 demography and fertility were included in the curricula of the medical schools. Specialized organizations concentrated on training and further education of family planning workers and specialists. In 1971 an international seminar was held to discuss family planning in socialist countries, and in 1972 abortion was legalized and an attempt was made to instruct youth in the most effective methods of contraceptives.

  18. Emergence of divergent Zaire ebola virus strains in Democratic Republic of the Congo in 2007 and 2008.

    PubMed

    Grard, Gilda; Biek, Roman; Tamfum, Jean-Jacques Muyembe; Fair, Joseph; Wolfe, Nathan; Formenty, Pierre; Paweska, Janusz; Leroy, Eric

    2011-11-01

    Zaire ebolavirus was responsible for 2 outbreaks in Democratic Republic of the Congo (DRC), in 1976 and 1995. The virus reemerged in DRC 12 years later, causing 2 successive outbreaks in the Luebo region, Kasai Occidental province, in 2007 and 2008. Viruses of each outbreak were isolated and the full-length genomes were characterized. Phylogenetic analysis was then undertaken to characterize the relationships with previously described viruses. The 2 Luebo viruses are nearly identical but are not related to lineage A viruses known in DRC or to descendants of the lineage B viruses encountered in the Gabon-Republic of the Congo area, with which they do, however, share a common ancestor. Our findings strongly suggest that the Luebo 2007 outbreak did not result from viral spread from previously identified foci but from an independent viral emergence. The previously identified epidemiological link with migratory bat species known to carry Zaire ebolavirus RNA support the hypothesis of viral spillover from this widely dispersed reservoir. The high level of similarity between the Luebo2007 and Luebo2008 viruses suggests that local wildlife populations (most likely bats) became infected and allowed local viral persistence and reemergence from year to year.

  19. Emergence of Divergent Zaire Ebola Virus Strains in Democratic Republic of the Congo in 2007 and 2008

    PubMed Central

    Biek, Roman; Muyembe Tamfum, Jean-Jacques; Fair, Joseph; Wolfe, Nathan; Formenty, Pierre; Paweska, Janusz; Leroy, Eric

    2011-01-01

     Background. Zaire ebolavirus was responsible for 2 outbreaks in Democratic Republic of the Congo (DRC), in 1976 and 1995. The virus reemerged in DRC 12 years later, causing 2 successive outbreaks in the Luebo region, Kasai Occidental province, in 2007 and 2008. Methods. Viruses of each outbreak were isolated and the full-length genomes were characterized. Phylogenetic analysis was then undertaken to characterize the relationships with previously described viruses. Results. The 2 Luebo viruses are nearly identical but are not related to lineage A viruses known in DRC or to descendants of the lineage B viruses encountered in the Gabon–Republic of the Congo area, with which they do, however, share a common ancestor. Conclusions. Our findings strongly suggest that the Luebo 2007 outbreak did not result from viral spread from previously identified foci but from an independent viral emergence. The previously identified epidemiological link with migratory bat species known to carry Zaire ebolavirus RNA support the hypothesis of viral spillover from this widely dispersed reservoir. The high level of similarity between the Luebo2007 and Luebo2008 viruses suggests that local wildlife populations (most likely bats) became infected and allowed local viral persistence and reemergence from year to year. PMID:21987750

  20. Civic Education in the Czech Republic: Curriculum Reform for Democratic Citizenship. Evaluator's Report.

    ERIC Educational Resources Information Center

    Torney-Purta, Judith

    This report evaluates a project undertaken in the Czech Republic to create lesson scenarios to revise the existing social studies curricular framework for the third form of secondary school (ages 17-18) with special reference to the overarching objectives for civic education reform started in 1989. These objectives included the elimination of…

  1. Communists, Social Democrats, and the homosexual movement in the Weimar Republic.

    PubMed

    Herzer, M

    1995-01-01

    Two cliches of gay historiography concerning the relationship between homosexuals and the political parties of the Weimar Republic are here subjected to critical examination. The notion that the political left of that era was similar in its homophobia to the right-wing and centrist parties is challenged with a number of particulars showing that the goals of the homosexual movement were supported almost exclusively by the left, especially the Communist Party, and that leftist homophobia was an atypical exception. Attention is also devoted to the active involvement of homosexual men in the Nazi movement and the destruction of the Weimar Republic, which casts doubt on the notion that homosexuals were merely passive victims of Nazi homophobia and persecution. The possibility of a special affinity between homosexual men and the Nazi movement is explored using the example of the Nazi leader Ernst Röhm.

  2. Contribution of the german democratic republic (east germany) to the intercosmos program of study of materials in space aboard the orbiting station salyut 6

    SciTech Connect

    Barthel, V.; Kuhl, R.

    1986-03-01

    This article reviews the experiments between the USSR, the German Democratic Republic, and Vietnam in a program of international cooperation aboard the Salyut 6 orbiter. The study of materials in space was undertaken to research the effects of orbital and gravitational conditions on crystal growth, melting, sublimation, structure, smelting and transport phenomena in glass and semiconductor materials. Bismuth, antimony, lead, tellurium, germanium, and their various alloys were studied.

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

    NASA Astrophysics Data System (ADS)

    Burlet, Christian; Vanbrabant, Yves; Decree, Sophie

    2014-05-01

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

  4. Comparison of the U.S. and German Approaches to Democratic Civil-Military Relations

    DTIC Science & Technology

    2003-06-01

    375 Schoenbohm, p. 68. 376 Falkenberg , Thomas, Civil-Military Relations and its Problems -Germany and Russia-, Thesis at the Naval Postgraduate...but supported by the powerful institution of the 407 Craig, pp. 423-426. 408 Falkenberg , p. 47. 409

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

    PubMed

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

    2016-12-01

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

  6. Evidence for partial melt in the crust beneath Mt. Paektu (Changbaishan), Democratic People's Republic of Korea and China.

    PubMed

    Kyong-Song, Ri; Hammond, James O S; Chol-Nam, Ko; Hyok, Kim; Yong-Gun, Yun; Gil-Jong, Pak; Chong-Song, Ri; Oppenheimer, Clive; Liu, Kosima W; Iacovino, Kayla; Kum-Ran, Ryu

    2016-04-01

    Mt. Paektu (also known as Changbaishan) is an enigmatic volcano on the border between the Democratic People's Republic of Korea (DPRK) and China. Despite being responsible for one of the largest eruptions in history, comparatively little is known about its magmatic evolution, geochronology, or underlying structure. We present receiver function results from an unprecedented seismic deployment in the DPRK. These are the first estimates of the crustal structure on the DPRK side of the volcano and, indeed, for anywhere beneath the DPRK. The crust 60 km from the volcano has a thickness of 35 km and a bulk V P/V S of 1.76, similar to that of the Sino-Korean craton. The V P/V S ratio increases ~20 km from the volcano, rising to >1.87 directly beneath the volcano. This shows that a large region of the crust has been modified by magmatism associated with the volcanism. Such high values of V P/V S suggest that partial melt is present in the crust beneath Mt. Paektu. This region of melt represents a potential source for magmas erupted in the last few thousand years and may be associated with an episode of volcanic unrest observed between 2002 and 2005.

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

    PubMed

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

    2012-04-01

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

  8. Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

    PubMed

    Ashbaugh, Hayley R; Kuang, Brandon; Gadoth, Adva; Alfonso, Vivian H; Mukadi, Patrick; Doshi, Reena H; Hoff, Nicole A; Sinai, Cyrus; Mossoko, Mathias; Kebela, Benoit Ilunga; Muyembe, Jean-Jacques; Wemakoy, Emile Okitolonda; Rimoin, Anne W

    2017-09-01

    Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.

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

    PubMed

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

    2017-02-01

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

  10. Quantifying gas emissions from the "Millennium Eruption" of Paektu volcano, Democratic People's Republic of Korea/China.

    PubMed

    Iacovino, Kayla; Ju-Song, Kim; Sisson, Thomas; Lowenstern, Jacob; Kuk-Hun, Ri; Jong-Nam, Jang; Kun-Ho, Song; Song-Hwan, Ham; Oppenheimer, Clive; Hammond, James O S; Donovan, Amy; Liu, Kosima W; Kum-Ran, Ryu

    2016-11-01

    Paektu volcano (Changbaishan) is a rhyolitic caldera that straddles the border between the Democratic People's Republic of Korea and China. Its most recent large eruption was the Millennium Eruption (ME; 23 km(3) dense rock equivalent) circa 946 CE, which resulted in the release of copious magmatic volatiles (H2O, CO2, sulfur, and halogens). Accurate quantification of volatile yield and composition is critical in assessing volcanogenic climate impacts but is challenging, particularly for events before the satellite era. We use a geochemical technique to quantify volatile composition and upper bounds to yields for the ME by examining trends in incompatible trace and volatile element concentrations in crystal-hosted melt inclusions. We estimate that the ME could have emitted as much as 45 Tg of S to the atmosphere. This is greater than the quantity of S released by the 1815 eruption of Tambora, which contributed to the "year without a summer." Our maximum gas yield estimates place the ME among the strongest emitters of climate-forcing gases in the Common Era. However, ice cores from Greenland record only a relatively weak sulfate signal attributed to the ME. We suggest that other factors came into play in minimizing the glaciochemical signature. This paradoxical case in which high S emissions do not result in a strong glacial sulfate signal may present a way forward in building more generalized models for interpreting which volcanic eruptions have produced large climate impacts.

  11. 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.

  12. 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.

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

    PubMed

    Douglas, Pamela Heidi

    2014-10-01

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

  14. [On the history of the German Democratic Republic Journal Psychiatry, Neurology and Medical Psychology (1949-1990)].

    PubMed

    Teitge, M; Kumbier, E

    2015-05-01

    Scientific journals were established in the Soviet occupied zone following WWII in order to distinguish themselves from the other occupying powers. Starting in 1949 a journal with the title "Psychiatry, Neurology and Medical Psychology" was founded as no publishing house existed in the field of psychiatry and neurology and it became necessary to establish a new journal that was competitive. The journal was primarily distributed in the German Democratic Republic (GDR) until 1990 but the interest internationally was very limited. State affairs had a great influence from the very beginning so that the political involvement was reflected in the selection of staff, such as the publishers and the head of the editorial department and by the close interconnection between the Society for Psychiatry and Neurology of the GDR and the editorship of the journal. The publishers who were primarily responsible and the authors were at the interface of politics and science. Nevertheless, in an international comparison many parallels can be found in the orientation with respect to the content.

  15. Evidence for partial melt in the crust beneath Mt. Paektu (Changbaishan), Democratic People’s Republic of Korea and China

    PubMed Central

    Kyong-Song, Ri; Hammond, James O. S.; Chol-Nam, Ko; Hyok, Kim; Yong-Gun, Yun; Gil-Jong, Pak; Chong-Song, Ri; Oppenheimer, Clive; Liu, Kosima W.; Iacovino, Kayla; Kum-Ran, Ryu

    2016-01-01

    Mt. Paektu (also known as Changbaishan) is an enigmatic volcano on the border between the Democratic People’s Republic of Korea (DPRK) and China. Despite being responsible for one of the largest eruptions in history, comparatively little is known about its magmatic evolution, geochronology, or underlying structure. We present receiver function results from an unprecedented seismic deployment in the DPRK. These are the first estimates of the crustal structure on the DPRK side of the volcano and, indeed, for anywhere beneath the DPRK. The crust 60 km from the volcano has a thickness of 35 km and a bulk VP/VS of 1.76, similar to that of the Sino-Korean craton. The VP/VS ratio increases ~20 km from the volcano, rising to >1.87 directly beneath the volcano. This shows that a large region of the crust has been modified by magmatism associated with the volcanism. Such high values of VP/VS suggest that partial melt is present in the crust beneath Mt. Paektu. This region of melt represents a potential source for magmas erupted in the last few thousand years and may be associated with an episode of volcanic unrest observed between 2002 and 2005. PMID:27152343

  16. "Ten Minimum Requirement": A Management Tool to Improve Quality of Healthcare Services in Lao People Democratic Republic (Lao PDR).

    PubMed

    Wada, Koji; Rattana, Sommana; Vongsamphanh, Chanphomma

    2015-12-01

    In Lao People's Democratic Republic (PDR), the mortality rate among children under 5 years of age is high (131 per 1000 live births in 2003), partly as a consequence of poor basic services provided by district hospitals. A simplified management tool, "Ten MR (Minimum Requirement)", was developed in Lao PDR. The tool assured the quality of health services including the processes of planning, implementing, self-monitoring, supervision, reporting and evaluation. The tool focused on ten basic services, integrating stakeholders from district hospitals and governing agencies. Each district hospital develops feasible annual activities, assigning responsibility to people based on a consensus between hospital staff and local governing agencies. Hospitals can self-monitor their activities on a monthly basis. Supervisory visits to district hospitals by local governing agencies improved activities and communication between staff. Visualization of progress promoted the sharing of achievements between staff and highlighted activities in need of more work. In 2004, district hospitals in Vientiane and Oudomxay provinces initiated the application of the tool. These district hospitals included primary care hospitals for outpatients, emergency care and in-patients, with a capacity of 10-20 beds, providing care for a population of between 30,000 and 80,000 people. The Ministry of Health recognized the effectiveness of Ten MR and implemented the expansion of the tool to all district hospitals in Lao PDR from 2011. Ten MR benefits district hospitals and governing agencies. Ten MR focuses on the daily routine work, enhancing team work and communication among all stakeholders.

  17. Prevalence of Schistosoma mansoni Infection in Four Health Areas of Kisantu Health Zone, Democratic Republic of the Congo

    PubMed Central

    Mbanzulu Makola, K.

    2016-01-01

    Background. Schistosomiasis is a public health problem in Democratic Republic of the Congo but estimates of its prevalence vary widely. The aim of this study was to determine prevalence of Schistosoma mansoni infection and associated risk factors among children in 4 health areas of Kisantu health zone. Methods. A cross-sectional study was carried out in 4 health areas of Kisantu health zone. 388 children randomly selected were screened for S. mansoni using Kato Katz technique and the sociodemographic data was collected. Data were entered and encoded using software EpiData version 3.1. Analysis was performed using SPSS version 21 software. Results. The prevalence of S. mansoni was 26.5% (103); almost two-thirds (63) (61.2%) had light infection intensity. A significant association was found between S. mansoni infection and age (p = 0.005), educational level (p = 0.001), and practices of swimming/bathing (p < 0.001) and using water from river/lake/stream for domestic use (p < 0.001). Kipasa health area had high prevalence of schistosomiasis (64.6%) (64/99; 95% CI 54.4–74.0) compared to other health areas. Conclusion. Schistosoma mansoni infection still remains a public health problem in these areas. There is a need to promote health education and promote behavioral changes in children towards schistosomiasis. PMID:27579346

  18. Prevalence of Endemic Pig-Associated Zoonoses in Southeast Asia: A Review of Findings from the Lao People's Democratic Republic

    PubMed Central

    Okello, Anna L.; Burniston, Stephanie; Conlan, James V.; Inthavong, Phouth; Khamlome, Boualam; Welburn, Susan C.; Gilbert, Jeffrey; Allen, John; Blacksell, Stuart D.

    2015-01-01

    The increasing intensification of pork production in southeast Asia necessitates an urgent requirement to better understand the dual impact of pig-associated zoonotic disease on both pig production and human health in the region. Sharing porous borders with five countries and representing many regional ethnicities and agricultural practices, the Lao People's Democratic Republic (Lao PDR) appears well placed to gauge the levels of pig-associated zoonoses circulating in the wider region. Despite this, little is known about the true impact of zoonotic pathogens such as leptospirosis, Trichinella, hepatitis E virus (HEV), Japanese encephalitis (JE), and Taenia solium on human health and livestock production in the country. A comprehensive review of the published prevalences of these five pig-associated zoonoses in Lao PDR has demonstrated that although suspicion remains high of their existence in pig reservoirs across the country, epidemiological data are scarce; only 31 epidemiological studies have been undertaken on these diseases in the past 25 years. A greater understanding of the zoonoses prevalence and subsequent risks associated with pork production in the southeast Asian region could help focus public health and food safety interventions at key points along the value chain, benefiting both livestock producers and the broader animal and human health systems in the region. PMID:25802431

  19. Integrated rapid mapping of onchocerciasis and loiasis in the Democratic Republic of Congo: impact on control strategies.

    PubMed

    Tekle, Afework Hailemariam; Zoure, Honorat; Wanji, Samuel; Leak, Stephen; Noma, Mounkaila; Remme, Jan H F; Amazigo, Uche

    2011-09-01

    Onchocerciasis can be effectively controlled by annual mass treatment with ivermectin in endemic communities. However, in communities that are endemic for loiasis there may be significant risk of severe adverse reactions after ivermectin treatment. Planning of control requires therefore mapping of these two infections using rapid assessment tools developed for each disease. These tools were initially implemented independently till the feasibility of combining them was demonstrated. This paper reports the results of integrated mapping in four epidemiological zones in the Democratic Republic of Congo and its implications on operational decision-making on ivermectin treatment. Rapid assessment surveys were conducted between 2004 and 2005 using both rapid epidemiological mapping of onchocerciasis (REMO) and rapid assessment procedure for loiasis (RAPLOA). The survey results were subjected to a spatial analysis in order to generate for each of the two diseases maps of the estimated prevalence of infection throughout the four zones. Surveys were undertaken in 788 villages where 25,754 males were examined for palpable onchocercal nodules and 62,407 people were interviewed for history of eye worm. The results showed major differences in the geographic distribution of the two diseases. Loiasis was highly endemic in some areas, where special precautions were required, but not in others where routine ivermectin treatment could proceed. Integrated rapid mapping of onchocerciasis and loiasis reduces both time and cost of surveys and greatly facilitates operational decision-making on ivermectin treatment in areas where loiasis might be co-endemic. Copyright © 2010 Elsevier B.V. All rights reserved.

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

    PubMed

    Marshall, Andrew J; Hohmann, Gottfried

    2005-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2017-04-01

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

  2. Novel Reassortant H5N6 Influenza A Virus from the Lao People's Democratic Republic Is Highly Pathogenic in Chickens.

    PubMed

    Butler, Jeffrey; Stewart, Cameron R; Layton, Daniel S; Phommachanh, Phouvong; Harper, Jennifer; Payne, Jean; Evans, Ryan M; Valdeter, Stacey; Walker, Som; Harvey, Gemma; Shan, Songhua; Bruce, Matthew P; Rootes, Christina L; Gough, Tamara J; Rohringer, Andreas; Peck, Grantley R; Fardy, Sarah J; Karpala, Adam J; Johnson, Dayna; Wang, Jianning; Douangngeun, Bounlom; Morrissy, Christopher; Wong, Frank Y K; Bean, Andrew G D; Bingham, John; Williams, David T

    2016-01-01

    Avian influenza viruses of H5 subtype can cause highly pathogenic disease in poultry. In March 2014, a new reassortant H5N6 subtype highly pathogenic avian influenza virus emerged in Lao People's Democratic Republic. We have assessed the pathogenicity, pathobiology and immunological responses associated with this virus in chickens. Infection caused moderate to advanced disease in 6 of 6 chickens within 48 h of mucosal inoculation. High virus titers were observed in blood and tissues (kidney, spleen, liver, duodenum, heart, brain and lung) taken at euthanasia. Viral antigen was detected in endothelium, neurons, myocardium, lymphoid tissues and other cell types. Pro-inflammatory cytokines were elevated compared to non-infected birds. Our study confirmed that this new H5N6 reassortant is highly pathogenic, causing disease in chickens similar to that of Asian H5N1 viruses, and demonstrated the ability of such clade 2.3.4-origin H5 viruses to reassort with non-N1 subtype viruses while maintaining a fit and infectious phenotype. Recent detection of influenza H5N6 poultry infections in Lao PDR, China and Viet Nam, as well as six fatal human infections in China, demonstrate that these emergent highly pathogenic H5N6 viruses may be widely established in several countries and represent an emerging threat to poultry and human populations.

  3. Ebola between outbreaks: intensified Ebola hemorrhagic fever surveillance in the Democratic Republic of the Congo, 1981-1985.

    PubMed

    Jezek, Z; Szczeniowski, M Y; Muyembe-Tamfum, J J; McCormick, J B; Heymann, D L

    1999-02-01

    Surveillance for Ebola hemorrhagic fever was conducted in the Democratic Republic of the Congo from 1981 to 1985 to estimate the incidence of human infection. Persons who met the criteria of one of three different case definitions were clinically evaluated, and blood was obtained for antibody confirmation by IFA. Contacts of each case and 4 age- and sex-matched controls were also clinically examined and tested for immunofluorescent antibody. Twenty-one cases of Ebola infection (persons with an antibody titer of > or = 1:64, or lower if they fit the clinical case definition) were identified, with a maximum 1-year incidence of 9 and a case fatality rate of 43%. Cases occurred throughout the year, but most (48%) occurred early in the rainy season. Fifteen percent of contacts had antibody titers > or =1:64 to Ebola virus, compared with 1% of controls (P < .0001). Results suggest that Ebola virus periodically emerges from nature to infect humans, that person-to-person transmission is relatively limited, and that amplification to large epidemics is unusual.

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

    PubMed

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

    2017-10-03

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

  5. Ethno-entomological observations from North Korea (officially known as the “Democratic People’s Republic of Korea”)

    PubMed Central

    2013-01-01

    In terms of scientific activities generally and ethnobiological pursuits in particular, North Korea, officially known as the Democratic People’s Republic of Korea, is an almost blank entity on the quilt of global research. During a sabbatical semester at Pyongyang University of Science and Technology the author used this opportunity to gather some information on the uses of insect and other terrestrial arthropods as human food and components of traditional healing methods in that country. Despite the widely publicised shortcomings in the supply of food stuffs to the population of North Korea, insects are not generally seen as a source of food worthy of exploitation. However, the therapeutic use of insects, centipedes and scorpions to treat illnesses as diverse as the common cold, skin rashes, constipation, dysentery, nervous prostration, whooping cough, osteomyelitis, tetanus, and various forms of cancer is apparently still popular. The arthropods used therapeutically are credited with anti-inflammatory, immunological and other health-promoting effects, because they are said to contain hormones, steroids, lipids and plant-derived alkaloids, all of which capable of exerting their effects on the human body. PMID:23324196

  6. Evidence for partial melt in the crust beneath Mt. Paektu (Changbaishan), Democratic People’s Republic of Korea and China

    USGS Publications Warehouse

    Kyong-Song, Ri; Hammond, James O. S.; Chol-Nam, Ko; Hyok, Kim; Yong-Gun, Yun; Gil-Jong, Pak; Chong-Song, Ri; Oppenheimer, Clive; Liu, Kosima W.; Iacovino, Kayla D.; Kum-Ran, Ryu

    2016-01-01

    Mt. Paektu (also known as Changbaishan) is an enigmatic volcano on the border between the Democratic People’s Republic of Korea (DPRK) and China. Despite being responsible for one of the largest eruptions in history, comparatively little is known about its magmatic evolution, geochronology, or underlying structure. We present receiver function results from an unprecedented seismic deployment in the DPRK. These are the first estimates of the crustal structure on the DPRK side of the volcano and, indeed, for anywhere beneath the DPRK. The crust 60 km from the volcano has a thickness of 35 km and a bulk VP/VS of 1.76, similar to that of the Sino-Korean craton. The VP/VS ratio increases ~20 km from the volcano, rising to >1.87 directly beneath the volcano. This shows that a large region of the crust has been modified by magmatism associated with the volcanism. Such high values of VP/VS suggest that partial melt is present in the crust beneath Mt. Paektu. This region of melt represents a potential source for magmas erupted in the last few thousand years and may be associated with an episode of volcanic unrest observed between 2002 and 2005.

  7. Pfhrp2-Deleted Plasmodium falciparum Parasites in the Democratic Republic of the Congo: A National Cross-sectional Survey.

    PubMed

    Parr, Jonathan B; Verity, Robert; Doctor, Stephanie M; Janko, Mark; Carey-Ewend, Kelly; Turman, Breanna J; Keeler, Corinna; Slater, Hannah C; Whitesell, Amy N; Mwandagalirwa, Kashamuka; Ghani, Azra C; Likwela, Joris L; Tshefu, Antoinette K; Emch, Michael; Juliano, Jonathan J; Meshnick, Steven R

    2017-07-01

    Rapid diagnostic tests (RDTs) account for more than two-thirds of malaria diagnoses in Africa. Deletions of the Plasmodium falciparum hrp2 (pfhrp2) gene cause false-negative RDT results and have never been investigated on a national level. Spread of pfhrp2-deleted P. falciparum mutants, resistant to detection by HRP2-based RDTs, would represent a serious threat to malaria elimination efforts. Using a nationally representative cross-sectional study of 7,137 children under five years of age from the Democratic Republic of Congo (DRC), we tested 783 subjects with RDT-/PCR+ results using PCR assays to detect and confirm deletions of the pfhrp2 gene. Spatial and population genetic analyses were employed to examine the distribution and evolution of these parasites. We identified 149 pfhrp2-deleted parasites, representing 6.4% of all P. falciparum infections country-wide (95% confidence interval 5.1-8.0%). Bayesian spatial analyses identified statistically significant clustering of pfhrp2 deletions near Kinshasa and Kivu. Population genetic analysis revealed significant genetic differentiation between wild-type and pfhrp2-deleted parasite populations (GST = .046, p ≤ .00001). Pfhrp2-deleted P. falciparum is a common cause of RDT-/PCR+ malaria among asymptomatic children in the DRC and appears to be clustered within select communities. Surveillance for these deletions is needed, and alternatives to HRP2-specific RDTs may be necessary.

  8. Attitudes Toward Sexual Violence Survivors: Differences Across Professional Sectors in Kenya and the Democratic Republic of the Congo.

    PubMed

    Ferdowsian, Hope; Kelly, Scott; Burner, Mary; Anastario, Mike; Gohlke, Grace; Mishori, Ranit; McHale, Thomas; Naimer, Karen

    2016-03-27

    Sexual violence survivors who decide to report their assault interact with health care, law enforcement, and legal and judicial professionals. Professionals' attitudes about sexual violence and survivors play an important role in caring for survivors and in the pursuit of justice. Despite evidence showing the relationship between service provider beliefs and survivor outcomes, relatively little is known about professionals' beliefs about sexual violence or their attitudes toward sexual violence survivors. Between June 2012 and December 2014, our study examined the beliefs and attitudes of 181 professionals from the health care, legal, and law enforcement sectors in the Eastern Democratic Republic of the Congo (DRC) and the Rift Valley region of Kenya, areas with a high prevalence of sexual violence. To determine correlates of beliefs and attitudes about sexual violence and sexual violence survivors, multiple logistic regression models were adjusted for demographic and occupational characteristics. Respondents who agreed that survivors got what they deserved (7%) or that survivors should feel ashamed (9%) were the minority, while those who would be willing to care for a family member with a history of sexual violence (94%) were the majority. Profession was significantly associated with beliefs and attitudes about sexual violence and survivors. Law enforcement professionals were more likely than health professionals and lawyers to indicate that survivors should feel ashamed. Our findings suggest a need for interventions that adequately address potentially harmful beliefs and attitudes of some professionals serving sexual violence survivors.

  9. Determinants of Antenatal Care Attendance among Pregnant Women Living in Endemic Malaria Settings: Experience from the Democratic Republic of Congo

    PubMed Central

    Manianga, Célestin; Kapanga, Serge; Mona, Esther; Pululu, Philippe

    2016-01-01

    Background. Antenatal care (ANC) attendance helps pregnant women to benefit from preventive and curative services. Methods. Determinants for ANC attendance were identified through a cross-sectional survey in the Democratic Republic of Congo. Sociocultural bottlenecks were assessed via focus groups discussion of married men and women. Results. In this survey, 28 of the 500 interviewed pregnant women (5.6%) did not attend ANC services and 82.4% booked over the first trimester. The first visit is positively influenced by the reproductive age (OR: 0.52, 95% CI(0.28–0.95), p < 0.04), the educational level (OR: 0.41,95% CI(0.17–0.97), p < 0.04), the nearby health center (OR: 0.43, 95% CI(0.2–0.92), p < 0.03), and the presence of a male partner (OR: 10.48, 95% CI(2.1–52.23), p < 0.001). The barriers to early booking were (i) the cost of service; (ii) the appearance or individual income; (iii) the geographical inaccessibility or distance to health facilities; (iv) social and religious prohibitions; (v) the stigmatization from other women when conceiving in the late ages or young or while still lactating (parity); (vi) the time for waiting for services. Conclusion. The early ANC attendance is delayed among poor women with little education and living alone. PMID:27703482

  10. Filarial Antigenemia and Loa loa Night Blood Microfilaremia in an Area Without Bancroftian Filariasis in the Democratic Republic of Congo

    PubMed Central

    Bakajika, Didier K.; Nigo, Maurice M.; Lotsima, Jean Pierre; Masikini, Germain A.; Fischer, Kerstin; Lloyd, Melanie M.; Weil, Gary J.; Fischer, Peter U.

    2014-01-01

    Implementation of mass drug administration for lymphatic filariasis (LF) has been delayed in central Africa because of incomplete mapping and coendemic loiasis. We mapped two regions in eastern Democratic Republic of Congo that were suspected to have LF. Night blood samples were collected from 2,724 subjects in 30 villages. Filarial antigenemia rates by card test exceeded 1% in 28 villages (range = 0–14%). Prevalence rates for large sheathed microfilariae (Mf) ranged from 4% to 40%; Mansonella perstans rates ranged from 22% to 98%. Large Mf were exclusively Loa loa by microscopy, and only 1 of 337 samples tested by quantitative polymerase chain reaction (qPCR) was positive for Wuchereria bancrofti DNA. Filarial antigen positivity was strongly associated with high L. loa Mf counts. Periodicity studies revealed atypical patterns, with no significant diurnal periodicity in some individuals. Thus, methods routinely used for LF mapping may not be reliable in areas in central Africa that are highly endemic for loiasis. PMID:25223938

  11. Filarial antigenemia and Loa loa night blood microfilaremia in an area without bancroftian filariasis in the Democratic Republic of Congo.

    PubMed

    Bakajika, Didier K; Nigo, Maurice M; Lotsima, Jean Pierre; Masikini, Germain A; Fischer, Kerstin; Lloyd, Melanie M; Weil, Gary J; Fischer, Peter U

    2014-12-01

    Implementation of mass drug administration for lymphatic filariasis (LF) has been delayed in central Africa because of incomplete mapping and coendemic loiasis. We mapped two regions in eastern Democratic Republic of Congo that were suspected to have LF. Night blood samples were collected from 2,724 subjects in 30 villages. Filarial antigenemia rates by card test exceeded 1% in 28 villages (range = 0-14%). Prevalence rates for large sheathed microfilariae (Mf) ranged from 4% to 40%; Mansonella perstans rates ranged from 22% to 98%. Large Mf were exclusively Loa loa by microscopy, and only 1 of 337 samples tested by quantitative polymerase chain reaction (qPCR) was positive for Wuchereria bancrofti DNA. Filarial antigen positivity was strongly associated with high L. loa Mf counts. Periodicity studies revealed atypical patterns, with no significant diurnal periodicity in some individuals. Thus, methods routinely used for LF mapping may not be reliable in areas in central Africa that are highly endemic for loiasis. © The American Society of Tropical Medicine and Hygiene.

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

    PubMed

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

    2015-08-01

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

  13. Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013

    PubMed Central

    Carrel, Margaret; Janko, Mark; Mwandagalirwa, Melchior Kashamuka; Morgan, Camille; Fwamba, Franck; Muwonga, Jérémie; Tshefu, Antoinette K.; Meshnick, Steven; Emch, Michael

    2016-01-01

    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 km2 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. Seroprevalence of antibodies against dengue virus among pregnant women in the Democratic Republic of Sao Tome and Principe.

    PubMed

    Yen, Tsai-Ying; Trovoada dos Santos, Maria de Jesus; Tseng, Lien-Feng; Chang, Shu-Feng; Cheng, Chien-Fu; Carvalho, Arlindo Vicente de Assunção; Shu, Pei-Yun; Lien, Jih-Ching; Tsai, Kun-Hsien

    2016-03-01

    Dengue fever has become a worldwide public health concern, threatening an estimated 40% of the world's population. However, most resources and attention are still focused on malaria, while dengue statuses are poorly recognized in many African countries. In this serological survey, dengue virus (DENV) transmission was demonstrated by using serum samples collected from 78 pregnant women in the Democratic Republic of Sao Tome and Principe (DRSTP) during 2003 to 2004. Immunofluorescence assay was performed and 31 samples (39.74%) were found positive for DENV antibodies. Indirect enzyme-linked immunosorbent assay (ELISA) showed that 53 samples (67.95%) were positive for dengue E IgG, and 38 samples (48.72%) were positive for NS1 IgG. A prevalence of 35.90% was therefore determined for dengue IgG by considering samples that yielded positive results by all three tests. Cross-reactions with other flaviviruses were examined by indirect ELISA against Japanese encephalitis virus, West Nile virus, and yellow fever virus. Only one sample exhibited stronger absorbance against Japanese encephalitis virus and West Nile virus. Moreover, one sample was positive for dengue IgM. These results agreed with the previous researches in neighboring countries and suggested DENV exposure. The study contributes to raising public awareness of dengue and supporting future control strategies.

  15. Ancylostoma ceylanicum hookworm infection in Japanese traveler who presented chronic diarrhea after return from Lao People's Democratic Republic.

    PubMed

    Kaya, Daisuke; Yoshikawa, Masahide; Nakatani, Toshiya; Tomo-Oka, Fumimasa; Fujimoto, Yuki; Ishida, Koji; Fujinaga, Yukihisa; Aihara, Yosuke; Nagamatsu, Shinsaku; Matsuo, Eijo; Tokoro, Masaharu; Ouji, Yukiteru; Kikuchi, Eiryo

    2016-12-01

    Ancylostoma (A.) ceylanicum, one of the most common species of hookworms infecting dogs and cats, also causes patent infections in humans and is now considered to be the second most common hookworm species infecting populations in southeast Asia. A Japanese patient who returned from a visit to Thailand and Lao People's Democratic Republic (PDR) was presented with intermittent watery diarrhea with eosinophilia. Hookworm eggs were found in feces samples, and adult worms were confirmed to be present in the jejunum with capsule endoscopy and double balloon enteroscopy. A diagnosis of A. ceylanicum infection was made based on the morphology of the adult worms along with findings of a PCR-based molecular study using larvae obtained from a fecal sample culture. The infection was considered likely to have been obtained during a 1-month stay in a Laotian village, where the patient had eaten local food, worn sandals on bare feet, and lived as a local native villager, though he had stayed in modern hotels during the visit to Thailand. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Rape in Armed Conflicts in the Democratic Republic of Congo: A Systematic Review of the Scientific Literature.

    PubMed

    Kabengele Mpinga, Emmanuel; Koya, Mapendo; Hasselgard-Rowe, Jennifer; Jeannot, Emilien; Rehani, Sylvie B; Chastonay, Philippe

    2016-05-19

    We conducted a systematic review of the scientific literature between 1996 and 2013 on rape in war-ridden Eastern Democratic Republic of Congo (DRC) in order to better understand the interest of the scientific community in describing the magnitude and characteristics of the problem. The literature search was conducted in French and English using several databases (Pubmed, PsycInfo, Sapphire, BDSP, Embase, Rero, and Web of Science) with the key words "rape and DRC" combined with several Medical Subject Headings concepts. Our systematic review yielded 2,087 references, among which only 27 are original studies, that is 20 are based on population surveys and the remaining 7 are original data based on case studies and reviews. Ten studies provided prevalence rates of rape victims, 18 provided specific information on the profile of the victims, 10 reported that most of the perpetrators of rape were military personnel, 14 referred to the negligence of the government in protecting victims, and 10 reported a lack of competent health-care facilities. The awareness of rape in conflict-ridden DRC is still limited as reported in the scientific literature: Published scientific papers are scarce. Yet more research would probably help mobilize local authorities and the international community against this basic human rights violation.

  17. [Socioeconomic impact of armed conflict on the health of women and children in the Democratic Republic of the Congo].

    PubMed

    Omba Kalonda, J C

    2011-04-01

    Since 1996, the Democratic Republic of Congo (DRC) has been the theatre of armed conflict. More than 5.4 millions have died and 500,000 to 1,000,000 women have been raped. As a result of permanent insecurity including frequent massacres, burning of villages and plundering of personal property and crops, millions of Congolese people especially in eastern regions have been displaced with around 1.3 million in internal refugee camps. Rural populations have abandoned farming that was the main source of employment, food, and income. The purpose of this paper is to describe the socioeconomic impact of this armed conflict particularly on the health of women and children. Consequences include i) decreased food production, ii) worsening food insecurity and malnutrition, iii) reduced household income, and iv) inadequate health care leading to epidemic outbreaks of diseases such as cholera, measles, and meningitis. Food insecurity and poverty affect around 70% of the population. Chronic malnutrition and growth retardation affect 38% of children. The mortality rate for children under 5 has reached 205 per 1000 live births. Other than achieving lasting peace that is a prerequisite for development in the DRC, the main priority must be to provide victims with multiform assistance aimed at restarting the economy and ensuring food self-sufficiency, thereby reducing both malnutrition and child mortality. Better access to healthcare and to psychosocial, medical, and legal services is also needed for rape victims.

  18. Fistula after attended delivery and the challenge of obstetric care capacity in the eastern Democratic Republic of Congo.

    PubMed

    Benfield, Nerys; Young-Lin, Nichole; Kimona, Christophe; Kalisya, Luc M; Kisindja, Rogatien M

    2015-08-01

    To analyze the history of women with fistula in the eastern Democratic Republic of Congo (DRC) to understand the determinants of fistula development. In a retrospective observational study, data were analyzed from a survey of all women who underwent surgical fistula repair at HEAL Africa Hospital, Goma, between April 1, 2009, and March 1, 2012. Characteristics and obstetric histories were obtained by self-report. The mean age of the 202 participants at treatment was 30.7 years (range 5-69). The mean duration of fistula was 45.6 months (range 0-600). In total, 171 (91.4%) fistulas were caused by obstructed labor, and 147 (86.5%) were vesicovaginal. Most women (129/175 [73.8%]) reported having received care during early labor under the supervision of a nurse or doctor in a healthcare facility. Among 176 women for whom delivery data were available, 102 (57.9%) delivered at a hospital, 42 (23.8%) at a health center, and 32 (18.2%) at home. Only 46 (26.3%) of 175 women were transferred to a higher level of care during labor. In the eastern DRC, efforts to enable transport to a healthcare facility and to encourage attended births must be accompanied by improvements in the capacity of existing facilities and in the training of staff to enable the timely diagnosis of labor abnormalities and appropriate intervention. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Current status of human hookworm infections, ascariasis, trichuriasis, schistosomiasis mekongi and other trematodiases in Lao People's Democratic Republic.

    PubMed

    Laymanivong, Sakhone; Hangvanthong, Bouasy; Keokhamphavanh, Boualy; Phommasansak, Manisak; Phinmaland, Baunphone; Sanpool, Oranuch; Maleewong, Wanchai; Intapan, Pewpan M

    2014-04-01

    Soil-transmitted helminth (STH) infections, and schistosomiasis and other trematodiases often have a high prevalence in developing countries. Here, we present updated information on the prevalence of these parasites in the Lao People's Democratic Republic (Lao PDR) in 2012, arising from the annual national helminthiasis survey. Fecal specimens were collected from 8,610 inhabitants of 12 provinces and one municipality (Bokeo, Houaphan, Luang Namtha, Luang Prabang, Oudomxay, and Phongsaly Provinces from northern Lao PDR; Bolikhamxay and Xieng Khouang Provinces and Vientiane Municipality from the central part of the country; and Attapeu, Champasak, Saravan, and Sekong Provinces from southern Lao PDR). The overall prevalence of three major STHs, Ascaris lumbricoides, Trichuris trichiura, and hookworms (Necator americanus and Ancylostoma duodenale) were 11.6%, 8.5%, and 25.0%, respectively. Prevalence of Schistosoma mekongi infection was 0.1%, and of miscellaneous trematodiases (including opisthorchiasis) was 14.0%. Clearly, the nationwide parasite control project is still necessary to reduce morbidity caused by helminthic diseases.

  20. 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

  1. Analysis of a pilot program to implement physical therapy for women with gynecologic fistula in the Democratic Republic of Congo.

    PubMed

    Keyser, Laura; McKinney, Jessica; Salmon, Chris; Furaha, Cathy; Kinsindja, Rogatien; Benfield, Nerys

    2014-11-01

    To describe components of a physical therapy pilot program for women with gynecologic fistula, and to report prospective data from the first 2 years of program implementation. A single-cohort observational study with repeated measures was conducted at HEAL Africa Hospital, Goma, Democratic Republic of Congo. Hospital staff received training in pelvic floor physical therapy. Guidelines for exercise, functional training, and reproductive health education were integrated into the existing program. Demographics, clinical findings, and functional outcomes were recorded. Key stakeholders were interviewed to understand the perceived strengths and limitations of the program. A total of 205 women were followed up; 161 participated in physical therapy, with an average of 9.45 sessions. Of 161 women examined postoperatively, 102 (63.4%) reported no incontinence; they remained continent at discharge. Of 21 who indicated a change in level of incontinence during postoperative physical therapy, 15 (71.4%) improved. The program was feasible and well received by staff and patients. Pelvic floor physical therapy could have significant results in women with gynecologic fistula, may be an important adjunctive treatment in comprehensive fistula care, and warrants further investigation. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Developing Civil-Military Competencies Among Senior National Security Practitioners in Democratizing Latin America

    DTIC Science & Technology

    2008-01-01

    happening at the initiative of the military.26 The nature of planning and conducting peacekeeping operations, in particular, calls for close...exclusively on military topics. Civil-military relations issues come up within the context of developing plans under civilian oversight. The de... Estrategicos (ANEPE); its English name is The National Academy of Political and Strategic Studies. 22 ibid 23 ibid 24 “MINUSTAH – Facts and Figures

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-05-01

    To assess antibiotic susceptibility of community-acquired respiratory tract isolates from Ivory Coast, Kenya, Democratic Republic of Congo (DRC) and Senegal in 2011-14. Bacterial isolates were collected and MICs determined using Etest(®) for all antibiotics except erythromycin, for which testing was by disc diffusion. Susceptibility was assessed using CLSI, EUCAST and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. For macrolide interpretation, CLSI breakpoints were adjusted for incubation in CO2. Susceptibility to penicillin (using CLSI oral or EUCAST breakpoints) was low among isolates of Streptococcus pneumoniae from the DRC and Kenya (17.4% and 19%, respectively) but higher among isolates from the Ivory Coast (70%) and Senegal (85.7%). Penicillin susceptibility using CLSI iv breakpoints was higher in all countries, but still only 69.6% in the DRC. Macrolide susceptibility (based on CLSI erythromycin disc diffusion breakpoints) was also low in Kenya (∼65%) but 87%-100% elsewhere. Haemophilus influenzae were only collected in the DRC and Senegal, with β-lactamase prevalence of 39% and 4%, respectively. Furthermore, β-lactamase-negative ampicillin-resistant (BLNAR) isolates were found in DRC (four isolates, 17%), but only two isolates were found in Senegal (by EUCAST definition). Amoxicillin/clavulanic acid in vitro susceptibility was 73.9% in the DRC and 100% in Senegal based on CLSI breakpoints, but this reduced to 65.2% in the DRC when BLNAR rates were considered. Clarithromycin susceptibility was >95% in both countries. There was considerable variability in antibiotic susceptibility among the African countries participating in the surveillance programme. Thus, continued surveillance is necessary to track future changes in antibiotic resistance. Use of EUCAST versus CLSI breakpoints showed profound differences for cefaclor and ofloxacin against S. pneumoniae, with EUCAST showing lower susceptibility. © The Author 2016. Published by Oxford University

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-10-01

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

  7. Mental Health Disorders Among Women Victims of Conflict-Related Sexual Violence in the Democratic Republic of Congo.

    PubMed

    Dossa, Nissou Ines; Zunzunegui, Maria Victoria; Hatem, Marie; Fraser, William Donald

    2015-08-01

    To assess the effects of sexual violence (SV) in armed conflicts on women's mental health, on its own and in conjunction with reproductive health issues such as fistula or chronic pelvic pain (CPP). A cross-sectional population-based study of 320 women living in Goma, the Democratic Republic of Congo, aged 15 to 45 years, was conducted. Women who experienced conflict-related sexual violence (CRSV) were compared with those who experienced non-conflict-related sexual violence (NCRSV) and those who never experienced such acts. Data were gathered through individual interviews by local staff using standardized questionnaires. The outcomes investigated were post-traumatic stress disorder (PTSD) symptoms severity and psychological distress symptoms (PDS) severity. Experience of SV in either context was associated with more severe PDS (p < .0001). Only CRSV was associated with more severe PTSD symptoms (p < .0001). Women who suffered from fistula or CPP also had a higher PDS score mean (p < .0001 and p = .007) and a higher PTSD symptoms score mean (p < .0001, for both reproductive health issues). Multivariate analyses showed that compared with women who never experienced SV and never suffered from fistula or CPP, those who experienced CRSV and suffered from fistula or CPP had the most severe PDS and PTSD symptoms after adjustment for potential confounders. The differences in PDS and PTSD symptoms severity were all significant (p < .0001). Psychological and physical health care are urgently needed for women who experienced CRSV, particularly those with additional issues of fistula or CPP. Current interventions should simultaneously seek to improve both reproductive and mental health.

  8. Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo

    PubMed Central

    Labat, Francoise; Sharma, Anjali

    2016-01-01

    Objective To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). Design In-depth interviews were conducted and analysed using qualitative content analysis. Setting Governmental referral teaching hospital in Eastern DRC. Participants We purposively selected 2–4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Results Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs’ reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. Conclusions The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. PMID:27113232

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  10. Burden of Mycobacterium ulcerans Disease (Buruli Ulcer) and the Underreporting Ratio in the Territory of Songololo, Democratic Republic of Congo

    PubMed Central

    Saunderson, Paul; Ngwala Lukanu, Philippe; Masamba Minuku, Jean-Bedel; Imposo, Désiré Bofunga B.; Mbadu Diengidi, Blanchard; Kayinua, Makanzu; Tamfum Muyembe, Jean-Jacques; Tshindele Lutumba, Pascal; de Jong, Bouke C.; Portaels, Françoise; Boelaert, Marleen

    2013-01-01

    Background Cutaneous infection by Mycobacterium ulcerans, also known as Buruli ulcer (BU), represents the third most common mycobacterial disease in the world after tuberculosis and leprosy. Data on the burden of BU disease in the Democratic Republic of Congo are scanty. This study aimed to estimate the prevalence rate and the distribution of BU in the Songololo Territory, and to assess the coverage of the existing hospital-based reporting system. Methods We conducted a cross-sectional survey (July–August 2008) using the door-to-door method simultaneously in the two rural health zones (RHZ) of the Songololo Territory (RHZ of Kimpese and Nsona-Mpangu), each containing twenty health areas. Cases were defined clinically as active BU and inactive BU in accordance with WHO-case definitions. Results We detected 775 BU patients (259 active and 516 inactive) in a total population of 237,418 inhabitants. The overall prevalence of BU in Songololo Territory was 3.3/1000 inhabitants, varying from 0 to 27.5/1000 between health areas. Of the 259 patients with active BU, 18 (7%) had been reported in the hospital-based reporting system at Kimpese in the 6–8 months prior to the survey. Conclusion The survey demonstrated a huge variation of prevalence between health areas in Songololo Territory and gross underreporting of BU cases in the hospital-based reporting system. Data obtained may contribute to better targeted and improved BU control interventions, and serve as a baseline for future assessments of the control program. PMID:24340112

  11. High Prevalence and Diversity of Hepatitis Viruses in Suspected Cases of Yellow Fever in the Democratic Republic of Congo

    PubMed Central

    Le Gal, Frédéric; Ngwaka-Matsung, Nadine; Ahuka-Mundeke, Steve; Onanga, Richard; Pukuta-Simbu, Elisabeth; Gerber, Athenaïs; Abbate, Jessica L.; Mwamba, Dieudonné; Berthet, Nicolas; Leroy, Eric Maurice; Muyembe-Tamfum, Jean-Jacques

    2017-01-01

    ABSTRACT The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 105 IU/ml for HBV (range, 769 to 9.82 × 109 IU/ml) and 1.4 × 106 IU/ml for HDV (range, 3.1 × 102 to 2.9 × 108 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC. PMID:28202798

  12. Charcoal-inferred Holocene fire and vegetation history linked to drought periods in the Democratic Republic of Congo.

    PubMed

    Hubau, Wannes; Van den Bulcke, Jan; Van Acker, Joris; Beeckman, Hans

    2015-06-01

    The impact of Holocene drought events on the presumably stable Central African rainforest remains largely unexplored, in particular the significance of fire. High-quality sedimentary archives are scarce, and palynological records mostly integrate over large regional scales subject to different fire regimes. Here, we demonstrate a direct temporal link between Holocene droughts, palaeofire and vegetation change within present-day Central African rainforest, using records of identified charcoal fragments extracted from soil in the southern Mayumbe forest (Democratic Republic of Congo). We find three distinct periods of local palaeofire occurrence: 7.8-6.8 ka BP, 2.3-1.5 ka BP, 0.8 ka BP - present. These periods are linked to well-known Holocene drought anomalies: the 8.2 ka BP event, the 3rd millennium BP rainforest crisis and the Mediaeval Climate Anomaly. During and after these Holocene droughts, the Central African rainforest landscape was characterized by a fragmented pattern with fire-prone open patches. Some fires occurred during the drought anomalies although most fires seem to lag behind them, which suggests that the open patches remained fire-prone after the actual climate anomalies. Charcoal identifications indicate that mature rainforest patches did persist through the Early to Mid-Holocene climatic transition, the subsequent Holocene thermal optimum and the third millennium BP rainforest crisis, until 0.8 ka BP. However, disturbance and fragmentation were probably more prominent near the boundary of the southern Mayumbe forest. Furthermore, the dominance of pioneer and woodland savanna taxa in younger charcoal assemblages indicates that rainforest regeneration was hampered by increasingly severe drought conditions after 0.8 ka BP. These results support the notion of a dynamic forest ecosystem at multicentury time scales across the Central African rainforest.

  13. High prevalence and diversity of hepatitis viruses in suspected cases of yellow fever in the Democratic Republic of Congo.

    PubMed

    Makiala-Mandanda, Sheila; Le Gal, Frédéric; Ngwaka-Matsung, Nadine; Ahuka-Mundeke, Steve; Onanga, Richard; Bivigou-Mboumba, Berthold; Pukuta-Simbu, Elisabeth; Gerber, Athenaïs; Abbate, Jessica L; Mwamba, Dieudonné; Berthet, Nicolas; Leroy, Eric Maurice; Muyembe-Tamfum, Jean-Jacques; Becquart, Pierre

    2017-02-15

    The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), B (HBV), C (HCV), D (HDV) and E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, ELISA techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-HBc IgM), HCV and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. Seroprevalence was 16.7% for HAV, 24.6% HBV, 2.3% HCV and 10.4% for HEV and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 x 10(5) IU/mL for HBV (range: 769 to 9.82 x 10(9) IU/mL) and 1.4 x 10(6) IU/mL for HDV (range: 3.1 x 10(2) to 2.9 x 10(8) IU/mL). Genotypes A, E and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC.

  14. New Constraints on the Geochemistry of the Millennium Eruption of Mount Paektu (Changbaishan), Democratic People's Republic of Korea/China

    NASA Astrophysics Data System (ADS)

    Iacovino, K.; Kim, J. S.; Sisson, T. W.; Lowenstern, J. B.; Jang, J. N.; Song, K. H.; Ham, H. H.; Ri, K. H.; Donovan, A. R.; Oppenheimer, C.; Hammond, J. O. S.; Weber Liu, K.; Ryu, K. R.

    2015-12-01

    Mount Paektu (also known as Changbaishan) is a large caldera located on the border between China and the Democratic People's Republic of Korea. Circa 946 AD, Paektu produced one of the largest volcanic eruptions in recorded history, the so-called Millennium Eruption (ME), whose combined fall and pyroclastic flow deposits total approximately 25 km3 dense rock equivalent (95% commendite, 5% late stage trachyte). Despite its recent and potentially destructive history, the volcano is not well studied due to its relative inaccessibility. A seismic swarm beneath the volcano's summit in 2002-2005 spurred a unique collaboration between scientists from the DPRK, US, and the UK with the goals of characterizing Paektu's eruptive history and assessing its current state of activity. We present new results from this collaboration, including major and trace element (XRF, EMP and SHRIMP-RG) and volatile data (SHRIMP-RG and FTIR) on feldspar-, clinopyroxene-, and olivine-hosted melt inclusions (MI), matrix glasses, and bulk pumices from four ME comendites and one ME trachyte. MI are halogen rich (F≤4000 ppm, Cl≤5000 ppm) with moderate S (≤250 ppm) and H2O (≤4 wt%) and minimal CO2 (≤15 ppm, detection limit ~2 ppm). H2O contents in comendite MI indicate saturation pressures (at 725 °C) of ~150 MPa, corresponding to a magma chamber depth of ~6 km, similar to the depth inferred for the magmatic injection thought to have resulted in the 2002-05 earthquake swarm. ME comendite is consistent with a ca. 25% residual melt by fractional crystallization from an ME trachyte parent. Published U-series zircon ages from ME comendite indicate a magma residence time of 11ky. Thus, the late stage ME trachyte likely represents a mafic recharge event of a melt separate from but geochemically similar to the original ME comendite parent.

  15. "A responsibility for the whole society"--how the government tackles family planning in the German Democratic Republic.

    PubMed

    Mehlan, K H

    1990-06-01

    Government policy in the German Democratic Republic (GDR) can be summarized by the following: Family planning is a responsibility for the whole society. Every woman can choose when she wishes to be pregnant. She has the right to an abortion, and easy access to contraceptives. Each family has the right to determine their desired numbered of children. Women do not have a duty to reproduce. Every individual may receive information about preventing pregnancy. All physicians have the duty to counsel unmarried people and couples. Contraceptives are prescribed free of charge. In May, 1963 the Family Planning Association (FPA) of the GER was founded. In December, 1965 the Family Law was passed. It required the Ministry of Public Health to set up the medical branch of family counseling and marriage. Family planning centers were set up. The cooperate with youth groups, public health services, and women's organizations. In 1989 there were 250 centers, 1/10,000 women of fertile age. In March, 1972 abortion was legalized. Abortions are to be done by doctors in a "recognized" clinic within 12 weeks of pregnancy. A pregnancy of more than 12 weeks may only be ended if there are risks to the mother's life, or other serious medical reasons exist. The number of legal abortions decreased from 114,000 (abortion ratio 57) in 1972 to 80,000 in 1988 (abortion ratio of 37.2). There was a slight increase in live births. The % of wanted abortions unrelated to all pregnancies was 39% in 1972. It was 28% in 1986. Women with 2 or more children accounted for 75% of all abortions. Nearly 75% use contraceptives. Since 1965, pill users have risen to 70%. The IUD is used by 5-10%. Fewer than 10% of couples use condoms. Sterilization is only possible for medical indications, not contraceptive reasons. Sex education has not been taught in schools.

  16. Human Ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007.

    PubMed

    Leroy, Eric M; Epelboin, Alain; Mondonge, Vital; Pourrut, Xavier; Gonzalez, Jean-Paul; Muyembe-Tamfum, Jean-Jacques; Formenty, Pierre

    2009-12-01

    Twelve years after the Kikwit Ebola outbreak in 1995, Ebola virus reemerged in the Occidental Kasaï province of the Democratic Republic of Congo (DRC) between May and November 2007, affecting more than 260 humans and causing 186 deaths. During this latter outbreak we conducted several epidemiological investigations to identify the underlying ecological conditions and animal sources. Qualitative social and environmental data were collected through interviews with villagers and by direct observation. The local populations reported no unusual morbidity or mortality among wild or domestic animals, but they described a massive annual fruit bat migration toward the southeast, up the Lulua River. Migrating bats settled in the outbreak area for several weeks, between April and May, nestling in the numerous fruit trees in Ndongo and Koumelele islands as well as in palm trees of a largely abandoned plantation. They were massively hunted by villagers, for whom they represented a major source of protein. By tracing back the initial human-human transmission events, we were able to show that, in May, the putative first human victim bought freshly killed bats from hunters to eat. We were able to reconstruct the likely initial human-human transmission events that preceded the outbreak. This study provides the most likely sequence of events linking a human Ebola outbreak to exposure to fruit bats, a putative virus reservoir. These findings support the suspected role of bats in the natural cycle of Ebola virus and indicate that the massive seasonal fruit bat migrations should be taken into account in operational Ebola risk maps and seasonal alerts in the DRC.

  17. Quantification of land cover and land use within the rural complex of the Democratic Republic of Congo

    NASA Astrophysics Data System (ADS)

    Molinario, G.; Hansen, M. C.; Potapov, P. V.; Tyukavina, A.; Stehman, S.; Barker, B.; Humber, M.

    2017-10-01

    The rural complex is the inhabited agricultural land cover mosaic found along the network of rivers and roads in the forest of the Democratic Republic of Congo. It is a product of traditional small-holder shifting cultivation. To date, thanks to its distinction from primary forest, this area has been mapped as relatively homogenous, leaving the proportions of land cover heterogeneity within it unknown. However, the success of strategies for sustainable development, including land use planning and payment for ecosystem services, such as Reduced Emissions from Deforestation and Degradation, depends on the accurate characterization of the impacts of land use on natural resources, including within the rural complex. We photo-interpreted a simple random sample of 1000 points in the established rural complex, using 3106 high resolution satellite images obtained from the National Geospatial-Intelligence Agency, together with 406 images from Google Earth, spanning the period 2008–2016. Results indicate that nationally the established rural complex includes 5% clearings, 10% active fields, 26% fallows, 34% secondary forest, 2% wetland forest, 11% primary forest, 6% grasslands, 3% roads and settlements and 2% commercial plantations. Only a small proportion of sample points were plantations, while other commercial dynamics, such as logging and mining, were not detected in the sample. The area of current shifting cultivation accounts for 76% of the established rural complex. Added to primary forest (11%), this means that 87% of the rural complex is available for shifting cultivation. At the current clearing rate, it would take ~18 years for a complete rotation of the rural complex to occur. Additional pressure on land results in either the cultivation of non-preferred land types within the rural complex (such as wetland forest), or expansion of agriculture into nearby primary forests, with attendant impacts on emissions, habitat loss and other ecosystems services.

  18. Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo.

    PubMed

    Labat, Francoise; Sharma, Anjali

    2016-04-25

    To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). In-depth interviews were conducted and analysed using qualitative content analysis. Governmental referral teaching hospital in Eastern DRC. We purposively selected 2-4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs' reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Health care seeking and financial behaviours of the elderly during wartime in Goma, Democratic Republic of Congo

    PubMed Central

    Kwalya, Timothée M.; Kasagila, Eric K.; Watongoka, L. Hubert; Mupenda, Bavon W.

    2010-01-01

    ABSTRACT Background Health and social services utilisation is seen to be more closely related to age than to other socio-demographic characteristics. Many health problems are known to increase with age and this demographic trend may lead to an increase in the absolute number of health conditions in this population. However, questions are still emerging as to how the elderly seek care in response to their needs in the context of a war-torn region. Objectives The aim of this study was to determine the behaviour of the elderly in seeking care during a time of conflict. Method A descriptive cross-sectional study was carried out in the health district Goma, in the Democratic Republic of the Congo (DRC), using a multistage sampling of 500 senior citizens. Eight trained field-workers were deployed in the field where they administered a structured questionnaire. Results The public health sector was well known and preferred by 186 participants (37.2%), but only used by 16 (3.2%) participants. Financial support received by the elderly came from their own relatives and fellow believers in 33.5% and 20.2% of cases, respectively. Almost 71% of monetary support is the result of begging and unknown sources – there is no government involvement whatsoever. Much of the external support that the elderly receive involves support in the form of food. Disease expenses remain a main concern of the elderly themselves. Conclusion Government support for the elderly in the DRC is non-existent. There is an overuse of private sector and traditional medicine, despite the preference indicated for the public health sector. As a recommendation, a general increase in income-related activities could contribute to alleviating the health state of the elderly in a war situation. Further studies might explore in future the contribution of those results on the health of elders.

  20. Adherence to Artemisinin Combination Therapy for the treatment of uncomplicated malaria in the Democratic Republic of the Congo

    PubMed Central

    Siddiqui, M. Ruby; Willis, Andrew; Bil, Karla; Singh, Jatinder; Mukomena Sompwe, Eric; Ariti, Cono

    2015-01-01

    Between 2011 and 2013 the number of recorded malaria cases had more than doubled, and between 2009 and 2013 had increased almost 4-fold in MSF-OCA (Médecins sans Frontières – Operational Centre Amsterdam) programmes in the Democratic Republic of the Congo (DRC). The reasons for this rise are unclear. Incorrect intake of Artemisinin Combination Therapy (ACT) could result in failure to treat the infection and potential recurrence. An adherence study was carried out to assess whether patients were completing the full course of ACT. One hundred and eight malaria patients in Shamwana, Katanga province, DRC were visited in their households the day after ACT was supposed to be completed. They were asked a series of questions about ACT administration and the blister pack was observed (if available). Sixty seven (62.0%) patients were considered probably adherent. This did not take into account the patients that vomited or spat their pills or took them at the incorrect time of day, in which case adherence dropped to 46 (42.6%). The most common reason that patients gave for incomplete/incorrect intake was that they were vomiting or felt unwell (10 patients (24.4%), although the reasons were not recorded for 22 (53.7%) patients). This indicates that there may be poor understanding of the importance of completing the treatment or that the side effects of ACT were significant enough to over-ride the pharmacy instructions. Adherence to ACT was poor in this setting. Health education messages emphasising the need to complete ACT even if patients vomit doses, feel unwell or their health conditions improve should be promoted. PMID:25949803

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

    PubMed Central

    2013-01-01

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

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

    PubMed

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

    2015-01-01

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

  3. Prevalence of tuberculosis and associated risk factors in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo.

    PubMed

    Kalonji, Guillaume MuasaPatoka; De Connick, Gérard; Okenge Ngongo, Léon; Kazumba Nsaka, Dieudonné; Kabengele, Thierry; Tshimungu Kandolo, Félicien; Ilunga-Ilunga, Félicien; Adelin, Albert; Giet, Didier

    2016-01-01

    Tuberculosis still remains a major public health concern in several provinces of the Democratic Republic of Congo, especially in prison settings. The present study aimed at determining tuberculosis (TB) prevalence and associated risk factors in inmates of the Mbuji-Mayi Central Prison. This cross-sectional study was performed over a 6-month period (January to June 2015) in Mbuji-Mayi Central Prison. A total of 733 inmates were screened systematically for TB. The diagnosis was based on clinical examination and bacteriological tests. Tuberculosis was diagnosed in 130 inmates, what amounts to a 17.7 % prevalence (95 % confidence interval [CI] 15.1-20.6 %). The mean age ± SD of infected inmates was 31 ± 9.5 years old, and 94.8 % of them were male. Inmates were detained for a median period of 24 months (range: 3 months to 12 years). A cough lasting more than 2 weeks, body temperature higher than 39 °C, and weight loss were the predominating clinical signs. Factors independently associated with TB infection were overcrowding; highest population attributable fraction ([PAF] 88.2 %; adjusted odds ratio [OR] 9.8 [95 % CI 3.1-31.6]); malnutrition (body mass index of less than 18.5 kg/m(2)) (PAF 35.6 %; adjusted OR 2.1 [1.3-3.0]); and a detention period equal to or greater than 12 months (PAF 38.7 %; adjusted OR 2.1 [1.4-3.1]). Improving detention and sanitary conditions, as well as providing an adequate and early healthcare, are urgently needed to reduce TB prevalence in the prison environment.

  4. [Inaccurate information about the size of the penis in the Democratic Republic of the Congo: about 21 information sources].

    PubMed

    Mulenga, Philippe Cilundika; Kazadi, Alex Bukasa

    2016-01-01

    Penis size is a huge topic of anxiety for a lot of men. Some of them are unhappy with their penis size as shown in the study conducted by Tiggemann in 2008. There are relatively few studies on erect penis size. This may reflect cultural taboos of researchers or doctors interacting with men who are in a state of sexual arousal. On the other hand, it is important for people who announce details on penis size to give the average penis size first and then sizes suggested by the researchers. We performed a cross-sectional survey in the two major urban centres of the Democratic Republic of Congo namely Kinshasa and Lubumbashi over a period of two years from May 2014 to May 2016. A total of 21 information sources constituted our sample, 8 in Kinshasa and 13 in Lubumbashi. We found it sufficient because in our culture discussing about sexual matter is rare. The parameters studied were: the nature of the source, the accuracy of the measurement method, the presence of bibliographical reference, the announced penis size. The majority of information sources used were radio or television broadcastings (23,8%); this can be explained by the fact that there are an increasing number of radio and television stations in our country and especially in large cities. With regard to accuracy of information about penis measurement method when sharing the message about penis size, our study showed that the majority of information sources did not indicate it when they announced penis size to the public (85,7%). Several sources did not report bibliographical references (57,1%). Announced data analysis on penis size showed that the average penis size was: 14 cm (28,6%), 15 cm (23,8%) and 15-20 cm (19%). All these results are intended to offer a warning to all players responsible for diffusing information on sexual health (penis size): scientific rigor consists in seeking information from reliable sources.

  5. Association between oral health habits and dental caries among children in Pyongyang, Democratic People's Republic of Korea.

    PubMed

    Tarvonen, P-L; Suominen, A L; Yang, G S; Ri, Y S; Sipilä, K

    2016-05-26

    To evaluate the self-reported oral health habits and their association with the occurrence of dental caries among children in Pyongyang, Democratic People's Republic of Korea (DPRK), after 6 years of activities under the auspices of the Children's Oral Health Promotion Programme (COHPP). The data were collected in September 2013 in two of the most central districts of Pyongyang City, DPRK. The sample consisted of 492 children aged 10 and 13 years who had participated in the COHPP for 6 years. The children filled in a self-completed, structured questionnaire on oral health habits and were examined clinically by a dentist. The differences in mean (SD) number of decayed primary (dt) and permanent teeth (DT) and their sum (dt + DT) subdivided according to genders, age groups, districts and self-reported oral health habits were evaluated using Mann-Whitney U-test. The associations between self-reported oral health habits and the occurrence of dental caries were evaluated with chi-square test and logistic regression analyses. The school-aged children commonly reported healthy oral hygiene habits but sweet snacks were commonly used. The occurrence of dental caries associated statistically significantly with the frequency of sweet snacking (p=0.011) but not with the frequency of tooth brushing (p=0.725) or the use of water for thirst instead of sugary beverages (p=0.189). A more effective promotion of healthy dietary habits with innovative approaches and close collaboration with different social actors will be needed in future. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    PubMed Central

    2011-01-01

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

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

    PubMed

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

    2015-01-01

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

  8. Estimation of chimpanzee community size and genetic diversity in Kahuzi-Biega National Park, Democratic Republic of Congo.

    PubMed

    Basabose, Augustin K; Inoue, Eiji; Kamungu, Sebulimbwa; Murhabale, Bertin; Akomo-Okoue, Etienne-Francois; Yamagiwa, Juichi

    2015-06-26

    A small chimpanzee habitat in the montane forest of Kahuzi-Biega National Park, Democratic Republic of Congo, is connected with the lowland forest of this park through a corridor, which is affected by human encroachment. To assess the conservation status of the chimpanzee population in this small habitat, we estimated the size of the community and evaluated its genetic diversity by using 279 fecal samples collected in the montane forest of Kahuzi. Using autosomal microsatellite (or short tandem repeat, STR) loci, we identified 32 individuals, comprising 19 females and 13 males. Samples from 24 individuals were collected at least twice and a genetic mark-recapture analysis estimated that the community size was 36 (range: 32-42). Data on nest site sharing confirmed that all the samples belonged to the same community. Nest site sharing information may be useful in population studies of unhabituated chimpanzees. The genetic structure and diversity of the 32 genotyped individuals was assessed using Y-chromosomal short tandem repeat (Y-STR) loci and mitochondrial D-loops. One dominant Y-STR haplotype was found, whereas there was no dominant haplotype in the mitochondrial region, reflecting a female-biased dispersal pattern, which is typical of chimpanzees. The genetic diversity for three markers in Kahuzi chimpanzees was comparable to that in other eastern chimpanzee populations. A relatively high heterozygosity and negative inbreeding coefficient (FIS ) for STR loci suggests that the study community belongs to an outbreeding chimpanzee population. These findings suggest that individuals of the study community may have reproductive contact with other chimpanzee individuals from neighboring communities in Kahuzi-Biega National Park, at least in the recent past. Am. J. Primatol. © 2015 Wiley Periodicals, Inc.

  9. Paying health workers for performance in a fragmented, fragile state: reflections from Katanga Province, Democratic Republic of Congo.

    PubMed

    Fox, Sarah; Witter, Sophie; Wylde, Emily; Mafuta, Eric; Lievens, Tomas

    2014-01-01

    The health financing system in the Democratic Republic of Congo (DRC) presents an extreme example of low government investment, high dependency on user fees and poor harmonization across donors. Within this context, performance-based financing mechanisms are being implemented by various donors in the expectation that they will improve health worker motivation and service delivery performance. Drawing on qualitative and quantitative data at different levels of the health system, this study focuses on one such programme in Katanga Province, which combines paying for performance (P4P) with a reduction in fees to users. Despite adding considerably to facility resources (providing the majority of the resources in the case study facilities), there was no evidence of benefits in terms of any of the service inputs, processes or outputs measured. The findings suggest that the positive effects on health worker motivation cannot be taken as a given, particularly, when staff are often expected to increase their workload to achieve the performance objectives and when another source of income, the income from user fees, may be reduced due to a fall in the prices of services. Moreover, in a context where health workers were already almost entirely dependent on users for their remuneration before the donor programme was introduced, the incentive effects of a performance contract may be muted. In addition, other income sources have particular value for staff, it seems-even though salaries and government allowances were low, and frequently delayed, health workers were highly dissatisfied at not receiving them. Salaries were seen as a more assured and long-term source of funding and an important recognition of their role as agents of the state. The authors conclude that while there may be a role for P4P in fragile contexts such as the DRC, to be effective it needs to be rooted in wider financing and human resource policy reforms.

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

    PubMed Central

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

    2013-01-01

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

  11. Human seroprevalence indicating hantavirus infections in tropical rainforests of Côte d'Ivoire and Democratic Republic of Congo.

    PubMed

    Witkowski, Peter T; Leendertz, Siv A J; Auste, Brita; Akoua-Koffi, Chantal; Schubert, Grit; Klempa, Boris; Muyembe-Tamfum, Jean-Jacques; Karhemere, Stomy; Leendertz, Fabian H; Krüger, Detlev H

    2015-01-01

    Hantaviruses are members of the Bunyaviridae family carried by small mammals and causing human hemorrhagic fevers worldwide. In Western Africa, where a variety of hemorrhagic fever viruses occurs, indigenous hantaviruses have been molecularly found in animal reservoirs such as rodents, shrews, and bats since 2006. To investigate the human contact to hantaviruses carried by these hosts and to assess the public health relevance of hantaviruses for humans living in the tropical rainforest regions of Western and Central Africa, we performed a cross-sectional seroprevalence study in the region of Taï National Park in Côte d'Ivoire and the Bandundu region near the Salonga National Park in the Democratic Republic (DR) of Congo. Serum samples were initially screened with enzyme-linked immunosorbent assays using nucleoproteins of several hantaviruses as diagnostic antigens. Positive results were confirmed by Western blotting and immunofluorescence testing. Seroprevalence rates of 3.9% (27/687) and 2.4% (7/295), respectively, were found in the investigated regions in Côte d'Ivoire and the DR Congo. In Côte d'Ivoire, this value was significantly higher than the seroprevalence rates previously reported from the neighboring country Guinea as well as from South Africa. Our study indicates an exposure of humans to hantaviruses in West and Central African tropical rainforest areas. In order to pinpoint the possible existence and frequency of clinical disease caused by hantaviruses in this region of the world, systematic investigations of patients with fever and renal or respiratory symptoms are required.

  12. Micromapping of thalassemia and hemoglobinopathies in diferent regions of northeast Thailand and Vientiane, Laos People's Democratic Republic.

    PubMed

    Tritipsombut, Jaruwan; Sanchaisuriya, Kanokwan; Phollarp, Prachatip; Bouakhasith, Dalouny; Sanchaisuriya, Pattara; Fucharoen, Goonnapa; Fucharoen, Supan; Schelp, Frank P

    2012-01-01

    In order to determine the prevalence of thalassemia and hemoglobinopathies in different regions of northeast (NE) Thailand and Vientiane, Laos People's Democratic Republic (PDR), a total of 1,809 blood samples were collected consecutively from individuals attending antenatal care services at 11 community hospitals in different regions of NE Thailand and three hospitals in Vientiane, Laos PDR, from May 2009 to April 2010. All individuals were investigated for thalassemia and hemoglobinopathies using standard methods. For individuals from NE Thailand, the carrier frequencies were 41.7% for Hb E [β26(B8)Glu→Lys, GAG>AAG], 5.8% for α(0)-thalassemia (α(0)-thal), and 0.9% for β-thal. The THAI deletion type of α(0)-thal was found in one individual from an ethnic minority. From a group of pregnant Laotian women, 30.1% were Hb E carriers. The prevalence of α(0)-thal of 8.6% for the Laotian women was similar to that found in the upper northeastern part of Thailand. The frequency of β-thal was 2.3 %. The proportion of carriers of α(+)-thal and Hb Constant Spring (Hb CS, α142, Term→Gln (TAA>CAA in α2)] ) from Thailand and Laos was significantly different. The frequency of Hb Paksé [α142, Term→Tyr (TAA>TAT in α2)] was relatively low for Thailand as well as for Laos. The results indicate that thalassemia and hemoglobinopathies are a significant health burden in the region and that a prevention and control program for severe thalassemia diseases should be established in Laos.

  13. Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013-14.

    PubMed

    Kismul, Hallgeir; Acharya, Pawan; Mapatano, Mala Ali; Hatløy, Anne

    2017-08-01

    Prevalence of child stunting in the Democratic Republic of Congo (DRC) is among the highest in the world. There is a need to systematically investigate how stunting operates at different levels of determination and identify major factors contributing to the development of stunting. The aim of this study was to look for key determinants of stunting in the DRC. This study used data from the DRC Demographic Health Survey 2013-14 which included anthropometric measurement for 9030 under 5 year children. Height-for-Age Z score was calculated and classified according to the WHO guideline. The association between stunting and bio-demographic characteristics was assessed using logistic regression. Prevalence of stunting was much higher in boys than girls. There was a significant rural urban gap in the prevalence of stunting with rural areas having a larger proportion of children living with stunting than urban. Male children, older than 6 months, preceding birth interval less than 24 months, being from lower wealth quintiles had the highest odds of stunting. Several provinces had in particular high odds of stunting. Early initiation of breastfeeding, mother's age more than 20 years at the time of delivery had lower odds of stunting. The taller the mother the less likely the child was to be stunted. Similarly, mother's BMI, access to safe water, access to hygienic toilet, mother's education were found negatively correlated with child stunting in the bivariate logistic regression, but they lost statistical significance in multivariate analysis together with numbers of children in the family and place of residence. Child stunting is widespread in the DRC and increasing prevalence is worrisome. This study has identified modifiable factors determining high prevalence of stunting in the DRC. Policy implementation should in particular target provinces with high prevalence of stunting and address modifiable determinants such as reducing socioeconomic disparity. Nutrition

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

    PubMed

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

    2011-04-25

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

  15. Quantifying gas emissions from the 946 CE Millennium Eruption of Paektu volcano, Democratic People's Republic of Korea/China

    USGS Publications Warehouse

    Iacovino, Kayla; Ju-Song, Kim; Sisson, Thomas W.; Lowenstern, Jacob B.; Ku-Hun, Ri; Jong-Nam, Jang; Kun-Ho, Song; Song-Hwan, Ham; Clive Oppenheimer,; James O.S. Hammond,; Amy Donovan,; Kosima Weber-Liu,; Kum-Ran , Ryu

    2016-01-01

    Paektu volcano (Changbaishan) is a rhyolitic caldera that straddles the border between the Democratic People's Republic of Korea (DPRK) and China. Its most recent large eruption was the Millennium Eruption (ME; 23 km3 DRE) circa 946 CE, which resulted in the release of copious magmatic volatiles (H2O, CO2, sulfur, and halogens). Accurate quantification of volatile yield and composition is critical in assessing volcanogenic climate impacts but is elusive, particularly for pre-historic or unmonitored eruptions. Here we employ a geochemical technique to quantify volatile composition and yield from the ME by examining trends in incompatible trace and volatile element concentrations in crystal-hosted melt inclusions. We estimate a maximum of 45 Tg S was injected into the stratosphere during the ME. If true yields are close to this maximum, this equates to more than 1.5 times the S released during the 1815 eruption of Tambora, which contributed to the "Year Without a Summer". Our maximum gas yield estimates place the ME among the strongest emitters of climate forcing gases in recorded human history in stark contrast to ice core records that indicate minimal atmospheric sulfate loading after the eruption. We conclude that the potential lack of strong climate forcing occurred in spite of the substantial S yield and suggest that other factors predominated in minimizing climatic effects. This paradoxical case in which high S emissions do not result in substantial climate forcing may present a way forward in building more generalized models for predicting which volcanic eruptions will produce large climate impacts.

  16. Pyrochlores from the Lueshe carbonatite complex (Democratic Republic of Congo): a geochemical record of different alteration stages

    NASA Astrophysics Data System (ADS)

    Nasraoui, M.; Bilal, E.

    2000-04-01

    Magmatic pyrochlores from the Lueshe syenite-carbonatite complex from the northeastern part of Democratic Republic of Congo (ex-Zaı̈re) are characterized by Ta/Nb ratios in an increasing order from pyroxenite, calcite-carbonatite (sövite), silicate xenoliths (nodules) to syenite. Substitutions involving Nb, Ta, Ti and REE have been precisely described. Hydrothermal alteration of Lueshe pyrochlore involves the substitution of Na ++F -=VA+VY and Ca+O=VA+VY (VA=A-site vacancy and VY=Y-site vacancy). In calcite carbonatite, hydrothermal alteration of pyrochlore took place during and after the precipitation of ancylite-(Ce), strontianite, celestite, baryte and fayalite according to a fluid composition of relatively low pH, aNa +, aCa 2+ and aHF, and high aSr 2+ and aLREE 3+. The supergene alteration is characterized by complete leaching of Na, Ca and F and partial incorporation of K, Ba, Sr and Ce resulting in the formation of kali-, bario-, strontio- and ceriopyrochlore respectively. The Na-poor pyrochlore may be an intermediate variety corresponding to an alteration stage between the hydrothermal and weathered pyrochlores. The IR spectroscopic study has indicated that the weathered pyrochlore is a hydrated variety containing two bands of OH vibration modes at 3413 and 1630 cm -1. During hydrothermal and supergene alterations, the cations at B-site remain relatively constant. The variable chemical compositions of the pyrochlores from the Lueshe complex represent geochemical memories of the different alteration conditions including the variation in the oxidation-reduction environment.

  17. Major increase in human monkeypox incidence 30 years after smallpox vaccination campaigns cease in the Democratic Republic of Congo

    PubMed Central

    Rimoin, Anne W.; Mulembakani, Prime M.; Johnston, Sara C.; Lloyd Smith, James O.; Kisalu, Neville K.; Kinkela, Timothee L.; Blumberg, Seth; Thomassen, Henri A.; Pike, Brian L.; Fair, Joseph N.; Wolfe, Nathan D.; Shongo, Robert L.; Graham, Barney S.; Formenty, Pierre; Okitolonda, Emile; Hensley, Lisa E.; Meyer, Hermann; Wright, Linda L.; Muyembe, Jean-Jacques

    2010-01-01

    Studies on the burden of human monkeypox in the Democratic Republic of the Congo (DRC) were last conducted from 1981 to 1986. Since then, the population that is immunologically naïve to orthopoxviruses has increased significantly due to cessation of mass smallpox vaccination campaigns. To assess the current risk of infection, we analyzed human monkeypox incidence trends in a monkeypox-enzootic region. Active, population-based surveillance was conducted in nine health zones in central DRC. Epidemiologic data and biological samples were obtained from suspected cases. Cumulative incidence (per 10,000 population) and major determinants of infection were compared with data from active surveillance in similar regions from 1981 to 1986. Between November 2005 and November 2007, 760 laboratory-confirmed human monkeypox cases were identified in participating health zones. The average annual cumulative incidence across zones was 5.53 per 10,000 (2.18–14.42). Factors associated with increased risk of infection included: living in forested areas, male gender, age < 15, and no prior smallpox vaccination. Vaccinated persons had a 5.2-fold lower risk of monkeypox than unvaccinated persons (0.78 vs. 4.05 per 10,000). Comparison of active surveillance data in the same health zone from the 1980s (0.72 per 10,000) and 2006–07 (14.42 per 10,000) suggests a 20-fold increase in human monkeypox incidence. Thirty years after mass smallpox vaccination campaigns ceased, human monkeypox incidence has dramatically increased in rural DRC. Improved surveillance and epidemiological analysis is needed to better assess the public health burden and develop strategies for reducing the risk of wider spread of infection. PMID:20805472

  18. National-scale estimation of gross forest aboveground carbon loss: a case study of the Democratic Republic of the Congo

    NASA Astrophysics Data System (ADS)

    Tyukavina, A.; Stehman, S. V.; Potapov, P. V.; Turubanova, S. A.; Baccini, A.; Goetz, S. J.; Laporte, N. T.; Houghton, R. A.; Hansen, M. C.

    2013-12-01

    Recent advances in remote sensing enable the mapping and monitoring of carbon stocks without relying on extensive in situ measurements. The Democratic Republic of the Congo (DRC) is among the countries where national forest inventories (NFI) are either non-existent or out of date. Here we demonstrate a method for estimating national-scale gross forest aboveground carbon (AGC) loss and associated uncertainties using remotely sensed-derived forest cover loss and biomass carbon density data. Lidar data were used as a surrogate for NFI plot measurements to estimate carbon stocks and AGC loss based on forest type and activity data derived using time-series multispectral imagery. Specifically, DRC forest type and loss from the FACET (Forêts d’Afrique Centrale Evaluées par Télédétection) product, created using Landsat data, were related to carbon data derived from the Geoscience Laser Altimeter System (GLAS). Validation data for FACET forest area loss were created at a 30-m spatial resolution and compared to the 60-m spatial resolution FACET map. We produced two gross AGC loss estimates for the DRC for the last decade (2000-2010): a map-scale estimate (53.3 ± 9.8 Tg C yr-1) accounting for whole-pixel classification errors in the 60-m resolution FACET forest cover change product, and a sub-grid estimate (72.1 ± 12.7 Tg C yr-1) that took into account 60-m cells that experienced partial forest loss. Our sub-grid forest cover and AGC loss estimates, which included smaller-scale forest disturbances, exceed published assessments. Results raise the issue of scale in forest cover change mapping and validation, and subsequent impacts on remotely sensed carbon stock change estimation, particularly for smallholder dominated systems such as the DRC.

  19. Mapping and characterizing the vegetation types of the Democratic Republic of Congo using SPOT VEGETATION time series

    NASA Astrophysics Data System (ADS)

    Vancutsem, C.; Pekel, J.-F.; Evrard, C.; Malaisse, F.; Defourny, P.

    2009-02-01

    The need for quantitative and accurate information to characterize the state and evolution of vegetation types at a national scale is widely recognized. This type of information is crucial for the Democratic Republic of Congo, which contains the majority of the tropical forest cover of Central Africa and a large diversity of habitats. In spite of recent progress in earth observation capabilities, vegetation mapping and seasonality analysis in equatorial areas still represent an outstanding challenge owing to high cloud coverage and the extent and limited accessibility of the territory. On one hand, the use of coarse-resolution optical data is constrained by performance in the presence of cloud screening and by noise arising from the compositing process, which limits the spatial consistency of the composite and the temporal resolution. On the other hand, the use of high-resolution data suffers from heterogeneity of acquisition dates, images and interpretation from one scene to another. The objective of the present study was to propose and demonstrate a semi-automatic processing method for vegetation mapping and seasonality characterization based on temporal and spectral information from SPOT VEGETATION time series. A land cover map with 18 vegetation classes was produced using the proposed method that was fed by ecological knowledge gathered from botanists and reference documents. The floristic composition and physiognomy of each vegetation type are described using the Land Cover Classification System developed by the FAO. Moreover, the seasonality of each class is characterized on a monthly basis and the variation in different vegetation indicators is discussed from a phenological point of view. This mapping exercise delivers the first area estimates of seven different forest types, five different savannas characterized by specific seasonality behavior and two aquatic vegetation types. Finally, the result is compared to two recent land cover maps derived from

  20. Experiences of female survivors of sexual violence in eastern Democratic Republic of the Congo: a mixed-methods study.

    PubMed

    Kelly, J T; Betancourt, T S; Mukwege, D; Lipton, R; Vanrooyen, M J

    2011-11-02

    The conflict in eastern Democratic Republic of the Congo (DRC) is the deadliest since World War II. Over a decade of fighting amongst an array of armed groups has resulted in extensive human rights abuses, particularly the widespread use of sexual violence against women. Using a mixed-methods approach, we surveyed a non-random sample of 255 women attending a referral hospital and two local non-governmental organizations to characterize their experiences of sexual and gender-based violence (SGBV). We then conducted focus groups of 48 women survivors of SGBV to elaborate on survey findings. Quantitative and qualitative data underwent thematic and statistical analysis respectively. Of the women surveyed, 193 (75.7%) experienced rape. Twenty-nine percent of raped women were rejected by their families and 6% by their communities. Thirteen percent of women had a child from rape. Widowhood, husband abandonment, gang rape, and having a child from rape were significant risk factors for social rejection. Mixed methods findings show rape survivors were seen as "contaminated" with HIV, contributing to their isolation and over 95% could not access prophylactic care in time. Receiving support from their husbands after rape was protective against survivors' feelings of shame and social isolation. Rape results not only in physical and psychological trauma, but can destroy family and community structures. Women face significant obstacles in seeking services after rape. Interventions offering long-term solutions for hyper-vulnerable women are vital, but lacking; reintegration programs on SGBV for women, men, and communities are also needed.

  1. Presence of extended-spectrum beta-lactamase-producing Enterobacteriaceae in waste waters, Kinshasa, the Democratic Republic of the Congo.

    PubMed

    De Boeck, H; Lunguya, O; Muyembe, J-J; Glupczynski, Y; Jacobs, J

    2012-11-01

    Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a major public health concern. We previously demonstrated the presence of ESBL-producing Enterobacteriaceae in sachet-packaged water bags sold in Kinshasa, the Democratic Republic of the Congo. In complement to the previous study, we aimed to assess the presence of ESBL-producing Enterobacteriaceae in waste waters in Kinshasa.Enterobacteriaceae isolates recovered from environmental water samples were screened and phenotypically confirmed as ESBL-producers by disk diffusion according to Clinical and Laboratory Standards Institute (CLSI) guidelines (CLSI M100-S21). Final identification to the species level and further antimicrobial susceptibility testing were carried out with MicroScan® NBC42 panels and the identification of bla (ESBL) coding genes was performed by a commercial multiplex ligation polymerase chain reaction (PCR) microarray (Check-Points CT 101, Wageningen, the Netherlands). Overall, 194 non-duplicate Enterobacteriaceae were recovered from several sewer and river sites in nine out of 24 municipalities of Kinshasa. Fourteen isolates (7.4 %) were confirmed as ESBL-producers, the main species being Enterobacter cloacae (46.6 %) and Klebsiella pneumoniae (40.0 %). Associated resistance to both aminoglycoside and fluoroquinolone antibiotics was observed in ten isolates; the remaining isolates showed co-resistance to either fluoroquinolone (n = 3) or to aminoglycoside (n = 1) alone. All but one isolate carried bla (CTX-M) genes belonging to the CTX-M-1 group. ESBL-producing Enterobacteriaceae are increasingly being reported from various sources in the community. The present results suggest that ESBL-producing Enterobacteriaceae are widespread in the environment in the community of Kinshasa. Cities in Central Africa should be added to the map of potentially ESBL-contaminated environments and highlight the need to reinforce safe water supply and public sanitation.

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

    PubMed

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

    2013-01-01

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

  3. Frequency, causes and human impact of motor vehicle-related road traffic accident (RTA) in Lubumbashi, Democratic Republic of Congo.

    PubMed

    Nangana, Luzitu Severin; Monga, Ben; Ngatu, Nlandu Roger; Mbelambela, Etongola Papy; Mbutshu, Lukuke Hendrick; Malonga, Kaj Francoise

    2016-09-01

    Road traffic accident (RTA)-related trauma remains a public health issue. The aim of this study was to determine the frequency, causes and human impact of motor vehicle-related RTA in Lubumbashi, Democratic Republic of Congo. A prospective cross-sectional study was conducted in the first semester of the year 2015 in which 288 drivers (144 RTA-causing drivers and 144 control drivers who have been declared not guilty by road safety agents) involved in 144 motor vehicle-related RTA were interviewed, and only data on all RTA involving two motor vehicles with at least four wheels were recorded and analyzed. Results showed a total of 144 RTA that involved two motor vehicles with four wheels occurring during the study period which affected 104 people, including 93 injury and 11 fatality cases. The mean age of RTA-causing drivers was 33.8 ± 7.4, whereas it was 35 ± 8.8 for control drivers. The majority of RTA-causing drivers (53.4 %) did not attend a driving school. Over speeding (32 %), distracted driving (22 %), overtaking (16 %) and careless driving/risky maneuver (15 %) and driving under the influence of alcohol (9 %) were the main causes of RTA occurrence. In addition, the absence of a valid driving license [aOR = 12.74 (±2.71); 95 % CI 3.877-41.916; p = 0.015], unfastened seat belt for the RTA-causing driver [aOR = 1.85 (±0.62); 95 % CI 1.306-6.661; p = 0.048] and presence of damages on RTA-causing vehicle [aOR = 33.56 (24.01); 95 % CI 1.429-78.352; p = 0.029] were associated with the occurrence of RTA-related fatality. This study showed a relatively high frequency of RTA occurring in Lubumbashi and suggests the necessity to reinforce road traffic regulation.

  4. Reduced perinatal mortality following enhanced training of birth attendants in the Democratic Republic of Congo: a time-dependent effect.

    PubMed

    Matendo, Richard; Engmann, Cyril; Ditekemena, John; Gado, Justin; Tshefu, Antoinette; Kinoshita, Rinko; McClure, Elizabeth M; Moore, Janet; Wallace, Dennis; Carlo, Waldemar A; Wright, Linda L; Bose, Carl

    2011-08-04

    In many developing countries, the majority of births are attended by traditional birth attendants, who lack formal training in neonatal resuscitation and other essential care required by the newly born infant. In these countries, the major causes of neonatal mortality are birth asphyxia, infection, and low-birth-weight/prematurity. Death from these causes is potentially modifiable using low-cost interventions, including neonatal resuscitation training. The purpose of this study was to evaluate the effect on perinatal mortality of training birth attendants in a rural area of the Democratic Republic of Congo (DRC) using two established programs. This study, a secondary analysis of DRC-specific data collected during a multi-country study, was conducted in two phases. The effect of training using the WHO Essential Newborn Care (ENC) program was evaluated using an active baseline design, followed by a cluster randomized trial of training using an adaptation of a neonatal resuscitation program (NRP). The perinatal mortality rates before ENC, after ENC training, and after randomization to additional NRP training or continued care were compared. In addition, the influence of time following resuscitation training was investigated by examining change in perinatal mortality during sequential three-month increments following ENC training. More than two-thirds of deliveries were attended by traditional birth attendants and occurred in homes; these proportions decreased after ENC training. There was no apparent decline in perinatal mortality when the outcome of all deliveries prior to ENC training was compared to those after ENC but before NRP training. However, there was a gradual but significant decline in perinatal mortality during the year following ENC training (RR 0.73; 95% CI: 0.56-0.96), which was independently associated with time following training. The decline was attributable to a decline in early neonatal mortality. NRP training had no demonstrable effect on early

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

    PubMed

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

    1998-04-01

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

  6. Sensitive Next-Generation Sequencing Method Reveals Deep Genetic Diversity of HIV-1 in the Democratic Republic of the Congo

    PubMed Central

    Wilkinson, Eduan; Vallari, Ana; McArthur, Carole; Sthreshley, Larry; Brennan, Catherine A.; Cloherty, Gavin; de Oliveira, Tulio

    2017-01-01

    ABSTRACT As the epidemiological epicenter of the human immunodeficiency virus (HIV) pandemic, the Democratic Republic of the Congo (DRC) is a reservoir of circulating HIV strains exhibiting high levels of diversity and recombination. In this study, we characterized HIV specimens collected in two rural areas of the DRC between 2001 and 2003 to identify rare strains of HIV. The env gp41 region was sequenced and characterized for 172 HIV-positive specimens. The env sequences were predominantly subtype A (43.02%), but 7 other subtypes (33.14%), 20 circulating recombinant forms (CRFs; 11.63%), and 20 unclassified (11.63%) sequences were also found. Of the rare and unclassified subtypes, 18 specimens were selected for next-generation sequencing (NGS) by a modified HIV-switching mechanism at the 5′ end of the RNA template (SMART) method to obtain full-genome sequences. NGS produced 14 new complete genomes, which included pure subtype C (n = 2), D (n = 1), F1 (n = 1), H (n = 3), and J (n = 1) genomes. The two subtype C genomes and one of the subtype H genomes branched basal to their respective subtype branches but had no evidence of recombination. The remaining 6 genomes were complex recombinants of 2 or more subtypes, including subtypes A1, F, G, H, J, and K and unclassified fragments, including one subtype CRF25 isolate, which branched basal to all CRF25 references. Notably, all recombinant subtype H fragments branched basal to the H clade. Spatial-geographical analysis indicated that the diverse sequences identified here did not expand globally. The full-genome and subgenomic sequences identified in our study population significantly increase the documented diversity of the strains involved in the continually evolving HIV-1 pandemic. IMPORTANCE Very little is known about the ancestral HIV-1 strains that founded the global pandemic, and very few complete genome sequences are available from patients in the Congo Basin, where HIV-1 expanded early in the global pandemic

  7. A cross-sectional study of the income sources of primary care health workers in the Democratic Republic of Congo.

    PubMed

    Maini, Rishma; Hotchkiss, David R; Borghi, Josephine

    2017-02-20

    In the Democratic Republic of Congo (DRC), the state system to remunerate health workers is poorly functional, encouraging diversification of income sources and corruption. Given the central role that health workers play in health systems, policy-makers need to ensure health workers are remunerated in a way which best incentivises them to provide effective and good quality services. This study describes the different sources and quantities of income paid to primary care health workers in Equateur, Maniema, Kasai Occidental, Province Orientale and Kasai Oriental provinces. It also explores characteristics associated with the receipt of different sources of income. Quantitative data on the income received by health workers were collected through baseline surveys. Descriptive statistics explored the demographic characteristics of health workers surveyed, and types and amounts of incomes received. A series of regression models were estimated to examine the health worker and facility-level determinants of receiving each income source and of levels received. Qualitative data collection was carried out in Kasai Occidental province to explore perceptions of each income source and reasons for receiving each. Nurses made up the majority of workers in primary care. Only 31% received a government salary, while 75% reported compensation from user fees. Almost half of all nurses engaged in supplemental non-clinical activities. Receipt of government payments was associated with income from private practice and non-clinical activities. Male nurses were more likely to receive per diems, performance payments, and higher total remuneration compared to females. Contextual factors such as provincial location, presence of externally financed health programmes and local user fee policy also influenced the extent to which nurses received many income sources. The receipt of government payments was unreliable and had implications for receipt of other income sources. A mixture of individual

  8. Sensitive Next-Generation Sequencing Method Reveals Deep Genetic Diversity of HIV-1 in the Democratic Republic of the Congo.

    PubMed

    Rodgers, Mary A; Wilkinson, Eduan; Vallari, Ana; McArthur, Carole; Sthreshley, Larry; Brennan, Catherine A; Cloherty, Gavin; de Oliveira, Tulio

    2017-03-15

    As the epidemiological epicenter of the human immunodeficiency virus (HIV) pandemic, the Democratic Republic of the Congo (DRC) is a reservoir of circulating HIV strains exhibiting high levels of diversity and recombination. In this study, we characterized HIV specimens collected in two rural areas of the DRC between 2001 and 2003 to identify rare strains of HIV. The env gp41 region was sequenced and characterized for 172 HIV-positive specimens. The env sequences were predominantly subtype A (43.02%), but 7 other subtypes (33.14%), 20 circulating recombinant forms (CRFs; 11.63%), and 20 unclassified (11.63%) sequences were also found. Of the rare and unclassified subtypes, 18 specimens were selected for next-generation sequencing (NGS) by a modified HIV-switching mechanism at the 5' end of the RNA template (SMART) method to obtain full-genome sequences. NGS produced 14 new complete genomes, which included pure subtype C (n = 2), D (n = 1), F1 (n = 1), H (n = 3), and J (n = 1) genomes. The two subtype C genomes and one of the subtype H genomes branched basal to their respective subtype branches but had no evidence of recombination. The remaining 6 genomes were complex recombinants of 2 or more subtypes, including subtypes A1, F, G, H, J, and K and unclassified fragments, including one subtype CRF25 isolate, which branched basal to all CRF25 references. Notably, all recombinant subtype H fragments branched basal to the H clade. Spatial-geographical analysis indicated that the diverse sequences identified here did not expand globally. The full-genome and subgenomic sequences identified in our study population significantly increase the documented diversity of the strains involved in the continually evolving HIV-1 pandemic.IMPORTANCE Very little is known about the ancestral HIV-1 strains that founded the global pandemic, and very few complete genome sequences are available from patients in the Congo Basin, where HIV-1 expanded early in the global pandemic. By

  9. Feasibility and implementation of community-based malaria case management with integrated vector control in the Democratic Republic of Congo.

    PubMed

    Swana, Edouard Kawawa; Makan, Ghislain Yav; Mukeng, Clarence Kaut; Mupumba, Henriette Ilunga; Kalaba, Gabriel Mutabusha; Luboya, Oscar Numbi; Bangs, Michael J

    2016-08-15

    Malaria prevalence in the Mulumbu Health Area in Lualaba Province, Democratic Republic of the Congo has remained high (>70 %) despite repeated vector control (indoor residual spray) and mass insecticide-treated bed net coverage. Therefore, a pilot study was implemented to attack the parasite directly and demonstrate the feasibility and acceptability of community case management of malaria (CCMm) using trained community health workers (CHWs). A 13 month prospective evaluation of CCMm was undertaken in 14 rural villages. Focus group discussions and structured interviews were conducted in pre- and post-intervention periods to assess community acceptability of CCMm. Weekly data collected by CHWs assessed program impact over time, matched with malaria school-based prevalence surveys (MSPS) in the Mulumbu Health Area (CCMm study arm) compared to a comparison (non-CCMm) arm in the Mpala Health Area approximately 25 km apart. Overall population perception of the CCMm was highly positive. 6619 community contacts were managed by CHWs from which 1433 (21.6 %) were malaria positive by rapid detection tests during the 10 month intervention. Among the malaria infected, 94.7 % (1358) were recorded as 'uncomplicated' infections with 99.7 % provided full course of treatment. CHWs referred 278 (4.2 %) patients deemed 'complicated' to a designated primary health center for advanced care. While pre-intervention MSPS data revealed significantly higher (p = 0.0135) malaria in the CCMm area compared to the non-CCMm area, at post-intervention there was no statistical difference (p = 0.562) between the two areas. Notably, for the first time, no malaria-related deaths were recorded in the 14 CCMm intervention villages during observation. Community case management of malaria was shown to be an effective and promising strategy for prompt and effective management of malaria. It was well accepted by the community and showed evidence of a reduction in malaria morbidity and mortality

  10. Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes.

    PubMed

    Kratz, Thomas; Roddy, Paul; Tshomba Oloma, Antoine; Jeffs, Benjamin; Pou Ciruelo, Diana; de la Rosa, Olimpia; Borchert, Matthias

    2015-01-01

    Data collected during the 2012 Ebola virus disease (EVD) epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV), establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre) were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3%) and of community EVD cases in the age group of 15-54 years (82.4%). All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay) or self-reported fever (88.2% upon admission) at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%), anorexia (82.4%), myalgia (70.6%), sore throat/difficulty swallowing (70.6%), arthralgia (76.5%) and nausea (70.6%). Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting) (76.4%) as well as general pain (94.1%) were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%), intestinal parasitosis (10.9%), and infectious syndrome (10.9%). There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease) and emphasizes the need for improving

  11. Ebola Virus Disease Outbreak in Isiro, Democratic Republic of the Congo, 2012: Signs and Symptoms, Management and Outcomes

    PubMed Central

    Kratz, Thomas; Roddy, Paul; Tshomba Oloma, Antoine; Jeffs, Benjamin; Pou Ciruelo, Diana; de la Rosa, Olimpia; Borchert, Matthias

    2015-01-01

    Data collected during the 2012 Ebola virus disease (EVD) epidemic in the Democratic Republic of the Congo were analysed for clinical signs, symptoms and case fatality of EVD caused by Bundibugyo virus (BDBV), establishment of differential diagnoses, description of medical treatment and evaluation of the quality of clinical documentation. In a quantitative observational prospective study, global epidemiological data from 52 patients (34 patients within the community, 18 patients treated in the Ebola Treatment Centre) were entered anonymously into a database, subsequently matched and analysed. Relevant findings include an over-representation of females among community EVD cases (85.3%) and of community EVD cases in the age group of 15-54 years (82.4%). All ETC patients had fever (55.6% of all 18 ETC patients during their hospital stay) or self-reported fever (88.2% upon admission) at some point of time during their illness. Major symptoms of ETC patients during hospital stay included asthenia (82.4%), anorexia (82.4%), myalgia (70.6%), sore throat/difficulty swallowing (70.6%), arthralgia (76.5%) and nausea (70.6%). Gastrointestinal signs and symptoms (nausea, diarrhoea, vomiting) (76.4%) as well as general pain (94.1%) were frequent in ETC patients. The median duration of EVD was 18 days, while the mean incubation period was 11.3 days. Differential diagnosis of EVD included malaria (28.3%), intestinal parasitosis (10.9%), and infectious syndrome (10.9%). There was also an important variation in clinical evolvement. Quality of documentation was adversely affected by the way patient file contents were transferred from inside to outside the high-risk zone, entailing a mean mismatch value of 27.3% between patient file contents inside vs. outside the high-risk zone. This study adds further description of EVD (frequently non-specific signs and symptoms, non frequent bleeding, a long incubation period, long duration of disease) and emphasizes the need for improving

  12. Deformation associated with the January 17, 2002, eruption of Nyiragongo volcano, Democratic Republic of the Congo, from radar interferometry

    NASA Astrophysics Data System (ADS)

    Poland, M.; Lu, Z.

    2004-05-01

    Nyiragongo volcano, in the western branch of the East African Rift in the Democratic Republic of Congo, erupted on January 17, 2002, after several years of repose. The activity lasted for approximately one day and sent lava flows into the city of Goma (18 km south of the summit), destroying approximately 13% (4.5 km2) of the city and causing several deaths. Unfortunately, there are few surface deformation measurements that span the eruption. Lake level measurements suggest subsidence in the Goma area, but this cannot be confirmed by other terrestrial geodetic methods. Intermittent volcanism at the summit of Nyiragongo continued throughout 2002 and 2003, including an active lava lake and gas plume. We produced radar interferograms of the Nyiragongo region using data from RADARSAT-1, ERS-1, and ERS-2. Between mid-1998 and January 14, 2002, there is no indication of significant deformation except for subsidence of a lava flow that was emplaced on the north flank of Nyamulagira (a neighboring volcano 14 km northwest of Nyiragongo) in 1989-1991 and possible inflation of that volcano (which erupted multiple times between 1998 and 2001). Interferograms covering January 14 to February 13, 2002, show a broad pattern of fringes across the entire rift valley with closely spaced fringes in the vicinity of Goma. After February 13 there are no indications of major surface displacements until July-August 2002, when fringes suggesting uplift appeared at the summit of Nyamulagira (possibly related to an eruption there in July 2002). Several large (M > 5) earthquakes that occurred ~50 km south of Nyiragongo in October 2002 and the resumption of lava lake activity following the January 2002 eruption do not appear to have caused notable deformation. Preliminary modeling of radar interferograms spanning the eruption suggests a broad rifting event dominated by horizontal extension. The displacements must have occurred in a relatively brief period of time with little precursory or post

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

    PubMed

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

    2009-08-01

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

  14. Newborn care in Indonesia, Lao People’s Democratic Republic and the Philippines: a comprehensive needs assessment

    PubMed Central

    2014-01-01

    Background Between 1990 and 2011, global neonatal mortality decline was slower than that of under-five mortality. As a result, the proportion of under-five deaths due to neonatal mortality increased. This increase is primarily a consequence of decreasing post-neonatal and child under-five mortality as a result of the typical focus of child survival programmes of the past two decades on diseases affecting children over four weeks of age. Newborns are lagging behind in improved child health outcomes. The aim of this study was to conduct a comprehensive, equity-focussed newborn care assessment and to explore options to improve newborn survival in Indonesia, Lao People’s Democratic Republic (PDR) and the Philippines. Methods We assessed newborn health policies, services and care in the three countries through document review, interviews and health facility visits. Findings were triangulated to describe newborns’ health status, the health policy and the health system context for newborn care and the equity situation regarding newborn survival. Results Main findings: (1) In the three countries, decline of neonatal mortality is lagging behind compared to that of under-five mortality. (2) Comprehensive newborn policies in line with international standards exist, although implementation remains poor. An important factor hampering implementation is decentralisation of the health sector, which created confusion regarding roles and responsibilities. Management capacity and skills at decentralised level were often found to be limited. (3) Quality of newborn care provided at primary healthcare and referral level is generally substandard. Limited knowledge and skills among providers of newborn care are contributing to poor quality of care. (4) Socio-economic and geographic inequities in newborn care are considerable. Conclusions Similar important challenges for newborn care have been identified in Indonesia, Lao PDR and the Philippines. There is an urgent need to address weak

  15. Patterns of sexual violence in Eastern Democratic Republic of Congo: reports from survivors presenting to Panzi Hospital in 2006

    PubMed Central

    2010-01-01

    Background Despite the signing of international peace agreements, a deadly war continues in the Democratic Republic of Congo (DRC) and sexual violence is a prominent modus operandi of many military groups operating in the region. Methods Retrospective cohort study of women who presented to Panzi Hospital in 2006 requesting post-sexual violence care. Data was extracted and analyzed to describe the patterns of sexual violence. Results A total of 1,021 medical records were reviewed. A majority of attacks occurred in individual homes (56.5%), with the fields (18.4%) and the forest (14.3%) also being frequent locations of attack. In total, 58.9% of all attacks occurred at night. Of the four primary types of sexual violence, gang rape predominated (59.3%) and rape Not Otherwise Specified (NOS) was also common (21.5%). Sexual slavery was described by 4.9% of the survivors and a combination of gang rape and sexual slavery was described by 11.7%. The mean number of assailants per attack was 2.5 with a range of one to > 15. There were several demographic predictors for sexual slavery. Controlling for age, education level and occupation, a marital status of "single" increased the risk of sexual slavery (OR = 2.97, 95% CI = 1.12-7.85). Similarly, after controlling for other variables, age was a significant predictor of sexual slavery with older women being at a slightly reduced risk (OR = 0.96, 95% CI = 0.92-0.99). Women who experienced sexual slavery were 37 times more likely to have a resultant pregnancy in comparison to those who reported other types of sexual violence (OR = 37.50, 95% CI = 14.57-99.33). Conclusions Among sexual violence survivors presenting to Panzi Hospital in 2006, the majority of attacks occurred in women's own homes, often at night. This represents a pattern of violence that differs from other conflict settings and has important implications regarding protection strategies. Sexual violence in South Kivu was also marked with a predominance of gang rape

  16. Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement

    PubMed Central

    Mpunga, Dieudonné; Lumbayi, JP; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert

    2017-01-01

    Objective: To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Methods: Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as “high” if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or “low” if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. Results: We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services (P<.001). Public facilities were less likely than private facilities to have high-quality services (P=.02). Among all 1,555 facilities surveyed, 14% had at least 3 types of methods available at the time of the survey; the most widely

  17. Knowledge, attitude and practice about cancer of the uterine cervix among women living in Kinshasa, the Democratic Republic of Congo

    PubMed Central

    2014-01-01

    Background Cervical cancer is the most frequent cancer of women in the Democratic Republic of Congo (DRC). Nevertheless, the level of women’s awareness about cervical cancer is unknown. Knowledge, attitude and practice (KAP) are important elements for designing and monitoring screening programs. The study purpose was to estimate KAP on cervical cancer and to identify associated factors. Methods A cross-sectional study was conducted in Kinshasa, DRC, including 524 women aged 16–78 years (median age 28; interquartile range 22–35). The women were interviewed at home by trained field workers using a standardized questionnaire. The women’s score on knowledge, attitude and practice were dichotomized as sufficient or insufficient. We used binary and multiple logistic regression to assess associations between obtaining sufficient scores and a series of socio-demographic factors: age, residence, marital status, education, occupation, religion, and parity. Results The women’s score on knowledge was not significantly correlated with their score on practice (Spearman’s rho = 0.08; P > 0.05). Obtaining a sufficient score on knowledge was positively associated with higher education (adjusted odds ratio (OR) 7.65; 95% confidence interval (95% CI) 3.31-17.66) and formal employment (adjusted OR 3.35; 95% CI 1.85-6.09); it was negatively associated with being single (adjusted OR 0.44; 95% CI 0.24-0.81) and living in the eastern, western and northern zone of Kinshasa compared to the city centre. The attitude score was associated with place of residence (adjusted OR for east Kinshasa: 0.49; 95% CI 0.27-0.86 and for south Kinshasa: 0.48; 95% CI 0.27-0.85) and with religion (adjusted OR 0.55; 95% CI 0.35-0.86 for women with a religion other than Catholicism or Protestantism compared to Catholics). Regarding practice, there were negative associations between a sufficient score on practice and being single (adjusted OR 0.24; 95% CI 0.13-0.41) and living in the eastern

  18. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for

  19. Novel simian foamy virus infections from multiple monkey species in women from the Democratic Republic of Congo

    PubMed Central

    2012-01-01

    Background Zoonotic transmission of simian retroviruses in Central Africa is ongoing and can result in pandemic human infection. While simian foamy virus (SFV) infection was reported in primate hunters in Cameroon and Gabon, little is known about the distribution of SFV in Africa and whether human-to-human transmission and disease occur. We screened 3,334 plasmas from persons living in rural villages in central Democratic Republic of Congo (DRC) using SFV-specific EIA and Western blot (WB) tests. PCR amplification of SFV polymerase sequences from DNA extracted from buffy coats was used to measure proviral loads. Phylogenetic analysis was used to define the NHP species origin of SFV. Participants completed questionnaires to capture NHP exposure information. Results Sixteen (0.5%) samples were WB-positive; 12 of 16 were from women (75%, 95% confidence limits 47.6%, 92.7%). Sequence analysis detected SFV in three women originating from Angolan colobus or red-tailed monkeys; both monkeys are hunted frequently in DRC. NHP exposure varied and infected women lived in distant villages suggesting a wide and potentially diverse distribution of SFV infections across DRC. Plasmas from 22 contacts of 8 WB-positive participants were all WB negative suggesting no secondary viral transmission. Proviral loads in the three women ranged from 14 – 1,755 copies/105 cells. Conclusions Our study documents SFV infection in rural DRC for the first time and identifies infections with novel SFV variants from Colobus and red-tailed monkeys. Unlike previous studies, women were not at lower risk for SFV infection in our population, providing opportunities for spread of SFV both horizontally and vertically. However, limited testing of close contacts of WB-positive persons did not identify human-to-human transmission. Combined with the broad behavioral risk and distribution of NHPs across DRC, our results suggest that SFV infection may have a wider geographic distribution within DRC. These

  20. Availability and Quality of Family Planning Services in the Democratic Republic of the Congo: High Potential for Improvement.

    PubMed

    Mpunga, Dieudonné; Lumbayi, J P; Dikamba, Nelly; Mwembo, Albert; Ali Mapatano, Mala; Wembodinga, Gilbert

    2017-06-27

    To determine the availability and quality of family planning services within health facilities throughout the Democratic Republic of the Congo (DRC). Data were collected for the cross-sectional study from April 2014 to June 2014 by the Ministry of Public Health. A total of 1,568 health facilities that reported data to the National Health Information System were selected by multistage random sampling in the 11 provinces of the DRC existing at that time. Data were collected through interviews, document review, and direct observation. Two dependent variables were measured: availability of family planning services (consisting of a room for services, staff assigned to family planning, and evidence of client use of family planning) and quality of family planning services (assessed as "high" if the facility had at least 1 trained staff member, family planning service delivery guidelines, at least 3 types of methods, and a sphygmomanometer, or "low" if the facility did not meet any of these 4 criteria). Pearson's chi-square test and odds ratios (ORs) were used to test for significant associations, using the alpha significance level of .05. We successfully surveyed 1,555 facilities (99.2%) of those included in the sample. One in every 3 facilities (33%) offered family planning services as assessed by the index of availability, of which 20% met all 4 criteria for providing high-quality services. Availability was greatest at the highest level of the health system (hospitals) and decreased incrementally with each health system level, with disparities between provinces and urban and rural areas. Facilities in urban areas were more likely than in rural areas to meet the standard for high-quality services (P<.001). Public facilities were less likely than private facilities to have high-quality services (P=.02). Among all 1,555 facilities surveyed, 14% had at least 3 types of methods available at the time of the survey; the most widely available methods were male condoms, combined

  1. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo.

    PubMed

    Casey, Sara E; Mitchell, Kathleen T; Amisi, Immaculée Mulamba; Haliza, Martin Migombano; Aveledi, Blandine; Kalenga, Prince; Austin, Judy

    2009-12-21

    Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection

  2. Asymptomatic malaria, growth status, and anaemia among children in Lao People's Democratic Republic: a cross-sectional study.

    PubMed

    Akiyama, Takeshi; Pongvongsa, Tiengkham; Phrommala, Souraxay; Taniguchi, Tomoyo; Inamine, Yuba; Takeuchi, Rie; Watanabe, Tadashi; Nishimoto, Futoshi; Moji, Kazuhiko; Kano, Shigeyuki; Watanabe, Hisami; Kobayashi, Jun

    2016-10-18

    Asymptomatic malaria can be observed in both stable endemic areas and unstable transmission areas. However, although much attention has been given to acute malaria infections, relatively little attention has been paid to asymptomatic malaria. Nonetheless, because the asymptomatic host serves as a reservoir for the malaria parasite, asymptomatic malaria is now recognized as an important obstacle to malaria elimination. Asymptomatic malaria is also associated with anaemia, a global public health problem with serious consequences on human health as well as social and economic development. In Lao People's Democratic Republic (Lao PDR), malaria, anaemia, and malnutrition are serious public health concerns. However, few studies have focused on the relationship between these variables. Therefore, this study investigated the relationship between asymptomatic malaria, growth status, and the prevalence of anaemia among children aged 120 months old or younger in rural villages in Lao PDR. In December 2010 and March 2011, data were collected from five villages in Savannakhet province. Anthropometric measurements, blood samples, and malaria rapid diagnostic tests were conducted. The presence of malaria was confirmed with polymerase chain reaction assays for Plasmodium falciparum. Underweight status, stunting, and anaemia were defined according to World Health Organization standards. The mean age of participants (n = 319) was 88.3 months old (Standard Deviation: 20.6, ranged from 30-119 months old), and 20 participants (6.3 %) had an asymptomatic malaria infection, 92 (28.8 %) were anaemic, 123 (38.6 %) were underweight, and 137 (42.9 %) were stunted. Stunted children were more likely to be infected with asymptomatic malaria [odds ratio (OR) 3.34, 95 % confidence interval (CI) 1.25-8.93], and asymptomatic malaria was associated with anaemia [OR 5.17, 95 % CI 1.99-13.43]. These results suggest a significant association between asymptomatic malaria and anaemia in

  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. 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.

  5. The evolution of the national licensing system of health care professionals: a qualitative descriptive case study in Lao People's Democratic Republic.

    PubMed

    Sonoda, Miwa; Syhavong, Bounkong; Vongsamphanh, Chanphomma; Phoutsavath, Phisith; Inthapanith, Phengdy; Rotem, Arie; Fujita, Noriko

    2017-08-07

    The introduction of a systematic framework for the licensing of health care professions, which is a crucial step in ensuring the quality of human resources for health (HRH), is still evolving in Lao People's Democraic Republic. The aim of this study was to review and document the evolution of Lao HRH policies and the development of its national licensing system. A qualitative descriptive case study methodology was applied to document and describe how Lao People's Democratic Republic laid the foundation for the development of a licensing system. The results demonstrate that Lao People's Democratic Republic is currently in the process of transitioning the focus of its HRH policies from the quantity and deployment of services to remote areas to improvements in the quality of services. The key events in the process of developing the licensing system are as follows: (1) the systematic development of relevant policies and legislation, (2) the establishment of responsible organizations and the assignment of responsible leaders, (3) the acceleration of development efforts in response to the Association of Southeast Asian Nations Mutual Recognition Arrangement for standard qualifications, (4) the strengthening of educational systems for fostering competent health care professionals, (5) the introduction of a 3-year compulsory service component in rural areas for newly recruited government servants, and (6) the introduction of a requirement to obtain a professional health care certificate to work in a private hospital. The Lao Ministry of Health (MOH) has endorsed a specific strategy for licensing to realize this system. The need for licensing systems has increased in recent years due to regional economic integration and a shift in policy toward achieving universal health coverage. A national licensing system would be a significant milestone in health system development, helping to ensure the competency of health care professionals by means of a national examination

  6. Package of essential noncommunicable disease (PEN) interventions in primary health-care settings in the Democratic People's Republic of Korea: A feasibility study.

    PubMed

    Hyon, Choe Suk; Nam, Kim Yong; Sun, Han Chae; Garg, Renu; Shrestha, Suraj Man; Ok, Kim Un; Kumar, Rajesh

    2017-09-01

    The prevention and control of noncommunicable diseases (NCDs) is a priority for the Democratic People's Republic of Korea. Mortality due to NCDs in people aged over 30 years was 1239 per 100 000 in 2009 and the 2014-2020 national strategy includes population-level goals for health promotion and disease prevention. This paper reports a pilot study on the feasibility of implementing components of the World Health Organization (WHO) Package of essential noncommunicable disease (PEN) interventions for primary health care in low-resource settings (WHO PEN) to enable early detection and management of cardiovascular disease and diabetes mellitus at the level of primary care. WHO PEN protocols were adapted for local use by household doctors, who provide ambulatory care in polyclinics in the mornings and household visits in the afternoons. The pilot project was implemented in two polyclinics in Pyongyang, covering a population of 32 000. After training, and during routine household visits in June 2014, 70 household doctors screened all adults aged over 35 years (18 340) for cardiovascular disease and diabetes mellitus, and their risk factors. A total of 2319 patients with cardiovascular disease or diabetes, and those with high-risk factors, were referred to the polyclinics for three quarterly visits for testing and management. Final household screening of the population was done in June 2015. This pilot project demonstrated the feasibility of integrating screening and management into the standard primary health-care system in the Democratic People's Republic of Korea. The household doctors were able to detect and manage risks for cardiovascular disease and diabetes by using the protocols based on WHO PEN. Among 18 340 individuals aged over 35 years, implementation of WHO PEN interventions led to a significant reduction in the number of people with a 10-year risk of cardiovascular disease ≥20% (from 1748 [9.5%] to 543 [3.0%]) over a 1-year period. Involvement of household

  7. 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.

  8. Epiplatys atratus (Cyprinodontiformes: Nothobranchiidae), a new species of the E. multifasciatus species group from the Lulua Basin (Kasaï drainage), Democratic Republic of Congo.

    PubMed

    Jouke R, Van Der Zee; José J Mbimbi Mayi, Munene; Rainer, Sonnenberg

    2013-01-01

    Epiplatys atratus, a new species of the E. multifasciatus group, is described from specimens collected from several tributaries of the middle Lulua River, a tributary of the Kasaï River, south of Kananga (Democratic Republic of the Congo, Kasaï Occidental Province). Epiplatys atratus is the south-eastern most representative of the genus. Large adult E. atratus males differ from all congeners in displaying a dark grey to black pigmentation of body and fins. In contrast to other Epiplatys species, with a fully exposed laterosensory system of the head, the lobes surrounding the supra-orbital part of the laterosensory system almost completely cover the system in large males of E. atratus. Also in males of E. atratus the dorsal fin is positioned on average more anteriorly than in other members of the E. multifasciatus group. Small males and females show a unique pattern of three fine oblique dark bars just behind the pectoral fin.

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

    PubMed Central

    Morffe, Jans; García, Nayla

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

    The human body louse is known as a vector for the transmission of three serious diseases—specifically, epidemic typhus, trench fever, and relapsing fever caused by Rickettsia prowazekii, Bartonella quintana, and Borrelia recurrentis, respectively—that have killed millions of people. It is also suspected in the transmission of a fourth pathogen, Yersinia pestis, which is the etiologic agent of plague. To date, human lice belonging to the genus Pediculus have been classified into three mitochondrial clades: A, B, and C. Here, we describe a fourth mitochondrial clade, Clade D, comprising head and body lice. Clade D may be a vector of B. quintana and Y. pestis, which is prevalent in a highly plague-endemic area near the Rethy Health District, Orientale Province, Democratic Republic of the Congo. PMID:26392158

  11. Applying community-based participatory research to better understand and improve kinship care practices: insights from the Democratic Republic of Congo, Nigeria, and Sierra Leone.

    PubMed

    Chukwudozie, Oge; Feinstein, Clare; Jensen, Celina; OʼKane, Claire; Pina, Silvia; Skovdal, Morten; Smith, Rebecca

    2015-01-01

    While the principles behind community-based participatory research are firmly established, the process of taking community-based participatory research with children and youth to scale and integrating it into the programming of non-governmental organizations has been scarcely documented. This article reflects on the experiences of Save the Children in implementing a multicountry community-based participatory research program to increase understanding of kinship care in the Democratic Republic of Congo, Nigeria, and Sierra Leone. The article discusses challenges faced and lessons learned and highlights how the research process enabled action and advocacy initiatives at different levels-leading to an increase in support and policy attention for children living in kinship care.

  12. Serologic survey among hospital and health center workers during the Ebola hemorrhagic fever outbreak in Kikwit, Democratic Republic of the Congo, 1995.

    PubMed

    Tomori, O; Bertolli, J; Rollin, P E; Fleerackers, Y; Guimard, Y; De Roo, A; Feldmann, H; Burt, F; Swanepoel, R; Killian, S; Khan, A S; Tshioko, K; Bwaka, M; Ndambe, R; Peters, C J; Ksiazek, T G

    1999-02-01

    From May to July 1995, a serologic and interview survey was conducted to describe Ebola hemorrhagic fever (EHF) among personnel working in 5 hospitals and 26 health care centers in and around Kikwit, Democratic Republic of the Congo. Job-specific attack rates estimated for Kikwit General Hospital, the epicenter of the EHF epidemic, were 31% for physicians, 11% for technicians/room attendants, 10% for nurses, and 4% for other workers. Among 402 workers who did not meet the EHF case definition, 12 had borderline positive antibody test results; subsequent specimens from 4 of these tested negative. Although an old infection with persistent Ebola antibody production or a recent atypical or asymptomatic infection cannot be ruled out, if they occur at all, they appear to be rare. This survey demonstrated that opportunities for transmission of Ebola virus to personnel in health facilities existed in Kikwit because blood and body fluid precautions were not being universally followed.

  13. Prevalence of IgG antibodies to Ebola virus in individuals during an Ebola outbreak, Democratic Republic of the Congo, 1995.

    PubMed

    Busico, K M; Marshall, K L; Ksiazek, T G; Roels, T H; Fleerackers, Y; Feldmann, H; Khan, A S; Peters, C J

    1999-02-01

    During the 1995 outbreak of Ebola (EBO) hemorrhagic fever in Kikwit, Democratic Republic of Congo, two surveys using a new ELISA for EBO (subtype Zaire) virus antigen were conducted to assess the prevalence of EBO IgG antibodies among residents of Kikwit and the surrounding area. The first study determined the proportion of antibody-positive individuals who were self-identified forest and city workers from the Kikwit area. Serum samples from 9 (2.2%) of 414 workers had IgG EBO antibodies. The second study determined the proportion of EBO antibody-positive individuals who lived in villages surrounding Kikwit. The prevalence of IgG EBO antibodies in this population was 9.3% (151161). The difference in the overall prevalence of EBO antibodies may indicate that villagers have a greater chance of exposure to EBO virus compared with those living in and in close proximity to cities.

  14. Pulmonary localization of Mansonella perstans in a 16 months-old male patient in a tertiary care hospital in Bukavu, Democratic Republic of Congo.

    PubMed

    Kabego, Landry; Kasengi, Joe Bwija; Mirindi, Patrick; Ruhanya, Vurayai; Lupande, David; Bulabula, André; Ngoma, Patrick

    2016-12-01

    Mansonella perstans is a human filarial parasite transmitted by biting midges (Diptera: Ceratopogonidae) belonging to the genus Culicoides and it is widely spread in sub-Saharan Africa. While most cases are asymptomatic, mansonelliasis can be associated with angioedema, arthralgia, swellings, pain in the scrotum or in serous cavities such as the pleura, the peritoneum, the pericardium, etc. Mansonelliasis can be really hard to treat, but it has been shown that an intensive treatment using albendazole can clear the parasite. Here we describe a case of a 16 months-old malnourished child with pneumonia due to M. perstans in the east of the Democratic Republic of Congo. Although our investigations confirmed M. perstans infection, this case shows that it is very difficult to come to a conclusive diagnosis.

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

    PubMed

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

    2015-11-01

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

  16. Pulmonary localization of Mansonella perstans in a 16 months-old male patient in a tertiary care hospital in Bukavu, Democratic Republic of Congo

    PubMed Central

    Kabego, Landry; Kasengi, Joe Bwija; Mirindi, Patrick; Ruhanya, Vurayai; Lupande, David; Bulabula, André; Ngoma, Patrick

    2016-01-01

    Introduction Mansonella perstans is a human filarial parasite transmitted by biting midges (Diptera: Ceratopogonidae) belonging to the genus Culicoides and it is widely spread in sub-Saharan Africa. While most cases are asymptomatic, mansonelliasis can be associated with angioedema, arthralgia, swellings, pain in the scrotum or in serous cavities such as the pleura, the peritoneum, the pericardium, etc. Mansonelliasis can be really hard to treat, but it has been shown that an intensive treatment using albendazole can clear the parasite. Case report Here we describe a case of a 16 months-old malnourished child with pneumonia due to M. perstans in the east of the Democratic Republic of Congo. Conclusion Although our investigations confirmed M. perstans infection, this case shows that it is very difficult to come to a conclusive diagnosis. PMID:28053918

  17. Eight hundred-year-old human remains from the Ituri tropical forest, Democratic Republic of Congo: the rock shelter site of Matangai Turu Northwest.

    PubMed

    Mercader, J; Garralda, M D; Pearson, O M; Bailey, R C

    2001-05-01

    Little is known about human prehistory in the central African lowland tropical forest due to a paucity of archaeological evidence. Here we report results from our archaeological investigations of a late Holocene site in the northeast Congo Basin, with emphasis on a single skeleton from the rock shelter site of Matangai Turu Northwest, in the Ituri Forest, Democratic Republic of Congo. The skeleton dates from approximately 810 BP (1235 calibrated AD) and is associated with Later Stone Age lithics, animal bone and shell remains from wild taxa, fruit endocarps from forest trees, phytoliths from tropical forest plants, Late Iron Age ceramics, and a single iron artifact. Phytolith analysis indicates that the habitat was dense tropical forest, without evidence of domesticated food.

  18. The Influence of Individual and Contextual Socioeconomic Status on Obstetric Care Utilization in the Democratic Republic of Congo: A Population-based Study

    PubMed Central

    Aremu, Olatunde; Lawoko, Stephen; Dalal, Koustuv

    2012-01-01

    Background: Maternal health care utilization continues to focus on the agenda of health care planners around the world, with high attention being paid to the developing countries. The devastating effect of maternal death at birth on the affected families is untold. This study examines the utilization of obstetric care in the Democratic Republic of Congo. Methods: We have used the nationally representative data from the 2007. Democratic Republic of Congo Demographic and Health Survey. Multilevel regression analysis has been applied to a nationally representative sample of 6,695 women, clustered around 299 communities in the country. Results: The results show that there are variations in the use of antenatal care and delivery care. Individual-level characteristics, such as women's occupation and household wealth status are shown to be associated with the use of antenatal care. Uptake of facility-based delivery has been seen to be dependent on the household wealth status, women's education, and partner's education. The effect of the neighborhoods’ socioeconomic disadvantage on the use of antenatal care and facility-based delivery are the same. Women from highly socioeconomically disadvantaged communities, compared to their counterparts from less socioeconomically disadvantaged neighborhoods, are less likely to utilize both the antenatal services and healthcare facility for child delivery. The result of this study has shown that both individual and contextual socioeconomic status play an important role in obstetric care uptake. Conclusion: Thus, intervention aimed at improving the utilization of obstetrics care should target both the individual economic abilities of the women and that of their environment when considering the demand side. PMID:22624085

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

    PubMed Central

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

    2015-01-01

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

  20. Botanical repellents and pesticides traditionally used against hematophagous invertebrates in Lao People's Democratic Republic: a comparative study of plants used in 66 villages.

    PubMed

    de Boer, Hugo; Vongsombath, Chanda; Pålsson, Katinka; Björk, Lars; Jaenson, Thomas G T

    2010-05-01

    Hematophagous parasites such as leeches, ticks, mites, lice, bedbugs, mosquitoes, and myiasis-producing fly larvae are common health problems in Lao People's Democratic Republic. Several arthropod-borne infections, e.g., malaria, dengue fever, and Japanese encephalitis, are endemic there. Effective vector control methods including the use of pesticides, insecticide-treated bed nets, and synthetic and plant-based repellents are important means of control against such invertebrates and the pathogens they may transmit or directly cause. In this study, we documented traditional knowledge on plants that are used to repel or kill hematophagous arthropods, including mosquitoes, bedbugs, human lice, mites and ticks, fly larvae, and blood-sucking leeches. Structured interviews were carried out in 66 villages comprising 17 ethnic groups, covering a range of cultures, throughout Lao People's Democratic Republic. A total of 92 plant species was recorded as traditional repellents (including plants for pesticidal usages) in 123 different plant-ectoparasite combinations. The number and species of plants, and animal taxa repelled (or killed) per plant species differed per region, village, and ethnic group. Traditional use was confirmed in the scientific literature for 74 of these plant species, and for an additional 13 species using literature on closely related species. The use of botanical repellents and pesticides from many plant species is common and widespread in the Lao countryside. In the future, the identification of the active components in certain plants to develop more optimal, inexpensive repellents, insecticides, acaricides, or antileech compounds as alternatives to synthetic repellents/pesticides against blood-feeding insects, ticks, mites, and leeches is warranted.

  1. [Labour in women with scarred uterus in the Democratic Republic of the Congo: trial of scar and factors influencing the outcome].

    PubMed

    Momat, Félix Kitenge Wa; Zalagile, Pierre Akilimali; Mukalenge, Faustin Chenge; Luboya, Oscar Numbi; Kalala, Cléophas Tshibangu; Mashinda, Désiré; Grangé, Gilles; Mukuku, Olivier; Kaj, Fanny Malonga; Lubamba, Chamy Cham; Bwama, Joseph Bagambe; Mukoko, Célestin Kayembe; Kakoma, Jean Baptiste; Kalungwe, Justin Kizonde

    2017-01-01

    Our study aims to identify risks factors associated with failed trial of scar and to set a predictive score of labour in women with scarred uterus in the Democratic Republic of the Congo. We conducted a multicenter cross-sectional analytic study of patients with scarred uterus in four maternity units in the Democratic Republic of the Congo (DRC) from 1 January to 31 December 2013. Logistic regression model was used to identify factors associated with failed trial of scar. We set a predictive score based on this model in order to predict trial of scar failure in maternity units in the DRC. ROC curve was used to assess the ability of the set score to identify patients at risk for trial of scar failure. The cut off point for the predictive score was determined on the basis of the Youden-index-based optimal sensitivity and specificity. All the tests in our study were carried out by using a significance threshold of α=0.05. Two explanatory factors in trial of scar failure were retained. They were the socio-demographic factor (maternal age) and three obstetric factors (fundal height, fetal presentation and premature rupture of membranes). Predictive score was set to predict trial of scar failure. This score was determined based on four elements: maternal age, evaluation of the gestational sac on admission, fundal height and fetal presentation. The minimum score was set at 4 and the maximum score was set at 16. The threshold value was set at 7. A total score greater than or equal to 7 reflects a risk of trial of scar failure. We set a predictive score to predict trial of scar failure. This score was determined based on four elements: maternal age, evaluation of the gestational sac on admission, fundal height and fetal presentation. A total score greater than or equal to 7 reflects a risk of trial of scar failure.

  2. [Incidence of malaria among United Nations troops deployed in the Ituri district of Democratic Republic of Congo (ex-Zaire) during a 12-month period spanning 2005 and 2006].

    PubMed

    Er-Rami, M; Lemkhennete, Z; Mosnier, E; Abouzahir, A

    2011-02-01

    The purpose of this study was to determine the incidence of malaria in United Nations (UN) troops deployed in northeastern Democratic Republic of Congo (ex-Zaire). A one-year study was conducted from June 2005 to May 2006. The study was retrospective for the first six months and prospective for the second. During the study period, a total of 99 cases of malaria requiring hospitalization at the UN Level II Hospital in the town of Bunia, Democratic Republic of Congo were recorded among UN troops. Malaria accounted for approximately 36% of all hospitalizations for medical diseases. The offending species in 98% of cases was Plasmodium falciparum. Transmission was highest from April to September. There were no deaths. Parasitemia was less than or equal to 2% in 91% of cases.

  3. [Academic medicine in the Soviet Occupation Zone, German Democratic Republic and East Germany. Annotated bibliography for the publication period 2001-2010 including an supplement for the publication period 1990-2000].

    PubMed

    Pasternack, Peer

    2011-01-01

    The bibliography lists separate publications of the period 2001-2010 concerning the history of academic medicine in the Soviet Occupation Zone and German Democratic Republic (GDR) and the transformation of the faculties of medicine after 1990. It also complements the previous bibliography (WmM 2001) for the publishing period 1990-2000. It registers a total of 153 separate publications (monographs, documentations, edited volumes, booklets, catalogues of exhibitions and special issues) and grey literature (not bookselling and internet publications, unpublished theses).

  4. 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

  5. Civil-Military Relations in the French Fourth Republic during the First Indochina War

    DTIC Science & Technology

    2015-05-21

    Republic, 1944-1958, 53-4; Cesari, “The Declining Value of Indochina,” 176. Alessandro Brogi addressed this point in A Question of Self - Esteem : The...dignity and self - esteem to regaining their power in Europe. Each political faction wanted a restored France but with slightly different twists. Much of...foreign invaders was by now a defining self - image of the Vietnamese people, whose regional suspicions were far less important than their shared national

  6. Foreign Assistance and Its Impact on Civil-Military Relations: A Case Study of Federal Democratic Republic of Nepal

    DTIC Science & Technology

    2014-03-01

    Conclusion,” Republica , August 26, 2013, http://www.myrepublica.com/portal/printable_news.php?new_id=60253. 209 Lekhnath Pandey, “Army Integration...IB_AmericanEngagementwithNepalsMaoists_MAdhika ri.pdf. “Army Integration Reaches Logical Conclusion.” Republica , 26 August 2013. Accessed November 12, 2013. http...Gurung, Dipak. “Owning National Army.” Republica , August 8, 2010. Accessed December 4, 2013. http://archives.myrepublica.com/portal/index.php? action

  7. Methodological approach and tools for systems thinking in health systems research: technical assistants' support of health administration reform in the Democratic Republic of Congo as an application.

    PubMed

    Ribesse, Nathalie; Bossyns, Paul; Marchal, Bruno; Karemere, Hermes; Burman, Christopher J; Macq, Jean

    2017-03-01

    In the field of development cooperation, interest in systems thinking and complex systems theories as a methodological approach is increasingly recognised. And so it is in health systems research, which informs health development aid interventions. However, practical applications remain scarce to date. The objective of this article is to contribute to the body of knowledge by presenting the tools inspired by systems thinking and complexity theories and methodological lessons learned from their application. These tools were used in a case study. Detailed results of this study are in process for publication in additional articles. Applying a complexity 'lens', the subject of the case study is the role of long-term international technical assistance in supporting health administration reform at the provincial level in the Democratic Republic of Congo. The Methods section presents the guiding principles of systems thinking and complex systems, their relevance and implication for the subject under study, and the existing tools associated with those theories which inspired us in the design of the data collection and analysis process. The tools and their application processes are presented in the results section, and followed in the discussion section by the critical analysis of their innovative potential and emergent challenges. The overall methodology provides a coherent whole, each tool bringing a different and complementary perspective on the system.

  8. A molecular phylogeny of Equatorial African Lacertidae, with the description of a new genus and species from eastern Democratic Republic of the Congo

    PubMed Central

    Greenbaum, Eli; Villanueva, Cesar O.; Kusamba, Chifundera; Aristote, Mwenebatu M.; Branch, William R.

    2011-01-01

    Currently, four species of the lacertid lizard genus Adolfus are known from Central and East Africa. We sequenced up to 2,825 bp of two mitochondrial (16S and cyt b) and two nuclear (c-mos and RAG1) genes from 41 samples of Adolfus (representing every species), two species each of Gastropholis and Holaspis, and in separate analyses combined this data with GenBank sequences of all other Eremiadini genera and four Lacertini outgroups. Data from DNA sequences were analyzed with maximum parsimony (PAUP), maximum-likelihood (RAxML) and Bayesian inference (MrBayes) criteria. Results demonstrated that Adolfus is not monophyletic: A. africanus (type species), A. alleni and A. jacksoni are sister taxa, whereas A. vauereselli and a new species from the Itombwe Plateau of Democratic Republic of the Congo are in a separate lineage. Holaspis and Gastropholis were recovered in separate clades. Based on this molecular data, relatively substantial sequence divergence and multiple morphological differences, we describe a new genus of lacertid for the lineage including A. vauereselli and the new Itombwe species. The recognition of this new, endemic genus underscores the conservation importance of the Albertine Rift, especially the Itombwe Plateau, a unique region that is severely threatened by unchecked deforestation, mining and poaching. PMID:22121299

  9. Prenatal Maternal Stress Predicts Methylation of Genes Regulating the Hypothalamic-Pituitary-Adrenocortical System in Mothers and Newborns in the Democratic Republic of Congo

    PubMed Central

    Kertes, Darlene A.; Kamin, Hayley S.; Hughes, David A.; Rodney, Nicole C.; Bhatt, Samarth; Mulligan, Connie J.

    2016-01-01

    Exposure to stress early in life permanently shapes activity of the hypothalamic-pituitary-adrenocortical (HPA) axis and the brain. Prenatally, glucocorticoids pass through the placenta to the fetus with postnatal impacts on brain development, birth weight, and HPA axis functioning. Little is known about the biological mechanisms by which prenatal stress affects postnatal functioning. This study addresses this gap by examining the effect of chronic stress and traumatic war-related stress on epigenetic changes in four key genes regulating the HPA axis in neonatal cord blood, placenta, and maternal blood: CRH, CRHBP, NR3C1, and FKBP5. Participants were 24 mother-newborn dyads in the conflict-ridden region of the eastern Democratic Republic of Congo. Birth weight data were collected at delivery and maternal interviews were conducted to assess culturally relevant chronic and war-related stressors. Chronic stress and war trauma had widespread effects on HPA axis gene methylation, with significant effects observed at transcription factor binding sites in all target genes tested. Some changes in methylation were unique to chronic or war stress, whereas others were observed across both stressor types. Moreover, stress exposures impacted maternal and fetal tissues differently, supporting theoretical models that stress impacts vary according to life phase. Methylation in several NR3C1 and CRH CpG sites, all located at transcription factor binding sites, was associated with birth weight. These findings suggest that prenatal stress exposure impacts development via epigenetic changes in HPA axis genes. PMID:26822443

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

    PubMed

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

    2014-02-07

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

  11. Intestinal Helminths of Wild Bonobos in Forest-Savanna Mosaic: Risk Assessment of Cross-Species Transmission with Local People in the Democratic Republic of the Congo.

    PubMed

    Narat, Victor; Guillot, Jacques; Pennec, Flora; Lafosse, Sophie; Grüner, Anne Charlotte; Simmen, Bruno; Bokika Ngawolo, Jean Christophe; Krief, Sabrina

    2015-12-01

    Phylogenetic and geographic proximities between humans and apes pose a risk of zoonotic transmission of pathogens. Bonobos (Pan paniscus) of the Bolobo Territory, Democratic Republic of the Congo, live in a fragmented forest-savanna mosaic setting, a marginal habitat for this species used to living in dense forests. Human activities in the forest have increased the risk of contacts between humans and bonobos. Over 21 months (September 2010-October 2013), we monitored intestinal parasites in bonobo (n = 273) and in human (n = 79) fecal samples to acquire data on bonobo parasitology and to assess the risk of intestinal helminth transmission between these hosts. Coproscopy, DNA amplification, and sequencing of stored dried feces and larvae were performed to identify helminths. Little difference was observed in intestinal parasites of bonobos in this dryer habitat compared to those living in dense forests. Although Strongylids, Enterobius sp., and Capillaria sp. were found in both humans and bonobos, the species were different between the hosts according to egg size or molecular data. Thus, no evidence of helminth transmission between humans and bonobos was found. However, because humans and this threatened species share the same habitat, it is essential to continue to monitor this risk.

  12. The Effect of Cognitive Therapy on Structural Social Capital: Results From a Randomized Controlled Trial Among Sexual Violence Survivors in the Democratic Republic of the Congo

    PubMed Central

    Bolton, Paul A.; Annan, Jeannie; Kaysen, Debra; Robinette, Katie; Cetinoglu, Talita; Wachter, Karin; Bass, Judith K.

    2014-01-01

    Objectives. We evaluated changes in social capital following group-based cognitive processing therapy (CPT) for female survivors of sexual violence. Methods. We compared CPT with individual support in a cluster-randomized trial in villages in South Kivu province, Democratic Republic of the Congo. Local psychosocial assistants delivered the interventions from April through July 2011. We evaluated differences between CPT and individual support conditions for structural social capital (i.e., time spent with nonkin social network, group membership and participation, and the size of financial and instrumental support networks) and emotional support seeking. We analyzed intervention effects with longitudinal random effects models. Results. We obtained small to medium effect size differences for 2 study outcomes. Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages. Conclusions. Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context. PMID:25033113

  13. The effect of cognitive therapy on structural social capital: results from a randomized controlled trial among sexual violence survivors in the Democratic Republic of the Congo.

    PubMed

    Hall, Brian J; Bolton, Paul A; Annan, Jeannie; Kaysen, Debra; Robinette, Katie; Cetinoglu, Talita; Wachter, Karin; Bass, Judith K

    2014-09-01

    We evaluated changes in social capital following group-based cognitive processing therapy (CPT) for female survivors of sexual violence. We compared CPT with individual support in a cluster-randomized trial in villages in South Kivu province, Democratic Republic of the Congo. Local psychosocial assistants delivered the interventions from April through July 2011. We evaluated differences between CPT and individual support conditions for structural social capital (i.e., time spent with nonkin social network, group membership and participation, and the size of financial and instrumental support networks) and emotional support seeking. We analyzed intervention effects with longitudinal random effects models. We obtained small to medium effect size differences for 2 study outcomes. Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages. Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context.

  14. Novel Reassortant H5N6 Influenza A Virus from the Lao People’s Democratic Republic Is Highly Pathogenic in Chickens

    PubMed Central

    Layton, Daniel S.; Phommachanh, Phouvong; Harper, Jennifer; Payne, Jean; Evans, Ryan M.; Valdeter, Stacey; Walker, Som; Harvey, Gemma; Shan, Songhua; Bruce, Matthew P.; Rootes, Christina L.; Gough, Tamara J.; Rohringer, Andreas; Peck, Grantley R.; Fardy, Sarah J.; Karpala, Adam J.; Johnson, Dayna; Wang, Jianning; Douangngeun, Bounlom; Morrissy, Christopher; Wong, Frank Y. K.; Bean, Andrew G. D.; Bingham, John; Williams, David T.

    2016-01-01

    Avian influenza viruses of H5 subtype can cause highly pathogenic disease in poultry. In March 2014, a new reassortant H5N6 subtype highly pathogenic avian influenza virus emerged in Lao People’s Democratic Republic. We have assessed the pathogenicity, pathobiology and immunological responses associated with this virus in chickens. Infection caused moderate to advanced disease in 6 of 6 chickens within 48 h of mucosal inoculation. High virus titers were observed in blood and tissues (kidney, spleen, liver, duodenum, heart, brain and lung) taken at euthanasia. Viral antigen was detected in endothelium, neurons, myocardium, lymphoid tissues and other cell types. Pro-inflammatory cytokines were elevated compared to non-infected birds. Our study confirmed that this new H5N6 reassortant is highly pathogenic, causing disease in chickens similar to that of Asian H5N1 viruses, and demonstrated the ability of such clade 2.3.4-origin H5 viruses to reassort with non-N1 subtype viruses while maintaining a fit and infectious phenotype. Recent detection of influenza H5N6 poultry infections in Lao PDR, China and Viet Nam, as well as six fatal human infections in China, demonstrate that these emergent highly pathogenic H5N6 viruses may be widely established in several countries and represent an emerging threat to poultry and human populations. PMID:27631618

  15. Low genetic diversity of Banana bunchy top virus, with a sub-regional pattern of variation, in Democratic Republic of Congo.

    PubMed

    Mukwa, L F T; Gillis, A; Vanhese, V; Romay, G; Galzi, S; Laboureau, N; Kalonji-Mbuyi, A; Iskra-Caruana, M L; Bragard, C

    2016-12-01

    Banana bunchy top virus (BBTV), belonging to the genus Babuvirus, is the most devastating and widespread banana virus. Banana and plantain are major crops in terms of household income and food security in Democratic Republic of Congo (DRC). Despite the large area under banana and plantain cultivation in the country, before this study, the genetic characterization of BBTV isolates had only been undertaken for two provinces. In the study presented here, genetic variation in BBTV was assessed from 52 BBTV isolates collected in five out of 11 provinces in DRC (Bandundu, Bas-Congo, Katanga, Kinshasa and Kasaï Oriental) and in two provinces using sequences previously described in databases. Full genome sequencing of DNA-R components was performed, revealing low genetic variation (98-100 % nucleotide identity) among the BBTV isolates detected. The phylogenetic analyses showed that all the DRC isolates were clustered in the South Pacific clade of BBTV. Based on the coding region for the replication initiator protein, haplotype diversity was estimated to be 0.944 ± 0.013, with 30 haplotypes from 68 isolates in DRC. Such diversity shows a haplotype distribution mainly at the sub-regional level in DRC. In addition, the sequence determination from the whole genome of selected isolates confirmed low genetic variation among isolates from seven DRC provinces (97-100 % nucleotide identity). This study strengthened the hypothesis of a single BBTV introduction some time ago, followed by the spread of the virus in the country.

  16. Antimicrobial resistance in human and animal pathogens in Zambia, Democratic Republic of Congo, Mozambique and Tanzania: an urgent need of a sustainable surveillance system

    PubMed Central

    2013-01-01

    A review of the published and unpublished literature on bacterial resistance in human and animals was performed. Sixty-eight articles/reports from the Democratic Republic of Congo (DRC), Mozambique, Tanzania and Zambia were reviewed. The majority of these articles were from Tanzania. There is an increasing trend in the incidence of antibiotic resistance; of major concern is the increase in multidrug- resistant Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Vibrio cholera, non-typhoid Salmonella and other pathogens responsible for nosocomial infections. The increase in methicillin- resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) producers in the countries under review confirms the spread of these clones worldwide. Clinical microbiology services in these countries need to be strengthened in order to allow a coordinated surveillance for antimicrobial resistance and provide data for local treatment guidelines and for national policies to control antimicrobial resistance. While the present study does not provide conclusive evidence to associate the increasing trend in antibiotic resistance in humans with the use of antibiotics in animals, either as feed additives or veterinary prescription, we strongly recommend a one-health approach of systematic surveillance across the public and animal health sectors, as well as the adherence to the FAO (Food and Agriculture Organization)-OIE (World Organization of animal Health) –WHO(World Health Organization) recommendations for non-human antimicrobial usage. PMID:24119299

  17. 2.5D change detection from satellite imagery to monitor small-scale mining activities in the Democratic Republic of the Congo

    NASA Astrophysics Data System (ADS)

    Kranz, Olaf; Lang, Stefan; Schoepfer, Elisabeth

    2017-09-01

    Mining natural resources serve fundamental societal needs or commercial interests, but it may well turn into a driver of violence and regional instability. In this study, very high resolution (VHR) optical stereo satellite data are analysed to monitor processes and changes in one of the largest artisanal and small-scale mining sites in the Democratic Republic of the Congo, which is among the world's wealthiest countries in exploitable minerals To identify the subtle structural changes, the applied methodological framework employs object-based change detection (OBCD) based on optical VHR data and generated digital surface models (DSM). Results prove the DSM-based change detection approach enhances the assessment gained from sole 2D analyses by providing valuable information about changes in surface structure or volume. Land cover changes as analysed by OBCD reveal an increase in bare soil area by a rate of 47% between April 2010 and September 2010, followed by a significant decrease of 47.5% until March 2015. Beyond that, DSM differencing enabled the characterisation of small-scale features such as pits and excavations. The presented Earth observation (EO)-based monitoring of mineral exploitation aims at a better understanding of the relations between resource extraction and conflict, and thus providing relevant information for potential mitigation strategies and peace building.

  18. Small mammal diversity and habitat requirements in the Kahuzi-Biega National Park and surrounding areas, eastern Democratic Republic of Congo.

    PubMed

    Kaleme, Prince K; Bates, John; Peterans, Julian Kerbis; Jacques, Mwanga M; Ndara, Benjamin R

    2007-12-01

    We conducted a study on diversity and habitat requirements of small mammals in the western part of the Albertine Rift, eastern Democratic Republic of Congo. The work aimed at providing a more complete list of species recorded to date and their habitat requirements to aid conservation efforts in the region. Trapping was conducted using Museum special, Victor traps, Sherman live traps and pitfall traps in four different habitats. A total of 57 species was recorded. Plantations and open habitats harbored the same species. In the forested areas we recorded 30 species which are not tolerant to disturbance. Eighteen species are Albertine Rift endemics. One species (Lophuromys cinereus), which is vulnerable and data deficient, has been recorded only in swamp. This study has recorded more species than the previous studies, some of which have not been reported in earlier studies. Differences between this and earlier studies are attributed to methods and the areas sampled. Some of the habitats sampled by previous workers have not been assessed. More research is needed, especially in swamps in mountain areas and in deep forests inhabited by species not present at lower altitudes.

  19. Cost-effectiveness of caesarean sections in a post-conflict environment: a case study of Bunia, Democratic Republic of the Congo.

    PubMed

    Deboutte, Danielle; O'Dempsey, Tim; Mann, Gillian; Faragher, Brian

    2013-07-01

    This paper demonstrates the feasibility of health services research in an unstable environment during the transition from crisis to development and its importance for future planning. Effectiveness and the cost of caesarean sections (CSs) were investigated in Bunia, a town affected by conflict and insecurity, in the Democratic Republic of the Congo (DRC) in 2008. The CS rate was 9.7 per cent of expected deliveries. All CSs in the study sample were emergency procedures. A humanitarian non-governmental organisation (NGO) hospital, offering free services, performed 75 per cent of all CSs. The estimated provider cost for CS in 2008 at this hospital was USD 103,514 (that is, USD 144 per CS). With a cost of between USD 3.8 and 9.2 per year of health adjusted life expectancy (HALE) gained, CSs at the NGO hospital were very cost-effective. The estimates give an indication of funding requirements to maintain adequate access to CS after the departure of the humanitarian organisation.

  20. Correlation between chemical composition and antibacterial activity of essential oils of some aromatic medicinal plants growing in the Democratic Republic of Congo.

    PubMed

    Cimanga, K; Kambu, K; Tona, L; Apers, S; De Bruyne, T; Hermans, N; Totté, J; Pieters, L; Vlietinck, A J

    2002-02-01

    The chemical composition of essential oils from 15 aromatic medicinal plant species growing in the Democratic Republic of Congo have been studied. More than 15 constituents in an amount higher than 0.1% were identified in each essential oil. 1,8-cineole, alpha and beta-pinene, p-cymene, myrcene, gamma-terpinene, alpha-terpineol and limonene were prevalent constituents in almost more than 10 selected plant species. Results from the antibacterial testing by the diffusion method indicate that all essential oils (5 microl per disc) inhibited the growth of selected bacteria at different extents. The most active antibacterial essential oils were those of the leaves of Eucalyptus camadulensis and Eucalyptus terticornis (12-30 mm zone diameter of inhibition). They showed particularly a most potent inhibition of Pseudomonas aeruginosa growth (15-16 mm), followed by Eucalyptus robusta (12 mm). Essential oils from the leaves of Eucalyptus alba, Eucalyptus citriodora, Eucalyptus deglupta, Eucalyptus globulus, Eucalyptus saligna, Eucalyptus robusta, Aframomum stipulatum, Cymbopogon citratus, Ocimum americanum and that of the seeds of Monodora myristica showed also a good antibacterial activity (10-18 mm). Eucalyptus propinqua, Eucalyptus urophylla and Ocimum gratissimum essential oils were the less active samples against the selected bacteria. No correlation between the amount of major constituents such as 1,8-cineol, alpha-pinene, p-cymene, cryptone or thymol and the antibacterial activity was observed.

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

    PubMed

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

    2008-07-01

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

  2. Discovery of a Leptospirosis Cluster Amidst a Pneumonic Plague Outbreak in a Miners’ Camp in the Democratic Republic of the Congo

    PubMed Central

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

    2014-01-01

    Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing 57 of them. Clinical signs, fast disease spread, and initial laboratory investigations suggested pneumonic plague. While leptospirosis had not recently been described in the region, it was considered as a differential diagnosis. Anti-Leptospira antibodies were detected by microscopic agglutination test (MAT). A confirmed case of leptospirosis was defined as having consistent clinical signs and any one of the following: seroconversion or four-fold increase in MAT titre for paired serum samples, or a MAT titre ≥ 1:400 for acute-phase serum samples. Twenty-nine of the 54 patients or convalescents tested for leptospirosis were seropositive. Two cases showed a confirmed infection for both plague and leptospirosis. While evidence supports the plague nature of this outbreak, the results suggest that some of the suspected plague cases might be due to leptospirosis. In any case, this diagnosis will have to be evoked in the future if a similar outbreak occurs in this region of Africa. PMID:24514425

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

    PubMed

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

    2012-09-01

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

  4. Long-term disease surveillance in Bandundu region, Democratic Republic of the Congo: a model for early detection and prevention of Ebola hemorrhagic fever.

    PubMed

    Lloyd, E S; Zaki, S R; Rollin, P E; Tshioko, K; Bwaka, M A; Ksiazek, T G; Calain, P; Shieh, W J; Kondé, M K; Verchueren, E; Perry, H N; Manguindula, L; Kabwau, J; Ndambi, R; Peters, C J

    1999-02-01

    After the large-scale outbreak of Ebola hemorrhagic fever (EHF) in Bandundu region, Democratic Republic of the Congo, a program was developed to help detect and prevent future outbreaks of EHF in the region. The long-term surveillance and prevention strategy is based on early recognition by physicians, immediate initiation of enhanced barrier-nursing practices, and the use of an immunohistochemical diagnostic test performed on formalin-fixed skin specimens of patients who die of suspected viral hemorrhagic fever. The program was implemented in September 1995 during a 4-day workshop with 28 local physicians representing 17 of 22 health zones in the region. Specimen collection kits were distributed to clinics in participating health zones, and a follow-up evaluation was conducted after 6 months. The use of a formalin-fixed skin specimen for laboratory confirmation of EHF can provide an appropriate method for EHF surveillance when linked with physician training, use of viral hemorrhagic fever isolation precautions, and follow-up investigation.

  5. The flies of the family Hybotidae (Diptera, Empidoidea) collected during the Boyekoli Ebale Congo 2010 Expedition in Democratic Republic of Congo.

    PubMed

    Grootaert, Patrick; Shamshev, Igor

    2013-01-14

    Thirty-two species of Hybotidae (Diptera: Empidoidea) were collected during the Boyekoli Ebale Congo 2010 Expedition that took place in the Democratic Republic of Congo along the Congo River between Kisangani and Bumba. Only four species were known previously. Here we present new records for Syndyas crisis Garrett Jones, 1940 and Crossopalpus aenescens (Wiedemann, 1830). In addition Syneches elevatus Bezzi, 1908 and Crossopalpus quadrispina (Collart, 1934) are re-described based on the type material as well as on new material. Elaphropeza ghesquierei (Collart, 1934) and E. plagiata (Bezzi, 1908) were not found during the expedition, but are also re-described. Twenty-five species are described as new to science: Crossopalpus yaekela sp. nov., Drapetis congoensis sp. nov., D. yaekelaensis sp. nov., D. zamba sp. nov., Elaphropeza angulata sp. nov., E. baeloi sp. nov., E. congoensis sp. nov., E. excavata sp. nov., E. furcata sp. nov., E. incerta sp. nov., E. infuscata sp. nov., E. interrupta sp. nov., E. juakalyi sp. nov., E. kona sp. nov., E. laudisoitae sp. nov., E. mai sp. nov., E. monoseta sp. nov., E. motane sp. nov., E. moyindo sp. nov., E. nuda sp. nov., E. yaekela sp. nov., E. zamba sp. nov., Stilpon congoensis sp. nov., S. variabilis sp. nov. and Syndyas zamba sp. nov. A species of Drapetis and Crossopalpus recorded from females only are diagnosed, but not named.

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

    PubMed

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

    2015-03-01

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

  7. Experience of the Air Medical Evacuation Team of Serbian Armed Forces in the United Nations Mission in the Democratic Republic of Congo--Deployment stress and psychological adaptation.

    PubMed

    Joković, Danilo B; Krstić, Dragan; Stojanović, Zvezdana; Spirić, Zeljko

    2016-02-01

    Wars of the nineties in former Yugoslavia, Somalia, Rwanda imposed new tasks to the United Nations (UN) forces, such as providing humanitarian aid, protection of civilians, peacekeeping, and in many instances providing armed enforcement of peace. The aim of this study was an observational analysis of Serbian participation in the UNs Mission in the Democratic Republic of Congo with the emphasis on stress and coping techniques. Serbian contribution in this mission dates back to April 2003 till the present days with a military contingent consisting of six members as a part of Air Medical Evacuation Team. The observed stressogenous factors acted before arrival to the mission area and in the mission area. In this paper we analysed ways to overcome them. The productive ways of overwhelming stress used in this mission were: honesty and openness in interpersonal communications, dedication to work, maintaining discipline and order, strict following of appropriate regime of work, diet, rest and recreation; regular communication with family and organizing and participation in various social, cultural and sports manifestations. This analysis indicates that out of all the observed factors, the most important is appropriate selection of personnel.

  8. [Prevalence of opportunistic digestive parasitic infections in Kinshasa, Democratic Republic of Congo. Results of a preliminary study in 50 AIDS patients].

    PubMed

    Wumba, R; Enache-Angoulvant, A; Develoux, M; Mulumba, A; Mulumba, P M; Hennequin, C; Odio, T W; Biligui, S; Sala, J; Thellier, M

    2007-04-01

    In the Democratic Republic of Congo (DRC), as in many African countries, AIDS and its procession of opportunistic infections are a major cause of morbidity and mortality. In Kinshasa, the estimated prevalence rate of HIV-infected persons is between 4 and 5%, corresponding to more than 200,000 people. Due to the lack of trained laboratory personnel and appropriate diagnostic equipment, no local investigation has been carried out to determine the prevalence of the opportunistic digestive parasitic infection in HIV-infected persons. As a step to obtaining this information that is needed for implementation of an adequate care policy, a preliminary investigation was carried out in Paris, France on 50 stool samples from 50 AIDS-patients hospitalized in 3 reference hospitals in Kinshasa. Eleven patients (22%) had digestive symptoms with a diarrhea syndrome. Further study using specialized techniques demonstrated 2 cases of digestive infection related to opportunistic parasites (4%). The first involved a Cryptosporidium sp. The second represented the first case of Enterocytozoon bieneusi infection reported in the literature from the DRC.

  9. 'If your husband doesn't humiliate you, other people won't': gendered attitudes towards sexual violence in eastern Democratic Republic of Congo.

    PubMed

    Kelly, Jocelyn; Kabanga, Justin; Cragin, Will; Alcayna-Stevens, Lys; Haider, Sadia; Vanrooyen, Michael J

    2012-01-01

    More than a decade of fighting in the Democratic Republic of the Congo (DRC) has resulted in extensive human rights abuses, of which sexual and gender-based violence (SGBV) is one of the most salient and disturbing features. This paper uses qualitative data, based on 10 focus groups with 86 women and men to better understand gendered community perspectives on SGBV and its consequences in South Kivu. We conclude that for many survivors, rape has consequences far beyond the physiological and psychological trauma associated with the attack. Respondents say sexual violence has become a societal phenomenon, in which the community isolation and shame experienced as a result of the attack become as important as concerns about the attack itself. Male focus group participants explain their own feelings of shame and anger associated with knowing their female relatives were raped. These findings highlight the complexity of community reintegration for survivors and identify a number of programmatic and policy implications, such as the need for counselling for survivors of sexual violence with their families as well as individually; the importance of income-generating training; and the need for improved justice mechanisms to bring perpetrators to justice.

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

    PubMed

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

    2013-10-01

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

  11. Object-based image analysis for the assessment of mineral extraction in conflict regions - a case study in the Democratic Republic of the Congo

    NASA Astrophysics Data System (ADS)

    Kranz, Olaf; Schoepfer, Elisabeth; Spröhnle, Kristin; Lang, Stefan

    2016-06-01

    In this study object-based image analysis (OBIA) techniques were applied to assess land cover changes related to mineral extraction in a conflict-affected area of the eastern Democratic Republic of the Congo (DRC) over a period of five years based on very high resolution (VHR) satellite data of different sensors. Object-based approaches explicitly consider spatio-temporal aspects which allow extracting important information to document mining activities. The use of remote sensing data as an independent, up-to-date and reliable data source provided hints on the general development of the mining sector in relation to socio-economic and political decisions. While in early 2010, the situation was still characterised by an intensification of mineral extraction, a mining ban between autumn 2010 and spring 2011 marked the starting point for a continuous decrease of mining activities. The latter can be substantiated through a decrease in the extend of the mining area as well as of the number of dwellings in the nearby settlement. A following demilitarisation and the mentioned need for accountability with respect to the origin of certain minerals led to organised, more industrialized exploitation. This development is likewise visible on satellite imagery as typical clearings within forested areas. The results of the continuous monitoring in turn facilitate non-governmental organisations (NGOs) to further foster the mentioned establishment of responsible supply chains by the mining industry throughout the entire period of investigation.

  12. Evaluation of medical supplies essential for the care of survivors of sex- and gender-based violence in post-conflict Eastern Democratic Republic of Congo.

    PubMed

    Rybarczyk, Megan; Tosha, Mafille; Mbika, Bicky; Bulonza, Patricia; Ramazani, Paul; Zahiga, Isaya; Safari, Octave; Bachunguye, Richard; Safari, Christian; Iragi, Aline; Glass, Nancy

    2011-05-01

    The fundamental concepts set forth in the formal Post-Conflict Needs Assessment (PCNA) initiative created by the United Nations Development Group have the potential to be adapted to assist local groups in documenting the needs of and the provision of health care to survivors of sex- and gender-based violence (SGBV) in Eastern Democratic Republic of Congo (DRC). In partnership with Congolese health care providers, we took the first step in advocating for a locally-adapted and focused needs assessment through the development and administration of surveys to providers in the South Kivu Province, DRC. The content of the surveys was largely based on lists of medical supplies deemed essential for reproductive health and for the care of survivors by the Reproductive Health Response in Crises Consortium. The providers in both urban and rural settings considered many of the supplies identified on the surveys necessary for the care of survivors (84%; p < 0.05) but considered few accessible (26%; p < 0.05) in their particular clinical settings. Providers also felt that the existing list of supplies was inadequate to meet the needs of survivors, and also that providers needed ongoing training to improve supply procurement and management, more knowledge of the needs of male survivors of SGBV, and more educational opportunities to improve the quality of care to survivors. Given the deficiencies expressed by providers in the surveys, this study demonstrated a critical need for a locally-adapted and focused needs assessment to improve health services to survivors.

  13. Observed Differences in the Human Footprint and Forest Fragmentation in the Primary Forest Area of the Democratic Republic of Congo: A Remote Sensing Study for 2000-2010

    NASA Astrophysics Data System (ADS)

    Molinario, G.

    2015-12-01

    Conflict in the Democratic Republic of Congo (DRC) and neighboring countries has caused the displacement of people internally and internationally sometimes leading to drastic changes in the impact that traditional slash and burn shifting cultivation has on the forest ecosystem. In other areas, the lack of infrastructure and governance has isolated and protected areas of core forest from large scale exploitation. Observing specific patterns of forest fragmentation caused either by the expansion of existing rural complex areas or of isolated forest perforations has allowed us to track the differential growth of the human footprint throughout forested area of the country during the period 2000-2010. Our methodological approach involved the development of a model of shifting cultivation and forest fragmentation in which spatial rules applied morphological image processing to the Forets d'Afrique Central Evaluee par Teledetection (FACET) product. The result is a disaggregated classification of the primary forest into patch, edge, perforated, fragmented and core forest subtypes which we subsequently re-aggregated into homogenous anthropogenic macro-areas of rural complex and isolated forest perforations. We tracked how subsequent forest loss observed in 2005 and 2010 grew or shrunk these areas, presumably with differential impacts on the forest ecosystem. Using this approach we were able to map forest degradation by contextualizing the contribution of forest loss to change in different types of areas, highlighting how it can be greatly underestimated by a non contextualized per-pixel assessment of forest cover loss.

  14. [Health Care in the German Democratic Republic (GDR) from the Patients' View: A Survey of Petitions Sent to the Socialist Unity Party of Germany (SED)].

    PubMed

    Bruns, F

    2016-05-01

    The aim of this paper is to explore the patients' view of the health system in the German Democratic Republic (GDR) in the 1980 s. It investigates how patients experienced everyday medical care in the GDR beyond the ideals of official health policy. A systematic analysis of patients' written petitions to the Central Committee of the Socialist Party in the GDR was undertaken. Patients articulated their experiences and expectations quite critically, using characteristic patterns of argumentation and, at times, successfully exerting pressure on the regime to answer their demands. Conflicts concerning disability pensions, factual or putative malpractice and complaints about run-down health facilities belong to the issues most frequently addressed. Persons who mentioned their membership in the Socialist Party had better chances to get their problems solved than those who did not disclose any affiliation to the Socialist Party. The petitions surveyed in this study provide insight into the lives of patients in the late GDR. Patients made particular demands of the socialist state and its health system. It is important to integrate the patients' perspective into historical research on medical care in the GDR. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Antimicrobial resistance in human and animal pathogens in Zambia, Democratic Republic of Congo, Mozambique and Tanzania: an urgent need of a sustainable surveillance system.

    PubMed

    Mshana, Stephen E; Matee, Mecky; Rweyemamu, Mark

    2013-10-12

    A review of the published and unpublished literature on bacterial resistance in human and animals was performed. Sixty-eight articles/reports from the Democratic Republic of Congo (DRC), Mozambique, Tanzania and Zambia were reviewed. The majority of these articles were from Tanzania. There is an increasing trend in the incidence of antibiotic resistance; of major concern is the increase in multidrug- resistant Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Vibrio cholera, non-typhoid Salmonella and other pathogens responsible for nosocomial infections. The increase in methicillin- resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) producers in the countries under review confirms the spread of these clones worldwide. Clinical microbiology services in these countries need to be strengthened in order to allow a coordinated surveillance for antimicrobial resistance and provide data for local treatment guidelines and for national policies to control antimicrobial resistance. While the present study does not provide conclusive evidence to associate the increasing trend in antibiotic resistance in humans with the use of antibiotics in animals, either as feed additives or veterinary prescription, we strongly recommend a one-health approach of systematic surveillance across the public and animal health sectors, as well as the adherence to the FAO (Food and Agriculture Organization)-OIE (World Organization of animal Health) -WHO(World Health Organization) recommendations for non-human antimicrobial usage.

  16. A Congolese-US participatory action research partnership to rebuild the lives of rape survivors and their families in eastern Democratic Republic of Congo.

    PubMed

    Glass, Nancy; Ramazani, Paul; Tosha, Mafille; Mpanano, Mitima; Cinyabuguma, Matthias

    2012-01-01

    The Democratic Republic of Congo (DRC) remains an all-too-potent reminder of how war, human rights violations and their related health and economic impacts can devastate a society. The last decade has seen the use of rape as a weapon of war in the DRC, where rebels and soldiers subject women and girls to brutalising attacks, rape, torture and mutilation. Survivors of sexual and gender-based violence (SGBV) are often further traumatised by infections, disease, poverty, stigma and social isolation. Substantial evidence exists showing an association between social determinants (e.g., poverty, stress and trauma, stigma, lack of access to health care) and health; however, limited research has been conducted to elucidate these relationships or to develop and test interventions to change social determinants of health, especially in conflict and post-conflict settings such as the DRC. The purpose of this article is to present a Congolese-US community-academic research partnership to obtain evidence to develop and implement a sustainable intervention to begin to address the social determinants of health, including poverty and traumatic stress for survivors of SGBV and their families in the South Kivu province of eastern DRC.

  17. Lesula: a new species of Cercopithecus monkey endemic to the Democratic Republic of Congo and implications for conservation of Congo's central basin.

    PubMed

    Hart, John A; Detwiler, Kate M; Gilbert, Christopher C; Burrell, Andrew S; Fuller, James L; Emetshu, Maurice; Hart, Terese B; Vosper, Ashley; Sargis, Eric J; Tosi, Anthony J

    2012-01-01

    In June 2007, a previously undescribed monkey known locally as "lesula" was found in the forests of the middle Lomami Basin in central Democratic Republic of Congo (DRC). We describe this new species as Cercopithecus lomamiensis sp. nov., and provide data on its distribution, morphology, genetics, ecology and behavior. C. lomamiensis is restricted to the lowland rain forests of central DRC between the middle Lomami and the upper Tshuapa Rivers. Morphological and molecular data confirm that C. lomamiensis is distinct from its nearest congener, C. hamlyni, from which it is separated geographically by both the Congo (Lualaba) and the Lomami Rivers. C. lomamiensis, like C. hamlyni, is semi-terrestrial with a diet containing terrestrial herbaceous vegetation. The discovery of C. lomamiensis highlights the biogeographic significance and importance for conservation of central Congo's interfluvial TL2 region, defined from the upper Tshuapa River through the Lomami Basin to the Congo (Lualaba) River. The TL2 region has been found to contain a high diversity of anthropoid primates including three forms, in addition to C. lomamiensis, that are endemic to the area. We recommend the common name, lesula, for this new species, as it is the vernacular name used over most of its known range.

  18. Lesula: A New Species of Cercopithecus Monkey Endemic to the Democratic Republic of Congo and Implications for Conservation of Congo’s Central Basin

    PubMed Central

    Hart, John A.; Detwiler, Kate M.; Gilbert, Christopher C.; Burrell, Andrew S.; Fuller, James L.; Emetshu, Maurice; Hart, Terese B.; Vosper, Ashley; Sargis, Eric J.; Tosi, Anthony J.

    2012-01-01

    In June 2007, a previously undescribed monkey known locally as “lesula” was found in the forests of the middle Lomami Basin in central Democratic Republic of Congo (DRC). We describe this new species as Cercopithecus lomamiensis sp. nov., and provide data on its distribution, morphology, genetics, ecology and behavior. C. lomamiensis is restricted to the lowland rain forests of central DRC between the middle Lomami and the upper Tshuapa Rivers. Morphological and molecular data confirm that C. lomamiensis is distinct from its nearest congener, C. hamlyni, from which it is separated geographically by both the Congo (Lualaba) and the Lomami Rivers. C. lomamiensis, like C. hamlyni, is semi-terrestrial with a diet containing terrestrial herbaceous vegetation. The discovery of C. lomamiensis highlights the biogeographic significance and importance for conservation of central Congo’s interfluvial TL2 region, defined from the upper Tshuapa River through the Lomami Basin to the Congo (Lualaba) River. The TL2 region has been found to contain a high diversity of anthropoid primates including three forms, in addition to C. lomamiensis, that are endemic to the area. We recommend the common name, lesula, for this new species, as it is the vernacular name used over most of its known range. PMID:22984482

  19. Adaptation of a U.S. evidence-based Positive Prevention intervention for youth living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo.

    PubMed

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

    2013-02-01

    Effective HIV prevention programs for people living with HIV/AIDS (PLWH) are important to reduce new infections and to ensure PLWH remain healthy. This paper describes the systematic adaptation of a U.S.-developed Evidence Based Intervention (EBI) using the Centers for Disease Control and Prevention (CDC) Map of Adaption Process for use at a Pediatric Hospital in Kinshasa, Democratic Republic of the Congo (DRC). The adapted intervention, Supporting Youth and Motivating Positive Action or SYMPA, a six-session risk reduction intervention targeted for youth living with HIV/AIDS (YLWH) in Kinshasa was adapted from the Healthy Living Project and guided by the Social Action Theory. This paper describes the process of implementing the first four steps of the ADAPT framework (Assess, Select, Prepare, and Pilot). Our study has shown that an EBI developed and implemented in the U.S. can be adapted successfully for a different target population in a low-resource context through an iterative process following the CDC ADAPT framework. This process included reviewing existing literature, adapting and adding components, and focusing on increasing staff capacity. This paper provides a rare, detailed description of the adaptation process and may aid organizations seeking to adapt and implement HIV prevention EBIs in sub-Saharan Africa and beyond.

  20. Measuring a hidden population: A novel technique to estimate the population size of women with sexual violence-related pregnancies in South Kivu Province, Democratic Republic of Congo.

    PubMed

    Johnston, Lisa G; McLaughlin, Katherine R; Rouhani, Shada A; Bartels, Susan A

    2017-03-01

    Successive sampling (SS)-population size estimation (PSE) is a technique used to estimate the sizes of hidden populations using data collected in respondent-driven sampling (RDS) surveys. We assess past estimations and use new data from an RDS survey to calculate a new PSE. In 2012, 852 adult women in South Kivu Province, Democratic Republic of Congo, who self-identified as survivors of sexual violence, resulting in a pregnancy, since the start of the war (in 1996) were sampled using RDS. We used imputed visibility, enrollment order, and prior estimates for PSE using SS-PSE in RDS Analyst. Prior estimates varied between Congolese local experts and researchers. We calculated the PSE of women with a sexual violence-related pregnancy in South Kivu using researchers' priors to be approximately 17,400. SS-PSE is an effective method for estimating the population sizes of hidden populations, useful for providing evidence for services and resource allocation. SS-PSE is beneficial because population sizes can be calculated after conducting the survey and do not rely on separate studies or additional data (as in network scale-up, multiplier, and capture-recapture methods).

  1. Adaptation of a U.S. evidence-based Positive Prevention intervention for youth living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

    PubMed Central

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

    2013-01-01

    Effective HIV prevention programs for people living with HIV/AIDS (PLWH) are important to reduce new infections and to ensure PLWH remain healthy. This paper describes the systematic adaptation of a U.S.-developed Evidence Based Intervention (EBI) using the Centers for Disease Control and Prevention (CDC) Map of Adaption Process for use at a Pediatric Hospital in Kinshasa, Democratic Republic of the Congo (DRC). The adapted intervention, Supporting Youth and Motivating Positive Action or SYMPA, a six-session risk reduction intervention targeted for youth living with HIV/AIDS (YLWH) in Kinshasa was adapted from the Healthy Living Project and guided by the Social Action Theory. This paper describes the process of implementing the first four steps of the ADAPT framework (Assess, Select, Prepare, and Pilot). Our study has shown that an EBI developed and implemented in the U.S. can be adapted successfully for a different target population in a low-resource context through an iterative process following the CDC ADAPT framework. This process included reviewing existing literature, adapting and adding components, and focusing on increasing staff capacity. This paper provides a rare, detailed description of the adaptation process and may aid organizations seeking to adapt and implement HIV prevention EBIs in sub-Saharan Africa and beyond. PMID:23063699

  2. Prenatal Maternal Stress Predicts Methylation of Genes Regulating the Hypothalamic-Pituitary-Adrenocortical System in Mothers and Newborns in the Democratic Republic of Congo.

    PubMed

    Kertes, Darlene A; Kamin, Hayley S; Hughes, David A; Rodney, Nicole C; Bhatt, Samarth; Mulligan, Connie J

    2016-01-01

    Exposure to stress early in life permanently shapes activity of the hypothalamic-pituitary-adrenocortical (HPA) axis and the brain. Prenatally, glucocorticoids pass through the placenta to the fetus with postnatal impacts on brain development, birth weight (BW), and HPA axis functioning. Little is known about the biological mechanisms by which prenatal stress affects postnatal functioning. This study addresses this gap by examining the effect of chronic stress and traumatic war-related stress on epigenetic changes in four key genes regulating the HPA axis in neonatal cord blood, placenta, and maternal blood: CRH, CRHBP, NR3C1, and FKBP5. Participants were 24 mother-newborn dyads in the conflict-ridden region of the eastern Democratic Republic of Congo. BW data were collected at delivery and maternal interviews were conducted to assess culturally relevant chronic and war-related stressors. Chronic stress and war trauma had widespread effects on HPA axis gene methylation, with significant effects observed at transcription factor binding (TFB) sites in all target genes tested. Some changes in methylation were unique to chronic or war stress, whereas others were observed across both stressor types. Moreover, stress exposures impacted maternal and fetal tissues differently, supporting theoretical models that stress impacts vary according to life phase. Methylation in several NR3C1 and CRH CpG sites, all located at TFB sites, was associated with BW. These findings suggest that prenatal stress exposure impacts development via epigenetic changes in HPA axis genes.

  3. Multistakeholder partnerships with the Democratic Peoples' Republic of Korea to improve childhood immunisation: A perspective from global health equity and political determinants of health equity.

    PubMed

    Kim, Hani; Marks, Florian; Novakovic, Uros; Hotez, Peter J; Black, Robert E

    2016-08-01

    To examine the current partnerships to improve the childhood immunisation programme in the Democratic Peoples' Republic of Korea (DPRK) in the context of the political determinants of health equity. A literature search was conducted to identify public health collaborations with the DPRK government. Based on the amount of publicly accessible data and a shared approach in health system strengthening among the partners in immunisation programmes, the search focused on these partnerships. The efforts by WHO, UNICEF, GAVI and IVI with the DPRK government improved the delivery of childhood vaccines (e.g. pentavalent vaccines, inactivated polio vaccine, two-dose measles vaccine and Japanese encephalitis vaccine) and strengthened the DPRK health system by equipping health centres, and training all levels of public health personnel for VPD surveillance and immunisation service delivery. The VPD-focused programmatic activities in the DPRK have improved the delivery of childhood immunisation and have created dialogue and contact with the people of the DPRK. These efforts are likely to ameliorate the political isolation of the people of the DPRK and potentially improve global health equity. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  4. Quantifying gas emissions from the “Millennium Eruption” of Paektu volcano, Democratic People’s Republic of Korea/China

    PubMed Central

    Iacovino, Kayla; Ju-Song, Kim; Sisson, Thomas; Lowenstern, Jacob; Kuk-Hun, Ri; Jong-Nam, Jang; Kun-Ho, Song; Song-Hwan, Ham; Oppenheimer, Clive; Hammond, James O. S.; Donovan, Amy; Liu, Kosima W.; Kum-Ran, Ryu

    2016-01-01

    Paektu volcano (Changbaishan) is a rhyolitic caldera that straddles the border between the Democratic People’s Republic of Korea and China. Its most recent large eruption was the Millennium Eruption (ME; 23 km3 dense rock equivalent) circa 946 CE, which resulted in the release of copious magmatic volatiles (H2O, CO2, sulfur, and halogens). Accurate quantification of volatile yield and composition is critical in assessing volcanogenic climate impacts but is challenging, particularly for events before the satellite era. We use a geochemical technique to quantify volatile composition and upper bounds to yields for the ME by examining trends in incompatible trace and volatile element concentrations in crystal-hosted melt inclusions. We estimate that the ME could have emitted as much as 45 Tg of S to the atmosphere. This is greater than the quantity of S released by the 1815 eruption of Tambora, which contributed to the “year without a summer.” Our maximum gas yield estimates place the ME among the strongest emitters of climate-forcing gases in the Common Era. However, ice cores from Greenland record only a relatively weak sulfate signal attributed to the ME. We suggest that other factors came into play in minimizing the glaciochemical signature. This paradoxical case in which high S emissions do not result in a strong glacial sulfate signal may present a way forward in building more generalized models for interpreting which volcanic eruptions have produced large climate impacts. PMID:28138521

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

    PubMed

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

    2015-04-01

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

  6. Child soldiers as zones of violence in The Democratic Republic of Congo: three cases of medico-legal evidence of torture.

    PubMed

    Guy, Kitwe Mulunda

    2009-01-01

    This article sets medico legal light on torture of three former child soldiers by comparing torture methods, consequences of torture and medical observations. It is focused on these child soldiers as representatives of the many abuses of children as soldiers in armed groups. The three persons were child soldiers during 12 years in The Democratic Republic of Congo (DRC) as members of three different armed groups. They were exposed to armed conflict events, experienced torture, and participated in atrocities, sexual abuse and traditional rituals during their role in armed conflict. They were psychologically distressed with unhealthy physical and mental states. The principles for working with child soldiers are described. The model addresses basic items: The confluence of the dimensions of the items will determine the specifics of medico legal evidence of torture in child soldiers, taking into consideration inputs that are required at the macro, community and individual levels. A primary goal is to prevent violence from occurring in child soldiers. Thus, much more deliberate effort is made to address the underlying causes of recruitment of children in armed groups in DRC and to invest more resources in conflict resolution before there is an outbreak of violence. Peace education tends to be introduced too late and does little to alleviate the use of children in armed conflict in DRC.

  7. Characterizing uncertainties of the national-scale forest gross aboveground biomass (AGB) loss estimate: a case study of the Democratic Republic of the Congo

    NASA Astrophysics Data System (ADS)

    Tyukavina, A.; Stehman, S.; Potapov, P.; Turubanova, S.; Baccini, A.; Goetz, S. J.; Laporte, N. T.; Houghton, R. A.; Hansen, M.

    2013-12-01

    Modern remote sensing techniques enable the mapping and monitoring of aboveground biomass (AGB) carbon stocks without relying on extensive in situ measurements. The Democratic Republic of the Congo (DRC) is among the countries where a national forest inventory (NFI) has yet to be established due to a lack of infrastructure and political instability. We demonstrate a method for producing national-scale gross AGB loss estimates and quantifying uncertainty of the estimates using remotely sensed-derived forest cover loss and biomass carbon density data. Forest cover type and loss were characterized using published Landsat-based data sets and related to LIDAR-derived biomass data from the Geoscience Laser Altimeter System (GLAS). We produced two gross AGB loss estimates for the DRC for the last decade (2000-2010): a conservative estimate accounting for classification errors in the 60-m resolution FACET forest cover change product, and a maximal estimate that also took into consideration omitted change at the 30m spatial resolution. Omitted disturbances were largely related to smallholder agriculture, the detection of which is scale-dependent. The use of LIDAR data as a substitute for NFI data to estimate AGB loss based on Landsat-derived activity data was demonstrated. Comparisons of our forest cover loss and AGB estimates with published studies raise the issue of scale in forest cover change mapping and its impact on carbon stock change estimation using remotely sensed data.

  8. 'There is fear but there is no other work': a preliminary qualitative exploration of the experience of sex workers in eastern Democratic Republic of Congo.

    PubMed

    Kiernan, Brendan; Mishori, Ranit; Masoda, Maurice

    2016-01-01

    Two decades of conflict and insecurity have had a devastating impact on many in the Democratic Republic of Congo (DRC), including marginalised groups such as sex workers. In the province of North Kivu, many residents face desperate conditions that render them vulnerable to exploitation and abuse. As a result, many turn to the sex trade in what can often be described as 'survival sex'. This small-scale qualitative study explores the experience of urban sex workers in the eastern region of the DRC. Sex workers were recruited at their place of business and asked to participate in a semi-structured interview. Eight participants were recruited, including seven women and one man. Our analysis identified several themes: (1) economic hardship as a catalyst for joining the sex trade, (2) significant work-related violence and (3) a paucity of available resources or assistance. Responses to specific prompts indicated that sex workers do not trust law enforcement and there are significant barriers to both medical care and local resources. Further studies of this vulnerable population and its needs are encouraged in order to develop programmes that provide the means to manage the hazards of their work and obtain an alternative source of income.

  9. Medical aid to the Spanish Republic during the Civil War (1936-1939).

    PubMed

    Shapiro, M F

    1982-07-01

    During international or civil wars, private citizens of noncombatant nations often provide medical aid to one or the contending factions. To examine the role of such an aid campaign in a military conflict, I did a detailed historical analysis of the prominent campaign in the United States to provide medical aid to the Republicans during the Spanish Civil War (1936 to 1939). Substantial medical aid was provided that clearly alleviated some suffering, but one of the major objectives of the campaign was to arouse public opinion sufficiently to end the boycott of aid to Republican forces by the American government; this objective was never achieved. I conclude that even a successful medical aid campaign to people in a military conflict may save some lives but may not affect substantially the course of the conflict. Persons who are primarily interested in influencing political or military developments may find tactics other than medical aid campaigns more useful in accomplishing their goals.

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

    PubMed

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

    2016-05-01

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

  11. Unity vs. Uniformity: The Influence of Ziya Gökalp and John Dewey on the Education System of the Republic of Turkey

    ERIC Educational Resources Information Center

    Celik, Rasit

    2014-01-01

    Creating a democratic nation-state and sustaining its progress was seen by the founders of the Republic of Turkey as necessary to achieving the goal of becoming a distinguished member among developed civilizations. The founders conceived of education as a main instrument in disseminating this new ideology and ensuring the emergence of a culture of…

  12. Preliminary assessment for the use of VORIS as a tool for rapid lava flow simulation at Goma Volcano Observatory, Democratic Republic of the Congo

    NASA Astrophysics Data System (ADS)

    Syavulisembo, A. M.; Havenith, H.-B.; Smets, B.; d'Oreye, N.; Marti, J.

    2015-10-01

    Assessment and management of volcanic risk are important scientific, economic, and political issues, especially in densely populated areas threatened by volcanoes. The Virunga volcanic province in the Democratic Republic of the Congo, with over 1 million inhabitants, has to cope permanently with the threat posed by the active Nyamulagira and Nyiragongo volcanoes. During the past century, Nyamulagira erupted at intervals of 1-4 years - mostly in the form of lava flows - at least 30 times. Its summit and flank eruptions lasted for periods of a few days up to more than 2 years, and produced lava flows sometimes reaching distances of over 20 km from the volcano. Though most of the lava flows did not reach urban areas, only impacting the forests of the endangered Virunga National Park, some of them related to distal flank eruptions affected villages and roads. In order to identify a useful tool for lava flow hazard assessment at Goma Volcano Observatory (GVO), we tested VORIS 2.0.1 (Felpeto et al., 2007), a freely available software (http://www.gvb-csic.es) based on a probabilistic model that considers topography as the main parameter controlling the lava flow propagation. We tested different parameters and digital elevation models (DEM) - SRTM1, SRTM3, and ASTER GDEM - to evaluate the sensitivity of the models to changes in input parameters of VORIS 2.0.1. Simulations were tested against the known lava flows and topography from the 2010 Nyamulagira eruption. The results obtained show that VORIS 2.0.1 is a quick, easy-to-use tool for simulating lava-flow eruptions and replicates to a high degree of accuracy the eruptions tested when input parameters are appropriately chosen. In practice, these results will be used by GVO to calibrate VORIS for lava flow path forecasting during new eruptions, hence contributing to a better volcanic crisis management.

  13. Prototype Positive Control Wells for Malaria Rapid Diagnostic Tests: Prospective Evaluation of Implementation Among Health Workers in Lao People's Democratic Republic and Uganda

    PubMed Central

    Bell, David; Bwanika, John Baptist; Cunningham, Jane; Gatton, Michelle; González, Iveth J.; Hopkins, Heidi; Kibira, Simon Peter S.; Kyabayinze, Daniel J.; Mayxay, Mayfong; Ndawula, Bbaale; Newton, Paul N.; Phommasone, Koukeo; Streat, Elizabeth; Umlauf, René

    2017-01-01

    Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis, but lack of quality control at point of care restricts trust in test results. Prototype positive control wells (PCW) containing recombinant malaria antigens have been developed to identify poor-quality RDT lots. This study assessed community and facility health workers' (HW) ability to use PCWs to detect degraded RDTs, the impact of PCW availability on RDT use and prescribing, and preferred strategies for implementation in Lao People's Democratic Republic (Laos) and Uganda. A total of 557 HWs participated in Laos (267) and Uganda (290). After training, most (88% to ≥ 99%) participants correctly performed the six key individual PCW steps; performance was generally maintained during the 6-month study period. Nearly all (97%) reported a correct action based on PCW use at routine work sites. In Uganda, where data for 127,775 individual patients were available, PCW introduction in health facilities was followed by a decrease in antimalarial prescribing for RDT-negative patients ≥ 5 years of age (4.7–1.9%); among community-based HWs, the decrease was 12.2% (P < 0.05) for all patients. Qualitative data revealed PCWs as a way to confirm RDT quality and restore confidence in RDT results. HWs in malaria-endemic areas are able to use prototype PCWs for quality control of malaria RDTs. PCW availability can improve HWs' confidence in RDT results, and benefit malaria diagnostic programs. Lessons learned from this study may be valuable for introduction of other point-of-care diagnostic and quality-control tools. Future work should evaluate longer term impacts of PCWs on patient management. PMID:27895267

  14. Vertical distribution of ammonia-oxidizing crenarchaeota and methanogens in the epipelagic waters of Lake Kivu (Rwanda-Democratic Republic of the Congo).

    PubMed

    Llirós, Marc; Gich, Frederic; Plasencia, Anna; Auguet, Jean-Christophe; Darchambeau, François; Casamayor, Emilio O; Descy, Jean-Pierre; Borrego, Carles

    2010-10-01

    Four stratified basins in Lake Kivu (Rwanda-Democratic Republic of the Congo) were sampled in March 2007 to investigate the abundance, distribution, and potential biogeochemical role of planktonic archaea. We used fluorescence in situ hybridization with catalyzed-reported deposition microscopic counts (CARD-FISH), denaturing gradient gel electrophoresis (DGGE) fingerprinting, and quantitative PCR (qPCR) of signature genes for ammonia-oxidizing archaea (16S rRNA for marine Crenarchaeota group 1.1a [MCG1] and ammonia monooxygenase subunit A [amoA]). Abundance of archaea ranged from 1 to 4.5% of total DAPI (4',6-diamidino-2-phenylindole) counts with maximal concentrations at the oxic-anoxic transition zone (∼50-m depth). Phylogenetic analysis of the archaeal planktonic community revealed a higher level of richness of crenarchaeal 16S rRNA gene sequences (21 of the 28 operational taxonomic units [OTUs] identified [75%]) over euryarchaeotal ones (7 OTUs). Sequences affiliated with the kingdom Euryarchaeota were mainly recovered from the anoxic water compartment and mostly grouped into methanogenic lineages (Methanosarcinales and Methanocellales). In turn, crenarchaeal phylotypes were recovered throughout the sampled epipelagic waters (0- to 100-m depth), with clear phylogenetic segregation along the transition from oxic to anoxic water masses. Thus, whereas in the anoxic hypolimnion crenarchaeotal OTUs were mainly assigned to the miscellaneous crenarchaeotic group, the OTUs from the oxic-anoxic transition and above belonged to Crenarchaeota groups 1.1a and 1.1b, two lineages containing most of the ammonia-oxidizing representatives known so far. The concomitant vertical distribution of both nitrite and nitrate maxima and the copy numbers of both MCG1 16S rRNA and amoA genes suggest the potential implication of Crenarchaeota in nitrification processes occurring in the epilimnetic waters of the lake.

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

    PubMed

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

    2017-01-01

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

  16. 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

  17. [University professors in the Soviet Occupation Zone and the German Democratic Republic up to 1961: Academic alternation of generations at university psychiatric hospitals].

    PubMed

    Kumbier, E; Haack, K

    2015-05-01

    After WWII a politically guided staffing policy foresaw an exchange program for professors from the Soviet Occupation Zone and the German Democratic Republic (GDR). In the field of medicine this initiative was not successful. With respect to university psychiatric/neurological hospitals this experiment failed as a result of a shortage of personnel due to the consequences of war, denazification and people migrating into western occupation zones. Criteria for politically selecting promising young talent which had been propagated by the Socialist Unity Party of Germany (Sozialistische Einheitspartei Deutschlands, SED) were thus not relevant in academic medicine until 1961; however, the communist rulers had great interest in bringing professional and academic resources up to date. Politically implicated representatives in the field were also included in this process. At the forefront was the interest in functioning medical care and education in order to be able to train much needed health professionals. At the end of the 1950s a new generation of professors was established at the university hospitals. This generation rotation demonstrated the politically intended replacement of the "old" professor generation and the transition to a new GDR generation that had been trained after 1945. This second generation of professors inherited vacant professorships and defined and shaped research and academia until the end of the GDR much more than the previous generation had and also more than the one that followed. The generation of professors continued to feel a strong affiliation with their academic teachers and consequently continued their tradition in the sense of a school, for the most part independent of political circumstances.

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

    PubMed Central

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

    2017-01-01

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

  19. Informal workers and access to healthcare: a qualitative study of facilitators and barriers to accessing healthcare for beer promoters in the Lao People's Democratic Republic.

    PubMed

    Sychareun, Vanphanom; Vongxay, Viengnakhone; Thammavongsa, Vassana; Thongmyxay, Souksamone; Phummavongsa, Phouthong; Durham, Jo

    2016-04-18

    Informal workers often face considerable risks and vulnerabilities as a consequence of their work and employment conditions. The purpose of this study was to examine the interplay between the experience of informal work and access to health, using as an example, female beer promoters employed in the informal economy, in the Lao People's Democratic Republic. In-depth interviews were undertaken with 24 female beer promoters working in beer shops, restaurants and entertainment venues in Vientiane City. The recruitment strategy of snowball sampling was used. Interviews explored the beer promoter's experience of the organization of work, perceived healthcare needs, access to healthcare and insurance, and health seeking practices. The data was analysed thematically and subsequently using Bourdieu's concepts of habitus, capital and field. Most of the beer promoters included in the study were 18 years of age, single, had worked as beer promoters for more than one year and just over half were working to support their higher education. The beer promoters demonstrated a holistic view of health, also viewing good health as contributing to being beautiful - an important attribute in their work. Many reported that their work conditions, including the noisy environment, exposure to second-hand tobacco smoke, long hours on their feet and sexual harassment negatively affected their physical and mental health. Only four participants had any form of health insurance with access to healthcare constrained by individual characteristics, health system factors and the conditions of their informal employment. Drawing on the work of Bourdieu, the study shows how both employment and illness are linked to habitus embodied in everyday practices, access to capital and the position the female beer promoters hold in the social hierarchy in the field of employment.

  20. 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

  1. Fluvial braidplain evolving into lagoonal environment in the coarse marginal facies of the lower buntsandstein relicts in saxony (German Democratic Republic)

    NASA Astrophysics Data System (ADS)

    Grunert, Siegfried

    The Lower Buntsandstein in Saxony (German Democratic Republic) is present in mainly isolated relicts in the Zeitz-Schmölln Syncline, the Borna Syncline and the Mügeln Basin where the Nordhausen-Folge and the lower part of the Bernburg-Folge are preserved. The separate occurrences are the remnants of a formerly continuous and extensive distribution of the Buntsandstein which was dissolved and split into pieces by erosion and tectonics. The Buntsandstein overlies the Zechstein; only in the eastern parts of the Mügeln Basin, the Triassic red beds lap on the crystalline basement. Palaeocurrents as revealed from cross-stratification and composition of the gravel-size clasts were directed towards the north and northwest. As most of the pebbles derived from provenance areas that are located some 10 - 30 km south of the occurrences, the Buntsandstein remnants in Saxony represent a marginal part of the basin, as also indicated by the coarse facies. Conglomerates were formed in highly- to moderately-braided river systems operating in braidplain belts or even alluvial-fan chains seaming the basement at the boundary of the depositional area. Towards the centre of the basin, the conglomerate train gives rapidly way to a sand flat in front of the braidplain belt or fan chain where the rivers are no longer capable to transport gravel-size material as a consequence of lowering of the palaeoslope gradient. Accumulation of sand by infilling of shallow watercourses and accretion of mud by plugging of overbank lakes and ponds take place at the margin of a lagoonal sea. The Buntsandstein onlapping on the crystalline basement buries a fossil block package in the granodiorite of the Meißen Massif which originated by weathering and pedogenesis in a semi-arid climate with alternating dry and wet periods. The temporarily brakish lagoonal sea is repeatedly refreshed by influx from braided rivers in the marginal parts that come from the continent.

  2. Anemia and Micronutrient Status of Women of Childbearing Age and Children 6-59 Months in the Democratic Republic of the Congo.

    PubMed

    Harvey-Leeson, Sarah; Karakochuk, Crystal D; Hawes, Meaghan; Tugirimana, Pierrot L; Bahizire, Esto; Akilimali, Pierre Z; Michaux, Kristina D; Lynd, Larry D; Whitfield, Kyly C; Moursi, Mourad; Boy, Erick; Foley, Jennifer; McLean, Judy; Houghton, Lisa A; Gibson, Rosalind S; Green, Tim J

    2016-02-17

    Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK) and Kongo Central (KC). We determined hemoglobin (Hb), serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR), retinol binding protein (RBP), C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC), children 6-23 months (26% vs. 59% in SK; 25% vs. 42% in KC), and children 24-59 months (14% vs. 35% in SK; 23% vs. 44% in KC), respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC), children 6-23 months (51% vs. 14% in SK; 74% vs. 10% in KC), and children 24-59 months (23% vs. 4% in SK; 58% vs. 1% in KC). Regardless of indicator, iron deficiency anemia (IDA) never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP) deficiencies were all very low (<5%); RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC), children 6-23 months (23% in SK; 20% in KC), and children 24-59 months (25% in SK; 27% in KC). The rate of biochemical zinc deficiency among Congolese women and children requires attention.

  3. 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.

  4. Simple markers for the detection of severe immunosuppression in children with HIV infection in highly resource-scarce settings: experience from the Democratic Republic of Congo

    PubMed Central

    Tshibassu, Pierre M.; Kayembe, Patrick K.; Kitetele, Faustin; Edidi, Samuel; Ekila, Mathilde B.; Wumba, Roger; Lepira, François B.; N. Aloni, Michel

    2015-01-01

    Objectives The decision to initiate the antiretroviral therapy in HIV-infected children living in poor countries is compromised by lack of resources. The objective of this study is to identify simple clinical and biological markers other than CD4+ count and viral load measurement that could help the decision to introduce antiretroviral treatment and to monitor patients. Methods A cross sectional study was conducted between January and March 2005 in Kinshasa, Democratic Republic of Congo. Results Eighty-four children infected with HIV were recruited. In this cohort, the lymphocytes (P = 0.001) and CD4 (P = 0.0001) were significantly lower in children with immunological stage 3 and viral load (P = 0.027) was significantly higher in children at the same immunological stage. Reticulocytes (r = +0.440), white blood cells count (r = +0.560), total lymphocytes (r = +0.675) and albumin (r = +0.381) showed positive significant correlations with CD4. Haemoglobin (r = − 0.372), Haematocrit (r = − 0.248), red blood cells (r = − 0.278) and CD4 (r = − 0.285) showed negative significant correlations with viral load. Neutropaenia (P = 0.02), enlarged nodes (P = 0.005) and oral candidiasis (P = 0.04) were associated with viral load >10 000 copies/ml. Oral candidiasis (P = 0.02) was associated with CD4 level < 15%. Conclusion Oral candidiasis, enlarged nodes, total lymphocytes count, neutropaenia and albumin predict severe immunodepression. These clinical and biological markers may guide the clinician in making the decision to initiate antiretroviral therapy in highly resource-scarce settings. PMID:26182826

  5. High prevalence of IgG antibodies to Ebola virus in the Efé pygmy population in the Watsa region, Democratic Republic of the Congo.

    PubMed

    Mulangu, Sabue; Borchert, Matthias; Paweska, Janusz; Tshomba, Antoine; Afounde, Afongenda; Kulidri, Amayo; Swanepoel, Robert; Muyembe-Tamfum, Jean-Jacques; Van der Stuyft, Patrick

    2016-06-10

    Factors related to the natural transmission of Ebola virus (EBOV) to humans are still not well defined. Results of previous sero-prevalence studies suggest that circulation of EBOV in human population is common in sub-Saharan Africa. The Efé pygmies living in Democratic Republic of the Congo are known to be exposed to potential risk factors of EBOV infection such as bush meat hunting, entry into caves, and contact with bats. We studied the pygmy population of Watsa region to determine seroprevalence to EBOV infection and possible risks factors. Volunteer participants (N = 300) aged 10 years or above were interviewed about behavior that may constitute risk factors for transmission of EBOV, including exposures to rats, bats, monkeys and entry into caves. Samples of venous blood were collected and tested for IgG antibody against EBOV by enzyme-linked immunosorbent assay (ELISA). The χ2-test and Fisher's exact test were used for the comparison of proportions and the Student's t-test to compare means. The association between age group and anti-EBOV IgG prevalence was analysed by a nonparametric test for trend. The prevalence of anti-EBOV IgG was 18.7 % overall and increased significantly with age (p = 0.023). No association was observed with exposure to risk factors (contacts with rats, bats, monkeys, or entry into caves). The seroprevalence of IgG antibody to EBOV in pygmies in Watsa region is among the highest ever reported, but it remains unclear which exposures might lead to this high infection rate calling for further ecological and behavioural studies.

  6. Economic, social and mental health impacts of an economic intervention for female sexual violence survivors in Eastern Democratic Republic of Congo.

    PubMed

    Bass, J; Murray, S; Cole, G; Bolton, P; Poulton, C; Robinette, K; Seban, J; Falb, K; Annan, J

    2016-01-01

    Conflict-affected communities face poverty and mental health problems, with sexual violence survivors at high risk for both given their trauma history and potential for exclusion from economic opportunity. To address these problems, we conducted a randomized controlled trial of a group-based economic intervention, Village Savings and Loans Associations (VSLA), for female sexual violence survivors in the Democratic Republic of Congo. In March 2011, 66 VSLA groups, with 301 study participants, were randomized to the VSLA program or a wait-control condition. Data were collected prior to randomization, at 2-months post-program in June 2012, and 8-months later for VSLA participants only. Outcome data included measures of economic and social functioning and mental health severity. VSLA program effect was derived by comparing intervention and control participants' mean changes from baseline to 2-month follow-up. At follow-up, VSLA study women reported significantly greater per capita food consumption and significantly greater reductions in stigma experiences compared with controls. No other study outcomes were statistically different. At 8-month follow-up, VSLA participants reported a continued increase in per capita food consumption, an increase in economic hours worked in the prior 7 days, and an increase in access to social resources. While female sexual violence survivors with elevated mental symptoms were successfully integrated into a community-based economic program, the immediate program impact was only seen for food consumption and experience of stigma. Impacts on mental health severity were not realized, suggesting that targeted mental health interventions may be needed to improve psychological well-being.

  7. Nuclear and chloroplast diversity and phenotypic distribution of rice (Oryza sativa L.) germplasm from the democratic people’s republic of Korea (DPRK; North Korea)

    PubMed Central

    2014-01-01

    Background Rice accounts for 43% of staple food production in the Democratic People’s Republic of Korea (DPRK). The most widely planted rice varieties were developed from a limited number of ancestral lines that were repeatedly used as parents in breeding programs. However, detailed pedigrees are not publicly available and little is known about the genetic, phenotypic, and geographical variation of DPRK varieties. Results We evaluated 80 O. sativa accessions from the DPRK, consisting of 67 improved varieties and 13 landraces. Based on nuclear SSR analysis, we divide the varieties into two genetic groups: Group 1 corresponds to the temperate japonica subpopulation and represents 78.75% of the accessions, while Group 2 shares recent ancestry with indica varieties. Interestingly, members of Group 1 are less diverse than Group 2 at the nuclear level, but are more diverse at the chloroplast level. All Group 2 varieties share a single Japonica maternal-haplotype, while Group 1 varieties trace maternal ancestry to both Japonica and Indica. Phenotypically, members of Group 1 have shorter grains than Group 2, and varieties from breeding programs have thicker and wider grains than landraces. Improved varieties in Group 1 also show similar and/or better levels of cold tolerance for most traits, except for spikelet number per panicle. Finally, geographic analysis demonstrates that the majority of genetic variation is located within regions that have the most intensive rice cultivation, including the Western territories near the capital city Pyungyang. This is consistent with the conscious and highly centralized role of human selection in determining local dispersion patterns of rice in the DPRK. Conclusions Diversity studies of DPRK rice germplasm revealed two genetic groups. The most widely planted group has a narrow genetic base and would benefit from the introduction of new genetic variation from cold tolerant landraces, wild accessions, and/or cultivated gene pools to

  8. [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.

  9. Anemia and Micronutrient Status of Women of Childbearing Age and Children 6–59 Months in the Democratic Republic of the Congo

    PubMed Central

    Harvey-Leeson, Sarah; Karakochuk, Crystal D.; Hawes, Meaghan; Tugirimana, Pierrot L.; Bahizire, Esto; Akilimali, Pierre Z.; Michaux, Kristina D.; Lynd, Larry D.; Whitfield, Kyly C.; Moursi, Mourad; Boy, Erick; Foley, Jennifer; McLean, Judy; Houghton, Lisa A.; Gibson, Rosalind S.; Green, Tim J.

    2016-01-01

    Little is known about the micronutrient status of women and children in the Democratic Republic of the Congo, which is critical for the design of effective nutrition interventions. We recruited 744 mother-child pairs from South Kivu (SK) and Kongo Central (KC). We determined hemoglobin (Hb), serum zinc, vitamin B12, folate, ferritin, soluble transferrin receptor (sTfR), retinol binding protein (RBP), C-reactive protein, and α-1 acid glycoprotein concentrations. Anemia prevalence was determined using Hb adjusted for altitude alone and Hb adjusted for both altitude and ethnicity. Anemia prevalence was lower after Hb adjustment for altitude and ethnicity, compared to only altitude, among women (6% vs. 17% in SK; 10% vs. 32% in KC), children 6–23 months (26% vs. 59% in SK; 25% vs. 42% in KC), and children 24–59 months (14% vs. 35% in SK; 23% vs. 44% in KC), respectively. Iron deficiency was seemingly higher with sTfR as compared to inflammation-adjusted ferritin among women (18% vs. 4% in SK; 21% vs. 5% in KC), children 6–23 months (51% vs. 14% in SK; 74% vs. 10% in KC), and children 24–59 months (23% vs. 4% in SK; 58% vs. 1% in KC). Regardless of indicator, iron deficiency anemia (IDA) never exceeded 3% in women. In children, IDA reached almost 20% when sTfR was used but was only 10% with ferritin. Folate, B12, and vitamin A (RBP) deficiencies were all very low (<5%); RBP was 10% in children. The prevalence of anemia was unexpectedly low. Inflammation-adjusted zinc deficiency was high among women (52% in SK; 58% in KC), children 6–23 months (23% in SK; 20% in KC), and children 24–59 months (25% in SK; 27% in KC). The rate of biochemical zinc deficiency among Congolese women and children requires attention. PMID:26901219

  10. External quality assessment of Giemsa-stained blood film microscopy for the diagnosis of malaria and sleeping sickness in the Democratic Republic of the Congo.

    PubMed

    Mukadi, Pierre; Gillet, Philippe; Lukuka, Albert; Atua, Benjamin; Sheshe, Nicole; Kanza, Albert; Mayunda, Jean Bosco; Mongita, Briston; Senga, Raphaël; Ngoyi, John; Muyembe, Jean-Jacques; Jacobs, Jan; Lejon, Veerle

    2013-06-01

    To report the findings of a second external quality assessment of Giemsa-stained blood film microscopy in the Democratic Republic of the Congo, performed one year after the first. A panel of four slides was delivered to diagnostic laboratories in all provinces of the country. The slides contained: (i) Plasmodium falciparum gametocytes; (ii) P. falciparum trophozoites (reference density: 113,530 per µl); (iii) Trypanosoma brucei subspecies; and (iv) no parasites. Of 356 laboratories contacted, 277 (77.8%) responded. Overall, 35.0% of the laboratories reported all four slides correctly but 14.1% reported correct results for 1 or 0 slides. Major errors included not diagnosing trypanosomiasis (50.4%), not recognizing P. falciparum gametocytes (17.5%) and diagnosing malaria from the slide with no parasites (19.0%). The frequency of serious errors in assessing parasite density and in reporting false-positive results was lower than in the previous external quality assessment: 17.2% and 52.3%, respectively, (P < 0.001) for parasite density and 19.0% and 33.3%, respectively, (P < 0.001) for false-positive results. Laboratories that participated in the previous quality assessment performed better than first-time participants and laboratories in provinces with a high number of sleeping sickness cases recognized trypanosomes more frequently (57.0% versus 31.2%, P < 0.001). Malaria rapid diagnostic tests were used by 44.3% of laboratories, almost double the proportion observed in the previous quality assessment. The overall quality of blood film microscopy was poor but was improved by participation in external quality assessments. The failure to recognize trypanosomes in a country where sleeping sickness is endemic is a concern.

  11. Forest cover dynamics of shifting cultivation in the Democratic Republic of Congo: a remote sensing-based assessment for 2000-2010

    NASA Astrophysics Data System (ADS)

    Molinario, G.; Hansen, M. C.; Potapov, P. V.

    2015-09-01

    Shifting cultivation has traditionally been practiced in the Democratic Republic of Congo by carving agricultural fields out of primary and secondary forest, resulting in the rural complex: a characteristic land cover mosaic of roads, villages, active and fallow fields and secondary forest. Forest clearing has varying impacts depending on where it occurs relative to this area: whether inside it, along its primary forest interface, or in more isolated primary forest areas. The spatial contextualization of forest cover loss is therefore necessary to understand its impacts and plan its management. We characterized forest clearing using spatial models in a Geographical Information System, applying morphological image processing to the Forets d’Afrique Central Evaluee par Teledetection product. This process allowed us to create forest fragmentation maps for 2000, 2005 and 2010, classifying previously homogenous primary forest into separate patch, edge, perforated, fragmented and core forest subtypes. Subsequently we used spatial rules to map the established rural complex separately from isolated forest perforations, tracking the growth of these areas in time. Results confirm that the expansion of the rural complex and forest perforations has high variance throughout the country, with consequent differences in local impacts on forest ecology and habitat fragmentation. Between 2000 and 2010 the rural complex grew by 10.2% (46 182 ha), increasing from 11.9% to 13.1% of the total land area (1.2% change) while perforated forest grew by 74.4% (23 856 ha), from 0.8% to 1.5%. Core forest decreased by 3.8% (54 852 ha), from 38% to 36.6% of the 2010 land area. Of particular concern is the nearly doubling of perforated forest, a land dynamic that represents greater spatial intrusion of forest clearing within core forest areas and a move away from the established rural complex.

  12. Field assessment of a novel household-based water filtration device: a randomised, placebo-controlled trial in the Democratic Republic of Congo.

    PubMed

    Boisson, Sophie; Kiyombo, Mbela; Sthreshley, Larry; Tumba, Saturnin; Makambo, Jacques; Clasen, Thomas

    2010-09-10

    Household water treatment can improve the microbiological quality of drinking water and may prevent diarrheal diseases. However, current methods of treating water at home have certain shortcomings, and there is evidence of bias in the reported health impact of the intervention in open trial designs. We undertook a randomised, double-blinded, placebo-controlled trial among 240 households (1,144 persons) in rural Democratic Republic of Congo to assess the field performance, use and effectiveness of a novel filtration device in preventing diarrhea. Households were followed up monthly for 12 months. Filters and placebos were monitored for longevity and for microbiological performance by comparing thermotolerant coliform (TTC) levels in influent and effluent water samples. Mean longitudinal prevalence of diarrhea was estimated among participants of all ages. Compliance was assessed through self-reported use and presence of water in the top vessel of the device at the time of visit. Over the 12-month follow-up period, data were collected for 11,236 person-weeks of observation (81.8% total possible). After adjusting for clustering within the household, the longitudinal prevalence ratio of diarrhoea was 0.85 (95% confidence interval: 0.61-1.20). The filters achieved a 2.98 log reduction in TTC levels while, for reasons that are unclear, the placebos achieved a 1.05 log reduction (p<0.0001). After 8 months, 68% of intervention households met the study's definition of current users, though most (73% of adults and 95% of children) also reported drinking untreated water the previous day. The filter maintained a constant flow rate over time, though 12.4% of filters were damaged during the course of the study. While the filter was effective in improving water quality, our results provide little evidence that it was protective against diarrhea. The moderate reduction observed nevertheless supports the need for larger studies that measure impact against a neutral placebo. Current

  13. A pilot study of a family focused, psychosocial intervention with war-exposed youth at risk of attack and abduction in north-eastern Democratic Republic of Congo.

    PubMed

    O'Callaghan, Paul; Branham, Lindsay; Shannon, Ciarán; Betancourt, Theresa S; Dempster, Martin; McMullen, John

    2014-07-01

    Rural communities in the Haut-Uele Province of northern Democratic Republic of Congo live in constant danger of attack and/or abduction by units of the Lord's Resistance Army operating in the region. This pilot study sought to develop and evaluate a community-participative psychosocial intervention involving life skills and relaxation training and Mobile Cinema screenings with this war-affected population living under current threat. 159 war-affected children and young people (aged 7-18) from the villages of Kiliwa and Li-May in north-eastern DR Congo took part in this study. In total, 22% of participants had been abduction previously while 73% had a family member abducted. Symptoms of post-traumatic stress reactions, internalising problems, conduct problems and pro-social behaviour were assessed by blinded interviewers at pre- and post-intervention and at 3-month follow-up. Participants were randomised (with an accompanying caregiver) to 8 sessions of a group-based, community-participative, psychosocial intervention (n=79) carried out by supervised local, lay facilitators or a wait-list control group (n=80). Average seminar attendance rates were high: 88% for participants and 84% for caregivers. Drop-out was low: 97% of participants were assessed at post-intervention and 88% at 3 month follow-up. At post-test, participants reported significantly fewer symptoms of post-traumatic stress reactions compared to controls (Cohen's d=0.40). At 3 month follow up, large improvements in internalising symptoms and moderate improvements in pro-social scores were reported, with caregivers noting a moderate to large decline in conduct problems among the young people. Trial Registration clinicalTrials.gov, Identifier: NCT01542398.

  14. Accumulation of toxic metals and organic micro-pollutants in sediments from tropical urban rivers, Kinshasa, Democratic Republic of the Congo.

    PubMed

    Kilunga, Pitchouna I; Sivalingam, Periyasamy; Laffite, Amandine; Grandjean, Dominique; Mulaji, Crispin K; de Alencastro, Luiz Felippe; Mpiana, Pius T; Poté, John

    2017-07-01

    The increasing contamination of fresh water resource by toxic metals and Persistence Organic Pollutants (POPs) is a major environmental concern globally. In the present investigation, surface sediments collected from three main rivers named, Makelele, Kalamu and Nsanga, draining through the city of Kinshasa, Democratic Republic of the Congo, were characterized for grain size, organic matter, toxic metals, POPs (including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs)), and polycyclic aromatic hydrocarbons (PAHs). Furthermore, enrichment factor (EF) and geoaccumulation index (Igeo) were performed to determine metal source and pollution status. The results highlighted high concentration of toxic metals in all sediment samples, reaching the values (mg kg(-1)) of 325 (Cu), 549 (Zn), 165 (Pb) and 1.5 (Cd). High values of PCBs and OCPs were detected in sediment samples, e.g. in Makelele river, PCB values ranged from 0.9 to 10.9 with total PCBs (∑7 PCBs × 4.3): 169.3 μg kg(-1); OCPs from 21.6 to 146.8 with ∑OCPs: 270.6 μg kg(-1). The PBDEs concentrations were higher in investigated rivers comparatively with values detected in many rivers from Sub-Saharan Africa. The ΣPAHs value ranged from 22.6 to 1011.9 μg kg(-1). River contamination may be explained by local intense domestic activities, urban and agricultural runoff, industrial and hospital wastewaters discharge into the rivers without prior treatment. This research provides not only a first baseline information on the extent of contamination in this tropical ecosystem but also represents useful tools incorporated to evaluate sediment quality in the river receiving systems which can be applied to similar aquatic environments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Transfer of rare earth elements from natural metalliferous (copper and cobalt rich) soils into plant shoot biomass of metallophytes from Katanga (Democratic Republic of Congo)

    NASA Astrophysics Data System (ADS)

    Pourret, Olivier; Lange, Bastien; Jitaru, Petru; Mahy, Grégory; Faucon, Michel-Pierre

    2014-05-01

    The geochemical behavior of rare earth elements (REE) is generally assessed for the characterization of the geological systems where these elements represent the best proxies of processes involving the occurrence of an interface between different media. REE behavior is investigated according to their concentrations normalized with respect to the upper continental crust. In this study, the geochemical fingerprint of REE in plant shoot biomass of an unique metallicolous flora (i.e., Crepidorhopalon tenuis and Anisopappus chinensis) was investigated. The plants originate from extremely copper and cobalt rich soils, deriving from Cu and Co outcrops in Katanga, Democratic Republic of Congo. Some of the species investigated in this study are able to accumulate high amounts of Cu and Co in shoot hence being considered as Cu and Co hyperaccumulators. Therefore, assessing the behavior of REE may lead to a better understanding of the mechanisms of metal accumulation by this flora. The data obtained in this study indicate that REE uptake by plants is not primarily controlled by their concentration and speciation in the soil as previously shown in the literature (Brioschi et al. 2013). Indeed, the REE patterns in shoots are relatively flat whereas soils patterns are Middle REE enriched. In addition, it is worth noting that Eu enrichments occur in aerial parts of the plants. These positive Eu anomalies suggest that Eu3 + can form stable organic complexes replacing Ca2 + in several biological processes as in xylem fluids associated with the general nutrient flux. Therefore, is is possible that the Eu mobility in these fluids is enhanced by its reductive speciation as Eu2 +. Eventually, the geochemical behavior of REE illustrates that metals accumulation in aerial parts of C. tenuis and A. chinensis is mainly driven by dissolved complexation. Brioschi, L., Steinmann, M., Lucot, E., Pierret, M., Stille, P., Prunier, J., Badot, P., 2013. Transfer of rare earth elements (REE) from

  16. 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

  17. Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo

    PubMed Central

    Phillips, Richard Odame; Phanzu, Delphin Mavinga; Beissner, Marcus; Badziklou, Kossi; Luzolo, Elysée Kalundieko; Sarfo, Fred Stephen; Halatoko, Wemboo Afiwa; Amoako, Yaw; Frimpong, Michael; Kabiru, Abass Mohammed; Piten, Ebekalisai; Maman, Issaka; Bidjada, Bawimodom; Koba, Adjaho; Awoussi, Koffi Somenou; Kobara, Basile; Nitschke, Jörg; Wiedemann, Franz Xaver; Kere, Abiba Banla; Adjei, Ohene; Löscher, Thomas; Fleischer, Bernhard; Bretzel, Gisela; Herbinger, Karl-Heinz

    2015-01-01

    Background The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guérin (BCG). Even though the BCG vaccine is still widely used, results on its effectiveness in preventing mycobacterial diseases are partially contradictory, especially regarding Buruli Ulcer Disease (BUD). The aim of this case-control study is to evaluate the possible protective effect of BCG vaccination on BUD. Methodology The present study was performed in three different countries and sites where BUD is endemic: in the Democratic Republic of the Congo, Ghana, and Togo from 2010 through 2013. The large study population was comprised of 401 cases with laboratory confirmed BUD and 826 controls, mostly family members or neighbors. Principal Findings After stratification by the three countries, two sexes and four age groups, no significant correlation was found between the presence of BCG scar and BUD status of individuals. Multivariate analysis has shown that the independent variables country (p = 0.31), sex (p = 0.24), age (p = 0.96), and presence of a BCG scar (p = 0.07) did not significantly influence the development of BUD category I or category II/III. Furthermore, the status of BCG vaccination was also not significantly related to duration of BUD or time to healing of lesions. Conclusions In our study, we did not observe significant evidence of a protective effect of routine BCG vaccination on the risk of developing either BUD or severe forms of BUD. Since accurate data on BCG strains used in these three countries were not available, no final conclusion can be drawn on the effectiveness of BCG strain in protecting against BUD. As has been suggested for tuberculosis and leprosy, well-designed prospective studies on different existing BCG vaccine strains are needed also for BUD. PMID:25569674

  18. Antenatal and delivery services in Kinshasa, Democratic Republic of Congo: care-seeking and experiences reported by women in a household-based survey.

    PubMed

    Feinstein, Lydia; Dimomfu, Bruno Lapika; Mupenda, Bavon; Duvall, Sandra; Chalachala, Jean Lambert; Edmonds, Andrew; Behets, Frieda

    2013-10-01

    Increasing coverage of quality reproductive health services, including prevention of mother-to-child transmission services, requires understanding where and how these services are provided. To inform scale-up, we conducted a population-based survey in Kinshasa, Democratic Republic of Congo. Stratified two-stage cluster sampling was used to select women ≥18 years old who had been pregnant within the prior three years. Participants were interviewed about their reproductive healthcare utilization and impressions of services received. We interviewed 1221 women, 98% of whom sought antenatal care (ANC). 78% of women began ANC after the first trimester and 22% reported <4 visits. Reasons for choosing an ANC facility included reputation (51%), friendly/accessible staff (39%), availability of comprehensive services (29%), medication access (26%), location (26%), and cost (21%). Most women reported satisfactory treatment by staff, but 47% reported that the ANC provider ignored their complaints, 23% had difficulty understanding responses to their questions, 22% wanted more time with the provider, 21% wanted more privacy, and 12% felt uncomfortable asking questions. Only 56% reported someone talked to them about HIV/AIDS. Strongest predictors of seeking inadequate ANC included low participant and partner education and lack of certain assets. Only 32% of women sought postnatal care. Some results varied by health zone. Scaling-up interventions to improve reproductive health services should include broad-based health systems strengthening and promote equitable access to quality ANC, delivery, and postnatal services. Personal and structural-level barriers to seeking ANC need to be addressed, with consideration given to local contexts. © 2013 John Wiley & Sons Ltd.

  19. Assessment of health service delivery capacities, health providers' knowledge and practices related to type 2 diabetes care in Kinshasa primary healthcare network facilities, Democratic Republic of the Congo.

    PubMed

    Kapongo, Remy Y; Lulebo, Aimée M; Mafuta, Eric M; Mutombo, Paulin B; Dimbelolo, Jean Claude M; Bieleli, Isidore E

    2015-01-22

    Democratic Republic of the Congo (DRC) is experiencing an increase in the morbi-mortality related to Non Communicable Diseases (NCD). The reform of DRC health system, based on Health District model, is needed in order to tackle this public issue. This article used 2006 International Diabetes Federation (IDF)'s guidelines to assess the capacities of health facilities belonging to Kinshasa Primary Health Care Network (KPHCN) in terms of equipments, as well as the knowledge, and the practice of their health providers related to type 2 diabetes care. A multicentric cross-sectional study was carried in 18 Health Facilities (HF) of KPHCN in charge of the follow-up of diabetic patients. The presence of IDF recommended materials and equipment was checked and 28 health providers were interviewed about their theoretical knowledge about patients' management and therapeutic objectives during recommended visits. Chi square test or Fisher exact test was used to compare proportions and the Student t-test to compare means. The integration of NCD healthcare in the KPHC network is feasible. The majority of HF possessed IDF recommended materials except for the clinical practice guidelines, urinary test strips, and monofilament, available in only one, two and four HF, respectively. KPHCN referral facilities had required materials for biochemical analyses, the ECG and for the fundus oculi test. Patients' management is characterized by a lack of attention on the impairment of renal function during the first visits and a poor respect of recommended practices during quarterly and annual visits. A poor knowledge of the reduction of cardiovascular risk factors-related therapeutic objectives has been also reported. The capacities, knowledge, and practice of T2D care were poor among HF of KPHCN. The lack of equipment and training of healthcare professionals should be supplied even to those who are not medical doctors. Special attention must to be put on the clinical practice guidelines

  20. TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo

    PubMed Central

    Kaboru, Berthollet Bwira; Ogwang, Brenda. A.; Namegabe, Edmond Ntabe; Mbasa, Ndemo; Kabunga, Deka Kambale; Karafuli, Kambale

    2013-01-01

    Background: HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods: A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results: Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion: HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region. PMID:24596866

  1. Obesity and diabetes mellitus association in rural community of Katana, South Kivu, in Eastern Democratic Republic of Congo: Bukavu Observ Cohort Study Results.

    PubMed

    Katchunga, Philippe Bianga; Cikomola, Justin; Tshongo, Christian; Baleke, Arsene; Kaishusha, David; Mirindi, Patrick; Tamburhe, Théodore; Kluyskens, Yves; Sadiki, Antoine; Bwanamudogo, Socrate; Kashongwe, Zacharie; Twagirumukiza, Marc

    2016-11-11

    Factual data exploring the relationship between obesity and diabetes mellitus prevalence from rural areas of sub-Saharan Africa remain scattered and are unreliable. To address this scarceness, this work reports population study data describing the relationship between the obesity and the diabetes mellitus in the general population of the rural area of Katana (South Kivu in the Democratic Republic of the Congo). A cohort of three thousand, nine hundred, and sixty-two (3962) adults (>15 years old) were followed between 2012 and 2015 (or 4105 person-years during the observation period), and data were collected using the locally adjusted World Health Organization's (WHO) STEPwise approach to Surveillance (STEPS) methodology. The hazard ratio for progression of obesity was calculated. The association between diabetes mellitus and obesity was analyzed with logistic regression. The diabetes mellitus prevalence was 2.8 % versus 3.5 % for obese participants and 7.2 % for those with metabolic syndrome, respectively. Within the diabetes group, 26.9 % had above-normal waist circumference and only 9.8 % were obese. During the median follow-up period of 2 years, the incidence of obesity was 535/100,000 person-years. During the follow-up, the prevalence of abdominal obesity significantly increased by 23 % (p <0.0001), whereas the increased prevalence of general obesity (7.8 %) was not significant (p = 0.53). Finally, diabetes mellitus was independently associated with age, waist circumference, and blood pressure but not body mass index. This study confirms an association between diabetes mellitus and abdominal obesity but not with general obesity. On the other hand, the rapid increase in abdominal obesity prevalence in this rural area population within the follow-up period calls for the urgent promoting of preventive lifestyle measures.

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

    PubMed

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

    2015-01-01

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

  3. Abducted children and youth in Lord's Resistance Army in Northeastern Democratic Republic of the Congo (DRC): mechanisms of indoctrination and control.

    PubMed

    Kelly, Jocelyn Td; Branham, Lindsay; Decker, Michele R

    2016-01-01

    Globally, an estimated 300,000 children under the age of 18 participate in combat situations; those in armed groups in particular suffer prolonged exposure to psychological and physical abuse. The Lord's Resistance Army (LRA) is a rebel movement known for its widespread conscription of children; yet little is known about this process once the group moved beyond northern Uganda. In this paper, we describe the processes related to abduction and indoctrination of youth by the LRA in northeastern Democratic Republic of the Congo ( DRC). In-depth interviews were conducted with formerly abducted children, their family members, community leaders, and service providers (total n = 34) in four communities in LRA-affected areas of northeastern DRC. Inductive coding of transcripts was undertaken to identify salient themes. Informants articulated a range of practices by the LRA to exert high levels of control over new recruits, including strict social isolation from recent abductees; control of communication; promoting new identity formation; and compelling children to act out strictly defined gendered roles. Witchcraft and secrecy are used to intimidate recruits and to magnify perception of the group's power. These methods promote de-identification with one's civilian and family life; and eventually the assimilation of a new language and identity. Indoctrination of newly abducted children into the LRA occurs via a complex system of control. This study provides one of the first detailed explorations of social and psychological mechanisms through which this is achieved, and focuses particularly on the gendered differences in the indoctrination process. Results support past findings that the LRA is a strategic and well-organized organization in its approach to enlisting child soldiers. Understanding some of the ways in which the LRA controls its recruits and the psychological impact of indoctrination enables reintegration programs to more effectively address these issues

  4. Vertical Distribution of Ammonia-Oxidizing Crenarchaeota and Methanogens in the Epipelagic Waters of Lake Kivu (Rwanda-Democratic Republic of the Congo)▿ †

    PubMed Central

    Llirós, Marc; Gich, Frederic; Plasencia, Anna; Auguet, Jean-Christophe; Darchambeau, François; Casamayor, Emilio O.; Descy, Jean-Pierre; Borrego, Carles

    2010-01-01

    Four stratified basins in Lake Kivu (Rwanda-Democratic Republic of the Congo) were sampled in March 2007 to investigate the abundance, distribution, and potential biogeochemical role of planktonic archaea. We used fluorescence in situ hybridization with catalyzed-reported deposition microscopic counts (CARD-FISH), denaturing gradient gel electrophoresis (DGGE) fingerprinting, and quantitative PCR (qPCR) of signature genes for ammonia-oxidizing archaea (16S rRNA for marine Crenarchaeota group 1.1a [MCG1] and ammonia monooxygenase subunit A [amoA]). Abundance of archaea ranged from 1 to 4.5% of total DAPI (4′,6-diamidino-2-phenylindole) counts with maximal concentrations at the oxic-anoxic transition zone (∼50-m depth). Phylogenetic analysis of the archaeal planktonic community revealed a higher level of richness of crenarchaeal 16S rRNA gene sequences (21 of the 28 operational taxonomic units [OTUs] identified [75%]) over euryarchaeotal ones (7 OTUs). Sequences affiliated with the kingdom Euryarchaeota were mainly recovered from the anoxic water compartment and mostly grouped into methanogenic lineages (Methanosarcinales and Methanocellales). In turn, crenarchaeal phylotypes were recovered throughout the sampled epipelagic waters (0- to 100-m depth), with clear phylogenetic segregation along the transition from oxic to anoxic water masses. Thus, whereas in the anoxic hypolimnion crenarchaeotal OTUs were mainly assigned to the miscellaneous crenarchaeotic group, the OTUs from the oxic-anoxic transition and above belonged to Crenarchaeota groups 1.1a and 1.1b, two lineages containing most of the ammonia-oxidizing representatives known so far. The concomitant vertical distribution of both nitrite and nitrate maxima and the copy numbers of both MCG1 16S rRNA and amoA genes suggest the potential implication of Crenarchaeota in nitrification processes occurring in the epilimnetic waters of the lake. PMID:20802065

  5. Geochemical and oxygen isotope signatures of mantle corundum megacrysts from the Mbuji-Mayi kimberlite, Democratic Republic of Congo, and the Changle alkali basalt, China

    NASA Astrophysics Data System (ADS)

    Giuliani, Gaston; Pivin, Marjorie; Fallick, Anthony E.; Ohnenstetter, Daniel; Song, Yucai; Demaiffe, Daniel

    2015-01-01

    Oxygen isotope signatures of ruby and sapphire megacrysts, combined with trace-element analysis, from the Mbuji-Mayi kimberlite, Democratic Republic of Congo, and the Changle alkali basalt, China, provide clues to specify their origin in the deep Earth. At Mbuji-Mayi, pink sapphires have δ18O values in the range 4.3 to 5.4‰ (N = 10) with a mean of 4.9 ± 0.4‰, and rubies from 5.5 to 5.6‰ (N = 3). The Ga/Mg ratio of pink sapphires is between 1.9 and 3.9, and in rubies, between 0.6 and 2.6. The blue or yellow sapphires from Changle have δ18O values from 4.6 to 5.2 ‰, with a mean of 4.9 ± 0.2‰ (N = 9). The Ga/Mg ratio is between 5.7 and 11.3. The homogenous isotopic composition of ruby suggests a derivation from upper mantle xenoliths (garnet lherzolite, pyroxenite) or metagabbros and/or lower crustal garnet clinopyroxenite eclogite-type xenoliths included in kimberlites. Data from the pink sapphires from Mbuji-Mayi suggest a mantle origin, but different probable protoliths: either subducted oceanic protolith transformed into eclogite with δ18O values buffered to the mantle value, or clinopyroxenite protoliths in peridotite. The Changle sapphires have a mantle O-isotope signature. They probably formed in syenitic magmas produced by low degree partial melting of a spinel lherzolite source. The kimberlite and the alkali basalt acted as gem conveyors from the upper mantle up to the surface.

  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.

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

    PubMed

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

    2015-01-01

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

  8. Prototype Positive Control Wells for Malaria Rapid Diagnostic Tests: Prospective Evaluation of Implementation Among Health Workers in Lao People's Democratic Republic and Uganda.

    PubMed

    Bell, David; Bwanika, John Baptist; Cunningham, Jane; Gatton, Michelle; González, Iveth J; Hopkins, Heidi; Kibira, Simon Peter S; Kyabayinze, Daniel J; Mayxay, Mayfong; Ndawula, Bbaale; Newton, Paul N; Phommasone, Koukeo; Streat, Elizabeth; Umlauf, René

    2017-02-08

    Rapid diagnostic tests (RDTs) are widely used for malaria diagnosis, but lack of quality control at point of care restricts trust in test results. Prototype positive control wells (PCW) containing recombinant malaria antigens have been developed to identify poor-quality RDT lots. This study assessed community and facility health workers' (HW) ability to use PCWs to detect degraded RDTs, the impact of PCW availability on RDT use and prescribing, and preferred strategies for implementation in Lao People's Democratic Republic (Laos) and Uganda. A total of 557 HWs participated in Laos (267) and Uganda (290). After training, most (88% to ≥ 99%) participants correctly performed the six key individual PCW steps; performance was generally maintained during the 6-month study period. Nearly all (97%) reported a correct action based on PCW use at routine work sites. In Uganda, where data for 127,775 individual patients were available, PCW introduction in health facilities was followed by a decrease in antimalarial prescribing for RDT-negative patients ≥ 5 years of age (4.7-1.9%); among community-based HWs, the decrease was 12.2% (P < 0.05) for all patients. Qualitative data revealed PCWs as a way to confirm RDT quality and restore confidence in RDT results. HWs in malaria-endemic areas are able to use prototype PCWs for quality control of malaria RDTs. PCW availability can improve HWs' confidence in RDT results, and benefit malaria diagnostic programs. Lessons learned from this study may be valuable for introduction of other point-of-care diagnostic and quality-control tools. Future work should evaluate longer term impacts of PCWs on patient management. © The American Society of Tropical Medicine and Hygiene.

  9. Nuclear and chloroplast diversity and phenotypic distribution of rice (Oryza sativa L.) germplasm from the democratic people's republic of Korea (DPRK; North Korea).

    PubMed

    Kim, HyunJung; Jeong, Eung Gi; Ahn, Sang-Nag; Doyle, Jeffrey; Singh, Namrata; Greenberg, Anthony J; Won, Yong Jae; McCouch, Susan R

    2014-01-01

    Rice accounts for 43% of staple food production in the Democratic People's Republic of Korea (DPRK). The most widely planted rice varieties were developed from a limited number of ancestral lines that were repeatedly used as parents in breeding programs. However, detailed pedigrees are not publicly available and little is known about the genetic, phenotypic, and geographical variation of DPRK varieties. We evaluated 80 O. sativa accessions from the DPRK, consisting of 67 improved varieties and 13 landraces. Based on nuclear SSR analysis, we divide the varieties into two genetic groups: Group 1 corresponds to the temperate japonica subpopulation and represents 78.75% of the accessions, while Group 2 shares recent ancestry with indica varieties. Interestingly, members of Group 1 are less diverse than Group 2 at the nuclear level, but are more diverse at the chloroplast level. All Group 2 varieties share a single Japonica maternal-haplotype, while Group 1 varieties trace maternal ancestry to both Japonica and Indica. Phenotypically, members of Group 1 have shorter grains than Group 2, and varieties from breeding programs have thicker and wider grains than landraces. Improved varieties in Group 1 also show similar and/or better levels of cold tolerance for most traits, except for spikelet number per panicle. Finally, geographic analysis demonstrates that the majority of genetic variation is located within regions that have the most intensive rice cultivation, including the Western territories near the capital city Pyungyang. This is consistent with the conscious and highly centralized role of human selection in determining local dispersion patterns of rice in the DPRK. Diversity studies of DPRK rice germplasm revealed two genetic groups. The most widely planted group has a narrow genetic base and would benefit from the introduction of new genetic variation from cold tolerant landraces, wild accessions, and/or cultivated gene pools to enhance yield potential and

  10. Is maternal education a social vaccine for childhood malaria infection? A cross-sectional study from war-torn Democratic Republic of Congo.

    PubMed

    Ma, Cary; Claude, Kasereka Masumbuko; Kibendelwa, Zacharie Tsongo; Brooks, Hannah; Zheng, Xiaonan; Hawkes, Michael

    2017-03-01

    In zones of violent conflict in the tropics, social disruption leads to elevated child mortality, of which malaria is the leading cause. Understanding the social determinants of malaria transmission may be helpful to optimize malaria control efforts. We conducted a cross-sectional study of healthy children aged 2 months to 5 years attending well-child and/or immunization visits in the Democratic Republic of Congo (DRC). Six hundred and forty-seven children were tested for malaria antigenemia by rapid diagnostic test and the accompanying parent or legal guardian simultaneously completed a survey questionnaire related to demographics, socioeconomic status, maternal education, as well as bednet use and recent febrile illness. We examined the associations between variables using multivariable logistic regression analysis, chi-squared statistic, Fisher's exact test, and Spearman's rank correlation, as appropriate. One hundred and twenty-three out of the 647 (19%) children in the study tested positive for malaria. Higher levels of maternal education were associated with a lower risk of malaria in their children. The prevalence of malaria in children of mothers with no education, primary school, and beyond primary was 41/138 (30%), 41/241 (17%), and 39/262 (15%), respectively (p = 0.001). In a multivariable logistic regression model adjusting for the effect of a child's age and study site, the following remained significant predictors of malaria antigenemia: maternal education, number of children under five per household, and HIV serostatus. Higher maternal education, through several putative causal pathways, was associated with lower malaria prevalence among children in the DRC. Our findings suggest that maternal education might be an effective 'social vaccine' against malaria in the DRC and globally.

  11. Species protection, the changing informal economy, and the politics of access to the bushmeat trade in the Democratic Republic of Congo.

    PubMed

    De Merode, Emmanuel; Cowlishaw, Guy

    2006-08-01

    Our understanding of the linkages between the bushmeat trade and the wider informal economy is limited. This lack of knowledge is particularly problematic for conservation under conditions of political instability, when the informal economy can be highly dynamic and impacts on wildlife populations can be severe. To explore these interlinked processes, we conducted a study of the bushmeat trade in Garamba National Park, Democratic Republic of Congo, through a combination of market surveys, semistructured interviews, and direct observation. We focused on the sale of protected and unprotected species in urban and rural markets, and the bushmeat commodity chains that supplied these markets, under conditions of political stability and armed conflict. During peacetime, protected species from the park (predominantly elephant and buffalo) rarely appeared in the rural markets, but they comprised more than half of all bushmeat sales in the urban markets. This pattern reflected differences in the rural and urban commodity chains. Automatic weapons were urban trade. The use of such weapons was discouraged by the traditional chiefs, who administered the village markets. During wartime, the sales of protected species in the urban markets increased fivefold because the military officers fled, leaving behind an open-access system that led to a massive increase in the exploitation of protected species. In contrast, the rural markets remained relatively stable because of the continued authority of the village chiefs. Our results indicate that sociopolitical factors can be an important determinant of species offtake and, therefore, that knowledge of the bushmeat commodity chain can be vital to controlling theprocesses that drive species extraction. In addition, our findings suggest that traditional authorities can be potentially valuable partners for bushmeat management.

  12. One Size Fits All? Standardised Provision of Care for Survivors of Sexual Violence in Conflict and Post-Conflict Areas in the Democratic Republic of Congo

    PubMed Central

    Au, Sokhieng; De Plecker, Eva; Zachariah, Rony; Manzi, Marcel; Lambert, Vincent; Abi-Aad, Elias; Nanan-N’Zeth, Kassi; Nzuya, Serge; Omba, Brigitte; Shako, Charly; MuishaBaroki, Derick; Basimuoneye, Jean Paul; Moke, Didier Amudiandroy; Lampaert, Emmanuel; Masangu, Lucien; De Weggheleire, Anja

    2014-01-01

    Background Outcomes of sexual violence care programmes may vary according to the profile of survivors, type of violence suffered, and local context. Analysis of existing sexual violence care services could lead to their better adaptation to the local contexts. We therefore set out to compare the Médecins Sans Frontières sexual violence programmes in the Democratic Republic of Congo (DRC) in a zone of conflict (Masisi, North Kivu) and post-conflict (Niangara, Haut-Uélé). Methods A retrospective descriptive cohort study, using routine programmatic data from the MSF sexual violence programmes in Masisi and Niangara, DRC, for 2012. Results In Masisi, 491 survivors of sexual violence presented for care, compared to 180 in Niangara. Niangara saw predominantly sexual violence perpetrated by civilians who were known to the victim (48%) and directed against children and adolescents (median age 15 (IQR 13–17)), while sexual violence in Masisi was more directed towards adults (median age 26 (IQR 20–35)), and was characterised by marked brutality, with higher levels of gang rape, weapon use, and associated violence; perpetrated by the military (51%). Only 60% of the patients in Masisi and 32% of those in Niangara arrived for a consultation within the critical timeframe of 72 hours, when prophylaxis for HIV and sexually transmitted infections is most effective. Survivors were predominantly referred through community programmes. Treatment at first contact was typically efficient, with high (>95%) coverage rates of prophylaxes. However, follow-up was poor, with only 49% of all patients in Masisi and 61% in Niangara returning for follow-up, and consequently low rates of treatment and/or vaccination completion. Conclusion This study has identified a number of weak and strong points in the sexual violence programmes of differing contexts, indicating gaps which need to be addressed, and strengths of both programmes that may contribute to future models of context

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

    PubMed Central

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

    2015-01-01

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

  14. Repeated stool sampling and use of multiple techniques enhance the sensitivity of helminth diagnosis: a cross-sectional survey in southern Lao People's Democratic Republic.

    PubMed

    Sayasone, Somphou; Utzinger, Jürg; Akkhavong, Kongsap; Odermatt, Peter

    2015-01-01

    Intestinal parasitic infections are common in Lao People's Democratic Republic (Lao PDR). We investigated the accuracy of the Kato-Katz (KK) technique in relation to varying stool sampling efforts, and determined the effect of the concurrent use of a quantitative formalin-ethyl acetate concentration technique (FECT) for helminth diagnosis and appraisal of concomitant infections. The study was carried out between March and May 2006 in Champasack province, southern Lao PDR. Overall, 485 individuals aged ≥6 months who provided three stool samples were included in the final analysis. All stool samples were subjected to the KK technique. Additionally, one stool sample per individual was processed by FECT. Diagnosis was done under a light microscope by experienced laboratory technicians. Analysis of three stool samples with KK plus a single FECT was considered as diagnostic 'gold' standard and resulted in prevalence estimates of hookworm, Opisthorchis viverrini, Ascaris lumbricoides, Trichuris trichiura and Schistosoma mekongi infection of 77.9%, 65.0%, 33.4%, 26.2% and 24.3%, respectively. As expected, a single KK and a single FECT missed a considerable number of infections. While our diagnostic 'gold' standard produced similar results than those obtained by a mathematical model for most helminth infections, the 'true' prevalence predicted by the model for S. mekongi (28.1%) was somewhat higher than after multiple KK plus a single FECT (24.3%). In the current setting, triplicate KK plus a single FECT diagnosed helminth infections with high sensitivity. Hence, such a diagnostic approach might be utilised for generating high-quality baseline data, assessing anthelminthic drug efficacy and rigorous monitoring of community interventions. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Effect of daily versus weekly home fortification with multiple micronutrient powder on haemoglobin concentration of young children in a rural area, Lao People's Democratic Republic: a randomised trial

    PubMed Central

    2011-01-01

    Background Multiple micronutrient deficiencies, in particular iron deficiency anaemia (IDA) is a severe public health problem in Lao People's Democratic Republic (Lao PDR). Because of the practical difficulties encountered in improving the nutritional adequacy of traditional complementary foods and the limitations associated with the use of liquid iron supplementation for the treatment and prevention of IDA in infants and young children, recently, home-fortification with multivitamins and minerals sprinkles was recommended. This study aims to compare the effect of twice weekly versus daily supplementation with multivitamins and minerals powder (MMP) on anaemia prevalence, haemoglobin concentration, and growth in infants and young children in a rural community in Lao PDR. Methods A randomized trial was conducted in six rural communities. Children aged 6 to 52 months (n = 336) were randomly assigned to a control group (n = 110) or to one of two intervention groups receiving either two sachets per week (n = 115) or a daily sachet (n = 111) of MMP for 24 weeks; 331 children completed the study. A finger prick of blood was taken at baseline, at week 12, and again at week 24 to determine haemoglobin concentration. Anthropometric measurements were taken every 4 weeks. The McNemar test was used to assess within group differences at three time points in the study subjects with anaemia and one-way ANOVA was used to assess changes in mean haemoglobin concentration in the treatment groups. Results MMP supplementation resulted in significant improvements in haemoglobin concentration and in the reduction of anaemia prevalence in the two treatment groups compared with the control group (p <0.001). The severely to moderately anaemic children (Hb <100 g/L) on daily supplementation recovered faster than those on twice weekly supplementation. MMP was well accepted and compliance was high in both treatment groups. Overall, the improvement in the weight for age Z-score was very small

  16. Multiparasitism and intensity of helminth infections in relation to symptoms and nutritional status among children: a cross-sectional study in southern Lao People's Democratic Republic.

    PubMed

    Sayasone, Somphou; Utzinger, Jürg; Akkhavong, Kongsap; Odermatt, Peter

    2015-01-01

    The occurrence and spatial distribution of intestinal helminth infection in children is fairly well understood. However, knowledge on how helminth infections govern intestinal morbidity is scarce. We conducted a cross-sectional study to assess and quantify the relationship between single and multiple species helminth infection with clinical and self-reported morbidity indicators and nutritional status in Champasack province, southern Lao People's Democratic Republic (Lao PDR). A random sample of 1313 children, aged 6 months to 12 years, from villages in nine rural districts were enrolled and examined for helminth infection using duplicate Kato-Katz thick smears. Morbidity was assessed by self-reported symptoms, coupled with clinical examination and appraisal of nutritional status and anaemia. Bivariate and multivariate logistic regression was employed to study associations between helminth infection and morbidity indicators and anaemia. We found considerable morbidity among the surveyed children, including hepatomegaly (13.7%), pale conjunctiva (13.2%) and abdominal pain (10.4%). Anaemia was recorded in 60.4% of the children, whilst signs of stunting and low body mass index (BMI) were observed in 49.8% and 33.3% of the surveyed children, respectively. Hookworm and Opisthorchis viverrini were the predominant helminth species with prevalences of 51.0% and 43.3%, respectively. The prevalence of Schistosoma mekongi in the surveyed children was 5.6%. Multiple species helminth infections were recorded in 40.4% of the study cohort. Morbidity was associated with specific helminth species infection (e.g. S. mekongi with hepatomegaly; adjusted odds ratio (aOR): 9.49, 95% confidence interval (CI): 2.07-43.51) and multiparasitism (e.g. two or more helminth species with abdominal pain; aOR: 2.40, 95% CI: 1.46-3.93). Anaemia was associated with hookworm infection (aOR: 1.64, 95% CI: 1.16-2.34) and multiparasitism (aOR: 1.64, 95% CI: 1.18-2.29). Low BMI was associated with O

  17. Initiating NTD programs targeting schistosomiasis and soil-transmitted helminthiasis in two provinces of the Democratic Republic of the Congo: Establishment of baseline prevalence for mass drug administration.

    PubMed

    Kabore, Achille; Ibikounle, Moudachirou; Tougoue, Jean Jacques; Mupoyi, Sylvain; Ndombe, Martin; Shannon, Scott; Ottesen, Eric A; Mukunda, Faustin; Awaca, Naomi

    2017-02-01

    Schistosomiasis (SCH) and soil-transmitted helminthiasis (STH) are widely distributed in the Democratic Republic of the Congo (DRC) and constitute a serious public health problem. As recommended by the World Health Organization (WHO), before launching mass chemotherapy to control these diseases, parasitological surveys were conducted in sentinel sites in six health zones (HZs) in Bandundu and Maniema provinces. Baseline prevalence and intensity of infection for SCH and STH were determined to establish the appropriate treatment plan using Praziquantel (PZQ) and Albendazole (ALB). Parasitological surveys were conducted from April to May 2015 in twenty-six selected sampling units (schools) for baseline mapping in six HZs: Fifty school children (25 females and 25 males) aged 9-15 years were randomly selected per sampling unit. A total of 1300 samples (urine and stool) were examined using haematuria dipsticks, parasite-egg filtration and the point-of-care Circulating Cathodic Antigen (POC-CCA) assay for urine samples and the Kato-Katz technique for stool specimens. Three species of schistosomes (S. mansoni, S. haematobium and S. intercalatum) and three groups of STH (hookworm, Ascaris and Trichuris) were detected at variable prevalence and intensity among the schools, the HZs and the provinces. In Bandundu, no SCH was detected by either Kato-Katz or the POC-CCA technique, despite a high prevalence of STH with 68% and 80% at Kiri and Pendjua HZs, respectively. In Maniema, intestinal schistosomiasis was detected by both Kato-Katz and POC-CCA with an average prevalence by Kato-Katz of 32.8% and by POC-CCA of 42.1%. Comparative studies confirmed the greater sensitivity (and operational feasibility) of the POC-CCA test on urine compared to Kato-Katz examination of stool for diagnosing intestinal schistosomiasis even in areas of comparatively light infections. STH was widely distributed and present in all HZs with a mean prevalence (95% CI) of 59.62% (46.00-65.00%). The

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

    NASA Astrophysics Data System (ADS)

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

    2005-07-01

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

  19. Spread of yellow fever virus outbreak in Angola and the Democratic Republic of the Congo 2015-16: a modelling study.

    PubMed

    Kraemer, Moritz U G; Faria, Nuno R; Reiner, Robert C; Golding, Nick; Nikolay, Birgit; Stasse, Stephanie; Johansson, Michael A; Salje, Henrik; Faye, Ousmane; Wint, G R William; Niedrig, Matthias; Shearer, Freya M; Hill, Sarah C; Thompson, Robin N; Bisanzio, Donal; Taveira, Nuno; Nax, Heinrich H; Pradelski, Bary S R; Nsoesie, Elaine O; Murphy, Nicholas R; Bogoch, Isaac I; Khan, Kamran; Brownstein, John S; Tatem, Andrew J; de Oliveira, Tulio; Smith, David L; Sall, Amadou A; Pybus, Oliver G; Hay, Simon I; Cauchemez, Simon

    2017-03-01

    Since late 2015, an epidemic of yellow fever has caused more than 7334 suspected cases in Angola and the Democratic Republic of the Congo, including 393 deaths. We sought to understand the spatial spread of this outbreak to optimise the use of the limited available vaccine stock. We jointly analysed datasets describing the epidemic of yellow fever, vector suitability, human demography, and mobility in central Africa to understand and predict the spread of yellow fever virus. We used a standard logistic model to infer the district-specific yellow fever virus infection risk during the course of the epidemic in the region. The early spread of yellow fever virus was characterised by fast exponential growth (doubling time of 5-7 days) and fast spatial expansion (49 districts reported cases after only 3 months) from Luanda, the capital of Angola. Early invasion was positively correlated with high population density (Pearson's r 0·52, 95% CI 0·34-0·66). The further away locations were from Luanda, the later the date of invasion (Pearson's r 0·60, 95% CI 0·52-0·66). In a Cox model, we noted that districts with higher population densities also had higher risks of sustained transmission (the hazard ratio for cases ceasing was 0·74, 95% CI 0·13-0·92 per log-unit increase in the population size of a district). A model that captured human mobility and vector suitability successfully discriminated districts with high risk of invasion from others with a lower risk (area under the curve 0·94, 95% CI 0·92-0·97). If at the start of the epidemic, sufficient vaccines had been available to target 50 out of 313 districts in the area, our model would have correctly identified 27 (84%) of the 32 districts that were eventually affected. Our findings show the contributions of ecological and demographic factors to the ongoing spread of the yellow fever outbreak and provide estimates of the areas that could be prioritised for vaccination, although other constraints such as vaccine

  20. Lymphatic filariasis in the Democratic Republic of Congo; micro-stratification overlap mapping (MOM) as a prerequisite for control and surveillance.

    PubMed

    Kelly-Hope, Louise A; Thomas, Brent C; Bockarie, Moses J; Molyneux, David H

    2011-09-18

    The Democratic Republic of Congo (DRC) has a significant burden of lymphatic filariasis (LF) caused by the parasite Wuchereria bancrofti. A major impediment to the expansion of the LF elimination programme is the risk of serious adverse events (SAEs) associated with the use of ivermectin in areas co-endemic for onchocerciasis and loiasis. It is important to analyse these and other factors, such as soil transmitted helminths (STH) and malaria co-endemicity, which will impact on LF elimination. We analysed maps of onchocerciasis community-directed treatment with ivermectin (CDTi) from the African Programme for Onchocerciasis Control (APOC); maps of predicted prevalence of Loa loa; planned STH control maps of albendazole (and mebendazole) from the Global Atlas of Helminth Infections (GAHI); and bed nets and insecticide treated nets (ITNs) distribution from Demographic and Health Surveys (DHS) as well as published historic data which were incorporated into overlay maps. We developed an approach we designate as micro-stratification overlap mapping (MOM) to identify areas that will assist the implementation of LF elimination in the DRC. The historic data on LF was found through an extensive review of the literature as no recently published information was available. This paper identifies an approach that takes account of the various factors that will influence not only country strategies, but suggests that country plans will require a finer resolution mapping than usual, before implementation of LF activities can be efficiently deployed. This is because 1) distribution of ivermectin through APOC projects will already have had an impact of LF intensity and prevalence 2) DRC has been up scaling bed net distribution which will impact over time on transmission of W. bancrofti and 3) recently available predictive maps of L. loa allow higher risk areas to be identified, which allow LF implementation to be initiated with reduced risk where L. loa is considered non-endemic. We

  1. Challenges of Implementing Antenatal Ultrasound Screening in a Rural Study Site: A Case Study From the Democratic Republic of the Congo.

    PubMed

    Swanson, David; Lokangaka, Adrien; Bauserman, Melissa; Swanson, Jonathan; Nathan, Robert O; Tshefu, Antoinette; McClure, Elizabeth M; Bose, Carl L; Garces, Ana; Saleem, Sarah; Chomba, Elwyn; Esamai, Fabian; Goldenberg, Robert L

    2017-06-27

    Persistent global disparities in maternal and neonatal outcomes and the emergence of compact ultrasound technology as an increasingly viable technology for low-resource settings provided the genesis of the First Look Ultrasound study. Initiated in 2014 in 5 low- and middle-income countries and completed in June 2016, the study's intervention included the training of health personnel to perform antenatal ultrasound screening and to refer women identified with high-risk pregnancies to hospitals for appropriate care. This article examines the challenges that arose in implementing the study, with a particular focus on the site in Equateur Province of the Democratic Republic of the Congo (DRC) where the challenges were greatest and the efforts to meet these challenges most illuminating. During the study period, we determined that with resources and dedicated staff, it was possible to leverage the infrastructure and implement ultrasound at antenatal care across a variety of remote sites, including rural DRC. However, numerous technical and logistical challenges had to be addressed including security of the equipment, electricity requirements, and integration of the intervention into the health system. To address security concerns, in most of the countries field sonographers were hired and dispatched each day with the equipment to the health centers. At the end of each day, the equipment was locked in a secure, central location. To obtain the required power source, the DRC health centers installed solar panels bolted on adjacent poles since the thatch roofs of the centers prohibited secure roof-top installation. To realize the full value of the ultrasound intervention, women screened with high-risk pregnancies had to seek a higher level of care at the referral hospital for a definitive diagnosis and appropriate care. While the study did provide guidance on referral and systems management to health center and hospital administration, the extent to which this resulted in

  2. Challenges of Implementing Antenatal Ultrasound Screening in a Rural Study Site: A Case Study From the Democratic Republic of the Congo

    PubMed Central

    Swanson, David; Lokangaka, Adrien; Bauserman, Melissa; Swanson, Jonathan; Nathan, Robert O; Tshefu, Antoinette; McClure, Elizabeth M; Bose, Carl L; Garces, Ana; Saleem, Sarah; Chomba, Elwyn; Esamai, Fabian; Goldenberg, Robert L

    2017-01-01

    Persistent global disparities in maternal and neonatal outcomes and the emergence of compact ultrasound technology as an increasingly viable technology for low-resource settings provided the genesis of the First Look Ultrasound study. Initiated in 2014 in 5 low- and middle-income countries and completed in June 2016, the study's intervention included the training of health personnel to perform antenatal ultrasound screening and to refer women identified with high-risk pregnancies to hospitals for appropriate care. This article examines the challenges that arose in implementing the study, with a particular focus on the site in Equateur Province of the Democratic Republic of the Congo (DRC) where the challenges were greatest and the efforts to meet these challenges most illuminating. During the study period, we determined that with resources and dedicated staff, it was possible to leverage the infrastructure and implement ultrasound at antenatal care across a variety of remote sites, including rural DRC. However, numerous technical and logistical challenges had to be addressed including security of the equipment, electricity requirements, and integration of the intervention into the health system. To address security concerns, in most of the countries field sonographers were hired and dispatched each day with the equipment to the health centers. At the end of each day, the equipment was locked in a secure, central location. To obtain the required power source, the DRC health centers installed solar panels bolted on adjacent poles since the thatch roofs of the centers prohibited secure roof-top installation. To realize the full value of the ultrasound intervention, women screened with high-risk pregnancies had to seek a higher level of care at the referral hospital for a definitive diagnosis and appropriate care. While the study did provide guidance on referral and systems management to health center and hospital administration, the extent to which this resulted in

  3. 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.

  4. Cryptosporidium spp., Giardia duodenalis, Enterocytozoon bieneusi and Other Intestinal Parasites in Young Children in Lobata Province, Democratic Republic of São Tomé and Principe

    PubMed Central

    Lobo, Maria Luísa; Augusto, João; Antunes, Francisco; Ceita, José; Xiao, Lihua; Codices, Vera; Matos, Olga

    2014-01-01

    Rare systemic studies concerning prevalence of intestinal parasites in children have been conducted in the second smallest country in Africa, the Democratic Republic of São Tomé and Príncipe. Fecal specimens from 348 children (214 in-hospital attending the Aires de Menezes Hospital and 134 from Agostinho Neto village) in São Tome Island were studied by parasitological and molecular methods. Of the 134 children from Agostinho Neto, 52.2% presented intestinal parasites. 32.1% and 20.2% of these children had monoparasitism and polyparasitism, respectively. Ascaris lumbricoides (27.6%), G. duodenalis (7.5%), T. trichiura (4.5%) and Entamoeba coli (10.5%) were the more frequent species identified in the children of this village. Giardia duodenalis (7.5%) and E. bieneusi (5.2%) were identified by PCR. Nested-PCR targeting G. duodenalis TPI identified Assemblage A (60%) and Assemblage B (40%). The E. bieneusi ITS-based sequence identified genotypes K (57.1%), KIN1 (28.6%) and KIN3 (14.3%). Among the 214 in-hospital children, 29.4% presented intestinal parasites. In 22.4% and 7.0% of the parasitized children, respectively, one or more species were concurrently detected. By microscopy, A. lumbricoides (10.3%) and Trichiuris trichiura (6.5%) were the most prevalent species among these children, and Cryptosporidium was detected by PCR in 8.9% of children. GP60 locus analysis identified 6.5% of C. hominis (subtypes IaA27R3 [35.7%], IaA23R3 [14.3%], IeA11G3T3 [28.6%] and IeA11G3T3R1 [21.4%]) and 2.3% of C. parvum (subtypes IIaA16G2R1 [20.0%], IIaA15G2R1 [20.0%], IIdA26G1 [40.0%] and IIdA21G1a [20.0%]). G. duodenalis and E. bieneusi were identified in 0.5% and 8.9% of the in-hospital children, respectively. G. duodenalis Assemblage B was characterized. The E. bieneusi genotypes K (52.6%), D (26.4%), A (10.5%) and KIN1 (10.5%) were identified. Although further studies are required to clarify the epidemiology of these infectious diseases in this endemic region the significance

  5. Melarsoprol Sensitivity Profile of Trypanosoma brucei gambiense Isolates from Cured and Relapsed Sleeping Sickness Patients from the Democratic Republic of the Congo

    PubMed Central

    Pyana Pati, Patient; Van Reet, Nick; Mumba Ngoyi, Dieudonné; Ngay Lukusa, Ipos; Karhemere Bin Shamamba, Stomy; Büscher, Philippe

    2014-01-01

    Background Sleeping sickness caused by Trypanosoma brucei (T.b.) gambiense constitutes a serious health problem in sub-Sahara Africa. In some foci, alarmingly high relapse rates were observed in patients treated with melarsoprol, which used to be the first line treatment for patients in the neurological disease stage. Particularly problematic was the situation in Mbuji-Mayi, East Kasai Province in the Democratic Republic of the Congo with a 57% relapse rate compared to a 5% relapse rate in Masi-Manimba, Bandundu Province. The present study aimed at investigating the mechanisms underlying the high relapse rate in Mbuji-Mayi using an extended collection of recently isolated T.b. gambiense strains from Mbuji-Mayi and from Masi-Manimba. Methodology/Principal Findings Forty five T.b. gambiense strains were used. Forty one were isolated from patients that were cured or relapsed after melarsoprol treatment in Mbuji-Mayi. In vivo drug sensitivity tests provide evidence of reduced melarsoprol sensitivity in these strains. This reduced melarsoprol sensitivity was not attributable to mutations in TbAT1. However, in all these strains, irrespective of the patient treatment outcome, the two aquaglyceroporin (AQP) 2 and 3 genes are replaced by chimeric AQP2/3 genes that may be associated with resistance to pentamidine and melarsoprol. The 4 T.b. gambiense strains isolated in Masi-Manimba contain both wild-type AQP2 and a different chimeric AQP2/3. These findings suggest that the reduced in vivo melarsoprol sensitivity of the Mbuji-Mayi strains and the high relapse rates in that sleeping sickness focus are caused by mutations in the AQP2/AQP3 locus and not by mutations in TbAT1. Conclusions/Significance We conclude that mutations in the TbAQP2/3 locus of the local T.b. gambiense strains may explain the high melarsoprol relapse rates in the Mbuji-Mayi focus but other factors must also be involved in the treatment outcome of individual patients. PMID:25275572

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

    PubMed Central

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

    2015-01-01

    Background Anaemia is associated with adverse outcomes including early death in the first year of antiretroviral therapy (ART). This study reports on the factors associated with persistent anaemia among HIV-infected patients initiating ART in the Democratic Republic of Congo (DR Congo). Methods We conducted a retrospective cohort study and analyzed data from patients receiving HIV care between January 2004 and December 2012 at two major hospitals in Goma, DR Congo. Haemoglobin concentrations of all patients on ART regimen were obtained prior to and within one year of ART initiation. A logistic regression model was used to identify the predictors of persistent anaemia after 12 months of ART. Results Of 756 patients, 69% of patients were anaemic (IC95%: 65.7–72.3) at baseline. After 12 months of follow up, there was a 1.2 g/dl average increase of haemoglobin concentration (P < 0.001) with differences depending on the therapeutic regimen. Patients who received zidovudine (AZT) gained less than those who did not receive AZT (0.99 g/dl vs 1.33 g/dl; p< 0.001). Among 445 patient who had anaemia at the beginning, 33% (147/445) had the condition resolved. Among patients with anaemia at ART initiation, those who did not receive cotrimoxazole prophylaxis before starting ART(AOR 3.89; 95% CI 2.09–7.25; P < 0.001) and a AZT initial regimen (AOR 2.19; 95% CI 1.36–3.52; P < 0.001) were significantly at risk of persistent anaemia. Conclusions More than two thirds of patients had anaemia at baseline. The AZT-containing regimen and absence of cotrimoxazole prophylaxis before starting ART were associated with persistent anaemia 12 months, after initiation of treatment. Considering the large proportion of patients with persistence of anaemia at 12 months, we suggest that it is necessary to conduct a large study to assess anaemia among HIV-infected patients in Goma. PMID:26474481

  7. Lymphatic filariasis in the Democratic Republic of Congo; micro-stratification overlap mapping (MOM) as a prerequisite for control and surveillance

    PubMed Central

    2011-01-01

    Background The Democratic Republic of Congo (DRC) has a significant burden of lymphatic filariasis (LF) caused by the parasite Wuchereria bancrofti. A major impediment to the expansion of the LF elimination programme is the risk of serious adverse events (SAEs) associated with the use of ivermectin in areas co-endemic for onchocerciasis and loiasis. It is important to analyse these and other factors, such as soil transmitted helminths (STH) and malaria co-endemicity, which will impact on LF elimination. Results We analysed maps of onchocerciasis community-directed treatment with ivermectin (CDTi) from the African Programme for Onchocerciasis Control (APOC); maps of predicted prevalence of Loa loa; planned STH control maps of albendazole (and mebendazole) from the Global Atlas of Helminth Infections (GAHI); and bed nets and insecticide treated nets (ITNs) distribution from Demographic and Health Surveys (DHS) as well as published historic data which were incorporated into overlay maps. We developed an approach we designate as micro-stratification overlap mapping (MOM) to identify areas that will assist the implementation of LF elimination in the DRC. The historic data on LF was found through an extensive review of the literature as no recently published information was available. Conclusions This paper identifies an approach that takes account of the various factors that will influence not only country strategies, but suggests that country plans will require a finer resolution mapping than usual, before implementation of LF activities can be efficiently deployed. This is because 1) distribution of ivermectin through APOC projects will already have had an impact of LF intensity and prevalence 2) DRC has been up scaling bed net distribution which will impact over time on transmission of W. bancrofti and 3) recently available predictive maps of L. loa allow higher risk areas to be identified, which allow LF implementation to be initiated with reduced risk where L. loa

  8. Effects of unconditional cash transfers on the outcome of treatment for severe acute malnutrition (SAM): a cluster-randomised trial in the Democratic Republic of the Congo.

    PubMed

    Grellety, Emmanuel; Babakazo, Pélagie; Bangana, Amina; Mwamba, Gustave; Lezama, Ines; Zagre, Noël Marie; Ategbo, Eric-Alain

    2017-04-26

    Cash transfer programs (CTPs) aim to strengthen financial security for vulnerable households. This potentially enables improvements in diet, hygiene, health service access and investment in food production or income generation. The effect of CTPs on the outcome of children already severely malnourished is not well delineated. The objective of this study was to test whether CTPs will improve the outcome of children treated for severe acute malnutrition (SAM) in the Democratic Republic of the Congo over 6 months. We conducted a cluster-randomised controlled trial in children with uncomplicated SAM who received treatment according to the national protocol and counselling with or without a cash supplement of US$40 monthly for 6 months. Analyses were by intention to treat. The hazard ratio of reaching full recovery from SAM was 35% higher in the intervention group than the control group (adjusted hazard ratio, 1.35, 95% confidence interval (CI) = 1.10 to 1.69, P = 0.007). The adjusted hazard ratios in the intervention group for relapse to moderate acute malnutrition (MAM) and SAM were 0.21 (95% CI = 0.11 to 0.41, P = 0.001) and 0.30 (95% CI = 0.16 to 0.58, P = 0.001) respectively. Non-response and defaulting were lower when the households received cash. All the nutritional outcomes in the intervention group were significantly better than those in the control group. After 6 months, 80% of cash-intervened children had re-gained their mid-upper arm circumference measurements and weight-for-height/length Z-scores and showed evidence of catch-up. Less than 40% of the control group had a fully successful outcome, with many deteriorating after discharge. There was a significant increase in diet diversity and food consumption scores for both groups from baseline; the increase was significantly greater in the intervention group than the control group. CTPs can increase recovery from SAM and decrease default, non-response and relapse rates during and

  9. 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

  10. Mortality rates above emergency threshold in population affected by conflict in North Kivu, Democratic Republic of Congo, July 2012-April 2013.

    PubMed

    Carrión Martín, Antonio Isidro; Bil, Karla; Salumu, Papy; Baabo, Dominique; Singh, Jatinder; Kik, Corry; Lenglet, Annick

    2014-09-01

    The area of Walikale in North Kivu, Democratic Republic of Congo, is intensely affected by conflict and population displacement. Médecins-Sans-Frontières (MSF) returned to provide primary healthcare in July 2012. To better understand the impact of the ongoing conflict and displacement on the population, a retrospective mortality survey was conducted in April 2013. A two-stage randomized cluster survey using 31 clusters of 21 households was conducted. Heads of households provided information on their household make-up, ownership of non-food items (NFIs), access to healthcare and information on deaths and occurrence of self-reported disease in the household during the recall period. The recall period was of 325 days (July 2012-April 2013). In total, 173 deaths were reported during the recall period. The crude mortality rate (CMR) was of 1.4/10,000 persons/day (CI95%: 1.2-1.7) and the under-five- mortality rate (U5MR) of 1.9/10,000 persons per day (CI95%: 1.3-2.5). The most frequently reported cause of death was fever/malaria 34.1% (CI95%: 25.4-42.9). Thirteen deaths were due to intentional violence. Over 70% of all households had been displaced at some time during the recall period. Out of households with someone sick in the last two weeks, 63.8% sought health care; the main reason not to seek health care was the lack of money (n = 134, 63.8%, CI95%: 52.2-75.4). Non Food Items (NFI) ownership was low: 69.0% (CI95%: 53.1-79.7) at least one 10 liter jerry can, 30.1% (CI95%: 24.3-36.5) of households with visible soap available and 1.6 bednets per household. The results from this survey in Walikale clearly illustrate the impact that ongoing conflict and displacement are having on the population in this part of DRC. The gravity of their health status was highlighted by a CMR that was well above the emergency threshold of 1 person/10,000/day and an U5MR that approaches the 2 children/10,000/day threshold for the recall period.

  11. Field Assessment of a Novel Household-Based Water Filtration Device: A Randomised, Placebo-Controlled Trial in the Democratic Republic of Congo

    PubMed Central

    Boisson, Sophie; Kiyombo, Mbela; Sthreshley, Larry; Tumba, Saturnin; Makambo, Jacques; Clasen, Thomas

    2010-01-01

    Background Household water treatment can improve the microbiological quality of drinking water and may prevent diarrheal diseases. However, current methods of treating water at home have certain shortcomings, and there is evidence of bias in the reported health impact of the intervention in open trial designs. Methods and Findings We undertook a randomised, double-blinded, placebo-controlled trial among 240 households (1,144 persons) in rural Democratic Republic of Congo to assess the field performance, use and effectiveness of a novel filtration device in preventing diarrhea. Households were followed up monthly for 12 months. Filters and placebos wer