war-torn democratic republic: Topics by Science.gov

Sample records for war-torn democratic republic

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

PubMed Central

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

2011-01-01

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

PubMed

Hashemi, Bahar; Ali, Sara; Awaad, Rania; Soudi, Laila; Housel, Lawrence; Sosebee, Stephen J

2017-01-01

War-torn populations are often hard to screen for mental health disorders. Classical data collection approaches, such as paper-based, online, or SMS-operated, are either infeasible or lack accuracy due to a variety of challenges associated with dynamics and consequences of war. In this paper, we introduce a novel approach for accurate and fast screening using free open-source software, Open Data Kit (ODK) mobile application. This approach was developed by the Palestine Children's Relief Fund (PCRF) to assess the mental health symptoms of 986 Palestinian children (age 6-18) in the aftermath of Israel's Operation Protective Edge (OPE) in 2014. The organization developed assessment questionnaires and trained local field workers on the use of the mobile application, and on recruiting and interviewing war victims. War-affected children were found to suffer from several alarming symptoms associated with post-traumatic stress disorder (PTSD), depression, and somatic symptoms. Children with highest number of psychological symptoms were referred for further evaluation and treatment. The use of ODK mobile technologies facilitated efficient screening of affected children in war zones. The offline data collection capability was crucial for handling the difficult conditions associated with war-torn areas, enabling timely intervention for urgent cases. Further applications of the novel mobile technology are to be explored.
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
Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

PubMed

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

2009-12-23

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

PubMed Central

2009-01-01

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

PubMed

Wood, Robin; Richardson, Eugene T

2013-09-01

Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.
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…
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.
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.
Is maternal education a social vaccine for childhood malaria infection? A cross-sectional study from war-torn Democratic Republic of Congo

PubMed Central

Ma, Cary; Claude, Kasereka Masumbuko; Kibendelwa, Zacharie Tsongo; Brooks, Hannah; Zheng, Xiaonan; Hawkes, Michael

2017-01-01

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. PMID:28220714
Congo: Elections and the Battle for Mineral Resources

ERIC Educational Resources Information Center

Social Education, 2007

2007-01-01

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

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in six foreign countries are presented in these situation reports. Countries included are Laos, Malawi, Pakistan, Republic of Korea, Somali Democratic Republic, and Tunisia. Information is provided under two topics, general background and family planning situation, where appropriate and if it is…
Hunger influenced life expectancy in war-torn Sub-Saharan African countries.

PubMed

Uchendu, Florence N

2018-04-27

Malnutrition is a global public health problem especially in developing countries experiencing war/conflicts. War might be one of the socio-political factors influencing malnutrition in Sub-Saharan African (SSA) countries. This study aims at determining the influence of war on corruption, population (POP), number of population malnourished (NPU), food security and life expectancy (LE) in war-torn SSA countries (WTSSA) by comparing their malnutrition indicators. Fourteen countries in WTSSA were stratified into zones according to war incidences. Countries' secondary data on population (POP), NPU, Food Security Index (FSI), corruption perceptions index (CPI), Global Hunger Index (GHI) and LE were obtained from global published data. T test, multivariate and Pearson correlation analyses were performed to determine the relationship between CPI, POP, GHI, FSI, NPU, male LE (MLE) and female LE (FLE) in WTSSA at p < .05. Data were presented in tables, means, standard deviation and percentages. Mean NPU, CPI, GHI, POP, FSI, MLE and FLE in WTSSA were 5.0 million, 28.3%, 18.2%, 33.8 million, 30.8%, 54.7 years and 57.1 years, respectively. GHI significantly influenced LE in both male and female POP in WTSSA. NPU, CPI, FSI, GHI and FLE were not significantly different according to zones except in MLE. Malnutrition indicators were similarly affected in WTSSA. Hunger influenced life expectancy. Policies promoting good governance, equity, peaceful co-existence, respect for human right and adequate food supply will aid malnutrition eradication and prevent war occurrences in Sub-Saharan African countries.
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.
Background Report on Eastern Democratic Republic of the Congo

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

Warren, Tracy A

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

ERIC Educational Resources Information Center

McIntyre, Thomas D.

1985-01-01

The use of sports in the German Democratic Republic and the People's Republic of China is both propagandist and ideological. International sports competition can enhance the country's image and domestic sport is a means of political socialization. (DF)
[Infant mortality in Germany (2008-2012)--lower in the former German Democratic Republic?].

PubMed

Trotter, A; Schnakenburg, C v; Pohlandt, F

2014-08-01

German infant mortality is ranked near the median of European countries. In Germany infant mortality is significantly higher in the German Federal Republic compared with the former German Democratic Republic. This is often used as reason for a call for structural requirements and minimum caseload for the care for very low birth weight infants. Neonatal and infant mortality were calculated for the 16 German federal states with data from the German statistical federal office for the years 2008-2012. Considerable variations were found for the neonatal (1.34-3.61‰, total Germany 2.31‰) and the infant (2.38-5.20‰, 3.47‰) mortality. The rate of stillborn infants was 3.56‰. A lower neonatal mortality in the former German Democratic Republic (1.62‰ vs. 2.44‰, p<0.0001, Chi-squared test) could not be confirmed for preterm infants with birth weight less than 1 500 g. In the former German Democratic Republic stillbirth was significantly more frequent in preterm infants with birth weight 500-999 g (p<0.0001). Combined stillbirth and neonatal mortality showed no difference between the German Federal Republic and former German Democratic Republic (5.45‰ and 5.29‰, respectively, n.s.; infants less than 500 g birth weight were excluded). The average number of preterm infants per perinatal centre and federal state had no influence on state specific neonatal mortality. If stillborn infants were accounted for no difference was found between the German Federal Republic and the former German Democratic Republic regarding mortality. Comparing infant mortality of different countries has to account for stillborn infants. Considerable variation of neonatal mortality is persisting throughout Germany despite structural requirements and introduction of a minimum caseload since 2005. A lower infant mortality in the former German Democratic Republic and implications drawn from are not supported by the presented nationwide data from the German statistical federal office
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

Book Publishing in the German Democratic Republic.

ERIC Educational Resources Information Center

Hueting, Gail P.

1982-01-01

Presents information about book publishing in the German Democratic Republic (GDR), drawing on a variety of sources, including a survey sent to the publishing houses themselves. The reading public, organization of the publishing industry, and centralized administration are discussed. An appendix listing GDR publishers and a 33-item reference list…
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
Molecular surveillance of Plasmodium falciparum resistance to artemisinin-based combination therapies in the Democratic Republic of Congo.

PubMed

Mvumbi, Dieudonné Makaba; Bobanga, Thierry Lengu; Kayembe, Jean-Marie Ntumba; Mvumbi, Georges Lelo; Situakibanza, Hippolyte Nani-Tuma; Benoit-Vical, Françoise; Melin, Pierrette; De Mol, Patrick; Hayette, Marie-Pierre

2017-01-01

Malaria is a major public health problem in the Democratic Republic of Congo. Despite progress achieved over the past decade in the fight against malaria, further efforts have to be done such as in the surveillance and the containment of Plasmodium falciparum resistant strains. We investigated resistance to artemisinin-based combination therapies currently in use in Democratic Republic of Congo by surveying molecular polymorphisms in three genes: pfcrt, pfmdr1 and pfk13 to explore possible emergence of amodiaquine, lumefantrine or artemisinin resistance in Democratic Republic of Congo. This study essentially revealed that resistance to chloroquine is still decreasing while polymorphism related to amodiaquine resistance seems to be not present in Democratic Republic of Congo, that three samples, located in the east of the country, harbor Pfmdr1 amplification and that none of the mutations found in South-East Asia correlated with artemisinine resistance have been found in Democratic Republic of Congo. But new mutations have been identified, especially the M476K, occurred in the same position that the M476I previously identified in the F32-ART strain, strongly resistant to artemisinine. Antimalarial first-line treatments currently in use in Democratic Republic of Congo are not associated with emergence of molecular markers of resistance.
The Russian Federation Islamic Republic of Dagestan: Curricular Decentralization, Social Cohesion, and Stability

ERIC Educational Resources Information Center

Eaton, Jana Sackman

2005-01-01

This article focuses on the curricular decentralization-sociopolitical stability nexus in the predominantly Muslim Russian Federation Republic of Dagestan, adjacent to war-torn Chechnya. Concomitant with the metamorphoses taking place in the economic and political sectors of society is the overhaul of institutionalized education. A major reform…
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…
Political Education in the Former German Democratic Republic.

ERIC Educational Resources Information Center

Dumas, Wayne; Dumas, Alesia

1996-01-01

Investigates civic education curricular reform in the former German Democratic Republic (GDR). Discusses the problems inherent in reforming an entire educational system, from textbooks to teachers, originally designed for Marxist-Leninist purposes. Examines the German state educational structure and the role that the main political parties play in…
[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.
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.
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…
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

... DEPARTMENT OF STATE [Public Notice 8231] Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of Congo Pursuant to Section 7031(b)(3) of the Department of State... the Act with respect to the Democratic Republic of Congo and I hereby waive this restriction. This...
76 FR 61134 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-03

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

PubMed Central

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

2006-01-01

To investigate the epidemiology of human African trypanosomiasis (sleeping sickness) in Kinshasa, Democratic Republic of Congo, 2 entomologic surveys were conducted in 2005. Trypanosoma brucei gambiense and human-blood meals were found in tsetse fly midguts, which suggested active disease transmission. Vector control should be used to improve human African trypanosomiasis control efforts. PMID:17326955
78 FR 76698 - Waiver of Restriction on Assistance to the Central Government of the Democratic Republic of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-18

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

ERIC Educational Resources Information Center

Hartoonian, Michael

1989-01-01

Surveys the purpose and goals of education in U.S. society, exploring the relationship between power and knowledge. Evaluates educational reform against the criteria of human dignity and meaning, outlining conditions for developing students who understand the power of knowledge and the purpose of education in a democratic republic. (GEA)
The Planning of Higher Education in the German Democratic Republic

ERIC Educational Resources Information Center

Nast, Manfred

1974-01-01

In the German Democratic Republic educational planning has to guarantee the realisation of several constitutional mandates: admission to universities and colleges in accordance with the principle of achievement, with the requirements of society, and with reference to the social composition of the people and equality of the sexes; the right to work…
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…
New Foci of Buruli Ulcer, Angola and Democratic Republic of Congo

PubMed Central

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

2008-01-01

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

ERIC Educational Resources Information Center

Cosandey, Olivier

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

PubMed

Jähne, M

2017-09-01

International relationships in ophthalmology in the former German Democratic Republic (GDR) were directed by the government and predominantly promoted relationships to socialist countries in Eastern Europe. The lack of freedom of travel, restrictions of import for scientific journals and general prevention of contacts by the State security service led to a stagnation in daily practice and in research, mainly from 1961 until 1989.
Stigmatisation and rejection of survivors of sexual violence in eastern Democratic Republic of the Congo.

PubMed

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

2017-04-01

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

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

PubMed

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

2017-04-01

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

ERIC Educational Resources Information Center

Aldersey, Heather Michelle; Haines, Shana Jackson

2018-01-01

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

ERIC Educational Resources Information Center

Reinarman, Craig

1991-01-01

A survey of approximately 60 college faculty members in several disciplines, all opposed to the Persian Gulf War, demonstrates their commitment to bringing the Gulf Crisis into the classroom democratically, not as an attempt to mobilize antiwar sentiment, but as an exercise in critical thinking. (SLD)
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…
Girl's Schooling in War-Torn Somalia

ERIC Educational Resources Information Center

Moyi, Peter

2012-01-01

A civil war has raged in Somalia since 1991. The civil war was the final blow to an already collapsed education system. Somalia has received little research and policy attention yet children, especially girls, are very vulnerable during times of conflict. The different gender roles, activities, and status in society create gender differentiated…
The Navies of the Federal Republic of Germany and the German Democratic Republic: A Comparison and Analysis of Structures, Alliance Relations, Doctrine, and Capabilities.

DTIC Science & Technology

1983-06-01

California VkSEP 8 1983 .. THESIS D THE NAVIES OF THE FEDERAL REPUBLIC OF GERMANY AND THE GERMAN DEMOCRATIC REPUBLIC: A COMPARISON AND ANALYSIS OF STRUCTURES...ALLIANCE RELATIONS, DOCTRINE, AND CAPABILITIES by John M. Tindall June 1983 O Thesis Advisor: David S. Yost LAJ Approved for public release... Thesis ; cratic Republic: A Comparison and Analy- J-u=e 1983 sis of Structures, Pffltance Relations, 6 ~ OG EOTM~E poctrline. and Capabi. 1
A Tale of Two Bridges: Educational Reform in the Lao People's Democratic Republic.

ERIC Educational Resources Information Center

Giacchino-Baker, Rosalie

1994-01-01

Educational systems in the Lao People's Democratic Republic are experiencing many problems, including inadequate facilities and equipment, a teacher shortage, a high dropout rate, unequal access for minorities, and precarious financing. Innovative projects sponsored by Ecoles Sans Frontieres, Japan Sotoshu Relief Committee, UNICEF, the Save the…
Nocturnal enuresis in children in Kinshasa, Democratic Republic of Congo.

PubMed

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

2012-10-01

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

DTIC Science & Technology

2009-03-23

of the genocide to flee into the Democratic Republic of the Congo where they continued their campaign to rid Rwanda of all Tutsis. Groups such as the...3.1.1: Rwanda Chapter 3.1.2: Uganda Chapter 3.2: Belgium Chapter 3.3: China Chapter 3.4: India Chapter 3.5: United States Chapter 4: System Dynamics... Rwanda (Democratic Forces for the Liberation of Rwanda ) mostly comprised of ethnic Hutu militia. GNI – Gross National Income IDA – International
Citizens Behind Barbed Wire: The Japanese Relocation and Democratic Ideals in Total War. Teacher and Student Manuals.

ERIC Educational Resources Information Center

Zimmerman, Paul

Focusing on the forcible relocation of West Coast Japanese-American citizens during World War II, the unit poses the question: Can democratic ideals and processes survive the conditions of total war? Some aspects of this episode considered are: public and official reactions to the Pearl Harbor attack; racial antipathies underlying the decision for…
Stock-outs, uncertainty and improvisation in access to healthcare in war-torn Northern Uganda.

PubMed

Muyinda, Herbert; Mugisha, James

2015-12-01

Stock-outs, also known as shortages or complete absence of a particular inventory, in public health facilities have become a hallmark in Uganda's health system making the notions of persistent doubt in access to healthcare - uncertainty, and doing more with less - 'improvisation', very pronounced. The situation becomes more critical in post-conflict areas with an over whelming burden of preexisting and conflict-related ailments amidst weak health systems. Particularly in the war-torn Northern Uganda, the intersection between the effects of violent conflict and shortage of medications is striking. There are problems getting the right type of medications to the right people at the right time, causing persistent shortages and uncertainty in access to healthcare. With reference to patients on Antiretroviral Therapy (ART), we present temporal trends in access to healthcare in the context of medication shortages in conflict-affected areas. We examine uncertainties in access to care, and how patients, medical practitioners, and the state - the key actors in the domain of supplying and utilizing medicines, respond. Our observation is that, while improvisation is a feature of biomedicine and facilitates problem solving in daily life, it is largely contextual. Given the rapidly evolving contexts and social and professional sensitivities that characterize war affected areas, there is a need for deliberate healthcare programs tailored to the unique needs of people and to the shaping of appropriate policies in post-conflict settings, which call for more North-South collaboration on equal terms. Copyright © 2015 Elsevier Ltd. All rights reserved.
New strategy for peace enforcement: the intervention brigade in the Democratic Republic of Congo

DTIC Science & Technology

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

ERIC Educational Resources Information Center

Brookfield, Stephen

2010-01-01

Democracy is the most venerated of American ideas, the one for which wars are fought and people die. So most people would probably agree that leaders should be able to lead well in a democratic society. Yet, genuinely democratic leadership is a relative rarity. Leading democratically means viewing leadership as a function or process, rather than…
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,…
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...
Tragic Pages: How the GDR, FRG and Japan Processed Their War History--Lessons for Education for Peace. Peace Education Miniprints No. 39.

ERIC Educational Resources Information Center

Aspeslagh, Robert

This document describes the ways in which Japan and the German nations have taught the history of World War II. According to the document, the former German Democratic Republic (GDR) took a pro-communist and anti-fascist approach to the subject. At the same time, the Western Allies pressured the Federal Republic of Germany (FRG) to institute a…
Group Trauma-Focused Cognitive-Behavioural Therapy with Former Child Soldiers and Other War-Affected Boys in the DR Congo: A Randomised Controlled Trial

ERIC Educational Resources Information Center

McMullen, John; O'Callaghan, Paul; Shannon, Ciaran; Black, Alastair; Eakin, John

2013-01-01

Background: The Democratic Republic of Congo (DRC) has been home to the world's deadliest conflict since World War II and is reported to have the largest number of child soldiers in the world. Despite evidence of the debilitating impact of war, no group-based mental health or psychosocial intervention has been evaluated in a randomised controlled…
Violence against sex workers by police and military in Democratic Republic of Congo.

PubMed

Ombeni, Alphonse Mihigo; Crago, Anna Louise

2008-12-01

Sex workers in the Sud-Kivu district of the Democratic Republic of Congo (DRC) are regularly subjected to sexual and other forms of violence. In this article, based on a presentation at a concurrent session at the conference, Alphonse Mihigo Ombeni and Anna Louise Crago describe the negative impacts of this violence on the sex workers' health and working conditions. Many have become HIV-positive.
Are the Rural Schools of the Democratic Republic of Congo Ready for the $100 Laptop?

ERIC Educational Resources Information Center

Banza, Nsomwe-a- Nfunkwa

2006-01-01

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

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

PubMed Central

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

2014-01-01

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

PubMed

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

2011-03-01

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

PubMed

Pillai, Vijayan; Wang, Ya-Chien; Maleku, Arati

2017-01-01

Globally, millions of people are affected by war and conflicts every year. However, women have increasingly suffered the greatest harm by war in more different ways than men. We conceptualize a reproductive rights approach toward examining the effects of war on women's reproductive health in developing countries. Given the rising concerns of exclusion to adequately address women's rights, sexual and gender-based violence, and post-conflict accountability, we specifically focus on the limitations of the Minimum Initial Service Package, a UN-sponsored reproductive health service program in conflict zones while offering a broad reproductive rights-based conceptual lens for examining reproductive health care services in war-torn areas. In addition, we discuss the roles social workers may play at both micro and macro levels in war-torn areas to bring about both short term and long term gains in women's reproductive health.
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…
Beyond the hype? The response to sexual violence in the Democratic Republic of the Congo in 2011 and 2014.

PubMed

Hilhorst, Dorothea; Douma, Nynke

2018-01-01

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

PubMed Central

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

2014-01-01

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

PubMed

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

2014-04-01

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

ERIC Educational Resources Information Center

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

2014-01-01

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

PubMed

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

2018-03-12

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

PubMed

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

2016-05-01

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

PubMed

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

2016-06-16

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

PubMed

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

2016-09-01

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

PubMed

Rackley, Edward B

2006-12-01

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

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

PubMed Central

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

2012-01-01

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

ERIC Educational Resources Information Center

Wegner, Kathryn L.

2013-01-01

The birth of formal citizenship education in the United States emerged in the context of mass immigration, the Progressive Movement, and the First World War. Wartime citizenship education has been chastised for its emphasis on patriotism and loyalty, and while this is a trend, historians have minimised the ways in which the democratic goals of the…
Outbreak of human monkeypox, Democratic Republic of Congo, 1996 to 1997.

PubMed Central

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

2001-01-01

Human monkeypox is a zoonotic smallpox-like disease caused by an orthopoxvirus of interhuman transmissibility too low to sustain spread in susceptible populations. In February 1997, 88 cases of febrile pustular rash were identified for the previous 12 months in 12 villages of the Katako-Kombe Health Zone, Democratic Republic of Congo (attack rate = 22 per 1,000; case-fatality rate = 3.7%). Seven were active cases confirmed by virus isolation. Orthopoxvirus- neutralizing antibodies were detected in 54% of 72 patients who provided serum and 25% of 59 wild-caught animals, mainly squirrels. Hemagglutination-inhibition assays and Western blotting detected antibodies in 68% and 73% of patients, respectively. Vaccinia vaccination, which protects against monkeypox, ceased by 1983 after global smallpox eradication, leading to an increase in the proportion of susceptible people. PMID:11384521
Emergence of vaccine-derived polioviruses, Democratic Republic of Congo, 2004-2011.

PubMed

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

2013-10-01

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

PubMed

Kaiser, Stephanie; Gross, Dominik

2015-07-01

The Anatomical Institute of the University of Cologne was founded in 1925. This paper highlights its institutional development and the sources from which it procured bodies for dissection. A comparison is drawn between the first years of the institute's existence during the Weimar Republic (1925-1932) and its rebuilding after war damage in the early post-war period (1947-1954). The institute and its procurement of bodies have not previously been investigated for these two time periods. The Third Reich, for which a detailed study already exists, will be mentioned as well to allow better evaluation of the periods before and after National Socialism. Based on newly evaluated archival material and body journals which will be examined both quantitatively and qualitatively, it becomes apparent that the Cologne institute experienced a chronic shortage of bodies both during the Weimar Republic and the first post-war decade (even though the delivery facilities were mostly the same). However, the situation of the institute in terms of structure, organization and personnel as well as body supply in the aftermath of World War II proved much more challenging than during the time of the Weimar Republic. Copyright © 2015 Elsevier GmbH. All rights reserved.
Social support under siege: An analysis of forced migration among women from the Democratic Republic of Congo.

PubMed

Wachter, Karin; Gulbas, Lauren E

2018-07-01

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

PubMed

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

2017-01-01

Chronic illnesses are a major public health problem in low-income countries. In the Democratic Republic of the Congo (DRC), few data are available, especially in palliative care. In this context, the present study aimed at describing the patterns of diseases in Kinshasa hospitals as well as risk factors associated with patients' evolving status and length of hospital stay. A prospective study was conducted in ten hospitals of Kinshasa, over a 1-year period. A total of 2699 patients with a chronic condition (non-communicable diseases (NCD) and/or AIDS) were consecutively enrolled in the study between January and December, 2013. Out of 2699 patients studied, 36.9% were suffering from cardiovascular diseases, 29.7% from comorbidity and 17.5% from AIDS. 27.5% of patients died while hospitalized, and 67.4% were lost to follow-up. The risk factors independently associated with death in hospitals were AIDS (adjusted OR = 2.2) and age over 65 years old (adjusted OR = 1.7). Peri-urban and rural areas were significantly associated with a mean adjusted hospital stay longer than 3 days. The length of stay (LOS) was shorter for women and patients living in urban areas. Patients survived for a median of 10 days (range 7-20 days). This study reveals the high proportion of patients suffering from advanced chronic diseases, including cardiovascular diseases, AIDS and comorbidity. It demonstrates the need for palliative care (PC) in medical practices in Kinshasa, the capital of the Democratic Republic of the Congo.
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…
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. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Net costs of health worker rural incentive packages: an example from the Lao People's Democratic Republic.

PubMed

Keuffel, Eric; Jaskiewicz, Wanda; Paphassarang, Chanthakhath; Tulenko, Kate

2013-11-01

Many developing countries are examining whether to institute incentive packages that increase the share of health workers who opt to locate in rural settings; however, uncertainty exists with respect to the expected net cost (or benefit) from these packages. We utilize the findings from the discrete choice experiment surveys applied to students training to be health professionals and costing analyses in Lao People's Democratic Republic to model the anticipated effect of incentive packages on new worker location decisions and direct costs. Incorporating evidence on health worker density and health outcomes, we then estimate the expected 5-year net cost (or benefit) of each incentive packages for 3 health worker cadres--physicians, nurses/midwives, and medical assistants. Under base case assumptions, the optimal incentive package for each cadre produced a 5-year net benefit (maximum net benefit for physicians: US$ 44,000; nurses/midwives: US$ 5.6 million; medical assistants: US$ 485,000). After accounting for health effects, the expected net cost of select incentive packages would be substantially less than the original estimate of direct costs. In the case of Lao People's Democratic Republic, incentive packages that do not invest in capital-intensive components generally should produce larger net benefits. Combining discrete choice experiment surveys, costing surveys and cost-benefit analysis methods may be replicated by other developing countries to calculate whether health worker incentive packages are viable policy options.
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
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.
Current Status of Human Taeniasis in Lao People's Democratic Republic

PubMed Central

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

2013-01-01

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. PMID:23710098
Description of a large measles epidemic in Democratic Republic of Congo, 2010-2013.

PubMed

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

2014-01-01

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

PubMed

Mukwege, Denis; Berg, Marie

2016-10-01

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

PubMed

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

2008-12-01

To determine the magnitude of traumatic gynecologic fistulas caused by sexual violence in the Democratic Republic of Congo. A retrospective analysis of hospital records from 604 consecutive patients who received treatment for gynecologic fistulas at Panzi Hospital between November 2005 and November 2007. Of the 604 patients, 24 (4%) reported that their fistulas had been caused by sexual violence; of these, 5 (0.8%) had developed fistulas as a direct result of forced penetration with foreign objects and/or gang rapes. Of the remaining patients, 6 had a fistula before they were raped, 9 developed iatrogenic fistulas following inappropriate instrumentation to manage rape-induced spontaneous abortion or stillbirth, or after abdominal hysterectomy, and 4 developed fistulas after prolonged and obstructed labor. Traumatic fistulas are rare compared to obstetric fistulas. Fistulas indirectly related to sexual violence are likely to be more common than those directly related. All fistulas resulting from sexual violence, whether direct or indirect, should be considered traumatic and special care should be given to these women.
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:…
Emergence of Vaccine-derived Polioviruses, Democratic Republic of Congo, 2004–2011

PubMed Central

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

2013-01-01

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

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

PubMed

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

2013-08-01

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

PubMed

Karim, Asad Mustafa; Hussain, Irfan; Malik, Sumera Kausar; Lee, Jung Hun; Cho, Ill Hwan; Kim, Young Bae; Lee, Sang Hee

2016-01-01

Military conflict has been a major challenge in the detection and control of emerging infectious diseases such as malaria. It poses issues associated with enhancing emergence and transmission of infectious diseases by destroying infrastructure and collapsing healthcare systems. The Orakzai agency in Pakistan has witnessed a series of intense violence and destruction. Military conflicts and instability in Afghanistan have resulted in the migration of refugees into the area and possible introduction of many infectious disease epidemics. Due to the ongoing violence and Talibanization, it has been a challenge to conduct an epidemiological study. All patients were sampled within the transmission season. After a detailed clinical investigation of patients, data were recorded. Baseline venous blood samples were taken for microscopy and nested polymerase chain reaction (nPCR) analysis. Plasmodium species were detected using nested PCR (nPCR) and amplification of the small subunit ribosomal ribonucleic acid (ssrRNA) genes using the primer pairs. We report a clinical assessment of the epidemic situation of malaria caused by Plasmodium vivax (86.5%) and Plasmodium falciparum (11.79%) infections with analysis of complications in patients such as decompensated shock (41%), anemia (8.98%), hypoglycaemia (7.3%), multiple convulsions (6.7%), hyperpyrexia (6.17%), jaundice (5%), and hyperparasitaemia (4.49%). This overlooked distribution of P. vivax should be considered by malaria control strategy makers in the world and by the Government of Pakistan. In our study, children were the most susceptible population to malaria infection while they were the least expected to use satisfactory prevention strategies in such a war-torn deprived region. Local health authorities should initiate malaria awareness programs in schools and malaria-related education should be further promoted at the local level reaching out to both children and parents.
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
Raman spectroscopy as a tool to characterize heterogenite (CoO·OH) (Katanga Province, Democratic Republic of Congo)

NASA Astrophysics Data System (ADS)

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

2011-10-01

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

PubMed Central

Labat, Francoise; Sharma, Anjali

2016-01-01

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

PubMed Central

2011-01-01

Background The conflict in eastern Democratic Republic of the Congo (DRC) is the deadliest since World War II. Over a decade of fighting amongst an array of armed groups has resulted in extensive human rights abuses, particularly the widespread use of sexual violence against women. Methods Using a mixed-methods approach, we surveyed a non-random sample of 255 women attending a referral hospital and two local non-governmental organizations to characterize their experiences of sexual and gender-based violence (SGBV). We then conducted focus groups of 48 women survivors of SGBV to elaborate on survey findings. Quantitative and qualitative data underwent thematic and statistical analysis respectively. Findings Of the women surveyed, 193 (75.7%) experienced rape. Twenty-nine percent of raped women were rejected by their families and 6% by their communities. Thirteen percent of women had a child from rape. Widowhood, husband abandonment, gang rape, and having a child from rape were significant risk factors for social rejection. Mixed methods findings show rape survivors were seen as "contaminated" with HIV, contributing to their isolation and over 95% could not access prophylactic care in time. Receiving support from their husbands after rape was protective against survivors' feelings of shame and social isolation. Interpretation Rape results not only in physical and psychological trauma, but can destroy family and community structures. Women face significant obstacles in seeking services after rape. Interventions offering long-term solutions for hyper-vulnerable women are vital, but lacking; reintegration programs on SGBV for women, men, and communities are also needed. PMID:22047181
Challenges for strengthening the health workforce in the Lao People's Democratic Republic: perspectives from key stakeholders.

PubMed

Qian, Yi; Yan, Fei; Wang, Wei; Clancy, Shayna; Akkhavong, Kongsap; Vonglokham, Manithong; Outhensackda, Somphou; Østbye, Truls

2016-11-29

The Lao People's Democratic Republic is facing a critical shortage and maldistribution of health workers. Strengthening of the health workforce has been adopted as one of the five priorities of the National Health Sector Strategy (2013-2025). This study aims to identify, explore, and better understand the key challenges for strengthening the Laotian health workforce. This study applied exploratory and descriptive qualitative methods and adapted a working life-span framework. Twenty-three key stakeholders with particular insights into the current situation of the health workforce were purposively recruited for in-depth interviews. Important policy documents were also collected from key informants during the interviews. Thematic analysis was employed for the textual data using MAXQDA 10. The overarching problem is that there is a perceived severe shortage of skilled health workers (doctors, nurses, and midwives) and lab technicians, especially in primary health facilities and rural areas. Key informants also identified five problems: insufficient production of health workers both in quantity and quality, a limited national budget to recruit enough health staff and provide sufficient and equitable salaries and incentives, limited management capacity, poor recruitment for work in rural areas, and lack of well-designed continuing education programs for professional development. These problems are interrelated, both in how the issues arise and in the effect they have on one another. To improve the distribution of health workers in rural areas, strategies for increasing production and strengthening retention should be well integrated for better effectiveness. It is also essential to take the Laotian-specific context into consideration during intervention development and implementation. Furthermore, the government should acknowledge the inadequate health management capacity and invest to improve human resource management capacity at all levels. Finally, assessment of
The War in Man; Media and Machines.

ERIC Educational Resources Information Center

Wilhelmsen, Frederick D.; Bret, Jane

The authors present a picture of contemporary man torn by conflicting forces, caught in a psychic house divided against itself, a victim of war between media and machines. Machines, they state, represent the rationalistic tradition which has brought man to the brink of psychic and social disaster. The media they see as offering hope--true…
The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo.

PubMed

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

2009-03-01

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

PubMed Central

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

2016-01-01

Introduction Cervical cancer is the leading cause of morbidity and mortality of women from cancer in the developing World. It is the primary cause of reduced life expectancy in Sub-Saharan countries such as Democratic Republic of Congo. The aim of this work was to determinate the socio-demographic profile of women with precancerous and cancerous lesions of the cervix, to determinate the frequency of VIA and VILI positive cases and to show the challenges that can be faced in managing patients with abnormalities in the city of Mbuji-Mayi in the Democratic Republic of Congo. Methods As part of its activities, the “Association de Lutte contre le Cancer du Col utérin” (ALCC) organized a community outreach followed by free voluntary testing for cervical cancer for two weeks (26thMarch to 10th April 2011) at the General Referral Hospital Kayembe in Mbuji-Mayi (Democratic Republic of Congo). Results A total of 229 women were examined. 38% of tests (VIA + VILI) were positive with 6 clinically suspected cases of invasive cancer at stage 1 (7% of cases). Nearly 70% of patients were still of childbearing age and had started their first sexual intercourse before 18 years of age and 86% of cases were multiparous. Given the material, financial and technical constraints, 75% of patients were placed in a monitoring program of 9 months to 1 year (= expectation and another test) while 11% of them were selected for a biopsy to be locally practiced and sent to the pathologist. Nearly 8% of the cases were candidates for hysterectomy. Conclusion Given the difficulties encountered and the frequency of positive tests, we recommend another study with a larger sample, improved working conditions (mainly equipment) and the association of another test such as the Human Papilloma Virus (HPV) test. PMID:27217888
Ecologic Features of Plague Outbreak Areas, Democratic Republic of the Congo, 2004–2014

PubMed Central

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

2018-01-01

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

PubMed

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

2013-11-01

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

PubMed

Dumont, K; Louw, J

2001-11-01

This article examines the origins and the development of psychological associations in the German Democratic Republic and the Republic of South Africa and the ways membership in the International Union of Psychological Science (IUPsyS)--founded in 1951--figured in the process. The political regimes in these 2 countries had difficulties of their own in achieving a standing in the international community and, as a result, psychologists faced significant dilemmas in gaining legitimacy for the discipline. Membership in the IUPsyS served an important function in gaining legitimacy for the discipline in both countries, but it also contradicted legitimizing strategies that involved the countries' distinctive political and social structures. Membership in the IUPsyS was sufficiently important for psychologists to try to strike a compromise between different legitimation strategies.
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/
Maryland physicians on a humanitarian mission to war-torn Croatia.

PubMed

Laukenmann, B

1993-04-01

Six physicians from Maryland, California, and Utah participated in a 10-day humanitarian mission to Croatia. They spent long hours in antiquated operating rooms performing maxillofacial and extremity reconstructive procedures; most patients were young or war-injured males. Though not a third world country, Croatia urgently needs finances to acquire drugs, supplies, textbooks, and equipment.
Surgical care for the direct and indirect victims of violence in the eastern Democratic Republic of Congo.

PubMed

Chu, Kathryn; Havet, Philippe; Ford, Nathan; Trelles, Miguel

2010-04-14

The provision of surgical assistance in conflict is often associated with care for victims of violence. However, there is an increasing appreciation that surgical care is needed for non-traumatic morbidities. In this paper we report on surgical interventions carried out by Médecins sans Frontières in Masisi, North Kivu, Democratic Republic of Congo to contribute to the scarce evidence base on surgical needs in conflict. We analysed data on all surgical interventions done at Masisi district hospital between September 2007 and December 2009. Types of interventions are described, and logistic regression used to model associations with violence-related injury. 2869 operations were performed on 2441 patients. Obstetric emergencies accounted for over half (675, 57%) of all surgical pathology and infections for another quarter (160, 14%). Trauma-related injuries accounted for only one quarter (681, 24%) of all interventions; among these, 363 (13%) were violence-related. Male gender (adjusted odds ratio (AOR) = 20.0, p < 0.001), military status (AOR = 4.1, p < 0.001), and age less than 20 years (AOR = 2.1, p < 0.001) were associated with violence-related injury. Immediate peri-operative mortality was 0.2%. In this study, most surgical interventions were unrelated to violent trauma and rather reflected the general surgical needs of a low-income tropical country. Programs in conflict zones in low-income countries need to be prepared to treat both the war-wounded and non-trauma related life-threatening surgical needs of the general population. Given the limited surgical workforce in these areas, training of local staff and task shifting is recommended to support broad availability of essential surgical care. Further studies into the surgical needs of the population are warranted, including population-based surveys, to improve program planning and resource allocation and the effectiveness of the humanitarian response.
Proposal by the German Democratic Republic on use of the geostationary orbit

NASA Astrophysics Data System (ADS)

Hampe, W.; Mueller, R.

In 1986, the German Democratic Republic submitted the working paper entitled "Draft principles governing the activities of States in the utilization of the geostationary orbit." The underlying motive for the G.D.R.—which supports the mandate given by the UN General Assembly to the Committee on the Peaceful Uses of Outer Space/Legal Sub-Committee, namely "to consider matters relating to the character and utilization of the geostationary orbit, including consideration of ways and means to ensure the rational and equitable use of the geostationary orbit without prejudice to the role of the International Telecommunication Union"—was that a generally accepted solution to the complex political, legal and technical questions relating to the use of the geostationary orbit both within the ITU and in the framework of the Legal Sub-Committee would be in the interest of all States. In that quest, both the ITU and the COPUOS/LSC should play a major part. Here, the Legal Sub-Committee could substantiate and develop the international legal framework for the use of the geostationary orbit in conformity with existing space law and the relevant ITU decisions.
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.

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

PubMed

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

2017-06-01

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

PubMed Central

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

2017-01-01

In the Democratic Republic of Congo, the incidence of sickle cell anemia (SCA) is estimated to affect 30,000 to 40,000 neonates per year. However, there is paucity of data on acute clinical manifestations in sickle cell children. In these circumstances, it is difficult to develop a health care policy for an adequate management of sickle cell patients. This was a seven years’ retrospective study of children admitted with acute sickle cell crisis in the Department of Pediatrics in University Hospital of Kinshasa, Kinshasa, the Democratic Republic of Congo. A total of 108 patients were identified as having SCA. There were 56 (51%) girls and 52 (49%) boys. Median age was 10.5 years (range 1-24 years). No child was diagnosed by neonatal screening. The median age of diagnosis of sickle cell anemia was 90 months (range: 8-250 months). The median age at the first transfusion was 36 months (range 4-168). In this series, 61 (56.5%) patients were eligible for hydroxyurea. However, this treatment was only performed in 4 (6.6%) of them. Pain episodes, acute anemic crisis and severe infection represent respectively 38.2%, 34.3% and 21.9% of events. Altered sensorium and focal deficit were encountered occasionally and represented 3.4% of acute events. Acute renal manifestations, cholelithiasis and priapism were rarely reported, in this cohort. In Kinshasa, the care of patients suffering from sickle cell anemia is characterized by the delayed diagnosis and low detection of organ complications compared to reports of Western countries. This situation is due to resources deficiencies. PMID:28626540
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.
Exclusive Breastfeeding and Clinical Malaria Risk in 6-Month-Old Infants: A Cross-Sectional Study from Kinshasa, Democratic Republic of the Congo

PubMed Central

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

2016-01-01

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

PubMed

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

2009-06-01

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

PubMed

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

2012-08-01

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

PubMed

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

2014-09-01

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

PubMed

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

2011-11-01

The detection of schistosomiasis cases among Belgian military personnel returning from a mission in the Democratic Republic of Congo (DRC) prompted a nested case-control study of all military personnel deployed in the DRC between 2005 and 2008 to identify all infections and to start appropriate treatment. Of 197 patients exposed at Lake Tanganyika in the Kalemie area of DRC, 49 (24.9%) were diagnosed with schistosomiasis. Swimming was significantly more frequent than wading in the seropositive group than in the seronegative group (88.9% vs. 73.6%; odds ratio [OR], 2.86; 95% confidence interval [CI], 0.97-9.01). Thirty-one of 49 patients (63.3%) were symptomatic; including skin problems in 34.7%, respiratory symptoms in 12.2%, fever in 14.3%, and 51.0% with gastrointestinal problems. Median eosinophil counts were significantly higher in seropositive patients (375 vs. 138 per tL; Wilcoxon rank sum test [Ws] = 10,559.00; p < 0.01; r = -0.49). In total, 20 (40.8%) of the 49 patients were treated for symptomatic infections and the remainder for asymptomatic schistosomiasis. Our study emphasizes the need for active systematic post-tropical screening in military personnel after deployment to Schistosoma-endemic regions of the world.
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
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.
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.
Exclusive Breastfeeding and Clinical Malaria Risk in 6-Month-Old Infants: A Cross-Sectional Study from Kinshasa, Democratic Republic of the Congo.

PubMed

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

2016-10-05

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

PubMed Central

2008-01-01

Objective To provide an accurate estimate of violent war deaths. Design Analysis of survey data on mortality, adjusted for sampling bias and censoring, from nationally representative surveys designed to measure population health. Estimated deaths compared with estimates in database of passive reports. Setting 2002-3 World health surveys, in which information was collected from one respondent per household about sibling deaths, including whether such deaths resulted from war injuries. Main outcome measure Estimated deaths from war injuries in 13 countries over 50 years. Results From 1955 to 2002, data from the surveys indicated an estimated 5.4 million violent war deaths (95% confidence interval 3.0 to 8.7 million) in 13 countries, ranging from 7000 in the Democratic Republic of Congo to 3.8 million in Vietnam. From 1995 to 2002 survey data indicate 36 000 war deaths annually (16 000 to 71 000) in the 13 countries studied. Data from passive surveillance, however, indicated a figure of only a third of this. On the basis of the relation between world health survey data and passive reports, we estimate 378 000 globalwar deaths annually from 1985-94, the last years for which complete passive surveillance data were available. Conclusions The use of data on sibling history from peacetime population surveys can retrospectively estimate mortality from war. War causes more deaths than previously estimated, and there is no evidence to support a recent decline in war deaths. PMID:18566045
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.
[Joining WHO of Republic of Korea and the projects in the 1950s].

PubMed

Lee, Sun Ho

2014-04-01

The Republic of Korea(ROK) and the World Health Organization(WHO) have done many projects successfully from 1949, in which the government of First Republic joined the WHO. However the relation between the ROK and the WHO have not been studied very much so far. The main purpose of this research, which could be done by the support of WHO, is connected with three questions. First research point would be "how could the ROK joined WHO in 1949 and what's the meaning of it? And the what's the difference in the process for the WHO between the ROK of 1949 and the DPRK(Democratic People's Republic of Korea) of 1973?" The first president of the ROK, Rhee Syngman, who had received his Ph. D.(about international politics) from Princeton University in 1910, was strongly interested in joining international institutes like UN, WHO. The ROK that could join WHO on 17 August 1949, with the approval of Assembly on 25 May 1949, was one of the founder members of the Western Pacific Region. By joining WHO, the ROK could get chance to increase the level of public health and its administration in 1950's. But the DPRK manage to became a member of WHO on 19 May 1973 and joined the South-East Asia Region. The joining of DPRK was influenced by the easing of the cold war after the Nixon Doctrine and the joining of the China(People's Republic of China). Second research point would be "What kind of roll did the WHO take in the First Republic?" Yet the public health administration of the First Republic that had been made in the period of US army military government was been strongly influenced by USA, the roll of WHO was also important in the 1950's. Last research point would be "What kind of the projects did the ROK and the WHO take part in during the period of he First Republic? How could evaluate the results?" The ROK and the WHO handled the projects including health services, communicable disease prevention and control, control of noncommunicable diseases, and protection of health. Specially
Transforming Schools into Democratic Organisations: The Case of the Secondary Schools Management Development Project in Botswana

ERIC Educational Resources Information Center

Monyatsi, Pedzani Perci

2005-01-01

As a democratic country which aims at nurturing and sustaining its envied democracy, organisations in Botswana are expected and encouraged to build and maintain democratic structures and principles. In September 1993, the Ministry of Education of the Republic of Botswana and the then British Overseas Development Agency (ODA) launched an ambitious…
Determinants of Children's Mental Health in War-Torn Settings: Translating Research Into Action.

PubMed

Miller, Kenneth E; Jordans, Mark J D

2016-06-01

Research on the mental health and psychosocial wellbeing of children in conflict-affected settings has undergone a significant paradigm shift in recent years. Earlier studies based on a war exposure model primarily emphasized the effects of direct exposure to armed conflict; this has gradually given way to a broader understanding of the diverse pathways by which organized violence affects children. A robustly supported comprehensive model includes risk factors at multiple points in time (prior war exposure, ongoing daily stressors) and at all levels of the social ecology. In particular, findings suggest that material deprivation and a set of family variables, including harsh parenting, parental distress, and witnessing intimate partner violence, are important mediators of the relationship between armed conflict and children's wellbeing. To date, however, interventions aimed at supporting war-affected children's wellbeing, both preventive and treatment-focused, have focused primarily on direct work with children, while paying only modest attention to ongoing risk factors in their families and broader environments. Possible reasons for the ongoing prioritization of child-focused interventions are considered, and examples are provided of recent evidence-based interventions that have reduced toxic stressors (harsh parenting and the use of violent discipline by teachers) in conflict-affected communities.
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

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

PubMed

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

2018-04-01

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

PubMed

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

2015-08-01

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

PubMed

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

2018-03-01

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

PubMed Central

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

2018-01-01

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

DTIC Science & Technology

2014-12-01

20503. 1. AGENCY USE ONLY (Leave blank) 2. REPORT DATE December 2014 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE THE...World War, low intensity conflicts have become real issues for democratic countries. Small wars are usually low in intensity but long in duration... rebellious bands while also facing institutional, legal, and ethical constraints. A real challenge is how long a democracy can deploy its military
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
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.
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.).
Women's Status and Intimate Partner Violence in the Democratic Republic of Congo.

PubMed

Tlapek, Sarah Myers

2015-09-01

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

DTIC Science & Technology

2011-03-01

acts as a form of insurance against failures in the local economy and job market , as the household is receiving income from differing locations and...E. S. (1966). A Theory of Migration. Demography, 47 - 57. 35. Lewis, W. A. (1954). Economic Development with Unlimited Supplies of Labour . The... Norway . 47. Rice, C. (2005, December 11). The Promise of Democratic Peace: Why Promoting Freedom is the Only Realistic Path to Security. The Washington
Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo.

PubMed

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

2014-06-01

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

PubMed

Power, Brian; Goossens, Carolyn

2009-06-01

The aim of this paper is to describe the processes underlying psychotic symptoms in an adolescent who presented to our service at the age of 15 years. A teenage female presented having experienced her early childhood in a war-torn third-world country, during which time her mother died, and she suffered worm infestation, neglect and trauma, before being adopted by a family in a developed country, where she lived for several years prior to relocating to Australia. The presenting complaints included longstanding anxiety, depressive and dissociative symptoms, with subsequent behavioural problems and learning difficulties. More recently, she had developed auditory hallucinations, and the antipsychotic she had been taking was beneficial. An MRI of the brain demonstrated lesions in keeping with healed parasitic disease (neurocysticercosis). The patient's hallucinations are discussed in the context of the relationship between a traumatic childhood and psychosis, and neurocysticercosis. Within months of her presentation, the hallucinations resolved as her step-mother became more available. Her antipsychotic medication is being carefully decreased, and the patient is engaging in psychological therapies to deal with her past trauma and disrupted attachment.
"Before the war we had it all": Family planning among couples in a post-conflict setting.

PubMed

Warren, Nicole; Alvarez, Carmen; Makambo, Maphie Tosha; Johnson-Agbakwu, Crista; Glass, Nancy

2017-08-01

There is little evidence about family planning knowledge, attitudes, and use among couples in post-conflict Democratic Republic of the Congo. We used qualitative descriptions to analyze data from 75 participants. Intimate partner violence (IPV) was common among participants. They were aware of family planning methods; however, IPV and fears of side effects were barriers to use. Although participants were concerned about the cost of large families, had positive attitudes toward family planning, and intended to use it, actual use was uncommon. The need for family planning was acute because of war-related poverty. Couples negotiated, but men had strong influence over family planning decisions. Couples saw health workers as a valuable resource. Interventions in this setting should include a couple-based approach that addresses IPV as well as family planning content.
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.
June Four: A Chronicle of the Chinese Democratic Uprising.

ERIC Educational Resources Information Center

1989

This book presents more than 200 photographs along with a chronological record from the "Ming Pao News," covering the events in People's Republic of China from the death of Hu Yaobang on April 15, 1989, which precipitated the Chinese student democratic movement, to the crushing of the movement at Tiananmen Square by the Chinese army on…
Human rabies: a descriptive observation of 21 children in Kinshasa, the Democratic Republic of Congo.

PubMed

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

2014-10-01

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

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

PubMed

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

2017-04-26

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

PubMed Central

2016-01-01

Discoid meniscus is an anatomical congenital anomaly more often found in the lateral meniscus. A discoid medial meniscus is a very rare anomaly, and even more rare is to diagnose a bilateral discoid medial meniscus although the real prevalence of this situation is unknown because not all the discoid medial menisci are symptomatic and if the contralateral knee is not symptomatic then it is not usually studied. The standard treatment of this kind of pathology is partial meniscectomy. Currently the tendency is to be very conservative so suture and saucerization of a torn discoid meniscus when possible are gaining support. We present the case of a 13-year-old patient who was diagnosed with symptomatic torn bilateral discoid medial meniscus treated by suturing the tear and saucerization. To the best of our knowledge this is the first case reported of bilateral torn discoid medial meniscus treated in this manner in the same patient. PMID:27656305
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
[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.
[Human African trypanosomiasis in the urban milieu: the example of Kinshasa, Democratic Republic if the Congo, in 1998 and 1999].

PubMed

Bilengue, C M; Meso, V K; Louis, F J; Lucas, P

2001-01-01

Human African trypanosomiasis is an essentially rural disease. Occurrence in urban areas is uncommon except in cities that reproduce rural conditions conducive to the survival of glossinidae, i.e., forest and water. This is the case in neighborhoods near the zoo in Brazzaville, People's Republic of the Congo and in the residual mangrove forest in Conakry, Guinea. In Kinshasa, Democratic Republic of the Congo, an average of 39 cases were reported annually from 1970 to 1995. This figure increased to 254 in 1996 and 226 in 1997. This sharp rise led authorities to organize screening operations in some neighborhoods of the capital city. Results documented 433 cases in 1998 and 912 cases in 1999. The highest prevalence was found in outlying areas. This finding was probably related to focus of screening in these locations and to the practice of market gardening on plots surrounding the city. Placement of 276 insect traps along the Ndjili River led to the capture of 42,231 glossinidae over a 4 month period. Taken together, these findings indicate that the conditions necessary for active disease transmission are now reunited and that priority should be given to intensifying screening operations and information campaigns to health care providers working in the city.
Genetic Evidence of Importation of Drug-Resistant Plasmodium falciparum to Guatemala from the Democratic Republic of the Congo

PubMed Central

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

2014-01-01

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

PubMed

Sas, Miriam A; Mertens, Marc; Kadiat, Jean G; Schuster, Isolde; Pongombo, Célestin P S; Maloba, Alois G K; Groschup, Martin H

2017-10-01

Crimean-Congo hemorrhagic fever virus (CCHFV) has been detected in many African countries. Unfortunately, little is known about the current CCHFV situation in most of those countries including the Democratic Republic of the Congo (DRC). In over 50 years, three human CCHF cases have been detected in DRC but no seroepidemiological investigation was performed so far. To determine the prevalence of CCHFV-specific antibodies we tested 838 serum samples of cattle, goat and sheep from the southern province Katanga, DRC. The detected seroprevalence in ruminants was 1.6% ranging from 0.4% to 3.4% between the two sampling sites, Kamina and Lubumbashi. The low prevalence indicates only sporadic introduction of CCHFV into this part of the country. DRC is a very large country and the study was performed only at two locations in one province; therefore, the investigations can be only a starting point for further epidemiological activities. Copyright © 2017 Elsevier GmbH. All rights reserved.
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.
Sense of coherence and its association with exposure to traumatic events, posttraumatic stress disorder, and depression in eastern Democratic Republic of Congo.

PubMed

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

2010-06-01

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

ERIC Educational Resources Information Center

Engels, Jeremy

2009-01-01

Robert Owen's "Declaration of Mental Independence," declaimed on the Fourth of July, 1826, was one of the most ill-received speeches in the early Republic. The attendant controversy provides an opportunity to theorize invective's role in democratic culture. Invective was useful in the early Republic, and continues to be useful today, because it is…
Fleeing from Democratic Ideals: The Content of U.S. History Textbooks.

ERIC Educational Resources Information Center

Romanowski, Michael H.

This paper examines how the discourse of textbooks leaves various impressions upon students regarding our democratic ideals of justice and equality. A qualitative content analysis of five widely sold secondary U.S. history textbooks was conducted. The content areas analyzed were the Japanese American internment during World War II and related…
Numerical modelling of torn boudinage

NASA Astrophysics Data System (ADS)

Dabrowski, Marcin; Grasemann, Bernhard

2017-04-01

The seminal text book by J.G. Ramsay outlines the importance of the progressive development of torn boudinage structures because the shape of boudins may vary greatly and is mainly dependent on the viscosity contrast between the more competent layer and the enclosing material and the values of the principal extensions of the finite strain ellipsoid. In this work we demonstrate that another parameter, the initial boudin separation, has a significant influence on the progressive development of the finite boudin shape. We use finite element simulations to study the shape evolution of torn boudins under pure and simple shear. The boudins are initially rectangular and the gaps between them are prescribed. The boudin interfaces are resolved with high-resolution, body-fitting, unstructured computational meshes and a second-order ODE integrator is used to ensure the numerical accuracy of the results. Both the boudins and the host are treated as either linear or non-linear viscous fluids. We neglect any recrystallization processes and the boudin interfaces are considered as fully coherent. We were able to reproduce the typical shape of fish-mouth boudins for a wide range of viscosity ratios between the highly viscous boudins and the host. We have systematically studied the effects due to the boudin-host viscosity ratio and the fluid stress exponents. Our results show that the initial separation can have a profound effect on the final shape of the boudins and we document the formation of hitherto undescribed complex boudin shapes for an initially narrow gap width.
Democratic Orientations among High School Seniors in the United States and Germany.

ERIC Educational Resources Information Center

Hastings, William L.; Payne, Kenneth A.

1990-01-01

Investigates strength of national identity and degrees of democratic orientation among honors high school seniors taking advanced political science courses in 1986 in the United States and the Federal Republic of Germany. Finds West German students less tolerant of minority free speech, more fearful of consequences of dissent, and less politically…
Post World War II Civil Rights Movement: The Struggle for Democracy and Beyond.

ERIC Educational Resources Information Center

Dunston, Aingred Ghislayne

Two main ideas are put forth in this paper: a description of the struggle of African-Americans to become full participants in the democratic process both before and after World War II; and an argument posited that through these struggles African Americans exposed the imperfections and weaknesses of the democratic society and provided for…
Spatial Patterns of Forest Cover Loss in the Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

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

2013-12-01

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

PubMed

Casey, Sara E; Cannon, Amy; Mushagalusa Balikubirhi, Benjamin; Muyisa, Jean-Bosco; Amsalu, Ribka; Tsolka, Maria

2017-01-01

Despite the inclusion of sexual and reproductive health (SRH) services in the minimum standards of health care in humanitarian settings, access to SRH services, and especially to contraception, is often compromised in war. Very little is known about continuation and switching of contraceptive methods in these settings. An evaluation of a contraceptive services program in North Kivu, Democratic Republic of the Congo (DRC) was conducted to measure 12-month contraceptive continuation by type of contraceptive method (short-acting or long-acting). A stratified systematic sample of women who initiated a contraceptive method 12-18 months prior to data collection was selected retrospectively from facility registers. A total of 548 women was interviewed about their contraceptive use: 304 who began a short-acting method (pills, injectables) and 244 who began a long-acting method (intra-uterine devices, implants). Key characteristics of short-acting method versus long-acting method acceptors were compared using chi-square statistics for categorical data and t-tests for continuous data. Unadjusted and adjusted Cox proportional hazard ratios were estimated to assess factors associated with discontinuation. At 12 months, 81.6% women reported using their baseline contraceptive method continuously, with more long-acting than short-acting contraceptive acceptors (86.1% versus 78.0%, p = .02) continuing contraceptive use. Use of a short-acting method (Hazard ratio (HR) 1.74 [95%CI 1.13-2.67]) and desiring a child within two years (HR 2.58 [95%CI 1.45-4.54]) were associated with discontinuation within the first 12 months of use. The vast majority (88.3%) of women reported no prior contraceptive use. This is the first study of contraceptive continuation in a humanitarian setting. The high percentages of women continuing contraceptive use found here demonstrates that women will choose to initiate and continue use of their desired contraceptive method, even in a difficult, unstable and
A New Clade of African Body and Head Lice Infected by Bartonella quintana and Yersinia pestis-Democratic Republic of the Congo.

PubMed

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

2015-11-01

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

Political Economy of American Education: Democratic Citizenship in the Heart of Empire

ERIC Educational Resources Information Center

Falk, Thomas Michael

2012-01-01

Chief among the goals of American education is the cultivation of democratic citizens. Contrary to State catechism delivered through our schools, America was not born a democracy; rather it emerged as a republic with a distinct bias against democracy. Nonetheless we inherit a great demotic heritage. Abolition, the labor struggle, women's…
Korean atomic bomb victims.

PubMed

Sasamoto, Yukuo

2009-01-01

After colonizing Korea, Japan invaded China, and subsequently initiated the Pacific War against the United States, Britain, and their allies. Towards the end of the war, U.S. warplanes dropped atomic bombs on Hiroshima and Nagasaki, which resulted in a large number of Koreans who lived in Hiroshima and Nagasaki suffering from the effects of the bombs. The objective of this paper is to examine the history of Korea atomic bomb victims who were caught in between the U.S., Japan, the Republic of Korea (South Korea) and the Democratic People's Republic of Korea (North Korea).
Treatment-seeking Paths in the Management of Severe Malaria in Children under 15 Years of Age Treated in Reference Hospitals of Kinshasa, Democratic Republic of Congo.

PubMed

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

2015-03-01

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

PubMed

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

2018-01-01

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

ERIC Educational Resources Information Center

Sommers, Marc

Conflict's path of devastation and chaos has dramatically slowed the ability of war-torn countries to reach the Education for All (EFA) goals adopted in Dakar (April 2000). This paper describes the situation confronting children, their families, and governments in conflict countries and describes the challenges of reaching universal primary…
Pyrethroid, DDT and malathion resistance in the malaria vector Anopheles gambiae from the Democratic Republic of Congo.

PubMed

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

2013-01-01

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

PubMed

Marshall, Andrew J; Hohmann, Gottfried

2005-01-01

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

PubMed

Ribesse, Nathalie; Iyeti, Alain; Macq, Jean

2015-01-01

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

PubMed

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

2018-03-01

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

PubMed

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

2017-10-09

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

PubMed

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

2014-06-01

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

PubMed

Mels, Cindy; Derluyn, Ilse; Broekaert, Eric; García-Pérez, Coral

2015-02-01

This study explores coping strategies used by war-affected eastern Congolese adolescents across age and sex, and the association between post-traumatic stress symptoms and engagement and disengagement coping. Cross-sectional data were collected in 11 secondary schools across four areas in the Ituri province, Democratic Republic of Congo. A total of 952 pupils (45.3% girls, 54.7% boys) aged 13-21 years (M = 15.83, standard deviation = 1.81) participated in self-report assessment, using instruments that were either specifically developed (Adolescent Complex Emergency Exposure Scale, assessing traumatic exposure), validated (Impact of Event Scale Revised, assessing post-traumatic stress symptoms) or reviewed (Kidcope, assessing coping strategies) for the study population. Reported coping strategies varied with age, and boys more frequently reported problem solving and resignation as compared with girls. Disengagement coping was associated with lower symptom scores in younger adolescent girls, as was the interaction effect between engagement and disengagement coping. We conclude that disengagement coping is not necessarily a maladaptive reaction to stressful events in war-affected situations and that future research should aim to better understand the heterogeneous patterns of stress and coping responses, including the role of factors such as the nature and appraisal of stressors, available resources for coping and cultural preferences. © 2013 John Wiley & Sons, Ltd.
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
The incidence of induced abortion in Kinshasa, Democratic Republic of Congo, 2016

PubMed Central

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

2017-01-01

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

PubMed

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

2017-01-01

In the Democratic Republic of Congo, the penal code prohibits the provision of abortion. In practice, however, it is widely accepted that the procedure can be performed to save the life of a pregnant woman. Although abortion is highly restricted, anecdotal evidence indicates that women often resort to clandestine abortions, many of which are unsafe. However, to date, there are no official statistics or reliable data to support this assertion. Our study provides the first estimates of the incidence of abortion and unintended pregnancy in Kinshasa. We applied the Abortion Incidence Complications Method (AICM) to estimate the incidence of abortion and unintended pregnancy. We used data from a Health Facilities Survey and a Prospective Morbidity Survey to determine the annual number of women treated for abortion complications at health facilities. We also employed data from a Health Professionals Survey to calculate a multiplier representing the number of abortions for every induced abortion complication treated in a health facility. In 2016, an estimated 37,865 women obtained treatment for induced abortion complications in health facilities in Kinshasa. For every woman treated in a facility, almost four times as many abortions occurred. In total, an estimated 146,713 abortions were performed, yielding an abortion rate of 56 per 1,000 women aged 15-49. Furthermore, more than 343,000 unintended pregnancies occurred, resulting in an unintended pregnancy rate of 147 per 1,000 women aged 15-49. Increasing contraceptive uptake can reduce the number of women who experience unintended pregnancies, and as a consequence, result in fewer women obtaining unsafe abortions, suffering abortion complications, and dying needlessly from unsafe abortion. Increasing access to safe abortion and improving post-abortion care are other measures that can be implemented to reduce unsafe abortion and/or its negative consequences, including maternal mortality.
[The War on "Red Drugs": Anticommunism and Drug Policy in Republic of Korea, 1945-1960].

PubMed

Park, Ji-Young

2016-04-01

This paper investigates the discourses and policies on narcotics in Republic of Korea from 1945 to 1960. Since the Liberation the narcotic problem was regarded as the vestige of Japanese imperialism. which was expected to be cleaned up. The image of narcotic crimes as the legacy of the colonial past was turned into as the result of the Red Army's tactics to attack on the liberalist camp around the Korean war. The government of ROK represented the source of the illegal drugs as the Red army and the spy from North Korea. The anticommunist discourse about narcotics described the spies, who introduced the enormous amount of poppies into ROK and brought about the addicts, as the social evil. Through this discourse on poppies from North Korea, the government of ROK emphasized the immorality of the communists reinforcing the anticommunist regime, which was inevitable for the government of ROK to legitimize the division of Korea and the establishment of the government alone. This paper examines how the discourses and policies on narcotics in ROK was shaped and transformed from 1945 to 1960 focusing the relationship between the them and the political context such as anticommunism, Korean war, the division of Korea, and etc. This approach would be helpful to reveal the effect of the ROK's own political situation to the public health system involving the management for drugs.
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

Past as Prelude: The Defense Debate in the Cold War

DTIC Science & Technology

1991-03-01

There were also congressional * investigations of fraud and preparedness mismanagement during World War II and the Korean War. As a freshman 3 Democratic...increased above the levels of the Truman administration with the establishment of new treaty organizations in the Middle East and Southeast Asia . The...Berlin, Cuba, and Southeast Asia . Kennedy quickly became disenchanted with the advice of the JCS in 1961, due to military setbacks in Laos and the 1 5
Preventing vertical transmission of HIV in Kinshasa, Democratic Republic of the Congo: a baseline survey of 18 antenatal clinics.

PubMed

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

2006-12-01

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

DTIC Science & Technology

2017-03-01

2000s to establish democratic regimes in Afghanistan and Iraq reflect an American foreign policy tradition that began at the end of World War II. The...Afghanistan and Iraq reflect an American foreign policy tradition that began at the end of World War II. The pairing of national security interests...Afghanistan and Iraq reflect an American foreign policy tradition that began at the end of World War II. The pairing of national security interests with the
Antecedent causes of a measles resurgence in the Democratic Republic of the Congo

PubMed Central

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

2015-01-01

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

PubMed

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

2015-01-01

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

PubMed

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

2018-06-01

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

ERIC Educational Resources Information Center

Hayes, Richard L.

1982-01-01

Charges that education in this democracy is not democratic. Reviews the humanistic trend in education from 1960 to the present. Suggests public schools are charged with the responsibility of preparing students for a future society and, in this interest, should promote more democratic instruction which requries more democratic leadership. (JAC)
Localised transmission hotspots of a typhoid fever outbreak in the Democratic Republic of Congo.

PubMed

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

2017-01-01

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

PubMed Central

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

2017-01-01

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

PubMed

Albrecht, Helmuth

2014-01-01

The invention of the laser in 1960 and the innovation process of laser technology during the following years coincided with the dramatic increase of the East-West-conflict during the 1960s - the peak of the so-called Cold War after the erection of the Berlin Wall in 1961. The predictable features of the new device, not only for experimental sciences, but also for technical and military applications, led instantly to a laser hype all over the world. Military funding and research played a major part in this development. Especially in the United States military laser research and development played an important role in the formation of Cold War sciences. The European allies followed this example to a certain degree, but their specific national environments led to quite different solutions and results. This article describes and analyzes the special features and background of this development for the Federal Republic of Germany in the area of conflict between science, politics and industry from 1960 to the early 1970s.
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.
Civic Education and Visions of War and Peace in the Spanish Transition to Democracy

ERIC Educational Resources Information Center

Mahamud Angulo, Kira; Groves, Tamar; Milito Barone, Cecilia Cristina; Hernández Laina, Yovana

2016-01-01

This article explores visions of war and peace in the education system during the Spanish transition to democracy. During those years, the Spanish state was faced with the challenge of leaving its authoritarian political past behind and forging a democratic civic culture. As the concepts of war and peace are inextricably linked to those of state…
Mental health, citizenship, and the memory of World War II in the Netherlands (1945-85).

PubMed

Oosterhuis, Harry

2014-03-01

After World War II, Dutch psychiatrists and other mental health care professionals articulated ideals of democratic citizenship. Framed in terms of self-development, citizenship took on a broad meaning, not just in terms of political rights and obligations, but also in the context of material, social, psychological and moral conditions that individuals should meet in order to develop themselves and be able to act according to those rights and obligations in a responsible way. In the post-war period of reconstruction (1945-65), as well as between 1965 and 1985, the link between mental health and ideals of citizenship was coloured by the public memory of World War II and the German occupation, albeit in completely different, even opposite ways. The memory of the war, and especially the public consideration of its victims, changed drastically in the mid-1960s, and the mental health sector played a crucial role in bringing this change about. The widespread attention to the mental effects of the war that surfaced in the late 1960s after a period of 20 years of public silence should be seen against the backdrop of the combination of democratization and the emancipation of emotions.
Satellite-based primary forest degradation assessment in the Democratic Republic of the Congo, 2000-2010

NASA Astrophysics Data System (ADS)

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

2013-06-01

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

PubMed Central

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

2014-01-01

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

PubMed Central

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

2016-01-01

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

PubMed

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

2015-01-01

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

PubMed Central

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

2015-01-01

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

PubMed

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

2017-09-01

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

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

PubMed

Nsakala, Gabriel Vodiena; Coppieters, Yves

2014-01-01

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

ERIC Educational Resources Information Center

Kimble, James J.

2005-01-01

The focus of this paper is domestic propaganda. The author presents comprehensive reviews of four books: (1) "Bending Spines: The Propagandas of Nazi Germany and the German Democratic Republic" by Randall L. Bytwerk (East Lansing, MI: Michigan State University Press, 2004); (2) "Radio Goes to War: The Cultural Politics of Propaganda…
The War on Democratic Public Space: A Perspective from the United States

ERIC Educational Resources Information Center

Hill, Robert J.

2006-01-01

There is a crisis in democratic public space in the USA. This essay explores key areas that are either causes or effects of the present predicament: post-9-11 fear, neoliberalisation/globalisation, migrating populations, and the growing power of right-wing fundamentalism, among others. (Contains 6 notes.)
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
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
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.
Sediment-hosted stratabound copper assessment of the Neoproterozoic Roan Group, central African copperbelt, Katanga Basin, Democratic Republic of the Congo and Zambia: Chapter T in Global mineral resource assessment

USGS Publications Warehouse

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

2014-01-01

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

PubMed

Carr, Russell B

2013-01-01

The author, himself an Iraq war veteran, presents a contemporary psychodynamic understanding, known as intersubjective therapy, of combat-related Post-traumatic Stress Disorder (PTSD). At the onset of this case example, the patient was highly suicidal and his PTSD symptoms had not responded to a first-line treatment: manualized cognitive processing therapy. Robert Stolorow's intersubjective, psychodynamic approach to traumatic emotional experiences was then selected for treatment, and illustrates how combat in Afghanistan shattered this soldier's world and self experience. Therapeutic action arises from this intersubjective perspective by providing a relational home so that unendurable emotions can be borne, processed, and integrated to achieve a more constant and individualized sense of self. Being a two-person model of therapy, the author also describes how his work with this traumatized soldier affected him, ultimately contributing to his own sense of authentic existing. The author discusses the need for therapists to recognize and acknowledge to traumatized patients their shared finitude and the ubiquity of trauma. In the Postscript, the patient describes what he felt was therapeutic and contrasts this to his previous experiences with manualized cognitive processing therapy.
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
Paris on the Mekong: using the aid effectiveness agenda to support human resources for health in the Lao People's Democratic Republic

PubMed Central

Dodd, Rebecca; Hill, Peter S; Shuey, Dean; Fernandes Antunes, Adélio

2009-01-01

Background This study examines the potential of aid effectiveness to positively influence human resources for health in developing countries, based on research carried out in the Lao People's Democratic Republic (Lao PDR). Efforts to make aid more effective – as articulated in the 2005 Paris Declaration and recently reiterated in the 2008 Accra Agenda for Action – are becoming an increasingly prominent part of the development agenda. A common criticism, though, is that these discussions have limited impact at sector level. Human resources for health are characterized by a rich and complex network of interactions and influences – both across government and the donor community. This complexity provides a good prism through which to assess the potential of the aid effectiveness agenda to support health development and, conversely, possibilities to extend the impact of aid-effectiveness approaches to sector level. Methods The research adopted a case study approach using mixed research methods. It draws on a quantitative analysis of human resources for health in the Lao People's Democratic Republic, supplementing this with a documentary and policy analysis. Qualitative methods, including key informant interviews and observation, were also used. Results The research revealed a number pathways through which aid effectiveness is promoting an integrated, holistic response to a range of human resources for health challenges, and has identified further opportunities for stronger linkages. The pathways include: (1) efforts to improve governance and accountability, which are often central to the aid effectiveness agenda, and can be used as an entry point for reforming workforce planning and regulation; (2) financial management reforms, typically linked to provision of budget support, that open the way for greater transparency and better management of health monies and, ultimately, higher salaries and revenues for health facilities; (3) commitments to harmonization that
Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: qualitative evidence using the most significant change technique.

PubMed

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

2015-01-01

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

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

O'Brien, W.V.; Langan, J.

This book presents papers on the ethical aspects of nuclear weapons. Topics considered include the concept of a ''just'' war, national defense, political aspects, religion and politics, the failure of deterrence, conventional warfare, nuclear deterrence and democratic politics, the future of the nuclear debate, non-proliferation policy, arms control, national security, and government policies.
Lamprologus markerti, a new lamprologine cichlid (Teleostei: Cichlidae) endemic to the lower Congo River in the Democratic Republic of Congo, west-central Africa.

PubMed

Tougas, Stephanie; Stiassny, Melanie L J

2014-08-15

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

ERIC Educational Resources Information Center

Ochonu, Moses

2008-01-01

African professors are often asked by Americans at academic gatherings, campus events, and informal social gatherings what they think of the never-ending civil war in the Democratic Republic of the Congo, the genocide in Sudan, anarchy in Somalia, last year's disastrous elections in Nigeria, the Kenyan political crisis, and other problems. Whether…
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.
Mycological and aflatoxin contamination of peanuts sold at markets in Kinshasa, Democratic Republic of Congo, and Pretoria, South Africa.

PubMed

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

2014-01-01

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

PubMed

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

2017-02-01

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

MedlinePlus

... to Surgery for Many Patients Spotlight on Research Physical Therapy to Treat Torn Meniscus Comparable to Surgery ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded ...
An approach to health system strengthening in the Democratic Peoples Republic of Korea (North Korea).

PubMed

Grundy, John; Moodie, Rob

2009-01-01

The Democratic Peoples Republic of Korea (DPRK), under the leadership of the Ministry of Public Health (MOPH), undertook the development of a Health System Strengthening (HSS) proposal through the support of the Global Alliance for Vaccines and Immunization (GAVI). The aim of this paper is to outline the approach to the development of the HSS strategy in DPRK, and describe opportunities and challenges associated with its development and future implementation. Sources of information for this review have included national programme plans, in country social sector reviews, information generated through HSS proposal developments and the international literature. Updated assessments in DPRK indicate some recent improvements in the health situation for women and children, but there remain ongoing concerns regarding health management, human resource and physical infrastructure barriers to health services access. In response to this situation, the DPRK developed a health system strengthening strategy, the main elements of which are the strengthening of health management and service delivery systems at the implementing agency levels of county (district) and Ri (sub district). Three success factors were associated with the reaching of consensus on HSS strategy in DPRK. These were partnerships formed between system planners and programme planners, the identification of an overall health sector strategic framework, and high-level leadership of the MOPH. Although DPRK is in the very early stages of health system reconstruction, there are significant and new opportunities to alleviate the health conditions of women and children in DPRK, through implementation of health system strengthening strategies that are nationally coordinated and internationally supported.
Worrying exposure to trace elements in the population of Kinshasa, Democratic Republic of Congo (DRC).

PubMed

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

2012-11-01

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

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

PubMed

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

2017-09-01

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

PubMed

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

2014-01-01

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

ERIC Educational Resources Information Center

Musil, Caryn McTighe

2015-01-01

"A step away from complacent knowing" argues that the humanities have long been understood as enhancing civic life and human intellectual and moral development. At moments when democratic societies seem at risk, however, such as the birth of the new US Republic, the aftermath of World War II, and in the face of an anemic…
[Acute renal failure and severe malaria in Congolese children living in Kinshasa, Democratic Republic of Congo].

PubMed

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

2013-06-01

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

PubMed

Tarvonen, P-L; Sipilä, K; Yang, G S; Kim, J K; Lamidi, M-L; Suominen, A L

2016-11-01

The aim was to compare the change in dental caries status in two different intervention groups of the Children's Oral Health Promotion Programme (COHPP). A longitudinal study among 500 children who had participated into the COHPP for 6 years was conducted in Pyongyang, Democratic People's Republic of Korea (DPRK). Children in Group I received intensified school-based intervention and were clinically examined at the age of 7 years in 2007 (n = 250), 10 years in 2010 (n = 250) and 13 years in 2013 (n = 242). Children in Group II (n = 250) joined the programme at the age of 4 years in kindergarten in 2007, were provided with early preschool-based intervention and were clinically examined at the age of 7 years in 2010 and 10 years in 2013. Both the prevalence and the mean number of dt + DT decreased significantly in both groups during the follow-up. This was due to decrease in the number of dt, whereas the number of DT remained relatively constant. Poisson regression showed that the association between the group status and the change in the number of dt + DT was statistically significant when adjusted for gender but disappeared when the school was included in the analysis. The decrease in dental caries may be partly due to the exfoliation of deciduous teeth and dental treatment received. However, the study gave some reference emphasizing the early starting of the prevention. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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 (H 2 O, CO 2 , 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.
Serosurveillance of Coxiellosis (Q-fever) and Brucellosis in goats in selected provinces of Lao People's Democratic Republic.

PubMed

Burns, Rebekah J L; Douangngeun, Bounlom; Theppangna, Watthana; Khounsy, Syseng; Mukaka, Mavuto; Selleck, Paul W; Hansson, Eric; Wegner, Matthew D; Windsor, Peter A; Blacksell, Stuart D

2018-04-01

Goat raising is a growing industry in Lao People's Democratic Republic, with minimal disease investigation to date, especially zoonoses. This study determined the proportional seropositivity of two zoonotic diseases: Q fever (causative agent Coxiella burnetii) and Brucellosis (Brucella species) in goats across five provinces (Vientiane Capital, Xayaboury, Xiengkhuang, Savannakhet and Attapeu). A total of 1458 goat serum samples were tested using commercial indirect ELISA for both pathogens, plus Rose Bengal agglutination test for Brucellosis. Overall individual seropositivity of C. burnetii was 4.1% and Brucella spp. was 1.4%. A multiple logistic regression model identified that province (Vientiane Capital, p = 0.05), breed (introduced Boer mixed breed, p = 0.006) and age (goats ≥3 years old, p = 0.014) were significant risk factors for C. burnetii seropositivity. The results of the survey indicated that province (Vientiane Capital, p<0.001), breed (introduced Boer mixed breed, p<0.001), production system (commercial, p<0.001), age (adult, p = 0.004), and farm size (large, 0.001) were all significant risk factors seropositivity for Brucella spp. It was concluded that Lao goats have been exposed to both C. burnetii and Brucella spp. however the risk of clinical disease has not yet been determined and there is an urgent need to determine human health risks and economic losses caused by Q fever and Brucellosis.
[Risk factors for multidrug-resistant tuberculosis in the city of Kinshasa in the Democratic Republic of Congo].

PubMed

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

2016-01-01

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

PubMed

Douglas, Pamela Heidi

2014-10-01

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

PubMed Central

Bin Abd Razak, Hamid Rahmatullah; Amit Kanta, Mitra

2016-01-01

We report a case of a chondral delamination lesion due to medial parapatellar plica friction syndrome involving the medial femoral condyle. This mimicked a torn medial meniscus in clinical and radiological presentation. Arthroscopy revealed a chondral delamination flap, which was debrided. Diagnosis of chondral lesions in the knee can be challenging. Clinical examination and MRI have good accuracy for diagnosis and should be used in tandem. Early diagnosis and treatment of chondral lesions are important to prevent progression to early osteoarthritis. PMID:28070434
Democratic Republic of Congo: Background and U.S. Policy

DTIC Science & Technology

2013-06-29

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

ERIC Educational Resources Information Center

Finkel, Steven E.; Stumbras, Sheryl

A study examined the impact of civic education programs on political participation and democratic attitudes among adults and high school students in South Africa. The study represents an extension of a similar assessment of civic education programs in the Dominican Republic and Poland. Questionnaires were administered by a professional survey…
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
Challenges to the New Republic: Prelude to the War of 1812. Public Policy Debate in the Classroom. Choices for the 21st Century Education Project. [Student Guidebook and] Teacher's Resource Book.

ERIC Educational Resources Information Center

Kampmeier, Scott

This 4-day curriculum unit explores U.S. foreign policy between 1787 and 1812. During this time the United States faced a series of foreign policy challenges that threatened its survival as an independent, constitutional republic. Between 1793 and 1815, a nearly continuous series of wars pitting the French against the British engulfed the European…
Canalicular laceration repair using a viscoelastic injection to locate and dilate the proximal torn edge.

PubMed

Örge, Faruk H; Dar, Suhail A

2015-06-01

Canalicular lacerations are common complications of eyelid trauma in the pediatric population. Irrigating air, water, and colored or viscous agents through the intact canaliculus have been suggested to identify the torn proximal edge. We report our experience in repairing canalicular lacerations using a novel viscoelastic injection technique with a Monoka monocanalicular stent. The medical records of patients <18 years of age who underwent repair of a canalicular laceration with a monocanalicular stent using superficial viscoelastic deployment to locate the torn canaliculus were retrospectively reviewed. Demographics, cause of eyelid injury, surgical management using our novel viscoelastic injection technique, and outcome were analyzed. A total of 38 children with lid lacerations were identified, of whom the 17 with canalicular involvement were included (mean age, 6.27 years). Canalicular injury in these 17 was due to dog bite (9 patients) and shearing trauma (8 patients). In 11 patients, the injury was located in the lower lid; in 4, the upper lid; and in 2, combined upper and lower lids. All patients had good anatomic repair and on follow-up had negative dye disappearance tests and were free of tearing. Deploying viscoelastic superficially near, and injecting into the injured canaliculus can improve visualization of the operative field by retracting the surrounding tissue and tamponading any bleeding, which aids in location and dilation of the torn canaliculus initially and in subsequent steps, eases intubation into the lubricated torn canaliculus and nasolacrimal duct, and avoids iatrogenic injury to an uninjured canaliculus. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.
Beyond individual war trauma: domestic violence against children in Afghanistan and Sri Lanka.

PubMed

Catani, Claudia; Schauer, Elisabeth; Neuner, Frank

2008-04-01

To date, research on the psychosocial consequences of mass trauma resulting from war and organized violence on children has primarily focused on the individual as the unit of treatment and analysis with particular focus on mental disorders caused by traumatic stress. This body of research has stimulated the development of promising individual-level treatment approaches for addressing psychological trauma. In contrast, there is virtually no literature addressing the effects of mass trauma on the family and community systems. Research conducted in Sri Lanka and Afghanistan, two long-standing war-torn societies, found that in addition to multiple exposure to war or disaster-related traumatic events children also indicated high levels of exposure to family violence. These findings point to the need for conjoint family- and community-based programs of prevention and intervention that are specifically tailored for the context of the affected society. In particular, programs should take issues such as poverty, child labor, and parental alcohol use into account in assessing and treating children in the aftermath of mass trauma.
Vaccine-Derived Poliovirus Outbreaks and Events - Three Provinces, Democratic Republic of the Congo, 2017.

PubMed

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

2018-03-16

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

PubMed

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

2017-09-01

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

PubMed

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

2015-04-08

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

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

PubMed

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

2016-01-01

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

PubMed Central

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

2016-01-01

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

PubMed Central

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

2017-01-01

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

PubMed

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

2017-01-01

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

USGS Publications Warehouse

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

2017-01-01

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

PubMed

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

2017-10-03

During 2012, 2013 and 2015, we collected small mammals within 25 km of the town of Boende in Tshuapa Province, the Democratic Republic of the Congo. The prevalence of monkeypox virus (MPXV) in this area is unknown; however, cases of human infection were previously confirmed near these collection sites. Samples were collected from 353 mammals (rodents, shrews, pangolins, elephant shrews, a potamogale, and a hyrax). Some rodents and shrews were captured from houses where human monkeypox cases have recently been identified, but most were trapped in forests and agricultural areas near villages. Real-time PCR and ELISA were used to assess evidence of MPXV infection and other Orthopoxvirus (OPXV) infections in these small mammals. Seven (2.0%) of these animal samples were found to be anti-orthopoxvirus immunoglobulin G (IgG) antibody positive (six rodents: two Funisciurus spp.; one Graphiurus lorraineus ; one Cricetomys emini ; one Heliosciurus sp.; one Oenomys hypoxanthus , and one elephant shrew Petrodromus tetradactylus ); no individuals were found positive in PCR-based assays. These results suggest that a variety of animals can be infected with OPXVs, and that epidemiology studies and educational campaigns should focus on animals that people are regularly contacting, including larger rodents used as protein sources.
Sit Down with Sabin: Margaret Torn: The Carbon Cycle Like You've Never Seen It (LBNL Summer Lecture Series)

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

Russell, Sabin; Torn, Margaret

2011-07-06

Lawrence Berkeley National Laboratory soil scientist Margaret Torn appears July 6, 2011 on "Sit Down with Sabin," a weekly conversation in which former reporter Sabin Russell chats with Berkeley Lab staff about innovative science. Torn discusses how she travels the world to learn more about soil's huge role in the global carbon cycle. Brought to you by Berkeley Lab Public Affairs.
Aspects of Education for Democratic Citizenship in Post-War Germany

ERIC Educational Resources Information Center

Phillips, David

2012-01-01

Interest in post-crisis education and concomitantly in education for democracy and citizenship, manifest in a large number of recent initiatives and publications, provides an opportunity to revisit the period of occupation in Germany after the Second World War, when there was concern--at least in the Western Zones--to create an awareness of the…
Learning about War and Peace in the Great Lakes Region of Africa

ERIC Educational Resources Information Center

Bird, Lyndsay

2007-01-01

Two-thirds of the world's conflicts are in Africa. In particular, the Great Lakes region (Rwanda, Burundi, Democratic Republic of Congo, Uganda and Tanzania) continues to see conflicts that are complex, extreme and seemingly intractable. By exploring the narrative experiences of those most affected by the conflicts in the region--specifically…
High prevalence of intestinal worms in children up to 5 years of age in Huaphan province, Lao People's Democratic Republic (PDR).

PubMed

Nanthavong, Naphavanh; Black, Antony P; Khattignavong, Phonepadith; Lorphachan, Lavy; Vilivong, Keooudomphone; Goossens, Sylvie; Buisson, Yves; Quet, Fabrice; Muller, Claude P; Nakamura, Satoshi

2017-08-01

The prevalence of soil-transmitted helminth infection is high in Lao People's Democratic Republic (PDR), reaching 62% among school-children. However, this prevalence presents wide regional variations, due to differences in healthcare access and environmental factors. Curiously, there are few studies on helminth infections in pre-school children - an age group targeted by the national de-worming campaign. Therefore, a preliminary study was conducted in a remote region of Huaphan Province, North Laos, to determine the prevalence of helminth infections in pre-school children. A total of 74 pre-school aged children provided stool samples for this study. Parasite eggs were detected in 41.9% with Ascaris lumbricoides being most common (32.4%). Presence of parasites was significantly associated with distance from health centres. Such a high prevalence of helminth infection indicates that the national deworming campaign is not adequate in the remote areas, in particular in villages distant from health care centres. It is necessary to ensure the proper administration of anti-helminthics to all children and to adapt the implementation of deworming campaigns to the specificities of each province.
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.
Ethics of mandatory premarital HIV testing in Africa: the case of Goma, Democratic Republic of Congo.

PubMed

Rennie, Stuart; Mupenda, Bavon

2008-08-01

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

PubMed Central

RENNIE, STUART; MUPENDA, BAVON

2015-01-01

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

PubMed Central

Burns, Rebekah J. L.; Douangngeun, Bounlom; Theppangna, Watthana; Khounsy, Syseng; Mukaka, Mavuto; Selleck, Paul W.; Hansson, Eric; Wegner, Matthew D.; Windsor, Peter A.

2018-01-01

Goat raising is a growing industry in Lao People’s Democratic Republic, with minimal disease investigation to date, especially zoonoses. This study determined the proportional seropositivity of two zoonotic diseases: Q fever (causative agent Coxiella burnetii) and Brucellosis (Brucella species) in goats across five provinces (Vientiane Capital, Xayaboury, Xiengkhuang, Savannakhet and Attapeu). A total of 1458 goat serum samples were tested using commercial indirect ELISA for both pathogens, plus Rose Bengal agglutination test for Brucellosis. Overall individual seropositivity of C. burnetii was 4.1% and Brucella spp. was 1.4%. A multiple logistic regression model identified that province (Vientiane Capital, p = 0.05), breed (introduced Boer mixed breed, p = 0.006) and age (goats ≥3 years old, p = 0.014) were significant risk factors for C. burnetii seropositivity. The results of the survey indicated that province (Vientiane Capital, p<0.001), breed (introduced Boer mixed breed, p<0.001), production system (commercial, p<0.001), age (adult, p = 0.004), and farm size (large, 0.001) were all significant risk factors seropositivity for Brucella spp. It was concluded that Lao goats have been exposed to both C. burnetii and Brucella spp. however the risk of clinical disease has not yet been determined and there is an urgent need to determine human health risks and economic losses caused by Q fever and Brucellosis. PMID:29649313
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.
[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.
Soil-transmitted helminth infections and risk factors in preschool children in southern rural Lao People's Democratic Republic.

PubMed

Kounnavong, Sengchanh; Vonglokham, Manithong; Houamboun, Keonakhone; Odermatt, Peter; Boupha, Boungnong

2011-03-01

The current widespread school-based control of soil-transmitted helminth (STH) infections is also advocated for preschool children. The objective of this study was to assess infection with STHs as well as their determinants in preschool children (<60 months) in southern rural Lao People's Democratic Republic (Lao PDR). A cluster survey was carried out from October to December 2006 in three districts of Savannakhet Province. The prevalence of Ascaris lumbricoides, hookworm and Trichuris trichiura was 27.4% (95% CI 27.0-27.6%), 10.9% (95% CI 10.7-11.0%) and 10.9% (95% CI 10.7-11.1%), respectively. Of the children studied, 28.4% had a monoparasitic infection and 9.3% had a polyparasitic infection. Older children had a higher risk for hookworm infection [odds ratio (OR) = 1.75, 95% CI 1.03-3.01; P = 0.041] and multiple infections (OR = 1.81, 95% CI 1.01-3.20; P = 0.044). Low socioeconomic status was associated with A. lumbricoides (OR = 0.61, 95% CI 0.38-0.98; P = 0.043) and monoparasitic infections (OR = 0.62, 95% CI 0.38-0.99; P = 0.049). In Lao PDR, deworming of preschool children is warranted. Preventive measures should address important risk factors. Health education regarding personal hygiene, appropriate water management and the construction and proper use of latrines are additional essential elements. Copyright © 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

A controversial idea as a cultural resource: The Lysenko controversy and discussions of genetics as a 'democratic' science in postwar Japan.

PubMed

Iida, Kaori

2015-08-01

The Japanese discussion of the theory of Soviet agronomist Trofim D. Lysenko began in the postwar years under the American occupation. Leftists introduced Lysenko's theory immediately after the war as part of a postwar scientists' movement. Unlike many American geneticists, who sharply criticized the theory, Japanese geneticists initially participated in the discussion in an even-handed way; their scientific interests in the roles of cytoplasm and the environment in heredity shaped their initial sympathetic reaction. As the Cold War divide deepened, however, Japanese scientists began expressing sharp anti-Lysenko criticisms that resembled the American criticisms. Interestingly, throughout the period, Japanese geneticists' overall aim in the discussion remained largely unchanged: to effectively reconstruct their discipline and maintain its proper image and authority. However, the shift in their reaction occurred due to an evolving sociopolitical context, especially the shift in the meaning of 'democratic' science from a science that employed democratic processes to a science of a liberal-democratic state. Regarding Lysenko's idea as a cultural resource could help to explain how and why it was treated differently in different places, and why a controversy emerged in certain contexts but not in others.
Geometry of torn boudin-An indicator of relative viscosity

NASA Astrophysics Data System (ADS)

Samanta, Susanta Kumar; Basu Majumder, Debojyoti; Sarkar, Goutam

2017-11-01

The present study determines the role of viscosity on the development of rectangular torn boudin and its various types, defined by the curvature of their exterior and face margins. Numerical modeling was performed with the help of Finite Element Method considering Maxwell visco-elastic materials in commercial code ANSYS. Seven different viscosities were used and interchanged among the boudin, inter-boudin and matrix materials to understand the effect of viscosity ratios, specifically of relative viscosity of inter-boudin material. Results show that the viscosity of inter-boudin material has significant control on the shape of torn boudins apart from the viscosity ratio of boudin to matrix material. Bone-shaped boudin develops only when the inter-boudin is more competent than boudin and it becomes more prominent when matrix is also competent than boudin, but incompetent than inter-boudin. When boudins are stiffer than inter-boudin, barrel-shaped and fish-head boudins with concave faces develop. Exterior or face margins remain almost straight when boudin is relatively rigid compared to its surrounding matrix materials, or when there is no or very little viscosity contrast between boudin and inter-boudin material even in case of large boudin-matrix viscosity contrast. Therefore, the relative viscosity among the boudin, inter-boudin and matrix materials can be estimated qualitatively by studying the shape of boudin in the field.
Harvey Cushing and the battle of Boston common: military medical preparedness for world war one.

PubMed

Rutkow, Eric; Rutkow, Ira

2010-07-01

To explore the events and people that shaped Harvey Cushing, one of the nation's leading surgeons, into a political actor as he rallied support for the issue of military medical preparedness for World War One. In a little remembered episode of American medical history, for 2 years before the nation's formal entry into World War One in April 1917, Harvey Cushing attempted to garner political and professional support for the idea of military medical preparedness. His efforts, including the proposed construction of a functioning Base Hospital on Boston Common, sparked controversy in a public that was torn between maintaining neutrality and going to war. An analysis of Harvey Cushing's unpublished letters, manuscripts, and papers located at the Yale University School of Medicine, New Haven, CT. While Harvey Cushing's crusade for military medical preparedness failed to win over the local public, it helped convince national military leaders that the civilian medical community was ready to assist in the war. This, in turn, laid the foundation for much of the American medical establishment's success on the battlefields of World War One. The disagreement surrounding the Battle of Boston Common, as Harvey Cushing had labeled the debate, reveals both how, even at the brink of war, ideas formulated on the war front could not be translated to the home front, and how early military medical preparedness, although national in character, was commanded by only a few select voices.
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.
Causes of death of prisoners of war during the Korean War (1950-1953).

PubMed

Lee, Myoung-Soon; Kang, Min-Jung; Huh, Sun

2013-03-01

This study aimed at analyzing the causes of death of prisoners of war (POWs) during the Korean War (1950-1953) who fought for the Communist side (North Korea and the People's Republic of China). In 1998, the United States Department of Defense released new information about the prisoners including, 7,614 deaths of the POW during the Korean War. The data on the causes of death of the POWs during the Korean War provides valuable information on the both the public health and history of the conflict. To analyze the causes of death of the POWs, we classified the clinical diagnosis and findings on 7,614 deaths into 22 chapters, as outlined in the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Second, we traced changes in the monthly death totals of POWs as well as deaths caused by common infectious diseases and external causes of death including injury over time from August 1950 to September 1953. The most common category of causes of deaths of POWs was infectious disease, 5,013 (65.8%) out of 7,614 deaths, followed by external causes including injury, 817 (10.7%). Overall, tuberculosis and dysentery/diarrhea were the most common causes of death. Deaths caused by acute and chronic infection, or external causes showed different patterns of increases and decline over time during the Korean War. The information and data on POWs' deaths during the Korean War reflects the critical impact of the POWs' living conditions and the effect of public health measures implemented in POW camps during the war.
The psychological impact of forced displacement and related risk factors on Eastern Congolese adolescents affected by war.

PubMed

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

2010-10-01

While the current knowledge base on the mental health effects of displacement is mainly limited to refugees residing in industrialised countries, this paper examines the impact of war-induced displacement and related risk factors on the mental health of Eastern Congolese adolescents, and compares currently internally displaced adolescents to returnees and non-displaced peers. Data were collected from a community sample of 819 adolescents aged 13 to 21 years, attending one of 10 selected schools across the Ituri district in the Democratic Republic of Congo. Respondents completed culturally adapted self-report measures of posttraumatic stress symptoms (using the Impact of Event Scale - Revised) and internalising and externalising behaviour problems (by means of the Hopkins Symptoms Checklist - 37 for Adolescents). Associated factors studied were age, sex, parental death, exposure to war-related violence and daily stressors. Internally displaced persons (IDPs) reported highest mean scores for the IES-R and the HSCL-37A internalising scale, followed by returnees, while non-displaced adolescents scored significantly lower. However, ANCOVA tests showed that posttraumatic stress and internalising symptoms were mainly associated with traumatic exposure and daily stressors and not with displacement status. Externalising problem scores were associated with traumatic exposure, daily stressors and displacement. Remarkably, death of father was associated with fewer externalising problems. Sex was differently associated with internalising and externalising problems through traumatic and daily stressors. As IDPs are highly exposed to violence and daily stressors, they report most psychological distress, when compared to returnees and non-displaced peers. The distinct mental health outcomes for returned youngsters illustrate how enhancing current socio-economic living conditions of war-affected adolescents could stimulate resilient outcomes, despite former trauma or displacement.
Civilization versus Barbarism: The Franco-Prussian War in French History Textbooks, 1875-1895

ERIC Educational Resources Information Center

Lehmann, Jörg

2015-01-01

In French history textbooks published after France's defeat in the Franco-Prussian War of 1870 to 1871, the presentation of the war and its outcome frequently include the myth of France's revanche and depictions of the Prussian enemy as barbarians. Other textbooks presented a narrative of progress in which the French Third Republic is shown as the…
Altered Gene and Protein Expressions in Torn Rotator Cuff Tendon Tissues in Diabetic Patients.

PubMed

Chung, Seok Won; Choi, Bo Mi; Kim, Ja Yeon; Lee, Yong-Soo; Yoon, Jong Pil; Oh, Kyung-Soo; Park, Kyung Sik

2017-03-01

To analyze and compare the gene and protein expression characteristics in torn rotator cuff tendon tissues between diabetic and nondiabetic patients. This was a pilot study. Twelve samples of rotator cuff tendon tissue from diabetic patients (mean age, 62.3 ± 9.9 years) and 12 age- and sex-matched nondiabetic tendon tissues (62.3 ± 9.9 years) were acquired from the torn tendon end of medium rotator cuff tears during arthroscopic surgery, after applying the same inclusion and exclusion criteria. Expressions of various genes of interest, including collagens I and III, matrix metalloprotease (MMP)-2, MMP-3, MMP-9, MMP-13, interleukin (IL)-1, IL-6, insulin-like growth factor-1, vascular endothelial growth factor, tenomodulin, tumor necrosis factor-α, and p53, were analyzed with real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). In addition, immunohistochemistry and western blot assay were performed for the genes that revealed significantly different expressions in real-time qRT-PCR between groups. Gene expression levels of MMP-9, MMP-13, IL-6, and tenomodulin were significantly higher in the diabetic than in the nondiabetic group by real-time qRT-PCR analyses (P = .011, .004, .009, and .010, respectively). The density of cells expressing MMP-9 and IL-6 was significantly increased in the torn tendons of the diabetic patients on immunohistochemical analysis, and the density of MMP-9 and IL-6 protein expressions was significantly higher in the diabetic group on western blot (P = .018 and .044, respectively). Diabetic torn cuff tendon tissues showed MMP-9 and IL-6 overexpressions compared with controls. The overexpressions of MMP-9 and IL-6 may be one of the explanations for the high healing failure rate after rotator cuff repair in the diabetic patients. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Assessment of hypertension management in primary health care settings in Kinshasa, Democratic Republic of Congo.

PubMed

Lulebo, Aimée M; Mapatano, Mala A; Kayembe, Patrick K; Mafuta, Eric M; Mutombo, Paulin B; Coppieters, Yves

2015-12-24

Hypertension-related complications have become more diagnosed at secondary and tertiary care levels, in the Democratic Republic of the Congo (DRC), probably indicative of poor management of hypertensive patients at primary health care level. This study aimed to assess the management of hypertension in primary health care settings by using guidelines of the International Forum for Prevention and Control of HTN in Africa (IFHA). A multi-center cross-sectional study was carried out in primary health care settings. A total of 102 nurses were surveyed using a structured interview. Mean and proportion comparisons were performed using the t Student test and the Chi-square test respectively. The Kinshasa Primary Health Care network facilities were compared with non-Kinshasa Primary Health Care network facilities. From the 102 nurses surveyed; 52.9% were female with a mean age of 41.1, (SD = 10) years, merely 9.5% benefited from in-job training on cardiovascular diseases or their risk factors, and 51.7% had guidelines on the management of hypertension. Less than a quarter of the nurses knew the cut-off values of hypertension, diabetes and obesity. Merely 14.7% knew the therapeutic goals for uncomplicated hypertension. Several of the indicators for immediate referral recommended by IFHA were unmentioned. The content of patient education was lacking, avoiding stress being the best advice provided to hypertensive patients. The antihypertensive most used were unlikely to be recommended by the IFHA. This study showed a considerable gap of knowledge and practices in the management of hypertensive patients at primary health care facilities in Kinshasa pertaining to the IFHA guidelines. We think that task-shifting for management of hypertension is feasible if appropriate guidelines are provided and nurses trained.
Sensibility analysis of VORIS lava-flow simulations: application to Nyamulagira volcano, Democratic Republic of Congo

NASA Astrophysics Data System (ADS)

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

2015-03-01

Assessment and management of volcanic risk are important scientific, economic, and political issues, especially in densely populated areas threatened by volcanoes. The Virunga area in the Democratic Republic of Congo, with over 1 million inhabitants, has to cope permanently with the threat posed by the active Nyamulagira and Nyiragongo volcanoes. During the past century, Nyamulagira erupted at intervals of 1-4 years - mostly in the form of lava flows - at least 30 times. Its summit and flank eruptions lasted for periods of a few days up to more than two years, and produced lava flows sometimes reaching distances of over 20 km from the volcano, thereby affecting very large areas and having a serious impact on the region of Virunga. In order to identify a useful tool for lava flow hazard assessment at the Goma Volcano Observatory (GVO), we tested VORIS 2.0.1 (Felpeto et al., 2007), a freely available software (http://www.gvb-csic.es) based on a probabilistic model that considers topography as the main parameter controlling lava flow propagation. We tested different Digital Elevation Models (DEM) - SRTM1, SRTM3, and ASTER GDEM - to analyze the sensibility of the input parameters of VORIS 2.0.1 in simulation of recent historical lava-flow for which the pre-eruption topography is known. The results obtained show that VORIS 2.0.1 is a quick, easy-to-use tool for simulating lava-flow eruptions and replicates to a high degree of accuracy the eruptions tested. In practice, these results will be used by GVO to calibrate VORIS model for lava flow path forecasting during new eruptions, hence contributing to a better volcanic crisis management.
Low prevalence of HIV and other selected sexually transmitted infections in 2004 in pregnant women from Kinshasa, the Democratic Republic of the Congo

PubMed Central

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

2008-01-01

SUMMARY This study examined the prevalence of HIV and other sexually transmitted infections (STIs) in pregnant women in Kinshasa, the Democratic Republic of the Congo (DRC). Between April and July 2004, antenatal attendees at two of the largest maternity clinics in Kinshasa were tested to identify HIV status, syphilis, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). HIV seroprevalence was 1·9% in 2082 women. With PCR techniques, CT and NG infections were also uncommon in the first 529 women (1·7% and 0·4%, respectively). No active syphilis infection case was identified by Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin test (RPR). A woman's risk of HIV infection was significantly associated with her reporting a male partner having had other female sexual partners (OR 2·7, 95% CI 1·2–6·2). The continuing low seroprevalence of HIV in pregnant women from Kinshasa was confirmed. Understanding factors associated with this phenomenon could help prevent a future HIV epidemic in low HIV transmission areas in Africa. PMID:18028581
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.
Changing spatial patterns and increasing rurality of HIV prevalence in the Democratic Republic of the Congo between 2007 and 2013.

PubMed

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

2016-05-01

The Democratic Republic of the Congo (DRC) has one of the lowest HIV prevalence in sub-Saharan Africa, estimated at 1.1% [0.9-1.3] of adults aged 15-49 in 2013 (UNAIDS). Within the 2 million km(2) country, however, there exists spatial variation in HIV prevalence, with the highest HIV prevalence observed in the large cities of Kinshasa and Lubumbashi. Globally, HIV is an increasingly rural disease, diffusing outwards from urban centers of high HIV prevalence to places where HIV was previously absent or present at very low levels. Utilizing data collected during Demographic and Health Surveillance (DHS) in 2007 and 2013 in the DRC, we sought to update the map of HIV prevalence in the DRC as well as to explore whether HIV in the DRC is an increasingly rural disease or remains confined to urban areas. Bayesian kriging and regression indicate that HIV prevalence in rural areas of the DRC is higher in 2013 than in 2007 and that increased distance to an urban area is no longer protective against HIV as it was in 2007. These findings suggest that HIV education, testing and prevention efforts need to diffuse from urban to rural areas just as HIV is doing. Copyright © 2016 Elsevier Ltd. All rights reserved.
Medical journals in the Republic of Macedonia after the Second World War.

PubMed

Polenakovic, M; Danevska, L

2011-01-01

An attempt was made to retrospectively examine the medical journals published in the Republic of Macedonia since the Second World War. An analysis was made of the basic data concerning the journals, most of which are deposited in the Central Library of the Medical Faculty at the Ss. Cyril and Methodius University in Skopje, and a few deposited in the National and the St. Clement of Ohrid University Library in Skopje. Some journal-related data were obtained by searching the electronic databases (mainly Medline/PubMed, Hinari, Ebsco) and the Internet as a global system of network of networks. After the Second World War several attempts at publishing biomedical journals have been made in the Republic of Macedonia. The number of journals has increased especially in the last ten years. Only a few of them have a long-term publishing tradition. In fact, the only journal to maintain continuity in publishing until today is the Macedonian Medical Review, that has been published regularly since 1946 until today. It is an official publication of the Macedonian Medical Society. The Annual of the Medical Faculty in Skopje was published from 1954 to 1997 under this name, and in 1997 it was renamed the Macedonian Journal of Medicine. There was an interruption in its publishing in 1999 and 2000 and it was regularly published until 2007, after which its publication ceased once more. In addition to these two journals, other medicine-related journals that have been published in the Republic of Macedonia (some of them, however, irregularly or they have ceased publication) are Acta Morphologica (since 2004); Physioacta (since 2007); Paediatrics Annual Review (since 1996); Epilepsy (since 1997); Acta Ortopedica et Traumatologica Macedonia (since 1999); MJMS-Macedonian Journal of Medical Sciences (since 2008); Prilozi Macedonian Academy of Arts and Sciences (since 1969); Macedonian Dental Review (since 1977); Dental Review (since 2007); Macedonian Pharmaceutical Bulletin (since 1964
Mirror, Mirror on the Wall: Examining the National Association of Scholars and Teachers for Democratic Culture Debate.

ERIC Educational Resources Information Center

Allen, Mike; Tollefson, Michael

This paper considers the ongoing debate between two organizations (National Association of Scholars and Teachers for a Democratic Culture) in higher education. The rhetorical positions of each side resemble those of the "cold war" between the United States and the Soviet Union of the 1950s and 1960s where each side created a mirror image…
Batwanema gen. n. and Chokwenema gen. n. (Oxyurida, Hystrignathidae), new nematode genera as parasites of Passalidae (Coleoptera) from the Democratic Republic of Congo

PubMed Central

Morffe, Jans; García, Nayla

2013-01-01

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

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

Doruska, J.

1995-12-01

The Czech Republic ranks among the countries with high total reserves of hard coal and lignite. Therefore coal always had and still has a significant role in covering the power demand of the Czech Republic. Transition of the national economy, based on the principles of the market economy and private ownership, affects among others also behavior of the mining companies. A strong emphasis is also aimed at the environmental aspects concerning both the process of coal mining and the process of its utilization. Within these intentions the power policy of the Czech Republic is formulated. The Czech Republic, which hasmore » 10 mil. inhabitants, ranks among the countries with a high share of industry in the process of creating the gross national product. This state has its historical roots as on the present territory of the Czech Republic there had been concentrated a majority of industrial and mining capacities of the Hapsburg Empire. The First World War resulted among others in the decline of the Hapsburg Empire. Within this process Czechoslovak Republic was established (apart from other things the center of democracy in the Central Europe). In that republic the industry had an important position. The industrial potential had been expanded even during the occupation of Czechoslovakia by Nazi Germany in the years 1939 - 1945. After the Second World War when Europe was divided into two political spheres Czechoslovakia became a significant industrial base of so called East Bloc. Such a development and the needs of the Eastern Bloc resulted in the intensive development of the heavy industry on the territory of Czechoslovakia.« less
Cost effectiveness of meniscal allograft for torn discoid lateral meniscus in young women.

PubMed

Ramme, Austin J; Strauss, Eric J; Jazrawi, Laith; Gold, Heather T

2016-09-01

A discoid meniscus is more prone to tears than a normal meniscus. Patients with a torn discoid lateral meniscus are at increased risk for early onset osteoarthritis requiring total knee arthroplasty (TKA). Optimal management for this condition is controversial given the up-front cost difference between the two treatment options: the more expensive meniscal allograft transplantation compared with standard partial meniscectomy. We hypothesize that meniscal allograft transplantation following excision of a torn discoid lateral meniscus is more cost-effective compared with partial meniscectomy alone because allografts will extend the time to TKA. A decision analytic Markov model was created to compare the cost effectiveness of two treatments for symptomatic, torn discoid lateral meniscus: meniscal allograft and partial meniscectomy. Probability estimates and event rates were derived from the scientific literature, and costs and benefits were discounted by 3%. One-way sensitivity analyses were performed to test model robustness. Over 25 years, the partial meniscectomy strategy cost $10,430, whereas meniscal allograft cost on average $4040 more, at $14,470. Partial meniscectomy postponed TKA an average of 12.5 years, compared with 17.30 years for meniscal allograft, an increase of 4.8 years. Allograft cost $842 per-year-gained in time to TKA. Meniscal allografts have been shown to reduce pain and improve function in patients with discoid lateral meniscus tears. Though more costly, meniscal allografts may be more effective than partial meniscectomy in delaying TKA in this model. Additional future long term clinical studies will provide more insight into optimal surgical options.
Helminth and Intestinal Protozoa Infections, Multiparasitism and Risk Factors in Champasack Province, Lao People's Democratic Republic

PubMed Central

Sayasone, Somphou; Mak, Tippi K.; Vanmany, Monely; Rasphone, Oroth; Vounatsou, Penelope; Utzinger, Jürg; Akkhavong, Kongsap; Odermatt, Peter

2011-01-01

Background Detailed investigations of multiparasitism are scarce in the Mekong River basin. We assessed helminth (trematode, nematode, and cestode), and intestinal protozoa infections, and multiparasitism in random population samples from three different eco-epidemiological settings in Champasack province, southern Lao People's Democratic Republic (Lao PDR), and determined underlying risk factors. Methodology Two stool samples were collected from 669 individuals aged ≥6 months over consecutive days and examined for helminth infections using the Kato-Katz method. Additionally, one stool sample per person was subjected to a formalin-ethyl acetate concentration technique for diagnosis of helminth and intestinal protozoa infections. Questionnaires were administered to obtain individual and household-level data pertaining to behavior, demography and socioeconomic status. Risk factors for hepato-biliary and intestinal parasitic infections and multiparasitism were determined using multiple logistic regressions analyses. Principal Findings Multiple species intestinal parasite infections were common: 86.6% of the study participants harbored at least two and up to seven different parasites concurrently. Regarding nematode infections, hookworm was the most prevalent species (76.8%), followed by Ascaris lumbricoides (31.7%) and Trichuris trichiura (25.0%). Regarding trematodes, Opisthorchis viverrini and Schistosoma mekongi infections were found in 64.3% and 24.2% of the participants, respectively. Infections with intestinal protozoa were rare. Conclusions/Significance There is a pressing need to intensify and sustain helminth control interventions in the southern part of Lao PDR. Given the high prevalence with nematode and trematode infections and the extent of multiparasitism, preventive chemotherapy is warranted. This intervention should be coupled with health education and improved access to clean water and adequate sanitation to consolidate morbidity control and enhance
Genomics of an emerging clone of Salmonella serovar Typhimurium ST313 from Nigeria and the Democratic Republic of Congo.

PubMed

Leekitcharoenphon, Pimlapas; Friis, Carsten; Zankari, Ea; Svendsen, Christina Aaby; Price, Lance B; Rahmani, Maral; Herrero-Fresno, Ana; Fashae, Kayode; Vandenberg, Olivier; Aarestrup, Frank M; Hendriksen, Rene S

2013-10-15

Salmonella enterica serovar Typhimurium ST313 is an invasive and phylogenetically distinct lineage present in sub-Saharan Africa. We report the presence of S. Typhimurium ST313 from patients in the Democratic Republic of Congo and Nigeria. Eighteen S. Typhimurium ST313 isolates were characterized by antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). Additionally, six of the isolates were characterized by whole genome sequence typing (WGST). The presence of a putative virulence determinant was examined in 177 Salmonella isolates belonging to 57 different serovars. All S. Typhimurium ST313 isolates harbored resistant genes encoded by blaTEM1b, catA1, strA/B, sul1, and dfrA1. Additionally, aac(6')1aa gene was detected. Phylogenetic analyses revealed close genetic relationships among Congolese and Nigerian isolates from both blood and stool. Comparative genomic analyses identified a putative virulence fragment (ST313-TD) unique to S. Typhimurium ST313 and S. Dublin. We showed in a limited number of isolates that S. Typhimurium ST313 is a prevalent sequence-type causing gastrointestinal diseases and septicemia in patients from Nigeria and DRC. We found three distinct phylogenetic clusters based on the origin of isolation suggesting some spatial evolution. Comparative genomics showed an interesting putative virulence fragment (ST313-TD) unique to S. Typhimurium ST313 and invasive S. Dublin.

Investigation of pregnancy-associated malaria by microscopy, rapid diagnostic test and PCR in Bandundu, the Democratic Republic of Congo.

PubMed

Ruh, Emrah; Bateko, Jean Paul; Imir, Turgut; Taylan-Ozkan, Aysegul

2018-01-01

The study was conducted to investigate malaria prevalence among a group of women in the Democratic Republic of Congo (DRC) who received intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). A total of 250 women from Bandundu city who received two doses of IPTp-SP were enrolled in the survey. Blood samples were collected at the time of delivery and malaria prevalence was determined using microscopy, rapid diagnostic test (RDT), and nested polymerase chain reaction (PCR). Malaria infection was detected in 81 (32.4%), 93 (37.2%), and 92 (36.8%) samples by microscopy, RDT, and PCR, respectively. Among 92 samples, P. falciparum mono-infection (n=87; 94.5%), P. falciparum+P. vivax (n=2; 2.2%) and P. falciparum+P. malariae (n=1; 1.1%) mixed infections, and P. vivax mono-infection (n=2; 2.2%) were detected. Prevalence of malaria was not affected by age and number of pregnancies (p>0.05). Microscopy and RDT, either alone (κ=0.29; p<0.001) or in combination (κ=0.33; p<0.001) showed a fair agreement with PCR. Our findings indicate that two doses of IPTp-SP did not protect the women against malaria in the DRC, and support the World Health Organization (WHO) guidelines that ensure a minimum of three doses of SP in pregnancy.
Demographics and care-seeking behaviors of sexual violence survivors in South Kivu province, Democratic Republic of Congo.

PubMed

Bartels, Susan A; Scott, Jennifer A; Leaning, Jennifer; Kelly, Jocelyn T; Joyce, Nina R; Mukwege, Denis; Vanrooyen, Michael J

2012-12-01

One of the most striking features of the ongoing conflict in the Democratic Republic of Congo (DRC) is the use of sexual violence. In spite of the brutality of these crimes, the experiences of women affected by sexual violence in Eastern DRC remain poorly characterized. This analysis aimed to (1) provide detailed demographics of sexual violence survivors presenting to Panzi Hospital; (2) examine how demographic factors might impact patterns of sexual violence; and (3) describe care-seeking behavior among sexual violence survivors. The demographics and care-seeking behavior of sexual violence survivors in South Kivu Province were described from a retrospective registry-based study of sexual violence survivors presenting to Panzi Hospital (2004-2008). A total of 4311 records were reviewed. The mean age of survivors was 35 years. Most women (53%) were married, self-identified with the Bashi tribe (65%), and reported agriculture as their livelihood (74%). The mean time delay between sexual assault and seeking care was 10.4 months. Five reasons were identified to help explain the lengthy delays to seeking care: waiting for physical symptoms to develop or worsen before seeking medical attention, lack of means to access medical care, concerns that family would find out about the sexual assault, stigma surrounding sexual violence, and being abducted into sexual slavery for prolonged periods of time. Many sexual assault survivors have very delayed presentations to medical attention. Promoting timely access of medical care may best be facilitated by reducing stigma and by educating women about the benefits of early medical care, even in the absence of injuries or symptoms.
Importation of chloroquine-resistant Plasmodium falciparum by Guatemalan peacekeepers returning from the Democratic Republic of the Congo

PubMed Central

2013-01-01

Background Malaria elimination is being pursued in five of seven Central American countries. Military personnel returning from peacekeeping missions in sub-Saharan Africa could import chloroquine-resistant Plasmodium falciparum, posing a threat to elimination and to the continued efficacy of first-line chloroquine (CQ) treatment in these countries. This report describes the importation of P. falciparum from among 150 Guatemalan army special forces and support staff who spent ten months on a United Nations’ peacekeeping mission in the Democratic Republic of the Congo (DRC) in 2010. Methods Investigators reviewed patients’ medical charts and interviewed members of the contingent to identify malaria cases and risk factors for malaria acquisition. Clinical specimens were tested for malaria; isolated parasites were characterized molecularly for CQ resistance. Results Investigators identified 12 cases (8%) of laboratory-confirmed P. falciparum infection within the contingent; one case was from a soldier infected with a CQ-resistant pfcrt genotype resulting in his death. None of the contingent used an insecticide-treated bed net (ITN) or completely adhered to malaria chemoprophylaxis while in the DRC. Conclusion This report highlights the need to promote use of malaria prevention measures, in particular ITNs and chemoprophylaxis, among peacekeepers stationed in malaria-endemic areas. Countries attempting to eliminate malaria should consider appropriate methods to screen peacekeepers returning from endemic areas for malaria infections. Cases of malaria in travellers, immigrants and soldiers returning to Central America from countries with CQ-resistant malaria should be assumed to be carry resistant parasites and receive appropriate anti-malarial therapy to prevent severe disease and death. PMID:24060234
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

2017-11-01

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.
Quality of the antimalarial medicine artemether - lumefantrine in eight cities of the Democratic Republic of the Congo.

PubMed

Mufusama, Jean-Pierre; Ioset, Karine Ndjoko; Feineis, Doris; Hoellein, Ludwig; Holzgrabe, Ulrike; Bringmann, Gerhard

2018-06-12

In the context of post-marketing surveillance supporting public-health authorities to take evidence-based decisions to fight the spread of poor-quality medicines, the quality of antimalarial artemether-lumefantrine (AL) medicines was assessed in the Democratic Republic of the Congo (DRC). A total of 150 samples of AL containing products was collected from private pharmaceutical outlets in eight main cities: Goma, Kikwit, Kinshasa, Kisangani, Lubumbashi, Matadi, Mbandaka, and Mbuji-Mayi. All drug samples were successively analyzed by visual inspection, thin-layer chromatography (TLC), and high-performance liquid chromatography (HPLC) following The International Pharmacopoeia. Out of the 150 collected drug samples, three (2%) failed the visual inspection as they had shelf lives different from those of other samples with the same brand name. Four samples (2.7%) did not pass the TLC test as they contained only one or even none of the two declared active pharmaceutical ingredients (APIs). HPLC assays showed that 46 (30.7%) samples had artemether contents below 90% and 17 (11.3%) above 110% of the content claimed on the label. For lumefantrine, 32 (21.7%) samples had contents below 90%, and eight (5.3%) had contents above 110%. This survey in DRC gives evidence that poor-quality antimalarial medicines are widely present. Based on three detection techniques, the study shows the necessity to equip developing countries with modern techniques such as HPLC, which, if combined with affordable techniques like TLC, could provide a pertinent analytical strategy to combat drug counterfeiting and poor manufacturing. This article is protected by copyright. All rights reserved.
Trends in the incidence of acute watery diarrhoea in the Lao People's Democratic Republic, 2009–2013

PubMed Central

Houatthongkham, Souphatsone; Sithivong, Noikaseumsy; Jennings, Gregory; Phengxay, Manilay; Teepruksa, Phanthaneeya; Khamphaphongphane, Bouaphanh; Vongphrachanh, Phengta; Southalack, Kongmany; Luo, Dapeng

2016-01-01

Diarrhoeal disease is the second leading cause of death in children under age 5 worldwide, with rotavirus being the main etiology. In the Lao People's Democratic Republic, acute watery diarrhoea (AWD) was introduced as one of the national notifiable diseases in 2004. We retrospectively reviewed the aggregate (n = 117 277) and case-based (n = 67 755) AWD surveillance data from 2009 to 2013 reported weekly from 1115 health facilities nationwide. Rotavirus rapid test data from all eight sentinel sites in Vientiane Capital in 2013 were also collected for analysis. The incidence of AWD ranged between 215 and 476 cases per 100 000 population and increased from 2009 to 2012 when it levelled off. The most affected age group was children under 5 who were about seven to nine times more likely to have AWD than the rest of the population (P < 0.0001). In children under 5, 74.8% of the cases were aged 0–24 months and AWD was 1.28 times more common in males (P < 0.0001). Among the 230 stool specimens tested in children under 5 in 2013, 109 (47.4%) tested positive for rotavirus. The increased AWD incidence over the study period may reflect a true increase in AWD or an improved sensitivity of the system. We recommend new mothers breastfeed up to two years after birth, which is known to reduce AWD morbidity and mortality in young children. We also recommend conducting rotavirus disease burden and cost–effectiveness studies to explore the benefits of introduction of rotavirus vaccine. PMID:27818837
Democratic parenting: paradoxical messages in democratic parent education theories

NASA Astrophysics Data System (ADS)

Oryan, Shlomit; Gastil, John

2013-06-01

Some prominent parent education theories in the United States and other Western countries base their educational viewpoint explicitly on democratic values, such as mutual respect, equality and personal freedom. These democratic parenting theories advocate sharing power with children and including them in family decision making. This study presents a textual analysis of two such theories, the Adlerian model of parent education and the Parent Effectiveness Training (PET) model, as they are embodied in two original bestselling textbooks. Through content and argumentation analysis of these influential texts, this study examines the paradoxes inherent in these two theories when they articulate how to implement fully democratic principles within the parent-child relationship. We discover that in spite of their democratic rationale, both books offer communication practices that guide the child to modify misbehaviour, enforce parental power, and manipulate the child to make decisions that follow parental judgment, and thus do not endorse the use of a truly democratic parenting style. We suggest, as an alternative to the democratic parenting style, that parents be introduced to a guardianship management style, in which they do not share authority with children, but seek opportunities for enabling children to make more autonomous decisions and participate in more family decision making.
Heath Sector Network Governance and State-building in South Kivu, Democratic Republic of Congo.

PubMed

Bwimana, Aembe

2017-12-01

Longstanding patterns of interaction exist between state and non-state actors seeking to improve public health in Democratic Republic of Congo (DRC). DRC is a weak state, and, in many cases, private actors have stepped in to fill the void created by the lack of state health care provision. However, the role of these interactions in creating a governance network in the health sector has been underexplored. Using data from 18 months of qualitative field research, this study aimed to explore governance networks in DRC's health sector, examining how multiple stakeholders work to manage the health system and how the resulting governance network has been relevant for the state-building process. The findings demonstrate that the health sector in South Kivu is emerging as an arena of networked governance based on active partnerships between state institutions and non-state actors. Interactions between state and non-state actors account for the persistence of the health sector in a setting characterized by state weakness. However, networked governance does not function optimally, because, although non-state interventions fill the void where the state falls short, the DRC state has faced the challenge of interacting with partners with fragmented and horizontally competing agendas. Although weak, the shadow of state authority is present in the arena of stakeholders' interactions, as the state plays a determining role by providing a regulatory framework. Overall, the findings show that the interactive engagement of non-state actors contributes to improving institutional capacity through these actors' engagement with state institutions for health system management and institutional development. However, although networked health sector governance does contribute to state capacity, it is difficult to assess the real influence of these interactions on the state-building process in a context of critical fragility, where coordination and alignment have been problematic. © The
[Circulating vaccine-derived poliovirus type 2 outbreak in Democratic Republic of Congo 2011-2012].

PubMed

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

2015-10-01

According to the WHO records of 2013, the incidence of poliomyelitis was reduced by more than 99%, the number of endemic countries decreased from 125 in 1988 to 3 in 2013 and over 10 million cases were prevented from poliomyelitis thanks to the intensive use of Oral polio vaccine (OPV). However, the emergence of circulating vaccine-derived poliovirus strains (cVDPV), causing serious epidemics like the wild poliovirus, is a major challenge on the final straight towards the goal of eradication and OPV cessation. This paper describes the cVDPVoutbreak that occurred in the Democratic Republic of Congo (DRC) from November 2011 to April 2012. All children under 15 years of age with acute flaccid paralysis (AFP) and confirmed presence of cVDPV in the stool samples were included. Thirty (30) children, all from the administrative territories of Bukama and Malemba Nkulu in the Katanga Province (south-east DRC), were reported. The virus responsible was the cVDPV type 2 (0.7% -3.5% divergent from the reference Sabin 2 strain) in 29 children (97%) and the ambiguous vaccine-derived poliovirus strain (0.7% divergent) was confirmed in one case (3%), a boy seventeen months old and already vaccinated four times with OPV. Twentyfive children (83%) were protected by any of the routine EPI vaccines and 3 children (10%) had never received any dose of OPV. In reaction, DRC has conducted five local campaigns over a period of 10 months (from January to October 2012) and the epidemic was stopped after the second round performed in March 2012. As elsewhere in similar conditions, low immunization coverage, poor sanitation conditions and the stop of the use of OPV2 have favoured the emergence of the third cVDPV epidemic in DRC. The implementation of the Strategic Plan for Polio eradication and endgame strategic plan 2013-2018 will prevent the emergence of cVDPV and set up the conditions for a coordinated OPV phase out.
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
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.
Causes of Death of Prisoners of War during the Korean War (1950-1953)

PubMed Central

Lee, Myoung-Soon; Kang, Min-Jung

2013-01-01

Purpose This study aimed at analyzing the causes of death of prisoners of war (POWs) during the Korean War (1950-1953) who fought for the Communist side (North Korea and the People's Republic of China). In 1998, the United States Department of Defense released new information about the prisoners including, 7,614 deaths of the POW during the Korean War. The data on the causes of death of the POWs during the Korean War provides valuable information on the both the public health and history of the conflict. Materials and Methods To analyze the causes of death of the POWs, we classified the clinical diagnosis and findings on 7,614 deaths into 22 chapters, as outlined in the International Statistical Classification of Diseases and Related Health Problems-10th Revision (ICD-10). Second, we traced changes in the monthly death totals of POWs as well as deaths caused by common infectious diseases and external causes of death including injury over time from August 1950 to September 1953. Results The most common category of causes of deaths of POWs was infectious disease, 5,013 (65.8%) out of 7,614 deaths, followed by external causes including injury, 817 (10.7%). Overall, tuberculosis and dysentery/diarrhea were the most common causes of death. Deaths caused by acute and chronic infection, or external causes showed different patterns of increases and decline over time during the Korean War. Conclusion The information and data on POWs' deaths during the Korean War reflects the critical impact of the POWs' living conditions and the effect of public health measures implemented in POW camps during the war. PMID:23364985
[An Association Between Autonomy and National Ideology: The Founding of the Association for Psychiatry and Neurology in Mecklenburg].

PubMed

Kumbier, E

2016-10-01

Following the end of World War II, regional associations for psychiatry and neurology were founded in the Soviet Occupation Zone. Using the association in Mecklenburg as an example and considering the way society developed in the German Democratic Republic (GDR), it will be shown whether and to what degree these were increasingly subject to state control. © Georg Thieme Verlag KG Stuttgart · New York.
To War or Not? Engaging Middle School Students in an Ongoing Online Discussion

ERIC Educational Resources Information Center

O'Brien, Joseph; Lawrence, Nicholas; Green, Kori

2014-01-01

In seeking to prepare students to be "citizens of a culturally diverse, democratic society in an interdependent world," teachers engage students in live, online discussions about what justifies war, while at the same time grappling with the requirements to teach the memorization of people, places and isolated events. Teachers and a…
Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges

PubMed Central

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

2018-01-01

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

PubMed Central

2011-01-01

Background External quality assessments (EQA) are an alternative to cross-checking of blood slides in the quality control of malaria microscopy. This study reports the findings of an EQA of malaria microscopy in the Democratic Republic of the Congo (DRC). Methods After validation, an EQA slide panel and a questionnaire were delivered to diagnostic laboratories in four provinces of DRC. The panel included three samples for diagnosis (sample 1: Plasmodium falciparum, 177,000/μl, sample 2: P. falciparum, 2,500/μl, sample 3: no parasites seen), one didactic sample (Howell-Jolly bodies) and one sample for assessing the quality of staining. Participating laboratories were addressed and selected through the network of the National Tuberculosis Control Programme. Participants were asked to return the responses together with a stained thin and thick blood film for evaluation of Giemsa stain quality. Results Among 174 participants (response rate 95.1%), 26.2% scored samples 1, 2 and 3 correctly and 34.3%, 21.5% and 5.8% of participants reported major errors in one, two or three samples respectively. Major errors included reporting "no malaria" or "non-falciparum malaria" for Plasmodium falciparum-positive samples 1 and 2 (16.1% and 34.9% of participants respectively) and "P. falciparum" for Plasmodium negative sample 3 (24.0%). Howell-Jolly bodies (didactic sample) were not recognized by any of the participants but reported as "P. falciparum" by 16.7% of participants. With parasite density expressed according to the "plus system", 16.1% and 21.5% of participants scored one "+" different from the reference score for samples 1 and 2 respectively and 9.7% and 2.9% participants scored more than two "+" different. When expressed as counts of asexual parasites/μl, more than two-thirds of results were outside the mean ± 2SD reference values. The quality of the Giemsa stain was poor, with less than 20% slides complying with all criteria assessed. Only one quarter of participants
Family Planning in the Democratic Republic of the Congo: Encouraging Momentum, Formidable Challenges.

PubMed

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

2018-03-21

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

PubMed Central

Polonsky, Jonathan; Ciglenecki, Iza; Bichet, Mathieu; Coldiron, Matthew; Thuambe Lwiyo, Enoch; Akonda, Innocent; Serafini, Micaela; Porten, Klaudia

2018-01-01

In 2013, a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage, retrospective cluster survey to estimate the attack rate, the case fatality rate, and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0%, (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children, those who did not receive care, and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measles related death. Vaccination coverage prior to the outbreak was low (76%), and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural, inaccessible resource-poor setting. PMID:29538437
Risk factors for measles mortality and the importance of decentralized case management during an unusually large measles epidemic in eastern Democratic Republic of Congo in 2013.

PubMed

Gignoux, Etienne; Polonsky, Jonathan; Ciglenecki, Iza; Bichet, Mathieu; Coldiron, Matthew; Thuambe Lwiyo, Enoch; Akonda, Innocent; Serafini, Micaela; Porten, Klaudia

2018-01-01

In 2013, a large measles epidemic occurred in the Aketi Health Zone of the Democratic Republic of Congo. We conducted a two-stage, retrospective cluster survey to estimate the attack rate, the case fatality rate, and the measles-specific mortality rate during the epidemic. 1424 households containing 7880 individuals were included. The estimated attack rate was 14.0%, (35.0% among children aged <5 years). The estimated case fatality rate was 4.2% (6.1% among children aged <5 years). Spatial analysis and linear regression showed that younger children, those who did not receive care, and those living farther away from Aketi Hospital early in the epidemic had a higher risk of measles related death. Vaccination coverage prior to the outbreak was low (76%), and a delayed reactive vaccination campaign contributed to the high attack rate. We provide evidences suggesting that a comprehensive case management approach reduced measles fatality during this epidemic in rural, inaccessible resource-poor setting.
2.5D change detection from satellite imagery to monitor small-scale mining activities in the Democratic Republic of the Congo

NASA Astrophysics Data System (ADS)

Kranz, Olaf; Lang, Stefan; Schoepfer, Elisabeth

2017-09-01

Mining natural resources serve fundamental societal needs or commercial interests, but it may well turn into a driver of violence and regional instability. In this study, very high resolution (VHR) optical stereo satellite data are analysed to monitor processes and changes in one of the largest artisanal and small-scale mining sites in the Democratic Republic of the Congo, which is among the world's wealthiest countries in exploitable minerals To identify the subtle structural changes, the applied methodological framework employs object-based change detection (OBCD) based on optical VHR data and generated digital surface models (DSM). Results prove the DSM-based change detection approach enhances the assessment gained from sole 2D analyses by providing valuable information about changes in surface structure or volume. Land cover changes as analysed by OBCD reveal an increase in bare soil area by a rate of 47% between April 2010 and September 2010, followed by a significant decrease of 47.5% until March 2015. Beyond that, DSM differencing enabled the characterisation of small-scale features such as pits and excavations. The presented Earth observation (EO)-based monitoring of mineral exploitation aims at a better understanding of the relations between resource extraction and conflict, and thus providing relevant information for potential mitigation strategies and peace building.

Discovery of a Leptospirosis Cluster Amidst a Pneumonic Plague Outbreak in a Miners’ Camp in the Democratic Republic of the Congo

PubMed Central

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

2014-01-01

Conditions in the Democratic Republic of the Congo provide an ideal environment for leptospirosis and plague, both of which can cause severe pulmonary manifestations. In December 2004, an outbreak of lethal pneumonia occurred in a local mining camp, affecting 130 persons and killing 57 of them. Clinical signs, fast disease spread, and initial laboratory investigations suggested pneumonic plague. While leptospirosis had not recently been described in the region, it was considered as a differential diagnosis. Anti-Leptospira antibodies were detected by microscopic agglutination test (MAT). A confirmed case of leptospirosis was defined as having consistent clinical signs and any one of the following: seroconversion or four-fold increase in MAT titre for paired serum samples, or a MAT titre ≥ 1:400 for acute-phase serum samples. Twenty-nine of the 54 patients or convalescents tested for leptospirosis were seropositive. Two cases showed a confirmed infection for both plague and leptospirosis. While evidence supports the plague nature of this outbreak, the results suggest that some of the suspected plague cases might be due to leptospirosis. In any case, this diagnosis will have to be evoked in the future if a similar outbreak occurs in this region of Africa. PMID:24514425
Paediatric in-patient care in a conflict-torn region of Somalia: are hospital outcomes of acceptable quality?

PubMed Central

Zachariah, R.; Hinderaker, S. G.; Khogali, M.; Manzi, M.; van Griensven, J.; Ayada, L.; Jemmy, J. P.; Maalim, A.; Amin, H.

2013-01-01

Setting: A district hospital in conflict-torn Somalia. Objective: To report on in-patient paediatric morbidity, case fatality and exit outcomes as indicators of quality of care. Design: Cross-sectional study. Results: Of 6211 children, lower respiratory tract infections (48%) and severe acute malnutrition (16%) were the leading reasons for admission. The highest case-fatality rate was for meningitis (20%). Adverse outcomes occurred in 378 (6%) children, including 205 (3.3%) deaths; 173 (2.8%) absconded. Conclusion: Hospital exit outcomes are good even in conflict-torn Somalia, and should boost efforts to ensure that such populations are not left out in the quest to achieve universal health coverage. PMID:26393014
Housing the Citizen-Consumer in Post-war Britain: The Parker Morris Report, Affluence and the Even Briefer Life of Social Democracy.

PubMed

Kefford, Alistair

2018-06-01

This article examines debates about the design and provision of post-war housing within the papers and report of the Parker Morris committee. It does so to show how the models of citizens' rights and expectations which underpinned post-war welfare provision were transformed by mass affluence and the dynamic sphere of commercial consumption. Parker Morris's deliberations demonstrate that, as early as the 1950s, the citizen-subject was reimagined as a consuming individual, with requirements based on their expressive needs and consuming desires, and that this had far-reaching consequences for social democratic systems of universal welfare provision. The introduction of consumerist imperatives into publicly defined models of citizens' needs enhanced the political and cultural authority of the commercial domain, prompted a heightened role for commercial experts and market logics within public governance, and served to devalue socialized forms of provision in favour of consumer choice in the private market. The article thus engages with the growing scholarship on the politics of mass consumerism by showing how the material and emotional comforts of post-war affluence came to be constructed as critical to social democratic citizenship and selfhood. Situating this uneasy entanglement of social democratic rights with consumer satisfaction as part of a wider trajectory of political change, the piece suggests that Parker Morris marks an early but significant moment in the transition from post-war welfarism and social democracy to the consumer- and market-oriented forms of governance which came to dominate British politics and society in the latter part of the twentieth century.
Normal grief and its correlates in Lubumbashi, an urban city in the Democratic Republic of Congo.

PubMed

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

2016-01-01

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

PubMed Central

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

2016-01-01

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

PubMed

Kika, T M; Lepira, F B; Kayembe, P K; Makulo, J R; Sumaili, E K; Kintoki, E V; M'Buyamba-Kabangu, J R

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

PubMed Central

Behets, Frieda; Edmonds, Andrew; Kitenge, François; Crabbé, François; Laga, Marie

2010-01-01

Background We examined HIV prevalence trends over 4.5 years among women receiving antenatal care in Kinshasa, Democratic Republic of Congo, by geographic location, clinic management and urbanicity. Methods Quarterly proportions and 95% confidence intervals (CIs) of pregnant women with HIV positive results were determined using aggregate service provision and uptake data from 22 maternity units that provided vertical HIV prevention services from October 2004 to March 2009. Assuming linearity, proportions were assessed for trend via the Cochran–Armitage test. Multivariable binomial regression was used to describe detailed prevalence trends. Results HIV testing was offered to 220 006 pregnant women; 210 348 (95.6%) agreed to be tested and 191 216 (90.9%) received their results. A total of 3999 women were found to be HIV positive, a prevalence of 1.90% (95% CI: 1.84–1.96%). The median quarterly proportion of women testing positive for HIV was 1.94% (range: 1.44–2.44%). Prevalence was heterogeneous in terms of maternity management, urbanicity and geographic location. Modeling suggested that the overall prevalence dropped from 2.04% (95% CI: 1.92–2.16%) to 1.77% (95% CI: 1.66–1.88%) over 4.5 years, a relative decrease of 13.2% (95% CI: 3.53–22.9%). Trend testing corroborated this decline (P < 0.01). Conclusions The decreasing HIV prevalence among Kinshasa antenatal care seekers is robust and encouraging. The relatively low prevalence and the weak existing healthcare system require prevention of mother-to-child transmission interventions that strengthen maternal and child healthcare service delivery. Complacency would be unwarranted: assuming a uniform national crude birth rate of 50/1000 and 1.8% antenatal HIV prevalence, approximately 7000 pregnant HIV infected women in Kinshasa, and 60 000 nationwide, are in need of care and prevention services yearly. PMID:20453017
The geography of malaria genetics in the Democratic Republic of Congo: A complex and fragmented landscape

PubMed Central

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

2014-01-01

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

PubMed

Guy, Kitwe Mulunda

2009-01-01

This article sets medico legal light on torture of three former child soldiers by comparing torture methods, consequences of torture and medical observations. It is focused on these child soldiers as representatives of the many abuses of children as soldiers in armed groups. The three persons were child soldiers during 12 years in The Democratic Republic of Congo (DRC) as members of three different armed groups. They were exposed to armed conflict events, experienced torture, and participated in atrocities, sexual abuse and traditional rituals during their role in armed conflict. They were psychologically distressed with unhealthy physical and mental states. The principles for working with child soldiers are described. The model addresses basic items: The confluence of the dimensions of the items will determine the specifics of medico legal evidence of torture in child soldiers, taking into consideration inputs that are required at the macro, community and individual levels. A primary goal is to prevent violence from occurring in child soldiers. Thus, much more deliberate effort is made to address the underlying causes of recruitment of children in armed groups in DRC and to invest more resources in conflict resolution before there is an outbreak of violence. Peace education tends to be introduced too late and does little to alleviate the use of children in armed conflict in DRC.
Detecting Ebola with limited laboratory access in the Democratic Republic of Congo: evaluation of a clinical passive surveillance reporting system.

PubMed

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

2017-09-01

Ebola virus disease (EVD) can be clinically severe and highly fatal, making surveillance efforts for early disease detection of paramount importance. In areas with limited access to laboratory testing, the Integrated Disease Surveillance and Response (IDSR) strategy in the Democratic Republic of Congo (DRC) may be a vital tool in improving outbreak response. Using DRC IDSR data from the nation's four EVD outbreak periods from 2007-2014, we assessed trends of Viral Hemorrhagic Fever (VHF) and EVD differential diagnoses reportable through IDSR. With official case counts from active surveillance of EVD outbreaks, we assessed accuracy of reporting through the IDSR passive surveillance system. Although the active and passive surveillance represent distinct sets of data, the two were correlated, suggesting that passive surveillance based only on clinical evaluation may be a useful predictor of true cases prior to laboratory confirmation. There were 438 suspect VHF cases reported through the IDSR system and 416 EVD cases officially recorded across the outbreaks examined. Although collected prior to official active surveillance cases, case reporting through the IDSR during the 2007, 2008 and 2012 outbreaks coincided with official EVD epidemic curves. Additionally, all outbreak areas experienced increases in suspected cases for both malaria and typhoid fever during EVD outbreaks, underscoring the importance of training health care workers in recognising EVD differential diagnoses and the potential for co-morbidities. © 2017 John Wiley & Sons Ltd.
Serologic Evidence of Ebolavirus Infection in a Population With No History of Outbreaks in the Democratic Republic of the Congo.

PubMed

Mulangu, Sabue; Alfonso, Vivian H; Hoff, Nicole A; Doshi, Reena H; Mulembakani, Prime; Kisalu, Neville K; Okitolonda-Wemakoy, Emile; Kebela, Benoit Ilunga; Marcus, Hadar; Shiloach, Joseph; Phue, Je-Nie; Wright, Linda L; Muyembe-Tamfum, Jean-Jacques; Sullivan, Nancy J; Rimoin, Anne W

2018-01-30

Previous studies suggest that cases of Ebola virus disease (EVD) may go unreported because they are asymptomatic or unrecognized, but evidence is limited by study designs and sample size. A large population-based survey was conducted (n = 3415) to assess animal exposures and behaviors associated with Ebolavirus antibody prevalence in rural Kasai Oriental province of the Democratic Republic of Congo (DRC). Fourteen villages were randomly selected and all healthy individuals ≥1 year of age were eligible. Overall, 11% of subjects tested positive for Zaire Ebolavirus (EBOV) immunoglobulin G antibodies. Odds of seropositivity were higher for study participants older than 15 years of age and for males. Those residing in Kole (closer to the outbreak site) tested positive at a rate 1.6× higher than Lomela, with seropositivity peaking at a site located between Kole and Lomela. Multivariate analyses of behaviors and animal exposures showed that visits to the forest or hunting and exposure to rodents or duikers predicted a higher likelihood of EBOV seropositivity. These results provide serologic evidence of Ebolavirus exposure in a population residing in non-EBOV outbreak locations in the DRC and define statistically significant activities and animal exposures that associate with EBOV seropositivity. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.
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.
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
Prevalence Study of Yaws in the Democratic Republic of Congo Using the Lot Quality Assurance Sampling Method

PubMed Central

Gerstl, Sibylle; Kiwila, Gédeon; Dhorda, Mehul; Lonlas, Sylvaine; Myatt, Mark; Ilunga, Benoît Kebela; Lemasson, Denis; Szumilin, Elisabeth; Guerin, Philippe J.; Ferradini, Laurent

2009-01-01

Background Until the 1970s the prevalence of non-venereal trepanomatosis, including yaws, was greatly reduced after worldwide mass treatment. In 2005, cases were again reported in the Democratic Republic of the Congo. We carried out a survey to estimate the village-level prevalence of yaws in the region of Equator in the north of the country in order to define appropriate strategies to effectively treat the affected population. Methodology/Principal Findings We designed a community-based survey using the Lot Quality Assurance Sampling method to classify the prevalence of active yaws in 14 groups of villages (lots). The classification into high, moderate, or low yaws prevalence corresponded to World Health Organization prevalence thresholds for identifying appropriate operational treatment strategies. Active yaws cases were defined by suggestive clinical signs and positive rapid plasma reagin and Treponema pallidum hemagglutination serological tests. The overall prevalence in the study area was 4.7% (95% confidence interval: 3.4–6.0). Two of 14 lots had high prevalence (>10%), three moderate prevalence (5–10%) and nine low prevalence (<5%.). Conclusions/Significance Although yaws is no longer a World Health Organization priority disease, the presence of yaws in a region where it was supposed to be eradicated demonstrates the importance of continued surveillance and control efforts. Yaws should remain a public health priority in countries where previously it was known to be endemic. The integration of sensitive surveillance systems together with free access to effective treatment is recommended. As a consequence of our study results, more than 16,000 people received free treatment against yaws. PMID:19623266
Why the United States Underestimated the Soviet BW Threat

DTIC Science & Technology

2006-09-01

air sampling.2 For example, the nuclear power plant at Yongbyon in the Democratic People’s Republic of Korea was detected operating shortly after it...Cirincione, Wolfsthal, and Rajkumar, Deadly Arsenals, 435-437. 3 short amount of time. Chemical weapons plants also have large footprints that can...chemical processing plant for industry or agriculture is possible. For example, phosgene was a chemical weapon used extensively in World War I. This
Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice.

PubMed

Wachter, Karin; Murray, Sarah M; Hall, Brian J; Annan, Jeannie; Bolton, Paul; Bass, Judy

2018-07-01

The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC). Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD). Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t = -2.49, p = .013), anxiety (t = -3.08, p = .002), and PTSD (t = -2.94, p = .003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma. Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.
[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.
Pfhrp2-Deleted Plasmodium falciparum Parasites in the Democratic Republic of the Congo: A National Cross-sectional Survey.

PubMed

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

2017-07-01

Rapid diagnostic tests (RDTs) account for more than two-thirds of malaria diagnoses in Africa. Deletions of the Plasmodium falciparum hrp2 (pfhrp2) gene cause false-negative RDT results and have never been investigated on a national level. Spread of pfhrp2-deleted P. falciparum mutants, resistant to detection by HRP2-based RDTs, would represent a serious threat to malaria elimination efforts. Using a nationally representative cross-sectional study of 7,137 children under five years of age from the Democratic Republic of Congo (DRC), we tested 783 subjects with RDT-/PCR+ results using PCR assays to detect and confirm deletions of the pfhrp2 gene. Spatial and population genetic analyses were employed to examine the distribution and evolution of these parasites. We identified 149 pfhrp2-deleted parasites, representing 6.4% of all P. falciparum infections country-wide (95% confidence interval 5.1-8.0%). Bayesian spatial analyses identified statistically significant clustering of pfhrp2 deletions near Kinshasa and Kivu. Population genetic analysis revealed significant genetic differentiation between wild-type and pfhrp2-deleted parasite populations (GST = .046, p ≤ .00001). Pfhrp2-deleted P. falciparum is a common cause of RDT-/PCR+ malaria among asymptomatic children in the DRC and appears to be clustered within select communities. Surveillance for these deletions is needed, and alternatives to HRP2-specific RDTs may be necessary. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
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.
75 FR 79443 - Unblocking of Specially Designated National Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

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

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

PubMed

Duysburgh, Els; Kerstens, Birgit; Diaz, Melissa; Fardhdiani, Vini; Reyes, Katherine Ann V; Phommachanh, Khamphong; Temmerman, Marleen; Rodriques, Basil; Zaka, Nabila

2014-02-15

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. 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. (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. Similar important challenges for newborn care have been identified in Indonesia, Lao PDR and the Philippines. There is an urgent need to address weak leadership and governance regarding newborn care, quality
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
Democracy in Action: 40 Years, Federal Republic of Germany. A Practical Guide for Teachers.

ERIC Educational Resources Information Center

Reeve, Ines; And Others

This guide celebrates the 40th anniversary, in 1989, of the Federal Republic of Germany and is designed to provide an opportunity to review how firmly the principles of democracy have become established in the people and the government of West Germany today. Part 1 gives an overview of the West German democratic experience, covering such topics as…
In the Aftermath of War: US Support for Reconstruction and Nation-Building in Panama Following Just Cause

DTIC Science & Technology

1993-08-01

Politics, 3d ed. (New York : University Press of America, 1988); Richard Shultz, "Can Democratic Governments Use Military Force in the War...Porras, Arnulfo Arias Madrid (Panama: Litho- Impresora , S. A., 1980); Ropp, Panamanian Politics ; and Milled . 10 . Nordlinger. While there is a rich
Democratizing science and technology education: Perspectives from the philosophy of education

NASA Astrophysics Data System (ADS)

Pierce, Clayton Todd

This study examines conceptualizations of science and technology and their relation to ideas of democratic education in the history of philosophy of education. My genealogical analysis begins by tracing the anti-democratic emergence of ideas and values of science and technology that have evolved through ancient and modern periods within the philosophy of education and continue to shape the ways science and technology are understood and treated in educational settings. From my critical engagement with Plato's Republic and Rousseau's Emile, I argue that anti-democratic structures and values have been embedded in philosophy of education through Plato's educational theory of techne and Rousseau's pedagogical theory that involves science and technology as important educational force. Following this theme, I analyze the work of John Dewey and Herbert Marcuse and their shared project for democratizing science and technology through education. Through a critical comparison of both theorists' models, I suggest that each provides positive legacies for philosophy of education to draw upon in rethinking the intersection of science, technology, and education: a strong model for understanding public problems associated with a highly technological and scientific society and a reconstructive framework for values and sensibilities that demands a new value relationship to be developed between humans and science and technology. Finally, I situate my critique and assessment of this history in the philosophy of education within the current science and technology education reform movement in the United States. I claim that the official models of science and technological literacy and inquiry, as constructed by the National Academy of Sciences and a host of governmental policies, shape science and technology education with a decidedly neo-liberal focus and purpose. In response to this anti-democratic movement I offer an alternative position that utilizes a counter-epistemology to the
Democratic Parenting: Paradoxical Messages in Democratic Parent Education Theories

ERIC Educational Resources Information Center

Oryan, Shlomit; Gastil, John

2013-01-01

Some prominent parent education theories in the United States and other Western countries base their educational viewpoint explicitly on democratic values, such as mutual respect, equality and personal freedom. These democratic parenting theories advocate sharing power with children and including them in family decision making. This study presents…
Children, Kitchen and Computer: Women--Torn between Family and Job. Developments in the Federal Republic of Germany. Social Report.

ERIC Educational Resources Information Center

Kischke, Martina I.

Focusing on the changing roles and consciousness of women currently living in the Federal Republic of Germany, this report is organized under seven topical headings. The first section, "Women and Politics," comments on the increasing influence of women in local politics, with 36 women currently occupying the posts of Lord Mayor, Mayor,…
In Pursuit of British Public Support for the Next War

DTIC Science & Technology

2011-06-17

the Liberal Democrats George Kennedy was to say ―the military strikes of the last 24 hours are sad...traction because ―more than half (53 percent) say they don’t really understand why Britain is still in Afghanistan.‖ 15 It is remarkable that after...is unwinnable and we should not be there, say voters,‖ The Independent, (April 21, 2010). http://www.independent.co.uk/news/uk/politics/afghan-war-is
Humboldt Goes to the Labour Market: How Academic Higher Education Fuels Labour Market Success in the Czech Republic

ERIC Educational Resources Information Center

Pabian, Petr; Sima, Karel; Kyncilova, Lucie

2011-01-01

The Czech Republic is one of the post-communist countries where the transformation from late industrial to knowledge economies and knowledge societies was complicated by the simultaneous transformations from communist centrally planned economies to democratic regimes and market economies. Furthermore, the transformation of higher education itself…
Globalisation, complex humanitarian emergencies and health.

PubMed

O'Dempsey, T J D; Munslow, B

2006-01-01

A new political economy of conflict has emerged in the aftermath of colonialism and the Cold War. Complex political emergencies have been simmering in the post-colonial world for more than three decades. Intra-country armed conflict, often combined with natural disasters, at present contributes to the displacement of over 20 million people world-wide. The international community remains profoundly uncomfortable with the complex political emergencies of the new era, torn between the respect for national sovereignty upon which the international political system of the United Nations and other agencies is built, and the growth of concern with human rights and a burgeoning International Humanitarian Law. Globalisation may have brought many benefits to some but there are also many losers. The Word Bank and the International Monetary Fund imposed structural adjustment policies to ensure debt repayment and economic restructuring that have resulted in a net reduction in expenditure on health, education and development. A downward spiral has been created of debt, disease, malnutrition, missed education, economic entrapment, poverty, powerlessness, marginalization, migration and instability. Africa's complex political emergencies are particularly virulent and tenacious. Three examples that are among the most serious humanitarian emergencies to have faced the world in recent times--those in Angola, the Democratic Republic of Congo and Sudan--are reviewed here in detail. The political evolution of these emergencies and their impact on the health of the affected populations are also explored.
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
Assessment of temperatures in the vaccine cold chain in two provinces in Lao People's Democratic Republic: a cross-sectional pilot study.

PubMed

Kitamura, Tomomi; Bouakhasith, Viraneth; Phounphenghack, Kongxay; Pathammavong, Chansay; Xeuatvongsa, Anonh; Norizuki, Masataro; Okabayashi, Hironori; Mori, Yoshio; Machida, Munehito; Hachiya, Masahiko

2018-04-27

All childhood vaccines, except the oral polio vaccine, should be kept at 2-8 °C, since the vaccine potency can be damaged by heat or freezing temperature. A temperature monitoring study conducted in 2008-2009 reported challenges in cold chain management from the provincial level downwards. The present cross-sectional pilot study aimed to assess the current status of the cold chain in two provinces (Saravan and Xayabouly) of Lao People's Democratic Republic between March-April 2016. Two types of temperature data loggers recorded the temperatures and the proportions of time exposed to < 0 or > 8 °C were calculated. The temperature remained within the appropriate range in the central and provincial storages. However, the vaccines were frequently exposed to > 8 °C in Saravan and < 0 °C in Xayabouly in the district storage. Vaccines were exposed to > 8 °C during the transportation in Saravan and to both > 8 and < 0 °C in Xayabouly. Thus, challenges in managing the cold chain in the district storage and during transportation remain, despite improvements at the provincial storage. A detailed up-to-date nationwide analysis of the current situation of the cold chain is warranted to identify the most appropriate intervention to tackle the remaining challenges.
The Representation of the Cold War in Three Estonian History Textbooks

ERIC Educational Resources Information Center

Korbits, Keit

2015-01-01

The article looks at the discursive strategies different Estonian history textbooks employ to represent the Cold War period, and the "commonsense" ideologies instilled through these representations. The textbooks analysed include two history books dating back to the Estonian Soviet Socialist Republic and, for contrast, one written during…
Should I get screened for sleeping sickness? A qualitative study in Kasai province, Democratic Republic of Congo.

PubMed

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

2012-01-01

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

PubMed

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

2012-01-01

HIV transmission through breastfeeding is a significant public health challenge. While breastfeeding provides important nutrition, and results in reduced morbidity and mortality, there is a risk of HIV transmission through breastfeeding. International prevention of mother-to-child transmission (PMTCT) guidelines recommend exclusive breastfeeding for six months among HIV-infected women on antiretroviral therapy. Promoting exclusive feeding has proved difficult in settings where mixed feeding is a cultural norm. Understanding the factors that influence HIV infected women's infant feeding choices and practices is critical to promoting adherence to PMTCT guidelines. We conducted in-depth interviews with 40 HIV+ pregnant and post-partum women in Kinshasa, Democratic Republic of Congo to understand their infant feeding experiences. Interviews were conducted in Lingala, and transcribed and translated into French for analysis. Deductive and inductive codes were applied, and matrices were created to facilitate cross-case analysis. Women had limited understanding of the specific mechanisms through which their infant feeding practices influenced HIV transmission risk. Clinical staff was the primary source of women's knowledge of HIV mother-to-child-transmission. Among the 24 post-partum women in the sample, seven women adhered to exclusive breastfeeding and two women to exclusive formula feeding for at least six months. Women's beliefs and awareness about HIV transmission through breastfeeding, as well as the information and support from clinical staff and other members of their support networks positively influenced their exclusive feeding. Common barriers to exclusive feeding included financial constraints, breast health problems, misinformation about HIV transmission, local norms, and prior feeding experiences. Health care workers play a key role in providing correct information on PMTCT and supporting women's infant feeding choices to adhere to guidelines of exclusive
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.
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
Nurses’ compliance with prevention of mother-to-child transmission national guidelines in selected sites in Kinshasa, Democratic Republic of Congo.

PubMed

Amboko, Augustin R M; Brysiewicz, Petra

2015-01-01

The Democratic Republic of Congo (DRC) implemented a prevention of mother-to-child transmission (PMTCT) of HIV infection programme in maternal, newborn and child health (MNCH) services in 2001 with nurses as key personnel. To date there is no information in the DRC and specifically in Kinshasa with respect to compliance with PMTCT national guidelines. The study aimed at describing nurses’ compliance with the PMTCT national guidelines in selected PMTCT sites of Kinshasa. A descriptive cross-sectional study was conducted in Kinshasa with 76 nurses in 18 selected PMTCT sites. The nurses’ compliance with PMTCT national guidelines was assessed using a healthcare provider self-reporting questionnaire developed by the researchers. The study showed that the mean score of nurses’ compliance with PMTCT national guidelines was 74% (95% CI: 69%-78%) which progressively decreased and was significantly different across different MNCH services (p = 0.025). With respect to categories of PMTCT recommendations, nurses were compliant with those related to education in labour and delivery, and antenatal services. Sociodemographic characteristics such as training, length of service and category of nurses did not influence nurses’ compliance score. These findings showed that nurses were noncompliant with PMTCT national guidelines, with the score level being 80% or more in the three MNCH services/units. Improvement of nurses’ ‘compliance with the PMTCT national guidelines requires effective monitoring of full integration of PMTCT as routine activities in MNCH care.
Reasons for non-compliance among patients with hypertension at Vanga Hospital, Bandundu Province, Democratic Republic of Congo: A qualitative study

PubMed Central

Mabuza, Langalibalele; Malete, Nomsa; Maduna, Patrick; Ndimande, John V.

2009-01-01

ABSTRACT Background Hypertension is a serious public health challenge in both economically developing and developed countries. Patients on outpatient medication for hypertension at Vanga Hospital in the Democratic Republic of Congo (DRC) often present with uncontrolled hypertension and some with hypertension emergencies. On enquiry, the problem appeared to revolve around compliance. Method The study was a qualitative, descriptive study using the focus group interview technique for data collection. Subjects were purposely selected. Interviews were conducted from 23 March to 19 July 2006. Three focus groups were formed: The first was heterogeneous in terms of gender (five males and three females), the second homogeneous (six males) and the last also homogeneous (six females). The group members varied with respect to characteristics such as place of residence, occupation and educational standard. The data collected were analysed using the thematic analysis method within grounded theory. Results Five themes emerged as possible explanations for non-compliance: Side effects discouraged patients from taking medication; patients took medication only when they experienced perceived symptoms of hypertension; poor knowledge of the disease and the medication used; lack of support by family members; and difficulty in obtaining antihypertensive medication. Conclusion Side effects of the medication, lack of information and support, difficulty in obtaining the medication and the fact that the disease is mainly silent played a major role in the poor adherence to hypertension medication. Sustained health promotion and education should be undertaken at all levels of patient contact to ensure good compliance.
High human exposure to pyrene (polycyclic aromatic hydrocarbon) in Kinshasa, a capital of the Democratic Republic of Congo.

PubMed

Tuakuila, Joel; Kabamba, Martin; Mata, Honoré

2013-01-01

Data on human exposure to chemicals in Africa are scarce. A biomonitoring study was conducted in a representative sample of the population in Kinshasa (Democratic Republic of Congo) to document exposure to polycyclic aromatics hydrocarbons. 1-hydroxypyrene (1-OHP) was measured by HPLC fluorescence in spot urine samples from 220 individuals (50.5% women), aged 6-70 years living in the urban area and from 50 additional subjects from the sub-rural area of Kinshasa. Data were compiled as geometric means and selected percentiles, expressed without (μg/L) or with creatinine adjustment (μg/g cr). Multiple regression analyses were applied to factors (creatinine, grilled meat habits and smoking habits) influencing 1-OHP (stepwise procedure, criteria: probability F to enter ≤ 0.05 and probability F to remove ≥ 0.10). According to the regression models, creatinine, grilled meat habits and smoking habits contribute to explain 45% of the variation in population's urinary 1-OHP by the environmental exposure. Overall, living in urban area of Kinshasa was associated with increased levels of 1-OHP in urine as compared to a population living in the sub-rural area [GM: 1.8 μg/L (n = 220) versus 1.4 μg/L (n = 50), p < 0.01] as well as compared to the reference values from databases involving American or German populations. This study reveals the high pyrene (PAH) exposure of the Kinshasa population. However, more work, with a rigorous design in the exposed population (monitoring of air concentrations and identifying other sources of pyrene -PAH exposure), is needed to establish further documentation.

High human exposure to pyrene (polycyclic aromatic hydrocarbon) in Kinshasa, a capital of the Democratic Republic of Congo

PubMed Central

2013-01-01

Background Data on human exposure to chemicals in Africa are scarce. A biomonitoring study was conducted in a representative sample of the population in Kinshasa (Democratic Republic of Congo) to document exposure to polycyclic aromatics hydrocarbons. Methods 1-hydroxypyrene (1-OHP) was measured by HPLC fluorescence in spot urine samples from 220 individuals (50.5% women), aged 6–70 years living in the urban area and from 50 additional subjects from the sub-rural area of Kinshasa. Data were compiled as geometric means and selected percentiles, expressed without (μg/L) or with creatinine adjustment (μg/g cr). Multiple regression analyses were applied to factors (creatinine, grilled meat habits and smoking habits) influencing 1-OHP (stepwise procedure, criteria: probability F to enter ≤ 0.05 and probability F to remove ≥ 0.10). Results According to the regression models, creatinine, grilled meat habits and smoking habits contribute to explain 45% of the variation in population’s urinary 1-OHP by the environmental exposure. Overall, living in urban area of Kinshasa was associated with increased levels of 1-OHP in urine as compared to a population living in the sub-rural area [GM: 1.8 μg/L (n = 220) versus 1.4 μg/L (n = 50), p < 0.01] as well as compared to the reference values from databases involving American or German populations. Conclusion This study reveals the high pyrene (PAH) exposure of the Kinshasa population. However, more work, with a rigorous design in the exposed population (monitoring of air concentrations and identifying other sources of pyrene –PAH exposure), is needed to establish further documentation. PMID:23782930
Identification of Dengue and Chikungunya Cases Among Suspected Cases of Yellow Fever in the Democratic Republic of the Congo.

PubMed

Makiala-Mandanda, Sheila; Ahuka-Mundeke, Steve; Abbate, Jessica L; Pukuta-Simbu, Elisabeth; Nsio-Mbeta, Justus; Berthet, Nicolas; Leroy, Eric Maurice; Becquart, Pierre; Muyembe-Tamfum, Jean-Jacques

2018-05-16

For more than 95% of acute febrile jaundice cases identified through surveillance for yellow fever, a reemerging arthropod-borne viral disease, no etiological exploration is ever done. The aim of this study was to test for other arthropod-borne viruses that can induce the same symptoms in patients enrolled in the yellow fever surveillance in the Democratic Republic of the Congo (DRC). Of 652 patients included in the surveillance of yellow fever in DRC from January 2003 to January 2012, 453 patients that tested negative for yellow fever virus (YFV) immunoglobulin M (IgM) antibodies were selected for the study. Real-time polymerase chain reaction was performed for the detection of dengue, West Nile, Chikungunya, O'nyong-nyong, Rift Valley fever, Zika, and YFV. The average age of patients was 22.1 years. We reported 16 cases (3.5%; confidence interval [CI]: 0.8-5.2) of dengue (serotypes 1 and 2) and 2 cases (0.4%; CI: 0.0-1.0) of Chikungunya. Three patients were co-infected with the two serotypes of dengue virus. Three cases of dengue were found in early July 2010 from the city of Titule (Oriental province) during a laboratory-confirmed outbreak of yellow fever, suggesting simultaneous circulation of dengue and yellow fever viruses. This study showed that dengue and Chikungunya viruses are potential causes of acute febrile jaundice in the DRC and highlights the need to consider dengue and Chikungunya diagnosis in the integrated disease surveillance and response program in the DRC. A prospective study is necessary to establish the epidemiology of these diseases.
Wealth and under-nourishment among married women in two impoverished nations: evidence from Burkina Faso and Congo Democratic Republic.

PubMed

Adebowale, Ayo Stephen; Palamuleni, Martin Enoch; Odimegwu, Clifford Obby

2015-02-08

Burkina Faso (BF) and Congo Democratic Republic (CDR) are among the top-ten poverty and hunger stricken countries globally. The influence of poverty and hunger on health is enormous. The objectives of the study are to; examine the association between poverty and nutritional status, it also identified socio-demographic and health related mediating factors that contribute to the relationship between poverty and poor nutritional status. The study focused on married or cohabiting women aged 15-49 years and utilized 2010 and 2007 DHS dataset from BF and CDR respectively. Mean age of the women in BF and CDR were 34.4 ± 9.3 and 34.7 ± 9.0 years respectively. About 19.4% and 18.4% of the poor were malnourished as against 7.7% and 9.7% of the rich women in BF and CDR respectively. Obesity and overweight were more prominent among the rich than the poor. Higher prevalence of under-nourish women was found among the older than the younger women in BF. In the countries, the prevalence of malnutrition was significantly higher among women; in the rural areas, with no formal education, anaemic and those who are not working. Multivariate analysis revealed that in the countries, the risk of under-nourishment was significantly higher among poor and middle class than the rich women despite controlling for confounding variables. Undernourished women were more common among the poor and those with no formal education. Programs that target nutrition of women of reproductive age should be strengthened in BF and CDR.
[Cerebrospinal fluid diagnostics in Germany since 1950 : Developments in the GDR and FRG in the context of society and science].

PubMed

Reiber, H

2016-12-01

The 40 years of separated development in two countries with extremely different political and social utopias allow consideration of the connection between science and society. The society-dependent development of cerebrospinal fluid (CSF) diagnostics in the German Democratic Republic (GDR) and the Federal Republic of Germany (FRG) is shown in the context of the international scientific development of the post-war era with new paradigms in physics, biology and genetics. As part of this contribution to the philosophy of science the consequences of the complex life science for a new view of disease research are discussed in contrast to the currently dominating, reductionistic medical industrial complex.
Different Battlegrounds, Similar Concerns? The "History Wars" and the Teaching of History in Australia and England

ERIC Educational Resources Information Center

Peterson, Andrew

2016-01-01

Debates about the purpose and content of history education in schools have been prevalent in most Westernised democratic nations over the last 30 years. Under discussion are essential questions concerning national identity/ies, competing narratives and the aims of history education. The impact of 'history wars' has been felt within both Australia…
Adaptation of a U.S. evidence-based Positive Prevention intervention for youth living with HIV/AIDS in Kinshasa, Democratic Republic of the Congo

PubMed Central

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

2013-01-01

Effective HIV prevention programs for people living with HIV/AIDS (PLWH) are important to reduce new infections and to ensure PLWH remain healthy. This paper describes the systematic adaptation of a U.S.-developed Evidence Based Intervention (EBI) using the Centers for Disease Control and Prevention (CDC) Map of Adaption Process for use at a Pediatric Hospital in Kinshasa, Democratic Republic of the Congo (DRC). The adapted intervention, Supporting Youth and Motivating Positive Action or SYMPA, a six-session risk reduction intervention targeted for youth living with HIV/AIDS (YLWH) in Kinshasa was adapted from the Healthy Living Project and guided by the Social Action Theory. This paper describes the process of implementing the first four steps of the ADAPT framework (Assess, Select, Prepare, and Pilot). Our study has shown that an EBI developed and implemented in the U.S. can be adapted successfully for a different target population in a low-resource context through an iterative process following the CDC ADAPT framework. This process included reviewing existing literature, adapting and adding components, and focusing on increasing staff capacity. This paper provides a rare, detailed description of the adaptation process and may aid organizations seeking to adapt and implement HIV prevention EBIs in sub-Saharan Africa and beyond. PMID:23063699
Individual and household characteristics of persons with Plasmodium falciparum malaria in sites with varying endemicities in Kinshasa Province, Democratic Republic of the Congo.

PubMed

Mwandagalirwa, Melchior Kashamuka; Levitz, Lauren; Thwai, Kyaw L; Parr, Jonathan B; Goel, Varun; Janko, Mark; Tshefu, Antoinette; Emch, Michael; Meshnick, Steven R; Carrel, Margaret

2017-11-09

The Democratic Republic of the Congo (DRC) bears a large share of global malaria burden despite efforts to control and eliminate the disease. More detailed understanding of individual and household level characteristics associated with malaria are needed, as is an understanding of how these characteristics vary spatiotemporally and across different community-level malaria endemicities. An ongoing study in Kinshasa Province is designed to address gaps in prior malaria surveillance in the DRC by monitoring malaria across seasons, age groups and in high and low malaria sites. Across seven sites, 242 households and 1591 individuals are participating in the study. Results of the enrollment questionnaire, rapid diagnostic tests and PCR testing of dried blood spots are presented. Overall malaria prevalence in the study cohort is high, 27% by rapid diagnostic test and 31% by polymerase chain reaction, and malaria prevalence is highly varied across very small geographic distances. Malaria prevalence is highest in children aged 6-15. While the majority of households own bed nets, bed net usage is less than 50%. The study cohort will provide an understanding of how malaria persists in populations that have varying environmental exposures, varying community-level malaria, and varying access to malaria control efforts.
Violence, selection and infant mortality in Congo.

PubMed

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

2018-05-01

This paper documents the effects of the recent civil war in the Democratic Republic of Congo on mortality both in utero and during the first year of life. It instruments for conflict intensity using a mineral price index, which exploits the exogenous variation in the potential value of mineral resources generated by changes in world mineral prices to predict the geographic distribution of the conflict. Using estimates of civil war exposure on mortality across male and female newborn to assess their relative health, it provides evidence of culling effect (in utero selection) as a consequence of in utero shocks. Copyright © 2018 Elsevier B.V. All rights reserved.
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
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
[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.
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.
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.
Naval War College Review. Volume 65, Number 1, Winter 2012

DTIC Science & Technology

2012-01-01

be jettisoned if necessary. 42. For the new Japanese design, see Yoji Koda , “A New Carrier Race? Strategy, Force Plan- ning, and JS Hyuga,” Naval War...Yoji Koda , “The Emerging Republic of Korea Navy: A Japanese Perspective,” in the same issue (pp. 13–34). 5950_Kim.indd 74 11/30/2011 11:02:06
[Physicians as Experts of the Integration of war invalids of WWI and WWII].

PubMed

Wolters, Christine

2015-12-01

After the First World War the large number of war invalids posed a medical as well as a socio-political problem. This needed to be addressed, at least to some extent, through healthcare providers (Versorgungsbehörden) and reintegration into the labour market. Due to the demilitarization of Germany, this task was taken on by the civil administration, which was dissolved during the time of National Socialism. In 1950, the Federal Republic of Germany enacted the Federal War Victims Relief Act (Bundesversorgungsgesetz), which created a privileged group of civil and military war invalids, whereas other disabled people and victims of national socialist persecution were initially excluded. This article examines the continuities and discontinuities of the institutions following the First World War. A particular focus lies on the groups of doctors which structured this field. How did doctors become experts and what was their expertise?
Democratic Citizenship Education in Korea.

ERIC Educational Resources Information Center

Eoh, Myung-Ha

1999-01-01

Discusses the importance of democratic citizenship education in Korea. Highlights the forces enhancing democratic citizenship education especially the role of the nongovernmental organizations and the Korean Educational Developmental Institute. Considers the various forces inhibiting democratic citizenship education, such as corruption in the…
High prevalence of epilepsy in onchocerciasis endemic regions in the Democratic Republic of the Congo

PubMed Central

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

2017-01-01

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

USGS Publications Warehouse

Bermúdez-Lugo, Omayra

2014-01-01

The U.S. Geological Survey (USGS) analyzes supply chains to identify and define major components of mineral and material flows from ore extraction, through intermediate forms, to a final product. Two major reasons necessitate these analyses: (1) to identify risks associated with the supply of critical and strategic minerals to the United States and (2) to provide greater supply chain transparency so that policymakers have the information necessary to ensure domestic legislation compliance. This fact sheet focuses on the latter. The USGS National Minerals Information Center has been asked by governmental and non-governmental organizations to provide information on tin, tantalum, tungsten, and gold (collectively known as “3TG minerals”) processing facilities worldwide in response to U.S. legislation aimed at removing the link between the trade in these minerals and civil unrest in the Democratic Republic of the Congo. Post beneficiation processing plants (smelters and refineries) of 3TG mineral ores and concentrates were identified by company and industry association representatives as being the link in the 3TG mineral supply chain through which these minerals can be traced to their source of origin (mine); determining the point of origin is critical to establishing a transparent conflict mineral supply chain. This fact sheet, the first in a series of 3TG mineral fact sheets, focuses on the tungsten supply chain by listing plants that consume tungsten concentrates to produce ammonium paratungstate and ferrotungsten worldwide.
Trachoma in the Democratic Republic of the Congo: Results of 46 Baseline Prevalence Surveys Conducted with the Global Trachoma Mapping Project.

PubMed

Kilangalanga, Janvier; Ndjemba, Jean Marie; Uvon, Pitchouna A; Kibangala, Felix M; Mwandulo, Jean-Lebone Safari B; Mavula, Nicaise; Ndombe, Martin; Kazadi, Junior; Limbaka, Henry; Cohn, Daniel; Tougoue, Jean-Jacques; Kabore, Achille; Rotondo, Lisa; Willis, Rebecca; Bio, Amadou Alfa; Kadri, Boubacar; Bakhtiari, Ana; Ngondi, Jeremiah M; Solomon, Anthony W

2017-08-29

Trachoma was suspected to be endemic in parts of the Democratic Republic of the Congo (DRC). We aimed to estimate prevalences of trachomatous inflammation-follicular (TF), trichiasis, and water and sanitation (WASH) indicators in suspected-endemic Health Zones. A population-based prevalence survey was undertaken in each of 46 Health Zones across nine provinces of DRC, using Global Trachoma Mapping Project methods. A two-stage cluster random sampling design was used in each Health Zone, whereby 25 villages (clusters) and 30 households per cluster were sampled. Consenting eligible participants (children aged 1-9 years and adults aged ≥15 years) were examined for trachoma by GTMP-certified graders; households were assessed for access to WASH. A total of 32,758 households were surveyed, and 141,853 participants (98.2% of those enumerated) were examined for trachoma. Health Zone-level TF prevalence in 1-9-year-olds ranged from 1.9-41.6%. Among people aged ≥15 years, trichiasis prevalences ranged from 0.02-5.1% (95% CI 3.3-6.8). TF prevalence in 1-9-year-olds was ≥5% in 30 Health Zones, while trichiasis prevalence was ≥0.2% in 37 Health Zones. Trachoma is a public health problem in 39 of 46 Health Zones surveyed. To meet elimination targets, 37 Health Zones require expanded trichiasis surgery services while 30 health zones require antibiotics, facial cleanliness and environmental improvement interventions. Survey data suggest that trachoma is widespread: further surveys are warranted.

Pediatric Acute Severe Neurologic Illness and Injury in an Urban and a Rural Hospital in the Democratic Republic of the Congo.

PubMed

Tshimangani, Taty; Pongo, Jean; Bodi Mabiala, Joseph; Yotebieng, Marcel; O'Brien, Nicole F

2018-05-01

Empirical knowledge suggests that acute neurologic disorders are common in sub-Saharan Africa, but studies examining the true burden of these diseases in children are scarce. We performed this prospective, observational study to evaluate the prevalence, clinical characteristics, treatment approaches, and outcomes of children suffering acute neurologic illness or injury (ANI) in an urban and rural site in the Democratic Republic of the Congo. Over 12 months, 471 out of 6,563 children admitted met diagnostic criteria for ANI, giving a hospital-based prevalence of 72/1,000 admissions. Two hundred and seventy-two children had clinical findings consistent with central nervous system infection but lacked complete diagnostic evaluation for definitive classification. Another 151 children were confirmed to have cerebral malaria ( N = 109, 23% of admissions), bacterial meningitis ( N = 38, 8% of admissions), tuberculous meningitis ( N = 3, 0.6% of admissions), or herpes encephalitis ( N = 1, 0.21% of admissions). Febrile convulsions, traumatic brain injury, and epilepsy contributed less significantly to overall hospital prevalence of ANI (3.19/1,000, 1.37/1,000, and 1.06/1,000, respectively). Overall mortality for the cohort was 21% (97/471). Neurologic sequelae were seen in another 31% of participants, with only 45% completing the study with a normal neurologic examination. This type of data is imperative to help plan effective strategies for illness and injury prevention and control, and to allow optimal use of limited resources in terms of provision of acute care and rehabilitation for these children.
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.
Infant feeding practices and determinants of poor breastfeeding behavior in Kinshasa, Democratic Republic of Congo: a descriptive study.

PubMed

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

2013-10-01

Although breastfeeding is almost universally accepted in the Democratic Republic (DR) of Congo, by the age of 2 to 3 months 65% of children are receiving something other than human milk. We sought to describe the infant feeding practices and determinants of suboptimal breastfeeding behaviors in DR Congo. Survey questionnaire administered to mothers of infants aged ≤ 6 months and healthcare providers who were recruited consecutively at six selected primary health care facilities in Kinshasa, the capital. All 66 mothers interviewed were breastfeeding. Before initiating breastfeeding, 23 gave their infants something other than their milk, including: sugar water (16) or water (2). During the twenty-four hours prior to interview, 26 (39%) infants were exclusively breastfed (EBF), whereas 18 (27%), 12 (18%), and 10 (15%) received water, tea, formula, or porridge, respectively, in addition to human milk. The main reasons for water supplementation included "heat" and cultural beliefs that water is needed for proper digestion of human milk. The main reason for formula supplementation was the impression that the baby was not getting enough milk; and for porridge supplementation, the belief that the child was old enough to start complementary food. Virtually all mothers reported that breastfeeding was discussed during antenatal clinic visit and half reported receiving help regarding breastfeeding from a health provider either after birth or during well-child clinic visit. Despite a median of at least 14 years of experience in these facilities, healthcare workers surveyed had little to no formal training on how to support breastfeeding and inadequate breastfeeding-related knowledge and skills. The facilities lacked any written policy about breastfeeding. Addressing cultural beliefs, training healthcare providers adequately on breastfeeding support skills, and providing structured breastfeeding support after maternity discharge is needed to promote EBF in the DR Congo.
Phylogeny of imported and reestablished wild polioviruses in theDemocratic Republic of the Congo from 2006 to 2011.

PubMed

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

2014-11-01

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

PubMed Central

Massing, Louis Albert; Aboubakar, Soumah; Page, Anne-Laure; Cohuet, Sandra; Ngandwe, Adalbert; Mukomena Sompwe, Eric; Ramazani, Romain; Allheimen, Marcela; Levaillant, Philippe; Lechevalier, Pauline; Kashimi, Marie; de la Motte, Axelle; Calmejane, Arielle; Bouhenia, Malika; Dabire, Ernest; Bompangue, Didier; Kebela, Benoit; Porten, Klaudia

2018-01-01

Introduction Oral cholera vaccines are primarily recommended by the World Health Organization for cholera control in endemic countries. However, the number of cholera vaccines currently produced is very limited and examples of OCV use in endemic countries, and especially in urban settings, are scarce. A vaccination campaign was organized by Médecins Sans Frontières and the Ministry of Health in a highly endemic area in the Democratic Republic of Congo. This study aims to describe the vaccine coverage achieved with this highly targeted vaccination campaign and the acceptability among the vaccinated communities. Methods and findings We performed a cross-sectional survey using random spatial sampling. The study population included individuals one year old and above, eligible for vaccination, and residing in the areas targeted for vaccination in the city of Kalemie. Data sources were household interviews with verification by vaccination card. In total 2,488 people were included in the survey. Overall, 81.9% (95%CI: 77.9–85.3) of the target population received at least one dose of vaccine. The vaccine coverage with two doses was 67.2% (95%CI: 61.9–72.0) among the target population. The vaccine coverage was higher during the first round (74.0, 95%CI: 69.3–78.3) than during the second round of vaccination (69.1%, 95%CI: 63.9–74.0). Vaccination coverage was lower in male adults. The main reason for non-vaccination was to be absent during the campaign. No severe adverse events were notified during the interviews. Conclusions Cholera vaccination campaigns using highly targeted strategies are feasible in urban settings. High vaccination coverage can be obtained using door to door vaccination. However, alternative strategies should be considered to reach non-vaccinated populations like male adults and also in order to improve the efficiency of the interventions. PMID:29734337
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
Vaccination Coverage and Timelines Among Children 0-6 Months in Kinshasa, the Democratic Republic of Congo: A Prospective Cohort Study.

PubMed

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

2017-05-01

Objectives The Democratic Republic of Congo (DR Congo) is one of the ten countries, which accounts for 60% of unvaccinated children worldwide. The aim of this study was to assess predictors of incomplete and untimely immunization among a cohort of infants recruited at birth and followed up through 24 weeks in Kinshasa. Methods Complete immunization for each vaccine was defined as receiving all the recommended doses. Untimely immunization was defined as receiving the given dose before (early) or after (delayed) the recommended time window. Infants not immunized by the end of the follow-up time were considered missing. Multivariate hierarchical model and generalized logistic model were used to assess the independent contribution of each socio-economic and demographic factors considered to complete immunization and timeliness, respectively. Results Overall, of 975 infants from six selected clinics included in the analysis 84.7% were fully immunized the three doses of DTP or four doses of Polio by 24 weeks of age. Independently of the vaccine considered, the strongest predictor of incomplete and untimely immunization was the clinic in which the infant was enrolled. This association was strengthened after adjustment for socio-economic and demographic characteristics. Education and the socio-economic status also were predictive of completion and timeliness of immunization in our cohort. Discussion In conclusion, the strongest predictor for incomplete and untimely immunization among infants in Kinshasa was the clinics in which they were enrolled. The association was likely due to the user fee for well-baby clinic visits and its varying structure by clinic.
Genotypes of Rubella Virus and the Epidemiology of Rubella Infections in the Democratic Republic of the Congo, 2004–2013

PubMed Central

Pukuta, Elizabeth; Waku-Kouomou, Diane; Abernathy, Emily; Illunga, Benoit Kebela; Obama, Ricardo; Mondonge, Vital; Dahl, Benjamin A.; Maresha, Balcha G.; Icenogle, Joseph; Muyembe, Jean-Jacques

2017-01-01

Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of rubella virus circulating in the DRC. These data contribute to a better understanding of rubella burden and the dynamics of rubella virus circulation in Africa. Efforts to establish rubella surveillance in the DRC are needed to support rubella elimination in Africa. PMID:27479298
Post-partum depression in Kinshasa, Democratic Republic of Congo: validation of a concept using a mixed-methods cross-cultural approach.

PubMed

Bass, Judith K; Ryder, Robert W; Lammers, Marie-Christine; Mukaba, Thibaut N; Bolton, Paul A

2008-12-01

To determine if a post-partum depression syndrome exists among mothers in Kinshasa, Democratic Republic of Congo, by adapting and validating standard screening instruments. Using qualitative interviewing techniques, we interviewed a convenience sample of 80 women living in a large peri-urban community to better understand local conceptions of mental illness. We used this information to adapt two standard depression screeners, the Edinburgh Post-partum Depression Scale and the Hopkins Symptom Checklist. In a subsequent quantitative study, we identified another 133 women with and without the local depression syndrome and used this information to validate the adapted screening instruments. Based on the qualitative data, we found a local syndrome that closely approximates the Western model of major depressive disorder. The women we interviewed, representative of the local populace, considered this an important syndrome among new mothers because it negatively affects women and their young children. Women (n = 41) identified as suffering from this syndrome had statistically significantly higher depression severity scores on both adapted screeners than women identified as not having this syndrome (n = 20; P < 0.0001). When it is unclear or unknown if Western models of psychopathology are appropriate for use in the local context, these models must be validated to ensure cross-cultural applicability. Using a mixed-methods approach we found a local syndrome similar to depression and validated instruments to screen for this disorder. As the importance of compromised mental health in developing world populations becomes recognized, the methods described in this report will be useful more widely.
New Species of the Spider Genus Cheiracanthium from Continental Africa
(Araneae: Eutichuridae).

PubMed

Lotz, L N

2015-06-17

Eleven new species of Cheiracanthium, C. boendense sp. nov. (Democratic Republic of Congo), C. falcis sp. nov. (Gabon), C. foordi sp. nov. (South Africa), C. ghanaense sp. nov. (Ghana), C. kabalense sp. nov. (Uganda), C. kakamega sp. nov. (Kenya), C. kakumense sp. nov. (Democratic Republic of Congo, Ivory Coast, Ghana), C. lukiense sp. nov. (Democratic Republic of Congo), C. mayombense sp. nov. (Democratic Republic of Congo), C. shilabira sp. nov. (Democratic Republic of Congo, Kenya) and C. tanzanense sp. nov. (Tanzania) are described. Males of C. punctipedellum Caporiacco, 1949, C. sansibaricum Strand, 1907 and C. schenkeli Caporiacco, 1949 are described for the first time.
Factors associated with behavioral problems and cognitive impairment in children with epilepsy of Kinshasa, Democratic Republic of the Congo.

PubMed

Matonda-Ma-Nzuzi, Thierry; Mampunza Ma Miezi, Samuel; Mpembi, Magloire Nkosi; Mvumbi, Diane Muanza; Aloni, Michel Ntentani; Malendakana, Fanny; Mpaka Mbeya, Davin; Lelo, Gilbert Mananga; Charlier-Mikolajczak, Dominique

2018-01-01

Behavioral problems and cognitive impairment are common in children with epilepsy (CWE). In sub-Saharan Africa, little is known about these comorbidities particularly their relationships with socioeconomic features. The goal of this study was to identify clinical and socioeconomic factors associated with behavioral problems and cognitive impairment in CWE of Kinshasa (Democratic Republic of the Congo). This cross-sectional hospital-based study had included 104 CWE aged 6 to 17years. Behavioral problems were assessed by the child behavior checklist. The Wechsler nonverbal scale of ability was used to assess cognitive impairment. At least one behavioral problem was found in 34.6% of CWE. Internalized problems were increasing with father's age (p=0.034). Externalized problems were increasing with the decreased of mother's age (p=0.009) and with a previous antiepileptic treatment (p=0.032). Total behavioral problems were increasing with a previous antiepileptic treatment (p=0.029). Cognitive impairment was present in 73.3% of CWE. It was more common in boys (p=0.013), and it was increasing with a low household daily expenses (p=0.034), with a previous antiepileptic treatment (p=0.041), with an early onset of epileptic seizures (p=0.042), and with a high frequency of epileptic seizures (p=0.011). Behavioral problems and cognitive impairment are common in CWE. Multivariate analysis has shown that behavioral problems were associated with socioeconomic features only. Contrariwise, cognitive impairment was associated with both socioeconomic factors and clinical features. There is a need of more studies to improve knowledge of these comorbidities in the sub-Saharan Africa context. Copyright © 2017 Elsevier Inc. All rights reserved.
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.
Clinical Spectrum, Etiology, and Outcome of Neurological Disorders in the Rural Hospital of Mosango, the Democratic Republic of Congo.

PubMed

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

2017-11-01

There is little published information on the epidemiology of neurological disorders in rural Central Africa, although the burden is considered to be substantial. This study aimed to investigate the pattern, etiology, and outcome of neurological disorders in children > 5 years and adults admitted to the rural hospital of Mosango, province of Kwilu, Democratic Republic of Congo, with a focus on severe and treatable infections of the central nervous system (CNS). From September 2012 to January 2015, 351 consecutive patients hospitalized for recent and/or ongoing neurological disorder were prospectively evaluated by a neurologist, subjected to a set of reference diagnostic tests in blood or cerebrospinal fluid, and followed-up for 3-6 months after discharge. No neuroimaging was available. Severe headache (199, 56.7%), gait/walking disorders (97, 27.6%), epileptic seizure (87, 24.8%), and focal neurological deficit (86, 24.5%) were the predominant presentations, often in combination. Infections of the CNS were documented in 63 (17.9%) patients and mainly included bacterial meningitis and unspecified meningoencephalitis (33, 9.4%), second-stage human African trypanosomiasis (10, 2.8%), and human immunodeficiency virus (HIV)-related neurological disorders (10, 2.8%). Other focal/systemic infections with neurological manifestations were diagnosed in an additional 60 (17.1%) cases. The leading noncommunicable conditions were epilepsy (61, 17.3%), psychiatric disorders (56, 16.0%), and cerebrovascular accident (23, 6.6%). Overall fatality rate was 8.2% (29/351), but up to 23.8% for CNS infections. Sequelae were observed in 76 (21.6%) patients. Clinical presentations and etiologies of neurological disorders were very diverse in this rural Central African setting and caused considerable mortality and morbidity.
Genotypes of rubella virus and the epidemiology of rubella infections in the Democratic Republic of the Congo, 2004-2013.

PubMed

Pukuta, Elizabeth; Waku-Kouomou, Diane; Abernathy, Emily; Illunga, Benoit Kebela; Obama, Ricardo; Mondonge, Vital; Dahl, Benjamin A; Maresha, Balcha G; Icenogle, Joseph; Muyembe, Jean-Jacques

2016-10-01

Rubella is a viral infection that may cause fetal death or congenital defects, known as congenital rubella syndrome (CRS), during early pregnancy. The World Health Organization (WHO) recommends that countries assess the burden of rubella and CRS, including the determination of genotypes of circulating viruses. The goal of this study was to identify the genotypes of rubella viruses in the Democratic Republic of the Congo (DRC). Serum or throat swab samples were collected through the measles surveillance system. Sera that tested negative for measles IgM antibody were tested for rubella IgM antibody. Serum collected within 4 days of rash onset and throat swabs were screened by real-time RT-PCR for rubella virus RNA. For positive samples, an amplicon of the E1 glycoprotein gene was amplified by RT-PCR and sequenced. 11733 sera were tested for rubella IgM and 2816 (24%) were positive; 145 (5%) were tested for the presence of rubella RNA by real-time RT-PCR and 10 (7%) were positive. Seventeen throat swabs were analyzed by RT-PCR and three were positive. Sequences were obtained from eight of the positive samples. Phylogenetic analysis showed that the DRC rubella viruses belonged to genotypes 1B, 1E, 1G, and 2B. This report provides the first information on the genotypes of rubella virus circulating in the DRC. These data contribute to a better understanding of rubella burden and the dynamics of rubella virus circulation in Africa. Efforts to establish rubella surveillance in the DRC are needed to support rubella elimination in Africa. J. Med. Virol. 88:1677-1684, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

PubMed Central

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

2015-01-01

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

PubMed

Tarvonen, Pirkko-Liisa; Sipilä, Kirsi; Ri, Yon Sil; Jang, Jong Hyon; Kim, Jong Hyok; Suominen, Anna L

2016-10-01

The study aimed to examine awareness of and compliance with healthy oral habits reported by children and their parents in Pyongyang, Democratic People's Republic of Korea (DPRK), after a preventive programme. The data were collected in 2013 with self-completed, partly structured questionnaires from 1994 children aged 10 and 13 years and from 200 parents. Association between awareness of and compliance with healthy oral habits reported by the children and their parents was evaluated using Chi square tests and multivariate logistic regression analyses, children's oral health habits according to themselves and their parents were analysed using McNemar's test. Both children and their parents seemed to be familiar with healthy oral habits, although the awareness was not directly related to the reports of the children's oral practices. Most of the children reported brushing their teeth at least twice a day, using fluoride toothpaste and drinking water for thirst but frequent sweet snacking was common. Children's and their parents' reports were consistent with regard to sweet snacking frequency (p = 0.736) and the main thirst quencher (p = 0.349). Awareness of healthy oral habits appeared to be good among children and their parents. Unhealthy oral habits seemed to coincide with one another.
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.
"Democratic and Humanistic/Humane Paideia in the Euro-Cypriot Polity--Prospects for Reconstruction and Modernization": A Biographical Sociological Analysis of A Reform Initiative in a (De-)Globalizing World

ERIC Educational Resources Information Center

Klerides, Eleftherios

2018-01-01

In 2004, a reform report entitled "Democratic and Humanistic/ Humane Paideia in the Euro-Cypriot Polity: Prospects for Reconstruction and Modernization" was published by the Ministry of Education and Culture in the Republic of Cyprus. Professor Andreas M. Kazamias is held to have been the driving force behind this initiative, shaping…
[A new technic for arthroscopic reinsertion and augmentation of the recently torn anterior cruciate ligament].

PubMed

Boszotta, H; Wendrinsky, R; Sauer, G

1988-02-01

The arthroscopic examination of every recent haemarthrosis of the knee, even in cases without clinically obvious instability has increased the number of primary diagnosed ruptures of the LCA in the last years. The most frequent lesion of the LCA was the proximal rupture. The usual methods for the operative treatment of the ruptured LCA require the opening of the knee joint and cause the weakening of hamstrings, with all disadvantages connected with these procedures. Basing on the experiences in arthroscopic surgery of meniscal lesions and the good results of alloplastic augmentation an new method of arthroscopic refixation and augmentation of the torn LCA has been developed. The use of an arthroscopic meniscal stitcher enables anatomically exact reconstruction of the torn ligament through a femoral tunnel. Augmentation by an LAD-band (Kennedy) or Trevira band (Hoechst) allows postoperative functional treatment, avoiding atrophic degeneration of muscles and loss of mobility by immobilisation. Postoperative pain is reduced to a minimum compared to conventional technics. The period of rehabilitation is considerably shortened.
The republic in crisis and future possibilities.

PubMed

Domingues, José Maurício

2017-06-01

This text gives a brief reconstruction of the process of impeachment of Brazil's President Dilma Rousseff, which was a 'coup' effected through parliament, and situates it at the end of three periods of politics in the Brazilian republic: the first, broader, and democratizing; the second, the age of the PT (Workers' Party) as the force with the hegemony on the left; and the third, shorter, the cycle of its governments. Together, these phases constitute a crisis of the republic, although not a rupture of the country's institutional structure, nor a 'State of Exception'. The paper puts forward three main issues: the developmentalist project implemented by the governments of the PT, in alliance with Brazil's construction companies; the role of the judiciary, and in particular of 'Operation Carwash'; and the conflict-beset relationship between the new evangelical churches and the LGBT social movements. The essay concludes with an assessment of the defeat and isolation of the left at this moment, and also suggests that democracy, in particular, could be the kernel of a renewed project of the left.

Quantitative analysis of the difference between an intact complete discoid lateral meniscus and a torn complete discoid meniscus on MR imaging: a feasibility study for a new classification.

PubMed

Lee, Mi Hee; Choi, Sang-Hee; Woo, Sook Young

2010-12-01

To determine the quantitative difference between an intact complete discoid lateral meniscus (CDLM) and a torn CDLM on MR imaging. Between May 2005 to November 2009, 137 patients with a CDLM (107 intact CDLM and 30 torn CDLM) and 92 patients with a normal meniscus were included in this study. The evaluated parameters were the height of the posterior horn of the lateral and medial menisci on the sagittal images and their ratio as assessed by two observers twice at an interval of 1 month. Each parameter was analyzed based on the Kruskal Wallis test, and the analysis using the mixed model. Intraclass correlation coefficient (ICC) was used to determine the interobserver reliabilities at session 2. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CLDM, and a normal meniscus were 6.5, 7.3, 5.7 and 6.6, 6.4, 6.7 mm at session 1, respectively. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CDLM, and a normal meniscus for both observers were 6.5, 7.2, 5.7 and 6.6, 6.3, 6.8 mm at session 2, respectively. The ratio of the height of the lateral to the height of the medial meniscus for an intact CDLM at both sessions for both observers was 1.0. The ratios were 1.2 and 0.8 for a torn CDLM and for a normal meniscus, respectively, at both sessions for observer 1. The ratios were 1.2 and 0.9 for a torn CDLM and for a normal meniscus, respectively, at session 2 for observer 2. The heights of the posterior horn of the lateral meniscus on the sagittal images and the ratios of the heights of the lateral to the medial menisci in all three groups were statistically significantly different for both sessions (p < 0.0001). The interobserver ICCs for each parameter of both an intact CDLM and a torn CDLM at session 2 showed high correlations (p < 0.0001). The height of the lateral meniscus and the ratio of the height of the lateral to
Leadership in a Democratic School

ERIC Educational Resources Information Center

McCormick, Paul R.

2017-01-01

The purpose of this study is to examine the experiences of a democratic school leader and understand how his conception of leadership is congruent or incongruent with notions of democracy and democratic leadership. This small, participant-observer case study follows a democratic school leader and his staff for a year and examines those challenges…
Trump Is the Mask Torn off of Who We White People Are and Have Been

ERIC Educational Resources Information Center

Scheurich, James Joseph

2017-01-01

Currently, most white people seem to think that Trump and his values are some cruel, insane, accidental distortion of US society. In counterpoint to this view, I argue that he is not. Instead, Trump is mainly the "liberal" or "conservative" mask torn off of who we white people have been and what we have allowed in our name.…
War's enduring effects on the development of egalitarian motivations and in-group biases.

PubMed

Bauer, Michal; Cassar, Alessandra; Chytilová, Julie; Henrich, Joseph

2014-01-01

In suggesting that new nations often coalesce in the decades following war, historians have posed an important psychological question: Does the experience of war generate an enduring elevation in people's egalitarian motivations toward their in-group? We administered social-choice tasks to more than 1,000 children and adults differentially affected by wars in the Republic of Georgia and Sierra Leone. We found that greater exposure to war created a lasting increase in people's egalitarian motivations toward their in-group, but not their out-groups, during a developmental window starting in middle childhood (around 7 years of age) and ending in early adulthood (around 20 years of age). Outside this window, war had no measurable impact on social motivations in young children and had only muted effects on the motivations of older adults. These "war effects" are broadly consistent with predictions from evolutionary approaches that emphasize the importance of group cooperation in defending against external threats, though they also highlight key areas in need of greater theoretical development.
Blood cigarettes: cigarette smuggling and war economies in central and eastern Africa.

PubMed

Titeca, Kristof; Joossens, Luk; Raw, Martin

2011-05-01

To analyse cigarette smuggling practices in central and eastern Africa. Primary data were gathered during long-term qualitative field research in which about 400 interviews were conducted. Analysis of secondary sources included academic literature and reports from non-government organisations, multilateral organisations and the press. Our research suggests that the following factors play an important role in cigarette smuggling in eastern and central Africa: (1) government officials encounter difficulties monitoring the long and porous borders; (2) there is a general problem of corrupt government officials and particularly those who allow large-scale smugglers to operate; (3) criminal elements also play an important role in smuggling--cigarette smuggling has helped rebel groups to finance their activities, something illustrated through examples from the war economy in the eastern part of the Democratic Republic of Congo. Our research suggests that cigarette smuggling in this region is not primarily the result of different taxation levels in neighbouring states, but rather the outcome of weak state capacity, high levels of corruption and the activities of rebel groups. Under these conditions smuggling cigarettes becomes an attractive option as taxation is so easily avoided. This explains why in the low-income countries in this study there are high levels of smuggling in spite of low cigarette prices. Comprehensive supply control and enforcement legislation, and cooperation at national, regional and global level are needed to tackle fraudulent practices facilitated by corruption at state level, and to effectively punish interaction between cigarette traders and rebel groups.
[Use of modern contraceptive methods in the Democratic Republic of the Congo: prevalence and barriers in the health zone of Dibindi, Mbuji-Mayi].

PubMed

Ntambue, Abel Mukengeshayi; Tshiala, Rachel Ngalula; Malonga, Françoise Kaj; Ilunga, Tabitha Mpoyi; Kamonayi, Josaphat Mulumba; Kazadi, Simon Tshimankinda; Matungulu, Charles Matungu; Musau, Angel Nkola; Mulamba, Diese; Dramaix-Wilmet, Michèle; Donnen, Philippe

2017-01-01

This study aimed to determine modern contraceptive prevalence and the barriers to using modern contraceptive methods among the couples in Dibindi health zone, Mbuji-Mayi, in the Democratic Republic of the Congo. We conducted a cross-sectional descriptive study from May to June 2015. Nonpregnant married women aged 15-49 years old at the time of the investigation, living in Dibindi health zone for two years and having freely consented to participate in the study were included. Data were collected by open-ended interview of these women. Modern contraceptive prevalence was referred to women who were currently using, at the time of the investigation, modern contraceptives. The comparison between proportions was performed at the significance threshold of 5%. Bonferroni's test was used to compare, two by two, the proportions of barriers to using modern contraceptive methods. Modern contraceptive prevalence in Dibindi was 18.4% in 2015. It was low with regard to family planning services available in this health zone. Several women refused to use modern contraceptive methods despite available information because of their desire for motherhood, religious prohibition, opposition on the part of their husband and fear of side effects. Sufficient client-centered or couple-centered information and family planning information should be strengthened in order to eliminate the false beliefs and to increase the use of modern contraceptive methods.
The Right to Be Included: Homeschoolers Combat the Structural Discrimination Embodied in Their Lawful Protection in the Czech Republic

ERIC Educational Resources Information Center

Kašparová, Irena

2015-01-01

There is a 240-year tradition of compulsory school attendance in the Czech Republic. To many, compulsory school attendance is synonymous with the right to be educated. After the collapse of communism in 1989, along with the democratization of the government, the education system was slowly opened to alternatives, including the right to educate…
The misuse of Cyproheptadine: a non-communicable disease risk behaviour in Kinshasa population, Democratic Republic of Congo.

PubMed

Lulebo, Aimée M; Bavuidibo, Carine D; Mafuta, Eric M; Ndelo, Josaphat D; Mputu, Lievin's Corneille M; Kabundji, Dalton M; Mutombo, Paulin B

2016-02-09

Obesity is one of the main risk factors of non-communicable diseases (NCDs) worldwide, especially in sub-Saharan Africa. The use of Cyproheptadine increases body weight and the risk of becoming obese. The aim of this study is to determine the prevalence of Cyproheptadine misuse in the Kinshasa population and to describe its characteristics. A cross-sectional study was conducted in two town sectors of Kinshasa, Democratic Republic of Congo (DRC), over a 4 month period (May 2011 to August 2011). Data from 499 participants, aged between 13 and 55 years were collected and analyzed. Mean and standard deviation were used for quantitative variables and frequency and percentage for categorical variables. In order to determine the relationship between socio-demographic status and Cyproheptadine use the Chi-square test was conducted. Student's t-test was used to compare means age of Cyproheptadine users and non-users. Logistic regression was used to determine predictors of Cyproheptadine use. A p-value of <0.05 was considered statistically significant. Overall, 499 participants were enrolled (352 females, 147 males, mean age ± standard deviation 24.9 ± 9.7 years) in the study. The majority of the study participants (72.9 %) had used Cyproheptadine as an appetite stimulant. Females were 11 times more likely to use Cryproheptadine (OR = 11.9; 95 % CI: 7.1-20.1) than males. People aged between 36 and 55 were three times less likely to use Cryproheptadine (OR = 0.3; 95 % CI: 0.2-0.8) compared to teenagers. More than half of the participants (69.0 %) declared to take daily Cyproheptadine. Half of the study participants (50.0 %) used Cyproheptadine for more than a year and also declared to combine it with Dexamethasone (87.6 %). This study shows that the Kinshasa population is significantly misusing Cyproheptadine and is highly exposed to its risk, including obesity.
Assessment of pfcrt 72-76 haplotypes eight years after chloroquine withdrawal in Kinshasa, Democratic Republic of Congo.

PubMed

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

2013-12-20

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

PubMed

Phoummalaysith, Bounfeng; Yamamoto, Eiko; Xeuatvongsa, Anonh; Louangpradith, Viengsakhone; Keohavong, Bounxou; Saw, Yu Mon; Hamajima, Nobuyuki

2018-05-03

Routine vaccination is administered free of charge to all children under one year old in Lao People's Democratic Republic (Lao PDR) and the national goal is to achieve at least 95% coverage with all vaccines included in the national immunization program by 2025. In this study, factors related to the immunization system and characteristics of provinces and districts in Lao PDR were examined to evaluate the association with routine immunization coverage. Coverage rates for Bacillus Calmette-Guerin (BCG), Diphtheria-Tetanus-Pertussis-Hepatitis B (DTP-HepB), DTP-HepB-Hib (Haemophilus influenzae type B), polio (OPV), and measles (MCV1) vaccines from 2002 to 2014 collected through regular reporting system, were used to identify the immunization coverage trends in Lao PDR. Correlation analysis was performed using immunization coverage, characteristics of provinces or districts (population, population density, and proportion of poor villages and high-risk villages), and factors related to immunization service (including the proportions of the following: villages served by health facility levels, vaccine session types, and presence of well-functioning cold chain equipment). To determine factors associated with low coverage, provinces were categorized based on 80% of DTP-HepB-Hib3 coverage (<80% = low group; ≥80% = high group). Coverages of BCG, DTP-HepB3, OPV3 and MCV1 increased gradually from 2007 to 2014 (82.2-88.3% in 2014). However, BCG coverage showed the least improvement from 2002 to 2014. The coverage of each vaccine correlated with the coverage of the other vaccines and DTP-HepB-Hib dropout rate in provinces as well as districts. The provinces with low immunization coverage were correlated with higher proportions of poor villages. Routine immunization coverage has been improving in the last 13 years, but the national goal is not yet reached in Lao PDR. The results of this study suggest that BCG coverage and poor villages should be targeted to improve
Assessing the cost-effectiveness of different measles vaccination strategies for children in the Democratic Republic of Congo.

PubMed

Doshi, Reena H; Eckhoff, Philip; Cheng, Alvan; Hoff, Nicole A; Mukadi, Patrick; Shidi, Calixte; Gerber, Sue; Wemakoy, Emile Okitolonda; Muyembe-Tafum, Jean-Jacques; Kominski, Gerald F; Rimoin, Anne W

2017-10-27

One of the goals of the Global Measles and Rubella Strategic Plan is the reduction in global measles mortality, with high measles vaccination coverage as one of its core components. While measles mortality has been reduced more than 79%, the disease remains a major cause of childhood vaccine preventable disease burden globally. Measles immunization requires a two-dose schedule and only countries with strong, stable immunization programs can rely on routine services to deliver the second dose. In the Democratic Republic of Congo (DRC), weak health infrastructure and lack of provision of the second dose of measles vaccine necessitates the use of supplementary immunization activities (SIAs) to administer the second dose. We modeled three vaccination strategies using an age-structured SIR (Susceptible-Infectious-Recovered) model to simulate natural measles dynamics along with the effect of immunization. We compared the cost-effectiveness of two different strategies for the second dose of Measles Containing Vaccine (MCV) to one dose of MCV through routine immunization services over a 15-year time period for a hypothetical birth cohort of 3 million children. Compared to strategy 1 (MCV1 only), strategy 2 (MCV2 by SIA) would prevent a total of 5,808,750 measles cases, 156,836 measles-related deaths and save U.S. $199 million. Compared to strategy 1, strategy 3 (MCV2 by RI) would prevent a total of 13,232,250 measles cases, 166,475 measles-related deaths and save U.S. $408 million. Vaccination recommendations should be tailored to each country, offering a framework where countries can adapt to local epidemiological and economical circumstances in the context of other health priorities. Our results reflect the synergistic effect of two doses of MCV and demonstrate that the most cost-effective approach to measles vaccination in DRC is to incorporate the second dose of MCV in the RI schedule provided that high enough coverage can be achieved. Published by Elsevier Ltd.
A Retrospective Analysis of the Carter Koreanization Plan: A Case Study of a Blurred Vision

DTIC Science & Technology

1992-04-06

SS WD 0 A otrnD V19S9O WMAM Lietennt oloelHowrd .LIMEia Unte tae Am Best Available Copy UNCLASSIFIED SECURITY CLASSIFICATION OF THIS PAGE REPORT...long-standing, overriding aims of Kim Il Sung, the capricious and bellicose leader of the Democratic People’s Republic of Korea (DPRK), has been to...in Northeast Asia in gejneral and, given Kim Il Sung’s belligerence, on South Korean soil in particular. Since the outbreak of the Korean Wa-r the
Evidence of man-vector contact in torn long-lasting insecticide-treated nets

PubMed Central

2013-01-01

Background Studies indicate that physical damage to long-lasting insecticide-treated nets (LLINs) occurs at a surprisingly rapid rate following net distribution. To what extent does such damage affect the impact of LLINs? Can vectors pass a compromised LLIN barrier to bite? Do more resistant vectors enter the insecticide-treated nets (ITNs) through holes? Methods The study was carried out in three geo-locations. Two types of LLINs (polyester and polyethylene) with ‘standardized’ physical damage were compared with similarly damaged, but non-insecticidal (control) nets. The proportionate Holes Index (pHI) of each net was 276. Mosquitoes were captured inside the nets, identified taxonomically, and subjected to molecular analysis to estimate Knock-down resistance (Kdr) frequency. Results The most commonly observed species was Anopheles gambiae, accounting for approximately 70% (1,076/1,550) of the total mosquitoes collected both in LLINs and non-insecticidal nets. When compared with controls, number of vectors captured in torn LLINs was significantly reduced. Nonetheless in a night, an average of 5 An. gambiae s.l could enter the damaged LLINs to bite. Similar numbers of resistant mosquitoes were collected in both LLINs and non-insecticidal (control) nets (p > 0.05). Conclusions At a pHI of 276, man-vector contact was observed in torn LLINs. The insecticide at the surface of LLINs could only reduce the number of vectors. Resistant mosquitoes have opportunity to enter both non-insecticidal (control) nets and LLINs to bite. PMID:23941585
31 CFR 211.1 - Withholding delivery of checks.

Code of Federal Regulations, 2013 CFR

2013-07-01

... conditions in the Republic of Cuba and the Democratic People's Republic of Korea (North Korea) are such that... of the Democratic People's Republic of Korea (North Korea), the Socialist Republic of Vietnam, and...
31 CFR 211.1 - Withholding delivery of checks.

Code of Federal Regulations, 2011 CFR

2011-07-01

... conditions in the Republic of Cuba and the Democratic People's Republic of Korea (North Korea) are such that... of the Democratic People's Republic of Korea (North Korea), the Socialist Republic of Vietnam, and...
31 CFR 211.1 - Withholding delivery of checks.

Code of Federal Regulations, 2014 CFR

2014-07-01

... conditions in the Republic of Cuba and the Democratic People's Republic of Korea (North Korea) are such that... of the Democratic People's Republic of Korea (North Korea), the Socialist Republic of Vietnam, and...
31 CFR 211.1 - Withholding delivery of checks.

Code of Federal Regulations, 2012 CFR

2012-07-01

... conditions in the Republic of Cuba and the Democratic People's Republic of Korea (North Korea) are such that... of the Democratic People's Republic of Korea (North Korea), the Socialist Republic of Vietnam, and...
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.
Health care in Bosnia and Herzegovina before, during, and after 1992–1995 war: a personal testimony

PubMed Central

Šimunović, Vladimir J

2007-01-01

Market-based health care reform during democratic transition in Bosnia and Herzegovina was complicated by the 1992–1995 war, that devastated the country and greater part of its health care infrastructure. The course of the transition and consequences of war for the health system and health professionals are presented here from the perspective of the author. The description of real-life situations and their context is used to illustrate the problems physicians, as well as international community, were faced with and how they tried to cope with them during and after the war. Speaking openly about the mistakes that were made in those times is the first step in preventing them from happening again and an invitation for exchange of opinions and open academic discussion. PMID:17535419
The Electronic Republic? Evidence on the Impact of the Internet on Citizenship and Civic Engagement in the U.S.

ERIC Educational Resources Information Center

VanFossen, Phillip J.

2006-01-01

In 1991, Lawrence Grossman wrote that "a new political system is taking shape in the United States. As we approach the twenty-first century, America is turning into an electronic republic, a democratic system that is vastly increasing the people's day-to-day influence on decisions of state." Grossman's forecast implied a sea change in the way…

Pathological spirit possession as a cultural interpretation of trauma-related symptoms.

PubMed

Hecker, Tobias; Barnewitz, Eva; Stenmark, Hakon; Iversen, Valentina

2016-07-01

Spirit possession is a phenomenon frequently occurring in war-torn countries. It has been shown to be an idiom of distress entailing dissociative symptoms. However, its association with trauma exposure and trauma-related disorders remains unclear. This study aimed to explore subjective disease models and the relationship between pathological spirit possession and trauma-related disorders in the Eastern Democratic Republic of the Congo. Seventy-three (formerly) possessed persons (74% female, mean age = 34 years), referred by traditional and spiritual healers, were interviewed about their experiences of pathological spirit possession, trauma exposure, posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, shame and guilt, psychotic symptoms, somatic complaints, and the impairment of psychosocial functioning. The most common disease model for pathological spirit possession was another person having sent the spirit, mostly a family member or a neighbor, out of jealousy or conflict over resources. Significant correlations were found between spirit possession over lifetime and PTSD symptom severity, feelings of shame and guilt, depressive symptoms, somatic complaints, and psychotic symptoms. Spirit possession during the preceding 4 weeks was associated with PTSD symptom severity, impairment of psychosocial functioning, and psychotic symptom severity. The results of this study indicate that pathological spirit possession is a broad explanatory framework for various subjectively unexplainable mental and physical health problems, including but not limited to trauma-related disorders. Understanding pathological spirit possession as a subjective disease model for various mental and physical health problems may help researchers and clinicians to develop culturally sensitive treatment approaches for affected individuals. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
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
Accuracy of malaria rapid diagnosis test Optimal-IT(®) in Kinshasa, the Democratic Republic of Congo.

PubMed

Muhindo, Hypolite Mavoko; Ilombe, Gillon; Meya, Ruth; Mitashi, Patrick M; Kutekemeni, Albert; Gasigwa, Didier; Lutumba, Pascal; Van Geertruyden, Jean-Pierre

2012-07-06

Despite some problems related to accuracy and applicability, malaria rapid diagnostic tests (RDTs), are currently considered the best option in areas with limited laboratory services for improving case management and reducing over-treatment. However, their performance must be established taking into the account the particularities of each endemic area. In the Democratic Republic of Congo, the validity of Optimal-IT(®) and Paracheck-Pf(®), respectively based on the detection of lactate dehydrogenase and histidine-rich protein-2, was assessed at primary health care level (PHC). This was a two-stage cluster randomized survey, conducted in one health centre in 12 health zones in Kinshasa city. All patients with malaria presumptive diagnosis were eligible. Gold standard was microscopy performed by experts from the parasitology unit, Kinshasa University. 624 patients were enrolled. 53.4% (95% CI: 49.4-57.3) owed a bed net, obtained in 74.5% of cases (95% CI: 69.4-79.1) through community-based distribution by the National Malaria Control Programme. Microscopy expert reading confirmed 123 malaria cases (19.7%; 95% CI: 16.7-23.1). Overall sensitivity were 79.7% (95% CI: 72.4-86.8), 87.8% (95% CI: 81.9-93.6) and 86.2% (95% CI: 79.9-92.3), respectively, for Optimal-IT(®), Paracheck-Pf(®) and microscopy performed at PHC. Specificity was 97.0% (95% CI: 95.5-98.5), 91.6% (95% CI: 89.1-94.0) and 49.1% (95% CI: 44.7-53.4). The proportion of confirmed cases seemed similar in under-fives compared to others. Any treatment prior to the current visit was a predictor for malaria (AOR: 2.3; 95% CI: 1.5-3.5), but not malaria treatment (AOR: 0.87; 95% CI: 0.4-1.8). Bed net ownership tended to protect against malaria (AOR: 0.67; 95% CI: 0.45-0.99). Although microscopy is considered as the "gold standard" for malaria diagnosis at point of care level, this study showed that its accuracy may not always be satisfactory when performed in health centres.
Exceptionally low prevalence of refractive error and visual impairment in schoolchildren from Lao People's Democratic Republic.

PubMed

Casson, Robert J; Kahawita, Shyalle; Kong, Aimee; Muecke, James; Sisaleumsak, Siphetthavong; Visonnavong, Vithoune

2012-10-01

Vientiane Province is an urbanizing region in Southeast Asia. We aimed to determine the prevalence of refractive error and visual impairment in primary school-aged children in this region. Prospective, cross-sectional survey. A total of 2899 schoolchildren from Vientiane Province, Lao People's Democratic Republic (Lao PDR). Ten districts from Vientiane were randomly selected and 2 primary schools were randomly selected from each district. All children aged 6 to 11 years at selected schools were eligible to participate. The examination included visual acuity (VA) testing, cycloplegic retinoscopy with subjective refinement if indicated, ocular motility testing, and anterior segment and fundus examinations in visually impaired children. Cycloplegic refraction and VA. There was an estimated total of 3330 children who were eligible to participate, and data were recorded from 2899 (87%) of these children. Complete refractive data were available on 2842 children (85% of eligible population). The mean spherical equivalent (SE) in the right eyes was +0.60 diopter (D) (95% confidence interval [CI], 0.49-0.72), and the mean SE in the left eyes was +0.59 (95% CI, 0.50-0.68). The prevalence of hyperopia was 2.8% (95% CI, 1.9-3.7; 88 subjects), and the prevalence of myopia was 0.8% (95% CI, 0.3-1.4; 24 subjects). The majority of children (98%; 95% CI, 97.0-99.0) had normal unaided binocular VA (at least 20/32 in their better eye). The overall prevalence of any visual impairment (presenting VA <20/32 in the better eye) was 1.9% (95% CI, 1.0-2.9; 55 subjects). In multivariate logistic regression analysis, age (P = 0.001) was a significant predictor, and female gender (P = 0.08) and Yao ethnicity (P = 0.09) were borderline significant predictors of the presence of any visual impairment. Visual impairment is not a public health concern in this primary school-aged population; however, visually impaired children in the community were not studied. From this baseline, future surveys
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.
Taenia solium Cysticercosis in the Democratic Republic of Congo: How Does Pork Trade Affect the Transmission of the Parasite?

PubMed Central

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

2010-01-01

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

PubMed Central

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

2017-01-01

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

PubMed

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

2017-05-01

The majority of patients with acute febrile jaundice (>95%) identified through a yellow fever surveillance program in the Democratic Republic of Congo (DRC) test negative for antibodies against yellow fever virus. However, no etiological investigation has ever been carried out on these patients. Here, we tested for hepatitis A (HAV), hepatitis B (HBV), hepatitis C (HCV), hepatitis D (HDV), and hepatitis E (HEV) viruses, all of which can cause acute febrile jaundice, in patients included in the yellow fever surveillance program in the DRC. On a total of 498 serum samples collected from suspected cases of yellow fever from January 2003 to January 2012, enzyme-linked immunosorbent assay (ELISA) techniques were used to screen for antibodies against HAV (IgM) and HEV (IgM) and for antigens and antibodies against HBV (HBsAg and anti-hepatitis B core protein [HBc] IgM, respectively), HCV, and HDV. Viral loads and genotypes were determined for HBV and HVD. Viral hepatitis serological markers were diagnosed in 218 (43.7%) patients. The seroprevalences were 16.7% for HAV, 24.6% for HBV, 2.3% for HCV, and 10.4% for HEV, and 26.1% of HBV-positive patients were also infected with HDV. Median viral loads were 4.19 × 10 5 IU/ml for HBV (range, 769 to 9.82 × 10 9 IU/ml) and 1.4 × 10 6 IU/ml for HDV (range, 3.1 × 10 2 to 2.9 × 10 8 IU/ml). Genotypes A, E, and D of HBV and genotype 1 of HDV were detected. These high hepatitis prevalence rates highlight the necessity to include screening for hepatitis viruses in the yellow fever surveillance program in the DRC. Copyright © 2017 Makiala-Mandanda et al.
Workplace violence towards Congolese health care workers: a survey of 436 healthcare facilities in Katanga province, Democratic Republic of Congo.

PubMed

Muzembo, Basilua Andre; Mbutshu, Lukuke Hendrick; Ngatu, Nlandu Roger; Malonga, Kaj Francoise; Eitoku, Masamitsu; Hirota, Ryoji; Suganuma, Narufumi

2015-01-01

The aim of this study was to investigate workplace violence by patients or their relatives towards health-care workers in Congolese hospitals. Through the autumn of 2012, a cross-sectional survey on workplace violence was conducted in a sample of 2,210 registered health-care workers (989 males and 1,221 females, aged 33 ± 8 years) from 436 hospitals located in the province of Katanga, Democratic Republic of the Congo. Verbal aggression, harassment and physical violence perpetrated by patients or their relatives within the previous year along with factors contributing to violence, were recorded, and the response rate was 99%. About 80.1% of the health-care workers had experienced one or more types of workplace violence. Overall, the severity of workplace violence varied from verbal aggression (57.4%) and harassment (15.2%) to physical violence (7.5%). Patients were the major perpetrators of verbal aggression and harassment, whereas patients' relatives were mainly involved in physical violence. The frequency of workplace violence was similar across hospitals. Male health-care workers were more likely to be victims of physical violence, whereas female health-care workers were the prime target for harassment. Only 34.3% of the violent episodes were reported to a supervisor. Furthermore, disrespect for medical deontology was the main cause of workplace violence perceived by 68.8% of the health-care workers. Although it has not been officially recognized, there has been workplace violence towards health-care workers perpetrated by patients or their relatives despite the fact that health-care workers have traditionally been highly respected in Congolese society. Further studies on this issue may suggest opportunities for combating violence in Congolese hospitals.
Predictors of measles vaccination coverage among children 6-59 months of age in the Democratic Republic of the Congo.

PubMed

Ashbaugh, Hayley R; Hoff, Nicole A; Doshi, Reena H; Alfonso, Vivian H; Gadoth, Adva; Mukadi, Patrick; Okitolonda-Wemakoy, Emile; Muyembe-Tamfum, Jean Jacques; Gerber, Sue K; Cherry, James D; Rimoin, Anne W

2018-01-25

Measles is a significant contributor to child mortality in the Democratic Republic of the Congo (DRC), despite routine immunization programs and supplementary immunization activities (SIA). Further, national immunization coverage levels may hide disparities among certain groups of children, making effective measles control even more challenging. This study describes measles vaccination coverage and reporting methods and identifies predictors of vaccination among children participating in the 2013-2014 DRC Demographic and Health Survey (DHS). We examined vaccination coverage of 6947 children aged 6-59 months. A multivariate logistic regression model was used to identify predictors of vaccination among children reporting vaccination via dated card in order to identify least reached children. We also assessed spatial distribution of vaccination report type by rural versus urban residence. Urban children with educated mothers were more likely to be vaccinated (OR = 4.1, 95% CI: 1.6, 10.7) versus children of mothers with no education, as were children in wealthier rural families (OR = 2.9, 95% CI: 1.9, 4.4). At the provincial level, urban areas more frequently reported vaccination via dated card than rural areas. Results indicate that, while the overall coverage level of 70% is too low, socioeconomic and geographic disparities also exist which could make some children even less likely to be vaccinated. Dated records of measles vaccination must be increased, and groups of children with the greatest need should be targeted. As access to routine vaccination services is limited in DRC, identifying and targeting under-reached children should be a strategic means of increasing country-wide effective measles control. Published by Elsevier Ltd.
The Treatment of the Holocaust in Textbooks: The Federal Republic of Germany, Israel, The United States of America. Holocaust Studies Series.

ERIC Educational Resources Information Center

Braham, Randolph L., Ed.

This book presents an overview of the treatment of the Holocaust in the textbooks used in the Federal Republic of Germany, Israel, and the United States. Selection of these three countries was based on historical, political, and state administration criteria. All three countries are democratic but vary in terms of history, heritage, and…
3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2011 CFR

2011-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...
31 CFR 547.301 - Arms or any related materiel.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO SANCTIONS... use by units of the army and police of the Democratic Republic of the Congo, provided that said units... the Congo; (3) Are in the process of their integration in the territory of the Democratic Republic of...
31 CFR 547.301 - Arms or any related materiel.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO SANCTIONS... use by units of the army and police of the Democratic Republic of the Congo, provided that said units... the Congo; (3) Are in the process of their integration in the territory of the Democratic Republic of...
3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2012 CFR

2012-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...
3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2013 CFR

2013-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...
75 FR 23847 - Blocking of Specially Designated National Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-04

... Conflict in the Democratic Republic of Congo''. DATES: The designation by the Director of OFAC of the five... President found that the situation in the Democratic Republic of the Congo constitutes an unusual and... Kivu, Congo, Democratic Republic of the; DOB 1973; POB Nord-Kivu, DRC; alt. POB Rwanda; nationality...
3 CFR - Continuation of the National Emergency With Respect to the Situation in or in Relation to the...

Code of Federal Regulations, 2014 CFR

2014-01-01

... to the Situation in or in Relation to the Democratic Republic of the Congo Presidential Documents... Respect to the Situation in or in Relation to the Democratic Republic of the Congo On October 27, 2006, by... relation to the Democratic Republic of the Congo and, pursuant to the International Emergency Economic...
31 CFR 547.301 - Arms or any related materiel.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO SANCTIONS... use by units of the army and police of the Democratic Republic of the Congo, provided that said units... the Congo; (3) Are in the process of their integration in the territory of the Democratic Republic of...
31 CFR 547.301 - Arms or any related materiel.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DEMOCRATIC REPUBLIC OF THE CONGO SANCTIONS... use by units of the army and police of the Democratic Republic of the Congo, provided that said units... the Congo; (3) Are in the process of their integration in the territory of the Democratic Republic of...

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.
Azimuth Check: An Analysis of Military Transformation in the Republic of Korea-is it Sufficient

DTIC Science & Technology

2009-12-01

States (US) forces organized, trained, and equipped to deal with a complex and ambiguous collapse of the Democratic People’s Republic of 1 Yong -sup...Han, “Analyzing South Korea’s Defense Reform 2020,” The Korean Journal of Defense Analysis 18, no. 1 (Spring 2006): 111. 2 Yong -sup Han, 115. Han...2006, US Secretary of Defense Donald Rumsfeld and ROK Defense Minister Yoon Kwang- Ung jointly announced transition of wartime operational control
Democratic Bodies: Exemplary Practice and Democratic Education in a K-5 Dance Residency

ERIC Educational Resources Information Center

Leonard, Alison E.

2014-01-01

This research highlights a K-5 dance artist-in-residence as a form of democratic and exemplary dance education that ignited collaboration, promoted equity, fostered student autonomy, and demonstrated rigor in school curriculum. Through examining observation, interview, and performance-based data and calling upon critical, democratic education…
Global Health Observatory (GHO): Life Expectancy

MedlinePlus

... Overview Statistics Cooperation strategies Democratic Republic of the Congo » Emergencies Focus on » Bangladesh Rohingya Democratic Republic of the Congo Iraq Nigeria Somalia South Sudan Syrian Arab Republic ...
Frequently Asked Questions and Answers on Smallpox

MedlinePlus

... Overview Statistics Cooperation strategies Democratic Republic of the Congo » Emergencies Focus on » Bangladesh Rohingya Democratic Republic of the Congo Iraq Nigeria Somalia South Sudan Syrian Arab Republic ...
75 FR 77044 - Blocking of Specially Designated National Pursuant to Executive Order 13413

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

... Conflict in the Democratic Republic of Congo.'' DATES: The designation by the Director of OFAC of the four... States Code. In the Order, the President found that the situation in the Democratic Republic of the Congo.... DOB 1975; POB Ngungu, Masisi Territory, North Kivu province, Democratic Republic of the Congo; Lt. Col...
Democratic Leadership in Education

ERIC Educational Resources Information Center

Woods, Philip A.

2005-01-01

In this book Philip Woods turns his attention to issues of democracy and leadership. He has provided an eloquent, intellectually compelling and sophisticated account of a new leadership label--democratic leadership. He argues that the purpose of "democratic" leadership is to create and help sustain an environment that enables everyone…
Democratization of Learning through Thematic Assignment

ERIC Educational Resources Information Center

Medellu, Christophil S.; Lumingkewas, S.; Walangitan, J. F.

2015-01-01

This article describes the results of research on learning democratization in Sangihe. This study is the first year of a five-year plan. Long-term goal of this research is to create the democratic science learning in schools. Democratic learning model was developed through thematic assignment, involving the participation of parents and…
War on Two Fronts: The Fight against Parasites in Korea and Vietnam.

PubMed

Harrison, Mark; Yim, Sung Vin

2017-07-01

The Vietnam War has long been regarded as pivotal in the history of the Republic of Korea, although its involvement in this conflict remains controversial. While most scholarship has focused on the political and economic ramifications of the war - and allegations of brutality by Korean troops - few scholars have considered the impact of the conflict upon medicine and public health. This article argues that the war had a transformative impact on medical careers and public health in Korea, and that this can be most clearly seen in efforts to control parasitic diseases. These diseases were a major drain on military manpower and a matter of growing concern domestically. The deployment to Vietnam boosted research into parasitic diseases of all kinds and accelerated the domestic campaign to control malaria and intestinal parasites. It also had a formative impact upon the development of overseas aid.
Post-Traumatic Stress Disorder in Adolescents in Lebanon as Wars Gained in Ferocity: A Systematic Review

PubMed Central

Shaar, Khuzama Hijal

2013-01-01

Significance for public health Post traumatic stress disorder (PTSD) in adolescents has been implicated in developmental impairments, mental and scholastic problems, alcohol and drug abuse, and antisocial behavior in its victims among others. Absence of review studies regarding the prevalence of PTSD in adolescents in Lebanon, a country plagued by decades of civil strife and external occupation and invasion, is noted. Such information may reinforce the need to develop national public health policies to identify PTSD in children and adolescents, provide them with counseling and treatment, and formulate prevention strategies to protect vulnerable youth from devastations of war. For decades, Lebanon was war-torn by civil strife, and occupation and invasion by neighboring countries. In time, these wars have escalated in intensity from sniping, barricading streets and random shelling of residential quarters to the use of rockets, aerial bombing, and heavy artillery. Adverse mental health effects are noted in times of war with post traumatic stress disorder (PTSD) as a main outcome. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of PTSD in the adolescent population of Lebanon, to investigate the increase in these rates with the escalation of war intensity, and to examine PTSD determinants. A search strategy was developed for online databases (PubMed and Google Scholar) between inception to the first week of January 2013. Search terms used were PTSD, adolescents and Lebanon. Eleven studies reporting PTSD in adolescents met the inclusion criteria for a total number of 5965 adolescents. Prevalence rates of PTSD ranged from 8.5% to 14.7% for the civil war, 3.7% for adolescents with sensory disabilities, 21.6% for the Grapes of Wrath War, and 15.4% to 35.0% for the 2006 July War. Some increase in PTSD rates in time is noted. Type of trauma such as bereavement, injury, house destruction, and economic problems, low
Justifying British Advertising in War and Austerity, 1939-51.

PubMed

Haughton, Philippa

2017-09-01

Drawing together institutional papers, the trade- and national-press, and Mass-Observation documents, this article examines the changing ways that the Advertising Association justified commercial advertising from 1939 to 1951. It argues that the ability to repeatedly re-conceptualize the social and economic purposes of advertising was central to the industry's survival and revival during the years of war and austerity. This matters because the survival and revival of commercial advertising helps to explain the composition of the post-war mixed economy and the emergence of a consumer culture that became the 'golden age' of capitalism. While commercial advertising's role in supporting periods of affluence is well documented, much less is known about its relationship with war and austerity. This omission is problematic. Advertising was only able to shape the 1950s and 1960s economy because its corporate structures remained intact during the 1940s, as the industry withstood the challenges of wartime and the difficulties presented under Attlee's government. Recognizing the deliberate attempts of advertising people to promote a role for commercial advertising invites us to reconsider the inevitability of post-war affluence, while offering fresh insight into the debate around consumer education, freedom of choice, and the centrality of advertising and communication in democratic society: issues central to the society Britain was, and hoped to become. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Treatment outcomes for human African Trypanosomiasis in the Democratic Republic of the Congo: analysis of routine program data from the world's largest sleeping sickness control program.

PubMed

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

2012-09-01

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

PubMed

Brajsa-Zganec, Andreja

2005-01-01

The aim of the study was to investigate whether different levels of depressive symptoms in early adolescent boys and girls could be predicted on the basis of war experiences, perceived available social support (instrumental support, support to self-esteem, belonging and acceptance) and extraversion. The sample consisted of 583 children ages 12 to 15 years; 283 children were displaced from different parts of Croatia for a period of approximately three and a half years. The following instruments were administered: Questionnaire on Children's Stressful and Traumatic War Experiences, Reynolds Adolescent Depression Scale, Junior Eysenck Personality Questionnaire, and Interpersonal Support Evaluation List. Regression analyses showed that more war experiences were related to more depressive symptoms for boys only. The greater extent of perceived available social support for boys (instrumental support, support to self-esteem, belonging and acceptance) related to fewer depressive symptoms. For girls, perceived instrumental support and self-esteem were related to fewer depressive symptoms. Predictors in the boys' sample accounted for 35% of the variance in the results on the depression scale, and 27% in the girls' sample. We conclude that boys suffer more from the long-term effects of war than girls. In situations where children cannot be shielded from stressful events, such as war, a greater level of perceived social support is related to fewer depressive symptoms both for boys and girls in early adolescence.
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
The Democratization of Production

ERIC Educational Resources Information Center

Bull, Glen; Groves, James

2009-01-01

Just as the democratization of information through personal computers was a key advance of the 20th century, the democratization of production through improvements in fabrication technologies will be a pivotal development in the 21st century. Digital fabrication is the process of translating a digital design into a physical object. At one time,…
BNDF methylation in mothers and newborns is associated with maternal exposure to war trauma.

PubMed

Kertes, Darlene A; Bhatt, Samarth S; Kamin, Hayley S; Hughes, David A; Rodney, Nicole C; Mulligan, Connie J

2017-01-01

The BDNF gene codes for brain-derived neurotrophic factor, a growth factor involved in neural development, cell differentiation, and synaptic plasticity. Present in both the brain and periphery, BDNF plays critical roles throughout the body and is essential for placental and fetal development. Rodent studies show that early life stress, including prenatal stress, broadly alters BDNF methylation, with presumed changes in gene expression. No studies have assessed prenatal exposure to maternal traumatic stress and BDNF methylation in humans. This study examined associations of prenatal exposure to maternal stress and BDNF methylation at CpG sites across the BDNF gene. Among 24 mothers and newborns in the eastern Democratic Republic of Congo, a region with extreme conflict and violence to women, maternal experiences of war trauma and chronic stress were associated with BDNF methylation in umbilical cord blood, placental tissue, and maternal venous blood. Associations of maternal stress and BDNF methylation showed high tissue specificity. The majority of significant associations were observed in putative transcription factor binding regions. This is the first study in humans to examine BDNF methylation in relation to prenatal exposure to maternal stress in three tissues simultaneously and the first in any mammalian species to report associations of prenatal stress and BDNF methylation in placental tissue. The findings add to the growing body of evidence highlighting the importance of considering epigenetic effects when examining the impacts of trauma and stress, not only for adults but also for offspring exposed via effects transmitted before birth.
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
The social context of severe child malnutrition: a qualitative household case study from a rural area of the Democratic Republic of Congo.

PubMed

Kismul, Hallgeir; Hatløy, Anne; Andersen, Peter; Mapatano, Mala; Van den Broeck, Jan; Moland, Karen Marie

2015-05-19

The magnitude of child malnutrition including severe child malnutrition is especially high in the rural areas of the Democratic Republic of Congo (the DRC). The aim of this qualitative study is to describe the social context of malnutrition in a rural part of the DRC and explore how some households succeed in ensuring that their children are well-nourished while others do not. This study is based on participant observation, key informant interviews, group discussions and in-depth interviews with four households with malnourished children and four with well-nourished children. We apply social field theory to link individual child nutritional outcomes to processes at local level and to the wider socio-economic environment. We identified four social fields that have implications for food security and child nutritional outcomes: 1) household size and composition which determined vulnerability to child malnutrition, 2) inter-household cooperation in the form of 'gbisa work party' which buffered scarcity of labour in peak seasons and facilitated capital accumulation, 3) the village associated with usufruct rights to land, and 4) the local NGO providing access to agricultural support, clean drinking water and health care. Households that participated in inter-household cooperation were able to improve food and nutrition security. Children living in households with high pressure on productive members were at danger of food insecurity and malnutrition. Nutrition interventions need to involve local institutions for inter-household cooperation and address the problem of social inequalities in service provision. They should have special focus on households with few resources in the form of land, labour and capital.
Teaching Career Skills in War-Torn Iraq

ERIC Educational Resources Information Center

Eliah, Elaine

2006-01-01

While western Iraq's Anbar province was making headlines with its voter turnout this past December 2005, a quieter turnout of its young men was making headway graduating from school. In Habbaniyah, a volatile city where rockets and mortars destroy buildings and lives all too suddenly and frequently, the Iraq Construction Apprentice Program (ICAP)…

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

PubMed

Ndjinga, Julie K; Minakawa, Noboru

2010-10-12

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

PubMed

Phaku, P; Lebughe, M; Strauß, L; Peters, G; Herrmann, M; Mumba, D; Mellmann, A; Muyembe-Tamfum, J-J; Schaumburg, F

2016-07-01

Staphylococcus aureus from sub-Saharan Africa is frequently resistant to antimicrobial agents that are commonly used to treat invasive infections in resource-limited settings. The underlying mechanisms of resistance are largely unknown. We therefore performed whole genome sequencing (WGS) on S. aureus from the Democratic Republic of the Congo (DRC) to analyse the genetic determinants of antimicrobial resistance. One hundred S. aureus samples were collected from community-associated asymptomatic nasal carriers in the metropolitan area of Kinshasa, DRC, between 2013 and 2014. Phenotypic resistance against 15 antimicrobial agents was compared to the genotypic results that were extracted from WGS data using Mykrobe predictor and the SeqSphere(+) software that screened for 106 target genes associated with resistance. Isolates were phenotypically resistant against penicillin (97%, n=97), trimethoprim (72%, n=72) and tetracycline (54%, n=45). Thirty-three isolates (33%) were methicillin-resistant S. aureus (MRSA). Of these, nine isolates (27.3%) were oxacillin-susceptible MRSA (OS-MRSA) and belonged to ST8 (t1476). The Y195F mutation of FemA was associated with OS-MRSA (p 0.015). The majority of trimethoprim resistant isolates carried dfrG. Tetracycline resistance was associated with tet(K). The concordance between phenotypic susceptibility testing and both WGS analysis tools was similar and ranged between 96% and 100%. In conclusion, a high proportion of OS-MRSA in the DRC was linked to mutations of FemA. Genotypic and phenotypical antimicrobial susceptibility testing showed high concordance. This encourages the future use of WGS in routine antimicrobial susceptibility testing. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Life satisfaction and trauma in clinical and non-clinical children living in a war-torn environment: A discriminant analysis.

PubMed

Veronese, Guido; Pepe, Alessandro

2017-07-01

The aim of this work was to discriminate between healthy children and children at risk of developing mental impairments by evaluating the impact on contextual and individual factors of a context characterized by war. We tested the hypothesis that a linear discriminant function composed of trauma, life satisfaction, and affect balance has the power to classify the children as community or clinical referred. Membership of the clinical-referred group was associated with poorer life satisfaction and higher levels of trauma. Community-referred profiles were associated with lesser trauma. Perceived life satisfaction regarding family and school was the main contributor to the discriminant function.
Pb isotopic constraints on the formation of the Dikulushi Cu-Pb-Zn-Ag mineralisation, Kundelungu Plateau (Democratic Republic of Congo)

NASA Astrophysics Data System (ADS)

Haest, Maarten; Schneider, Jens; Cloquet, Christophe; Latruwe, Kris; Vanhaecke, Frank; Muchez, Philippe

2010-04-01

Base metal-Ag mineralisation at Dikulushi and in other deposits on the Kundelungu Plateau (Democratic Republic of Congo) developed during two episodes. Subeconomic Cu-Pb-Zn-Fe polysulphide ores were generated during the Lufilian Orogeny (c. 520 Ma ago) in a set of E-W- and NE-SW-oriented faults. Their lead has a relatively unradiogenic and internally inhomogeneous isotopic composition (206Pb/204Pb = 18.07-18.49), most likely generated by mixing of Pb from isotopically heterogeneous clastic sources. These sulphides were remobilised and enriched after the Lufilian Orogeny, along reactivated and newly formed NE-SW-oriented faults into a chalcocite-dominated Cu-Ag mineralisation of high economic interest. The chalcocite samples contain only trace amounts of lead and show mostly radiogenic Pb isotope signatures that fall along a linear trend in the 207Pb/204Pb vs. 206Pb/204Pb diagram (206Pb/204Pb = 18.66-23.65; 207Pb/204Pb = 15.72-16.02). These anomalous characteristics reflect a two-stage evolution involving admixture of both radiogenic lead and uranium during a young fluid event possibly c. 100 Ma ago. The Pb isotope systematics of local host rocks to mineralisation also indicate some comparable young disturbance of their U-Th-Pb systems, related to the same event. They could have provided Pb with sufficiently radiogenic compositions that was added to less radiogenic Pb remobilised from precursor Cu-Pb-Zn-Fe polysulphides, whereas the U most likely originated from external sources. Local metal sources are also suggested by the 208Pb/204Pb-206Pb/204Pb systematics of combined ore and rock lead, which indicate a pronounced and diversified lithological control of the immediate host rocks on the chalcocite-dominated Cu-Ag ores. The Pb isotope systematics of polysulphide mineralisation on the Kundelungu Plateau clearly record a diachronous evolution.
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
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.
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.
A ROK (Republic of Korea) Perspective on Korean Security and Desirable Roles for the United States.

DTIC Science & Technology

1988-03-23

World War II, the United States and the Soviet Union agreed to divide responsiblity for disarming the Japanese forces still in Korea. The line of...from the U.S. while reducing those from Japan. But any significant change, such as lowering import tariffs or removing *monopoly protection, will...1988, has said that it will promote increased democratization with the resolution of a number of outstanding political issues, political- social
From Goya to Afghanistan--an essay on the ratio and ethics of medical war pictures.

PubMed

van Bergen, Leo; de Mare, Heidi; Meijman, Frans J

2010-01-01

For centuries pictures of the dead and wounded have been part and parcel of war communications. Often the intentions were clear, ranging from medical instructions to anti-war protests. The public's response could coincide with or diverge from the publisher's intention. Following the invention of photography in the nineteenth century, and the subsequent claim of realism, the veracity of medical war images became more complex. Analysing and understanding such photographs have become an ethical obligation with democratic implications. We performed a multidisciplinary analysis of War Surgery (2008), a book containing harsh, full-colour photographs of mutilated soldiers from the Iraq and Afghanistan wars. Our analysis shows that, within the medical context, this book is a major step forward in medical war communication and documentation. In the military context the book can be conceived as an attempt to put matters right given the enormous sacrifice some individuals have suffered. For the public, the relationship between the 'reality' and 'truth' of such photographs is ambiguous, because only looking at the photographs without reading the medical context is limiting. If the observer is not familiar with medical practice, it is difficult for him to fully assess, signify and acknowledge the value and relevance of this book. We therefore assert the importance of the role of professionals and those in the humanities in particular in educating the public and initiating debate.
Dietary composition and ovarian function among Lese horticulturalist women of the Ituri Forest, Democratic Republic of Congo.

PubMed

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

1998-04-01

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

PubMed

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

2017-12-04

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

DTIC Science & Technology

1983-01-01

ledgm ents ................................................... xvii WAR AND SOCIETY IN AMERICA: SOME QUESTIONS ..... I 1. THE AMERICAN REVOLUTION 5 The...Price of War ...................................... 6 A Revolutionary Society at War ............................ 8 The Revolutionary Economy...obilizing the Union for War .................................... 67 Civil War and American Society . ................................ 71 O rganizing the
War on Two Fronts: The Fight against Parasites in Korea and Vietnam

PubMed Central

Harrison, Mark; Yim, Sung Vin

2017-01-01

The Vietnam War has long been regarded as pivotal in the history of the Republic of Korea, although its involvement in this conflict remains controversial. While most scholarship has focused on the political and economic ramifications of the war – and allegations of brutality by Korean troops – few scholars have considered the impact of the conflict upon medicine and public health. This article argues that the war had a transformative impact on medical careers and public health in Korea, and that this can be most clearly seen in efforts to control parasitic diseases. These diseases were a major drain on military manpower and a matter of growing concern domestically. The deployment to Vietnam boosted research into parasitic diseases of all kinds and accelerated the domestic campaign to control malaria and intestinal parasites. It also had a formative impact upon the development of overseas aid. PMID:28604294
Democratic Learning in U.S. Career Education

ERIC Educational Resources Information Center

Benjamin, Amanda; Hyslop-Margison, Emery; Taylor, Josh

2010-01-01

This paper analyzes various U.S. career education programs through a democratic learning framework that adopts three foundational principles: 1) Democratic career education respects student rationality by encouraging student critique and evaluation of course material; 2) Democratic career education includes alternative perspectives on vocationally…
The Fall and Redemption of People and Systems: Potential Lessons from the "Star Wars" Saga

ERIC Educational Resources Information Center

Guerrero, Anthony P. S.; Jamora, Maria Jasmin

2007-01-01

Through an analysis of the fall and redemption of Anakin Skywalker and the Galactic Republic of the Star Wars saga, educators may be able to convey valuable lessons to students learning about child and adolescent psychiatry and to junior psychiatrists learning about psychiatric administration and liaison. Specifically, educators may be able to…
Gambling in the Czech Republic.

PubMed

Szczyrba, Zdeněk; Mravčík, Viktor; Fiedor, David; Černý, Jakub; Smolová, Irena

2015-07-01

To provide an overview of gambling and associated problems in the Czech Republic, including an overview of the historical context, legislation, prevalence, treatment and research base and agenda. A review of literature and relevant sources. The trajectory of gambling patterns in the territory of the Czech Republic in the 20th century reflected broad socio-political changes. Those included significant expansion between the wars, strict state control and bans on some gambling activities during the communist regime and finally dynamic development characterized by a boom in electronic gaming machines (EGMs) and increasing accessibility of gambling facilities after 1989, which aggravated gambling-related problems. Many municipalities have banned EGMs, which has created conflict in regulation at state and municipal levels. The draft gambling law prepared in 2014 aims to clarify the regulatory framework. Before 2012 there was only sporadic research interest in gambling, but in 2012 the first complex research on gaming and problem gambling in the Czech population took place. The estimated prevalence of problem gambling is currently 2% in the population aged 15-64 years. Preventive measures, counselling and treatment services for problem gamblers are limited. Weak and ineffective regulation of the gambling market in the Czech Republic during the past 20 years, despite the large growth in gambling, has led to inadequate prevention and response to problem gambling which has become a considerable public health, social and political issue. © 2015 Society for the Study of Addiction.
Genetic Assessment of African Swine Fever Isolates Involved in Outbreaks in the Democratic Republic of Congo between 2005 and 2012 Reveals Co-Circulation of p72 Genotypes I, IX and XIV, Including 19 Variants

PubMed Central

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

2017-01-01

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

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

PubMed

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

2017-02-18

African swine fever (ASF) is a devastating disease of domestic pigs. It is a socioeconomically important disease, initially described from Kenya, but subsequently reported in most Sub-Saharan countries. ASF spread to Europe, South America and the Caribbean through multiple introductions which were initially eradicated-except for Sardinia-followed by re‑introduction into Europe in 2007. In this study of ASF within the Democratic Republic of the Congo, 62 domestic pig samples, collected between 2005-2012, were examined for viral DNA and sequencing at multiple loci: C-terminus of the B646L gene (p72 protein), central hypervariable region (CVR) of the B602L gene, and the E183L gene (p54 protein). Phylogenetic analyses identified three circulating genotypes: I (64.5% of samples), IX (32.3%), and XIV (3.2%). This is the first evidence of genotypes IX and XIV within this country. Examination of the CVR revealed high levels of intra-genotypic variation, with 19 identified variants.
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
Perspectives on Asia's Futures II. Report of a Seminar under Major Programme I: Reflection on World Problems and Future-Oriented Studies (2nd, Bangkok, Thailand, April 11-14, 1989).

ERIC Educational Resources Information Center

United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

Representatives of the socialist countries of the Asia-Pacific region, namely, the Democratic People's Republic of Korea, the Lao People's Democratic Republic, the Mongolian People's Republic, and the Socialist Republic of Viet Nam, met to discuss research studies about perspectives on the future in these countries. (Representatives of the…
The Pied Piper of Neo Liberalism Calls the Tune in the Republic of Ireland: An Analysis of Education Policy Text from 2000-2012

ERIC Educational Resources Information Center

Simmie, Geraldine Mooney

2012-01-01

This article offers an analysis of the rhetoric of education policy text during the timeframe from 2000 to 2012 in the Republic of Ireland. The study was framed within two different discourses of the role of the teacher: one discourse regards the teacher as a professional within a dynamic system of democratic relations (Anyon, 2011; Apple, 2012;…
Depression, retention in care, and uptake of PMTCT service in Kinshasa, the Democratic Republic of Congo: a prospective cohort.

PubMed

Yotebieng, Kelly A; Fokong, Kunuwo; Yotebieng, Marcel

2017-03-01

There is a clear need for effective strategies to address the factors that affect retention, or lost-to-follow-up (LTFU) and adherence to HIV care and treatment. Depression in particular may play an important role in the high rates of LTFU along the prevention of mother-to-child HIV transmission (PMTCT) cascade in sub-Saharan Africa. This study assessed the association between prenatal depression and (1) LTFU or (2) uptake of PMTCT services. As part of a randomized control trial to evaluate the effect of conditional cash transfers on retention in and uptake of PMTCT services, newly diagnosed HIV-infected women, ≤32 weeks pregnant, registering for antenatal care (ANC), in 85 clinics in Kinshasa, Democratic Republic of Congo (DRC), were recruited and followed-up until LTFU, death, transfer out, or six weeks postpartum. Participants were interviewed at enrollment using a questionnaire which included the Patient Health Questionnaire (PHQ-9). Depression was defined as a PHQ-9 score of ≥15. Among 433 women enrolled, 51 (11.8%) had a PHQ-9 score ≥15 including 15 (3.5%) with a score ≥20. At six weeks postpartum, 67 (15.5%) were LFTU and 331 (76.4%) were in care and had accepted all available PTMCT services. Of participants with depression at enrollment, 17.7% (9/51) were LTFU at six weeks postpartum compared to 15.2% (58/382) among those without, but the association was not statistically significant. On the other hand, 78.4% (40/51) of participants with prenatal depression were in care at six weeks postpartum and had attended all their scheduled visits and accepted available services compared to 76.2% (291/382) among those without depression. In this cohort of newly diagnosed HIV-infected pregnant women, prenatal depression assessed with a PHQ-9 score ≥15 was not a strong predictor of LTFU among newly diagnosed HIV-infected women in Kinshasa, DRC.
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
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
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
Misconceptions about HIV infection in Kinshasa (Democratic Republic of Congo): a case-control study on knowledge, attitudes and practices.

PubMed

Carlos, Silvia; Martínez-González, Miguel Ángel; Burgueño, Eduardo; López-Del Burgo, Cristina; Ruíz-Canela, Miguel; Ndarabu, Adolphe; Tshilolo, Léon; Tshiswaka, Philomène; Labarga, Pablo; de Irala, Jokin

2015-08-01

To evaluate the prevalence of HIV-related misconceptions in an outpatient centre of Kinshasa (Democratic Republic of Congo) and analyse the association between these beliefs and HIV infection. A case-control study was carried out from December 2010 until June 2012. We assessed 1630 participants aged 15-49 attending a primary outpatient centre in Kinshasa: 762 HIV Voluntary Counselling and Testing attendees and 868 blood donors. A 59-item questionnaire about knowledge, attitudes and practice was administered during a face-to-face interview, followed by an HIV test. Cases and controls were respondents with a newly diagnosed HIV-positive or HIV-negative test, respectively. Unconditional logistic regression was used to analyse the association between misconceptions and HIV seropositivity. 274 cases and 1340 controls were recruited. Cases were more likely than controls to have a low socioeconomic status, no education, to be divorced/separated or widowed. An association was found between the following variables and HIV seropositivity: having a poor HIV knowledge (adjusted OR=2.79; 95% CI 1.43 to 5.45), not knowing a virus is the cause of AIDS (adjusted OR=2.03; 95% CI 1.38 to 2.98) and reporting more than three HIV-transmission-related misconceptions (adjusted OR=3.30; 95% CI 1.64 to 6.64), such as thinking an HIV-positive person cannot look healthy and that HIV is transmitted by sorcery, God's punishment, a kiss on the mouth, mosquitoes, coughs/sneezes or undercooked food. Despite having access to healthcare services, there are still many people in Kinshasa that have HIV-related misconceptions that increase their HIV risk. Our findings underscore the need for a culturally adapted and gender-orientated basic HIV information into Congolese HIV prevention programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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
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
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
[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.
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.
32 CFR 270.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OF CERTAIN FORMER OPERATIVES INCARCERATED BY THE DEMOCRATIC REPUBLIC OF VIETNAM General § 270.1... incarcerated by the Democratic Republic of Vietnam as a result of the participation by the persons in certain operations conducted by the Republic of Vietnam. ...
32 CFR 270.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OF CERTAIN FORMER OPERATIVES INCARCERATED BY THE DEMOCRATIC REPUBLIC OF VIETNAM General § 270.1... incarcerated by the Democratic Republic of Vietnam as a result of the participation by the persons in certain operations conducted by the Republic of Vietnam. ...
32 CFR 270.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF CERTAIN FORMER OPERATIVES INCARCERATED BY THE DEMOCRATIC REPUBLIC OF VIETNAM General § 270.1... incarcerated by the Democratic Republic of Vietnam as a result of the participation by the persons in certain operations conducted by the Republic of Vietnam. ...
32 CFR 270.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF CERTAIN FORMER OPERATIVES INCARCERATED BY THE DEMOCRATIC REPUBLIC OF VIETNAM General § 270.1... incarcerated by the Democratic Republic of Vietnam as a result of the participation by the persons in certain operations conducted by the Republic of Vietnam. ...
32 CFR 270.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF CERTAIN FORMER OPERATIVES INCARCERATED BY THE DEMOCRATIC REPUBLIC OF VIETNAM General § 270.1... incarcerated by the Democratic Republic of Vietnam as a result of the participation by the persons in certain operations conducted by the Republic of Vietnam. ...
Pedagogical Practices: Nurturing and Maintaining Democratic Habits

ERIC Educational Resources Information Center

Hubler-Larimore, Lucretia Marie

2011-01-01

This case study examined the pedagogical practices of four teachers of one public elementary school whose mission seeks to nurture and maintain democratic habits for participation in a democratic society. Historically, public schools have been charged with the duty of preparing young minds to live within in a democratic society and as such this…

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