Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to pr...Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .展开更多
Context: Breast cancer is a high-mortality disease. Early detection has considerably reduced mortality in developed countries. Objectives: To assess the knowledge, attitudes and practices of Congolese women in Kinshas...Context: Breast cancer is a high-mortality disease. Early detection has considerably reduced mortality in developed countries. Objectives: To assess the knowledge, attitudes and practices of Congolese women in Kinshasa on breast cancer, their levels and to identify factors associated with insufficient knowledge, negative attitudes and non-beneficial practices. Material and Methods: This was a descriptive cross-sectional study with analytical aims, carried out from June 1 to September 30, 2023, in Kinshasa. It involved 1170 female respondents, aged 18 to 65, who agreed to take part in the survey. Data were collected using a pre-established questionnaire. Data analysis was performed using SPSS software version 20.0. The study variables were socio-demographics, morbid history, knowledge, attitudes and practices of respondents regarding breast cancer. Statistical measures and tests used were Mean ± standard deviation, median, proportions, logistic regression Backward stepwise and p Results: 60% had insufficient knowledge, 75% had negative attitudes and 80% had non-beneficial practices. The risk factors common to insufficient knowledge, negative attitudes and non-beneficial practices towards breast cancer were low level of education, membership of revivalist or Muslim churches, and primiparity. Conclusion: 60% of Congolese women in Kinshasa have insufficient knowledge about breast cancer, 75% have negative attitudes and 80% have non-beneficial practices, with a positive association between insufficient knowledge and negative attitudes on the one hand, and insufficient knowledge and non-beneficial practices on the other. In this context, increasing the population’s literacy and access to information are essential.展开更多
Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. ...Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. Several African countries have reported an upward trend in both the age of childbirth and the frequency of women with AMA over the past 20 years. In the Democratic Republic of Congo (DRC), where maternal and neonatal morbidity and mortality remain very high, data on AMA pregnancies go back more than 20 years. Objective: We propose evaluating obstetrical outcomes among women in AMA in our setting and the associated factors. Methods: This retrospective cohort study will be conducted in two healthcare facilities (ESS) in Kinshasa. The study population will consist of all women who delivered a single fetus after 28 weeks of gestation between January 2012 and December 2022 (10 years) in the selected ESS. The data collected will be analyzed using R software version 4.2.0. Quantitative variables will be summarized as means with standard deviation or medians with interquartile range. Qualitative variables will be presented as proportions (%). Multivariate logistic regression will be used to determine the main maternal-fetal complications associated with AMA and predictors of obstetric outcomes. P Discussion: The high maternal and infant mortality rates in DRC are among the highest in the world. The context of maternal age has become a topic of growing interest due to its potential implications for the health of women and newborns, it is crucial to identify the risk factors associated with obstetric outcomes by identifying obstetrical outcomes associated with advanced maternal age in the DRC. Many Congolese women tend to start their maternity journey at a relatively young age. However, there is also an emerging trend towards delayed childbearing, particularly in urban areas and among women with access to education and family planning services. Conclusion: The results of this study will enable us to update the frequency of AMA pregnancies in our environment. The socio-demographic and clinical profile of these pregnancies will be determined. The main maternal-fetal complications associated with AMA in our setting and the associated factors will be identified.展开更多
Background and objective: Chronic rhinosinusitis (CRS), a common disease worldwide, has a major impact on patients’ quality of life (QoL). In recent years, the measurement of health-related QoL has made it possible t...Background and objective: Chronic rhinosinusitis (CRS), a common disease worldwide, has a major impact on patients’ quality of life (QoL). In recent years, the measurement of health-related QoL has made it possible to assess the patient’s state of health, the severity of the CRS and the treatment. The aim of this study was to assess the QoL of patients with CRS in a hospital setting in Kinshasa. Methods: This was a cross-sectional analytical study conducted from June 2020 to May 2021 in the ENT service of the Kinshasa University Hospital and the Monkole Hospital Center. The study involved 113 patients aged at least 18 years, whose QOL was compared with that of a control group consisting of 100 non-patients. QOL was assessed using the Sino-Nasal Outcome Test (SNOT-22) Questionnaire. Results: The mean age of the patients was 41.0 years (18 - 74 years) and that of the controls was 39.1 years (19 - 77 years). More than half of the participants were university graduates. The median SNOT-22 score was 44 (14 - 78) in patients and 7 (1 - 40) in controls. Compared with subjects without CRS, patients with CRS had significantly higher scores in all four domains of the SNOT-22. Around 9 out of 10 patients had a severely impaired QoL compared with 2 out of 10 controls. Considering mildly impaired QoL, we found that in the otological and sleep domains, scores were not significantly different between patients and controls. In the case of severely impaired QoL, however, only the otological domain showed a non-significant difference in scores between the two groups. Conclusion: CRS is a real public health problem in our environment and significantly alters the QoL of patients suffering from it, with repercussions on their professional productivity;hence the need for better management.展开更多
Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my ...Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my experience and the challenges of this aesthetic plastic surgery among black African women. Material and Methods: A retrospective study was conducted about the abdominoplasties, liposuctions and Brazilian butt lift (BBL) which I operated in public and private hospitals at Kinshasa (Democratic Republic of Congo) in black African women. It covers a period of 13 years, going from December 1, 2010 to December 1, 2023. For this study, I had at least 6 months period (to Juin 1, 2024) to assess the occurrence of early and late postoperative complications. Results: I performed 84 abdominoplasties, 144 liposuctions and 23 Brazilian butt lifts (BBL). The average age at the time of abdominoplasty was 44 years with extremes ranging from 26 to 55 years and a concentration of cases (60.7%) in the age group of 40 to 49 years. The age group of 20 to 29 years old represented the lowest rate of requests for abdominoplasty (4.7%). Patients with a BMI of 30 to 2 were the majority (61.9%), followed by those between 25 to 2 (29.7%). 67.8% of patients were obese (BMI ≥ 30 kg/m2). The average age at the time of liposuction was 41 years with extremes ranging from 21 years to 69 years;and more than half of cases (68%) in the age group between 30 and 49 years. As for Brazilian butt lift (BBL), the average age was 33 years with extremes ranging from 24 to 42 years and a concentration of patients (91.3%) between 20 and 39 years. The immediate postoperative complications of abdominoplasties observed were: seroma in 7% of cases, hematoma and partial infection of the surgical site in 5% of cases. Pathological scars (hypertrophic, keloid) after abdominoplasties were observed in 9% of cases. The most common complication of liposuction was contour deformity. I observed 16 patients (11.1%) with soft-tissue depressions or elevations, skin panniculus or folds. For Brazalian Butt Lift (BBL), complications like asymmetry for 2 patients (8.9%), contour irregularities for 2 patients (8.9%), and excessive fat removal for 6 patients (26%), had observed. I have not recorded any cases of death or pulmonary embolism. Conclusion: I perform aesthetic plastic surgery procedures in black African women with a high socioeconomic standard of living compared to the average of the general population. The renunciation of planned surgery is motivated by the impossibility of paying the cost of the operation as well as by popular and religious perceptions regarding cosmetic surgery. The results of these aesthetic plastic surgery procedures carried out are very satisfactory for them. The challenges to overcome are mainly threefold: the unforeseeable complications of these cosmetic plastic surgery procedures, popular and religious perceptions of cosmetic surgery as well as the poverty of the population.展开更多
Load shedding is a major problem in Central Africa, with negative consequences for both society and the economy. However, load profile analysis can help to alleviate this problem by providing valuable information abou...Load shedding is a major problem in Central Africa, with negative consequences for both society and the economy. However, load profile analysis can help to alleviate this problem by providing valuable information about consumer demand. This information can be used by power utilities to forecast and reduce power cuts effectively. In this study, the direct method was used to create load profiles for residential feeders in Kinshasa. The results showed that load shedding on weekends results in significant financial losses and changes in people’s behavior. In November 2022 alone, load shedding was responsible for $ 23,4 08,984 and $ 2 80,9 07,808 for all year in losses. The study also found that the SAIDI index for the southern direction of the Kinshasa distribution network was 122.49 hours per feeder, on average. This means that each feeder experienced an average of 5 days of load shedding in November 2022. The SAIFI index was 20 interruptions per feeder, on average, and the CAIDI index was 6 hours, on average, before power was restored. This study also proposes ten strategies for the reduction of load shedding in the Kinshasa and central Africa power distribution network and for the improvement of its reliability, namely: Improved load forecasting, Improvement of the grid infrastructure, Scheduling of load shedding, Demand management programs, Energy efficiency initiatives, Distributed Generation, Automation and Monitoring of the Grid, Education and engagement of the consumer, Policy and regulatory assistance, and Updated load profile analysis.展开更多
As many think that respect for the environment, is not only a question intended for industrialists but has all the sectors of life, in particular sanitary also. In this regard, our article brings alternative managemen...As many think that respect for the environment, is not only a question intended for industrialists but has all the sectors of life, in particular sanitary also. In this regard, our article brings alternative management of human waste (excrement) to solve the problems that plague our dear beautiful capital, namely: 1) Lack of latrines that meet the standards;2) Emptying of septic tanks directly into the gutters and;3) Water pollution by sewage csompanies. In order to carry out the cartographic analysis of the study area, we used Shapefile data from the OpenStreetMap, Diva-Gis. These different data allowed us, analyzed, to categorize with the software ArArcGIS 0.8.1 to produce different zones according to the cases incurred in the city of Kinshasa. To do this, the analytical method uses the Buswell equation to determine the amount of gas contained in human excrement. Focusing on the analysis of the excrements produced by the population of age superior to 10 years, for 2023, we obtained: 138355.7283 m<sup>3</sup>/day of CH4 (885476.66 kWh/day or 885.476 MWh/day), which, energy can light: 138,355 lamps of 60 to 100 W for six hours or nearly 70,000 lamps of 60 to 100 W for 12 hours. Considering the last one which offers the lowest access rate, i.e. 3% of the district population to these latrines, we have: a) In Tshangu, we produce: 1618.762 <sup>3>/day (10360.07 kWh/day or 10.36 MWh/day) which can light nearly 1600 lamps from 60 to 100 W for six hours or nearly 800 lamps from 60 to 100 W for twelve hours. b) Mont-Amba, we produce 1402.927 <sup>3>/day (8978.73 kWh/day or 8.97 MWh/day) which can light nearly 1400 lamps from 60 to 100 W for six hours or nearly 700 lamps from 60 to 100 W for twelve hours;c) In Lukunga, we produce: 946.35 <sup>3>/day (6056.66 kWh/day or 6.056 MWh/day) which can light nearly 900 lamps from 60 to 100 W for six hours or nearly 450 lamps from 60 to 100 W for twelve hours. d) Funa, we produce: 182.629 <sup>3>/day (1168.83 kWh/day or 1.17 MWh/day) which can light almost 180 lamps from 60 to 100 W for six hours or almost 90 lamps from 60 to 100 W for twelve hours.展开更多
Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life...Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life expectancy and quality of life of PLHIV. Objective: The objective of this study was to determine the profile of PLHIV initiating AntiRetroViral Treatment (ART) in the era of Dolutegravir in Kinshasa. Methods: Cross-section of a prospective cohort to determine the profile of PLHIV initiating ART in Kinshasa. The inclusions were from October 04, 2021 to February 15, 2022. Confirmation of the diagnosis was carried out by Nested PCR. The inclusion criteria were: being at least 18 years old, confirmed HIV positive, naïve to ART, consenting and having signed an informed consent. The parameters of interest followed for the present study were: age, sex, religion, level of study, marital status, occupation, height, weight, body mass index (BMI), the clinical profile, the opportunistic infections as well as the para-clinical assessment (biochemistry and molecular biology). Results: 67 (56.3%) women and 52 (43.7%) men were included, thus 119 patients, all confirmed positive for HIV by Nested PCR on the gag, pol and env regions. The average age of the patients included is 39.87 ± 12.36 years and the most represented age group is that of 36 to 45 years with 37 patients (31.9%). The average height was 1.66 ± 0.08 meters, with an average weight of 56.41 ± 13.30 kg, giving an average Body Mass Index (BMI) of 21.54 ± 5.17 kg/m<sup>2</sup>. The majority of patients were married (46.1%), of Protestant religion (70.7%), with secondary education (66.7%), and working in the informal sector (29.4%). 49 patients (41.5%) were in clinical stage 3 and 55 patients (47.0%) had a normal clinical status. Malaria (45.4%) and tuberculosis (29.4%) were the most common Opportunistic Infections. The mean values of the patients’ assessed biochemical parameters were within the ranges. The median VL value was 4.16 log<sub>10</sub> RNA copies/ml. Subtype A (20.2%) is dominant. Mutations K65R (2 cases), T69P/N (5 cases), K70R (9 cases) and M184V (8 cases) were listed. Conclusion: In Kinshasa, PLHIV start ART late. The biochemical parameters evaluated are within normal ranges, with high VLs. Subtype A remains predominant and there are mutations conferring resistance to ART.展开更多
Introduction: The sixth month appointment (M6) is crucial because at the start of the ART course, it is an indicator of the prognosis of the evolution of care and decision-making on the continuity of treatment. Object...Introduction: The sixth month appointment (M6) is crucial because at the start of the ART course, it is an indicator of the prognosis of the evolution of care and decision-making on the continuity of treatment. Objective: The objective of this study is therefore to present the profile of People Living with HIV under treatment with Dolutegravir 6 months after starting ART in Kinshasa. Methods: The present study is a cross-sectional view at M6 of a prospective cohort to determine the profile of People Living with HIV (PLHIV) after 6 months of ARV Treatment (ART) in Kinshasa, DRC. During the M6 appointment, from April to August 2022, a sample of 5 ml of blood was taken for the various analyzes from all HIV patients included. The collection of sociodemographic data as well as biological and clinical data was carried out under the same conditions as at inclusion. The parameters recorded during M6 were: age, sex, and religion, level of study, marital status, profession, socio-economic level, height, weight, Body Mass Index (BMI), clinical profile, opportunistic infections as well as biochemical and molecular assessment. Results: In M6, 62 patients were registered including 38 women (61.3%), thus giving a sex ratio of 1.58 in favor of women. Fifty-seven (57) patients did not respond to the appointment, representing a loss rate of 47.89%. The most common age group is between 36 and 45 years old with 16 patients (26.7%). The mean age was 42.4 ± 13.3 years. The mean weight was 60.5 ± 15.4 kg with a mean BMI of 22.6 ± 5.8 kg/m<sup>2</sup>. Thirty-four (34) patients (61.82%) were in Clinical Stage 3. Thirty-six (36) patients (67.92%) had a normal clinical condition. The most common opportunistic infections among patients in M6 were: skin pruritus (25.8%), dermatitis (22.6%) and rash (21%). The mean values of biochemical parameters of patients in M6 were within normal ranges. The median VL value was 2.92 log10 RNA copies/ml with 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF02_AG (16.13%) and C subtypes (14.52%). The mutations K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) were listed in M6. Conclusion: After 6 months of treatment, the majority of patients are in clinical stage 3 with a normal clinical state. Skin infections are the majority opportunistic infections. Certain biological parameters are considerably altered. A high virological failure rate with the presence of certain mutations associated with resistance to Lamivudine and Tenofovir.展开更多
Background: There is no study that estimates the prevalence of vernal keratoconjunctivitis and the association between vernal keratoconjunctivitis and intestinal parasitic infestation in our setting. Purpose: This stu...Background: There is no study that estimates the prevalence of vernal keratoconjunctivitis and the association between vernal keratoconjunctivitis and intestinal parasitic infestation in our setting. Purpose: This study aimed to estimate the vernal keratoconjunctivitis prevalence, describe the profile of sensitization and determine the association between vernal keratoconjunctivitis disease and intestinal parasitic infestation in school children of Kinshasa during the scholar year from 2022 to 2023. Methods: An observational, cross-sectional study was performed from September 2022 to June 2023. The children with vernal keratoconjunctivitis were recruited by using the four-stage probability sampling technique. Children attending in the school children of Kinshasa with vernal keratoconjunctivitis were enrolled in the classroom and underwent a clinical examination and skin prick test for 11 allergens and stool examination direct with microscope in the Laboratory. Data were entered in Microsoft Sheets using SPSS version 20.0. The Chi-square test was used to compare the sex, age groups, home environment (grow trees and/or flowers around the yard), dampness in the house, keeping pets (cat and/or dog), number of people per household, number of people sharing a bedroom and intestinal parasitic infestation. The significant level was set to a value of p Results: A total of 28,800 students from four-stage probabilist sampling technique in school of Kinshasa were included, and 2100 students had symptoms according to the vernal keratoconjunctivitis-related symptom questionnaire. Children with vernal keratoconjunctivitis were enrolled and the mean age ± standard was 7.2 ± 3.7 years, with a prevalence of 7.2% and gender was three boys for one girl. All vernal keratoconjunctivitis children recruited in urban and rural part had 33.1% positive skin prick test (SPT) and 67.9% showed polysensitization. Children an urban part was more sensitized than rural respectively with Dermatophagoides pteronyssinus 28.1% vs 28.9%, p = 0.00001, Blomia tropicalis. 15.9% vs 14.9%, p = 0.00001 and cockroach 12% vs 13%, p = 0.00001 in both parts. Vernal keratoconjunctivitis children in rural part were more affected to the intestinal parasite than urban with Ascaris lumbricoides 14% vs 18.3%, p = 0.0006, followed by Ancylostoma duodenale 9.5% vs 12.5%, p = 0.003, Anguillule 7.9% vs 10.1%, p = 0.001, Oxyure 5.7% vs 8.2%, p = 0.0001 and Trichuris trichiura 2.6% vs 3.3%, p = 0.0009. Conclusion: This study outlines that the prevalence of vernal keratoconjunctivitis was 7.2% and 33.1% of children attending for vernal keratoconjunctivitis in school children had a positive skin prick test to at least one allergen, in particular for Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach. The most common intestinal parasitic infestation was Ascaris lumbricoides, Ancylostoma duodenale, Anguillule and Trichuris trichiura.展开更多
Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The object...Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The objective of this study is therefore to present the virological and molecular profile of People Living with HIV under treatment with Dolutegravir 6 months after being put on ART in Kinshasa. Methods: The present study is a cross-sectional view at the sixth month of a prospective cohort to determine the virological and molecular profile of People Living with HIV (PLHIV) after 6 months of ART based on Dolutegravir (DTG) in Kinshasa. A sample of 5 mL of blood was taken from all HIV patients included. The collection of biological data was carried out under the same conditions as at inclusion. After extraction, Quantitative Real-Time PCR was carried out to determine the quantity of HIV RNA in the samples according to the protocols previously described. Reverse Transcription PCR (RT-PCR) and Nested PCR were carried out to amplify the regions of interest for Protease and Reverse Transcriptase for sequencing. Results: The median VL value was 2.92 log<sub>10</sub> RNA copies/mL. With 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF_02AG (16.13%), subtypes C (14.52%), D (9.68%) and K (6.45%). The K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) mutations were listed as existing mutations for Nucleotide Reverse Transcriptase Inhibitors. Conclusion: After 6 months of ART, 59.67% of People Living with HIV on Tenofovir-Lamivudine-Dolutegravir is in therapeutic success while 40.33% are in a state of treatment failure. Subtype A remains dominant in the population of PLHIV. Resistance mutations were detected for Lamivudine and Tenofovir, but none for Dolutegravir.展开更多
Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the...Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the virological profile of Patients Living with HIV (PLHIV) after 12 months of AntiRetro Viral Treatment (ART) based on Dolutegravir (DTG) in Kinshasa. Method: The present study is a cross-sectional view of the virological profile of the twelfth month of a prospective cohort of PLHIV at M12 of DTG-based ART in Kinshasa. During the M12 appointment, a blood sample was taken for Molecular Biology analyses from all PLHIV included. Result: During the M12 appointment, 28 patients were registered, including 16 (57.1%) women. Nine (9) patients (45.0%) had an undetectable Viral Load (VL). The median VL value was 3.18 log<sub>10</sub> RNA copies/mL (1530 RNA copies/mL). The mutations K65R, T69P/N, K70R and M184V have been listed as mutations conferring resistance to Nucleotide Reverse Transcriptase Inhibitors. No mutations associated with Dolutegravir were observed at M12. Conclusion: After 12 months of AntiRetroViral Treatment based on Dolutegravir, half of the Patients on first-line ART are in a state of virological failure.展开更多
Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV...Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV/AIDS. Objective: the Objective of this study is to present the virological and molecular profile of People Living with HIV starting Antiretroviral Therapy in Kinshasa in the era of the Dolutegravir. Methods: This was a transversal study to determine virological and molecular profile of People Living with HIV (PLHIV) starting an ARV Treatment. The patient’s inclusion period was from October 04, 2021 to February 15, 2022. A sample of 5 ml of blood was taken in a tube with EDTA anticoagulant for Molecular Biology analyzes (Viral Load and Sequencing) in all HIV patients, after reading and signing informed consent. The population was made up of adult patients over the age of 18, infected with HIV and starting ART. Results: 119 patients (56.3% of women) were included in this study, thus a sex-ratio of 1.29. The average age of patients included was 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 with 37 patients (31.9%) followed by that from 26 to 35 years with 24 patients (20.7%). Out of 119 patients, 21 patients had an undetectable Viral Load (VL). The median value of VL was 4.16 log10 RNA copies/ml. 114 samples were successfully amplified. Subtype A was dominant with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%, and D (10.5 %). K65R (1.8%), T69P/N (4.4%), K70R (7.9%) and M184V (7.0%) mutations were listed as existing mutations for Nucleotide Transcriptase Inhibitors. Conclusion: 38 patients (31.93%) started the TARV with a positive virological prognosis. The subtype A remains dominant in Kinshasa with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%. For Inhibitors of Transcriptase Reverse Nucleotide;K65R, T69P/N, K70E/R and M184V mutations were found in patients’ naive of ARV Treatment.展开更多
Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spec...Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spectacular reduction in the frequency of Opportunistic Infections. Objective: The objective of this study is to present the evolution of Opportunistic Infections in People Living with HIV under AntiRetroViral Treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a prospective cohort to present the evolutionary profile of OIs in PLHIV on ART for 6 months in Outpatient Treatment Centers (OTC) in Kinshasa. Sixteen OTCs had been included. The population of the present work was patients over 18 years of age at inclusion, infected with HIV-1 and initiating ART in the selected OTC. Results: On inclusion, 119 patients were included of which 56.3% were women. Malaria (45.4%), tuberculosis (29.4%) and cutaneous pruritus (23.5%) were the most common Opportunistic Infections (OIs). In the third month of ART, 37 patients came for the consultation of which 70.3% were women. Non-specific STIs (97.3%), skin pruritus (37.8%) and malaria (24.3%) were the dominant OIs among patients. At the sixth month of ART, 62 patients came for the medical consultation of which 61.3% were women. Skin pruritus (25.8%), dermatitis (22.6%) and rash (21%) were the most common OIs. Conclusion: The evolutionary profile is marked by the conservation of Opportunistic Infections such as dermatitis (pruritus and rashes) and malaria.展开更多
Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships...Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.展开更多
Context: The biochemical assessment is a real-time indicator of the state and evolution of an infection. Among other things, it makes it possible to determine the right moment when it becomes necessary to start or cha...Context: The biochemical assessment is a real-time indicator of the state and evolution of an infection. Among other things, it makes it possible to determine the right moment when it becomes necessary to start or change a treatment. Objective: The objective of this study is to present the Biological profile of People Living with HIV starting AntiRetroViral treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a descriptive cross-sectional to determine the biological profile of People Living with HIV (PLHIV) starting AntiRetroViral Treatment (ART). The patient inclusion period was from October 4, 2021 to February 15, 2022. Sixteen centers were included. A sample of 5 ml of blood was taken in a tube with EDTA. Patients were randomly included consecutively in the centers during consultations. The population was made up of adults aged over 18, infected with HIV and starting ART. The parameters of interest retained for the present study were: sex, age, hemoglobin level, blood sugar, urea, creatinine, transaminases, total cholesterol, triglycerides, proteins total, as well as amylase. Results: 119 patients were included in this study in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients is 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). The mean values of the biological parameters of the patients at the start of ART are as follows: 31.61 ± 20.71 IU/L for ALT/SGPT, 25.81 ± 19.96 IU/L for AST/SGOT, 79.35 ± 49.49 IU/L for Amylase, 108.13 ± 62.17 mg/dl for Total Cholesterol, 2.77 ± 1.27 mg/dl for Creatinine, 72.53 ±22.23 mg/dl for Glycaemia, 10.30 ± 2.33 g/dl for Hemoglobin, 7.91 ± 1.75 g/dl for Total Protein, 131.23 ± 68.80 mg/dl for Triglycerides, and 33.61 ± 26.27 mg/dl for Urea. Conclusion: Mean values of PLHIV are, for the most part, within the normal range. The average creatinine is higher than the normal average value while the average total cholesterol is below the limit values.展开更多
Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is charact...Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.展开更多
Context: Two years after the transition to Dolutegravir (DTG), at the national level, data on compliance with the execution of this transition and the rational use of the new molecule are not available. Objective: The...Context: Two years after the transition to Dolutegravir (DTG), at the national level, data on compliance with the execution of this transition and the rational use of the new molecule are not available. Objective: The objective of this study was to determine compliance with first-line ART prescriptions among People Living with HIV starting AntiRetroViral treatment in Kinshasa during the Dolutegravir era. Methods: This study is a descriptive cross-sectional study to determine compliance with first-line ART prescriptions among people living with HIV during the Dolutegravir era in Kinshasa. Sixteen Outpatients Treatment Centers (OTCs) were included in the study for their expertise in the care of PLHIV, their technical collection platform and their accessibility. The parameters of interest were: age, sex, outpatient treatment centers, and medical prescription. Results: One hundred and nineteen (119) patients were included in this work in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients included is 39.87 ± 12.36 years with extremities of 18 to 69 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). One hundred and nineteen (119) patients were received from 16 centers in Kinshasa, according to 6 OTC for the district of Funa, 4 OTC for Tshangu and 3 OTC respectively for Lukunga and Mont-Amba. All the centers respect the new recommendations of the National Program;all patients (100%) are on the Tenofovir (TDF) + Lamivudine (3TC) + Dolutegravir (DTG) combination. Conclusion: Compliance with the prescription of DTG as a first-line ARV in the DRC is effective in the city province of Kinshasa.展开更多
Background: Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world, and the occurrence of this infection during pregnancy is responsible for adverse obstetrical outcomes like pre...Background: Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world, and the occurrence of this infection during pregnancy is responsible for adverse obstetrical outcomes like premature labor, premature rupture of membranes (PROM) and low birth weight (birth weight < 2500 g). The association with a number of factors (maternal age, low level of education, low socio-economic status and multiple sexual partners, etc.) that can be found in our environment suggest its probably high prevalence amongst vaginal infections that are responsible for adverse obstetrical outcomes, but up-to-date estimates are lacking. Objective: To assess the obstetrical risk associated with Trichomonas vaginalis (T. vaginalis) infection in our environment. Methods: We designed a protocol for a prospective cohort study which will take place in four medical facilities in the city of Kinshasa, where all pregnant women with a pregnancy of at least 20 weeks and who will give written consent will be included. Vaginal swab specimens will be collected for T. vaginalis research by direct microscopy wet mount. Follow-up will consist of recording the process of the pregnancy and obstetrical outcomes. Conclusion: Results from this study will allow to enhance management and also bring updated estimates on T. vaginalis prevalence and its obstetrical outcomes for infected pregnant woman in our environment.展开更多
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 we...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.S).And 627women(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.IgC 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 primoinfection,indicating a need for measures to prevent and control toxoplasmosis during pregnancy.展开更多
文摘Context: Antiretroviral therapies improve the prognosis of NeuroAIDS contrasting with a high frequency of Minor Neurocognitive Disorders (MND) even in aviremic subjects. Objective: The objective of this study is to present the neurological and cognitive profile of People Living with HIV (PLHIV) initiating antiretroviral treatment in Kinshasa in the era of Dolutegravir (DTG). Methods: This is a multicenter, cross-sectional study with a descriptive aim carried out in 16 HIV Outpatient Treatment Centers (OTC) in Kinshasa from October 4, 2021 to February 15, 2022. The International HIV Dementia Scale (IHDS) correlated with the Activities of Daily Living (IADL) scale facilitated the categorization of NeuroCognitive Disorders (NCD) of PLHIV evaluated after carrying out a summary neurological examination. Results: Of the 96 patients recruited, 56.3% were women with a sex ratio of 0.68. The average age was 40.1 ± 12.1 years. The secondary education level was the majority at 64.6%. Malaria (44.8%) and tuberculosis (32.3%) were more common as opportunistic infections. They were alcoholics in (30.2%). Their history was heart disease (15.6%), high blood pressure (18.8%);drug abuse (10.4%). The IHDS score was light in 55.2% of cases. The correlation between IHDS/IADL watches asymptomatic neurocognitive impairments (ANI) in 77.1%, almost all of subjects are found with normal overall functioning (94.8%) and a disturbed neurological examination in 53.1% of cases with a predominance of motor impairments in 79.1%. Conclusion: In view of these results, early and systematic screening of NCD and associated factors remains necessary in our context. .
文摘Context: Breast cancer is a high-mortality disease. Early detection has considerably reduced mortality in developed countries. Objectives: To assess the knowledge, attitudes and practices of Congolese women in Kinshasa on breast cancer, their levels and to identify factors associated with insufficient knowledge, negative attitudes and non-beneficial practices. Material and Methods: This was a descriptive cross-sectional study with analytical aims, carried out from June 1 to September 30, 2023, in Kinshasa. It involved 1170 female respondents, aged 18 to 65, who agreed to take part in the survey. Data were collected using a pre-established questionnaire. Data analysis was performed using SPSS software version 20.0. The study variables were socio-demographics, morbid history, knowledge, attitudes and practices of respondents regarding breast cancer. Statistical measures and tests used were Mean ± standard deviation, median, proportions, logistic regression Backward stepwise and p Results: 60% had insufficient knowledge, 75% had negative attitudes and 80% had non-beneficial practices. The risk factors common to insufficient knowledge, negative attitudes and non-beneficial practices towards breast cancer were low level of education, membership of revivalist or Muslim churches, and primiparity. Conclusion: 60% of Congolese women in Kinshasa have insufficient knowledge about breast cancer, 75% have negative attitudes and 80% have non-beneficial practices, with a positive association between insufficient knowledge and negative attitudes on the one hand, and insufficient knowledge and non-beneficial practices on the other. In this context, increasing the population’s literacy and access to information are essential.
文摘Introduction: Pregnancies at advanced maternal age (AMA) are those occurring after the age of 35 years old. They carry a high risk of maternal-fetal morbidity and mortality, thus constituting a public health problem. Several African countries have reported an upward trend in both the age of childbirth and the frequency of women with AMA over the past 20 years. In the Democratic Republic of Congo (DRC), where maternal and neonatal morbidity and mortality remain very high, data on AMA pregnancies go back more than 20 years. Objective: We propose evaluating obstetrical outcomes among women in AMA in our setting and the associated factors. Methods: This retrospective cohort study will be conducted in two healthcare facilities (ESS) in Kinshasa. The study population will consist of all women who delivered a single fetus after 28 weeks of gestation between January 2012 and December 2022 (10 years) in the selected ESS. The data collected will be analyzed using R software version 4.2.0. Quantitative variables will be summarized as means with standard deviation or medians with interquartile range. Qualitative variables will be presented as proportions (%). Multivariate logistic regression will be used to determine the main maternal-fetal complications associated with AMA and predictors of obstetric outcomes. P Discussion: The high maternal and infant mortality rates in DRC are among the highest in the world. The context of maternal age has become a topic of growing interest due to its potential implications for the health of women and newborns, it is crucial to identify the risk factors associated with obstetric outcomes by identifying obstetrical outcomes associated with advanced maternal age in the DRC. Many Congolese women tend to start their maternity journey at a relatively young age. However, there is also an emerging trend towards delayed childbearing, particularly in urban areas and among women with access to education and family planning services. Conclusion: The results of this study will enable us to update the frequency of AMA pregnancies in our environment. The socio-demographic and clinical profile of these pregnancies will be determined. The main maternal-fetal complications associated with AMA in our setting and the associated factors will be identified.
文摘Background and objective: Chronic rhinosinusitis (CRS), a common disease worldwide, has a major impact on patients’ quality of life (QoL). In recent years, the measurement of health-related QoL has made it possible to assess the patient’s state of health, the severity of the CRS and the treatment. The aim of this study was to assess the QoL of patients with CRS in a hospital setting in Kinshasa. Methods: This was a cross-sectional analytical study conducted from June 2020 to May 2021 in the ENT service of the Kinshasa University Hospital and the Monkole Hospital Center. The study involved 113 patients aged at least 18 years, whose QOL was compared with that of a control group consisting of 100 non-patients. QOL was assessed using the Sino-Nasal Outcome Test (SNOT-22) Questionnaire. Results: The mean age of the patients was 41.0 years (18 - 74 years) and that of the controls was 39.1 years (19 - 77 years). More than half of the participants were university graduates. The median SNOT-22 score was 44 (14 - 78) in patients and 7 (1 - 40) in controls. Compared with subjects without CRS, patients with CRS had significantly higher scores in all four domains of the SNOT-22. Around 9 out of 10 patients had a severely impaired QoL compared with 2 out of 10 controls. Considering mildly impaired QoL, we found that in the otological and sleep domains, scores were not significantly different between patients and controls. In the case of severely impaired QoL, however, only the otological domain showed a non-significant difference in scores between the two groups. Conclusion: CRS is a real public health problem in our environment and significantly alters the QoL of patients suffering from it, with repercussions on their professional productivity;hence the need for better management.
文摘Background: In low-income African countries, the demand and use of plastic surgery operations including abdominoplasty, liposuction and Brazilian butt lift (BBL) are increasing. The goal of this work is to present my experience and the challenges of this aesthetic plastic surgery among black African women. Material and Methods: A retrospective study was conducted about the abdominoplasties, liposuctions and Brazilian butt lift (BBL) which I operated in public and private hospitals at Kinshasa (Democratic Republic of Congo) in black African women. It covers a period of 13 years, going from December 1, 2010 to December 1, 2023. For this study, I had at least 6 months period (to Juin 1, 2024) to assess the occurrence of early and late postoperative complications. Results: I performed 84 abdominoplasties, 144 liposuctions and 23 Brazilian butt lifts (BBL). The average age at the time of abdominoplasty was 44 years with extremes ranging from 26 to 55 years and a concentration of cases (60.7%) in the age group of 40 to 49 years. The age group of 20 to 29 years old represented the lowest rate of requests for abdominoplasty (4.7%). Patients with a BMI of 30 to 2 were the majority (61.9%), followed by those between 25 to 2 (29.7%). 67.8% of patients were obese (BMI ≥ 30 kg/m2). The average age at the time of liposuction was 41 years with extremes ranging from 21 years to 69 years;and more than half of cases (68%) in the age group between 30 and 49 years. As for Brazilian butt lift (BBL), the average age was 33 years with extremes ranging from 24 to 42 years and a concentration of patients (91.3%) between 20 and 39 years. The immediate postoperative complications of abdominoplasties observed were: seroma in 7% of cases, hematoma and partial infection of the surgical site in 5% of cases. Pathological scars (hypertrophic, keloid) after abdominoplasties were observed in 9% of cases. The most common complication of liposuction was contour deformity. I observed 16 patients (11.1%) with soft-tissue depressions or elevations, skin panniculus or folds. For Brazalian Butt Lift (BBL), complications like asymmetry for 2 patients (8.9%), contour irregularities for 2 patients (8.9%), and excessive fat removal for 6 patients (26%), had observed. I have not recorded any cases of death or pulmonary embolism. Conclusion: I perform aesthetic plastic surgery procedures in black African women with a high socioeconomic standard of living compared to the average of the general population. The renunciation of planned surgery is motivated by the impossibility of paying the cost of the operation as well as by popular and religious perceptions regarding cosmetic surgery. The results of these aesthetic plastic surgery procedures carried out are very satisfactory for them. The challenges to overcome are mainly threefold: the unforeseeable complications of these cosmetic plastic surgery procedures, popular and religious perceptions of cosmetic surgery as well as the poverty of the population.
文摘Load shedding is a major problem in Central Africa, with negative consequences for both society and the economy. However, load profile analysis can help to alleviate this problem by providing valuable information about consumer demand. This information can be used by power utilities to forecast and reduce power cuts effectively. In this study, the direct method was used to create load profiles for residential feeders in Kinshasa. The results showed that load shedding on weekends results in significant financial losses and changes in people’s behavior. In November 2022 alone, load shedding was responsible for $ 23,4 08,984 and $ 2 80,9 07,808 for all year in losses. The study also found that the SAIDI index for the southern direction of the Kinshasa distribution network was 122.49 hours per feeder, on average. This means that each feeder experienced an average of 5 days of load shedding in November 2022. The SAIFI index was 20 interruptions per feeder, on average, and the CAIDI index was 6 hours, on average, before power was restored. This study also proposes ten strategies for the reduction of load shedding in the Kinshasa and central Africa power distribution network and for the improvement of its reliability, namely: Improved load forecasting, Improvement of the grid infrastructure, Scheduling of load shedding, Demand management programs, Energy efficiency initiatives, Distributed Generation, Automation and Monitoring of the Grid, Education and engagement of the consumer, Policy and regulatory assistance, and Updated load profile analysis.
文摘As many think that respect for the environment, is not only a question intended for industrialists but has all the sectors of life, in particular sanitary also. In this regard, our article brings alternative management of human waste (excrement) to solve the problems that plague our dear beautiful capital, namely: 1) Lack of latrines that meet the standards;2) Emptying of septic tanks directly into the gutters and;3) Water pollution by sewage csompanies. In order to carry out the cartographic analysis of the study area, we used Shapefile data from the OpenStreetMap, Diva-Gis. These different data allowed us, analyzed, to categorize with the software ArArcGIS 0.8.1 to produce different zones according to the cases incurred in the city of Kinshasa. To do this, the analytical method uses the Buswell equation to determine the amount of gas contained in human excrement. Focusing on the analysis of the excrements produced by the population of age superior to 10 years, for 2023, we obtained: 138355.7283 m<sup>3</sup>/day of CH4 (885476.66 kWh/day or 885.476 MWh/day), which, energy can light: 138,355 lamps of 60 to 100 W for six hours or nearly 70,000 lamps of 60 to 100 W for 12 hours. Considering the last one which offers the lowest access rate, i.e. 3% of the district population to these latrines, we have: a) In Tshangu, we produce: 1618.762 <sup>3>/day (10360.07 kWh/day or 10.36 MWh/day) which can light nearly 1600 lamps from 60 to 100 W for six hours or nearly 800 lamps from 60 to 100 W for twelve hours. b) Mont-Amba, we produce 1402.927 <sup>3>/day (8978.73 kWh/day or 8.97 MWh/day) which can light nearly 1400 lamps from 60 to 100 W for six hours or nearly 700 lamps from 60 to 100 W for twelve hours;c) In Lukunga, we produce: 946.35 <sup>3>/day (6056.66 kWh/day or 6.056 MWh/day) which can light nearly 900 lamps from 60 to 100 W for six hours or nearly 450 lamps from 60 to 100 W for twelve hours. d) Funa, we produce: 182.629 <sup>3>/day (1168.83 kWh/day or 1.17 MWh/day) which can light almost 180 lamps from 60 to 100 W for six hours or almost 90 lamps from 60 to 100 W for twelve hours.
文摘Background: For several decades, the introduction of AntiRetrovirals (ARVs) has improved the symptomatology of People Living with HIV (PLHIV), a spectacular reduction in morbidity and mortality, an improvement in life expectancy and quality of life of PLHIV. Objective: The objective of this study was to determine the profile of PLHIV initiating AntiRetroViral Treatment (ART) in the era of Dolutegravir in Kinshasa. Methods: Cross-section of a prospective cohort to determine the profile of PLHIV initiating ART in Kinshasa. The inclusions were from October 04, 2021 to February 15, 2022. Confirmation of the diagnosis was carried out by Nested PCR. The inclusion criteria were: being at least 18 years old, confirmed HIV positive, naïve to ART, consenting and having signed an informed consent. The parameters of interest followed for the present study were: age, sex, religion, level of study, marital status, occupation, height, weight, body mass index (BMI), the clinical profile, the opportunistic infections as well as the para-clinical assessment (biochemistry and molecular biology). Results: 67 (56.3%) women and 52 (43.7%) men were included, thus 119 patients, all confirmed positive for HIV by Nested PCR on the gag, pol and env regions. The average age of the patients included is 39.87 ± 12.36 years and the most represented age group is that of 36 to 45 years with 37 patients (31.9%). The average height was 1.66 ± 0.08 meters, with an average weight of 56.41 ± 13.30 kg, giving an average Body Mass Index (BMI) of 21.54 ± 5.17 kg/m<sup>2</sup>. The majority of patients were married (46.1%), of Protestant religion (70.7%), with secondary education (66.7%), and working in the informal sector (29.4%). 49 patients (41.5%) were in clinical stage 3 and 55 patients (47.0%) had a normal clinical status. Malaria (45.4%) and tuberculosis (29.4%) were the most common Opportunistic Infections. The mean values of the patients’ assessed biochemical parameters were within the ranges. The median VL value was 4.16 log<sub>10</sub> RNA copies/ml. Subtype A (20.2%) is dominant. Mutations K65R (2 cases), T69P/N (5 cases), K70R (9 cases) and M184V (8 cases) were listed. Conclusion: In Kinshasa, PLHIV start ART late. The biochemical parameters evaluated are within normal ranges, with high VLs. Subtype A remains predominant and there are mutations conferring resistance to ART.
文摘Introduction: The sixth month appointment (M6) is crucial because at the start of the ART course, it is an indicator of the prognosis of the evolution of care and decision-making on the continuity of treatment. Objective: The objective of this study is therefore to present the profile of People Living with HIV under treatment with Dolutegravir 6 months after starting ART in Kinshasa. Methods: The present study is a cross-sectional view at M6 of a prospective cohort to determine the profile of People Living with HIV (PLHIV) after 6 months of ARV Treatment (ART) in Kinshasa, DRC. During the M6 appointment, from April to August 2022, a sample of 5 ml of blood was taken for the various analyzes from all HIV patients included. The collection of sociodemographic data as well as biological and clinical data was carried out under the same conditions as at inclusion. The parameters recorded during M6 were: age, sex, and religion, level of study, marital status, profession, socio-economic level, height, weight, Body Mass Index (BMI), clinical profile, opportunistic infections as well as biochemical and molecular assessment. Results: In M6, 62 patients were registered including 38 women (61.3%), thus giving a sex ratio of 1.58 in favor of women. Fifty-seven (57) patients did not respond to the appointment, representing a loss rate of 47.89%. The most common age group is between 36 and 45 years old with 16 patients (26.7%). The mean age was 42.4 ± 13.3 years. The mean weight was 60.5 ± 15.4 kg with a mean BMI of 22.6 ± 5.8 kg/m<sup>2</sup>. Thirty-four (34) patients (61.82%) were in Clinical Stage 3. Thirty-six (36) patients (67.92%) had a normal clinical condition. The most common opportunistic infections among patients in M6 were: skin pruritus (25.8%), dermatitis (22.6%) and rash (21%). The mean values of biochemical parameters of patients in M6 were within normal ranges. The median VL value was 2.92 log10 RNA copies/ml with 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF02_AG (16.13%) and C subtypes (14.52%). The mutations K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) were listed in M6. Conclusion: After 6 months of treatment, the majority of patients are in clinical stage 3 with a normal clinical state. Skin infections are the majority opportunistic infections. Certain biological parameters are considerably altered. A high virological failure rate with the presence of certain mutations associated with resistance to Lamivudine and Tenofovir.
文摘Background: There is no study that estimates the prevalence of vernal keratoconjunctivitis and the association between vernal keratoconjunctivitis and intestinal parasitic infestation in our setting. Purpose: This study aimed to estimate the vernal keratoconjunctivitis prevalence, describe the profile of sensitization and determine the association between vernal keratoconjunctivitis disease and intestinal parasitic infestation in school children of Kinshasa during the scholar year from 2022 to 2023. Methods: An observational, cross-sectional study was performed from September 2022 to June 2023. The children with vernal keratoconjunctivitis were recruited by using the four-stage probability sampling technique. Children attending in the school children of Kinshasa with vernal keratoconjunctivitis were enrolled in the classroom and underwent a clinical examination and skin prick test for 11 allergens and stool examination direct with microscope in the Laboratory. Data were entered in Microsoft Sheets using SPSS version 20.0. The Chi-square test was used to compare the sex, age groups, home environment (grow trees and/or flowers around the yard), dampness in the house, keeping pets (cat and/or dog), number of people per household, number of people sharing a bedroom and intestinal parasitic infestation. The significant level was set to a value of p Results: A total of 28,800 students from four-stage probabilist sampling technique in school of Kinshasa were included, and 2100 students had symptoms according to the vernal keratoconjunctivitis-related symptom questionnaire. Children with vernal keratoconjunctivitis were enrolled and the mean age ± standard was 7.2 ± 3.7 years, with a prevalence of 7.2% and gender was three boys for one girl. All vernal keratoconjunctivitis children recruited in urban and rural part had 33.1% positive skin prick test (SPT) and 67.9% showed polysensitization. Children an urban part was more sensitized than rural respectively with Dermatophagoides pteronyssinus 28.1% vs 28.9%, p = 0.00001, Blomia tropicalis. 15.9% vs 14.9%, p = 0.00001 and cockroach 12% vs 13%, p = 0.00001 in both parts. Vernal keratoconjunctivitis children in rural part were more affected to the intestinal parasite than urban with Ascaris lumbricoides 14% vs 18.3%, p = 0.0006, followed by Ancylostoma duodenale 9.5% vs 12.5%, p = 0.003, Anguillule 7.9% vs 10.1%, p = 0.001, Oxyure 5.7% vs 8.2%, p = 0.0001 and Trichuris trichiura 2.6% vs 3.3%, p = 0.0009. Conclusion: This study outlines that the prevalence of vernal keratoconjunctivitis was 7.2% and 33.1% of children attending for vernal keratoconjunctivitis in school children had a positive skin prick test to at least one allergen, in particular for Dermatophagoides pteronyssinus, Blomia tropicalis and cockroach. The most common intestinal parasitic infestation was Ascaris lumbricoides, Ancylostoma duodenale, Anguillule and Trichuris trichiura.
文摘Context: The appointment of the M6 is crucial because it is an indicator of the prognosis of the evolution of the care and the decision-making on the continuation of the AntiRetroViral Treatment. Objective: The objective of this study is therefore to present the virological and molecular profile of People Living with HIV under treatment with Dolutegravir 6 months after being put on ART in Kinshasa. Methods: The present study is a cross-sectional view at the sixth month of a prospective cohort to determine the virological and molecular profile of People Living with HIV (PLHIV) after 6 months of ART based on Dolutegravir (DTG) in Kinshasa. A sample of 5 mL of blood was taken from all HIV patients included. The collection of biological data was carried out under the same conditions as at inclusion. After extraction, Quantitative Real-Time PCR was carried out to determine the quantity of HIV RNA in the samples according to the protocols previously described. Reverse Transcription PCR (RT-PCR) and Nested PCR were carried out to amplify the regions of interest for Protease and Reverse Transcriptase for sequencing. Results: The median VL value was 2.92 log<sub>10</sub> RNA copies/mL. With 17.75% of patients experiencing major failure of first-line treatment. Subtype A is dominant with 13 cases (20.98%);followed by CRF_02AG (16.13%), subtypes C (14.52%), D (9.68%) and K (6.45%). The K65R (3 cases), T69P/N (6 cases), K70R (9 cases) and M184V (8 cases) mutations were listed as existing mutations for Nucleotide Reverse Transcriptase Inhibitors. Conclusion: After 6 months of ART, 59.67% of People Living with HIV on Tenofovir-Lamivudine-Dolutegravir is in therapeutic success while 40.33% are in a state of treatment failure. Subtype A remains dominant in the population of PLHIV. Resistance mutations were detected for Lamivudine and Tenofovir, but none for Dolutegravir.
文摘Context: The evaluation of plasma Viral Load constitutes an indicator of the progression of the infection, the effectiveness and the tolerance of the treatment. Objective: The objective of this study is to present the virological profile of Patients Living with HIV (PLHIV) after 12 months of AntiRetro Viral Treatment (ART) based on Dolutegravir (DTG) in Kinshasa. Method: The present study is a cross-sectional view of the virological profile of the twelfth month of a prospective cohort of PLHIV at M12 of DTG-based ART in Kinshasa. During the M12 appointment, a blood sample was taken for Molecular Biology analyses from all PLHIV included. Result: During the M12 appointment, 28 patients were registered, including 16 (57.1%) women. Nine (9) patients (45.0%) had an undetectable Viral Load (VL). The median VL value was 3.18 log<sub>10</sub> RNA copies/mL (1530 RNA copies/mL). The mutations K65R, T69P/N, K70R and M184V have been listed as mutations conferring resistance to Nucleotide Reverse Transcriptase Inhibitors. No mutations associated with Dolutegravir were observed at M12. Conclusion: After 12 months of AntiRetroViral Treatment based on Dolutegravir, half of the Patients on first-line ART are in a state of virological failure.
文摘Context: Despite the new recommendations “Test and Treat”, the virological and molecular parameters remain important information for Antiretroviral Treatment and adequate for monitoring of patients infected with HIV/AIDS. Objective: the Objective of this study is to present the virological and molecular profile of People Living with HIV starting Antiretroviral Therapy in Kinshasa in the era of the Dolutegravir. Methods: This was a transversal study to determine virological and molecular profile of People Living with HIV (PLHIV) starting an ARV Treatment. The patient’s inclusion period was from October 04, 2021 to February 15, 2022. A sample of 5 ml of blood was taken in a tube with EDTA anticoagulant for Molecular Biology analyzes (Viral Load and Sequencing) in all HIV patients, after reading and signing informed consent. The population was made up of adult patients over the age of 18, infected with HIV and starting ART. Results: 119 patients (56.3% of women) were included in this study, thus a sex-ratio of 1.29. The average age of patients included was 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 with 37 patients (31.9%) followed by that from 26 to 35 years with 24 patients (20.7%). Out of 119 patients, 21 patients had an undetectable Viral Load (VL). The median value of VL was 4.16 log10 RNA copies/ml. 114 samples were successfully amplified. Subtype A was dominant with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%, and D (10.5 %). K65R (1.8%), T69P/N (4.4%), K70R (7.9%) and M184V (7.0%) mutations were listed as existing mutations for Nucleotide Transcriptase Inhibitors. Conclusion: 38 patients (31.93%) started the TARV with a positive virological prognosis. The subtype A remains dominant in Kinshasa with 23 cases (20.2%);followed by the subtype C and CRF02_AG each with 14.0%. For Inhibitors of Transcriptase Reverse Nucleotide;K65R, T69P/N, K70E/R and M184V mutations were found in patients’ naive of ARV Treatment.
文摘Background: Opportunistic infections (OI), which are still a major problem in the care of People Living with HIV (PLHIV), occur in situations of immunosuppression. The AntiRetroViral Treatments (ART) used allow a spectacular reduction in the frequency of Opportunistic Infections. Objective: The objective of this study is to present the evolution of Opportunistic Infections in People Living with HIV under AntiRetroViral Treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a prospective cohort to present the evolutionary profile of OIs in PLHIV on ART for 6 months in Outpatient Treatment Centers (OTC) in Kinshasa. Sixteen OTCs had been included. The population of the present work was patients over 18 years of age at inclusion, infected with HIV-1 and initiating ART in the selected OTC. Results: On inclusion, 119 patients were included of which 56.3% were women. Malaria (45.4%), tuberculosis (29.4%) and cutaneous pruritus (23.5%) were the most common Opportunistic Infections (OIs). In the third month of ART, 37 patients came for the consultation of which 70.3% were women. Non-specific STIs (97.3%), skin pruritus (37.8%) and malaria (24.3%) were the dominant OIs among patients. At the sixth month of ART, 62 patients came for the medical consultation of which 61.3% were women. Skin pruritus (25.8%), dermatitis (22.6%) and rash (21%) were the most common OIs. Conclusion: The evolutionary profile is marked by the conservation of Opportunistic Infections such as dermatitis (pruritus and rashes) and malaria.
文摘Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.
文摘Context: The biochemical assessment is a real-time indicator of the state and evolution of an infection. Among other things, it makes it possible to determine the right moment when it becomes necessary to start or change a treatment. Objective: The objective of this study is to present the Biological profile of People Living with HIV starting AntiRetroViral treatment in Kinshasa in the era of Dolutegravir. Methods: The present study is a descriptive cross-sectional to determine the biological profile of People Living with HIV (PLHIV) starting AntiRetroViral Treatment (ART). The patient inclusion period was from October 4, 2021 to February 15, 2022. Sixteen centers were included. A sample of 5 ml of blood was taken in a tube with EDTA. Patients were randomly included consecutively in the centers during consultations. The population was made up of adults aged over 18, infected with HIV and starting ART. The parameters of interest retained for the present study were: sex, age, hemoglobin level, blood sugar, urea, creatinine, transaminases, total cholesterol, triglycerides, proteins total, as well as amylase. Results: 119 patients were included in this study in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients is 39.87 ± 12.36 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). The mean values of the biological parameters of the patients at the start of ART are as follows: 31.61 ± 20.71 IU/L for ALT/SGPT, 25.81 ± 19.96 IU/L for AST/SGOT, 79.35 ± 49.49 IU/L for Amylase, 108.13 ± 62.17 mg/dl for Total Cholesterol, 2.77 ± 1.27 mg/dl for Creatinine, 72.53 ±22.23 mg/dl for Glycaemia, 10.30 ± 2.33 g/dl for Hemoglobin, 7.91 ± 1.75 g/dl for Total Protein, 131.23 ± 68.80 mg/dl for Triglycerides, and 33.61 ± 26.27 mg/dl for Urea. Conclusion: Mean values of PLHIV are, for the most part, within the normal range. The average creatinine is higher than the normal average value while the average total cholesterol is below the limit values.
文摘Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.
文摘Context: Two years after the transition to Dolutegravir (DTG), at the national level, data on compliance with the execution of this transition and the rational use of the new molecule are not available. Objective: The objective of this study was to determine compliance with first-line ART prescriptions among People Living with HIV starting AntiRetroViral treatment in Kinshasa during the Dolutegravir era. Methods: This study is a descriptive cross-sectional study to determine compliance with first-line ART prescriptions among people living with HIV during the Dolutegravir era in Kinshasa. Sixteen Outpatients Treatment Centers (OTCs) were included in the study for their expertise in the care of PLHIV, their technical collection platform and their accessibility. The parameters of interest were: age, sex, outpatient treatment centers, and medical prescription. Results: One hundred and nineteen (119) patients were included in this work in accordance with the inclusion criteria;67 (56.3%) are female, giving a sex ratio of 1.29 in favor of women. The average age of the patients included is 39.87 ± 12.36 years with extremities of 18 to 69 years. The most represented age group is that of 36 to 45 years with 37 patients (31.9%). One hundred and nineteen (119) patients were received from 16 centers in Kinshasa, according to 6 OTC for the district of Funa, 4 OTC for Tshangu and 3 OTC respectively for Lukunga and Mont-Amba. All the centers respect the new recommendations of the National Program;all patients (100%) are on the Tenofovir (TDF) + Lamivudine (3TC) + Dolutegravir (DTG) combination. Conclusion: Compliance with the prescription of DTG as a first-line ARV in the DRC is effective in the city province of Kinshasa.
文摘Background: Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world, and the occurrence of this infection during pregnancy is responsible for adverse obstetrical outcomes like premature labor, premature rupture of membranes (PROM) and low birth weight (birth weight < 2500 g). The association with a number of factors (maternal age, low level of education, low socio-economic status and multiple sexual partners, etc.) that can be found in our environment suggest its probably high prevalence amongst vaginal infections that are responsible for adverse obstetrical outcomes, but up-to-date estimates are lacking. Objective: To assess the obstetrical risk associated with Trichomonas vaginalis (T. vaginalis) infection in our environment. Methods: We designed a protocol for a prospective cohort study which will take place in four medical facilities in the city of Kinshasa, where all pregnant women with a pregnancy of at least 20 weeks and who will give written consent will be included. Vaginal swab specimens will be collected for T. vaginalis research by direct microscopy wet mount. Follow-up will consist of recording the process of the pregnancy and obstetrical outcomes. Conclusion: Results from this study will allow to enhance management and also bring updated estimates on T. vaginalis prevalence and its obstetrical outcomes for infected pregnant woman in our environment.
基金Supported by the VLIR UOS Project(Grant N.VLIR:42/FA02000/13/5806),University of Antwerp and University of Kinshasa
文摘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.S).And 627women(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.IgC 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 primoinfection,indicating a need for measures to prevent and control toxoplasmosis during pregnancy.
