Protecting the health of the most vulnerable in the overlooked Democratic Republic of Congo crisis.

Background and Aim: The Democratic Republic of Congo (DRC) is facing a humanitarian crisis due to prolonged conflicts, human rights abuses, and gender-based violence. This perspective article aims to discuss the challenges faced by vulnerable populations in the DRC, including the impact of interventions and broader humanitarian strategies. Methods: A search on Google Scholar was carried out to identify relevant journal articles. Additionally, relevant reports and data on the DR Congo crisis were sourced from the websites of international and humanitarian organizations including the United Nations High Commissioner for Refugees, World Health Organization, United Nations Office for the Coordination of Humanitarian Affairs, and the Norwegian Refugee Council. Results: The crisis has led to 6.1 million displaced individuals and 1 million seeking asylum in neighboring countries. Insecurity and displacement further exacerbate the crisis, exacerbating health issues and malnutrition, particularly among women and children. The deterioration of water, sanitation, and hygiene infrastructure in the region facilitates the spread of infectious diseases. The UN has appealed for $8.3 billion in humanitarian assistance in West and Central Africa, including DRC. However, more attention and efforts are needed to curb the menace of the conflict. Conclusions: Addressing root causes like political volatility, economic disparity, and social unrest is crucial for sustained health protection. Tailoring humanitarian assistance to the context of conflict is essential, prioritizing mental health support and psychosocial services. Improving access to healthcare is crucial. Addressing food insecurity is essential, involving targeted food assistance programs, improving agricultural practices, and establishing income-generating activities. Sustaining international assistance and investments are needed to address the health needs of the most vulnerable populations.

Achieving climate sustainability in the Republic of Congo: The role of economic growth, biomass energy consumption, rule of law and government effectiveness- a NARDL Approach.

This study explores the relationship between economic growth (GDP), biomass energy consumption (BEC), Rule of Law, and Government Effectiveness on climate change (CO2 emissions) in the Republic of Congo from 1990 to 2020. We employed a nonlinear autoregressive distributed Lag (NARDL) model to analyse data from World Bank databases. Higher GDP leads to lower CO2 emissions in the long run. Increased BEC also reduces emissions, but a decrease can have a small negative impact. Interestingly, a stronger Rule of Law and Government Effectiveness is associated with higher CO2 emissions in the short run, potentially due to relaxed environmental regulations. However, a stronger Rule of Law and Government Effectiveness leads to lower emissions in the long run, suggesting a potential shift towards sustainable practices. These findings provide valuable insights for policymakers aiming to achieve economic growth and climate stability in the Republic of Congo.

Maternal mortality in Eastern Democratic Republic of Congo: a 10-year multi-zonal institutional death review.

BACKGROUND: Maternal mortality (MM) remains a real scourge that hits hardest in the poorest regions of the world, particularly those affected by conflict. However, despite this worrying reality, few studies have been conducted about MM ratio in the Democratic Republic of Congo (DRC). The study aimed to describe the trends as well as the epidemiological profile and causes of reported institutional maternal deaths between 2013 and 2022 in Eastern DRC. METHODS: A retrospective descriptive study was conducted between March 2023 and August 2023 in eight Health Zones (HZ), five in South Kivu Province (Mwana, Minova, Miti-Murhesa, Kamituga and Idjwi) and three in North Kivu Province (Kirotshe, Karisimbi and Kayna) in the eastern region of the DRC. Our study covers 242 health facilities: 168 health centers (HC), 16 referral health centers (RHCs),50 referral hospitals (RH) and 8 general referral hospitals (GRHs). Data from registers and medical records of maternal deaths recorded in these zones from 2013-2022 were extracted along with information on the number of deliveries and live births. Sociodemographic, clinical parameters, blood and ultrasound tests and suspected causes of death between provinces were assessed. RESULTS: In total, we obtained 177 files on deceased women. Of these, 143 (80.8%) were retained for the present study, including 75 in the 3 HZs of North Kivu and 68 in the 5 HZs of South Kivu. From 2013 to 2022, study sites experienced two significant drops in maternal mortality ratio (MMR) (in 2015 and 2018), and a spike in 2016-2017. Nonetheless, the combined MMR (across study sites) started and ended the 10-year study period at approximately the same level (53 and 57 deaths per 100,000 live births in 2013 and 2022 respectively). Overall, 62,6% of the deaths were reported from secondary hospital. Most deaths were of married women in their thirties (93.5%). Almost half (47.8%) had not completed four antenatal consultations. The main direct causes of death were, in decreasing order of frequency: post-partum haemorrhage (55.2%), uterine rupture (14.0), hypertensive disorders (8.4%), abortion (7.7%) puerperal infections (2.8%) and placental abruption (0.7%). When comparing among provinces, reported abortion-related maternal mortality (14.1% vs 0%) was more frequent in North Kivu than in South Kivu. CONCLUSION: This study imperatively highlights the need for targeted interventions to reduce maternal mortality. By emphasizing the crucial importance of antenatal consultations, intrapartum/immediate post-partum care and quality of care, significant progress can be made in guaranteeing maternal health and reducing many avoidable deaths.

Visitation patterns of endangered grey parrots (Psittacus erithacus) in a forest clearing in the Democratic Republic of the Congo.

The grey parrot (Psittacus erithacus), once abundant, has become increasingly threatened due to the combined effects of capture for the global pet trade and habitat loss. Although grey parrots are well studied in captivity, effective conservation efforts require a better understanding of their ecological requirements in the wild. The aim of this paper is to quantify grey parrot behaviours across the annual cycle. To do that, we studied groups of grey parrots gathering in a natural forest clearing in the Nkuba Conservation Area, eastern Democratic Republic of the Congo. Using parrot counts and focal sampling, combined with descriptive statistics, we found that an average of 40 grey parrots visited the clearing each day, following a regular pattern in which they first perched in the trees surrounding the clearing, vocalizing loudly, until the group landed in the clearing to feed, drink and interact with each other. Generalized linear models (GLMs) and generalized additive models (GAMs) showed that the time at which parrots arrived, landed at, and left clearings was influenced by the weather, seasonality and the month of the year. We also found that parrots shortened their visits when disturbed by predators or the presence of humans. Although the underlying mechanisms for grey parrot visits to forest clearings remains unclear, the consistency of this behaviour observed elsewhere in Africa and the feeding observed in the clearing in this study suggest that these area support important foraging habitat for the wild grey parrots. Therefore, ensuring the availability of such clearings is paramount to the long-term survival of the species. We suggest that future efforts to protect grey parrots in their native habitats focus on identifying clearings visited by parrots, monitoring these clearings and allowing parrots to visit them without disturbance or risk of capture.

A baseline monitoring of radiological sediment quality and associated risk assessment in coastal ecosystems of the Republic of Congo.

This study presents the first data on levels of natural radioactive elements in sediments from coastal ecosystems of the Republic of Congo. Sediment samples from five coastal sites were collected and analyzed by high-resolution gamma spectrometry for determination of activities of long-lived gamma-emitting radionuclides (234Th, 238U, 226Ra, 210Pb, 228Th, 228Ra, and 40 K). The specific activities were of the same order of magnitude as those measured in sediments of most countries neighboring the Republic of Congo. However, variations in activities were observed from one site to another and also from one sampling point to another within the same site without exceeding the global average reference values. It can be assumed, therefore, that no significant anthropogenic impact is perceptible in the study area. The most commonly used radiological hazard parameters, based mainly on 238U, 232Th, and 40 K activities, were assessed and the ERICA tool was applied to quantify the radiation exposure burden to human and biota resulting from radionuclides in sediments. Besides being useful for future monitoring efforts, the data produced in this work could be important for the worldwide database on radioactivity in the oceans and seas (MARIS) since no data are available in the Congolese marine environment.

Waste newspaper as cellulose resource of activated carbon by sodium salts for methylene blue and congo red removal.

The work was aimed at evaluating the adsorptive properties of waste newspaper (WN) activated carbons chemically produced using sodium salts for methylene blue (MB) and congo red (CR) removal. The activated carbons, designated as AC1, AC2, AC3 and AC4 were prepared through impregnation with NaH2PO4, Na2CO3, NaCl and NaOH, respectively and activation at 500 °C for 1 h. The activated carbons were characterized for surface chemistry, thermal stability, specific area, morphology and composition. The AC1 with a surface area of 917 m2/g exhibits a greater MB capacity of 651 mg/g. Meanwhile, a greater CR capacity was recorded by AC2 at 299 mg/g. The pseudo-second order model fitted well with the kinetic data, while the equilibrium data could be described by Langmuir model. The thermodynamic parameters, i.e.., positive ΔH°, negative ΔG° and positive ΔS° suggest that the adsorption of dyes is endothermic, spontaneous and feasible at high solution temperature. To conclude, WN is a potential cellulose source for producing activated carbon, while NaH2PO4 activation could be employed to convert WN into activated carbon for effective dye wastewater treatment.

Antibiotic consumption in hospitals in humanitarian settings in Afghanistan, Bangladesh, Democratic Republic of Congo, Ethiopia and South Sudan.

BACKGROUND: Antimicrobial resistance is of great global public health concern. In order to address the paucity of antibiotic consumption data and antimicrobial resistance surveillance systems in hospitals in humanitarian settings, we estimated antibiotic consumption in six hospitals with the aim of developing recommendations for improvements in antimicrobial stewardship programs. METHODS: Six hospitals supported by Médecins sans Frontières were included in the study: Boost-Afghanistan, Kutupalong-Bangladesh, Baraka and Mweso-Democratic Republic of Congo, Kule-Ethiopia, and Bentiu-South Sudan. Data for 36,984 inpatients and antibiotic consumption data were collected from 2018 to 2020. Antibiotics were categorized per World Health Organization Access Watch Reserve classification. Total antibiotic consumption was measured by Defined Daily Doses (DDDs)/1000 bed-days. RESULTS: Average antibiotic consumption in all hospitals was 2745 DDDs/1000 bed-days. Boost hospital had the highest antibiotic consumption (4157 DDDs/1000 bed-days) and Bentiu the lowest (1598 DDDs/1000 bed-days). In all hospitals, Access antibiotics were mostly used (69.7%), followed by Watch antibiotics (30.1%). The most consumed antibiotics were amoxicillin (23.5%), amoxicillin and clavulanic acid (14%), and metronidazole (13.2%). Across all projects, mean annual antibiotic consumption reduced by 22.3% during the study period, mainly driven by the reduction in Boost hospital in Afghanistan. CONCLUSIONS: This was the first study to assess antibiotic consumption by DDD metric in hospitals in humanitarian settings. Antibiotic consumption in project hospitals was higher than those reported from non-humanitarian settings. Routine systematic antibiotic consumption monitoring systems should be implemented in hospitals, accompanied by prescribing audits and point-prevalence surveys, to inform about the volume and appropriateness of antibiotic use and to support antimicrobial stewardship efforts in humanitarian settings.

Evaluation of the relationship between YKL-40 level and clinical severity in patients with Crimean-Congo hemorrhagic fever.

Crimean-Congo hemorrhagic fever (CCHF) is a widespread tick-borne viral disease. YKL-40 (also known as chitinase-3-like-1 protein) is an acute phase protein released by various immune cells. The purpose of this study was to investigate the relationship between YKL-40 level and the clinical course and prognosis of CCHF. The study included 78 patients who were admitted to our hospital between April 15 and 30 August 2022 and had a positive polymerase chain reaction test result for CCHF. The patients were divided into two groups, severe and non-severe. In addition, a control group consisting of 22 healthy people was established. Mean serum YKL-40 levels were significantly higher in patients than controls (106.8 ng/mL ± 91.2 and 47.1 ng/mL ± 35.3, respectively; p < 0.001). However, mean YKL-40 levels were also significantly higher in patients with severe CCHF compared to non-severe cases (173.3 ± 112.3 and 67.5 ± 41.7, respectively; p < 0.001). A comparison of the 10 exitus patients and the 68 survivors revealed significantly higher YKL-40 levels in the exitus group (mean: 214.0 ± 139.0 and 92.8 ± 73.6, respectively; p = 0.001). A receiver operating characteristic analysis for YKL-40 levels to distinguish between severe and non-severe patients found an area under the curve of 0.925. YKL-40 levels were measured with a sensitivity of 97% and a specificity of 84% with a cutoff value of 90.7 ng/mL. YKL-40 levels measured at the time of hospital presentation in patients with CCHF can be used as a biomarker for clinical course and prognosis.

[History of the study of amyloidosis: from the Rokitansky's theory to the present day].

In the history of amyloidosis studying the concept of liquids dyscrasia has been predominated and finally it is resulted in accepting a serum protein-precursor as a leading amyloidogenic factor in the disease pathogenesis. Consequently basic diagnostic and treatment strategy was aimed to find and eliminate this protein from the blood and this approach evidenced high effectiveness in most frequent AA and AL-amyloidosis characterized with anomaly high levels of precursors in the blood. At the same time there are less frequent and slower progressing inheritant forms of systemic amyloidosis including transthyretin induced, which are less depending on amyloidogenecity of amyloid precursor and because of that, in example, the effectiveness of transthyretin stabilizers or blockers of its synthesis is limited comparing with the precursor elimination in AA or AL. Developed in the middle of XX century a theory of local synthesis by macrophages is more preferable to describe the pathogenesis of these forms. And modern proteome analysis using give rise to confirm the key meaning of macrophage in the amyloidogenesis and proves necessity to know deeply mechanisms of macrophagial autophagia - basic tool of maintaining intracellular protein homeostasis. That is why it is difficult to hope on high effectiveness of chemical amyloid solvents in vivo, which being under macrophages regulation never could realize its chemical activities.

Creating sustainable capacity for river science in the Congo basin through the CRuHM project.

In this article, we examine the scientific and sustainable research capacity outcomes of the 'Congo River: user Hydraulics and Morphology' or CRuHM project, a six-year effort supported by the Royal Society's Africa Capacity Building Initiative. This project brought together a consortium of African and UK universities to undertake the first large-scale scientific expeditions to the Congo basin of the modern era in order to better understand the hydraulics and geomorphology of this understudied but globally important river. The river is essential for navigation, irrigation, drinking water and hydroelectric power generation for the 10 basin countries and is critically important for biodiversity and global nutrient, carbon and climatological cycles. This article summarizes the new scientific understanding contributed by the project and the steps taken to ensure a meaningful legacy that would continue long beyond the finite lifetime of available funding. Actions taken to achieve this include establishing a new hydrology research centre at the University of Kinshasa as well as steps to build a wider international community of Congo basin researchers. In this way, we hope to build momentum for future funding initiatives and collaboration.

Bioinspired copper oxide nanocomposites: harnessing plant extracts for enhanced photocatalytic performance.

This study focuses on developing copper oxide-based nanocomposites using plant extracts for photocatalytic applications. Curcuma amada leaf and Alysicarpus vaginalis leaf extracts were utilized alongside recycled copper precursors to synthesize photocatalysts via a green synthesis approach. Structural characterization through X-ray diffraction confirmed the formation of monoclinic CuO with reduced crystallite sizes due to plant extract incorporation. Fourier-transform infrared spectroscopy identified additional functional groups from the plant extracts, enhancing the material's properties. UV-Vis spectroscopy demonstrated increased light absorption and narrowed bandgaps in the nanocomposites, crucial for efficient photocatalysis under visible light. Morphological studies using FESEM revealed unique leaf-like structures in nanocomposites, indicative of the plant extract's influence on morphology. Photocatalytic degradation of methylene blue, rhodamine B, Congo red, and reactive blue 171 dyes showed enhanced performance of plant extract-modified CuO compared to without plant extract mediated CuO, attributed to improved charge carrier separation and extended lifetime. The effects of pH, catalyst dosage, and dye concentration on degradation efficiency were systematically investigated, highlighting optimal conditions for each dye type. Radical scavenger studies confirmed the roles of holes and hydroxyl radicals in the degradation process. Kinetic analysis revealed pseudo-second-order kinetics for dye degradation, underscoring the effectiveness of the nanocomposites. Overall, this research provides insights into sustainable photocatalytic materials using plant extracts and recycled copper, showcasing their potential for environmental remediation applications.

Cytokine Storm Syndrome Associated with Hemorrhagic Fever and Other Viruses.

A wide variety of infections can trigger cytokine storm syndromes including those caused by bacteria, viruses, fungi and parasites. The most frequent viral trigger is Epstein-.Barr virus which is covered in Chapter 16. CSS associated with COVID-19 is also discussed separately (Chapter 22). This chapter will focus on other viruses including the hemorrhagic fever viruses, influenza, parainfluenza, adenovirus, parvovirus, hepatitis viruses, measles, mumps, rubella, enterovirus, parechovirus, rotavirus, human metapneumovirus and human T-lymphotropic virus. The published literature consists of many single case reports and moderate-sized case series reporting CSS, in most circumstances meeting the 2004 diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). There is no published clinical trial evidence specifically for management of HLH associated with these viruses. In some situations, patients received supportive therapy and blood product transfusions only but in most cases, they were treated with one or more of intravenous corticosteroids, intravenous immunoglobulin and/or etoposide. These were successful in many patients although in significant numbers progression of infection to CSS was associated with mortality.

Epidemiology and clinical characteristics of acute malnutrition among under-5 children attending a rural hospital in the Democratic Republic of Congo: a cross-sectional study.

Background: Malnutrition, a public health problem in a low-income country such as the Democratic Republic of Congo (DR Congo), is a major killer among children under 5 who are most at risk of acute malnutrition. This study aims to describe the epidemiological and clinical characteristics of acute malnutrition in children under 5 years old. Methods: The authors conducted a retrospective and descriptive cross-sectional study on children under 5 with acute malnutrition from April 2022 to April 2023. A total of 287 malnourished children were consulted, hospitalized in a rural hospital, and registered for participation in this study. Results: Two hundred eighty-seven (25%) children were victims of acute malnutrition. The age group between 13 and 24 months is the most affected by acute malnutrition with 30%. The male-to-female(M/F) sex ratio was 1.17. Kwashiorkor is the most common form of acute malnutrition with 171 (59.6%) cases. Abdominal bloating, weight loss as well as diarrhea and vomiting were the more frequent clinical signs. Shock is the most complication of acute malnutrition. Therapeutic milk (Food 75 and Food 100) was the most effective in management. Twenty-nine (10.1%) other children died from acute malnutrition and 258 (89.9%) children progressed to full recovery. Conclusion: Acute malnutrition in children remains a public health problem worldwide and particularly in low-income countries such as DR Congo. It is associated with multiple physiological vulnerabilities and has many short- and long-term complications in children who have suffered from it.

National burden of Ebola virus disease in Democratic Republic of the Congo: the urgency to act.

Ebola virus disease (EVD) has long been a major public health concern for Democratic Republic of the Congo (DR Congo). First identified in DR Congo in 1976, the country has witnessed more than 25 outbreaks of this deadly disease, which has a case fatality rate of nearly 90% and manifesting with symptoms such as diarrhoea, vomiting, stomachache and haemorrhagic fever. African fruit bats have been speculated to be the reservoir of this virus. DR Congo is currently facing another EVD outbreak simultaneously with other communicable diseases, rendering it vulnerable to a shortage of medical and paramedical staff along with distrust among remote communities towards local authorities due to armed conflict and political instability. Moreover, lack of ring vaccinations and inefficient surveillance of suspected individuals are some other significant hurdles in disease control. Despite the availability of rVSV-ZEBOV/Erbevo vaccine and many antibody-based vaccines, challenges including politicization, low access to remote communities, and illiteracy have limited their effectiveness. Recently, the Congolese govt. has put in efforts such as building local capacities at the health zone level, outbreak control intervention, community engagement and social mobilization to counter the rising EVD cases. Four successive Strategic Response Plans have been implemented to increase resource mobilization by DR Congo and her partners. The Spread of zoonotics such as EVD can be confronted by implementing the One Health approach, which involves medical staff, veterinarians and public health officials.

Dermoscopy of Amyloidosis Cutis Dyschromica.

Amyloidosis cutis dyschromica is a very rare form of primary cutaneous amyloidosis characterized by prepubertal onset of hyper and hypopigmented spots and amyloid deposits in the papillary dermis. We report two cases of this condition highlighting its dermoscopic findings.

Epidemiologic Features and Risk Factors for Crimean-Congo Hemorrhagic Fever in Dhi Qar Province, Iraq.

BACKGROUND: Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Iraq, where recurrent epidemics have been constantly observed during the last five years. The present study aimed to determine the factors associated with Crimean-Congo hemorrhagic fever (CCHF) cases in Dhi Qar province during the year 2022. METHODS: A test-negative case-control design was used to analyze 621 CCHF patients, of which 162 were confirmed and 459 were suspected cases. To identify the confirmed and suspected cases, reverse transcriptase polymerase chain reaction (RT-PCR) was used. Suspected patients whose PCR test results were negative were selected as the control group. Data on potential risk factors for CCHF were collected as existing data for previous years for the same geographical locations in Dhi Qar province. Logistic regression analyses were used to determine the correlation between probable risk factors and confirmed CCHF cases. RESULTS: The incidence rate of CCHF was 6.8% per 100,000 people. The total number of deaths was 48 for patients with a case fatality rate of 7.7%. The patients' ages ranged from one year to 65 years, with an overall mean ± SD of 36.08 ± 18.29 years. A total of 98.2% of the patients were between 15 and 65 years of age; 58% of the reported patients were male, and the male-to-female ratio was 1.4:1. Additionally, contact with raw meat, animal contact, and tick bite had the highest percentages for CCHF positivity cases. CONCLUSIONS: Male gender, high-risk jobs like housewives, health staff, shepherds, butchers, animal dealers, slaughterhouse workers, veterinary staff, and farmers, tick bites, and contact with raw meat were statistically significant predictors for increasing CCHF incidence in Dhi Qar province during the year 2022.

Interobserver agreement and diagnostic challenges of Congo red staining for amyloid detection on fat pad aspiration biopsies.

INTRODUCTION: Congo red staining of fat pad fine needle aspiration specimens is a method utilized for evaluation of amyloid deposition. However, these specimens can pose diagnostic challenges for cytopathologists. As part of ongoing internal quality improvement measures, the objective of this study was to evaluate the intradepartmental interobserver agreement of these specimens and to identify factors that affect the variability of the interpretations. MATERIALS AND METHODS: There were 7 participants, which included 3 trainees, 3 cytopathologists, and 1 cytotechnologist. Each participant reviewed 50 Congo red stained fat pad fine needle aspiration slides. The interpretations were categorized into 3 groups: negative, indeterminate/suspicious, and positive. The participants also noted any interpretation challenges they encountered for each case. RESULTS: There was only slight interobserver agreement among all participants (κ = 0.133). Stratified by participant group, the interobserver agreement among the trainees was slight bordering on poor (κ = 0.028) and among cytopathologists was fair (κ = 0.249). The highest agreement between 2 observers was between 2 cytopathologists and the level of agreement was moderate bordering on fair (κ = 0.426). There were only 3 cases (6.0%) with full agreement among observers, while in 25 cases (50.0%), there were 2 category differences in interpretations. The primary diagnostic challenge reported by participants was when weak or focal birefringence was encountered as well as cases complicated by poor stain quality and overstaining. CONCLUSIONS: We found only slight interobserver agreement among all study participants. A major area of challenge was cases with weak birefringence resulting in high variance of interpretation among participants.

High efficiency of treated-phengite clay by sodium hydroxide for the Congo red dye adsorption: Optimization, cost estimation, and mechanism study.

Wastewater textile dye treatment is a challenge that requires the development of eco-friendly technology to avoid the alarming problems associated with water scarcity and health-environment. This study investigated the potential of phengite clay as naturally low-cost abundant clay from Tamgroute, Morocco (TMG) that was activated with a 0.1 M NaOH base (TMGB) after calcination at 850 °C for 3 h (TMGC) before its application in the Congo red (CR) anionic dye from the aqueous solution. The effect of various key operational parameters: adsorbent dose, contact time, dye concentration, pH, temperature, and the effect of salts, was studied by a series of adsorption experiments in a batch system, which affected the adsorption performance of TMG, TMGC, and TMGB for CR dye removal. In addition, the properties of adsorption kinetics, isotherms, and thermodynamics were also studied. Experimental results showed that optimal adsorption occurred at an acidic pH. At a CR concentration of 100 mg L-1, equilibrium elimination rates were 68%, 38%, and 92% for TMG, TMGC, and TMGB, respectively. The adsorption process is rapid, follows pseudo-second-order kinetics, and is best described by a Temkin and Langmuir isotherm. The thermodynamic parameters indicated that the adsorption of CR onto TMGB is endothermic and spontaneous. The experimental values of CR adsorption on TMGB are consistent with the predictions of the response surface methodology. These led to a maximum removal rate of 99.97% under the following conditions: pH = 2, TMGB dose of 7 g L-1, and CR concentration of 50 mg L-1. The adsorbent TMGB's relatively low preparation cost of around $2.629 g-1 and its ability to regenerate in more than 6 thermal calcination cycles with a CR removal rate of around 56.98%, stimulate its use for textile effluent treatment on a pilot industrial scale.

Perinatal mortality and its predictors in Beni City, Democratic Republic of Congo: a cross-sectional study.

BACKGROUND: Globally, perinatal mortality rates have decreased considerably in the last 30 years. However, in sub-Saharan African countries perinatal mortality remains a public health burden. Therefore, this study aimed to determine the Perinatal Mortality Rate and the factors associated with perinatal mortality in Beni City, Northeastern Democratic Republic of Congo. METHODS: A hospital-based retrospective cross-sectional study was conducted among 1394 deliveries that were documented in Beni General Referral Hospital from 2 January to May 31, 2022. The study was done in the conflict-ridden Beni city of the North Kivu Province. Analysis was done using Open Epi and SPSS version 22. Binary and Multivariate logistic regression analyses were performed. Odds ratio with 95% confidence interval was used to measure strength of association. RESULTS: Findings indicate that 60.7% of 1394 participants were below the age of 21 years, and 95.1% (1325) Beni residents. The Perinatal Mortality Rate was 42.3 per 1000 live births. Majority (51) of the postpartum women who experienced perinatal mortality didn`t have a history of perinatal mortality as compared to their counterparts. Multivariable analysis revealed that birth weight (AoR = 0.082, 95% CI 0.014-0.449, p < 0.05) and Apgar score in the 10th minute (AoR = 0.082, 95% CI 0.000- 0.043, p < 0.05) were significantly associated with Perinatal mortality. CONCLUSION: The high perinatal mortality rate in Beni General Referral Hospital, approximately four in every 100 births remains a disturbing public health concern of which is attributable to low birth weight and Apgar score. This study may help policy-makers and healthcare providers to design preventive interventions.