Environmental and sociodemographic factors associated with household malaria burden in the Congo.

BACKGROUND: Malaria is one of the most severe public health issues that result in massive morbidity and mortality in most countries of the sub-Saharan Africa (SSA). This study aimed to determine the scope of household, accessibility to malaria care and factors associated with household malaria in the Democratic Republic of Congo (DRC). METHODS: This was a community-based cross-sectional study conducted in an urban and a rural sites in which 152 households participated, including 82 urban and 70 rural households (1029 members in total). The 'malaria indicator questionnaire' (MIQ) was anonymously answered by household heads (respondents), reporting on malaria status of household members in the last 12 months. RESULTS: There were 67.8% of households using insecticide-treated bed nets (ITN) only, 14.0% used indoor residual spraying (IRS) only, 7.3% used ordinary bed nets (without insecticide treatment), 1.4% used mosquito repelling cream, 2.2% combined ITN and IRS, whereas 7.3% of households did not employ any preventive measure; p < 0.01). In addition, 96.7% of households were affected by malaria (at least one malaria case), and malaria frequency per household was relatively high (mean: 4.5 ± 3.1 cases reported) in the last 12 months. The mean individual malaria care expenditure was relatively high (101.6 ± 10.6 USD) in the previous 12 months; however, the majority of households (74.5%) earned less than 50 USD monthly. In addition, of the responders who suffered from malaria, 24.1% did not have access to malaria care at a health setting. Furthermore, a multivariate analysis with adjustment for age, education level and occupation showed that household size (OR = 1.43 ± 0.13; 95% CI 1.18-1.73; p < 0.001), inappropriate water source (OR = 2.41 ± 0.18; 95% CI 1.17-2.96; p < 0.05) absence of periodic water, sanitation and hygiene (WASH) intervention in residential area (OR = 1.63 ± 1.15; 95% CI 1.10-2.54; p < 0.05), and rural residence (OR = 4.52 ± 2.47; 95% CI 1.54-13.21; p < 0.01) were associated with household malaria. CONCLUSION: This study showed that household size, income, WASH status and rural site were malaria-associated factors. Scaling up malaria prevention through improving WASH status in the residential environment may contribute to reducing the disease burden.

Respiratory health of dust-exposed Congolese coltan miners.

PURPOSE: In Democratic Republic of the Congo (DRC), informal coltan mining has been expanding amidst increased insecurity due to armed conflicts. We investigated the impact of occupational dust-exposure on the respiratory health of Congolese coltan miners. METHODS: In total, 441 Congolese workers participated in this study, including 199 informal coltan miners and 242 office workers (controls). Information on respiratory complaints was collected using two standardized questionnaires. Physical examination (vital signs, auscultation) and lung function test (Peak Flow meter) were performed. In addition, workplace airborne PM2.5 and volatile organic compounds (VOC) concentrations were measured. RESULTS: Higher airborne PM2.5 (range 180-210 µg/m3) and VOC (range 1.4-2.3 µg/m3) levels were detected at coltan mining work stations as compared with control sites (19-44 and 0.5-0.8 µg/m3, respectively). All respiratory complaints and disorders were more prevalent in informal coltan miners than in controls. Additionally, a markedly lower mean PEFR was observed in coltan miners than in controls (347.93 ± 6.88 vs. 493.23 ± 67.38 L/min, respectively). Moreover, positive associations between informal coltan mining and almost all respiratory complaints were observed, except wheezing at effort and night cough. On the other hand, an inverse association was observed between lung function (PEFR) and PM2.5 exposure, between PEFR and VOC exposure, and also between PEFR and current smoking. CONCLUSIONS: This study showed high prevalence of respiratory complaints in Congolese informal coltan miners, suggesting the necessity to implement efficient occupational safety measures and regulate this informal mining business.

Air Quality in the Working Environment and Respiratory Health of Female Congolese Stone Quarry Workers.

BACKGROUND AND AIM: Environmental and occupational exposure to high dust levels are known to be associated with lung function impairment. We assessed the ambient air quality in the working environment and the respiratory health of female stone quarry workers in Lubumbashi, Democratic Republic of Congo (DRC) in a context of severe economic, security, and health crises. METHODS: This was a case-control study conducted in three stone quarry sites. Participants were 256 dust-exposed female stone quarry workers matched to 256 unexposed female office workers and market tax collectors (N = 512). They each answered a structured respiratory health questionnaire and underwent physical examination and a lung function test with the use of a spirometer and peak flow meter. Quality of ambient air in the working environment was assessed by means of a BRAMC air quality monitor (BR-AIR-329). RESULTS: Results showed that exposed women did not use any personal protective equipment (PPE); in quarry sites, abnormally high levels of PM2.5 (205 ± 13.2 µg/m3 vs. 31.3 ± 10.3 µg/m3 in control sites; p < 0.001) and volatile organic compounds (VOC, 2.2 ± 0.2 µg/m3 vs. 0.5 ± 0.3 µg/m3, respectively; p < 0.01) were found. Furthermore, respiratory complaints were more common among exposed women (32.4% vs. 3.5% in controls; p < 0.01), who had abnormal chest auscultation and reduced lung capacity than controls (mean PEFR: 344.8 ± 2.26 and 405 ± 67.7 L/s, respectively; p < 0.001 Conclusion. Findings from this study show that in the midst of severe crises in the DRC, women stone quarry workers are exposed to abnormally high levels of respiratory hazards, which contribute to impaired lung function. There is a need to regulate quarry work and improve the working conditions in quarry sites in the DRC.

Occupational COVID-19 Prevention among Congolese Healthcare Workers: Knowledge, Practices, PPE Compliance, and Safety Imperatives.

The SARS-CoV-2 (COVID-19) pandemic has had a tremendous impact on the functionality of health systems and world affairs. We assessed knowledge, attitudes, and practices (KAPs) of healthcare workers (HCWs) in the Democratic Republic of the Congo (DRC). This was a cross-sectional study conducted in 23 referral hospitals located in three towns of the DRC (Lubumbashi, Kamina, Mbuji-Mayi). In total, 613 HCWs were surveyed using the World Health Organization's (WHO's) "Exposure Risk Assessment in the Context of COVID-19" questionnaire. Participants included medical doctors (27.2%) and other categories of HCWs (72.8%). The mean age was 40.3 ± 11.7 years. Over 80% (range: 83-96%) of respondents had sufficient knowledge on each of the three domains: COVID-19 symptoms, disease transmission, and patient care approach. However, attitudes and practices scores were relatively low. Only 27.7% of HCWs were willing to receive a COVID-19 vaccine when it is available, whereas 55% of HCWs complied with good practices; 49.4% wore masks consistently and, surprisingly, only 54.9% used personal protective equipment (PPE) consistently at work and during contact with patients. Knowledge level was positively associated with the use of social media as a primary source of COVID-19-related information and the category of residence, with HCWs from towns already affected by the COVID-19 epidemic being more likely to have positive attitudes (adjusted OR, 1.64; 95%CI, 1.32-2.20) and comply with good practices (aOR, 2.79; 95%CI, 1.93-4.06). This study showed that most Congolese HCWs had sufficient knowledge on COVID-19, whereas the majority did not comply with consistent PPE use. The government of the DRC should urgently take major steps in capacity building for HCWs in outbreak preparedness and supplying hospitals with PPE.

[Asteroid hyalopathy (benson's disease): about a case]. / Hyalopathie asteroide: à propos d'une observation.

We here report a case of a 58 year-old diabetic male patient with asteroid hyalopathy, an affection rarely described in the literature. This study can help focus the attention of scientists on the pathologies of the vitreous disorders in diabetic patients as well as on other systemic diseases asteroid hyalopathy may be associated with.