The Lipodystrophy Syndrome in HIV-Infected Children under Antiretroviral Therapy: A First Report from the Central Africa.

BACKGROUND: Despite the high prevalence of the HIV/AIDS, few studies focused on the prevalence of lipodystrophy in pediatric HIV patients on antiretroviral therapy (ARV) in sub-Saharan African countries. The aim of this study was to assess the prevalence and to identify the risk factors of metabolic disorders related to ARV therapy in this population. METHODS: A cross-sectional study was completed in Kinshasa, the Democratic Republic of Congo. HIV-infected children aged between six and 18 years on ARV were consecutively recruited. For each case, two control children (one non-HIV infected child and one HIV-infected antiretroviral therapy-naïve child) were also recruited. RESULTS: 80 HIV-infected on ARV therapy children (group 1), 80 noninfected children (group 2) and 65 HIV-infected antiretroviral therapy-naïve children (group 3) were recruited. The frequency of lipoatrophy was not statistically different between group 1 (16.3%) and group 3 (21.5%). A significantly higher proportion of lipohypertrophy, hypercholesterolemia, and lactic acidosis was noted in children of group 1, compared to the controls (p<0.05). Mixed form was rarely observed in this series. The frequency of hypertriglyceridemia was not different between the 3 groups (p>0.05). CONCLUSION: Lipohypertrophy, hypercholesterolemia, and lactic acidosis emerge as a frequent metabolic disorders due to ARV therapy.

Characteristics, behaviors and association between Human African Trypanosomiasis and HIV seropositivity among volunteer blood donors in a semi-rural area: A survey from Kikwit, the Democratic Republic of Congo.

Blood safety is a major element in the strategy to control the HIV epidemic. The aim of this study was to determine the prevalence and the associated factors of a positive HIV test among blood donors and its association between Human African Trypanosomiasis in Kikwit, the Democratic Republic of Congo. A cross-sectional study was conducted between November 2012 and May 2013. An anonymous questionnaire was designed to extract relevant data. The average mean age of participants was 30 years. The majority were man (67.8%). The overall prevalence of HIV, syphilis, hepatitis B, hepatitis C and human African trypanosomiasis was respectively 3.2%, 1.9%, 1.6%, 1.3% and 1.3%. Alcohol intake, casual unprotected sex, not using condoms during casual sex, sex after alcohol intake and seroprevalence of human African trypanosomiasis were significantly associated with a positive HIV test result ( p<0.05). In this study, sexual risk behaviors were the major risk factors associated with positive HIV tests in blood donors living in Kikwit. It is important to raise awareness about HIV and voluntary blood donation in response to some observations noted in this study such as the low educational level of the blood donors, the low level of knowledge of HIV prevention methods.

Assessment of attitudes towards adverse events following immunization with oral poliovirus vaccine: a pilot study among high school students of Kinshasa, the Democratic Republic of Congo.

OBJECTIVE: The aim of this study is to evaluate the reaction of students to adverse events following immunization in order to offer a baseline for developing a communication and risk management plan. METHOD: This is a cross-sectional study conducted in Kinshasa. A survey was conducted between the third and the fourth rounds of Supplementary Immunization Activity. Nine hundred and fifty questionnaires were used and addressed students who attended this university from 1 to 10 June 2011. RESULTS: Completed questionnaires were received from 848 students, with 485 females (57·2%), 343 males (40·4%), and 20 unknown (2·4%); 46·9% of students were from the faculty of medicine and 24·7% was from the third graduate degree. From those who completed the questionnaire, 136 (16·4%) reported experiencing an adverse events following immunization. Concerning the attitude of students towards adverse events following immunization, 79 students (58·5%) did nothing; 54 (40·0%) opted for self-medication; 2 (1·5%) went to the hospital. CONCLUSION: The main finding of our study is the low rate of people referring to health-care providers for vaccine-related problems, more specially for adverse events following immunization. A risk management plan should be focused in strategies to increase communication between population and health-care providers.

Renal function in children suffering from sickle cell disease: challenge of early detection in highly resource-scarce settings.

BACKGROUND: The prevalence of Sickle cell disease is extremely high in Democratic Republic of Congo. Despite this high prevalence of the disease, data on renal abnormalities in children are rare. METHOD: The study proposed to assess blood pressure, glomerular function, urea and uric acid levels in 65 steady state Congolese children with homozygous sickle cell disease and 67 normal controls. RESULTS: In Hb-SS group, blood pressure level tended to be lower than Hb-AA groups but there was no statistically significant difference (p>0.05) between the two groups. The absolute values for GFR corrected for BSA were significantly higher in Hb-SS group compared to Hb-AA group (130.5±34.1 ml/min/1.73 m2 vs 113.7±24.5 ml/min/1.73 m2; p = 0.004). Children with Hb-SS were more likely to hyperfiltrate (30.8% of subjects) than children with Hb-AA (6.1% of subjects). Proteinuria was found in 4 (6.2%) children with Hb-SS. Uric acid level was significantly increased in children with Hb-SS compared to corresponding values in control group (4.4±1.3 mg/dl vs 3.5±1.1 mg/dl; p<0.001). Urea level was significantly decreased compared to corresponding values in Hb-AA group (15.3±8.3 mg/dl vs 22.9±10.1 mg/dl; p<0.001). CONCLUSION: Hyperfiltration, low creatinine, lower urea and high uric acid are more common in children with sickle cell disease than in normal controls.