Testing the feasibility of a translated and culturally adapted person-centred training programme in maternal and newborn healthcare in Democratic Republic of Congo: A process evaluation.

OBJECTIVE: Ensuring quality of maternal and newborn healthcare is challenging in the Democratic Republic of Congo (DRC) as the maternal and newborn mortality and morbidity rate is high. Essential for quality care is a person-centred approach. One model of person-centred care (PCC) has been developed at Gothenburg University. To support its implementation a training programme, "Mutual Meetings", has been developed. This study aims to test the feasibility of a translated and culturally adapted version of this PCC training programme for healthcare providers in the maternal and newborn healthcare context of DRC. METHODS: The PCC programme was translated into French and tested in a workshop with 31 maternal and newborn healthcare providers in eastern DRC. The feasibility of the programme was evaluated through focus group interviews and individual interviews. The interview transcripts were analysed deductively using key components in a process evaluation framework including fidelity, dose, reach, adaptation, acceptability, and application. RESULTS: The French PCC programme exceeded the participants' expectations and was found being applicable in both teaching and clinical setting with some suggested contextual modifications. Its pedagogic structure including a participatory reflective approach, was perceived innovative and inspirational, mediated a sense of comfort, and enabled the participants to use a person-centred approach towards each other. CONCLUSION: The results show that the French on-site version of the PCC training programme was valid in terms of feasibility and how it was received by the participants. The study demonstrates the importance of contextual adaptation of complex interventions in new settings.

Bone tumors in children: Round cell sarcoma of the thigh: A case report.

INTRODUCTION AND IMPORTANCE: Bone tumor in children is a very large pathology and represents about 5% of pediatric cancers located mainly in the limbs. This is a case of a rare form of bone tumor of the round cell sarcoma type of the right femur in an 18-month-old female infant whose diagnosis and therapeutic decision are specific. CASE PRESENTATION: We present an 18-month-old girl, admitted to the panzi general reference hospital and presenting a painful swelling of the right thigh evolving for more than a month and which gradually increased in size in a febrile context with ipso-lateral inguinal adenopathy; Bone biopsy revealed round cell sarcoma and immunohistochemistry was not available. While waiting for chemotherapy, the proposed surgery was a hip disarticulation in an 18-month-old girl. CLINICAL DISCUSSION: Early discovery of the tumor at infant age is rare, it can occur in any part of the limb. The lower end of the femur and the upper end of the tibia or fibula account for 60% of cases. Its diagnosis is not easy, the management and improvement of the prognosis are linked to the use of chemotherapy and local treatment and conservative surgical resection, avoiding amputation or disarticulation. It is not easy to accept, neither for the child's parents nor for the healthcare team. CONCLUSION: Thigh sarcoma in an infant is rare and atypically discovered when faced with complications, infection or remote signs with difficulty in diagnosis and management; multidisciplinarity is very necessary, also involving psychologists despite the poor prognosis.

Gastric cancer for young adults: Case series of three cases.

INTRODUCTION AND IMPORTANCE: Gastric cancer is the fifth most common malignant tumor in the world. It is considered to be the second most common cause of cancer-related death. It is still described as the preserve of people aged over 50. However, it is rarely described in young people. In this study, we report three cases of gastric cancer for subjects under 35 years of age. METHODS: The study was a retrospective single-center non-consecutive case series. RESULTS: We report three cases of gastric cancer for young people under 35 years old. The consultation reason was chronic pain with a mean evolution of 2.1 years associated with post prandial vomiting. Clinical, biological and prognostic aspects were evaluated. Biopsies in all these patients were consistent with a moderately differentiated adenocarcinoma. The mean age was 28.3 years, with males predominating. CONCLUSION: Gastric cancer is generally considered to be a pathology of the elderly, but it can also occur in younger patients. Late consultation for treatment leads to late-stage diagnosis and a poorer prognosis.

Epidemiology, Diagnosis and Therapeutic Approaches of Cryptorchidism at the Panzi General Hospital, DR Congo: A 5-year Retrospective Study.

BACKGROUND: Cryptorchidism is a common congenital malformation characterized by unilateral or bilateral undescended testis in the scrotum. It is a common disease in pediatric urology although the prevalence is yet to be determined in the East DR Congo. The aim of this study was to describe the prevalence, clinical and therapeutic features of cryptorchidism at the Panzi General Hospital. METHODS: Medical records of patients who underwent pediatric surgery between January 2011 and December 2016 were reviewed. The prevalence of cryptorchidism, associated malformations, sociodemographic features of patients and therapeutic protocols were examined. Collected data were analyzed using SPSS software. RESULTS: A total of 5066 children were received during the study period in the service, of which 76 suffered from cryptorchidism giving a prevalence of 1.50% and an annual incidence of 12.70. Unilateral cases were found in 53(69.74%) patients among which 66.04% and 33.96% had unilateral right and left cryptorchidism respectively. Cryptorchidism was associated with other malformations in 71.1% of patients. The age of patients ranged from 0 to 15 years and 78.9% were older than two years. Surgery was the only therapeutic approach and fixation of cryptorchid testis in dartos through inguinal incision was the preferred therapeutic used method. CONCLUSION: This study indicates that cryptorchidism is a relatively common and neglected disease in the Est-DR Congo, due to late consultation. Therefore, the local population and pediatricians should be sensitized on scrotal palpation techniques in order to shorten the consultation delay and prevent testis damages.