Reference intervals for cd, hg, Mn and Pb in the general children population (3-14 years) of Kinshasa, Democratic Republic of Congo (DRC) between June 2019 and June 2020.

The reference intervals (RIs), proposed by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) and the International Union of Pure and Applied Chemistry (IUPAC), were derived for Cd, Hg, Mn and Pb in the blood and urine of the children population living in Kinshasa (n = 200, aged 3-14 years with 97 girls). Levels of metals were measured using coupled plasma mass (ICP-MS). In blood, the proposed RIs [P5-P95 (GM)] were 0.022-1.112 µg/L (0.074), 35.69-144.50 µg/L (71.43), 0.060 to 1.161 µg/L (0.208) and 6.597-15.740 µg/L (9.882) for Cd, Pb, Hg and Mn, respectively. Urinary levels [(P5-P95 (GM)] were 0.082-1.530 µg/L (0.366) for Cd, 1.827-18.500 µg/L (5.458) for Pb, 0.323-1.953 µg/L (0.709) for Hg and 0.070 to 1.703 µg/L (0.186) for Mn. As compared to the CDC updated blood Pb reference value (35 µg/L), Pb levels remain higher of public health concern. Cd and Mn levels were similar to those found in the same city in 2015 and databases involving non-occupationally exposed populations from other countries. Hg levels significantly lower than those found in the same city in 2015, probably due to exclusion criteria of metal exposure applying in the present survey (occupationally exposed to the studied metals, smoking habits, amalgam tooth fillings, fish consumption habit more than one time per week, etc.). These background metal exposures will be useful for future occupational and/or environmental surveys as well as undertaking a reliable regulation of chemical exposure in Kinshasa via a national HBM program.

Toxic metal (Cd, Hg, Mn, Pb) partition in the maternal/foetal unit: A systematic mini - review of recent epidemiological studies.

The aim of this study was to summarise the available information regarding the partition of toxic metal (Cd, Hg, Mn, Pb) levels in the maternal/foetal unit from large epidemiological studies. We performed a systematic search of PubMed/MedLine, EMBASE, and ISI Web of Science for papers on Cd, total Hg, Mn or Pb levels in the maternal/cord blood that were published in English (n > = 200; 2010-2017). Data on year of publication, sample size, location, year of survey, and main results were extracted. We found a total of 35 papers. Most studies included large convenience samples of healthy pregnant women. The maternal/cord blood was properly used as a biomarker of prenatal exposure to toxic metals. The partition of these toxic metal levels in the maternal/foetal unit was metal-specific. Cd median levels (IQR) in cord blood reported worldwide were much lower [∼ 70 % < LOD = ± 0.11 µg/L] than those found in maternal blood [0.23 µg/L (0.15-0.35), ∼ 65 % > LOD]. Considering that Cd was under LOD in 70 % of the cord blood, Cd cord:maternal ratio as well as Cd cord proportion were not provided. Total Hg median levels (IQR) in cord blood [0.75 µg/L (0.40-1.19), ∼30 % < LOD = ±0.35 µg/L] were usually higher than in maternal blood [0.55 µg/L (0.40-0.85), ∼ 10 % < LOD = ±0.15 µg/L]. Hg cord:maternal ratio was 1.34 (1.00-1.91), and infants born would have Hg cord:(cord + maternal) proportion ranged from 0.50 to 0.63. Mn was the only metal that was detected in 100 % in both maternal (LOD : ±0.50 µg/L) and cord (LOD = ±0.2 µg/L) blood. Mn median levels (IQR) in cord blood [32.96 µg/L (26.90-40.10)] were 2 times higher than in maternal blood [14.01 µg/L (11.50-17.58)]. Mn cord:maternal ratio was 2.35 (1.09-3.80), and infants born would have Mn proportion ranged from 0.52 to 0.79. Pb median levels (IQR) in cord blood [5.79 µg/L (4.34-8.38), ∼ 5% < LOD : ±2.07 µg/L] were usually equal to or lower than those reported in maternal blood [8.07 µg/L (5.79-10.76), ∼ 1% < LOD = ±1.03 µg/L]. Pb cord:maternal ratio was 0.71 (0.59-0.96), and infants born would have Pb proportion ranged from 0.37 to 0.49. Globally, the results indicate that total Hg and Mn levels were lower in maternal blood but higher in cord blood. However, much greater variability was seen with Cd and Pb. At delivery, total Hg and Pb levels in maternal blood were strong predictors of cord blood levels. Our findings empty that understanding the partition, levels and correlations of toxic metals in the maternal/cord blood may help to elucidate the adverse effects of these metals on foetuses and neonates.

Tentative reference values for environmental pollutants in blood or urine from the children of Kinshasa.

The DRC, as most of African nations, does not have a national biomonitoring programme and there is a lack of information on background levels of environmental pollutants in the general DRC population, particularly in children. The focus of the data presented in this report aims to establish the background levels of a range of environmental pollutants in urine or blood from the children population of Kinshasa. Based on the representative data collection of the Kinshasa population, the survey selected 125 children aged 1-14years and living in Kinshasa (6years on average, 56% of girls, 100% of non-smokers, without amalgam fillings and consumers of fish 3 times per week). Biomarkers of a range of metals (As, Cd, Hg and Pb), pyrene (PAH) and benzene were analyzed in the blood or urine samples. Globally, the results indicate that the exposure levels of children living in Kinshasa are 10 times higher than those published by the American, Canadian and German children surveys. This study provides the first Reference Values of environmental pollutants [As, Cd, Hg, Pb, pyrene (PAH) and benzene] in the Kinshasa children population and reveals elevated levels of all biomarkers studied. The data set of this study may allow environmental and health authorities of DRC to undertake a national biomonitoring programme, especially with four insights for the protection of human heath.

Toxic and essential elements in children's blood (<6 years) from Kinshasa, DRC (the Democratic Republic of Congo).

In this study we determined the concentration of 9 trace elements (As, Cd, Cu, Hg, Mn, Mo, Pb, Se and Zn) in whole blood of children (n=100, 64 girls, 36 boys and median age: 36 months) using inductively coupled plasma mass spectrometry (ICP-MS). The proportion of children potentially deficient in essential elements or poisoned by toxic elements was evaluated. The aging effects on the concentration of these elements were also investigated. The median values were 3.17µg/L (As), 0.15µg/L (Cd), 1.1mg/L (Cu), 2.1µg/L (Hg), 10.4µg/L (Mn), 17.7µg/L (Mo), 8.7µg/dL (Pb), 10.7µg/L (Se) and 5.0mg/L (Zn). The concentration of many elements (As, Cd, Hg, Mn, Pb and Zn) showed significant age variations but not sex influence. Regarding levels of the essential elements (Cu, Mn, Mo, Se and Zn), B-Cu, B-Mn, B-Se and B-Zn were in the normal range, whereas exceeded levels were observed for B-Mo. None of these children was deficient in essential elements. Except B-Cd, all toxic elements showed exceeded blood levels. The proportion of children potentially poisoned by toxic elements varies from 10% (n=10) to 95% (n=95) and depends on toxic element: 95% for As, 10% for Hg and 35% for Pb. The main health concerns emerging from this study are the high As, Hg and Pb exposures of the Kinshasan children requiring further documentation, corrective actions and the implementation of appropriate regulations.

[AIDS and the Third World]. / SIDA et tiers monde.

PIP: A survey of existing knowledge about the etiology, treatment, prevention, and epidemiology of HIV infection and AIDS is presented, with particular emphasis on Africa and the Third World. A brief introduction argues that the impact of AIDS in Africa is likely to be especially severe because of poverty and lack of development. The 1st chapter discusses the HIV virus and its mode of attack on the body's immune system, describes related retroviruses, explains and diagrams how the ELISA, Western Blot, and other diagnostic tests work, and describes the common signs and symptoms of the various stages of HIV infection. The 2nd chapter assesses the prospects for development of a vaccine, the difficulty of determining the lethality of HIV infection after only a few years of experience, and the efficacy of AZT, alpha interferon, and other possible treatments. Existing epidemiologic data, the divergent transmission pattern in different world regions and their recent trends, high risk behavior, the probable future course of the epidemic, and possible social and economic effects of the epidemic are discussed in chapter 3. The following chapter discusses AIDS prevention campaigns, safer sex, condom use, and IEC campaigns for the public, with examples from Kenya, Uganda, Rwanda, the US, and elsewhere. Chapter 5 focuses on the epidemic in Africa. Topics covered include the possible African origin of HIV, the deficiencies of existing epidemiologic data, AIDS control programs in Africa, and special problems in Africa related to the possibility of infection during lactation and the possible dangers of vaccinating children seropositive for HIV. The next chapter sketches a general strategy for AIDS prevention and outlines the role of WHO. The final chapter assesses knowledge of the level of infection in Latin America, the Middle East, Asia and the Pacific, North America, and Western and Eastern Europe.^ieng