Access to High Quality Surgical Repair Services is a Fundamental Right of Patients with Obstetric Fistulas: A Study on Quality of Life Data in the Democratic Republic of the Congo.

Purpose: The aim of this study was to assess quality of life (QoL) using the WHOQOL-BREF questionnaire among obstetric fistula (OF) patients before and after surgical repair of OF (SROF). Methods: A longitudinal cohort study was conducted between November 2022 and October 2023 in the Democratic Republic of the Congo (DRC) among OF patients to assess their QoL before and after SROF. A systematic sampling technique was used to recruit a total of 158 OF patients. The WHOQOL-BREF questionnaire assessed general health, life experience, as well as physical, social, psychological, and environmental domains. Results: The mean age among the 158 respondents was 33.51 ± 9.63 years, and 77.85% of them lived in rural areas. In terms of surgical outcomes, 80.38% had closure of the OF with regained continence, 5.7% had closure of the OF with persistent incontinence, and 13.9% had a failed surgical repair. Overall mean QoL scores were higher after OF surgical repair (3.83, standard deviation [SD]=0.89) in comparison to pre-operative (1.58, SD=0.63) (p<0.001). These QoL improvements included physical (mean score 66.32 post-surgery versus 28.37 before, p<0.001), social (mean score 64.92 post-surgery versus 27.90 before, p<0.001), psychological (mean score 68.09 post-surgery versus 21.28 before, p<0.001), environmental (mean score 48.41 post-surgery versus 16.91 before p<0.001), and general domains. Patients with a successful OF repair had a better QoL score than those with a closed fistula but ongoing incontinence or those for whom surgery failed to close the fistula. Conclusion: The present study showed that among OF patients, all QoL domains were impaired before surgical repair and significantly improved after surgery. Successful OF closure alleviates the consequences of OF and helps to restore patients' wellbeing. Our findings call for improved access to high-quality surgical repair services as a fundamental right for OF patients.

Knowledge of risk factors and early detection methods toward breast cancer among healthcare workers in Kinshasa, Democratic Republic of the Congo.

BACKGROUND: Breast cancer (BC) is the most prevalent cancer among women, and it typically presents late in developing countries like the Democratic Republic of the Congo (DRC), leading to higher mortality rates. Late detection at advanced stages of breast cancer can be attributed to the absence of appropriate screening programs and low levels of awareness. AIMS: To evaluate the level of BC knowledge among healthcare workers (HCWs) and identify determinants of good BC knowledge. METHODS AND RESULTS: An analytical cross-sectional survey was conducted from March 1 to 31, 2022 involving HCWs practicing in Kinshasa, DRC. Data were collected using a questionnaire administered through direct interviews. Bivariate and multivariate regression techniques were applied. The study interviewed 543 HCWs, with a median age of 35 years (interquartile range: 29-43). Of these, 61% had good BC knowledge, while 39% had poor BC knowledge. Multivariate analysis revealed that HCWs aged 50 years and over (adjusted odds ratio [aOR] = 2.3 [1.2-4.5]), female HCWs (aOR = 1.8 [1.1-2.4]), HCWs working in public healthcare facilities (aOR = 1.5 [1.1-2.5]), and HCWs who had received training on BC (aOR = 1.9; 95% CI: 1.5-3.3) were determinants of good BC knowledge. CONCLUSION: This study found that 61% of the surveyed HCWs had good BC knowledge. However, there is still room for improvement in terms of knowledge dissemination. Therefore, it is important to implement continuing medical education programs that focus on raising awareness and improving BC knowledge among HCWs.

Determinants and predictive model of failure of surgical repair of obstetric vesico-vaginal fistula in the Democratic Republic of the Congo.

INTRODUCTION: Surgical repair of obstetric fistula aims to restore the anatomical and functional integrity of the urinary tract, enabling affected women to regain their dignity and quality of life. However, such repairs can end in a failure. The aim of this study is to develop a predictive score to identify factors influencing failure of surgical repair of obstetric vesico-vaginal fistula (FSROVVF) in the Democratic Republic of the Congo. METHODS: This was an analytical cross-sectional study of 318 women with obstetric vesico-vaginal fistula (OVVF) who had undergone surgical management. A bivariate and then a multivariate analysis were performed. Score discrimination was assessed using the ROC curve and C-index, and score calibration using the Hosmer-Lemeshow test. RESULTS: Surgical repair of OVVF was unsuccessful in 16.98% of cases (54/318). After logistic modeling, six criteria emerged as predictive factors for FSROVVF: the presence of fibrosis (AOR = 5.01; 95% CI:1.73-14.49), the presence of 2 or more fistulas (AOR = 9.04; 95% CI:3.01-27.13), the association of OVVF with another anatomoclinical entity of fistula (AOR = 3.16; 95% CI:1.09-9.13), the fistula size > 3 cm (AOR = 3.65; 95% CI:1.36-9.76), the peri-operative hemorrhage (AOR = 7.01; 95% CI:2.33-21.03), and the post-operative infection (AOR = 178.89; 95% CI:26.09-1226.64). A score ranging from 0 to 13 points was obtained, of which a value ≤ 5 points defines a low risk of FSROVVF, a value between 6 and 8 points defines a moderate risk and value ≥ 9 points corresponds to a high risk of FSROVVF. The area under the ROC curve of the score is 0.925 with a sensitivity of 61.11%, a specificity of 96.59%, a positive predictive value of 78.57% and a negative predictive value of 92.39%. CONCLUSION: This study demonstrated that the number of fistulas ≥ 2, fistula size > 3 cm, fibrosis, association of OVVF with other types of fistulas, peri-operative hemorrhage, and post-operative infection are factors predictive of FSROVVF. These six factors are key contributors to the score used to predict FSROVVF. Once validated, this score will inform and enable preoperative counseling regarding the prognosis and the chances of a successful outcome of surgical repair of OVVF.

Assessing high-risk sexual practices associated with human immunodeficiency virus infection among young female sex workers in Lubumbashi, Democratic Republic of the Congo: a cross-sectional study.

INTRODUCTION: Young female sex workers (YFSWs) face a higher risk of HIV infection compared to older workers, but there is a lack of comprehensive data on their sexual practices and HIV infection risks, which may present unique challenges and vulnerabilities. The study aimed to identify high-risk sexual practices associated with HIV infection among YFSWs in Lubumbashi. METHODS: We conducted an analytical cross-sectional study and used a comprehensive sample of all YFSWs who presented to the HIV/Sexually Transmitted Infections Screening and Treatment Center in Lubumbashi between April 2016 and December 2017. We collected data on socio-demographic characteristics and behavioral risk factors of female sex workers were collected using a structured questionnaire. Using STATA version 16, multivariate logistic regression was fitted and the results were presented as adjusted odds ratios (aORs) with their 95% confidence intervals (95% CIs). RESULTS: A total of 572 YFSWs were included in the study, 19 of whom were HIV-positive (3.3%; 95% CI: 2.1-5.1%). Participants who were forced to have sex (aOR = 12.2; 95% CI: 3.2-46.4; p < 0.0001), those who did not use condoms systematically (aOR = 4.1; 95% CI: 1.3-13.0; p = 0.018), and those who had anal sex (aOR = 23.8; 95% CI: 6.9-82.4; p < 0.0001) were more likely to be HIV-positive. CONCLUSION: The study reveals a concerning trend of higher hospital HIV prevalence among YFSWs compared to the general Congolese population. It also highlights a significant link between high-risk sexual practices and HIV infection, highlighting the need for urgent interventions.

HEAL Africa score to predict failure of surgical repair of obstetric urethro-vaginal fistula in the Democratic Republic of the Congo.

INTRODUCTION: Obstetric fistula (OF) repair surgery aims to restore the anatomical and functional integrity of the urinary tract, allowing affected women to regain their dignity and quality of life. However, in some cases, this surgical repair may fail. The objective of this study was to develop a predictive score to identify factors associated with the failure of surgical repair of obstetric urethro-vaginal fistula (FSROUVF) in the Democratic Republic of the Congo (DRC). METHODS: This is an analytical cross-sectional study of 358 patients with obstetric urethro-vaginal fistula (OUVF) who received surgical repair. We conducted bivariate and multivariate analyses. Score discrimination was assessed using the receiver operating characteristic (ROC) curve, C-index, and score calibration according to the Hosmer-Lemeshow test. RESULTS: Surgical repair of OUVF failed in 24.86% of cases (89/358). After logistic modelling, 6 criteria predicted FSROUVF: the use of intravaginal indigenous products (AOR = 3.59; 95% CI: 1.51-8.53), the presence of fibrosis (AOR = 6.37; 95% CI: 1.70-23.82), the presence of 2 or more fistulas in the same patient (AOR = 7.03; 95% CI: 3.14-15.72), the total urethral damage (AOR = 3.29; 95% CI: 1.36-7.95), the fistula size > 3 cm (AOR = 5.65; 95% CI: 2.12-15.01), and the postoperative infection (AOR = 351.10; 95% CI: 51.15-2409.81). A score of 0 to 14 was obtained, with a value ≤5 points indicating a low risk of FSROUVF, a value between 6 and 8 indicating a moderate risk, and a value ≥9 points corresponding to a high risk of FSROUVF. The area under the ROC curve of the score is 0.938 with a sensitivity of 60.67%, a specificity of 96.28%, a positive predictive value of 84.38%, and a negative predictive value of 88.10%. CONCLUSION: We report a FSROUVF rate in the DRC approaching a quarter of operative patients. Predictors of failure included fibrosis, presence of 2 or more fistulas, total urethral involvement, fistula size greater than 3 cm, postoperative infection, and use of intravaginal indigenous products. These factors are constitutive of the HEAL Africa score, which once validated, may have value in pre-operative counselling of patients. This study could be valuable for policy and strategies to address the problem of OUVF in the DRC and in resource limited settings more generally.

[Epidemio-clinical and seminal profile of the man consulting for the desire to procreate: current situation in Lubumbashi, in the Democratic Republic of Congo]. / Profil épidémio-clinique et séminal de l'homme consultant pour désir de procréation: état des lieux à Lubumbashi, en République Démocratique du Congo.

Introduction: in Lubumbashi, as in upscale areas where explorations of fertility are very clever, the spermogram remains the essential analysis in the diagnosis of male infertility. This is the cause of 40% of couple infertility. The spermogram is the first step in identifying seminal abnormalities. The objective of this study was to determine the epidemiological-clinical and seminal profile of the man consulting for the desire to procreate in Lubumbashi. Methods: this was a cross-sectional study. We received 202 subjects in Lubumbashi, whose spermogram was performed from August 1st, 2020 to July 31st, 2021. The semen parameters were studied and interpreted according to WHO standards (2010) with studies of factors associated with their disturbance. Bivariate and multivariate analyzes had been carried out. The statistical significance threshold was set at p < 0.05. Results: the epidemiological-clinical profile of the respondents was as follows: the most represented age group was 30 to 39 years; infertility was primary in 80.69% of cases; the duration of the desire for paternity was 2 years at most in 44.55% of cases. The sperm abnormalities found were: oligozoospermia (40.09%), azoospermia (11.38%), asthenozoospermia (18.31%) and teratozoospermia (10.39%). Oligozoospermia was significantly associated with varicocele (ORa = 10.9 [3.0-39.5]; p < 0.0001), genital infection (ORa =2.7 [1.0-7, 2]; p = 0.041) and obesity (ORa = 2.6 [1.0-7.9]; p = 0.020) while azoospermia was the cure for inguinal hernia (ORa = 4.2 [1.0-17.2]; p = 0.049) and malnutrition (ORa =6.0 [1.2-29.7]; p = 0.027). Asthenozoospermia was significantly associated with the age group of 40 to 49 years (ORa = 6.6 [1.2-37.4]; p = 0.034), tobacco (ORa =7.5 [2.7 -21.0]; p = 0.000), undernutrition (ORa = 7.7 [1.0-61.9]; p = 0.045) and overweight (ORa =3.8 [1.3-11, 5]; p=0.019). Teratozoospermia was significantly associated with smoking (ORa = 5.6 [1.8-17.7]; p = 0.003) and overweight (ORa =5.3 [1.2-23.3]; p = 0.027). Conclusion: more than half of the respondents had, of the three main fertility parameters, at least one that was disturbed. Sperm count was the most affected parameter. Alcohol, tobacco, genital infection and malnutrition were the most common risk factors for the abnormalities observed.

Knowledge regarding breast cancer among Congolese women in Kinshasa, Democratic Republic of the Congo.

INTRODUCTION: Breast cancer is the most frequent type of cancer in women and is characterized by late clinical signs in developing countries, including the Democratic Republic of the Congo. One of the main reasons of death from breast cancer is lack of awareness and screening, which has led to late diagnosis (at an advanced stage). This study aims to measure women's knowledge regarding breast cancer in Kinshasa, in the Democratic Republic of the Congo. MATERIALS AND METHODS: A cross-sectional study of 489 women aged 20-65 years was conducted. Data was collected using a predesigned, tested, self-administered questionnaire. The questionnaire included specific sections to test the participants' knowledge related to breast cancer and its screening, and practices related to breast self-examination (BSE). Bivariate and multivariate analyzes were used. RESULTS: Our results indicated that 22.09% of the participants had good breast cancer knowledge and 77.91% had poor breast cancer knowledge. Overall, 322 (65.85%) participants recognized that BSE is a valuable method for early screening of BSE. In total, 136 (27.81%) respondents had learned to do the BSE and 216 (44.17%) had reported doing it. Two hundred and ninety-two (59.71%) respondents mentioned that any woman was at risk for breast cancer and 357 (71.78%) mentioned that it was possible to prevent breast cancer. Determinants of an adequate level of knowledge were higher/university educational level (adjusted odds ratio = 2.70; 95% confidence interval: 1.27-5.73; p = .010) and having previously been screened for breast cancer (adjusted odds ratio = 2.31; 95% confidence interval: 1.40-3.83; p = .001). CONCLUSION: The majority (77.91%) of women have demonstrated poor knowledge of signs/symptoms, risk factors, and screening methods of breast cancer. Additional efforts should be made through women's healthcare workers to raise knowledge of breast cancer screening.

Profil épidémiologique et mortalité due à la tuberculose dans la zone de Santé de Kamina, Province du Haut-Lomami, en Démocratique du Congo / Epidemiological profile and deaths related to TB disease in the Kamina´s Health Zone, Haut-Lomami Province, Democratic Republic of the Congo

Introduction: Était de décrire le profil épidémiologique, clinique et évolutif des patients tuberculeux suivis dans le milieu urbano-rural de Kaminaen République Démocratique du Congo (RDC). Méthodes: il s´agit d´une étude transversale par analyse rétrospective de dossiers des patients suivis pour tuberculose sur une période allant du 1er Janvier 2018 au 31 Décembre 2021. Résultats: sur un total de 612 échantillons analysés, 216 cas de tuberculose ont été confirmés par le laboratoire, soit une fréquence de 35,3 %. Notre échantillon était constitué de 138 hommes et 78 femmes, soit un sex-ratio de 1,77. L´âge moyen était de 35,37±18,14 années. La majorité des patients était dans la tranche d´âge comprise entre 21-40 ans. La profession libérale représentait 94,4 % de notre effectif, soit 204 patients. Il y a eu 63,4% des patients souffraient d´une tuberculose pulmonaire dont 70,9 % était guéris. La sérologie VIH était positive chez 6 patients, soit un taux de séroprévalence VIH de 2,77 %. Au total, 27 malades sont décédés sur les 612, soit un taux de mortalité de 4,41 %. C´est la tranche d´âge de malades ages de plus de 60 ans qui a connu une mortalitéélévée, soit 5 cas sur 20 (25 %), suivie de celle des malades ages de moins de 20 ans, 11 cas sur 49 (22,4 %). D´autre part, le résultat a montré un taux de mortalité plus élévé chez les tuberculeux séropositif, 33,3 %, contre 11.9 % chez les séronégatifs. Conclusion: ce rapport montre un taux élevé de tuberculose dans la zone de santé de Kamina ; il confirme le fait que la TB est endémique dans la région. Il est nécessaire d'améliorer les conditions de vie de la population et le système de santé local en ce qui concerne la prévention et la gestion de la TB afin de réduire sa morbi-mortalité.

Introduction: the purpose of this study was to describe the epidemiological, clinical and evolutionary profile of patients with tuberculosis followed in the urban-rural area of Kamina, Democratic Republic of the Congo (DRC). Methods: we conducted a cross-sectional study based on a retrospective analysis of the medical records of patients followed for tuberculosis over the period January 1, 2018 -December 31, 2021. Results: out of 612 samples analysed, 216 cases had received lab confirmation of tuberculosis, reflecting a rate of 35.3%. Our sample consisted of 78 women and 138 men (sex ratio 1.77). The average age of patients was 35,37±18.14 years. The majority of patients were in the age range 21-40 years. Self-employed people accounted for 94.4% of our workforce (204 patients); 63.4% of patients suffered from pulmonary tuberculosis, 70.9% of whom were cured. Serology test for HIV was positive in 6 patients (i.e. an HIV seroprevalence rate of 2.77%). In total, 27 patients out of 612 died, (i.e. a mortality rate of 4.41%). Patients aged over 60 had higher mortality rates (5 out of 20 cases; 25%), followed by patients under 20 (11 out of 49 cases; 22.4%). On the other hand, our results showed a higher mortality rate among HIV-positive patients with tuberculosis (33.3%, compared to 11.9% among HIV-negative patients). Conclusion: this study shows a high rate of tuberculosis in the Kamina health zone, confirming the fact that TB is endemic in the region. There is a need to improve the living conditions of the population and the local health system with regard to the prevention and management of TB in order to reduce morbidity and mortality

Risk Factors for Hemorrhagic Stroke among Adults in the Democratic Republic of the Congo: A Hospital-Based Study in a Limited Resource Setting.

Background: The prevalence of stroke is increasing in sub-Saharan Africa. The scarcity of hospital-based stroke data in Lubumbashi (in the Democratic Republic of the Congo) led to the study, which was designed to describe the epidemiology of stroke and identify risk factors associated with hemorrhagic stroke among adult patients in Lubumbashi. Methods: This was a cross-sectional study of 158 adult patients admitted for stroke in the internal medicine department of Lubumbashi University Clinics from January 2018 to December 2020. Sociodemographic and clinical features, cardiovascular risk factors, and hospital mortality were collected. A logistic regression has determined the risk of developing a hemorrhagic stroke. Results: Of 9,919 hospitalized patients, 158 had a stroke with a hospital prevalence of 1.6%; 86 (54.4%) patients had a hemorrhagic stroke while 72 (45.6%) had an ischemic stroke. Of which 41.1% (65/158) were women. The mean age was 60.8 ± 13.3 years. Main clinical signs were hemiplegia (63.3%), headache (48.7%), speech disorders (38.6%), and dizziness (38.6%). Hypertension (82.9%) and hyperglycemia (53.2%) were the most common risk factors. Inhospital mortality was 22.8%. After logistic regression, independent predictors for developing hemorrhagic stroke were hypertension (aOR = 8.19; 95% CI: 2.72-24.66; p < 0.0001) and atrial fibrillation (aOR = 4.89; 95% CI: 1.41-16.89; p = 0.012). Conclusion: This study highlights the high stroke mortality in a resource-limited hospital and the burden of hypertension in the development of hemorrhagic stroke. It illustrates the need to establish stroke care setting to improve the quality of stroke care.

Predictors of Mortality in Adults with Acute Kidney Injury Requiring Dialysis: A Cohort Analysis.

Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is accompanied by considerable mortality. This present study evaluated predictors of mortality at initiation of hemodialysis (HD) in AKI patients in Goma (in the Democratic Republic of the Congo (DRC)). Methods: A single-centre cohort survey evaluated the clinical profile and survival rates of AKI patients admitted to HD in the only HD centre in Goma, North Kivu province (DRC). Data were collected from patients who underwent HD for AKI. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. The survival study used the Kaplan-Meier curve. Predictors of mortality were evaluated using Cox regression. Results: Of the 131 eligible patients, the mean age was 43.69 ± 16.56 years (range: 18-90 years). Men represented 54.96% of the cohort. The overall HD mortality rate was 25.19% (n = 33). In multivariate analysis, independent predictors of mortality in AKI stage 3 patients admitted to HD were as follows: age ≥ 60 years (adjusted hazard ratio (AHR) = 15.89; 95% CI: 3.98-63.40; p < 0.0001), traditional herbal medicine intake (AHR = 5.10; 95% CI: 2.10-12.38; p < 0.0001), HIV infection (AHR = 5.55; 95% CI: 1.48-20.73; p=0.011), anemia (AHR = 9.57; 95% CI: 2.08-43.87; p=0.004), hyperkalemia (AHR = 6.23; 95% CI: 1.26-30.72; p=0.025), respiratory distress (AHR = 4.66; 95% CI: 2.07-10.50; p < 0.0001), and coma (AHR = 11.39; 95% CI: 3.51-36.89; p < 0.0001). Conclusion: Initiation of hemodialysis with AKI has improved survival in patients with different complications.

Immunohistochemical Features of Breast Cancer Seen in Women in Kinshasa, Democratic Republic of the Congo: A Six-Year Retrospective Study.

Introduction: The molecular classification of breast cancer (BC) based on gene expression and then protein profile has made it possible to distinguish different molecular subtypes. The objective of this study was to describe immunohistochemical features of BC infiltrating women at the Nganda Hospital Center in Kinshasa, Democratic Republic of the Congo (DRC). Methods: A retrospective study from 2014 to 2019 involved 190 patients with invasive BC who were enrolled at the Nganda Hospital Center. The tumors were analyzed histologically and classified after an immunohistochemical study into subtypes: luminal A, luminal B, HER2-overexpressed, and triple-negative. A chi-square test was performed to assess the relationship between age, histological grade, and these subtypes. Results: The luminal A subtype (44.74%) was the most common, followed by luminal B (40.53%), triple-negative (10.53%), and HER2-overexpressed (4.20%). The mean age of the patients at diagnosis was 48.27 years. Of all cases, 94.21% were ductal, 2.63% were mucinous, and 2.11% were lobular. They were classified as grade I in 68.82% of the cases, grade II in 28.42% of the cases, and grade III in 3.16% of the cases. There was a significant association between histological grade and breast cancer subtypes (p < 0.0001), but no correlation was found with age (p = 0.467). Conclusion: In our BC patients, the luminal A was predominant, while HER2-overexpressed was the least found. A strong association was noted between histological grade and molecular subtypes. These results should allow for important clinical and policy implications for BC control in the DRC.

Prevalence and Factors Associated with Acute Kidney Injury in Sub-Saharan African Adults: A Review of the Current Literature.

Acute kidney injury (AKI) is a complex condition that can occur in both community and hospital settings and has many aetiologies. These aetiologies may be infectious, toxic, surgical, or related to the different management methods. Although it is a major public health problem worldwide, it must be emphasised that both its incidence and mortality rate appear to be very high in sub-Saharan African (SSA) countries compared to developed countries. The profile of AKI is very different from that of more developed countries. There are no reliable statistics on the incidence of AKI in SSA. Infections (malaria, HIV, diarrhoeal, and other diseases), nephrotoxins, and obstetric and surgical complications are the main aetiologies in Africa. The management of AKI is costly and associated with high rates of prolonged hospitalisation and in-hospital mortality.

Prevalence of Hypertension and Associated Factors in Lubumbashi City, Democratic Republic of Congo: A Community-Based Cross-Sectional Study.

BACKGROUND: Hypertension is the leading cause of cardiovascular disease morbidity and mortality worldwide. Its struggle involves knowing its prevalence. Insufficient data on hypertension in adults in Lubumbashi, Democratic Republic of Congo (DRC), prompted the conduct of this study. The objectives were to determine the prevalence of hypertension and to identify the associated factors in adults in Lubumbashi. Methodology. A cross-sectional study was carried out among 6,708 adults from October 15th to November 24th, 2018, in Lubumbashi. Anthropometric data, lifestyle, and medical history were collected. Hypertension was defined when the mean of the last two blood pressure (BP) measurements was greater than or equal for systolic (SBP) at 140 mmHg and for diastolic (DBP) at 90 mmHg or a history of taking antihypertensive medication whatever the value of the BP. Logistic regression was used to identify the relative effects of hypertension risk factors and all statistical tests were declared significant at a p value <0.05. RESULTS: The female participants numbered 4479 (66.8%). The mean age of all participants was 47.9 ± 16.5 years. The mean SBP and DBP were 128.4 ± 25.9 mmHg and 79.1 ± 15.3 mmHg, respectively. The overall prevalence of hypertension was 33.6%. This prevalence was statistically higher in women than in men (34.5% vs. 31.7%; p=0.024). After logistic regression, the risk of hypertension increased with age >50 years (aOR = 5.85 [5.19-6.60]), overweight (aOR = 1.25 [1.11-1.41]), obesity (aOR = 1.25 [1.11-1.41]), central obesity (aOR = 1.37 [1.16-1.61]), diabetes mellitus (aOR = 2.19 [1.63-2.95]), alcohol consumption (aOR = 1.21 [1.05-1.39]), nonconsumption of vegetables (aOR = 1.35 [1.02-1.80]), and history of stroke (aOR = 2.57 [1.88-3.51]). Hypertension was inversely associated with being underweight (aOR = 0.68 [0.53-0.87]). CONCLUSION: The prevalence of hypertension in the city of Lubumbashi is high as in other cities of the DRC and Africa. This situation requires the implementation of prevention, detection, and treatment programs for hypertension.

Clinical, Histopathological, and Prognostic Characteristics of Patients with Prostate Cancer in Lubumbashi, Democratic Republic of Congo.

INTRODUCTION: Prostate cancer is currently a public health problem with a frequency that varies from country to country. This study aims to describe the epidemiological, clinical, and histopathological and outcome features of prostate cancer in Lubumbashi in the Democratic Republic of Congo. MATERIALS AND METHODS: This was a descriptive longitudinal study of patients diagnosed with prostate cancer at the University Clinics of Lubumbashi. The study period was 3 years (2017 to 2019). Parameters studied were age and clinical, biological (PSA level, prostatic specific antigen), histopathological, and outcome features. RESULTS: The mean age of patients was 68.7 years (range: 47 and 90 years). The 60 to 69 age group was the most affected (43.18%). Elderly subjects (≥60 years old) represented 89.77% of the cases (n = 79). Voiding disorders were the main reason for consultation in 55.68% of the cases. The mean PSA level was 133.7 ng/ml (range: 4 and 1564.5 ng/ml) at diagnosis and 125.4 ng/ml after 3 months of follow-up (range: 0.16 and 1782.1 ng/ml). Adenocarcinoma was the predominant histological type (100%). In prognosis, 31.82% of patients had a Gleason score greater than 7 and 59.10% had a high risk at the D'Amico risk classification for Prostate Cancer. Hormone therapy was administered alone in 75% of the cases and in combination with pulpectomy in 13.64% of the cases. The 3-year overall survival was 56.82%. CONCLUSION: Prostate cancer is frequent and has a poor outcome in our country. The establishment of an individual screening policy would be an undeniable advantage in improving the prognosis.

Tolosa-Hunt Syndrome: A Painful Ophthalmoplegia.

Tolosa-Hunt syndrome is a painful ophthalmoplegia characterized by recurrent unilateral orbital pain, ipsilateral oculomotor paralysis, and a rapid response to steroids. Our report describes a 37-year-old young woman who presented with right ptosis, ipsilateral ophthalmoplegia, and painful headache with no other neurological deficits in which all biological and neuroimaging investigations were normal. Complete recovery within one week of corticosteroid therapy was observed. This is probably the first case of Tolosa-Hunt syndrome reported in Dakar, Senegal.

Prevalence and characteristics of HIV infection among female sex workers in Lubumbashi, Democratic Republic of Congo.

INTRODUCTION: female sex workers (FSWs) are considered a high-risk group for acquiring HIV infection due to their HIV prevalence estimated to be 10-20 times higher than in woman in the general population. This study aimed to determine the prevalence and risk factors of HIV among female sex workers (FSWs) in Lubumbashi. METHODS: a cross-sectional study was conducted among FSWs presenting for the first time at the sexually transmitted infections (STIs) clinic of Katuba, Lubumbashi, between April 2016 and December 2017. Information on the participants´ socio-demographic characteristics, sexual behaviors, and HIV serology results were collated and analyzed using a multiple logistic regression to identify factors associated to HIV infection among FSWs. RESULTS: information on 1555 sex workers was analysed in this study, the prevalence of HIV was 8.2%. The median age of the participants was 26 years (IQR: 21-34). Of the 127 HIV positive sex workers, 74% have been in the business for two years or less, 97% sell sex as their main income, 74% have more than 5 sexual intercourses per week, 95% reported using condom, 73% reported having history of STIs, 70% reported using alcohol before sex and 97% reported having three or more sexual partners per week. After adjusting for potentials cofounders, Age, Sex work as main income, years of selling sex, condom use, and alcohol use before sex were found to have a significant effect on HIV infection among sex workers. CONCLUSION: these findings highlight the vulnerability of FSWs to HIV infection and the necessity of immediate interventions to strengthen HIV prevention through behavioral change strategies and making available Pre-exposure Prophylaxis (PrEP) for FSWs in Lubumbashi.

Case Report: Three Cases of Neurocysticercosis in Central Africa.

Neurocysticercosis (NCC) is an infection prevalent in developing countries; however, it is neglected in the Democratic Republic of the Congo (DRC) and in sub-Saharan Africa. Here, we present three different cases seen in a consulting room in Lubumbashi. These cases are evidence that NCC is more common than it was previously thought in sub-Saharan Africa. Neurocysticercosis is a pathology-neglected and ignored infection, not only by the population but also by health professionals and health authorities in the DRC, and because of that, it is important to increase the research about NCC in the DRC to assess the prevalence and risk factors for NCC to assess the severity of the phenomenon and to help designing appropriate prevention and control measures.

Epidemiology of Epilepsy in Lubumbashi, Democratic Republic of Congo.

BACKGROUND: Epilepsy is one of the most common neurological conditions, but the majority of epilepsy patients in sub-Saharan countries do not receive appropriate treatment. In the Democratic Republic of Congo (DRC), particularly in Lubumbashi, very few epidemiological studies on epilepsy have emerged. This study aims to analyze demographic characteristics, semiology of epileptic seizures, and their etiologies in patients followed in hospital. METHODS: This is a prospective descriptive study that enrolled 177 epileptic patients who performed a neurological consultation at the Centre Médical du Centre Ville (CMDC) in Lubumbashi (DRC) from January 1, 2016, to December 31, 2017. RESULTS: The mean age of the patients was 20.0 years (range: 5 months and 86 years). The male sex was predominant (57.1%). The mean age at the seizure onset was 13.1 years, and the mean duration between onset of seizures and consultation was 83.5 months. The family history of epilepsy was present in 27.7%. Generalized tonic-clonic seizures were the most frequent (58.2%), followed by atonic generalized seizures (9.6%) and focal clonic seizures (8.5%). The etiology was found in 68 (38.4%) patients and was dominated by neurocysticercosis (26.5%), meningitis (25%), perinatal pathologies (20.6%), and head injury (20.6%). CONCLUSION: This study is a useful starting point from which health programs and health professionals can work to improve the diagnosis and quality of epilepsy management in our community.

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.

Evolution clinique et biologique des enfants infectés par le VIH sous traitement antirétroviral à Lubumbashi, République Démocratique du Congo

Introduction: en 2014, moins de 3 enfants sur dix (823 000 enfants environ) vivant avec le VIH avaient accès à un traitement antirétroviral (TAR), contre plus de quatre adultes sur dix. En conséquence, les enfants survivants qui ont une chance d´accéder au TAR sont traités souvent tardivement, à un stade avancé de la maladie. À Lubumbashi (RDC), les études sur l´évaluation du TAR chez l´enfant sont quasi nulles. Cette étude avait comme objectif décrire les caractéristiques sociodémographiques, cliniques, immunologiques et thérapeutiques des enfants infectés par le VIH et sous TAR et identifier les facteurs associés à un échec thérapeutique. Méthodes: il s'agit d'une étude transversale, réalisée du 1er janvier au 31 mars 2015 et portant sur une cohorte d'enfants de moins de 15 ans infectés par le VIH, suivis dans le service de Pédiatrie de l´hôpital Jason Sendwe. Résultats: 62 enfants âgés de moins de 15 ans infectés par le VIH ont été mis sous TAR. Les filles étaient prédominants (54,8%). 83,9% étaient à un stade clinique avancé (3 ou 4) lors de l´initiation au TAR. Notre étude montre que l´échec thérapeutique était significativement associé à l´âge ≥10 ans lors de l´évaluation de la prise en charge. Conclusion: l´étude a permis de montrer le retard avec lequel la prise en charge de l´enfant infecté VIH à Lubumbashi s´effectue; suggérant ainsi un renforcement du programme de la PTME et un dépistage précoce en vue d´une prise en charge précoce et la mise en place d´un mécanisme de rétention des enfants suivis