Factors associated with uncontrolled asthma in adult asthmatics in Kinshasa, Democratic Republic of Congo.

BACKGROUND: The ultimate goal of asthma treatment is long-term control. Uncontrolled asthma is a major public health problem worldwide, but there is a lack of data on asthma control and its causes in the Democratic Republic of Congo (DRC). OBJECTIVE: To determine the socio-demographic, environmental, clinical, and biological factors and comorbidities associated with uncontrolled adult asthma in Kinshasa, DRC. METHODS: We performed a cross-sectional study of 216 male and female asthmatics aged 18 and over consecutively recruited from tertiary clinics and the community in Kinshasa between June 2017 and February 2018. For each subject, socio-demographic, clinical, para clinical and environmental data were recorded. Forced Expiratory Volume in one second (FEV1) values were obtained by Spirometry, allergen testing performed using the skin prick test, serum vitamin D levels measured by radioimmunoassay, and asthma control assessed using the asthma control test (ACT) score. Multiple logistic regression identified factors associated with uncontrolled asthma. RESULTS: The average age of participants was 45.2 (SD 17.6) years, 74% were female, and 42% had a low educational level. Among all asthmatics, the prevalence of uncontrolled asthma was 56%, abnormal serum vitamin D level 95%, abnormal FEV1 65%, sensitization to two allergens (cat dander and dust mites) 18%, sleep disorders 37%, and heartburn 60%. Male (aOR 2.24; 95% CIs 1.04-4.79), low educational level (aOR 3.26; 95% CIs 1.54-6.67), sensitization to both cat dander and dust mites (aOR 2.67; 95% CIs 1.16-6.14), FEV1 ≤80% (aOR 2.07; 95% CIs 1.08-3.96), abnormal serum vitamin D level (aOR 5.11; 95% CIs 1.17-22.33), sleep disorders (aOR 1.96; 95% CIs 1.04-3.71), and heartburn (aOR 2.02; 95% CIs 1.04-3.92) were significantly associated with uncontrolled asthma. CONCLUSION: Uncontrolled asthma is common in Kinshasa, and these factors associated with uncontrolled asthma may be considered as targets for future intervention strategies.

Protective BCL11A and HBS1L-MYB polymorphisms in a cohort of 102 Congolese patients suffering from sickle cell anemia.

BACKGROUND: We aimed to investigate the distribution of selected BCL11A and HMIP polymorphisms (SNP's), and to assess the correlation with HPFH in a cohort of sickle cell patients. METHODS: A preliminary cross-sectional study was conducted in 102 patients. Group 1 was composed of patients with HPFH and Group 2 consisted of patients without HbF. We assessed 8 SNPs previously associated with HPFH in cohorts genetically close to the Congolese population. Observed frequencies were compared to expected frequencies. RESULTS: In the group 1, at rs7606173, the observed frequency for the genotype GG was significantly higher and the genotype GC was significantly lower than their respective expected frequencies. At rs9399137, the observed frequency of the genotype TT was significantly lower than expected. Conversely, the observed frequency of the genotype TC was significantly higher than expected. The observed frequency of the genotype TT at rs11886868 was significantly lower than the expected whereas the frequency of the genotype TC was significantly higher than observed. The lowest HbF level was recorded in patients with genotype CC at rs11886868. CONCLUSION: In this preliminary study, the results demonstrate that alleles of some of the 8 studied SNPs are not randomly distributed among patients with or without HPFH in this cohort.