The road towards sustainable control of schistosomiasis in the Democratic Republic of Congo: Pre-assessment of staff performance and material resources in endemic regions

Objective To improve knowledge and practice of health staff as well as the availability of material resources for diagnosis and management of schistosomiasis in two endemic provinces of DRC (Kinshasa and Bas-Congo). Methods Structured interviews were performed using questionnaires with staff from 35 healthcare facilities in 9 health zones (HZ) of Kinshasa and 2 HZ in Bas-Congo. Results Schistosomiasis was reported to be present in all the included HZ. Health staff knew the most important symptoms of schistosomiasis, but advanced symptoms were more accurately reported in Bas-Congo. Knowledge of symptoms related to schistosomiasis such as anemia (P = 0.0 115) and pollakiuria (P = 0.0 260) was statistically different in both two provinces. Kato-Katz technique and urine filtration were unavailable in both provinces. Parasitological diagnosis was mostly performed using the direct smear method. PZQ was available in 70% of the health facilities, all situated in Bas-Congo. Diagnosis and treatment mostly relied on symptoms and cost more in urban area than in rural. Conclusions Though knowledge on schistosomiasis among health staff appears sufficient, substantial efforts still must be made to improve the availability of diagnostic tools and treatment in the health facilities in DRC.

[Asymptomatic Parasitemia in under five, school age children and households self-medication, Lubumbashi, Democratic Republic of Congo]. / Parasitémie asymptomatique chez les enfants de moins de 5 ans, enfants en âge scolaire et prise en charge des épisodes fébriles dans les ménages de Lubumbashi, République Démocratique du Congo.

INTRODUCTION: Long neglected, asymptomatic malaria is currently recognized as a potential threat and obstacle to malaria control. In DR Congo, the prevalence of this parasite is poorly documented. This study aims to determine the prevalence of asymptomatic parasitaemia in children less than 5 years of age as well as in those aged over five years for what concerns ongoing mass control interventions (LLINs). METHODS: This is a cross-sectional study conducted among school age children, children less than 5 years of age living in the household of Lubumbashi. Schools, students and children less than 5 years of age were selected randomly. Thick and thin blood smears and rapid tests were performed and read. RESULTS: Out of 350 examined students, 43 (12, 3%), IC 95% (9, 14-16, 04) had positive thick smear. Only plasmodium falciparum was identified in all the 43 cases. 314 households (90.5%) declared that they had administered anti-malarial drugs to their children to treat fever at home. More than one-third of households (39.9%) declared that they had administered antipyretics to their children to relieve fever, 19.7% administered quinine and only less than 2% artemether-lumefantrine. Considering the use of the TDR technique, the prevalence of asymptomatic parasitaemia was 3%, IC 95% (from 2.075 to 4.44), but if we consider microscopy as the gold standard, the prevalence was 1.9%, IC 95% (from 1.13 to 3.01). CONCLUSION: Asymptomatic malaria is not without health consequences, so it is important to conduct such investigations to detect new malaria device programmes.

Toxoplasmosis among pregnant women: high seroprevalence and risk factors in Kinshasa, Democratic Republic of Congo.

OBJECTIVE: To determine the seroprevalence of toxoplasmosis in pregnant women, as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo. METHODS: Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate. They were interviewed with a structured questionnaire about known risk factors (age, meat consumption, contact with soil, and presence of cat) and a venous blood sample was taken. Sera were analysed for total immunoglobulins (Ig) by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay. IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity. RESULTS: A total of 781 women were included. Median age was 28 years old (IQR: 8.5). And 627 women (80.3%; 95% CI: 77.5-83.1) were found to be positive to total Ig and 17 out of 387 (4.4%; 95% CI: 2.3-6.4) were positive to IgM. IgG avidity was low for 2 (11.8%) women, intermediate for 2 (11.8%) and high for 13 women (76.4%). There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed. CONCLUSION: In Kinshasa, toxoplasmosis endemicity is highly prevalent. One woman out of twenty five had a recent toxoplasmosis infection and 20% were not protected against primo-infection, indicating a need for measures to prevent and control toxoplasmosis during pregnancy.