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1.
PLoS One ; 16(6): e0236971, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34106949

RESUMO

Coronaviruses play an important role as pathogens of humans and animals, and the emergence of epidemics like SARS, MERS and COVID-19 is closely linked to zoonotic transmission events primarily from wild animals. Bats have been found to be an important source of coronaviruses with some of them having the potential to infect humans, with other animals serving as intermediate or alternate hosts or reservoirs. Host diversity may be an important contributor to viral diversity and thus the potential for zoonotic events. To date, limited research has been done in Africa on this topic, in particular in the Congo Basin despite frequent contact between humans and wildlife in this region. We sampled and, using consensus coronavirus PCR-primers, tested 3,561 wild animals for coronavirus RNA. The focus was on bats (38%), rodents (38%), and primates (23%) that posed an elevated risk for contact with people, and we found coronavirus RNA in 121 animals, of which all but two were bats. Depending on the taxonomic family, bats were significantly more likely to be coronavirus RNA-positive when sampled either in the wet (Pteropodidae and Rhinolophidae) or dry season (Hipposideridae, Miniopteridae, Molossidae, and Vespertilionidae). The detected RNA sequences correspond to 15 alpha- and 6 betacoronaviruses, with some of them being very similar (>95% nucleotide identities) to known coronaviruses and others being more unique and potentially representing novel viruses. In seven of the bats, we detected RNA most closely related to sequences of the human common cold coronaviruses 229E or NL63 (>80% nucleotide identities). The findings highlight the potential for coronavirus spillover, especially in regions with a high diversity of bats and close human contact, and reinforces the need for ongoing surveillance.


Assuntos
Animais Selvagens/virologia , Quirópteros/virologia , Infecções por Coronavirus/veterinária , Coronavirus/isolamento & purificação , Roedores/virologia , Animais , Animais Selvagens/genética , Quirópteros/genética , Congo/epidemiologia , Coronavirus/genética , Infecções por Coronavirus/enzimologia , Infecções por Coronavirus/patologia , Infecções por Coronavirus/virologia , República Democrática do Congo/epidemiologia , Monitoramento Ambiental/métodos , Filogenia , RNA Viral/genética , Roedores/genética
2.
PLoS Negl Trop Dis ; 15(5): e0009318, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33956817

RESUMO

The Republic of Congo (RoC) is one of the African countries with the most histoplasmosis cases reported. This review summarizes the current status regarding epidemiology, diagnostic tools, and treatment of histoplasmosis in the RoC. A computerized search was performed from online databases Medline, PubMed, HINARI, and Google Scholar to collect literature on histoplasmosis in the RoC. We found 57 cases of histoplasmosis diagnosed between 1954 and 2019, corresponding to an incidence rate of 1-3 cases each year without significant impact of the AIDS epidemic in the country. Of the 57 cases, 54 (94.7%) were cases of Histoplasma capsulatum var. duboisii (Hcd) infection, African histoplasmosis. Three cases (5.3%) of Histoplasma capsulatum var. capsulatum infection were recorded, but all were acquired outside in the RoC. The patients' ages ranged between 13 months to 60 years. An equal number of cases were observed in adults in the third or fourth decades (n = 14; 24.6%) and in children aged ≤15 years. Skin lesions (46.3%), lymph nodes (37%), and bone lesions (26%) were the most frequent clinical presentations. Most diagnoses were based on histopathology and distinctive large yeast forms seen in tissue. Amphotericin B (AmB) was first line therapy in 65% of the cases and itraconazole (25%) for maintenance therapy. The occurrence of African histoplasmosis in apparently normal children raises the possibility that African histoplasmosis is linked to environmental fungal exposure.


Assuntos
Osso e Ossos/microbiologia , Histoplasma/isolamento & purificação , Histoplasmose/tratamento farmacológico , Histoplasmose/epidemiologia , Linfonodos/microbiologia , Pele/microbiologia , Adolescente , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Osso e Ossos/patologia , Criança , Pré-Escolar , Congo/epidemiologia , Exposição Ambiental/efeitos adversos , Feminino , Histoplasma/classificação , Histoplasma/efeitos dos fármacos , Histoplasmose/diagnóstico , Humanos , Lactente , Itraconazol/uso terapêutico , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Pele/patologia , Adulto Jovem
3.
BMC Health Serv Res ; 21(1): 294, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33794895

RESUMO

BACKGROUND: Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. While reference sickle cell centers have been implemented in capital cities of African countries and have proven to be beneficial for SCD patients. In the Democratic Republic of Congo, they have never been set up in remote areas for families with low or very low sources of income. METHOD: A cohort of 143 children with SCD aged 10 years old (IQR (interquartile range): 6-15 years) (sex ratio male/female = 1.3) were clinically followed for 12 months without any specific intervention aside from the management of acute events, and then for 12 months with a monthly medical visit, biological follow-up, and chemoprophylaxis (folic acid/penicillin), adequate fluids and malaria prevention. RESULTS: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1-5). The implementation of standardized and regular follow-ups in a new sickle cell reference center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease in the lymphocyte count and spleen size (p < 0.001). A significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. CONCLUSIONS: The creation of a sickle cell reference center and the regular follow-up of children with sickle cell disease are possible and applicable in the context of a remote city of an African country and represent simple and accessible measures that can reduce the morbimortality of children with sickle cell disease.


Assuntos
Anemia Falciforme , África , Anemia Falciforme/epidemiologia , Anemia Falciforme/terapia , Transfusão de Sangue , Criança , Pré-Escolar , Congo/epidemiologia , Feminino , Hospitalização , Humanos , Lactente , Masculino
4.
Nat Med ; 27(4): 710-716, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33846610

RESUMO

On 1 August 2018, the Democratic Republic of the Congo (DRC) declared its tenth Ebola virus disease (EVD) outbreak. To aid the epidemiologic response, the Institut National de Recherche Biomédicale (INRB) implemented an end-to-end genomic surveillance system, including sequencing, bioinformatic analysis and dissemination of genomic epidemiologic results to frontline public health workers. We report 744 new genomes sampled between 27 July 2018 and 27 April 2020 generated by this surveillance effort. Together with previously available sequence data (n = 48 genomes), these data represent almost 24% of all laboratory-confirmed Ebola virus (EBOV) infections in DRC in the period analyzed. We inferred spatiotemporal transmission dynamics from the genomic data as new sequences were generated, and disseminated the results to support epidemiologic response efforts. Here we provide an overview of how this genomic surveillance system functioned, present a full phylodynamic analysis of 792 Ebola genomes from the Nord Kivu outbreak and discuss how the genomic surveillance data informed response efforts and public health decision making.


Assuntos
Surtos de Doenças , Ebolavirus/genética , Genômica , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/genética , Análise de Sequência de DNA , Congo/epidemiologia , Vacinas contra Ebola/imunologia , Genoma Viral , Doença pelo Vírus Ebola/transmissão , Doença pelo Vírus Ebola/virologia , Filogenia , Recidiva , Reinfecção/virologia , Análise Espaço-Temporal
5.
Ann Agric Environ Med ; 28(1): 127-130, 2021 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-33775078

RESUMO

INTRODUCTION: Pygmy tribes inhabit tropical environment of Central Africa. After expulsion from their original habitat by the Bantu people, they settled in a local forest ecosystem where they live with very low sanitary standards. Their actual morbidity remains unknown. OBJECTIVE: The aim of the study was to analyze the prevalence of intestinal parasitic infections in BaAka Pygmies inhabiting the Congo Basin in the Central African Republic. MATERIAL AND METHODS: The study was conducted in 2015, and involved a group of 950 Pygmies living inthe Sangha-Mbaere and Lobaye prefectures. Single stool samples were collected from study participants, fixed in 10% formalin, transported from Africa to Europe, and analyzed by light microscopy using 5 different diagnostic methods (direct smear, decantation with distilled water, Fülleborne's flotation, Kato-Miura thick smear, DiaSyS/PARASYS system sedimentation) at the Military Institute of Medicine in Warsaw, Poland. RESULTS: Microscopic examination revealed infections with 14 different species of intestinal nematodes, cestodes, trematodes and protozoa. According to the study findings, 90.5% of BaAka Pygmies were found to be infected with intestinal parasites, and 70.8% had mixed infections. Most of the pathogenic intestinal parasites were nematodes (85.0%), with Asrcaris lumbricoides (29.8%), hookworm (29.4%) and Trichuris trichiura (10.7%) being predominant. CONCLUSIONS: Poor sanitation, limited the high prevalence of intestinal parasitic infections in the community of Pygmies. The negative test results may prove the effectiveness of periodic deworming campaigns chich, implemented by non-governmental organizations, are voluntary with respect to the informed consent principle.


Assuntos
Enteropatias Parasitárias/epidemiologia , Parasitos/isolamento & purificação , Adolescente , Animais , República Centro-Africana/epidemiologia , República Centro-Africana/etnologia , Criança , Pré-Escolar , Congo/epidemiologia , Congo/etnologia , Ecossistema , Feminino , Humanos , Enteropatias Parasitárias/economia , Enteropatias Parasitárias/parasitologia , Masculino , Parasitos/classificação , Parasitos/genética , Pobreza , Prevalência , População Rural/estatística & dados numéricos , Adulto Jovem
6.
J Gerontol A Biol Sci Med Sci ; 76(5): 842-850, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-33438029

RESUMO

BACKGROUND: Visual impairment (VI) and determinants of poor cardiovascular health are very common in Sub-Saharan Africa. However, we do not know whether these determinants are associated with VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo. METHODS: Participants were Congolese adults aged 65 or older included in Epidemiology of Dementia in Central Africa-Follow-up population-based cohort. Near VI was defined as visual acuity less than 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at first follow-up were investigated using multivariable logistic regression models. RESULTS: Among the 549 participants included, 378 (68.8%; 95% confidence interval [CI]: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high body mass index of at least 25 kg/m2 (odds ratio [OR] = 2.15; 95% CI: 1.25-3.68), diabetes (OR = 2.12; 95% CI: 1.06-4.25) and hypertension (OR = 1.65; 95% CI: 1.02-2.64) were independently associated with near VI. CONCLUSIONS: Several determinants of poor cardiovascular health were associated with near VI in this population. This study suggests that promoting good cardiovascular health could represent a target for VI prevention among older adults.


Assuntos
Doenças Cardiovasculares/epidemiologia , Pessoas com Deficiência Visual , Idoso , Índice de Massa Corporal , Estudos de Coortes , Congo/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Masculino
7.
J Pediatr ; 228: 110-116.e1, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32918918

RESUMO

OBJECTIVE: To identify exposure pathways to fecal pathogens that are significant contributors to diarrheal diseases and impaired growth in young children, and to evaluate scalable interventions to reduce fecal contamination from these pathways. STUDY DESIGN: Reducing Enteropathy, Undernutrition, and Contamination in the Environment (REDUCE) was a prospective cohort study of 370 children <5 years of age was conducted in Walungu Territory, South Kivu, Democratic Republic of the Congo. Child mouthing behaviors were assessed through caregiver reports and 5-hour structured observations. Caregiver reports of child contact with animals and child diarrhea were also obtained. Anthropometric measurements were collected at baseline and at a 6-month follow-up. RESULTS: Children observed putting soil in their mouth during structured observation at baseline had a significantly higher odds of diarrhea at the 6-month follow-up (OR, 1.79; 95% CI, 1.04 to 3.07). Children observed mouthing feces during structured observation had a significant reduction in height-for-age z-score (HAZ) from baseline to the 6-month follow-up (ΔHAZ, -0.69; 95% CI, -1.34 to -0.04). A significant reduction in HAZ was also observed for children with caregiver reports of touching guinea pigs (-0.33; 95% CI, -0.58 to -0.08) and rabbits (-0.34; 95% CI, -0.64 to -0.04) and children with feces in their sleeping space during unannounced spot checks (-0.41; 95% CI, -0.74 to -0.09). CONCLUSIONS: These findings emphasize the urgent need for infant water, sanitation, and hygiene interventions targeting child mouthing behaviors, fecal contamination in child living spaces, and child contact with domestic animals to reduce exposure to fecal pathogens among susceptible populations.


Assuntos
Comportamento Infantil , Diarreia/epidemiologia , Fômites/microbiologia , Higiene , Desnutrição/epidemiologia , Animais , Pré-Escolar , Congo/epidemiologia , Diarreia/etiologia , Diarreia/prevenção & controle , Exposição Ambiental/efeitos adversos , Fezes , Feminino , Seguimentos , Cobaias , Humanos , Lactente , Recém-Nascido , Intestinos/microbiologia , Masculino , Boca , Estudos Prospectivos , Coelhos
9.
J Psychiatr Res ; 132: 13-17, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33035760

RESUMO

OBJECTIVE: Studies have documented the significant direct and indirect psychological, social, and economic consequences of the Coronavirus disease 2019 (COVID-19) in many countries but little is known on its impact in low- and middle-income countries (LMICs) already facing difficult living conditions and having vulnerable health systems that create anxiety among the affected populations. Using a multinational convenience sample from four LMICs (DR Congo, Haiti, Rwanda, and Togo), this study aims to explore the prevalence of anxiety symptoms and associated risk and protective factors during the COVID-19 pandemic. METHODS: A total of 1267 individuals (40.8% of women) completed a questionnaire assessing exposure and stigmatization related to COVID-19, anxiety, and resilience. Analyses were performed to examine the prevalence and predictors of anxiety. RESULTS: Findings showed a pooled prevalence of 24.3% (9.4%, 29.2%, 28.5%, and 16.5% respectively for Togo, Haiti, RDC, and Rwanda, x2 = 32.6, p < .0001). For the pooled data, exposure to COVID-19 (ß = 0.06, p = .005), stigmatization related to COVID-19 (ß = 0.03, p < .001), and resilience (ß = -0.06, p < .001) contributed to the prediction of anxiety scores. Stigmatization related to COVID-19 was significantly associated to anxiety symptoms in all countries (ß = 0.02, p < .00; ß = 0.05, p = .013; ß = 0.03, p = .021; ß = 0.04, p < .001, respectively for the RDC, Rwanda, Haiti, and Togo). CONCLUSIONS: The findings highlight the need for health education programs in LMICs to decrease stigmatization and the related fears and anxieties, and increase observance of health instructions. Strength-based mental health programs based on cultural and contextual factors need to be developed to reinforce both individual and community resilience and to address the complexities of local eco-systems.


Assuntos
Ansiedade/epidemiologia , COVID-19/epidemiologia , Países em Desenvolvimento/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Resiliência Psicológica , Estigma Social , Adulto , Ansiedade/etiologia , Congo/epidemiologia , Feminino , Haiti/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Proteção , Fatores de Risco , Ruanda/epidemiologia , Togo/epidemiologia
10.
Int J Infect Dis ; 106: 3-7, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33370565

RESUMO

INTRODUCTION: The Republic of the Congo detected its first case of coronavirus disease 2019 (COVID-19) on March 14, 2020, and within several weeks, the country had introduced protective measures that were still in force in July 2020. Over the course of time, the progression in the number of clinical cases has appeared to be lower than expected, although reverse transcription polymerase chain reaction (RT-PCR) testing has been somewhat limited. In order to evaluate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within the Congolese population, a seroprevalence study was conducted on healthy individuals from different districts of Brazzaville who were willing to know their COVID-19 infection status. METHODS: Oropharyngeal swab and blood samples were collected from 754 healthy volunteers between April 2020 and July 2020. The samples were analyzed for SARS-CoV-2 using a qualitative RT-PCR assay, and Immunoglobulin G (IgG) and Immunoglobulin M (IgM) antibodies were detected using two different rapid tests. RESULTS: A total of 56 participants (7.4%) tested positive for SARS-CoV-2. The remaining 698 participants (92.6%) had negative RT-PCR results; of these, 117 were found to have anti-SARS-CoV-2 antibodies using serological tests. For these RT-PCR-negative subjects, the seroprevalence of IgG and IgM was found to increase over time: from 1.7% and 2.5% in April, up to 14.2% and 17.6% in July, respectively. In April 2020, 5% of the women were found to have IgG or IgM antibodies, whereas the antibodies were not detected in any of the men. The seroprevalence in RT-PCR negative subjects was significantly higher in women within IgG (P = 0.012) and IgM (P = 0.045) over the first three months. CONCLUSION: The proportion of the population who seroconvert over the course of the first wave is an important data to predict the risk of future COVID-19 waves and this will facilitate the efficient use of limited resources in a low income country like the Republic of the Congo.


Assuntos
Doenças Assintomáticas , COVID-19/epidemiologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , SARS-CoV-2/imunologia , Adulto , COVID-19/sangue , Teste Sorológico para COVID-19 , Congo/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Soroepidemiológicos
11.
Rev. esp. anestesiol. reanim ; 67(10): 556-558, dic. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-195348

RESUMO

La mayoría de la bibliografía mundial sobre la pandemia Covid-19 se ha focalizado en los países del continente asiático, europeo o americano. En África parece que la incidencia es menor. En este artículo se hipotetiza sobre alguna de las posibles causas que han dado lugar a estas diferencias. La pirámide poblacional, la temperatura ambiente, la vulnerabilidad/resistencia de los habitantes del continente o factores sociopolíticos son subrayados. En caso de que la pandemia se extendiera en el continente africano, posiblemente la falta de recursos sanitarios haría que las consecuencias fueran desastrosas y de una magnitud dantesca


Most of the international bibliography published on Covid-19 pandemics is focused in the Asian, European or American continents. It seems that incidence is lower in Africa. In this article we hypothetize on several of the possible causes sustaining these differences. Population pyramid, climate, african population own vulnerability/resistance or sociopolitical factors are underlined. In the case the pandemics will spread in Africa, the lack of basic healthcare resources will perhaps make the consequences disastrous and of a dantesque magnitude


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Congo/epidemiologia , África/epidemiologia , Fatores Etários , Incidência , Temperatura
12.
JAMA Netw Open ; 3(11): e2026750, 2020 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-33206194

RESUMO

Importance: The overwhelming majority of fetal and neonatal deaths occur in low- and middle-income countries. Fetal and neonatal risk assessment tools may be useful to predict the risk of death. Objective: To develop risk prediction models for intrapartum stillbirth and neonatal death. Design, Setting, and Participants: This cohort study used data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Global Network for Women's and Children's Health Research population-based vital registry, including clinical sites in South Asia (India and Pakistan), Africa (Democratic Republic of Congo, Zambia, and Kenya), and Latin America (Guatemala). A total of 502 648 pregnancies were prospectively enrolled in the registry. Exposures: Risk factors were added sequentially into the data set in 4 scenarios: (1) prenatal, (2) predelivery, (3) delivery and day 1, and (4) postdelivery through day 2. Main Outcomes and Measures: Data sets were randomly divided into 10 groups of 3 analysis data sets including training (60%), test (20%), and validation (20%). Conventional and advanced machine learning modeling techniques were applied to assess predictive abilities using area under the curve (AUC) for intrapartum stillbirth and neonatal mortality. Results: All prenatal and predelivery models had predictive accuracy for both intrapartum stillbirth and neonatal mortality with AUC values 0.71 or less. Five of 6 models for neonatal mortality based on delivery/day 1 and postdelivery/day 2 had increased predictive accuracy with AUC values greater than 0.80. Birth weight was the most important predictor for neonatal death in both postdelivery scenarios with independent predictive ability with AUC values of 0.78 and 0.76, respectively. The addition of 4 other top predictors increased AUC to 0.83 and 0.87 for the postdelivery scenarios, respectively. Conclusions and Relevance: Models based on prenatal or predelivery data had predictive accuracy for intrapartum stillbirths and neonatal mortality of AUC values 0.71 or less. Models that incorporated delivery data had good predictive accuracy for risk of neonatal mortality. Birth weight was the most important predictor for neonatal mortality.


Assuntos
Recursos em Saúde/tendências , Morte Perinatal/etiologia , Mortalidade Perinatal/tendências , Natimorto/epidemiologia , Adulto , Peso ao Nascer , Estudos de Coortes , Congo/epidemiologia , Feminino , Guatemala/epidemiologia , Humanos , Índia/epidemiologia , Lactente , Mortalidade Infantil , Recém-Nascido , Quênia/epidemiologia , Masculino , Paquistão/epidemiologia , Valor Preditivo dos Testes , Gravidez , Estudos Prospectivos , Fatores de Risco , Zâmbia/epidemiologia
13.
Viruses ; 12(9)2020 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-32933109

RESUMO

The Republic of Congo (RoC) declared a chikungunya (CHIK) outbreak on 9 February 2019. We conducted a ONE-Human-Animal HEALTH epidemiological, virological and entomological investigation. Methods: We collected national surveillance and epidemiological data. CHIK diagnosis was based on RT-PCR and CHIKV-specific antibodies. Full CHIKV genome sequences were obtained by Sanger and MinION approaches and Bayesian tree phylogenetic analysis was performed. Mosquito larvae and 215 adult mosquitoes were collected in different villages of Kouilou and Pointe-Noire districts and estimates of Aedes (Ae.) mosquitos' CHIKV-infectious bites obtained. We found two new CHIKV sequences of the East/Central/South African (ECSA) lineage, clustering with the recent enzootic sub-clade 2, showing the A226V mutation. The RoC 2019 CHIKV strain has two novel mutations, E2-T126M and E2-H351N. Phylogenetic suggests a common origin from 2016 Angola strain, from which it diverged around 1989 (95% HPD 1985-1994). The infectious bite pattern was similar for 2017, 2018 and early 2019. One Ae. albopictus pool was RT-PCR positive. The 2019 RoC CHIKV strain seems to be recently introduced or be endemic in sylvatic cycle. Distinct from the contemporary Indian CHIKV isolates and in contrast to the original Central-African strains (transmitted by Ae. aegypti), it carries the A226V mutation, indicating an independent adaptive mutation in response to vector replacement (Ae. albopictus vs Ae. aegypti).


Assuntos
Febre de Chikungunya/epidemiologia , Febre de Chikungunya/virologia , Vírus Chikungunya/classificação , Adolescente , Adulto , Aedes/virologia , Animais , Teorema de Bayes , Vírus Chikungunya/genética , Vírus Chikungunya/fisiologia , Criança , Pré-Escolar , Congo/epidemiologia , Surtos de Doenças , Feminino , Humanos , Larva , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores , Mutação , Filogenia , Adulto Jovem
14.
PLoS Negl Trop Dis ; 14(8): e0008661, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32866145

RESUMO

Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients' houses with chlorine. We conducted mixed-methods evaluations of three household spraying programs in the Democratic Republic of Congo and Haiti, including 18 key informant interviews, 14 household surveys and observations, and 418 surface samples collected before spraying, 30 minutes and 24 hours after spraying. The surfaces consistently most contaminated with Vibrio cholerae were food preparation areas, near the patient's bed and the latrine. Effectiveness varied between programs, with statistically significant reductions in V. cholerae concentrations 30 minutes after spraying in two programs. Surface contamination after 24 hours was variable between households and programs. Program challenges included difficulty locating households, transportation and funding limitations, and reaching households quickly after case presentation (disinfection occurred 2-6 days after reported cholera onset). Program advantages included the concurrent deployment of hygiene promotion activities. Further research is indicated on perception, recontamination, cost-effectiveness, viable but nonculturable V. cholerae, and epidemiological coverage. We recommend that, if spraying is implemented, spraying agents should: disinfect surfaces systematically until wet using 0.2/2.0% chlorine solution, including kitchen spaces, patients' beds, and latrines; arrive at households quickly; and, concurrently deploy hygiene promotion activities.


Assuntos
Cólera/epidemiologia , Cólera/prevenção & controle , Desinfecção/métodos , Características da Família , Cloro , Congo/epidemiologia , Surtos de Doenças/prevenção & controle , Feminino , Haiti/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Inquéritos e Questionários , Toaletes , Vibrio cholerae
15.
Pan Afr Med J ; 36: 143, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32874407

RESUMO

Introduction: clandestine abortions increase maternal morbi-mortality in sub-Saharan Africa and are closely linked to restrictive legislation and low contraceptive prevalence. In Brazzaville street drugs are commonly used to induce abortion. The purpose of this study is to determine street drug prevalence and socio-demographic characteristics of these patients. Methods: we conducted a longitudinal study of 67 patients with induced abortion complications admitted to the Talangaï Hospital from July to December 2018. (i) Socio-demographic (ii) and obstetrical (iii) characteristics as well as abortion features (procedure, Manganguiste involvement, abortion rank and cost) were collected and analyzed using EPI info 7 software. We compared the means using student's test, proportions with CHI-2, p value was set to < 0.05. Results: the average age of patients was 25 years ± 6.6; 59.7% of them were attending college, 53.8% had no income-generating activity, 38.8% lived alone and in 15% of cases biological father had denied paternity. Street drugs had been used in 74.5% of cases, mean abortion cost was 3500 CFA (US$7) and 29500CFA (US$59) when it had been performed by health-care professionals. High school respondents were more likely (73.69%) to know at least contraceptive methods (p<0.05). Greater numbers of singles (p=0.000) and of those who knew a contraceptive method (p=0.003) expressed the intention to use contraception. Conclusion: combatting the use of street drugs and securing the right to safe voluntary abortion are necessary to limit complications due to clandestine abortions.


Assuntos
Aborto Criminoso/efeitos adversos , Aborto Criminoso/estatística & dados numéricos , Aborto Induzido/efeitos adversos , Aborto Induzido/estatística & dados numéricos , Drogas Ilícitas , Aborto Criminoso/mortalidade , Aborto Induzido/mortalidade , Adolescente , Adulto , Congo/epidemiologia , Escolaridade , Feminino , Humanos , Drogas Ilícitas/provisão & distribuição , Estudos Longitudinais , Mortalidade Materna , Morbidade , Paridade , Gravidez , Prevalência , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
16.
Medicine (Baltimore) ; 99(35): e21606, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871876

RESUMO

The increasing availability of antiretroviral therapy (ART) worldwide is yet to result in decreasing HIV-related mortality among adolescents (10-19 years old) living with HIV (ALHIV) in part because of poor adherence. the poor adherence might itself be due to high level of depression. We assess the prevalence of depressive symptomatology and it's associated with adherence among ALHIV receiving ART care in Brazzaville and Pointe Noire, Republic of Congo (RoC).Adolescents aged 10 to 19 years, on antiretroviral therapy (ART), followed in the two Ambulatory Treatment Centers (ATC) in Brazzaville and Pointe Noire, RoC were included in this cross-sectional study. From April 19 to July 9, 2018, participants were administered face to face interviews using a standardized questionnaire that included the nine-item Patient Health Questionnaire (PHQ-9). Participants who reported failing to take their ART more than twice in the 7 days preceding the interview were classified as non-adherent. Bivariate and multivariable log-binomial models were used to estimate the prevalence ratio (PR) and 95% confidence interval (95%CI) assessing the strength of association between predictors and presence of depressive symptoms (PHQ-9 score ≥9).Overall, 135 adolescents represented 50% of ALHIV in active care at the 2 clinics were interviewed. Of those, 67 (50%) were male, 81 (60%) were 15 to 19 years old, 124 (95%) had been perinatally infected, and 71 (53%) knew their HIV status. Depressive symptoms were present in 52 (39%) participants and 78 (58%) were adherent. In univariate analyses, the prevalence of depressive symptoms was relative higher among participants who were not adherent compared to those who were (73% vs 33%; PR: 2.20 [95%CI: 1.42-3.41]). In multivariate analysis, after adjustment for report of been sexually active, alcohol drinking, age category (10-14 and 15-19), not in school, loss of both parents, the association between depression and adherence was strengthened (PR: 2.06 [95%CI: 1.23-3.45]).The prevalence of depressive symptoms in adolescents living with HIV is high and was strongly associated with poor adherence even after adjustment of potential confounders. Efforts to scale-up access to screening and management of depression among ALHIV in sub-Saharan is needed for them to realize the full of ART.


Assuntos
Antirretrovirais/uso terapêutico , Depressão/epidemiologia , Infecções por HIV/psicologia , Adesão à Medicação/psicologia , Adolescente , Instituições de Assistência Ambulatorial , Estudos de Casos e Controles , Criança , Congo/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/psicologia , Adesão à Medicação/estatística & dados numéricos , Assistência Perinatal/estatística & dados numéricos , Assistência Perinatal/tendências , Prevalência , Inquéritos e Questionários , Adulto Jovem
17.
Eur Rev Med Pharmacol Sci ; 24(15): 8226-8231, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767354

RESUMO

OBJECTIVE: To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared. MATERIALS AND METHODS: Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVID-John Hopkins University website. Lethality of countries located within the 5th parallels North/South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate. RESULTS: A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01-0.51). This result does not seem to be totally related to the differences in age distribution of different sites. CONCLUSIONS: The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.


Assuntos
Clima , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Estações do Ano , Tempo (Meteorologia) , Betacoronavirus , Brunei/epidemiologia , Burundi/epidemiologia , COVID-19 , Congo/epidemiologia , Infecções por Coronavirus/epidemiologia , Equador/epidemiologia , Guiné Equatorial/epidemiologia , Europa (Continente) , França/epidemiologia , Gabão/epidemiologia , Humanos , Ilhas do Oceano Índico/epidemiologia , Indonésia/epidemiologia , Quênia/epidemiologia , Malásia/epidemiologia , Melanesia/epidemiologia , Micronésia/epidemiologia , Países Baixos/epidemiologia , Pandemias , Papua Nova Guiné/epidemiologia , Pneumonia Viral/epidemiologia , Ruanda/epidemiologia , SARS-CoV-2 , Samoa/epidemiologia , São Tomé e Príncipe/epidemiologia , Seicheles/epidemiologia , Singapura/epidemiologia , Somália/epidemiologia , Timor-Leste/epidemiologia , Clima Tropical , Uganda/epidemiologia , Reino Unido/epidemiologia
18.
Viruses ; 12(6)2020 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-32570742

RESUMO

Non-human primates (NHPs) are known hosts for adenoviruses (AdVs), so there is the possibility of the zoonotic or cross-species transmission of AdVs. As with humans, AdV infections in animals can cause diseases that range from asymptomatic to fatal. The aim of this study was to investigate the occurrence and diversity of AdVs in: (i) fecal samples of apes and monkeys from different African countries (Republic of Congo, Senegal, Djibouti and Algeria), (ii) stool of humans living near gorillas in the Republic of Congo, in order to explore the potential zoonotic risks. Samples were screened by real-time and standard PCRs, followed by the sequencing of the partial DNA polymerase gene in order to identify the AdV species. The prevalence was 3.3 folds higher in NHPs than in humans. More than 1/3 (35.8%) of the NHPs and 1/10 (10.5%) of the humans excreted AdVs in their feces. The positive rate was high in great apes (46%), with a maximum of 54.2% in chimpanzees (Pan troglodytes) and 35.9% in gorillas (Gorilla gorilla), followed by monkeys (25.6%), with 27.5% in Barbary macaques (Macaca sylvanus) and 23.1% in baboons (seven Papio papio and six Papio hamadryas). No green monkeys (Chlorocebus sabaeus) were found to be positive for AdVs. The AdVs detected in NHPs were members of Human mastadenovirus E (HAdV-E), HAdV-C or HAdV-B, and those in the humans belonged to HAdV-C or HAdV-D. HAdV-C members were detected in both gorillas and humans, with evidence of zoonotic transmission since phylogenetic analysis revealed that gorilla AdVs belonging to HAdV-C were genetically identical to strains detected in humans who had been living around gorillas, and, inversely, a HAdV-C member HAdV type was detected in gorillas. This confirms the gorilla-to-human transmission of adenovirus. which has been reported previously. In addition, HAdV-E members, the most often detected here, are widely distributed among NHP species regardless of their origin, i.e., HAdV-E members seem to lack host specificity. Virus isolation was successful from a human sample and the strain of the Mbo024 genome, of 35 kb, that was identified as belonging to HAdV-D, exhibited close identity to HAdV-D members for all genes. This study provides information on the AdVs that infect African NHPs and the human populations living nearby, with an evident zoonotic transmission. It is likely that AdVs crossed the species barrier between different NHP species (especially HAdV-E members), between NHPs and humans (especially HAdV-C), but also between humans, NHPs and other animal species.


Assuntos
Infecções por Adenoviridae/epidemiologia , Infecções por Adenoviridae/veterinária , Mastadenovirus/classificação , Mastadenovirus/isolamento & purificação , Infecções por Adenoviridae/transmissão , Argélia/epidemiologia , Animais , Chlorocebus aethiops/virologia , Congo/epidemiologia , DNA Viral/genética , DNA Polimerase Dirigida por DNA/genética , Djibuti/epidemiologia , Fezes/virologia , Gorilla gorilla/virologia , Humanos , Macaca/virologia , Mastadenovirus/genética , Pan troglodytes/virologia , Papio hamadryas/virologia , Papio papio/virologia , Senegal/epidemiologia , Zoonoses Virais/epidemiologia , Zoonoses Virais/transmissão
19.
PLoS Negl Trop Dis ; 14(4): e0008121, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32240161

RESUMO

BACKGROUND: Non-typhoidal Salmonella (NTS) are a major cause of bloodstream infection (BSI) in sub-Saharan Africa. This study aimed to assess its longitudinal evolution as cause of BSI, its serotype distribution and its antibiotic resistance pattern in Kisantu, DR Congo. METHODS: As part of a national surveillance network, blood cultures were sampled in patients with suspected BSI admitted to Kisantu referral hospital from 2015-2017. Blood cultures were worked-up according to international standards. Results were compared to similar data from 2007 onwards. RESULTS: In 2015-2017, NTS (n = 896) represented the primary cause of BSI. NTS were isolated from 7.6% of 11,764 suspected and 65.4% of 1371 confirmed BSI. In children <5 years, NTS accounted for 9.6% of suspected BSI. These data were in line with data from previous surveillance periods, except for the proportion of confirmed BSI, which was lower in previous surveillance periods. Salmonella Typhimurium accounted for 63.1% of NTS BSI and Salmonella Enteritidis for 36.4%. Of all Salmonella Typhimurium, 36.9% did not express the O5-antigen (i.e. variant Copenhagen). O5-negative Salmonella Typhimurium were rare before 2013, but increased gradually from then onwards. Multidrug resistance was observed in 87.4% of 864 NTS isolates, decreased ciprofloxacin susceptibility in 7.3%, ceftriaxone resistance in 15.7% and azithromycin resistance in 14.9%. A total of 14.2% of NTS isolates, that were all Salmonella Typhimurium, were multidrug resistant and ceftriaxone and azithromycin co-resistant. These Salmonella isolates were called extensively drug resistant. Compared to previous surveillance periods, proportions of NTS isolates with resistance to ceftriaxone and azithromycin and decreased ciprofloxacin susceptibility increased. CONCLUSION: As in previous surveillance periods, NTS ranked first as the cause of BSI in children. The emergence of O5-negative Salmonella Typhimurium needs to be considered in the light of vaccine development. The high proportions of antibiotic resistance are worrisome.


Assuntos
Antibacterianos/farmacologia , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/microbiologia , Salmonella typhimurium/efeitos dos fármacos , Salmonella typhimurium/isolamento & purificação , Adolescente , Adulto , Azitromicina , Ceftriaxona , Criança , Pré-Escolar , Ciprofloxacina , Congo/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Salmonella/efeitos dos fármacos , Infecções por Salmonella/diagnóstico , Salmonella enteritidis/efeitos dos fármacos , Sorogrupo , Febre Tifoide/tratamento farmacológico , Adulto Jovem
20.
Mycoses ; 63(6): 543-552, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32181941

RESUMO

BACKGROUND: The Republic of Congo (RoC) is characterised by a high prevalence of tuberculosis and HIV/AIDS, which largely drive the epidemiology of serious fungal infections. OBJECTIVE: We aimed to estimate the current burden of serious fungal infections in RoC. MATERIAL AND METHODS: Using local, regional or global data and estimates of population and at-risk population groups, deterministic modelling was employed to estimate national incidence or prevalence of the most serious fungal infections. RESULTS: Our study revealed that about 5.4% of the Congolese population (283 450) suffer from serious fungal infections yearly. The incidence of cryptococcal meningitis, Pneumocystis jirovecii pneumonia and disseminated histoplasmosis in AIDS patients was estimated at 560, 830 and 120 cases per year. Oral and oesophageal candidiasis collectively affects 12 320 HIV-infected patients. Chronic pulmonary aspergillosis, 67% post-tuberculosis, probably has a prevalence of 3420. Fungal asthma (allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitisation) probably has a prevalence of 3640 and 4800, although some overlap due to disease definition is likely. The estimated prevalence of recurrent vulvovaginal candidiasis and tinea capitis is 85 440 and 178 400 respectively. Mostly related to agricultural activity, fungal keratitis affects an estimated 700 Congolese yearly. CONCLUSION: These data underline the urgent need for an intensified awareness towards Congolese physicians to fungal infections and for increased efforts to improve diagnosis and management of fungal infections in the RoC.


Assuntos
Micoses/epidemiologia , Micoses/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/complicações , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Doença Crônica/epidemiologia , Congo/epidemiologia , Efeitos Psicossociais da Doença , Humanos , Incidência , Prevalência , Tuberculose/complicações , Tuberculose/epidemiologia
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