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1.
MMWR Morb Mortal Wkly Rep ; 69(1): 10-13, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31917781

RESUMO

Tailoring communicable disease preparedness and response strategies to unique population movement patterns between an outbreak area and neighboring countries can help limit the international spread of disease. Global recognition of the value of addressing community connectivity in preparedness and response, through field work and visualizing the identified movement patterns, is reflected in the World Health Organization's declaration on July 17, 2019, that the 10th Ebola virus disease (Ebola) outbreak in the Democratic Republic of the Congo (DRC) was a Public Health Emergency of International Concern (1). In March 2019, the Infectious Diseases Institute (IDI), Uganda, in collaboration with the Ministry of Health (MOH) Uganda and CDC, had previously identified areas at increased risk for Ebola importation by facilitating community engagement with participatory mapping to characterize cross-border population connectivity patterns. Multisectoral participants identified 31 locations and associated movement pathways with high levels of connectivity to the Ebola outbreak areas. They described a major shift in the movement pattern between Goma (DRC) and Kisoro (Uganda), mainly through Rwanda, when Rwanda closed the Cyanika ground crossing with Uganda. This closure led some travelers to use a potentially less secure route within DRC. District and national leadership used these results to bolster preparedness at identified points of entry and health care facilities and prioritized locations at high risk further into Uganda, especially markets and transportation hubs, for enhanced preparedness. Strategies to forecast, identify, and rapidly respond to the international spread of disease require adapting to complex, dynamic, multisectoral cross-border population movement, which can be influenced by border control and public health measures of neighboring countries.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Migração Humana/estatística & dados numéricos , Participação da Comunidade , República Democrática do Congo/epidemiologia , Surtos de Doenças/prevenção & controle , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Ruanda/epidemiologia , Uganda/epidemiologia
2.
MMWR Morb Mortal Wkly Rep ; 69(1): 14-19, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31917783

RESUMO

On August 1, 2018, the Democratic Republic of the Congo (DRC) declared its 10th Ebola virus disease (Ebola) outbreak in an area with a high volume of cross-border population movement to and from neighboring countries. The World Health Organization (WHO) designated Rwanda, South Sudan, and Uganda as the highest priority countries for Ebola preparedness because of the high risk for cross-border spread from DRC (1). Countries might base their disease case definitions on global standards; however, historical context and perceived risk often affect why countries modify and adapt definitions over time, moving toward or away from regional harmonization. Discordance in case definitions among countries might reduce the effectiveness of cross-border initiatives during outbreaks with high risk for regional spread. CDC worked with the ministries of health (MOHs) in DRC, Rwanda, South Sudan, and Uganda to collect MOH-approved Ebola case definitions used during the first 6 months of the outbreak to assess concordance (i.e., commonality in category case definitions) among countries. Changes in MOH-approved Ebola case definitions were analyzed, referencing the WHO standard case definition, and concordance among the four countries for Ebola case categories (i.e., community alert, suspected, probable, confirmed, and case contact) was assessed at three dates (2). The number of country-level revisions ranged from two to four, with all countries revising Ebola definitions by February 2019 after a December 2018 peak in incidence in DRC. Case definition complexity increased over time; all countries included more criteria per category than the WHO standard definition did, except for the "case contact" and "confirmed" categories. Low case definition concordance and lack of awareness of regional differences by national-level health officials could reduce effectiveness of cross-border communication and collaboration. Working toward regional harmonization or considering systematic approaches to addressing country-level differences might increase efficiency in cross-border information sharing.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola/diagnóstico , Doença pelo Vírus Ebola/epidemiologia , Vigilância em Saúde Pública/métodos , República Democrática do Congo/epidemiologia , Humanos , Ruanda/epidemiologia , Sudão do Sul/epidemiologia , Fatores de Tempo , Uganda/epidemiologia
4.
J Sci Food Agric ; 100(2): 634-647, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31591722

RESUMO

BACKGROUND: Vitamin A deficiency (VAD) is widespread in sub-Saharan Africa (SSA). Unlike in developed countries, where the main source of vitamin A comes from meat, the diet of poor populations in SSA is largely plant based. It is thus important to identify local / popular plants with higher vitamin A content for combating VAD. Banana (including plantains) is an important staple food crop in this region. The identification and promotion of vitamin A-rich banana cultivars could contribute significantly to the alleviation of VAD in areas heavily dependent on the crop. We assessed pro-vitamin A carotenoid (pVACs) content in the fruit pulp of 48 local plantains from eastern Democratic Republic of Congo, to identify cultivars that could help reduce VAD, especially among young children and women of reproductive age. RESULTS: Mean pVACs content varied from 175-1756 µg/100 gfw in ripe fruits. Significant increases (P < 0.001) in total pVACs content occurred after ripening in all cultivars except 'UCG II'. Retinol activity equivalents (RAE) in ripe fruits ranged from 12-113 µg/100 gfw. Fifteen plantain cultivars, including 'Adili II', 'Nzirabahima', 'Mayayi', 'Buembe', and 'Sanza Tatu' (associated with RAE values of 44 µg/100 gfw and above) can be considered as good sources of pVACs. Modest consumption (250 or 500 gfw) of the fruit pulp of the five best plantain cultivars at ripening stage 5 meets between 39-71% and 44-81% of vitamin A dietary reference intake (DRI) respectively, for children below 5 years old and women of reproductive age. CONCLUSION: The 15 best plantain cultivars (especially the top 5) could potentially be introduced / promoted as alternative sources of pro-vitamin A in banana-dependent communities, and help to reduce cases of VAD substantially. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.


Assuntos
Carotenoides/análise , Musa/química , Vitamina A/análise , Adolescente , Adulto , Carotenoides/metabolismo , Pré-Escolar , República Democrática do Congo , Feminino , Frutas/química , Frutas/metabolismo , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Musa/classificação , Musa/metabolismo , Provitaminas/análise , Vitamina A/metabolismo , Deficiência de Vitamina A/dietoterapia , Deficiência de Vitamina A/metabolismo , Adulto Jovem
5.
MMWR Morb Mortal Wkly Rep ; 68(50): 1162-1165, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31856146

RESUMO

On August 1, 2018, the Democratic Republic of the Congo Ministry of Health (DRC MoH) declared the tenth outbreak of Ebola virus disease (Ebola) in DRC, in the North Kivu province in eastern DRC on the border with Uganda, 8 days after another Ebola outbreak was declared over in northwest Équateur province. During mid- to late-July 2018, a cluster of 26 cases of acute hemorrhagic fever, including 20 deaths, was reported in North Kivu province.* Blood specimens from six patients hospitalized in the Mabalako health zone and sent to the Institut National de Recherche Biomédicale (National Biomedical Research Institute) in Kinshasa tested positive for Ebola virus. Genetic sequencing confirmed that the outbreaks in North Kivu and Équateur provinces were unrelated. From North Kivu province, the outbreak spread north to Ituri province, and south to South Kivu province (1). On July 17, 2019, the World Health Organization designated the North Kivu and Ituri outbreak a public health emergency of international concern, based on the geographic spread of the disease to Goma, the capital of North Kivu province, and to Uganda and the challenges to implementing prevention and control measures specific to this region (2). This report describes the outbreak in the North Kivu and Ituri provinces. As of November 17, 2019, a total of 3,296 Ebola cases and 2,196 (67%) deaths were reported, making this the second largest documented outbreak after the 2014-2016 epidemic in West Africa, which resulted in 28,600 cases and 11,325 deaths.† Since August 2018, DRC MoH has been collaborating with partners, including the World Health Organization, the United Nations Children's Fund, the United Nations Office for the Coordination of Humanitarian Affairs, the International Organization of Migration, The Alliance for International Medical Action (ALIMA), Médecins Sans Frontières, DRC Red Cross National Society, and CDC, to control the outbreak. Enhanced communication and effective community engagement, timing of interventions during periods of relative stability, and intensive training of local residents to manage response activities with periodic supervision by national and international personnel are needed to end the outbreak.


Assuntos
Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , República Democrática do Congo/epidemiologia , Surtos de Doenças/prevenção & controle , Ebolavirus/isolamento & purificação , Feminino , Doença pelo Vírus Ebola/prevenção & controle , Humanos , Laboratórios , Masculino , Prática de Saúde Pública
6.
Zootaxa ; 4630(1): zootaxa.4630.1.1, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31712497

RESUMO

An updated revision of Afrotropical Dryinidae is presented. Nine subfamilies, 23 genera and 430 species (including 60 new species) are treated. Six new species-level synonymies and three new combinations are proposed. Descriptions, geographic distribution, known hosts, natural enemies and type material of each species are presented, together with illustrations of the main morphological characters and keys to the subfamilies, genera and species. A complete list of references concerning the Afrotropical Dryinidae and their hosts is provided. The following new species are described: Anteon ambrense, sp. nov. (Madagascar), Anteon beankanum, sp. nov. (Madagascar), Anteon elongatum, sp. nov. (Madagascar), Anteon hoekense, sp. nov. (South Africa), Anteon mabibiense, sp. nov. (South Africa), Anteon majunganum, sp. nov. (Madagascar), Anteon malagasy, sp. nov. (Madagascar), Anteon musmani, sp. nov. (Kenya), Anteon nigropictum, sp. nov. (South Africa), Anteon nimbense, sp. nov. (Guinea), Anteon pseudohova, sp. nov. (Madagascar), Anteon sakalavense, sp. nov. (Madagascar), Anteon tulearense, sp. nov. (Kenya, Madagascar), Aphelopus sequeirai, sp. nov. (Kenya), Apoaphelopus fisheri, sp. nov. (Madagascar), Apoaphelopus wallacei, sp. nov. (Kenya), Bocchus forestalis, sp. nov. (Madagascar), Bocchus granulatus, sp. nov. (South Africa), Bocchus harinhalai, sp. nov. (Madagascar), Bocchus nigroflavus, sp. nov. (Madagascar), Bocchus parkeri, sp. nov. (Madagascar), Bocchus ruvidus, sp. nov. (Madagascar), Conganteon hawleyi, sp. nov. (Kenya), Conganteon sensitivum, sp. nov. (Madagascar), Crovettia afra, sp. nov. (Kenya, Madagascar), Deinodryinus ambrensis, sp. nov. (Madagascar), Deinodryinus granulatus, sp. nov. (South Africa), Deinodryinus nigropictus, sp. nov. (South Africa), Deinodryinus piceus, sp. nov. (Madagascar), Dryinus bellicosus, sp. nov. (Madagascar), Dryinus dentatiforceps, sp. nov. (South Africa), Dryinus erenianus, sp. nov. (Ivory Coast), Dryinus milleri, sp. nov. (Kenya), Dryinus mobotensis, sp. nov. (Madagascar), Dryinus nigrithorax, sp. nov. (Ivory Coast), Dryinus teres, sp. nov. (Madagascar), Dryinus tulearensis, sp. nov. (Madagascar), Dryinus whittleorum, sp. nov. (Kenya), Gonatopus avontuurensis, sp. nov. (South Africa), Gonatopus bellicosus, sp. nov. (Madagascar), Gonatopus comorensis, sp. nov. (Union of the Comoros), Gonatopus costalis, sp. nov. (South Africa), Gonatopus flavotestaceus, sp. nov. (Madagascar), Gonatopus gumovskyi, sp. nov. (Democratic Republic of the Congo), Gonatopus hantamensis, sp. nov. (South Africa), Gonatopus harinhalai, sp. nov. (Madagascar), Gonatopus karooensis, sp. nov. (South Africa), Gonatopus koebergensis, sp. nov. (South Africa), Gonatopus marojejyanus, sp. nov. (Madagascar), Gonatopus minutus, sp. nov. (Madagascar), Gonatopus nigropictus, sp. nov. (South Africa), Gonatopus ranomafanensis, sp. nov. (Madagascar), Gonatopus robertsoni, sp. nov. (South Africa), Gonatopus rugithorax, sp. nov. (South Africa), Gonatopus scholtzi, sp. nov. (South Africa), Gonatopus wikstrandae, sp. nov. (Kenya), Lonchodryinus madagascolus, sp. nov. (Madagascar), Madecadryinus ranomafanensis, sp. nov. (Madagascar), Neodryinus bimaculatus, sp. nov. (Madagascar), Neodryinus keleboensis, sp. nov. (Democratic Republic of the Congo). The ♀ of Deinodryinus danielssoni Olmi, 1998, is described for the first time. The following new synonymies are presented: Anteon fiorii Olmi, 1984 (=A. proteicolum Olmi, 2006, syn. nov.); Anteon madagascolum (Benoit, 1954) (=Anteon brooksi Olmi, 2003, syn. nov.); Anteon zairense Benoit, 1951 (=A. terminale Olmi, 2007, syn. nov.); Aphelopus incisus Olmi, 1984 (=A. himyarita Olmi van Harten, 2006, syn. nov.); Bocchus watshami Olmi, 1987 (=Bocchus simoni Olmi, 2005, syn. nov.); Dryinus ugandanus Olmi, 1984 (=Dryinus constantiae Olmi, 2006, syn. nov.). The following new combinations are presented: Dryinus luweli (Benoit, 1951) new comb. in place of Lestodryinus luweli Benoit, 1951; Gonatopus africanus (Benoit, 1951) new comb. in place of Aphelopus africanus Benoit, 1951; Gonatopus ghanensis (Olmi, 1987) new comb. in place of Pseudogonatopus ghanensis Olmi, 1987. Gynander specimens of Deinodryinus rusticus Olmi, 2004 and Deinodryinus steineri Olmi, 1994 are described (first gynander specimens of Dryinidae from the Afrotropical region). The authors provide well-illustrated identification keys to all species of Afrotropical Dryinidae. Online Lucid Phoenix and Lucid matrix interactive keys are provided at http://www.waspweb.org.


Assuntos
Vespas , Distribuição Animal , Animais , Comores , Costa do Marfim , República Democrática do Congo , Quênia , Madagáscar , África do Sul
7.
Zootaxa ; 4568(1): zootaxa.4568.1.3, 2019 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-31715870

RESUMO

Angola and the Democratic Republic of the Congo are relatively unknown in terms of their herpetological diversity. Based on specimens collected in the Congolese region of the Katanga and the northeast of Angola during the first decades of the twentieth century, de Witte and Laurent independently suggested, based on morphological and coloration differences, that populations of T. megalura of these regions could belong a new "race". We compared specimens of T. megalura (including the type specimens of T. megalura and T. massaiana) with Angolan and Katangan museum specimens as well as newly collected specimens from Angola. Coloration pattern and morphological characters, in combination with substantial divergence in the 16S mitochondrial gene, confirm the distinctiveness of the west Central African form, and it is here described as a new species. Data regarding its natural history, ecology and global distribution are presented.


Assuntos
Lagartos , Angola , Animais , República Democrática do Congo , Genes Mitocondriais
8.
Zootaxa ; 4623(3): zootaxa.4623.3.7, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31716251

RESUMO

Currently 10 species are listed in the genus Ophthalmothrips: amyae and conocephalus from South Africa, pomeroyi from Tanzania, lesnei from Mozambique, breviceps and faurei from India, formosanus from Taiwan, longiceps and miscanthicola from East Asia, and yunnanensis from China. Here, conocephalus is newly recorded from Madagascar, faurei from China and Japan, lesnei from Kenya, pomeroyi from Zaire (Democratic Republic of Congo), and the first records of males of lesnei and pomeroyi are provided. A key to males and females of the 10 species is provided.


Assuntos
Tisanópteros , Animais , China , República Democrática do Congo , Extremo Oriente , Feminino , Índia , Japão , Quênia , Madagáscar , Masculino , Moçambique , África do Sul , Taiwan , Tanzânia
9.
Zootaxa ; 4668(3): zootaxa.4668.3.7, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31716621

RESUMO

The present paper contains descriptions of four new species of the genus Tumicla Wallengren, 1863: T. elephantina sp. nov. (South Mozambique), T. mbeghai sp. nov. (NE Tanzania), T. admiranda sp. nov. (SE Democratic Republic of the Congo) and T. smithi sp. nov. (Central Zambia). The male paratype specimen of T. doa Kühne 2007 is proved to be not conspecific with the holotype female but belongs to an undescribed species described here as T. mbeghai sp. nov. rendering Tumicla doa to be known by the female holotype only. Adults, male and female genitalia of the new and related species are illustrated.


Assuntos
Mariposas , Animais , República Democrática do Congo , Feminino , Masculino , Moçambique , Tanzânia , Zâmbia
10.
Zootaxa ; 4664(3): zootaxa.4664.3.5, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31716667

RESUMO

The identification of the male of Cyana (Cyabarda) torrida (Holland, 1893) is corrected, the male is illustrated for the first time. Cyana suessmuthi Karisch, 2013 is transferred to the subgenus Cyabarda Karisch, 2013, its female adult and female genitalia are illustrated and diagnosed for the first time. A new species Cyana (Cyabarda) nambi sp. nov. similar to C. torrida is described from Uganda. Cyana torrida maculata Karisch, 2013 is upgraded to species rank and transferred to the subgenus Idiovulpecula Karisch, 2013: C. (Idiovulpecula) maculata Karisch, 2013, stat. nov. Two new species of the subgenus Idiovulpecula are described: C. (Idiovulpecula) lowa sp. nov. (Democratic Republic of the Congo) and C. (Idiovulpecula) foya sp. nov. (Liberia). Adults and genitalia of new and related species are illustrated.


Assuntos
Mariposas , Animais , República Democrática do Congo , Feminino , Libéria , Masculino , Países Baixos , Uganda
11.
Pan Afr Med J ; 33: 326, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692828

RESUMO

Introduction: Human immunodeficiency virus (HIV) and tuberculosis (TB) are the leading causes of death from infectious disease worldwide. The prevalence of HIV among children with TB in moderate to high prevalence countries ranges between 10% and 60%. This study aimed to determine the prevalence of HIV infection among children treated for TB in Directly Observed Treatment Short-Course (DOTS) clinics in Lubumbashi and to identify risk of death during this co-infection. Methods: This is a cross-sectional study of children under-15, treated for tuberculosis from January 1, 2013 to December 31, 2015. Clinical, paraclinical and outcome data were collected in 22 DOTS of Lubumbashi. A statistical comparison was made between dead and survived HIV-infected TB children. We performed the multivariate analyzes and the significance level set at p-value <0.05. Results: A total of 840 children with TB were included. The prevalence of HIV infection was 20.95% (95% CI: 18.34-23.83%). The mortality rate was higher for HIV-infected children (47.73%) compared to HIV-uninfected children (17.02%) (p<0.00001). Age <5 years (aOR=6.50 [1.96-21.50]), a poor nutritional status (aOR=23.55 [8.20-67.64]), and a negative acid-fast bacilli testing (aOR=4.51 [1.08-18.70]) were associated with death during anti-TB treatment. Conclusion: TB and HIV co-infection is a reality in pediatric settings in Lubumbashi. High mortality highlights the importance of early management.


Assuntos
Antituberculosos/administração & dosagem , Infecções por HIV/epidemiologia , Estado Nutricional , Tuberculose/epidemiologia , Criança , Pré-Escolar , Coinfecção , Estudos Transversais , República Democrática do Congo/epidemiologia , Terapia Diretamente Observada , Feminino , Infecções por HIV/mortalidade , Humanos , Masculino , Prevalência , Fatores de Risco , Tuberculose/tratamento farmacológico , Tuberculose/mortalidade
12.
Pan Afr Med J ; 33: 253, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692839

RESUMO

Introduction: sickle cell disease is a genetic disease with autosomal inheritance associated with haemoglobin structure abnormality which causes the formation of hemoglobin S. The purpose of our study was to collect data on digestive diseases in patients with sickle cell disease in Lubumbashi and to highlight their epidemiological and clinical features. Methods: We conducted a retrospective, descriptive, cross-sectional study at the Research Center for Sickle Cell Disease in Lubumbashi. All the records of patients on follow-up for sickle cell disease with digestive disease during our 3-year period (January 2015 to December 2017) were analyzed. Data were collected using a survey taking into account different study parameters including: age, sex, the reason for consultation, diagnosis, the type of vaso-occlusive crisis, the paraclinical examinations made, hydroxyurea treatment. Results: out of a total of 403 medical records examined we found 206 cases (n=206) of sickle cell disease associated with digestive disease, accounting for a rate of 51,11% of patients with sickle cell disease who suffered from digestive diseases. Both sexes were represented with a slight female predominance (51.94%) and a sex ratio M/F of 0.92. The most represented age ranges 1-6 years (32.52%), the average age was 11.8 years; the standard deviation was 21.9; the extreme ages were 13 months and 38 years. The reason for consultation was dominated by fever (60,67%), abdominal pain (44.66%) and digestive disorders (30,09%). Vaso-occlusive abdominal crises were found in 65 patients (31.55%) among whom 36 had only 1 crisis, 24 had 2 crises and 5 had 3 crises. Intestinal diseases were found in 121 patients (69,41%) dominated by intestinal parasites (found in 58 patients whose collection of stool samples showed 4 parasites: Yersinia enterocolitis, Entamoeba histolytica, Giardia intestinalis and Clostridium difficile). Gastric diseases were found in 105 patients ( 50,97%) divided into peptic ulcer (45 patients) and gastritis (60 patients); biliary vesicular disease was found in 40 patients (19.41%) including vesicular lithiasis without cholecystitis (32 patients), lithiasic cholecystitis (5 patients) and lithiasis in the main biliary tract (3 cases); there was 1 single case diagnosed with acute pancreatitis. The most common associated diseases in our study were respiratory diseases (169 cases;82,03%), oto-rhino-laryngological diseases (157 cases;76.21%), bony, vaso-occlusive crises (146 cases; 70,87%), urogenital diseases (64 cases; 31.06%) and malaria (51 patients; 24.75%). Hepatic diseases and diseases of the spleen were found in 18 cases (8.73%) and 47 cases (22,81%) respectively. Ultrasound was requested in 79 patients but only 31 of them underwent it because of the lack of financial means (it costs 20 U.S. dollars). In the case of clinically obvious splenomegaly, the search for Howell-Jolly bodies was requested in 23 patients but it was only performed in 2 patients because it costs 10 U.S. dollars). Routine blood count, hemoglobin, hematocrit, inflammatory assessment and thick drop examination were performed in all our patients but liver assessment, tests done on stool samples, urine test were recommended based on patient's complaint. Out of 206 patients, only 60 were under hydroxyurea treatment (29,16%). Conclusion: digestive diseases are common in patients with sickle cell disease and account for almost half of patients with diagnosed sickle cell disease. Unfortunately, best management is limited by poverty leading to less very useful paraclinical examinations in patients with digestive diseases resulting from sickle cell disease.


Assuntos
Anemia Falciforme/complicações , Doenças do Sistema Digestório/epidemiologia , Hidroxiureia/uso terapêutico , Dor Abdominal/epidemiologia , Dor Abdominal/etiologia , Adolescente , Adulto , Anemia Falciforme/tratamento farmacológico , Criança , Pré-Escolar , Estudos Transversais , República Democrática do Congo/epidemiologia , Doenças do Sistema Digestório/etiologia , Doenças do Sistema Digestório/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Esplenomegalia/epidemiologia , Esplenomegalia/etiologia , Adulto Jovem
13.
Pan Afr Med J ; 33: 295, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692843

RESUMO

Introduction: Spirometric reference values cannot be extrapolated in the populations, being subject to many environmental and human variables; hence the interest of local studies in this field. Methods: This study aims to determine the reference values among healthy adults in Kinshasa. We conducted a cross-sectional study including 7443 subjects (3208 women, 43%). FEV1, FVC, PEF were correlated with anthropometric data. Five age groups were formed and comparisons were made on the basis of sex, age, BMI and of the practice of sporting activity. Results: Differences are evident between the sexes, in terms of FEV1 (3.00 vs 2.21 L), FVC (3.19 vs 2.38) and the PEF (6.8 vs 5.70 L/s); same as for the outer age categories. FEV1 ranged between 2.33 et 4.54 vs 1.93-3.3 L in the age group 20-29 years and 1,76-3,39 vs 1,60 vs 2,53 L in the age group 60-70 years; FVC ranged between 2,44-4,89 vs 1,96-3,56 L and 1,79-3,78 vs 1,66-2,74 L ; PEF ranged between 4,34-12.2 vs 3,62-8.58 L/s and 2.99-6.76 vs 2.99-7.34L/s in the age group 60-70 years. Conclusion: The differences related to gender, age, anthropometric data as well as to the practice of sporting activity are obvious. These results warrant further and more extended investigations and show the relevance of values based on percentiles in the determinantion of a spirometry standard in a given population.


Assuntos
Volume Expiratório Forçado/fisiologia , Fenômenos Fisiológicos Respiratórios , Espirometria , Adulto , Fatores Etários , Idoso , Antropometria , Estudos Transversais , República Democrática do Congo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais , Adulto Jovem
15.
MMWR Morb Mortal Wkly Rep ; 68(39): 851-854, 2019 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-31581162

RESUMO

Infection prevention and control (IPC) in health care facilities is essential to protecting patients, visitors, and health care personnel from the spread of infectious diseases, including Ebola virus disease (Ebola). Patients with suspected Ebola are typically referred to specialized Ebola treatment units (ETUs), which have strict isolation and IPC protocols, for testing and treatment (1,2). However, in settings where contact tracing is inadequate, Ebola patients might first seek care at general health care facilities, which often have insufficient IPC capacity (3-6). Before 2014-2016, most Ebola outbreaks occurred in rural or nonurban communities, and the role of health care facilities as amplification points, while recognized, was limited (7,8). In contrast to these earlier outbreaks, the 2014-2016 West Africa Ebola outbreak occurred in densely populated urban areas where access to health care facilities was better, but contact tracing was generally inadequate (8). Patients with unrecognized Ebola who sought care at health care facilities with inadequate IPC initiated multiple chains of transmission, which amplified the epidemic to an extent not seen in previous Ebola outbreaks (3-5,7). Implementation of robust IPC practices in general health care facilities was critical to ending health care-associated transmission (8). In August 2018, when an Ebola outbreak was recognized in the Democratic Republic of the Congo (DRC), neighboring countries began preparing for possible introduction of Ebola, with a focus on IPC. Baseline IPC assessments conducted in frontline health care facilities in high-risk districts in Uganda found IPC gaps in screening, isolation, and notification. Based on findings, additional funds were provided for IPC, a training curriculum was developed, and other corrective actions were taken. Ebola preparedness efforts should include activities to ensure that frontline health care facilities have the IPC capacity to rapidly identify suspected Ebola cases and refer such patients for treatment to protect patients, staff members, and visitors.


Assuntos
Infecção Hospitalar/prevenção & controle , Surtos de Doenças/prevenção & controle , Administração de Instituições de Saúde , Doença pelo Vírus Ebola/prevenção & controle , Controle de Infecções/organização & administração , República Democrática do Congo/epidemiologia , Pesquisa sobre Serviços de Saúde , Doença pelo Vírus Ebola/epidemiologia , Humanos , Medição de Risco , Uganda
17.
Middle East Afr J Ophthalmol ; 26(2): 83-88, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31543665

RESUMO

PURPOSE: The purpose of this study is to describe the methodology and to assess the effectiveness of a community-based rehabilitation (CBR) program to identify and refer children with blinding cataract for the management and surgery to reduce the burden of childhood blindness due to cataract in Kinshasa. METHODS: Church-based volunteers were trained to identify children with presumed eye disorders in their localities and households and to refer them for cataract identification by an ophthalmic nurse during parishes' visits. Volunteers were parishioners living in the quartiers where identification took place and worked as community workers with the CBR program. Nurses used a lamp-torch to rule out cataract. Selected children were referred to the tertiary eye health facility at St Joseph Hospital for diagnosis and management. RESULTS: Identification took place in 31 out of 165 parishes in the Archdioceses of Kinshasa from 2000 to 2016 and 11,106 children aged <16 years were screened. Among them, 1277 children (11.5%) were presumed to have cataract. Ninety-two children among them died before surgery; 107 children were lost to further follow-up and did not report to the CBR center for referral. Reasons given were change of home address, moving in their lieu of origin, death, and refusal of treatment by the parents. Finally, only 1078 children were referred to the pediatric ophthalmologist and 705 children (65.4%) were definitively diagnosed to have treatable cataract, while in 373 children (34.6%), cataract surgery was not indicated for several reasons. There was a positive history of familial cataract in 36 children (2.8%). CONCLUSION: Using church-based volunteers and ophthalmic nurses during community screening proved efficient in the identification and referral of pediatric cataract. Keeping regular identification activities in the community and maintaining high-quality and accessible pediatric cataract surgery services can help to clear up the backlog of cataract blind children.


Assuntos
Extração de Catarata , Catarata/diagnóstico , Serviços de Saúde Comunitária/organização & administração , Organizações Religiosas/organização & administração , Encaminhamento e Consulta/organização & administração , Adolescente , Cegueira/prevenção & controle , Catarata/terapia , Criança , Pré-Escolar , Estudos Transversais , República Democrática do Congo , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pediatria , Voluntários
19.
BMC Public Health ; 19(1): 1153, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438898

RESUMO

BACKGROUND: Measles continues to circulate in the Democratic Republic of Congo, and the country suffered from several important outbreaks over the last 5 years. Despite a large outbreak starting in the former province of Katanga in 2010 and the resulting immunization activities, another outbreak occurred in 2015 in this same region. We conducted measles seroprevalence surveys in four health zones (HZ) in the former Katanga Province in order to assess the immunity against measles in children 6 months to 14 years after the 2015 outbreak. METHODS: We conducted multi-stage cluster surveys stratified by age group in four HZs, Kayamba, Malemba-Nkulu, Fungurume, and Manono. The age groups were 6-11 months, 12-59 months, and 5-14 years in Kayamba and Malemba-Nkulu, 6-59 months and 5-14 years in Manono and Fungurume. The serological status was measured on dried capillary blood spots collected systematically along with vaccination status (including routine Extended Program of Immunization (EPI), and supplementary immunization activities (SIAs)) and previous self-reported history of suspected measles. RESULTS: Overall seroprevalence against measles was 82.7% in Kayamba, 97.6% in Malemba-Nkulu, 83.2% in Manono, and 74.4% in Fungurume, and it increased with age in all HZs. It was 70.7 and 93.8% in children 12-59 months in Kayamba and Malemba-Nkulu, and 49.8 and 64.7% in children 6-59 months in Fungurume and Manono. The EPI coverage was low but varied across HZ. The accumulation of any type of vaccination against measles resulted in an overall vaccine coverage (VC) of at least 85% in children 12-59 months in Kayamba and Malemba-Nkulu, 86.1 and 74.8% in children 6-59 months in Fungurume and Manono. Previous measles infection in 2015-early 2016 was more frequently reported in children aged 12-59 months or 6-59 months (depending on the HZ). CONCLUSION: The measured seroprevalence was consistent with the events that occurred in these HZs over the past few years. Measles seroprevalence might prove a valuable source of information to help adjust the timing of future SIAs and prioritizing support to the EPI in this region as long as the VC does not reach a level high enough to efficiently prevent epidemic flare-ups.


Assuntos
Surtos de Doenças/prevenção & controle , Programas de Imunização , Vacina contra Sarampo/administração & dosagem , Sarampo/epidemiologia , Adolescente , Criança , Pré-Escolar , República Democrática do Congo/epidemiologia , Feminino , Humanos , Lactente , Masculino , Sarampo/prevenção & controle , Estudos Soroepidemiológicos
20.
Pan Afr Med J ; 33: 66, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448028

RESUMO

Introduction: Unattended pregnancies are characterized by significant morbidity maternal and morbidity and mortality fetal. This study aims to determine the frequency of unattended pregnancies, to describe the socio-demographic profile and to assess the maternal and fetal outcomes during childbirth among women who did not attend antenatal care (ANC) in the city of Lubumbashi. Methods: It was an analytical cross-sectional study of maternal pregnancy from December 2013 to May 2014 in 10 maternity hospitals in Lubumbashi. Women who did not receive ANC were compared to women who had followed them (ANC≥4). Maternal socio-demographic parameters, maternal and perinatal morbidity and mortality were analyzed. Results: We found that the frequency of no pregnancy monitoring was 21.23% and the mean number of antenatal visits was 2.6 ± 1.9. An analysis of the relationship between ANC and socio-demographic characteristics of women who were delivered shows that the lack of follow-up was 2.29 times higher for adolescent girls than for adult women (OR=2.29 [1.54-3.41]), 4 times higher for women living alone than for women living in unions (OR=4.00 [2.05-7.79]) and 4.08 times higher for women with low levels of education (illiterate or primary) than among those with a high level of education (OR=4.08 [3.08-5.40]). Compared to those who followed them well, we did not find that women who did not attend ANC had a high risk of obstetric emergency (OR = 1.90 [1.26-2.95]), rupture of membranes fetal admission (OR=1.31 [1.02-1.68]), fetal mal presentation (OR=1.89 [1.03-3.44]), caesarean delivery (OR=1.78 [1.21-2.63]), eclampsia (OR=3.00 [1.09-8.70]), uterine rupture (OR=4.76 [1.00-47.19]) and anemia (OR=2.33 [1.06-5.13]). Rates of preterm birth (OR = 1.93 [1.33-2.80]), post-maturity (OR=1.47 [1.00-2.30]), low birth weight (OR=2.33 [1.56-3.46]), neonatal depression (OR=3.89 [2.52-6.02]), neonatal transfer (OR=1.60 [1.11-2.32]) and perinatal mortality (OR=2.70 [1.59-4.57]) were significantly higher in neonates from women with prenatal consultations than in those with well followed. Conclusion: Our study shows that the lack of follow-up of ANC is associated with high maternal morbidity and high perinatal morbidity and mortality in our environment.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Cesárea/estatística & dados numéricos , Estudos Transversais , República Democrática do Congo/epidemiologia , Escolaridade , Feminino , Maternidades , Humanos , Recém-Nascido , Mortalidade Perinatal , Gravidez , Adulto Jovem
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