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Seasonal hematocrit variation and health risks in the adult population of Kinshasa, Democratic Republic of Congo
C Makena Hightower, Joyce D Hightower, Beatriz Y Salazar Vázquez, et al
Vascular Health and Risk Management , 2009, DOI: http://dx.doi.org/10.2147/VHRM.S8136
Abstract: sonal hematocrit variation and health risks in the adult population of Kinshasa, Democratic Republic of Congo Original Research (2957) Total Article Views Authors: C Makena Hightower, Joyce D Hightower, Beatriz Y Salazar Vázquez, et al Published Date November 2009 Volume 2009:5 Pages 1001 - 1005 DOI: http://dx.doi.org/10.2147/VHRM.S8136 C Makena Hightower1, Joyce D Hightower2, Beatriz Y Salazar Vázquez1,3, Marcos Intaglietta1 1Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA; 2Group de Reflection, Actions et Etude de Culture, Kinshasa, Democratic Republic of Congo; 3Facultad de Medicina, Universidad Juárez del Estado de Durango, Durango, Durango, México Abstract: Hematocrit (Hct) as an indicator of blood viscosity and mean arterial blood pressure (MAP) were assessed according to the season in adult participants of health screenings conducted throughout Kinshasa, Democratic Republic of Congo. Data was collected at the end of summer (April) and the end of winter (August) and identified by gender. Male Hcts in August were significantly higher (P < 0.0001) than in April (48.3% ± 4.2% and 45.7% ± 2.3%, respectively) while male MAP (85.0 ± 8.4 mm Hg) was identical to that recorded in April (85.4 ± 7.7 mm Hg). August female Hcts (41.4% ± 3.1%) were statistically higher than those recorded in April (39.6% ± 1.9%, P = 0.001), MAP being 82.3 ± 7.3 vs 87.9 ± 6.6 mm Hg, respectively (P = 0.0001). Systolic and diastolic blood pressures, heart rate, body mass indices, ages, and personal and familial medical histories of the August and April groups were not significantly different. This study offers further support for the assertion that the relationship between blood viscosity and pressure of a healthy population shows that increased Hct, and therefore increased blood viscosity is associated with lowered MAP, and presumably peripheral vascular resistance.
Retinoblastoma in the Democratic Republic of Congo: 20-Year Review from a Tertiary Hospital in Kinshasa  [PDF]
Aimé Kazadi Lukusa,Michel Ntetani Aloni,Bertin Kadima-Tshimanga,Mo?se Mvitu-Muaka,Jean Lambert Gini Ehungu,René Ngiyulu,Pépé Ekulu Mfutu,Aléine Budiongo Nzazi
Journal of Cancer Epidemiology , 2012, DOI: 10.1155/2012/920468
Abstract: Background. To determine clinical profile and management of retinoblastoma among children at Kinshasa in Democratic Republic of Congo. Patients and methods. The medical records of patients with a diagnosis of retinoblastoma seen at the University Hospital of Kinshasa from January 1985 till December 2005 were retrospectively reviewed. Demographic profile, clinical data, modes of treatment and outcome were analysed. Results. A total of 49 children, of whom 40 had adequate data on record were identified as retinoblastoma (28 males and 12 females). Nine cases had bilateral disease. The median age at the first symptoms was 9 months (range, 1 month to 6 years) for unilateral retinoblastoma and 18 months (range, 1 month to 3.5 years) for bilateral retinoblastoma. The median age at the first oncology consultation was 2.4 years (range, 6 months to 6 years) for unilateral retinoblastoma and 2.4years (range, 9 months to 4 years) for bilateral disease. Leukokoria was present in 67.5% of subjects. Seventy-five percent abandoned the treatment. The mortality was 92.5%. Conclusion. In Democratic Republic of Congo, retinoblastoma remains a life threatening disease characterized by late referral to a specialized unit and affordability of chemotherapy; all leading to an extension of the disease and high mortality. 1. Introduction Retinoblastoma is the most frequent childhood intraocular tumour with an approximately incidence of one in 15,000–20,000 births in the world [1]. In Africa, it is the most important life-threatening ocular malignancy [2–4]. Management of retinoblastoma has been changing during years with a survival rate of more than 95% in developed countries [5, 6]. However, in developing countries these cures are less than 50%, primarily because of advanced disease at time of diagnosis [7–9]. Previous studies had reported epidemiological and clinical characteristics of the disease [10–12]. In the Democratic Republic of Congo (DRC), retinoblastoma represents 5/188 of malignant tumors in children [13], 8% of exophthalmos [14]. In other previous study, retinoblastoma was the most common histologic form representing 31.7% of all malignant of the eye [15]. However, there is still a paucity of information on clinical findings and on the outcomes of children with retinoblastoma. The last paper on presenting signs of retinoblastoma in Congolese patients gave a five-year ophthalmology view [16]. At the other side, it is necessary for health plan to have the main characteristics of all children with retinoblastoma followed in Democratic Republic of Congo. This
Seasonal hematocrit variation and health risks in the adult population of Kinshasa, Democratic Republic of Congo  [cached]
C Makena Hightower,Joyce D Hightower,Beatriz Y Salazar Vázquez,et al
Vascular Health and Risk Management , 2009,
Abstract: C Makena Hightower1, Joyce D Hightower2, Beatriz Y Salazar Vázquez1,3, Marcos Intaglietta11Department of Bioengineering, University of California, San Diego, La Jolla, CA, USA; 2Group de Reflection, Actions et Etude de Culture, Kinshasa, Democratic Republic of Congo; 3Facultad de Medicina, Universidad Juárez del Estado de Durango, Durango, Durango, MéxicoAbstract: Hematocrit (Hct) as an indicator of blood viscosity and mean arterial blood pressure (MAP) were assessed according to the season in adult participants of health screenings conducted throughout Kinshasa, Democratic Republic of Congo. Data was collected at the end of summer (April) and the end of winter (August) and identified by gender. Male Hcts in August were significantly higher (P < 0.0001) than in April (48.3% ± 4.2% and 45.7% ± 2.3%, respectively) while male MAP (85.0 ± 8.4 mm Hg) was identical to that recorded in April (85.4 ± 7.7 mm Hg). August female Hcts (41.4% ± 3.1%) were statistically higher than those recorded in April (39.6% ± 1.9%, P = 0.001), MAP being 82.3 ± 7.3 vs 87.9 ± 6.6 mm Hg, respectively (P = 0.0001). Systolic and diastolic blood pressures, heart rate, body mass indices, ages, and personal and familial medical histories of the August and April groups were not significantly different. This study offers further support for the assertion that the relationship between blood viscosity and pressure of a healthy population shows that increased Hct, and therefore increased blood viscosity is associated with lowered MAP, and presumably peripheral vascular resistance.Keywords: blood pressure, African adults, blood viscosity, cardiovascular, shear stress
Estimation of Clinical, Immunological and Virological Failure of First Line Antiretroviral Treatment in Kinshasa, Democratic Republic of Congo
Erick Ntambwe Kamangu
Open Access Library Journal (OALib Journal) , 2018, DOI: 10.4236/oalib.1104560
Abstract:
Background: The prevalence of Human Immunodeficiency Virus (HIV) infection was 1.2% in the Democratic Republic of Congo, according to the Demographic Health Study report in 2014. In 2012, the severe failure rate to first-line ART in Kinshasa was estimated at more than 16%. Objective: The objective of this study is to determine the rate of clinical, immunological and virological failure in first-line treatment in Kinshasa. Methodology: At the 6th month of Antiretroviral Treatment (ART), 138 patients from a follow-up cohort of 8 centers in Kinshasa were received for paraclinical evaluations and analyses. The clinical and paraclinical parameters were recorded on the individual patient sheets as well as the survey forms. Clinical parameters, viral load and CD4 were evaluated at the 6th month of ART. Results: One hundred and thirty-eight (138) patients had returned for follow-up treatment, 81 women and 57 men. The average age of patients is 37 ± 12 years. The dominant age groups are those of 26 to 35 years and 36 to 45 years with 39 patients (28.3%) each, followed by those of 18 to 25 years (21.7%). One hundred and twenty-five (125) patients (90.5%) were in clinical stage 3 and 13 (9.5%) in clinical stage 4 according to the WHO classification. CD4 levels ranged from 98 to 1050 cells/mm3 and a median value of 560 cells/mm3. The median value of the patients’ VLs was 0.90 log10 copies of RNA/ml with respective minimum and maximum values of 0 and 4.82 log10 copies of RNA/ml. The virological failure rate was 24.6%. Conclusions: The rate of virological failure of first-line antiretroviral treatment of patients under treatment in Kinshasa is 24.6% for the year 2015.
Preventing vertical transmission of HIV in Kinshasa, Democratic Republic of the Congo: a baseline survey of 18 antenatal clinics
Behets,Frieda MTF; Matendo,Richard; Vaz,Lara ME; Kilese,Nick; Nanlele,Diderot; Kokolomami,Jack; Okitolando,Emile W; Van Rie,Annelies;
Bulletin of the World Health Organization , 2006, DOI: 10.1590/S0042-96862006001200013
Abstract: objective: to assess the content and delivery of essential antenatal services before implementation of programmes for prevention of mother-to-child transmission (pmtct) of human immunodeficiency virus (hiv). methods: we assessed 18 antenatal care centres (eight public units and ten managed by nongovernmental organizations) in kinshasa, democratic republic of the congo. we used a survey to capture information about the number and type of antenatal health workers, infrastructure capacity and the delivery of basic antenatal care services such as: nutritional counselling; tetanus toxoid vaccination; prevention and management of anaemia, malaria, sexually transmitted infections, and tuberculosis; and counselling for postpartum contraception. findings: antenatal care units differed with respect to size, capacity, cost, service delivery systems and content. for instance, 17 of the 18 sites offered anaemia screening but only two sites included the cost in the card that gives access to antenatal care. nine of the clinics (50%) reported providing the malaria prophyalxis sulfadoxine pyrimethamine as per national policy. four (22%) of the sites offered syphilis screening. conclusion: scaling up pmtct programmes in under-resourced settings requires evaluation and strengthening of existing basic antenatal care service delivery.
Perceptions of Health, Health Care and Community-Oriented Health Interventions in Poor Urban Communities of Kinshasa, Democratic Republic of Congo  [PDF]
Vivi Maketa, Mimy Vuna, Sylvain Baloji, Symphorien Lubanza, David Hendrickx, Raquel Andrea Inocêncio da Luz, Marleen Boelaert, Pascal Lutumba
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0084314
Abstract: In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city’s major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and interventions. Novel ways of reducing the high out-of-pocket expenditure should also be explored.
The importance of education to increase the use of bed nets in villages outside of Kinshasa, Democratic Republic of the Congo
Julie K Ndjinga, Noboru Minakawa
Malaria Journal , 2010, DOI: 10.1186/1475-2875-9-279
Abstract: Two villages along the Congo River, totalling 142 households with 640 residents, were surveyed using a standard questionnaire. The interview determined the number, ages, and sexes of family members; the education level of the family head; the number, colour, and type of nets owned; and the number of nets used in the previous night. The size of house was also measured, and numbers of rooms and beds were recorded. These variables were examined to reveal important factors that affect bed net use.A total of 469 nets were counted, and nearly all nets were white LLINs. Of these nets, 229 (48.8%) nets were used by 284 (44.4%) residents. Bed nets were used by over 90% of children 5 to 15 years of age, whereas less than 50% of the residents in other age groups used bed nets. The important variables affecting bed net use were numbers of beds and rooms in the house and the education level of the family head of household.Education was the most important factor affecting bed net use in the villages outside Kinshasa. Development of an educational programme, particularly one directed toward parents, is necessary to reduce misconceptions and increase prevalence of bed net use among all age groups.Malaria is one of the leading causes of morbidity and mortality in the Democratic Republic of the Congo (DRC), with approximately 180,000 deaths attributed to malaria each year [1]. This is one fifth of the 863,000 malaria deaths reported worldwide by the World Health Organization in 2008 [2]. The large number of malaria cases in the DRC is due to high malaria transmission rates, and it is exacerbated by two decades of civil war that have decimated the health care infrastructure and the government's ability to deliver social services.Insecticide-treated bed nets offer essential protection against mosquitoes and significantly reduce morbidity and mortality due to malaria, particularly in endemic areas [3,4]. The DRC government distributed nearly 11.2 million long-lasting insecticide-treated
Assessing the Impact of Credit Constraints on Farm Household Economic Welfare in the Hinterland of Kinshasa, Democratic Republic of Congo
KH Muayila, E Tollens
African Journal of Food, Agriculture, Nutrition and Development , 2012,
Abstract: This study investigates the impact of credit constraints on farm household economic welfare. Data were cross sectional and collected at household level in the Hinterland of Kinshasa, Democratic Republic of Congo. The sample survey consists of 202 farm households randomly selected. The survey was conducted from February to March 2008. The non-parametric method known as the Propensity Score Matching was applied to compute the impact of credit constraints on farm household welfare. The credit constraints were identified based on direct questions to households about their credit status. The household economic welfare was measured using the consumption approach. The results from descriptive statistics establish the existence of high level of credit constraints among farm households in the area of study. The majority of farm households (71%) have to endure credit constraints. The results of descriptive statistics indicate that the lack of collateral, the loan terms conditions, the credit technology, the higher level of agricultural risks, the high interest rates and the low returns on farming activities explain the limited access to credit by farmers. The results of logit model show that household social capital, household access to remittances, household land holding and household access to extension service tend to reduce the probability of being credit constrained, while the household size tends to increase the propensity of being credit constrained. The results of the propensity score matching report that credit constraints reduce per capita food consumption per day from -197 FC to -219 FC (-0.35$ to -0.39$). The impact of credit constraints on per capita non-food consumption per day is quite difficult to be supported. The results report that only ATT obtained from Radius estimator shows a negative and significant effect at p<0.010. The average effect of credit constraints on per capita total consumption per day is estimated at about -328 FC (-0.59$) under Radius matching, -269FC (-0.48 $) under Kernel matching and -280 FC (-0.50$) under Stratification matching. The average impact on the ratio of per capita total consumption per day to poverty line of 1$ and to poverty line of 2$ ranges from -0.59 to 0, 48 and from -0.29 to -0.23, respectively. The study concludes that the improvement of farm household access to credit could result in increasing economic welfare.
Immunisation-related knowledge, attitudes and practices of mothers in Kinshasa, Democratic Republic of the Congo
MA Mapatano, K Kayembe, L Piripiri, K Nyandwe
South African Family Practice , 2008,
Abstract: Background: In the Democratic Republic of Congo, it was reported in 1995 that the routine coverage for BCG was as low as 47%, and that it was 27% for DPT3, 28% for OPV3 and 39% for measles vaccine. The trend also was declining unevenly. This study aimed to determine the reasons for such low coverage, examining the socio-demographic characteristics of mothers and health system factors such as health services barriers. It further sought to assess the knowledge, attitudes and practices of mothers associated with routine immunisation. Methods: In 1999, a cross-sectional household survey applied a systematic sampling technique in a sample of eight out of the 22 health zones that then served the population of Kinshasa. These were dichotomised into low- and high-coverage health zones, based on BCG immunisation coverage. Mothers of children aged from zero to four years were the respondents to a standardised questionnaire. Results: A total of 1 613 children aged zero to four years participated in the study. Awareness of immunisation and its importance in protecting a child against diseases was universal, although most mothers could not tell exactly against which diseases. Mothers had positive attitudes towards immunisation (98%). Coverage based on the immunisation card, however, was as low as 37%, indicating a discrepancy between the high level of knowledge and positive attitudes, with the observed low immunisation coverage. The father's education and the mother's experience of an EPI-targeted disease in the family emerged as significant predictors of complete immunisation of the child. The father's involvement and the mother's ability to cite signs of severity of EPI diseases were associated with the child's vaccination status in the high-coverage health zone. The mother's vaccine-related knowledge was a predictor of immunisation status only in the low-coverage zone. Conclusion: Different factors determine the complete vaccination status, depending on whether the child lives in a zone with low or high routine EPI coverage. For example, the father's involvement is associated with the child's vaccination status in the high- coverage zone, but not in the low-coverage zone. Programmes and policy makers should take these factors into account when designing strategies to increase immunisation coverage. South African Family Practice Vol. 50 (2) 2008: pp. 61-61e
Attention deficit and hyperactivity disorder among school children in Kinshasa, Democratic Republic of Congo
E Kashala, T Tylleskar, I Elgen, K T Kayembe, K Sommerfelt
African Health Sciences , 2005,
Abstract: Objectives: To estimate the prevalence and determinants of attention deficit and hyperactivity disorder (ADHD) symptoms among school children in Kinshasa, an African urban setting. Methods: The 18-items of the Disruptive Behaviour Disorder rating scale (DBD), which is based on the Diagnostic and Statistical Manual for mental disorders 4th edition (DSM-IV), were used to investigate the presence of ADHD symptoms. Parents interviews, using a questionnaire specially designed for the study, were performed to identify socio-demographic characteristics. All children were subject to a clinical examination. Results: The estimated prevalence of DSM-IV ADHD symptoms was 6 %. Those with family health problems, younger age at start of primary school, good nutritional status and poor school performance more often had DSM-IV ADHD symptoms. Conclusions: ADHD symptoms are as common among school children in Kinshasa as elsewhere. The socio-demographic factors described as risk factors for ADHD in high-income countries were not identified in this study.
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