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Search Results: 1 - 10 of 401281 matches for " Nazaire M Nseka "
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High prevalence of undiagnosed chronic kidney disease among at-risk population in Kinshasa, the Democratic Republic of Congo
Ernest K Sumaili, Eric P Cohen, Chantal V Zinga, Jean-Marie Krzesinski, Nestor M Pakasa, Nazaire M Nseka
BMC Nephrology , 2009, DOI: 10.1186/1471-2369-10-18
Abstract: In a cross-sectional study, 527 people from primary and secondary health care areas in the city of Kinshasa were studied from a random sample of at-risk out-patients with hypertension, diabetes, obesity, or HIV+. We measured blood pressure (BP), blood glucose level, proteinuria, body mass index, and estimated glomerular filtration rate (eGFR by MDRD equation) using calibrated creatinine levels based on one random measurement. The associations between health characteristics, indicators of kidney damage (proteinuria) and kidney function (<60 ml/min/1.73 m2) were also examined.The prevalence of CKD in this study was 36%, but only 12% were aware of their condition. 4% of patients had stage 1 CKD, 6% stage 2, 18% stage 3, 2% stage 4, and 6% had stage 5. 24 hour quantitative proteinuria (>300 mg/day) was found in 19%. In those with the at-risk conditions, the % of CKD was: 44% in patients with hypertension, 39% in those with diabetes; 16% in the obese and 12% in those who were HIV+. 82% of those with a history of diabetes had elevated serum glucose levels at screening (≥ 126 mg/dl). Only 6% of individuals with hypertension having CKD had reduced BP to lower than 130/80 mmHg. In multivariate analysis, diabetes, proteinuria and hypertension were the strongest determinants of CKD 3+.It appears that one out of three people in this at-risk population has undiagnosed CKD and poorly controlled CKD risk factors. This growing problem poses clear challenges to this developing country. Therefore, CKD should be addressed through the development of multidisciplinary teams and improved communication between traditional health care givers and nephrology services. Attention to CKD risk factors must become a priority.Chronic Kidney Disease (CKD) is a worldwide health problem [1]. Indeed, the incidence and prevalence of CKD has increased in recent years in both developed and developing countries [2] including in Sub-Saharan Africa (SSA) [3]. In SSA, CKD affects mainly young adults in their
Chronic kidney disease among high school students of Kinshasa
Justine B Bukabau, Jean Robert R Makulo, Nestor M Pakasa, Eric P Cohen, Fran？ois B Lepira, Nazaire M Nseka, Patrick K Kayembe, Ernest K Sumaili
BMC Nephrology , 2012, DOI: 10.1186/1471-2369-13-24
Abstract: In an epidemiological cross sectional study, a random sample of 524 pupils (263 boys, mean age of 18.7 ± 1.4 years) from school environment of Kinshasa were studied. Recorded parameters of interest were anthropometric, proteinuria, serum creatinine and estimated glomerular filtration rate (eGFR) according to the Schwartz formula using uncalibrated creatinine levels from one random measurement. CKD was defined as the presence of kidney damage (daily proteinuria ≥ 300 mg) and/or reduced kidney function (eGFR < 60 ml/min/1.73 m2). Concordances between eGFR according to Schwartz, Cockcroft-Gault (C-G) indexed for BSA and modification of diet in renal disease (MDRD) study equations were computed using the kappa coefficient.The prevalence of CKD by the Schwartz formula was 1.5%. By stage, 0.8% had CKD stage 1 (proteinuria with normal eGFR) and 0.8% had CKD stage 3 (eGFR, 30 to 59 ml/min/1.73 m2). The prevalence of proteinuria ≥ 300 mg/day was 1% (one case had 2.7g/day). Agreement between eGFR according to Schwartz formula and the MDRD formula was excellent (kappa: 88.8%). Although correlations between all formulas were excellent (0.99; 0.87, and 0.89), agreement was poor between eGFR according to Schwartz and C-G indexed BSA equation (kappa: 52.7%) and, poorer with C-G unadjusted for BSA (kappa: 26.9%).In the large African city of Kinshasa, 2% of high school students have CKD. This high prevalence rate emphasizes the need for appropriate detection and prevention measures in this vulnerable young age population group.
Renal Function in Children Suffering from Sickle Cell Disease: Challenge of Early Detection in Highly Resource-Scarce Settings
Michel Ntetani Aloni, René Makwala Ngiyulu, Jean-Lambert Gini-Ehungu, Célestin Ndosimao Nsibu, Mathilde Bothale Ekila, Fran？ois Bompeka Lepira, Nazaire Mangani Nseka
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0096561
Abstract: Background The prevalence of Sickle cell disease is extremely high in Democratic Republic of Congo. Despite this high prevalence of the disease, data on renal abnormalities in children are rare. Method The study proposed to assess blood pressure, glomerular function, urea and uric acid levels in 65 steady state Congolese children with homozygous sickle cell disease and 67 normal controls. Results In Hb-SS group, blood pressure level tended to be lower than Hb-AA groups but there was no statistically significant difference (p>0.05) between the two groups. The absolute values for GFR corrected for BSA were significantly higher in Hb-SS group compared to Hb-AA group (130.5±34.1 ml/min/1.73 m2 vs 113.7±24.5 ml/min/1.73 m2; p = 0.004). Children with Hb-SS were more likely to hyperfiltrate (30.8% of subjects) than children with Hb-AA (6.1% of subjects). Proteinuria was found in 4 (6.2%) children with Hb-SS. Uric acid level was significantly increased in children with Hb-SS compared to corresponding values in control group (4.4±1.3 mg/dl vs 3.5±1.1 mg/dl; p<0.001). Urea level was significantly decreased compared to corresponding values in Hb-AA group (15.3±8.3 mg/dl vs 22.9±10.1 mg/dl; p<0.001). Conclusion Hyperfiltration, low creatinine, lower urea and high uric acid are more common in children with sickle cell disease than in normal controls.
The Atherogenic Dyslipidemia Ratio Log (Tg)/Hdl-C Was Not Associated with Urinary Albumin Excretion Rate (Uaer) and Increased Cardiovascular Risk in Black Patients with Type 2 Diabetes  [PDF]
M. F. Kajingulu, B. F. Lepira, I. N. F. Mbutiwi, J. R. R. Makulo, E. Bieleli, M. N. Nseka
World Journal of Cardiovascular Diseases (WJCD) , 2016, DOI: 10.4236/wjcd.2016.61003
Abstract: Objective: The objective is to assess the relationship of Log (TG)/HDL-c as surrogate estimate of atherogenic dyslipidemia with urinary albumin excretion rate and cardiovascular risk among black patients with type 2 diabetes. Patients and methods: A post-hoc analysis of data from 181 type 2 diabetes patients enrolled in a cross-sectional study of urinary albumin excretion rate seen at a tertiary healthcare. Microalbuminuria and macroalbuminuria were defined as ACR 30 - 299.9 mg/g and ACR ≥ 300 mg/g, respectively. Quartiles of Log (TG)/HDL-c were used as surrogate estimates of atherogenic dyslipidemia. Cardiovascular risk was assessed using WHO chart for estimation of CV risk in low and middle income countries. Comparisons across Log (TG)/HDL-c quartiles were performed using one way ANOVA and Chi square for trend as appropriate. P < 0.05 defined the level of statistical significance. Results: A high prevalence (69%) of atherogenic dyslipidemia (AD) was observed in the present case series of Black Africans with type 2 diabetes. Average total cholesterol levels showed significant (p = 0.010) trends towards lower values across quartiles of Log (TG)/ HDL-c. No significant trends were observed for average UAER and cardiovascular risk across quartiles of Log (TG)/HDL-c. Conclusion: Log (TG)/HDL-c as a surrogate estimate of atherogenic failed to predict cardiovascular risk in the present case series of black patients with type 2 diabetes.
Interdialytic 24-Hours Ambulatory Blood Pressure versus Dialysis Unit Blood Pressure for the Diagnosis of Electrocardiographic-Left Ventricular Hypertrophy in Chronic Hemodialysis Black Patients  [PDF]
Cédric Kabemba Ilunga, Fran？ois Bompeka Beka Lepira, Jean Robert Rissassi Makulo, Yves Lubenga, Trésor Mvunzi, Noel Utshudi, Aliocha Nkodila, Vieux Momeme Mokoli, Ernest Kiswaya Sumaili, Nazaire Mangani Nseka, Eleuthère Vita Kintoki
World Journal of Cardiovascular Diseases (WJCD) , 2019, DOI: 10.4236/wjcd.2019.911075
Abstract: Background and Aim: In hemodialysis patients, 24-hours interdialytic ABPM better detects TOD than dialysis unit blood pressure. Therefore, the present study was aimed to assess the diagnostic performance of 24-hours ABPM vs. dialysis unit BPs for the diagnosis of ECG-LVH in steady state chronic hemodialysis black patients. Methods: From March 31 to September 30, 2018, interdialytic ABPM was performed after a mid-week hemodialysis session for 24 hours using a Spacelab 90207 ABPM monitor in the non-access arm in 45 stable chronic hemodialysis black patients (age ≥ 20 years, hemodialysis for at least 3 months and informed consent) attending 3 hemodialysis centers in Kinshasa. Ambulatory BP was recorded every 20 minutes during the day (6 AM to 10 PM) and every 30 minutes during the night (10 PM to 6 AM). ECG-LVH was defined using Cornell product criteria. ROC curve method was used to assess the performance of dialysis unit BPs vs. interdialytic 24-hours ABPM in diagnosing ECG-LVH. P < 0.05 defined the level of statistical significance. Results: Whatever the method of BP measurement, all the SBP values were related to ECG-LVH with similar AUC and overlapping 95% CI; however, they were not significantly different from each other. 24-hours interdialytic ambulatory SBP (AUC 0.748; 95%
Sickle Cell Trait, Hemoglobin Levels and Anemia among Black Patients with Predialysis Chronic Kidney Disease: A Post Hoc Analysis  [PDF]
F. B. Lepira, T. K. Mukendi, F. I. N. Mbutiwi, J. R. Makulo, E. K. Sumaili, P. K. Kayembe, N. M. Nseka
World Journal of Cardiovascular Diseases (WJCD) , 2016, DOI: 10.4236/wjcd.2016.68029
Abstract: Objective: To assess the relationship between SCT, hemoglobin levels and anemia in CKD black patients. Method: A post-hoc analysis of data from 188 patients, enrolled in a cross-sectional study of sickle cell trait (SCT) and chronic kidney disease (CKD), was performed to assess the relationship between SCT, hemoglobin (Hb) levels and anemia defined as Hb < 12 g/dl in men and <11 g/dl in women. Student t test, Mann Whitney and Chi square test were used as appropriate for different comparisons. P < 0.05 defined the level of statistical significance. Results: SCT (HbAS) and normal hemoglobin (HbAA) were present in 39 (21%) and 149 (79%) CKD patients, respectively. Despite similar estimated GFR (eGFR) and age, HbAS patients had significantly lower Hb levels (8.8 ± 1.8 vs 10 ± 2.2 g/dl; p = 0.001) and a higher proportion of anemia (95% vs 72%, p = 0.001). In multiple linear regression analysis, eGFR, BMI, SBP and SCT emerged as independent determinants of Hb levels. The presence of SCT was associated with 1.185 g/dl decrease in Hb levels. Conclusion: In the present case series, SCT was associated with lower Hb levels suggesting its potential contribution to the pathogenesis of CKD-associated anemia.
Blood Pressure Patterns and Factors Associated with Relative Hypertension among Steady State Sickle Cell Disease Patients in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Study  [PDF]
P. I. Mboliasa, F. B. Lepira, J. R. Makulo, A. Nkodila, E. K. Sumaili, J. B. Bukabau, V. M. Mokoli, A. L. Longo, C. V. Zinga, F. M. P. Kanjingulu, Y. M. Nlandu, Y. M. Engole, M. M. Mukendi, E. M. Kadima, C. K. Ilunga, P. M. Ekulu, N. M. N. Nseka
World Journal of Cardiovascular Diseases (WJCD) , 2018, DOI: 10.4236/wjcd.2018.83021
Abstract: Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complications. Objective: To determine the prevalence of BP patterns and assess factors associated with relative hypertension insickle cell anemia (SCA) adult patients. Methods: Clinical data and office BP were obtained from 103 consecutive steady-state SCA adult patients (mean age 26 ± 7.9 years, 66% females, 22.3% on hydroxyurea) attending four healthcare centers providing SCD-specific care in Kinshasa. Seated BP was measured using an automated electronic device. Three consecutive blood pressure measurements were taken with 2 minutes interval between readings and the average of the 2 last readings was considered for the analyses. Normal BP, relative hypertension and systemic hypertension were defined as BP < 120/70 mmHg, 120 - 139/70 - 89 mmHg and ≥140/90 mmHg, respectively. Results: Normal BP, relative hypertension and systemic hypertension were observed in 56 (54%), 43(42%) and 4 (4%) of SCA patients, respectively. In multivariate analysis, factors associated with relative hypertension were leg ulcer (aOR 2.05; 95%CI 1.77 -
Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients
Wumba R, Longo-Mbenza B, Menotti J, Mandina M, Kintoki F, Situakibanza NH, Kakicha MK, Zanga J, Mbanzulu-Makola K, Nseka T, Mukendi JP, Kendjo E, Sala J, Thellier M
International Journal of General Medicine , 2012, DOI: http://dx.doi.org/10.2147/IJGM.S32344
Abstract: emiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients Original Research (1567) Total Article Views Authors: Wumba R, Longo-Mbenza B, Menotti J, Mandina M, Kintoki F, Situakibanza NH, Kakicha MK, Zanga J, Mbanzulu-Makola K, Nseka T, Mukendi JP, Kendjo E, Sala J, Thellier M Published Date July 2012 Volume 2012:5 Pages 603 - 611 DOI: http://dx.doi.org/10.2147/IJGM.S32344 Received: 28 March 2012 Accepted: 12 April 2012 Published: 19 July 2012 Roger Wumba,1 Benjamin Longo-Mbenza,2 Jean Menotti,3,4 Madone Mandina,5 Fabien Kintoki,5 Nani Hippolyte Situakibanza,1,5 Marie Kapepela Kakicha,6 Josue Zanga,1 Kennedy Mbanzulu-Makola,1 Tommy Nseka,1 Jean Pierre Mukendi,1 Eric Kendjo,7 Jean Sala,1 Marc Thellier7,8 1Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 2Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa; 3Laboratory of Parasitology and Mycology, Saint-Louis Hospital, Public Assistance-Hospitals of Paris, Paris, France; 4Faculty of Medicine, Lariboisière-Saint-Louis, University of Paris VII, Paris, France; 5Department of Internal Medicine, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 6Department of Pediatrics, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 7National Center for Malaria Research, AP-HP, CHU Pitie Salpêtrière, Paris, France; 8Laboratory of Parasitology and Mycology, Pitié Salpêtrière Hospital, Public Assistance-Hospitals of Paris, Pierre and Marie Curie University, Paris, France Background: The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients. Methods: In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk. Results: Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and hel
A Study of the Hepatic Tolerance of the Ethyl Acetate Fraction of Morinda morindoides (Baker) Milne- Redhead (Rubiaceae) Extract in Rabbit
I Otis Tra –Bi, B Nazaire Djyh, C Bahi, S Meite, J David N’guessan
Tropical Journal of Pharmaceutical Research , 2010,
Abstract: Purpose: In this study, the effect of the ethyl acetate fraction of the extract of Morinda morindoides (Baker) Milne-Redhead (Rubiaceae) on the tissue and metabolic integrity of rabbit liver was evaluated. Methods: Thirty rabbits (divided equally between male and female) were randomly distributed into five (5) groups of six (6) rabbits each. These animals received, by intraperitoneal injection, twice a week the ethyl acetate fraction (F1) of the hydroalcohol extract of Morinda morindoides in doses ranging from 25 to 100 êg/kg body weight for Groups 2 (Gp2) to 5 (Gp5) while Group 1 (Gp1) and control, received 1 ml of MacEwen physiological fluid. Blood sampling was carried out to evaluate various parameters: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gammaglutamyltransferase (GT), lactate dehydrogenase (LDH), total cholesterol, HDL cholesterol, triglycerides, glucose and total proteins Results: Analysis of the parameters following administration of the extract fraction showed slight increases in AST and ALT activities as well as the concentrations of total cholesterol and glucose, compared to their initial values. On the other hand, protein, glyceride, total cholesterol and high density lipoprotein cholesterol levels as well as the activities of ALP, GT and the LDH did not change significantly (p >0.05). Nevertheless, the changes observed during the study were within the limits of the normal values for these various parameters in rabbit. Conclusion: These results revealed that the ethyl acetate fraction (F1) of the hydroalchol extract of Morinda morindoides, when used in the dose range evaluated in this study, may be well tolerated by the liver.
Management of Breast Cancer in Visceral Surgery of CNHU-HKM of Cotonou in Benin  [PDF]
Dansou Gaspard Gbessi, Ismail Lawani, Chrystelle Tawo-Nounagnon, Francis Moïse Dossou, Yacoubou Imorou Souaïbou, Delphin Kuassi Mehinto, Jean-Léon Olory-Togbe, Kémoko Osséni Bagnan, Nazaire Padonou
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.73022
Abstract: Breast cancer affects more females than males. It occurs earlier with the black females and is often diagnosed at a stage of complication. This study aims to describe its epidemiological characteristics, the changing stages, and to analyze the treatment and means of interdisciplinary and international cooperation in its care and treatment. Our study was retrospective, descriptive and analytic on breast cancer patients received at CNHU-HKM of Cotonou between January 1, 2001 and December 31, 2013. Breast cancer accounts for 24.24% of mammary pathologies and most affects the left breast. Females aged from 40 to 59 years old are the most affected. For males, the average age was 47.5 years old. Patients mostly consult at a later stage where the tumor is already palpable with nodal metastasis. Breast echography and mammography had been done only for 23.85% of the cases. In an anatomical pathology perspective, the invasive ductal carcinoma was the most common type with 87.2%. For the therapeutical aspect, a radical mastectomy according to Patey was realized in 81.65% of the cases; 48.65% underwent a chemotherapy and 14.7% were able to do a radiotherapy. The chance at life for patients was decreasing while the life time is increasing. Also, the average life span of patients was increased by the combination of diverse types of treatments notably when radiotherapy is done. The incidence of breast cancers in Visceral Surgery A and B department of CNHU-HKM-Cotonou is increasing over years.
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