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Factors Associated with Mortality among Multidrug Resistant Tuberculosis MDR/RR-TB Patients in Democratic Republic of Congo  [PDF]
Murhula Innocent Kashongwe, Leopoldine Mbulula, Pierre Umba, Francois Bompeka Lepira, Michel Kaswa, Zacharie Munogolo Kashongwe
Journal of Tuberculosis Research (JTR) , 2017, DOI: 10.4236/jtr.2017.54029
Abstract: Background: Tuberculosis remains a very common infectious disease in Democratic Republic of Congo (DRC). The resistance to drugs worsens the prognosis and the outcome of patients affected tuberculosis and increase their mortality. Objective: To identify factors associated with death among Multidrugs resistant tuberculosis (MDR/RR TB) patients referred to the referential hospital, Centre d’Excellence Damien (CEDA). Materials and Methods: A retrospective cohort study of patients attending health care to the Center CEDA, a referral center for management of MDR/RR-TB in DR Congo. This study included all MDR/RR-TB patients referred from February 1st, 2015 to February 29th, 2017. A multivariate COX regression was performed to identify factors associated with mortality in the target population. Kaplan Meier method described the survival of patients and the comparison of curves was performed by the test of log Rank. Results: 199 patients were included in our study. Male gender was predominant with a sex ratio of 1.3. The mean age of patients was 35.8 ± 13.9 years. Among them, 18 (15.1%) were died. The major complications were Chronicles pulmonary Heart failure (p = 0.035), Chronic respiratory insufficiency (p = 0.004), depression (p = 0.044), undernutrition (p = 0.033), alcohol addiction (p = 0.006) and high smoking (p = 0.019). In multivariated analysis, factors associated to the death were alcohol addiction (HRa = 12.64, 95% CI 2.36 - 14.55, p = 0.003), asthenia (HRa = 4.75, 95% CI 1.56 - 14.50, p < 0.001), pulmonary consolidation (HRa = 10.01 95% CI 2.34 - 12.86, p = 0.02), some chest X-ray abnormalities such as signs of pulmonary fibrosis (HR = 4.7, 95% CI 2.78 - 28.94, p = 0.002) and the Chronic respiratory insufficiency (HRa = 3.77, 95% CI 1.37 - 10.43, p = 0.010). Conclusion: The present retrospective cohort study revealed that structural and functional pulmonary alteration emerged as the main factors associated with mortality among MDR/RR TB patients in Kinshasa. National Tuberculosis Programs should take into account those parameters while defining mortality reduction strategy.
First Use of Bedaquiline in Democratic Republic of Congo: Two Case Series of Pre Extensively Drug Resistant Tuberculosis  [PDF]
Murhula Innocent Kashongwe, Leopoldine Mbulula, Brian Bakoko, Pamphile Lubamba, Murielle Aloni, Simon Kutoluka, Pierre Umba, Luc Lukaso, Michel Kaswa, Jean Marie Ntumba Kayembe, Zacharie Munogolo Kashongwe
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.62012
Abstract: In this manuscript the authors have studied the first two patients who were successfully treated with the treatment regimen containing Bedaquiline as second-line drug. The patients were diagnosed with pre-extensively drug-resistant tuberculosis (preXDR TB) whose prognosis was fatal in Democratic Republic of Congo (DRC). Bedaquiline is arguably one of the molecules of the future in the management of ultra-resistant tuberculosis. However, a larger cohort study may help to establish its effectiveness. Case report: Patients 1, 29 years old, with a history of multidrug-resistant TB (MDR-TB) one year previously. He showed signs of TB impregnation again 6 months after the last treatment. Bascilloscopy was positive again. The pre-extensively tuberculosis (pre-XDR TB) diagnosis was made by the Hain test (GenoType® MTBDRsl, Hain Lifescience). Patient 2, brother of the first patient, with a history of MDR TB a year before. He had low back pain with right parietal dorso swelling four months after the last treatment. The x-ray of the column showed L4-L5 disc disease. Parietal ultrasound showed a parietal abscess to the right of thoracic vertebrae with fistulization. Surgical biopsy and pus culture confirmed the diagnosis of Pre-XDR Extrapulmonary TB. The treatment regimen was the same for both patients: 6 months with Amikacin (Am) Bedaquiline (Bdq) Prothionamide (Pto) Paraamino Salicylic acid (PAS) Linezolid (Lzd) Cycloserine (Cs) Pyrazinamide (Z) and 14 months with PAS Lzd Cs Z. The side effects were minor. Bacteriological controls (smears and cultures) after 20 months of treatment are negative to date.
Trends in Tuberculosis Epidemiology among Children in the Democratic Republic of Congo  [PDF]
Aketi Loukia, Shiku Diayisu Joseph, Kashongwe Zacharie, Lay Gertrude, Kibadi Kapay, Kayembe Kalambay Patrick
Journal of Tuberculosis Research (JTR) , 2016, DOI: 10.4236/jtr.2016.44026
Abstract: Setting: The epidemiology of tuberculosis (TB) among children in the Democratic Republic of Congo (DRC) is not well known. Objective: This study aimed to describe the trends in TB epidemiology among children in the DRC and to compare these trends in children and adults. Design: Data from the National TB program, the WHO Global TB Report, and a demographic survey of health in the DRC were retrospectively analyzed. The study period was from 1995 to 2014. The notification rate, absolute incidence and incidence rate of TB per 100,000 population were reported. Results: In 2014, 12,785 (12.6% of adult cases) TB cases were reported in children and 101,303 in adults. Among children, 3438 (26.89%) had PTB+; 2828 (22.11%) had PTB; and 6519 (50.98%) had extrapulmonary TB (EPTB). Children under 5 years had a lower reported prevalence of TB (184 cases). The incidence rate per 100,000 population was 10 in children and 181 in adults. The TB incidence decreased between 2010 (11.47) and 2014 (10.46). The proportion of children in overall cases of PTB+ was 4% to 5% in all districts. Conclusion: Caring for childhood TB remains a challenge in the DRC. Improved diagnostic procedures and effective training of providers who care for childhood TB are needed.
Maternal Knowledge of Tuberculosis and Bacillus Calmette Guerin Vaccination in Pediatric Health Services in Kinshasa  [PDF]
Loukia Aketi, Joseph Shiku Diayisu, Zacharie Kashongwe, Grace Nkabikueni, Patrick Kayembe Kalambay, Jean-Marie Kayembe
Journal of Tuberculosis Research (JTR) , 2017, DOI: 10.4236/jtr.2017.51004
Abstract: Introduction: To participate effectively in the fight against tuberculosis (TB), mothers need to have a good knowledge of TB and its prevention. The objective of this study was to evaluate the knowledge of mothers about TB and Bacillus Calmette Guérin (BCG). Methods: This was a cross-sectional survey performed from September to December 2015 in 4 health care facilities of Kinshasa. It concerned mothers of children who received BCG vaccine. The frequencies and chi-square of Pearson were used to report results. Results: A total of 380 couples of the children and their mothers were recruited. The median age of children was 16 months (ranges: 6 days to 59 months); 224 (58.9%) of them received BCG during the period recommended; 62 (16.3%) experienced a side effect. There was a significant association (p = 0.00) between sides effects and the delayed vaccination. The average age of the mothers was 29.3 ± 6.4 years; 352 (92.6%) had heard about TB; 28 (7.4%) never heard about it; 168 (44.2%) knew that TB is a contagious disease; only 111 (29.2%) knew the mode of transmission; 87 (22.9%) did not know any signs of TB, and 54 (14.2%) knew about prevention with the BCG vaccine. Factors significantly associated with the mothers’ lack of knowledge were a low level of education (p = 0.01), young age (p = 0.02), and place of residence (p = 0.04). Conclusion: There is an urgent need to improve the education of the population, particularly those who lives in poor conditions and who are uneducated.
Some aspects of symmetric Gamma process mixtures
Zacharie Naulet,Eric Barat
Statistics , 2015,
Abstract: In this article, we present some specific aspects of symmetric Gamma process mixtures for use in regression models. We propose a new Gibbs sampler for simulating the posterior and we establish consistency results related to the Gaussian mean regression problem.
Fostering accurate HIV/AIDS knowledge among unmarried youths in Cameroon: Do family environment and peers matter?
Zacharie Tsala Dimbuene, Barthelemy Kuate Defo
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-348
Abstract: Data were drawn from the Cameroon Family Life and Health Survey (CFHS) conducted in 2002. The CFHS collected information on a representative sample of 4 950 people aged 10 years and over nested within 1 765 selected households from the 75 localities forming the administrative prefecture of Bandjoun, using detailed questionnaires about family, HIV/AIDS/STDs knowledge, sexual behaviors, contraception, health, media exposure, household assets and neighborhood characteristics. The survey cooperation rates were high (97%). For the purpose of this study, a sub-sample of 2 028 unmarried youths aged 12 - 29 years was utilized.Overall, 42% of respondents reported accurate knowledge of documented HIV transmission routes whereas 21% of them had inaccurate knowledge such as AIDS can be transmitted through mosquito bites or casual contact with an infected person. Only 9% of respondents were knowledgeable about all HIV prevention strategies. Multivariate analyses showed that family structure, communication with parents/guardians and peers about sexual topics were significantly associated with accurate HIV knowledge. Additionally, age, education, sexual experience and migration had significant effects on accurate knowledge. Finally, living in poor households and disadvantaged neighborhoods significantly increased inaccurate knowledge of HIV transmission modes and prevention strategies.This paper evidenced the limited effects of HIV interventions/programmes in sub-Saharan Africa. Indeed, few respondents reported accurate knowledge about HIV transmission routes and prevention strategies. Findings showed that the role of family environment as source of accurate HIV knowledge transmission routes and prevention strategies is of paramount significance; however, families have been poorly integrated in the design and implementation of the first generation of HIV interventions. There is an urgent need that policymakers work together with families to improve the efficiency of these interven
Simulation of a DI Diesel Engine Performance Fuelled on Biodiesel Using a Semi-Empirical 0D Model  [PDF]
Claude Valery Ngayihi Abbe, Robert Nzengwa, Raidandi Danwe, Zacharie Merlin Ayissi, Marcel Obounou
Energy and Power Engineering (EPE) , 2013, DOI: 10.4236/epe.2013.510066

Diesel engines have proven over the years important in terms of efficiency and fuel consumption to power generation ratio. Many research works show the potential of biodiesel as a substitute for conventional gasoil. Mainly, previous and recent researches have focused on experimental investigation of diesel engine performance fuelled by biodiesel. Researches on the mathematical description of diesel engine process running on biodiesel are scarce, and mostly about chemical and thermodynamic description of the combustion process of biodiesel rather than performance studies. This work describes a numerical investigation on the performance analysis of a diesel engine fuelled by palm oil biodiesel. The numerical investigation was made using a semi empirical 0D model based on Wiebe’s and Watson’s model which was implemented via the open access numerical calculation software Scilab. The model was validated first by comparing with experimental pressure and performance data of a one cylinder engine at rated speed and secondly by comparing with a six cylinders engine performance data at various crankshaft rotational speeds. Simulations were then made to analyze the engine performance when running on biodiesel. The calculations were made at constant combustion duration and constant coefficient of excess air. Results showed that the model matches the overall experimental data, such as the power output and peak cylinder pressure. The ignition delay was somehow underestimated by the model for the first experiment, which caused a slight gap on in cylinder pressure curve, whereas it predicted the average ignition delay fairly well for the second set of validation. The simulations of engine performance when running on biodiesel confirmed results obtained in previous experimental researches on biodiesel. The model will be further investigated for engine control when shifting to biodiesel fuel.

On the polyhedron of the K-partitioning problem with representative variables
Zacharie Ales,Arnaud Knippel,Alexandre Pauchet
Mathematics , 2014,
Abstract: The K-partitioning problem consists of partitioning the vertices of a graph in K sets so as to minimize a function of the edge weights. We introduce a linear mixed integer formulation with edge variables and representative variables. We consider the corresponding polyhedron and show which inequalities are facet-defining. We study several families of facet-defining inequalities and provide experimental results showing that they improve significantly the linear relaxation of our formulation.
Management of Cervical Intra Epithelial Neoplasia by Loop Electrosurgical Excision Procedure in a Low Resource Country: An Experience from the Yaoundé General Hospital, Cameroon  [PDF]
Jean Dupont Kemfang Ngowa, Anny Ngassam, Jovanny Fouogue Tsuala, Juny Metogo, Zacharie Sando, Angèle Kabeyene, Jean Marie Kasia
Open Journal of Obstetrics and Gynecology (OJOG) , 2015, DOI: 10.4236/ojog.2015.59070
Abstract: Background: Cervical cancer is the third most common cancer worldwide, and 80% of cases occur in the developing world. A critical component of effective cervical cancer screening programs is the ability to offer women appropriate and effective treatment for cervical intra epithelial neoplasia (CIN). Objectives: This study aimed at assessing the primary experience of management of CIN by Loop Electrosurgical Excision Procedure (LEEP) in a low resource country. Methods: We carried out a descriptive cross sectional study at the Yaoundé General Hospital in Cameroon. Results: Twenty three cases of CIN were treated by LEEP. Mean age of patients was 40.5 ± 9.9 years. Six (26.1%) patients were infected by the Human Immunodeficiency Virus (HIV). LEEP was indicated in 21 (91.30%) cases for CIN2 and CIN3. The mean duration of the surgical procedure was 10 ± 3 minutes. There was one (4.3%) complication (persistent cervical bleeding). Surgical margins were negative for dysplasia or invasive carcinoma in 18 (78.26%) cases and non-applicable in 5 (21.73%) cases (thermal artefacts of margins and cervicitis without CIN). One patient with micro invasive carcinoma on post-operative histology was treated by total hysterectomy. Cervical cytology was normal at 6 months post LEEP for 15 cases out of 16 (93.8%) patients who performed the test. One woman achieved pregnancy and delivered a term baby. Conclusion: Treatment of CIN by LEEP is feasible, safe and effective in our setting.
Investigation of ovarian cancer associated sialylation changes in N-linked glycopeptides by quantitative proteomics
Vivekananda Shetty, Julie Hafner, Punit Shah, Zacharie Nickens, Ramila Philip
Clinical Proteomics , 2012, DOI: 10.1186/1559-0275-9-10
Abstract: In this study, we investigated the N-linked sialylated glycopeptides in serum samples from healthy and ovarian cancer patients using Lectin-directed Tandem Labeling (LTL) and iTRAQ quantitative proteomics methods. We identified 45 N-linked sialylated glycopeptides containing 46 glycosylation sites. Among those, ten sialylated glycopeptides were significantly up-regulated in ovarian cancer patients’ serum samples. LC-MS/MS analysis of the non-glycosylated peptides from the same samples, western blot data using lectin enriched glycoproteins of various ovarian cancer type samples, and PNGase F (+/?) treatment confirmed the sialylation changes in the ovarian cancer samples.Herein, we demonstrated that several proteins are aberrantly sialylated in N-linked glycopeptides in ovarian cancer and detection of glycopeptides with abnormal sialylation changes may have the potential to serve as biomarkers for ovarian cancer.The American Cancer Society estimates that in 2011, about 21,990 new cases of ovarian cancer will be diagnosed and 15,460 women will die of ovarian cancer in the United States (ovariancancer.org) [1-3]. When ovarian cancer is detected early, the five year survival rate is over 90% [4]. Serum measurement of CA125, the current standard, has an early stage detection rate of only about 28% and when combined with ultrasound still only identifies 48% [5,6]. Development of improved diagnostic tools for early detection of ovarian cancer, including the discovery of new ovarian cancer biomarkers, has the potential to significantly improve the survival rate.It has been shown that in the cancer transformation process, changed expression and post translational modification of proteins occurs, resulting in a change in the protein structure and function. Investigating these modifications specific for cancer may provide vital information and serve as biomarkers for the diseased state. Glycosylation is a common and essential form of post translational modification of proteins.
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