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Determinants of Maternal Deaths among Women with Obstetric Complications in Kasai Province from 2022 to 2024  [PDF]
Célestin Mamba, Richard Mukendi, Paul Makan Mawaw, Tabitha Ilunga Mpoyi, Joséphine Monga Kalenga, Bienfait Mwarabu Much’apa, Simon Ilunga Kandolo, Albert Mwembo Tambwe
Open Access Library Journal (OALib Journal) , 2026, DOI: 10.4236/oalib.1115846
Abstract: Introduction: Maternal mortality remains a major public health problem worldwide. According to recent estimates from the World Health Organization, approximately 287,000 maternal deaths were recorded globally in 2020, with more than 95% occurring in low- and middle-income countries. In the Democratic Republic of Congo (DRC), the maternal mortality ratio remains high, estimated at 760 deaths per 100,000 live births. The objective of our study was to identify the factors explaining maternal deaths among women who experienced obstetric complications in the Kasai Province. Methods: This was a mixed-methods study, combining quantitative and qualitative approaches. A case-control analytical design was complemented by a phenomenological design. The study was conducted in the Kasai Province from 2022 to 2024 and included 708 records of women who experienced obstetric complications. Results: Among women who experienced obstetric complications, 25% died, reflecting a high obstetric mortality rate. Reports from the Provincial Health Directorate (DPS) indicate a maternal mortality rate of 119 deaths per 100,000 live births. The main factors associated with maternal deaths were maternal age over 40 years, lack of skilled birth attendants, lack of follow-up antenatal care, interpregnancy interval of less than 2 years, and delayed access to care (p < 0.05). Postpartum hemorrhage was the direct obstetric cause, while gestational malaria was the indirect cause (p < 0.05). Responsibility for maternal deaths was shared among the community, healthcare facility administration, and healthcare providers. Conclusion: Maternal mortality remains high in the DRC, particularly in Kasai Province. The observed maternal deaths are linked to largely preventable factors and involve multiple responsibilities. An integrated approach, taking into account community, institutional, and professional dimensions, is essential for a sustainable reduction in maternal mortality.
Performance of the Maternal and Perinatal Death Surveillance System in Kasai Province from 2022 to 2024  [PDF]
Célestin Mamba, Richard Mukendi, Paul Makan Mawaw, Tabitha Ilunga Mpoyi, Joséphine Monga Kalenga, Bienfait Mwarabu Much’apa, Simon Ilunga Kandolo, Albert Mwembo Tambwe
Open Access Library Journal (OALib Journal) , 2026, DOI: 10.4236/oalib.1115848
Abstract: Introduction: Maternal and Perinatal Death Surveillance and Response still poses serious challenges in the DRC and in the Kasai province. The objective of this study was to evaluate its performance, identify gaps, and propose appropriate solutions to contribute to reducing maternal and perinatal mortality in the province. Methods: This was a mixed-methods study with a comprehensive design (cross-sectional analytical for quantitative data, phenomenological for qualitative data) covering the period from January 1, 2022, to December 31, 2024. Quantitative data were analyzed using Epi Info (v7.2.6.0) with descriptive and inferential statistics (95% CI). Qualitative data were analyzed thematically. Results: The performance of the system’s pillars ranged from 19% to 56%. Only 25% of deaths were reviewed in the province during the evaluation period. Providers trained in maternal and perinatal mortality monitoring (MPM), the availability of MPM forms, the existence of an MPM committee in the health district (HD), the completion of maternal and perinatal death reviews, and the holding of HD MPM meetings are associated with the performance of the MPM system (p < 0.05). Conclusion: The MPM system remains underperforming in Kasai Province. To strengthen its performance, it is important to address its core components by strengthening infrastructure, financial management, and communication; and to build the capacity of MPM and HZN providers and foster their retention.
Determinants of Perinatal Deaths among Births with Complications in Kasai Province from 2022 to 2024  [PDF]
Célestin Mamba, Richard Mukendi, Paul Makan Mawaw, Tabitha Ilunga Mpoyi, Joséphine Monga Kalenga, Bienfait Mwarabu Much’apa, Simon Ilunga Kandolo, Albert Mwembo Tambwe
Open Access Library Journal (OALib Journal) , 2026, DOI: 10.4236/oalib.1115847
Abstract: Introduction: Neonatal mortality remains a major public health problem worldwide. A World Health Organization report indicates that 4 million children die before their first month of life. In Africa, an analysis has shown that perinatal mortality rates range from 66 to 124 per 1000 live births. In the Democratic Republic of Congo (DRC), the perinatal mortality rate remains high, estimated at 32 per 1000 live births. The objective of this study Identify the factors associated with perinatal deaths among births with complications in Kasai Province. Methods: This was a mixed-methods study, combining quantitative and analytical approaches. A case-control analytical design was complemented by a phenomenological design. The study was conducted in Kasai Province from 2022 to 2024 and included 798 records of newborns who experienced birth complications. Results: Among newborns who experienced birth complications, 33.3% died, reflecting a high obstetric mortality rate, even though DPS reports indicate a perinatal mortality rate of 2 deaths per 1000 live births. Factors associated with these deaths were living in a rural area, prematurity, lack of antenatal care visits, low birth weight, and male sex (p < 0.05). Neonatal sepsis, asphyxia, and dystocia were also contributing factors (p < 0.05). Responsibility for perinatal deaths was shared among the community, healthcare facility administration, and healthcare providers. Conclusion: Perinatal mortality remains high in the DRC, particularly in Kasai Province. The observed perinatal deaths are linked to largely preventable factors and involve multiple responsibilities. An integrated approach, taking into account community, institutional, and professional dimensions, is essential for a lasting reduction in perinatal mortality.
Supports filmiques transversaux en pratique de la langue : document authentique ou authentiquement intéressant ? Transversal film resources for language practice : authentic or authentically interesting materials ?
Joséphine Rémon
Recherche et Pratiques Pédagogiques en Langues de Spécialité : Cahiers de l'APLIUT , 2012, DOI: 10.4000/apliut.2702
Abstract: Dans le cadre d’une réflexion sur les supports filmiques dans l’enseignement des langues, nous nous proposons de revisiter la notion de document authentique pour apporter une contribution théorique à l’appréhension de l’attractivité d’une ressource filmique et à l’appréhension de la nature de l’acte pédagogique que représente l’utilisation de ces ressources. Des exemples de vidéos disponibles sur Internet montrent que l’opposition entre le didactique et l’authentique laisse place à la transversalité des thématiques, fédérées par le concept de question socialement vive .Si les ressources filmiques n’ont pas le monopole des questionnements éthiques, le regarder ensemble pédagogique en fait un vecteur privilégié pour aborder les questions vives.Avec ces ressources capables de générer une écoute engagée , la langue devient le vecteur d’une modification d’un système de connaissances, au-delà de la poursuite d’objectifs langagiers mis au service d’une interpellation citoyenne. As part of a reflection on films and videos for language teaching, this paper re-examines the notion of authentic material and presents a theoretical contribution to understanding a video resource’s attractiveness, and to understanding what pedagogical act is represented by the use of such resources. Examples of videos from the Internet show that the traditional opposition between didactic and authentic documents is replaced by the transversal nature of certain topics, connected through the controversies they can generate.While it is true that films and videos are not the only resource allowing one to tackle ethical issues, watching them as a group in class makes them a most adequate vector for work on controversial topics.With these resources capable of triggering engagement in the process of listening, language becomes the way to challenge a knowledge system, far beyond linguistic objectives that are used to serve a wider questioning by the citizen.
à l’intérieur des images
Joséphine Alida Jacquier
Flaubert : Revue Critique et Génétique , 2010,
Abstract: Par une remarquable analyse, Jean Seznec a pu montrer à quel point le caractère presque surréaliste de La Tentation de saint Antoine de Flaubert est d aux lectures scientifiques, parmi celles-ci la Symbolique de Friedrich Creuzer, traduit de l’allemand par Joseph-Daniel Guigniaut sous le titre Religions de l’antiquité, considérées principalement dans leurs formes symboliques et mythologiques. à partir des observations de Seznec, Michel Foucault formula plus tard sa conception du fantastique singulièrement moderne . Mais l’affinité entre les textes de Creuzer et de Flaubert se déclare-t-elle exclusivement par des reprises textuelles ? L’article suivant veut montrer que c’est aussi la pensée symbolique qui relie la science de ce grand mythologue allemand et le texte déroutant de l’ermite de Croisset : les caractères qui constituent selon Creuzer le symbole – soudaineté, aspect physique, et clarté – structurent pas seulement les descriptions flaubertiennes des hallucinations et visions artistiques, mais se révèlent aussi comme éléments essentiels de la composition du défilé épiphanique des dieux. Le geste disséquant de la science et la pensée symbolique forment la structure hybride de la Tentation : l’illusoire du texte, progressant toujours par la création de nouveaux espaces symboliques et hallucinés, inclut, par la référence scientifique, son propre anéantissement. In a striking essay, Jean Seznec could show in how far the almost surrealist character of Flaubert s La Tentation de saint Antoine is grounded on scientific readings such as the Symbolism by Friedrich Creuzer. The French translation of this work, the Religions de l'antiquité, considérées principalement dans leurs formes symboliques et mythologiques, was provided by Joseph-Daniel Guigniaut. Based on the observations of Seznec, Foucault formulated his conception of the fantastique singulièrement moderne . But does the affinity between the texts of Creuzer and Flaubert purely consist of textual copies?The following essay should show that it is the symbolical way of thinking that connects the science of the great German mythologist and the puzzling text of Flaubert. The characteristics that according to Creuzer constitute the symbol – suddenness, appearance and clarity – structure not only Flaubert s descriptions of hallucinations and artistic visions, but also reveal themselves as essential elements of the epiphanean défilé of the gods. The dissecting character of science and the symbolical way of thinking form the hybrid structure of the Tentation. The illusory of the text continuously p
Human Herpesvirus 6 and Neuroinflammation
Joséphine M. Reynaud,Branka Horvat
ISRN Virology , 2013, DOI: 10.5402/2013/834890
Abstract: Human herpesvirus (HHV-) 6A and HHV-6B are two distinct β-herpesviruses which have been associated with various neurological diseases, including encephalitis, meningitis, epilepsy, and multiple sclerosis. Although the reactivation of both viruses is recognized as the cause of some neurological complications in conditions of immunosuppression, their involvement in neuroinflammatory diseases in immunocompetent people is still unclear, and the mechanisms involved have not been completely elucidated. Here, we review the available data providing evidence for the capacity of HHV-6A and -6B to infect the central nervous system and to induce proinflammatory responses by infected cells. We discuss the potential role of both viruses in neuroinflammatory pathologies and the mechanisms which could explain virus-induced neuropathogenesis. 1. Introduction Human herpesvirus (HHV-) 6 was first isolated in 1986 by Salahuddin and colleagues [1]. This enveloped DNA virus belongs to the β-herpesvirus family and, together with its closest homologue HHV-7, forms the roseoloviruses subfamily. HHV-6 is widely spread in the population (seroprevalence > 90%) and can establish a persistent and most often asymptomatic infection in humans. Based on genetic, epidemiological, and functional features, the numerous isolated strains of HHV-6 were initially separated into two variants, HHV-6A and HHV-6B, which have recently been recognized as two distinct viruses. HHV-6A and -6B share an overall sequence identity of 90%, and several open reading frames are present in only one of the two viruses [2]. Primary infection with HHV-6B generally happens before the age of two; the virus is transmitted through saliva and close contacts with parents [3] and provokes exanthem subitum (or roseola), a benign febrile illness with skin rash. HHV-6A infection is thought to happen later in life and was not yet clearly identified as the causative agent for any disease. To date, the only identified cellular receptor for both HHV-6A and -6B is the complement-regulatory transmembrane protein CD46 [4]. This protein is ubiquitously expressed in humans, allowing the viruses to infect a wide range of cells and tissues, including cells from the central nervous system (CNS). Both viruses have a high tropism towards T cells, which are the best virus producers in vitro, and can establish a persistent infection in different tissues, including the salivary glands (for HHV-6B only) and peripheral lymphocytes. In immunocompromised patients, HHV-6A and -6B often reactivate and can provoke neurological pathologies.
Phenotype and Epidemiological Profile of Children with Sickle Cell Disease Followed-Up at the Mother and Child Hospital of N’Djamena  [PDF]
Franck Houndjahoue, Silé Souam Nguele, Mbanga Djimadoum, Joséphine Toralta, Khadidja Attimer, Hagre Youssouf, Blaise Ayivi
Open Journal of Pediatrics (OJPed) , 2016, DOI: 10.4236/ojped.2016.63033
Abstract: In Africa, sickle cell disease is still a public health issue. In Chad, a high prevalence area, it may represent a silent disease. To study the quality of care provided to children with sickle cell disease within the framework of a hospital initiative launched in 2011 and in the absence of a national program in Chad, we conducted this research in the pediatric sickle cell disease center of the Mother and Child Hospital of N’Djamena. This was a cross-sectional study, involving 364 children with sickle cell disease out of 12,500 children followed up from May 2011 to December 2014 (3.9%). The sex ratio was 1.3. The average age at diagnosis was 17 months, often in the context of vaso-occlusive crisis (34.6%). The follow-up protocol included monthly appointments following diagnosis of disease. We observed 80% non-compliance among cases; characteristics associated with non-compliance included families with several children, inaccessible anti-pneumococcal prophylaxis based on Penicillin V and very low anti-pneumococcal vaccine coverage (4.4%). These results suggest that there is a need to rapidly implement a national sickle cell disease program including preventive and curative care in Chad.
Evaluation of the Adequacy between the Workload and the Number of State Midwives and Maieuticians Practicing in the Gynecology-Obstetrics Departments of the University Hospitals of Burkina Faso  [PDF]
Timongo Fran？oise Danielle Millogo-Traore, Pazoudba Rachida Marie Joséphine Ouedraogo-Drabo, Pierre Yameogo
Open Journal of Obstetrics and Gynecology (OJOG) , 2022, DOI: 10.4236/ojog.2022.127058
Abstract: Objective: To evaluate the adequacy between the workload and the number of midwives and state midwives practicing in the gynecology-obstetrics services of the university hospitals of Burkina Faso. Methodology: This is a multicenter study conducted in 4 university hospitals representing this country (for brevity referred here to as A, B, C, and D) from May 1, 2018, to April 30, 2019. The Workload Indicators of Staffing Need (WISN) method was used to analyze the workload. Results: Dystocic delivery was the activity that took the most time. Inpatient activities were the most performed in terms of volume. At the University Hospitals D and C, there was an over-staffing of midwives and ma？euticians with a ratio of 1.93 and 2.12 respectively. At University Hospital B, the workload was in line with the existing number of State midwives and maieuticians. A low workload pressure (04%) was found at the University Hospital A. Conclusion: In most of the University Hospital Centers, there was no match between the workload and the number of midwives and ma？euticians. These results highlight the need for redeplayment of midwives and ma？euticians in order to ensure good health coverage for midwives and ma？euticians.
The Modulating Role of Self-Referential Stimuli and Processes in the Effect of Stress and Negative Emotion on Inhibition Processes in Borderline Personality Disorder: Proposition of a Model to Integrate the Self-Concept and Inhibition Processes
Gasser Saleh,Jean Gagnon,Joséphine Aldebert,Wan Seo Kim
Brain Sciences | An Open Access Journal from MDPI , 2019, DOI: https://doi.org/10.3390/brainsci9040077
Abstract: Impulsivity is an important clinical and diagnostic feature of borderline personality disorder (BPD). Even though it has been reported that BPD individuals’ inhibition performance is significantly reduced in the context of negative emotion or stress, this literature shows mixed results, raising questions about the possible role played by other factors. Winter (2016) proposed that negative emotion stimuli can be more disruptive for BPD individuals’ attention control performance because they induce higher distractibility self-referential processes. This article aimed to systematically review the literature regarding the effect of stress and negative emotions on three main inhibition processes—prepotent response inhibition, resistance to distractor interference, and resistance to proactive interference—in BPD and to verify the putative modulating role of self-referential stimuli and processes on these inhibition processes. All English and French experimental studies published until August 2018 were searched in PsychINFO and PubMED databases. The following keywords were used: “borderline* AND inhibit* OR interference* OR forget* OR task* AND emotion* OR stress* OR affect*”. A total of 1215 articles were included in the study. After full text revision, twenty-six papers were selected for review. The results of this review indicate that when stimuli or procedures involve self-reference stimuli or processes, BPD individuals’ performance seems to be more disrupted in all three inhibition processes. A model based on Winter’s and Kernberg’s models is proposed with the aim of integrating the self-concept with inhibition processes in BPD. View Full-Tex
Comment les enseignants immigrants formés à l’étranger vivent-ils les relations interpersonnelles et professionnelles à leur entrée dans le milieu scolaire québécois ?
Mukamurera, Joséphine,Niyubahwe, Aline,Sirois, Geneviève
- , 2018, DOI: https://doi.org/10.7202/1066950ar
Abstract: Le nombre d’enseignants immigrants formés à l’étranger (EIFé) ne cesse de cro？tre dans les milieux scolaires québécois. Malgré leur expérience d’enseignement acquise dans leurs pays d’origine, ils font figure de débutants dans le nouveau système scolaire dont ils ne connaissent pas les politiques, le fonctionnement, ni la culture professionnelle. Ainsi, leur socialisation peut comporter d’énormes défis puisqu’ils doivent à la fois s’intégrer dans leur milieu de travail dont les repères leur échappent, tout en étant appelés à coopérer et à travailler de concert avec les autres acteurs de la scène scolaire. Cet article a pour objectif de décrire et comprendre comment ces enseignants vivent les relations interpersonnelles et professionnelles lors de leurs premières années d’embauche dans le milieu scolaire québécois. Le cadre d’analyse de notre recherche s’appuie sur le concept d’insertion professionnelle, particulièrement sur le plan de la socialisation organisationnelle. Les données analysées sont issues d’une étude qualitative d’inspiration phénoménologique menée au moyen d’entrevues semi-dirigées auprès de 13 EIFé des régions de Montréal et de Sherbrooke. Les résultats suggèrent que les EIFé vivent souvent des problématiques frustrantes, marquées par un accueil froid, l’indifférence, l’isolement, la méfiance, l’absence de soutien et de collaboration ainsi que la non-reconnaissance professionnelle. Quelques-uns rapportent des expériences positives, ce qui laisse comprendre que la situation peut varier d’une école à l’autre en fonction des caractéristiques contextuelles et des qualités personnelles des EIFé. Ces résultats sont discutés et des pistes d’action sont proposées pour le milieu scolaire
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