scholarly journals Onchocerciasis-associated epilepsy in the Democratic Republic of Congo: Clinical description and relationship with microfilarial density

2019 ◽  
Author(s):  
Joseph Nelson Siewe Fodjo ◽  
Michel Ndahura Mandro ◽  
Deby Mukendi ◽  
Floribert Tepage ◽  
Sonia Menon ◽  
...  
Keyword(s):  
Seizure Frequency ◽  
Clinical Characteristics ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Wide Spectrum ◽  
Multivariable Analysis ◽  
Republic Of Congo ◽  
History Of ◽  
Health Zone ◽  
Density Methods

Background: High epilepsy prevalence and incidence were observed in onchocerciasis-endemic villages in the Democratic Republic of Congo (DRC). We sought to investigate the clinical characteristics of onchocerciasis-associated epilepsy (OAE), and the relationship with microfilarial density. Methods: In October 2017, ivermectin-naive persons with epilepsy (PWE) were recruited from onchocerciasis-endemic areas in the Logo health zone in the DRC. Additional PWE were enrolled in the Aketi health zone, where ivermectin had been distributed annually for 14 years. Past medical history, clinical characteristics and skin snips for Onchocerca volvulus detection were obtained from participants. Bivariate and multivariable analyses were used to investigate associations with microfilarial density. Results: Of the 420 PWE in the Logo health zone, 392 were skin snipped (36.5% positive). Generalized motor seizures were most frequent (392 PWE, 93.3%), and nodding seizures were reported in 32 (7.6%) participants. Twelve PWE (3.1%) presented Nakalanga features. More skin snip-positive participants reported a family history of epilepsy (p=0.027). Eighty-one onchocerciasis-infected PWE were recruited in the Aketi health zone. Positive correlations between seizure frequency and microfilarial density were observed in Logo (Spearman-rho=0.181; p=0.0003) and Aketi (Spearman-rho=0.228; p=0.046). In the multivariable analysis which adjusted for age, gender and previous anti-epileptic drug use, factors associated with high seizure frequency included: high microfilarial density (RR=1.004, 95% CI: 1.002–1.007; p<0.001), history of nodding seizures (RR=3.852, 95% CI: 2.926–5.082; p<0.001) and shorter duration of epilepsy (RR=0.948, 95% CI: 0.928–0.968; p<0.001). In Aketi, previous ivermectin use was associated with reduced seizures (RR=0.69, 95% CI: 0.58–0.83; p<0.001). Conclusion: In onchocerciasis-endemic regions in the DRC, a wide spectrum of seizures was observed. Nodding seizures, Nakalanga features, and a positive association between microfilarial density and seizures suggest a high OAE prevalence in the study villages, requiring a double management strategy: treatment with anti-epileptic drugs and stronger onchocerciasis elimination programs.

scholarly journals Mutual Health Insurance and Access to Care in the Health Zone of Kabinda, Kasai-Oriental, Democratic Republic of Congo (DRC)

OALib ◽  
2017 ◽  
Vol 04 (04) ◽  
pp. 1-11
Author(s):  
Cibangu Kazadi Richard ◽  
Bilonda Mpiana Alphonsine ◽  
Kabengele Mpinga Emmanuel ◽  
Mulewu Ngandu Hippolyte ◽  
Ciamala Mukendi Paul ◽  
...  
Keyword(s):  
Health Insurance ◽  
Access To Care ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Republic Of Congo ◽  
Health Zone

scholarly journals Reported History of Measles and Long-term Impact on Antibody to Tetanus in Children 6–59 Months of Age Receiving DTP in the Democratic Republic of Congo

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S323-S323 ◽  
Author(s):  
Hayley Ashbaugh ◽  
James D Cherry ◽  
Sue Gerber ◽  
Stephen G Higgins ◽  
Adva Gadoth ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Past History ◽  
Positive Control ◽  
P Value ◽  
Republic Of Congo ◽  
History Of ◽  
Long Term Impact ◽  
Induced Immunity

Abstract Background Recent studies suggest a measles-induced immune amnesia that could have long-term immunosuppressive effects via preferential depletion of memory B and T CD150+ lymphocytes. Methods We examined the association between past measles and tetanus antibody levels among children participating in the 2013–2014 Democratic Republic of Congo (DRC) Demographic and Health Survey (DHS). Our sample consisted of 833 children aged 6–59 months whose mothers were selected for interview. Mothers reported (via recall) history of measles within the lifetime of the child. Classification of children who previously had measles was completed using maternal recall and measles immunoglobulin G (IgG) serostatus obtained via dried blood spot (DBS) analysis. A multiplex chemiluminescent immunoassay platform was used to obtain serologic results and Assay Score (AS) was calculated as a ratio to a positive control included in each run. Tetanus serostatus was categorized as being above or below the sample median serology AS value. Tetanus vaccination status was obtained via dated vaccination card and limited to children receiving the complete 3-dose vaccination series. Results The median AS for tetanus serology among the entire sample of 833 children was 0.085, while children with history of measles had a median AS of 0.053 (N = 41) and children with no history of measles had a median AS of 0.088 (N = 792), chi-square P-value &lt; 0.05. A random intercept logistic regression model was used to examine the association between previous measles disease and odds of having below median levels of tetanus antibody. Controlling for potential confounding variables, the odds of a child with past history of measles having less than the median level of tetanus antibody was 3.86 (95% CI: 1.70, 8.78) among children fully vaccinated for tetanus. Conclusion The results suggest that, among children 6–59 months in DRC, measles may have a long-term impact on levels of pre-existing, vaccine-induced immunity to tetanus. These findings suggest the need for laboratory studies examining measles’ impact on pre-existing, vaccine-induced immunity and underscore the need for continued evaluation and improvement of DRC’s measles vaccination program. Disclosures All authors: No reported disclosures.

scholarly journals Single versus Multiple Dose Ivermectin Regimen in Onchocerciasis-Infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo

Pathogens ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 205 ◽  
Author(s):  
Michel Mandro ◽  
Joseph Nelson Siewe Fodjo ◽  
Alfred Dusabimana ◽  
Deby Mukendi ◽  
Steven Haesendonckx ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Seizure Frequency ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Analysis Data ◽  
Seizure Freedom ◽  
Republic Of Congo ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: There is anecdotal evidence that ivermectin may decrease seizure frequency in Onchocerca volvulus-infected persons with epilepsy (PWE). Methods: In October 2017, a 12-month clinical trial was initiated in rural Democratic Republic of Congo. PWE with onchocerciasis-associated epilepsy experiencing ≥2 seizures/month were randomly allocated to receive, over a one-year period, ivermectin once or thrice (group 1), while other onchocerciasis-infected PWE (OIPWE) were randomized to ivermectin twice or thrice (group 2). All participants also received anti-epileptic drugs. Data was analyzed using multiple logistic regression. Results: We enrolled 197 participants. In an intent-to-treat analysis (data from group 1 and 2 combined), seizure freedom was more likely among OIPWE treated with ivermectin thrice (OR: 5.087, 95% CI: 1.378–19.749; p = 0.018) and twice (OR: 2.471, 95% CI: 0.944–6.769; p = 0.075) than in those treated once. Similarly, >50% seizure reduction was more likely among those treated with ivermectin twice (OR: 4.469, 95% CI: 1.250–16.620) and thrice (OR: 2.693, 95% CI: 1.077–6.998). Absence of microfilariae during the last 4 months increased the odds of seizure freedom (p = 0.027). Conclusions: Increasing the number of ivermectin treatments was found to suppress both microfilarial density and seizure frequency in OIPWE, suggesting that O. volvulus infection plays an etiological role in causing seizures.

scholarly journals The Historical Taboo: Colonial Discourses and Postcolonial Identities in Belgium

Werkwinkel ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 107-123 ◽  
Author(s):  
Julien Bobineau
Keyword(s):  
Empirical Analysis ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Colonial History ◽  
Dr Congo ◽  
Republic Of Congo ◽  
Age Related ◽  
History Of ◽  
Sub Saharan

Abstract This article examines so-called colonial discourses in Belgium related to the former Sub-Saharan colony owned by Leopold II of Belgium which today is known as the Democratic Republic of Congo (DR Congo) or the Congo-Kinshasa. Having introduced the colonial history of the DR Congo from the 15th century until 1910, the study starts with a discussion of Van den Braembussche’s concept of a ‘historical taboo’ and four ways of engaging with such implicit interdictions. Finally, an empirical analysis of colonial discourses in Belgium from the 1890s until today will be presented in conjunction with Belgium’s linguistic-cultural division, taking into account age-related divergence.

scholarly journals Prevalence of Hypertension and Associated Factors in Lubumbashi City, Democratic Republic of Congo: A Community-Based Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jacques Mbaz Musung ◽  
Placide Kambola Kakoma ◽  
Clarence Kaut Mukeng ◽  
Stéphane Lubamba Tshimanga ◽  
Jeef Paul Munkemena Banze ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Associated Factors ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
History Of ◽  
The Mean

Background. Hypertension is the leading cause of cardiovascular disease morbidity and mortality worldwide. Its struggle involves knowing its prevalence. Insufficient data on hypertension in adults in Lubumbashi, Democratic Republic of Congo (DRC), prompted the conduct of this study. The objectives were to determine the prevalence of hypertension and to identify the associated factors in adults in Lubumbashi. Methodology. A cross-sectional study was carried out among 6,708 adults from October 15th to November 24th, 2018, in Lubumbashi. Anthropometric data, lifestyle, and medical history were collected. Hypertension was defined when the mean of the last two blood pressure (BP) measurements was greater than or equal for systolic (SBP) at 140 mmHg and for diastolic (DBP) at 90 mmHg or a history of taking antihypertensive medication whatever the value of the BP. Logistic regression was used to identify the relative effects of hypertension risk factors and all statistical tests were declared significant at a p value <0.05. Results. The female participants numbered 4479 (66.8%). The mean age of all participants was 47.9 ± 16.5 years. The mean SBP and DBP were 128.4 ± 25.9 mmHg and 79.1 ± 15.3 mmHg, respectively. The overall prevalence of hypertension was 33.6%. This prevalence was statistically higher in women than in men (34.5% vs. 31.7%; p = 0.024 ). After logistic regression, the risk of hypertension increased with age >50 years (aOR = 5.85 [5.19–6.60]), overweight (aOR = 1.25 [1.11–1.41]), obesity (aOR = 1.25 [1.11–1.41]), central obesity (aOR = 1.37 [1.16–1.61]), diabetes mellitus (aOR = 2.19 [1.63–2.95]), alcohol consumption (aOR = 1.21 [1.05–1.39]), nonconsumption of vegetables (aOR = 1.35 [1.02–1.80]), and history of stroke (aOR = 2.57 [1.88–3.51]). Hypertension was inversely associated with being underweight (aOR = 0.68 [0.53–0.87]). Conclusion. The prevalence of hypertension in the city of Lubumbashi is high as in other cities of the DRC and Africa. This situation requires the implementation of prevention, detection, and treatment programs for hypertension.

An overview of refrigeration and its impact on the development in the Democratic Republic of Congo

2015 ◽  
Vol 26 (3) ◽  
pp. 79-89 ◽  
Author(s):  
Jean Fulbert Ituna-Yudonago ◽  
J. M. Belman-Flores ◽  
V. Pérez-García
Keyword(s):  
Sustainable Development ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Social Indicators ◽  
Cooling Capacity ◽  
Industrial Sector ◽  
Republic Of Congo ◽  
The Sustainable Development ◽  
Post Colonial ◽  
History Of

The development of refrigeration is a priority in all countries, given the multidimensional roles that it plays in the sustainable development of society. In developing countries, efforts are being made to catch up with the delayed experienced in the use of refrigeration. To achieve this goal, several countries are allowed to trace the history of refrigeration in their countries in order to understand the main causes of non-expansion, and then set up a new strategy of sustainable development for this technology. The Democratic Republic of Congo (DRC) is a developing country that has experienced a very interesting history of refrigeration, but is still less known by the Congolese themselves as well as by scientists. This paper has traced out the outline in the history of refrigeration in the DRC. Surveys were conducted in the industrial, health, residential, commercial, and tourism sectors during the colonial and post-colonial period. Results showed that the use of refrigeration in the DRC has been remarkably observed in the industrial sector, especially in breweries, with a cooling capacity ranging from 50.1 thousand to 2.88 million kWh, about 5 659 % between 1929 and 1957; from 3 million to 26.5 million kWh, about 783.3 % between 1958 and 1980, and then dropped to 6.5 million kWh in 2004 before resuming its growth up to 11 million kWh in 2009. The variations in the use of refrigeration during the above periods significantly influenced the economy, in the sense that the economic and social indicators of the country grew from 0.415 to 0.430 between 1975 and 1985, and then declined to 0.375 in 2000, due to political instability, before rising up to 0.410 in 2005.

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