scholarly journals Extracellular pH, osmolarity, temperature and humidity could discourage SARS-CoV-2 cell docking and propagation via intercellular signaling pathways

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12227
Author(s):  
Franco Cicconetti ◽  
Piero Sestili ◽  
Valeria Madiai ◽  
Maria Cristina Albertini ◽  
Luigi Campanella ◽  
...  
Keyword(s):  
Sodium Bicarbonate ◽  
Low Income ◽  
Democratic Republic Of Congo ◽  
Vaccination Campaign ◽  
Thick Layer ◽  
Extracellular Ph ◽  
High Rate ◽  
Low Income Countries ◽  
World Population ◽  
Cell Infection

The COVID-19 pandemic and its virus variants continue to pose a serious and long-lasting threat worldwide. To combat the pandemic, the world’s largest COVID-19 vaccination campaign is currently ongoing. As of July 19th 2021, 26.2% of the world population has received at least one dose of a COVID-19 vaccine (1.04 billion), and one billion has been fully vaccinated, with very high vaccination rates in countries like Israel, Malta, and the UEA. Conversely, only 1% of people in low-income countries have received at least one dose with examples of vaccination frequency as low as 0.07% in the Democratic Republic of Congo. It is thus of paramount importance that more research on alternate methods to counter cell infection and propagation is undertaken that could be implemented in low-income countries. Moreover, an adjunctive therapeutic intervention would help to avoid disease exacerbation in high-rate vaccinated countries too. Based on experimental biochemical evidence on viral cell fusion and propagation, herein we identify (i) extracellular pH (epH), (ii) temperature, and (iii) humidity and osmolarity as critical factors. These factors are here in discussed along with their implications on mucus thick layer, proteases, abundance of sialic acid, vascular permeability and exudate/edema. Heated, humidified air containing sodium bicarbonate has long been used in the treatment of certain diseases, and here we argue that warm inhalation of sodium bicarbonate might successfully target these endpoints. Although we highlight the molecular/cellular basis and the signalling pathways to support this intervention, we underscore the need for clinical investigations to encourage further research and clinical trials. In addition, we think that such an approach is also important in light of the high mutation rate of this virus originating from a rapid increase.

scholarly journals Midwives’ challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo—an interview study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Malin Bogren ◽  
Malin Grahn ◽  
Berthollet Bwira Kaboru ◽  
Marie Berg
Keyword(s):  
Work Environment ◽  
Low Income ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Quality Of Healthcare ◽  
International Standards ◽  
Low Income Countries ◽  
Professional Status ◽  
Republic Of Congo ◽  
Main Category

Abstract Background The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of the mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service is therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods Data were collected in two out of 26 provinces in the DRC through ten focus group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis. Results The midwives’ challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category—Loving one’s work makes it worthwhile to remain in one’s workplace, despite a difficult work environment and low professional status—consisting of three generic categories: Midwifery is not just a profession; it’s a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions. Conclusion Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including (i) conducting midwifery education programmes following international standards, (ii) prioritising and enforcing policies to include adequate remuneration for midwives, (iii) involving midwives’ associations in policy and planning about the midwifery workforce, and (iv) ensuring that midwives’ working environments are safe and well equipped.

scholarly journals Midwives’ challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo – An interview study

2020 ◽  
Author(s):  
Malin Bogren ◽  
Malin Grahn ◽  
Berthollet Bwira Kaboru ◽  
Marie Berg
Keyword(s):  
Work Environment ◽  
Low Income ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Quality Of Healthcare ◽  
International Standards ◽  
Low Income Countries ◽  
Professional Status ◽  
Republic Of Congo ◽  
Main Category

Abstract Background: The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of Goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service, are therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods: Data were collected in two out of 26 provinces in the DRC through ten focus-group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis.Results: The midwives’ challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category – Loving one’s work makes it worthwhile to remain in one’s workplace, despite a difficult work environment and low professional status – consisting of three generic categories: Midwifery is not just a profession; it’s a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions. Conclusion: Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including: i) conducting midwifery education programmes following international standards; ii) prioritising and enforcing policies to include adequate remuneration for midwives; iii) involving midwives’ associations in policy and planning about the midwifery workforce; and iv) ensuring that midwives’ working environments are safe and well equipped.

scholarly journals Rapid, Cheap, and Effective COVID-19 Diagnostics for Africa

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2105
Author(s):  
Lukman Yusuf ◽  
Mark Appeaning ◽  
Taiwo Gboluwaga Amole ◽  
Baba Maiyaki Musa ◽  
Hadiza Shehu Galadanci ◽  
...  
Keyword(s):  
Low Income ◽  
Nucleic Acid Amplification ◽  
High Rate ◽  
Low Income Countries ◽  
Rt Pcr ◽  
Antibody Testing ◽  
Middle Income ◽  
Diagnostic Assays ◽  
Middle Income Countries ◽  
To Come

Background: Although comprehensive public health measures such as mass quarantine have been taken internationally, this has generally been ineffective, leading to a high infection and mortality rate. Despite the fact that the COVID-19 pandemic has been downgraded to epidemic status in many countries, the real number of infections is unknown, particularly in low-income countries. However, precision shielding is used in COVID-19 management, and requires estimates of mass infection in key groups. As a result, rapid tests for the virus could be a useful screening tool for asymptomatic virus shedders who are about to come into contact with sensitive groups. In Africa and other low- and middle-income countries there is high rate of COVID-19 under-diagnosis, due to the high cost of molecular assays. Exploring alternate assays to the reverse transcriptase polymerase chain reaction (RT-PCR) for COVID-19 diagnosis is highly warranted. Aim: This review explored the feasibility of using alternate molecular, rapid antigen, and serological diagnostic assays to accurately and precisely diagnose COVID-19 in African populations, and to mitigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR diagnostic challenges in Africa. Method: We reviewed publications from internet sources and searched for appropriate documents available in English. This included Medline, Google Scholar, and Ajol. We included primary literature and some review articles that presented knowledge on the current trends on SARS-CoV-2 diagnostics in Africa and globally. Results: Based on our analysis, we highlight the utility of four different alternatives to RT-PCR. These include two isothermal nucleic acid amplification assays (loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA)), rapid antigen testing, and antibody testing for tackling difficulties posed by SARS-CoV-2 RT-PCR testing in Africa. Conclusion: The economic burden associated COVID-19 mass testing by RT-PCR will be difficult for low-income nations to meet. We provide evidence for the utility and deployment of these alternate testing methods in Africa and other LMICs.

scholarly journals Challenges of ongoing Covid and Ebola epidemics amidst violence and other epidemics in DR Congo

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Amorim Tomaz ◽  
F I P M Bastos ◽  
R S Santos ◽  
M Mossoko
Keyword(s):  
Low Income ◽  
Ebola Virus ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Virus Disease ◽  
Emerging Diseases ◽  
Low Income Countries ◽  
Republic Of Congo ◽  
Poor Countries ◽  
Conflict Zone

Abstract The world has seen outbreaks of emergency and re-emergency of infectious diseases very often in the past years, many of them with devastating consequences for low-income countries with fragile or nonexistent health system, covid-19 being by now the last of a long series of global challenges. Although it is a huge challenge for the whole world, one country is facing it together with a current Ebola outbreak plus violence and some other diseases. The Democratic Republic of Congo is facing the immediate effects of both epidemics as illness and death, however its consequences at the political and economic level are usually more complex and may be protracted. Following the debate on why poor countries remain poor, it is maybe useful to rethink poverty and inequality keeping in mind Amartya Sen's seminal concepts: development must comprise freedom and respect for human rights and institutions at the price of fostering a vicious circle of (re)emerging diseases and structural violence. Ebola epidemics, that usually face some challenges when they happen alone, now together with malaria, measles, plague and covid, on top of violence in some areas, the disease sees its protocols harmed: for covid the orientation is to stay isolated, for Ebola the response includes tracking contacts. What means coming with a team to field to do the mapping in the middle of a confinement. The surveillance for such many epidemics on top of violence and humanitarian crisis makes the Democratic Republic of Congo one of the most worrying countries in terms of consequences of the Covid outbreak. Key messages Study of the association between the Covid, Ebola virus disease outbreak and the at-risk population living in the conflict zone in Eastern Democratic Republic of Congo. The study presents the difficulties that the population encountered in the face of restrictions imposed by armed groups to reach health services during an Ebola outbreak, in a conflict zone.

scholarly journals Pediatric pleural empyema: one of the management challenges in children of Democratic Republic of Congo

2017 ◽  
Vol 39 (2) ◽  
Author(s):  
Kibwe Alphonse Simbi ◽  
Valentin Kazadi ◽  
Louis-Marie Aissi ◽  
François Mbahewaka Katsuva ◽  
Numbi Oscar Luboya ◽  
...  
Keyword(s):  
Low Income ◽  
Democratic Republic Of Congo ◽  
Pleural Empyema ◽  
Low Income Countries ◽  
British Thoracic Society ◽  
Rapid Improvement ◽  
Chest X Ray ◽  
Basic Medical ◽  
Severe Lung

Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo. Chest X-ray showed a massive empyema that was resolved by immediate drainage and antibiotiocs. Results were rapid improvement and discharge after 3 weeks. A classic medical and imaging approach is a winning return in low-income countries. According to the British Thoracic Society guidelines, pleural effusion with compromising respiratory function can be managed by drainage and antibiotics.

scholarly journals Ethiopian pre-school children consuming a predominantly unrefined plant-based diet have low prevalence of iron-deficiency anaemia

2016 ◽  
Vol 19 (10) ◽  
pp. 1834-1841 ◽  
Author(s):  
Dawd Gashu ◽  
Barbara J Stoecker ◽  
Abdulaziz Adish ◽  
Gulelat D Haki ◽  
Karim Bougma ◽  
...  
Keyword(s):  
Low Income ◽  
Dietary Diversity ◽  
Total Sample ◽  
High Rate ◽  
Low Income Countries ◽  
Fe Deficiency ◽  
Food Groups ◽  
Cross Sectional ◽  
Deficiency Anaemia ◽  
Low Prevalence

AbstractObjectiveChildren from low-income countries consuming predominantly plant-based diets but little animal products are considered to be at risk of Fe deficiency. The present study determined the Fe status of children from resource-limited rural households.DesignA cross-sectional study.SettingTwenty six kebeles (the smallest administrative unit) from six zones of the Amhara region, Ethiopia.SubjectsChildren aged 54–60 months (n 628).ResultsGrain, roots or tubers were the main dietary components consumed by 100 % of the study participants, followed by pulses, legumes or nuts (66·6 %). Consumption of fruit and vegetables (19·3 %) and meat, poultry and fish (2·2 %) was low. Children had a mean dietary diversity score of 2·1 (sd 0·8). Most children (74·8 %, n 470) were in the lowest dietary diversity group (1–2 food groups). Rate of any morbidity in the preceding 14 d was 22·9 % (n 114). Infection or inflammation (α1-acid glycoprotein >1·2 g/l) was present in 30·2 % (n 184) of children. Children had a high rate of stunting (43·2 %). Of the total sample, 13·6 % (n 82) of children were anaemic, 9·1 % (n 57) were Fe deficient and 5·3 % (n 32) had Fe-deficiency anaemia. Fe-deficiency erythropoiesis was present in 14·2 % (n 60) of children.ConclusionsDespite consuming a predominantly plant-based diet and little animal-source foods, there was a low prevalence of Fe-deficiency anaemia. This illustrates that dietary patterns can be inharmonious with Fe biochemical status; thus, Fe-related interventions require biochemical screening.

scholarly journals Emergence of Rare Bovine–Human Reassortant DS-1-Like Rotavirus A Strains with G8P[8] Genotype in Human Patients in the Czech Republic

Viruses ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1015 ◽  
Author(s):  
Moutelíková ◽  
Sauer ◽  
Dvořáková Heroldová ◽  
Holá ◽  
Prodělalová
Keyword(s):  
Low Income ◽  
Childhood Mortality ◽  
High Rate ◽  
Interspecies Transmission ◽  
Low Income Countries ◽  
The Czech Republic ◽  
Rotavirus A ◽  
Group A Rotaviruses ◽  
Group A ◽  
First Time

Group A Rotaviruses (RVA) are the leading cause of acute gastroenteritis in children and a major cause of childhood mortality in low-income countries. RVAs are mostly host-specific, but interspecies transmission and reassortment between human and animal RVAs significantly contribute to their genetic diversity. We investigated the VP7 and VP4 genotypes of RVA isolated from 225 stool specimens collected from Czech patients with gastroenteritis during 2016–2019. The most abundant genotypes were G1P[8] (42.7%), G3P[8] (11.1%), G9P[8] (9.8%), G2P[4] (4.4%), G4P[8] (1.3%), G12P[8] (1.3%), and, surprisingly, G8P[8] (9.3%). Sequence analysis of G8P[8] strains revealed the highest nucleotide similarity of all Czech G8 sequences to the G8P[8] rotavirus strains that were isolated in Vietnam in 2014/2015. The whole-genome backbone of the Czech G8 strains was determined with the use of next-generation sequencing as DS-1-like. Phylogenetic analysis of all segments clustered the Czech isolates with RVA strains that were formerly described in Southeast Asia, which had emerged following genetic reassortment between bovine and human RVAs. This is the first time that bovine–human DS1-like G8P[8] strains were detected at a high rate in human patients in Central Europe. Whether the emergence of this unusual genotype reflects the establishment of a new RVA strain in the population requires the continuous monitoring of rotavirus epidemiology.

Factors Associated With Outcomes After Burn Care: A Retrospective Study in Eastern Democratic Republic of Congo

2021 ◽  
Author(s):  
Gauthier Bahizire Murhula ◽  
Patrick Bugeme Musole ◽  
Bienfait Kafupi Nama ◽  
Florent A Zeng Tshibwid ◽  
Daniel Mayeri Garhalangwamuntu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Low Income ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Low Income Countries ◽  
Hospital Death ◽  
Republic Of Congo ◽  
Surgical Department ◽  
Factors Associated ◽  
Burn Care

Abstract In low-income countries, the incidence of burns is high and severe burns are frequently managed at peripheral facilities. Outcome after burn care is poorly studied although it might help identify risk-group and improve treatment strategies. This study aimed to study factors associated with in-hospital outcomes in a burn cohort in the Democratic Republic of Congo. In this retrospective study, we included burn patients admitted to the surgical department at the Hôpital Provincial Général de Référence de Bukavu between January 2013 and December 2018. Differences between groups were tested using χ 2 test or Fisher's exact tests or Wilcoxon rank sum test, as appropriate. Multivariate logistic regression was used to analyze the effect of patients and of burn characteristics on in-hospital mortality, prolongated length of stay (=LOS ≥ 25 days), and occurrence of complications. The study population consisted of 100 patients, mainly young males with the rural origin, moderate-sized but deep burns. Of them, 46 developed complications, 12 died. Median LOS was 25 days (IQR: 15–42). In-hospital death was independently associated with Total Burn Surface Area percentage “TBSA%” (OR = 3.96; 95% CI = 1.67–9.40) and Full-thickness Burns (FTB) (10.68; 1.34–84.74); prolongated LOS with FTB (3.35; 1.07–10.49), and complication with rural origin (5.84; 1.51–22.53), TBSA% (3.96; 1.67–9.40), FTB (4.08; 1.19–14.00), and burns on multiple sites (4.38; 1.38–13.86). In-hospital death was associated with TBSA% and FTB, prolongated LOS with FTB, and complications with burns characteristics and rural origin of the patients. Additional studies are necessary to investigate the effect of provided burn care on outcomes.

scholarly journals Midwives’ Challenges and Factors that Motivate them to Remain in Their Workplace in the Democratic Republic of Congo – An Interview Study

2020 ◽  
Author(s):  
Malin Bogren ◽  
Malin Grahn ◽  
Berthollet Bwira Kaboru ◽  
Marie Berg
Keyword(s):  
Low Income ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Qualitative Content Analysis ◽  
Quality Of Healthcare ◽  
International Standards ◽  
Low Income Countries ◽  
Professional Status ◽  
Republic Of Congo ◽  
Healthcare Facilities

Abstract Background: The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of Goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service, are therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods: A qualitative content analysis method was used. Data was collected through ten focus-group discussions with a total of 63 midwives working at ten different healthcare facilities. Results: Loving one’s work made it worthwhile for the midwives to remain in the workplace. To be a midwife was not just a profession; it was a calling and made them proud, despite low professional status. The organisational system at facility level was unsupportive, with insufficient work-related security, no remuneration system, and rigid hierarchical management structures. A lack of resources and insufficient competence gave the midwives inadequate pre-conditions for carrying out their professional work.Conclusion: Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including: i) conducting midwifery education programmes following international standards; ii) prioritising and enforcing policies to include adequate remuneration for midwives; iii) involving midwives’ associations in policy and planning about the midwifery workforce; and iv) ensuring that midwives’ working environments are safe and well equipped.

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