Individual, household and neighborhood risk factors for malaria in the Democratic Republic of the Congo support new approaches to programmatic intervention

This comparative cross-sectional study aimed to better understand the respective contributions of protein malnutrition and cassava-derived cyanide poisoning in the development of konzo. We compared data on nutritional status and cyanide exposure of school-age adolescent konzo-diseased patients to those of non-konzo subjects of similar age from three areas in the Eastern Democratic Republic of the Congo. Our results show that konzo patients had a high prevalence of both wasting (54.5%) and stunting (72.7%), as well as of cyanide poisoning (81.8%). Controls from Burhinyi and those from Idjwi showed a similar profile with a low prevalence of wasting (3.3% and 6.5%, respectively) and intermediate prevalence of stunting (26.7% and 23.9%, respectively). They both had a high prevalence of cyanide poisoning (50.0% and 63.0%, respectively), similar to konzo-patients. On the other hand, controls from Bukavu showed the lowest prevalence of both risk factors, namely chronic malnutrition (12.1%) and cyanide poisoning (27.6%). In conclusion, cassava-derived cyanide poisoning does not necessarily coexist with konzo outbreaks. The only factor differentiating konzo patients from healthy individuals exposed to cyanide poisoning appeared to be their worse nutritional status. This further suggests that, besides the known role of cyanide poisoning in the pathogenesis of konzo, malnutrition may be a key factor for the disease occurrence.

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Prehypertension, Hypertension and Associated Risk Factors among Adults Living in the Port City of Boma in the Democratic Republic of the Congo. A Population-Based Cross-Sectional Survey

Acta Scientific Cancer Biology ◽

10.31080/ascb.2020.04.0222 ◽

2020 ◽

Vol 4 (5) ◽

pp. 24-32

Author(s):

Blaise Makoso Nimi ◽

François Lepira Bompeka ◽

Aliocha Nkodila ◽

Williams Ilenga ◽

Gédeon Long-Longo ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Population Based ◽

Port City ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Republic Of The Congo ◽

Associated Risk Factors

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Risk Factors for Hospitalization and Death From COVID-19 in South Sudan and Eastern Democratic Republic of the Congo

SSRN Electronic Journal ◽

10.2139/ssrn.3960666 ◽

2021 ◽

Author(s):

Eva Leidman ◽

Shannon Doocy ◽

Grace Heymsfield ◽

Abdou Sebushishe ◽

Mbong Eta Ngole ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

South Sudan ◽

Republic Of The Congo

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Prevalence, risk factors and clinical outcomes of Xpert MTB/RIF identified rifampicin-resistant tuberculosis in Bukavu, Democratic Republic of the Congo

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2016.02.835 ◽

2016 ◽

Vol 45 ◽

pp. 390

Author(s):

A. Bulabula ◽

A.B. Shindano ◽

J.B. Nachega

Keyword(s):

Risk Factors ◽

Clinical Outcomes ◽

Democratic Republic ◽

Resistant Tuberculosis ◽

Republic Of The Congo

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Prevalence and Sex-Specific Distribution of Cardiovascular Risk Factors in University Students in an Urban–Rural Environment of the Democratic Republic of the Congo

Journal of Community Health ◽

10.1007/s10900-018-0481-5 ◽

2018 ◽

Vol 43 (4) ◽

pp. 761-767

Author(s):

Fiston Ikwa Ndol Mbutiwi ◽

François Bompeka Lepira ◽

Taty Latelabwe Mbutiwi ◽

Donat Kenge Kumakuma ◽

Gloria Kikumbi Kumbukama ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

University Students ◽

Cardiovascular Risk Factors ◽

Democratic Republic ◽

Rural Environment ◽

Specific Distribution ◽

Republic Of The Congo ◽

Urban Rural

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Risk factors for low birth weight in Lubumbashi, Democratic Republic of the Congo

Médecine et Santé Tropicales ◽

10.1684/mst.2016.0607 ◽

2016 ◽

Vol 26 (4) ◽

pp. 386-390 ◽

Cited By ~ 1

Author(s):

P.M. Ilunga ◽

O. Mukuku ◽

P.M. Mawaw ◽

A.M. Mutombo ◽

T.K. Lubala ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Democratic Republic ◽

Republic Of The Congo

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The Epidemiology of Plasmodium vivax Among Adults in the Democratic Republic of the Congo: A Nationally-Representative, Cross-Sectional Survey

10.1101/2020.02.17.20024190 ◽

2020 ◽

Author(s):

Nicholas F. Brazeau ◽

Cedar L. Mitchell ◽

Andrew P. Morgan ◽

Molly Deutsch-Feldman ◽

Oliver John Watson ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Sub Saharan Africa ◽

Mitochondrial Genomes ◽

Republic Of The Congo ◽

Nationally Representative ◽

Sub Saharan ◽

Duffy Negative ◽

Malaria Risk Factors ◽

Population Genetic Analyses

ABSTRACTBackgroundReports of P. vivax infections among Duffy-negative hosts have begun to accumulate throughout sub-Saharan Africa. Despite this growing body of evidence, no nationally representative epidemiological surveys of P. vivax in sub-Saharan Africa nor population genetic analyses to determine the source of these infections have been performed.MethodsTo overcome this critical gap in knowledge, we screened nearly 18,000 adults in the Democratic Republic of the Congo (DRC) for P. vivax using samples from the 2013-2014 Demographic Health Survey. Infections were identified by quantitative PCR and confirmed with nested-PCR. P. vivax mitochondrial genomes were constructed after short-read sequencing. Risk factors, spatial distributions and population genetic analyses were explored.FindingsOverall, we found a 2.96% (95% CI: 2.28%, 3.65%) prevalence of P. vivax infections across the DRC. Nearly all infections were among Duffy-negative adults (486/489). Infections were not associated with typical malaria risk-factors and demonstrated small-scale heterogeneity in prevalence across space. Mitochondrial genomes suggested that DRC P. vivax is an older clade that shares its most recent common ancestor with South American isolates.InterpretationP. vivax is more prevalent across the DRC than previously believed despite widespread Duffy-negativity. Comparison to global and historical P. vivax sequences suggests that historic DRC P. vivax may have been transported to the New World on the wave of European expansion. Our findings suggest congolese P. vivax is an innocuous threat given its relatively flat distribution across space, lack of malaria risk factors, and potentially ancestral lineage.FundingNational Institutes of Health and the Wellcome Trust.

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Sachet water consumption as a risk factor for cholera in urban settings: Findings from a case control study in Kinshasa, Democratic Republic of the Congo during the 2017–2018 outbreak

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009477 ◽

2021 ◽

Vol 15 (7) ◽

pp. e0009477

Author(s):

Placide Mbala-Kingebeni ◽

Florian Vogt ◽

Berthe Miwanda ◽

Tresor Sundika ◽

Nancy Mbula ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Case Control Study ◽

Case Control ◽

Sub Saharan Africa ◽

P Value ◽

Republic Of The Congo ◽

Sub Saharan ◽

Context Specific ◽

Control Study

Background Behavioural risk factors for cholera are well established in rural and semi-urban contexts, but not in densely populated mega-cities in Sub-Saharan Africa. In November 2017, a cholera epidemic occurred in Kinshasa, the Democratic Republic of the Congo, where no outbreak had been recorded for nearly a decade. During this outbreak, we investigated context-specific risk factors for cholera in an urban setting among a population that is not frequently exposed to cholera. Methodology/Principal findings We recruited 390 participants from three affected health zones of Kinshasa into a 1:1 matched case control study. Cases were identified from cholera treatment centre admission records, while controls were recruited from the vicinity of the cases’ place of residence. We used standardized case report forms for the collection of socio-demographic and behavioural risk factors. We used augmented backward elimination in a conditional logistic regression model to identify risk factors. The consumption of sachet water was strongly associated with the risk of being a cholera case (p-value 0.019), which increased with increasing frequency of consumption from rarely (OR 2.2, 95% CI 0.9–5.2) to often (OR 4.0, 95% CI 1.6–9.9) to very often (OR 4.1, 95% CI 1.0–16.7). Overall, more than 80% of all participants reported consumption of this type of drinking water. The risk factors funeral attendance and contact with someone suffering from diarrhoea showed a p-value of 0.09 and 0.08, respectively. No socio-demographic characteristics were associated with the risk of cholera. Conclusions/Significance Drinking water consumption from sachets, which are sold informally on the streets in most Sub-Saharan African cities, are an overlooked route of infection in urban cholera outbreaks. Outbreak response measures need to acknowledge context-specific risk factors to remain a valuable tool in the efforts to achieve national and regional targets to reduce the burden of cholera in Sub-Saharan Africa.

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Sachet water consumption as a risk factor for cholera in urban settings: findings and implications from a case control study in Kinshasa, Democratic Republic of the Congo during the 2017-2018 outbreak

10.21203/rs.3.rs-36530/v1 ◽

2020 ◽

Author(s):

Placide Mbala-Kingebeni ◽

Florian Vogt ◽

Berthe Miwanda ◽

Tresor Sundika ◽

Nancy Mbula ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Case Control Study ◽

Case Control ◽

P Value ◽

Republic Of The Congo ◽

Sub Saharan ◽

Context Specific ◽

Control Study ◽

Sachet Water

Abstract Background: Cholera is endemic in the Democratic Republic of the Congo. Starting in 2016, a cholera epidemic swept through the country and in November 2017 reached the capital of Kinshasa, which had not experienced a cholera outbreak for nearly a decade. Behavioural risk factors for cholera are well established in rural and semi-urban contexts but not in densely populated mega-cities from Sub-Saharan Africa. Such information is crucial to guide context-specific control measures. We seized the outbreak in Kinshasa as an opportunity to investigate context-specific risk factors for cholera in this urban setting among a mobile population that is not frequently exposed to cholera. Methods: We recruited 390 participants into a 1:1 age-matched case control study from three affected health zones of Kinshasa between 1 and 28 February 2018. Cases were identified from cholera treatment centre admission records, while controls were recruited from the neighbourhood of the cases’ place of residence. We collected data on socio-demographic and behavioural risk factors using standardized case report forms. We used augmented backward elimination in a conditional logistic regression model to identify risk factors, using a p-values of 0.05 as cut-off to define statistical significance. Results: The consumption of sachet water was significantly associated with the risk of being a cholera case (p-value 0.019), which increased with increasing frequency of consumption from rarely [OR 2.223, 95% CI 0.944-5.235] to often [OR 4.031, 95% CI 1.642-9.891] to very often [OR 4.144, 95% CI 1.029-16.653]. Overall, more than 80% of all participants reported consumption of this type of drinking water. Funeral attendance and recent contact with someone suffering from diarrhoea were borderline insignificant risk factors (p-value 0.09 and 0.08, respectively). No socio-demographic characteristics were associated with the risk of cholera. Conclusions: Drinking water consumption from sachets, which are sold informally on the streets in most Sub-Saharan African cities, should be considered as a potential route of infection during future cholera outbreaks in similar urban settings. Outbreak investigation and response need to acknowledge context-specific risk factors to remain a valuable tool in the efforts to achieve national and regional targets to reduce the burden of cholera in Africa.

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