Metal mining and birth defects: a case-control study in Lubumbashi, Democratic Republic of the Congo

Background: The primary objective of the present study is to determine the episiotomy rate and factors associated with practice of episiotomy at the maternities in Bukavu town, South-Kivu, DRC.Methods: A case-control study was carried out the women who underwent the episiotomy (case) and those which did not undergo episiotomy (control) over one 12 months period between January to December 2015. A total of 1878 women had a vaginal delivery at a rate of one case for one control (939 cases and 939 controls) were included. Their medical files were exploited. The factors associated with episiotomy were performed by logistic regression.Results: The rate of episiotomy was 20.4%. It was found that after the logistic regression, the Primiparity (OR = 4,5;95% CI:2,31-4,49), the existence of a foetal distress (OR = 4,2;IC to 95% CI :2,36-5,29), the antecedent of episiotomy (OR = 3,9;95% CI:2,83-7,07), private character of maternity (OR= 3,3; 95% CI :2,12-6,30) and the fact that the childbirth was directed by a doctor (OR = 2,3; 95% CI :1,85-5,08) were strongly associated with the practice of the episiotomy in our medium of study.Conclusions: This study showed UA-S/D ratio and UA-RI>2SD are significant predictors of perinatal deaths and immediate neonatal resuscitation in preeclampsia. Acute fetal distress in labour or neonatal nursery admission could not be predicted.

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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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A Case-Control Study of Obstetric Fistula Risk Factors in the Democratic Republic of the Congo

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2016.612092 ◽

2016 ◽

Vol 06 (12) ◽

pp. 740-753 ◽

Cited By ~ 1

Author(s):

Leon Mubikayi ◽

Eric J. Chow ◽

David O. Matson ◽

Emmanuel Nzau ◽

Barthelemy Tandu

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Case Control Study ◽

Obstetric Fistula ◽

Case Control ◽

Republic Of The Congo ◽

Control Study

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Risk factors for epilepsy in Bas-Uélé Province, Democratic Republic of the Congo: a case–control study

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2016.05.018 ◽

2016 ◽

Vol 49 ◽

pp. 1-8 ◽

Cited By ~ 30

Author(s):

Robert Colebunders ◽

Michel Mandro ◽

John L. Mokili ◽

Gisele Mucinya ◽

Germain Mambandu ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Case Control Study ◽

Case Control ◽

Republic Of The Congo ◽

Control Study

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Testing for Interaction between Maternal Smoking and TGFA Genotype among Oral Cleft Cases Born in Maryland 1992–1996

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1997_034_0447_tfibms_2.3.co_2 ◽

1997 ◽

Vol 34 (5) ◽

pp. 447-454 ◽

Cited By ~ 17

Author(s):

Terri H. Beaty ◽

Nancy E. Maestri ◽

Jacqueline B. Hetmanski ◽

Diego F. Wyszynski ◽

Craig A. Vanderkolk ◽

...

Keyword(s):

Birth Defects ◽

Maternal Smoking ◽

Case Control Study ◽

Case Control ◽

Comprehensive Treatment ◽

Environment Interaction ◽

Oral Clefts ◽

Oral Cleft ◽

Increased Risk ◽

Control Study

Objective: Infants born in Maryland between June 1992 and June 1996 were used in a case-control study of nonsyndromic oral clefts to test for effects of maternal smoking and a polymorphic genetic marker at the transforming growth factor alpha (TGFA) locus, both of which have been reported to be risk factors for these common birth defects. Design and Setting: Cases were infants with an oral cleft ascertained through three comprehensive treatment centers, with additional ascertainment through a registry of birth defects maintained by the Maryland Health Department. Controls were healthy infants. Medical history information on infants and mothers were collected, along with DNA samples Patients, Participants: Among 286 cases contacted (72% ascertainment), there were 192 nonsyndromic isolated oral clefts (106 M; 86 F) available for this case-control study. Main Outcome Measures: The largest group of 149 Caucasian nonsyndromic cases and 86 controls was used to test for association with maternal smoking and genotype at the Taq1 polymorphism in TGFA. Results: While this modest sample had limited statistical power to detect gene-environment interaction, there was a significant marginal Increase In risk of having an oral cleft If the mother smoked (odds ratio = 1.75, 95%CI = 1.01 to 3.02). We could not demonstrate statistical interaction between maternal smoking and TGFA genotype in this study, however, and the observed increase in the C2 allele among cases was not statistically significant. Conclusions: We could not confirm either the reported association between oral clefts and TGFA genotype or its interaction with maternal smoking. However, these data do show an increased risk if the mother smoked during pregnancy, and this effect was greatest among infants with a bilateral cleft and no close family history of clefts.

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