scholarly journals 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

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.

scholarly journals 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

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.

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

2016 ◽  
Vol 06 (12) ◽  
pp. 740-753 ◽  
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

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

2016 ◽  
Vol 49 ◽  
pp. 1-8 ◽  
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

scholarly journals Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039456
Author(s):  
Leolin Katsidzira ◽  
Wisdom F Mudombi ◽  
Rudo Makunike-Mutasa ◽  
Bahtiyar Yilmaz ◽  
Annika Blank ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Case Control Study ◽  
Alpha Diversity ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Inflammatory Bowel ◽  
Sub Saharan ◽  
Nested Case Control ◽  
Control Study

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.

Risk Factors Associated With Dengue Fever Outbreak in Taiz Governorate, Yemen, 2018: Case-control Study

2021 ◽  
Author(s):  
Abdulkareem Ali Hussein Nassar ◽  
Amr Abdulaziz Torbosh ◽  
Yassin Abdulmalik Mahyoub ◽  
Mohammed Abdullah Al Amad
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Fatality ◽  
Case Control ◽  
Case Definition ◽  
P Value ◽  
Factors Associated ◽  
Control Study

Abstract Background: Dengue Fever (DF) is a significant health problem in Yemen especially in the coastal areas. On November 6, 2018, Taiz governorates surveillance officer notified the Ministry of Public Health and Population on an increase in the number of suspected DF in Al Qahirah and Al Mudhaffar districts, Taiz governorate. On November 7, 2018, Field Epidemiology Training Program sent a team to perform an investigation. The aims were to confirm and describe the outbreak by person, place and time in Taiz governorate, and identify its risk factors.Methodology: Descriptive and case-control study (1:2 ratio) were conducted. WHO case definition was used to identify cases in Al Qahirah or Al Mudhaffar districts during August-November 2018. Control was selected from the same districts who did not suffer from DF. Predesigned questionnaire was used to collect data related to sociodemographic, behavioral and environmental characteristics. Bivariate and multivariate backward stepwise analyses were used. The adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) were calculated. A P value < 0.05 was considered as the cut point for statistically significant. Epi info version 7.2 was used.Results: A total of 50 DF cases were found. Almost 52% were males and 76% were <30 years of age. The overall attack rate was 1/10,000 of the population. Case fatality rate was 4%. In multivariate analysis, not working (aOR = 26.6, 95% CI: 6.8–104.7), not using mosquito repellent (aOR = 13.9, 95% CI:1.4–136.8), wearing short sleeves/pants (aOR = 27.3, 95% CI: 4.8–156.8), poor sanitation (aOR = 5.4, 95% CI: 1.4–20.3), presence of outdoor trees (aOR = 13.2, 95% CI: 2.8–63.0) and houses without window nets (aOR = 15.7, 95% CI: 3.9–63.4) were statistically significant risk factors associated with DF outbreak. Eleven 11 (58%) of blood samples were positive for DF IgM.Conclusions: DF outbreak in Al Qahirah and Al Mudhaffar districts, Taiz governorate was confirmed. This study provides evidence-based information regarding the identified risk factors that contributed to the occurrence of this outbreak. Raising community awareness on the importance of personal protection measures and improving the sanitation services are strongly recommended.

scholarly journals A Case-Control Study for Assessing Risk Factors for Congenital Anomalies among Children in Sulaimani City

2018 ◽  
pp. 90-95 ◽  
Author(s):  
Niaz Mustafa Kamal ◽  
Nasih Othman
Keyword(s):  
Risk Factors ◽  
Congenital Anomalies ◽  
Maternal Obesity ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
P Value ◽  
Maternal Risk ◽  
Wide Range ◽  
Control Study

Congenital anomalies comprise a wide range of abnormalities in body structure or function that are present at birth and are of prenatal origin. These are defined as structural changes that have significant medical, social or cosmetic consequences for the affected individual, and typically require medical intervention. According to our Knowledge, research is scarce on these conditions in Sulaimaniyah city. Therefore, the current study was conducted to investigate potential risk factors for congenital anomalies. A case-control study was carried out from March to August 2017 involving 400 children (200 cases and 200 controls) aged 0-5 years. Required data were obtained on the risk factors through face to face interviews with mothers of cases and controls. The data were using descriptive statistical methods, Chi-square and Logistic Regression using STATA 11, calculating odds ratios and condensing P value less than 0.05 as statistically significant. The mean age of the children was 1.9 years and age of their mothers at the time of pregnancy was 28 years. Congenital heart anomalies were the commonest type accounting for 27.5%. Significant risk factors for congenital anomalies were family history (OR=2.24, P= 0.007), maternal obesity (OR= 2.26, P= 0.001), mothers age over 30 (OR=2.78, P= 0.002) and mothers not using folic acid during pregnancy (OR=2.12, P= 0.0007). In general, in order to control and prevent the cases of CM, it is important to provide health education and policies to reduce environmental and maternal risk factors. Further, studies with larger sample size are needed to investigate incidence and risk factors of congenital anomalies.

scholarly journals Factors associated with episiotomy practice in Bukavu, Democratic Republic of the Congo

2018 ◽  
Vol 7 (7) ◽  
pp. 2553
Author(s):  
Ntamulenga Innocent ◽  
Mulongo Mbarambara Philémon ◽  
Imani Prince ◽  
Yatoka Justine ◽  
Mukanire Ntakwinja ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Case Control Study ◽  
Neonatal Resuscitation ◽  
Fetal Distress ◽  
Case Control ◽  
Primary Objective ◽  
Foetal Distress ◽  
Factors Associated ◽  
Republic Of The Congo ◽  
Control Study

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.

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

2020 ◽  
Vol 4 (4) ◽  
pp. e158-e167 ◽  
Author(s):  
Daan Van Brusselen ◽  
Tony Kayembe-Kitenge ◽  
Sébastien Mbuyi-Musanzayi ◽  
Toni Lubala Kasole ◽  
Leon Kabamba Ngombe ◽  
...  
Keyword(s):  
Birth Defects ◽  
Democratic Republic ◽  
Case Control Study ◽  
Case Control ◽  
Metal Mining ◽  
Republic Of The Congo ◽  
Control Study

scholarly journals Traditional and Commercial Alcohols as Risk Factors for Esophageal Cancer in Tanzania

2020 ◽  
Vol 6 (Supplement_1) ◽  
pp. 36-36
Author(s):  
Alexandra Keir ◽  
Geoffrey Buckle ◽  
Larry Akoko ◽  
William Mgisha ◽  
Julius Mwaiselage ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Secondary Analysis ◽  
Case Control ◽  
First Case ◽  
Increased Risk ◽  
Context Specific ◽  
Control Study

PURPOSE Esophageal cancer (EC) is one of the most common cancers in East Africa; however, risk factors that underly the high incidence in this region are not well understood. We aimed to investigate the association between exposure to specific alcohol subtypes and EC in Tanzania. METHODS We performed a secondary analysis of data from a hospital-based, case-control study conducted at Muhimbili National Hospital and Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Cases of EC were identified between 2014 and 2016. Hospital controls were identified from patients with nonmalignant conditions and matched 1:1 for gender and age (± 10 years). Interviews were conducted using a survey with culturally relevant and context-specific questions on alcohol and smoking exposure. Conditional logistic regression analyses were applied to evaluate specific associations of potential exposures and EC. RESULTS A total of 473 EC cases and 473 controls were enrolled. Alcohol consumption was reported in 61% and 64% of cases and controls, respectively. Neither ‘current use of alcohol (any type)’, nor ‘ever use’ were associated with EC; however, local brew consumption was associated with increased EC risk (odds ratio [OR], 2.01; 95% CI, 1.53 to 2.66; P < .01). Increased risk was observed with consumption of gongo (OR, 2.91), komoni (OR, 2.41), wanzuki (OR, 2.40), kindi (OR, 3.13), and kangara (OR, 2.86). Smoking increased EC risk; however, it did not significantly modify the association between EC and alcohol subtypes. CONCLUSION This is the first case-control study to report a detailed analysis of alcohol exposures as a potential risk factor for EC in Tanzania. Although combined measures of alcohol use were not found to be associated with EC, several types of locally brewed alcohols emerged as risk factors. Additional research is needed to investigate these findings and examine the carcinogenic role of ingredients and/or contaminants, as well as any interactions with other putative risk factors in this region.

scholarly journals Risk Factors for Chikungunya Outbreak in Kebridhar City, Somali Ethiopia, 2019. Unmatched Case-Control Study

2020 ◽  
Author(s):  
Mikias Alayu ◽  
Tesfalem Teshome ◽  
Hiwot Amare ◽  
Solomon Kinde ◽  
Desalegn Belay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chikungunya Virus ◽  
Case Control Study ◽  
Case Control ◽  
Effective Control ◽  
Bed Nets ◽  
P Value ◽  
Water Holding ◽  
Control Study ◽  
Full Body

AbstractBackgroundChikungunya Virus is a Ribose Nucleic Acid (RNA) virus transmitted by a mosquito bite. Aedes Aegypti and Aedes Albopictus are responsible vectors for Chikungunya Virus transmission. CHIKV outbreaks are characterized by rapid spread and infection rates as high as 75%. A combination of health system efforts and healthy behavior practices by the community is essential for effective control.MethodsUnmatched case control study was done to identify risk factors of this outbreak. One case to two controls ratios was calculated. All cases during the study period (74 cases) and 148 controls were included in the study. Bivariate and multivariable analysis were implemented. Serum samples were tested by Real Time Polymerase Chain Reaction at Ethiopian Public Health Institute laboratory.ResultsA total of 74 chikungunya fever cases were reported starting from 19th May 2019 to 8th June 2019. Not using bed net at day time sleeping (P- value < 0.001, AOR 20.8, 95CI 6.4 – 66.7), presence of open water holding container (P- value 0.023, AOR 4, 95CI 1.2 – 13.5), presence of larvae in water holding container (P- value 0.015, AOR 4.8, 95CI 1.4 – 16.8), ill person with similar sign and symptoms in the family or neighbors (P- value <0.001, AOR 27.9, 95CI 6.5 – 120.4) and wearing not full body cover clothes (P- value 0.002, AOR 8.1, 95CI 2.2 – 30.1) were significant risk factors.ConclusionUsing bed nets at day time sleeping, cover the water holding containers, wearing full body cover cloths are protective factors.

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