scholarly journals Risk Factors for TB/HIV Coinfection and Consequences for Patient Outcomes: Evidence from 241 Clinics in the Democratic Republic of Congo

2021 ◽  
Vol 18 (10) ◽  
pp. 5165
Author(s):  
Gulzar Hussain Shah ◽  
Raimi Ewetola ◽  
Gina Etheredge ◽  
Lievain Maluantesa ◽  
Kristie Waterfield ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Viral Load ◽  
Logistic Regression Analysis ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Viral Load Suppression ◽  
Republic Of Congo ◽  
Hiv Coinfection ◽  
Health Zone

(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from 241 HIV/AIDS clinics in Haut-Katanga and Kinshasa, two provinces in the Democratic Republic of Congo. Chi-square and logistic regression analysis were performed. (3) Results: Significantly higher proportions of patients with TB/HIV coinfection were men (4.5%; women, 3.3%), were new patients (3.7%; transferred-in, 1.6%), resided in the Kinshasa province (4.0%; Haut-Katanga, 2.7%), and were in an urban health zone (3.9%) or semi-rural health zone (3.1%; rural, 1.2%). Logistic regression analysis showed that after controlling for demographic and clinical variables, TB/HIV coinfection increased the risk of death (adjusted odds ratio (AOR), 2.26 (95% confidence interval (CI): 1.94–2.64)) and LTFU (AOR, 2.06 (95% CI: 1.82–2.34)). TB/HIV coinfection decreased the odds of viral load suppression (AOR, 0.58 (95% CI: 0.46–0.74)). (4) Conclusions: TB/HIV coinfection raises the risk of negative outcomes such as death, LTFU, and lack of viral load suppression. Our findings can help HIV clinics in Democratic Republic of Congo and other African countries to customize their interventions to improve HIV care and reduce care disparities among patients.

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 Contextual factors influencing a training intervention aimed at improved maternal and newborn healthcare in a health zone of the Democratic Republic of Congo

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260153
Author(s):  
Malin Bogren ◽  
Sylvie Nabintu Mwambali ◽  
Marie Berg
Keyword(s):  
Neonatal Mortality ◽  
Healthcare Professionals ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Contextual Factors ◽  
Training Intervention ◽  
Republic Of Congo ◽  
Mortality And Morbidity ◽  
Factors Influencing ◽  
Health Zone

Background Maternal and neonatal mortality and morbidity in the Democratic Republic of Congo (DRC) are among the highest worldwide. As part of a quality improvement programme in a health zone in the DRC aimed at contributing to reduced maternal and neonatal mortality and morbidity, a three-pillar training intervention around childbirth was developed and implemented in collaboration between Swedish and Congolese researchers and healthcare professionals. The aim of this study is to explore contextual factors influencing this intervention. Methods A qualitative research design was used, with data collected through focus group discussions (n = 7) with healthcare professionals involved in the intervention before and at the end (n = 9). Transcribed discussions were inductively analysed using content analysis. Results Three generic categories describe the contextual factors influencing the intervention: i) Incentives motivated participants’ efforts to begin a training programme; ii) Involving the local health authorities was important; and (iii) Having physical space, electricity, and equipment in place was crucial. Conclusions This study and similar ones highlight that incentives of various types are crucial contextual factors that influence training interventions, and have to be considered already in the planning of such interventions. One such factor is expectations of monetary incentives. To meet this in a small research project like ours would require a reduction of the scale and thus limit the implementation of new evidence-based knowledge into practice aimed at reducing maternal mortality and morbidity.

scholarly journals Risk factors for neonatal sepsis in Lubumbashi, Democratic Republic of Congo: A retrospective case-control study

2021 ◽  
Vol 3 (1) ◽  
pp. 63-70
Author(s):  
Adonis Muganza Nyenga ◽  
◽  
Olivier Mukuku ◽  
Janet Ziazia Sunguza ◽  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Neonatal Sepsis ◽  
Democratic Republic ◽  
Case Control Study ◽  
Democratic Republic Of Congo ◽  
Case Control ◽  
Republic Of Congo ◽  
Tract Infections ◽  
Control Study

Purpose: Neonatal sepsis (NS) is a major cause of neonatal morbidity and mortality, particularly in developing countries. Delays in the identification and treatment of NS are the main contributors to the high mortality. This study aims to identify risk factors for NS in newborns in the two university hospitals in Lubumbashi, in the Democratic Republic of Congo. Methods: This hospital-based case-control study was carried out on 486 mother-newborn pairs using the systematic sampling method during November 2019 to October 2020. Data were analyzed using STATA software (version 15). Binary and multivariable logistic regression analyses were computed to identify the associated factors at 95% CI. Results: A total of 162 cases and 324 controls were included in this study. Multiple logistic regression analysis showed that the possible risk factors for NS in this study were low level of education (AOR = 9.16 [2.23-37.67]), maternal genitourinary tract infections (AOR = 42.59 [17.90-101.37]), premature rupture of membranes (AOR = 19.95 [7.27-54.76]), peripartum fever (AOR = 26.25 [2.31-297.83]), prolonged labor (AOR = 14.16 [3.88-51.71]), cesarean section (AOR = 3.57 [1.48-8.61]), obstructed vaginal delivery (AOR = 13.40 [1.32-136.19]), birth weight <1500 grams (AOR = 70.38 [8.64-572.95]), and between 1500-2500 grams (AOR = 7.90 [3.04-20.52]). Conclusion: The study found that maternal and neonatal factors were strongly associated with the risk of developing NS. The present study suggests the possibility of routine assessment of sepsis in newborns born with the above characteristics.

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.

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