Hépatite virale B en République Démocratique du Congo : aspects génotypiques, sociologiques et effets de la vaccination chez les nouveau-nés du Kivu

The Democratic Republic of Congo (DRC) is still facing numerous challenges to control hepatitis B infection. The present thesis has targeted several useful levels of action for the characterization of the profile of hepatitis B infection as well as for the optimization of preventive policies. The estimated seroprevalence rate seems to classify the DRC among countries of intermediate endemicity with a different genotypic viral profile found in the Eastern and the Western part, respectively. To hope to eradicate this virus, the DRC must extend the immunization coverage. Although slightly low, the rate of vaccine response is acceptable and ranged within many African rates. At the same time, efforts are needed to improve the level of health-care workers knowledge toward hepatitis B.(MED - Sciences médicales) -- UCL, 201

Genetic and phylogenic characterisation of Hepatitis B virus in the eastern part of Democratic Republic of Congo

Hepatitis B virus (HBV) genotypes show a distinctive geographical distribution worldwide and genotypes A, D and E are the most frequently found in Africa. There are only limited studies on HBV genotype distribution in Democratic Republic of Congo (DRC), all done in the western part showing a vast majority of genotype E. In our study, HBV strains from South Kivu, an eastern province of the DRC, were analysed. Sequencing of 41 serum samples from HBV infected patients revealed strains of genotype A in 40/41 (97.6%) and genotype E in 1/41 (2.4%). The phylogenetic analysis showed that nearly all genotypes A (38/40) were closely related to A1 subgenotype strains found in Rwanda, Haiti and Martinique while only two strains attached to the A2 subgenotype cluster were isolated. The remaining genotype E case was linked to the western African E crescent. Only the I169T nucleotide substitution was observed in 2 genotype A samples. In conclusion, the genotype A seems to be the most predominant genotype in eastern DRC with the majority belonging to the Afro-Asian subgenotype (A1). This contrasts with the western part of DRC where genotype E is predominant. These results support the hypothesis of an East-West genotypic demarcation. This article is protected by copyright. All rights reserved

Knowledge, Attitudes, and Practices of Health-Care Workers about Viral Hepatitis B and C in South Kivu.

Health-care workers (HCWs) are at risk of infections associated with accidental exposure to blood, including viral hepatitis B (HBV) and C (HCV). A survey using a questionnaire was conducted on 250 HCW in Bukavu, an eastern town of the Democratic Republic of Congo, to analyze their attitude and knowledge about these two viruses. A response rate of 86.8% (217/250) was obtained. The mean age of respondents was 39.6 ± 9.8 years, in majority from paramedical staff (66.4%) and with more than 5 years of professional experience (60.8%). The mean proportion of adequate answers on HBV and HCV was 33.2% (±11%) and 30.6% (±7%), respectively. Ninety-three HCW (42.8%) reported recent experience of blood exposure accident, more frequently among the paramedical staff (50%) than physicians (28.8%; P = 0.002). This was mainly related to inadequate protection resources (76.9%). Among all participants, only 24.4% had a history of at least one injection of HBV vaccine; this was more frequently found among physicians than among paramedical staff (49.3% versus 11.8%; P < 0.001). Moreover, only 3.8% of vaccinated HCW received the complete vaccination schedule of three vaccine doses. The efficiency of this vaccine is not well recognized by HCW, and the majority of them seemed to be more worried about the risk of infection by human immunodeficiency virus than by viral hepatitis. Our study reveals that the level of knowledge about HBV and HCV is rather low among HCW in Bukavu

Hepatitis B virus infection in the Democratic Republic of Congo: a systematic review of prevalence studies (2000–2016)

AIMS The Democratic Republic of Congo (DRC) is a country with a high endemicity of hepatitis B virus (HBV) even if no national survey of prevalence has been performed. Data are based on extrapolations or limited studies. This review aimed to summarize all information about HBV infection in DRC during the period 2000–2016 to provide refined estimates and contribute to a better knowledge of its epidemiology. SUBJECT AND METHODS We conducted a systematic search in electronic databases of all prevalence studies published between January 1st, 2000 and September 30th, 2016. Additional data from manual search or gray literature were also considered. We included only moderate or high quality studies using the JBI’ tools for qualitative evaluation of researches. HBsAg prevalence was estimated at 95% confidence interval (CI) as result of simple pooling analysis. RESULTS Twenty-eight studies were included with data providing from 154,926 subjects: in the majority of these studies (18 out of 28), results were obtained from blood donors. The estimated HBsAg prevalence was 4.9% (95% CI 4.2–5.0). The prevalence was estimated at 5.0% (95% CI 4.9–5.1) in blood donors and at 5.0% (95% CI 3.0–5.9) in pregnant women. CONCLUSION This review suggests that DRC is a country characterized by an intermediate level of HBV infection endemicity rate. It remains however an important public health problem and efforts should continue in prevention and in policy to control this viral disease

Prevalence of hepatitis B and C viral co-infection and associated factors with HIV infection in children in South Kivu, Democratic Republic of the Congo

Abstract Background The World Health Organization’s (WHO) 2030 goal of eradicating Hepatitis B and C viruses must also include HIV co-infected children. However, data on the prevalence of this condition are lacking in the Democratic Republic of Congo (DRC), which is considered as one of the countries with high-prevalence of these viruses. The need to assess the extent of this co-infection in the children of this country is therefore important in order to capitalize on efforts to improve prevention and management of both infections. Methodology This is a comparative cross-sectional study conducted from February 04, 2015 to September 03, 2019 at 14 General Reference Hospitals with a pediatric HIV management programme in South Kivu province. The study compared the frequency of hepatitis B (HBV) and C (HCV) markers and factors associated with these two viruses in two equal groups: HIV-positive and HIV-negative children. The data were analyzed using the SPSS version 20.0 software and the significance level was set at p-value less than 0.05. Results The study involved a total of 594 children, 297 of whom were HIV-positive and 297 negative. HBsAg was found in 8.7% of HIV-positive patients and 0.7% for HCV antibodies. On the other hand, among the HIV-negative patients, the proportion of HBsAg was 0.7% but no cases with anti-HCV antibodies were detected. HIV status increases by 14 times the risk of co-occurring with HBV [OR 14.1 (95% CI: 3.33–60.2); p < 0.001] and this risk is not apparent for HCV (p = 0.297). Multivariate logistic regression showed that history of jaundice in the family (aOR:4.19;95% CI: 2.12–11.59), recent hospitalization (aOR:10.7;95% CI: 6.69–17.2), surgery (aOR: 3.24;95% CI: 1.18–8.92), piercing (aOR: 4.26;95% CI: 1.70–10.7) and transfusion in the last 6 months (aOR: 2.69;95% CI: 1.55–4.67) were significantly associated with higher risk of being HBV- HIV co-infected. Conclusion This study investigated the importance of hepatitis viral co-infections in HIV-positive children in South Kivu. Particular attention should be paid to prevention and early detection of these co-infections in this population

Hepatitis B, hepatitis C and HIV in pregnant women in the community in the Democratic Republic of Congo.

info:eu-repo/semantics/publishe

Hepatitis B, hepatitis C and HIV among children 6 to 59 months in the community in the Democratic Republic of Congo.

info:eu-repo/semantics/publishe

Revue générale sur le terrain à risque des formes sévères COVID-19: General review of high-risk individuals of severe forms of COVID-19

Developing severe forms of COVID-19 with severe acute respiratory distress or multiple organ dysfunction syndromes remains a concern. Old age and obesity are the two mayor independent factors to develop severe forms of COVID-19. Chronic kidney disease, diabetes mellitus, cancer, chronic liver disease, and chronic respiratory disease have been found to be significantly associated with severe forms of COVID-19 but their specific implication is difficult to determine. From a pathophysiological view, bronchial asthma and chronic liver disease are also risk factors to be taken into consideration. However few studies are available.&nbsp; Through large statistical data, male sex has been found to be an established risk factor. However, the pathophysiological explanations mentioned remain very hypothetical. Contrastingly pregnancy, HIV and smoking need additional studies to establish their real implication.&nbsp;Conclusion. There are many suspected or proved risk factors of severe forms of COVID-19 but they do not probably have the same degree of influence on the prognosis of the disease. Thus, it remains important to keep close monitoring because of many unknowns persisting about this new disease. Les individus à risque de développer les formes sévères COVID-19 traduites par une détresse respiratoire aigüe sévère ou une défaillance multi-viscérale sont nombreux. L’âge avancé et l’obésité sont les deux terrains indépendants à risque de développer les formes sévères COVID-19. Les facteurs tels la maladie rénale chronique, le diabète sucré, le cancer, les maladies hépatiques chroniques et les maladies respiratoires chroniques sont significativement associées aux formes sévères de COVID-19 mais il est difficile de déterminer leur indépendance étant donné l’existence de plusieurs facteurs confondants dans les études. L’asthme bronchique et les maladies hépatiques chroniques sont du point de vue physiopathologique des terrains à risque à prendre avec considération, cependant les études réalisées sur ces deux sujets sont encore peu nombreuses. Le sexe masculin est un terrain qui se révèle de plus en plus à risque avec l’analyse de larges données statistiques, mais les explications physiopathologiques évoquées demeurent très hypothétiques. Par contre, la grossesse, le VIH et le tabagisme nécessitent encore des études supplémentaires pour être considérés comme terrains à risque des formes sévères COVID-19.&nbsp;Conclusion. Les multiples terrains à risque de formes symptomatiques sévères COVID-19 n’ont donc probablement pas la même influence dans le pronostic de la maladie, cependant il devrait tous nécessiter une surveillance rapprochée étant donné les multiples zones d’ombre persistant par rapport à cette pandémie. &nbsp

Hepatitis C virus in sub-Saharan Africa: a long road to elimination

The development of direct-acting antivirals against hepatitis C virus (HCV) has transformed the treatment landscape and underpinned the WHO goal of HCV elimination by 2030. However, as of 2021, few countries remain on track to achieve this goal. Reliable data remain scarce, especially those on national plans for HCV elimination in many regions of the world and particularly in sub-Saharan Africa, which accounts for around 11 million of 71 million people estimated to be living with HCV