Résection trans urétrale de la prostate : première expérience à Bukavu, RD Congo: Transurethral resection of the prostate: pilot experience in Bukavu, DR Congo

Context and objective. Despite its large use as alternative to open surgical adenomectomy, transurethral resection of the prostate (TURP) is still poorly performed in many African countries. The purpose of this study was to describe a pilotTURP experience in Bukavu. Methods.This retrospective study included 159 patients (average age: 68 ± 8.5 years) with benign prostatic hypertrophy (BPH), treated at three medical centres in Bukavu between February 2014 andFebruary 2017. Socio-demographic, clinical, and ultrasound data were recorded, and comorbidities and complications reported. Each patient was questionned about treatment received before surgery. Results. The average prostatic volume was 53.2 ± 22 grams. All patients were severelysymptomatic (mean International Prostate Symptoms Score (IPSS) 26.8 ± 5.8) and severely bored (mean quality of life score (QOL) 6.2 ± 0.8).Hypertension (42%) and type 2 diabetes (41%) were the most common comorbidities. The most frequent complications of BPH were urinary tractinfection (44%) and urinary retention (40%). Prior to hospital admission, 60% of patients used traditional medicine. Conclusion.This study has revealed a late reference of patients to the hospital, when the illness is already in advanced stage with complications. There is a need of implementing educational measures targeting early detection and reference of patients with BPH in this area. Résumé Contexte et objectif. Bien que la résection trans urétrale de la prostate (RTUP) se soit imposée comme alternative à l’adénomectomie chirurgicale classique à ciel ouvert, sa pratique reste exceptionnelle dans quelques contrées africaines. L’objectif de la présente étude était de décrire la première expérience de la RTUP à Bukavu. Méthodes. La présente étude documentaire a porté sur 159 patients avec hypertrophie bénigne de la prostate (HBP), opérés dans 3 centres médicaux de Bukavu entre février 2014 et février 2017. Les paramètres d’intérêts comprenaient les données sociodémographiques, cliniques, échographiques les comorbidités, les complications et l’attitude thérapeutique avant l’intervention. Résultats. Leur âge moyen était de 68±8,5 ans. Le volume prostatique moyen était de 53,2 ± 22 grammes. Tous les patients étaient sévèrement symptomatiques (score international des symptômes prostatiques (IPSS) moyen de 26,8 ± 5,8) et fortement ennuyés (score de la qualité de vie (QOL) moyen de 6,2 ± 0,8). L’hypertension artérielle (42%) et le diabète sucré de type 2 (41 %) étaient les comorbidités les plus fréquentes. Les complications de l’HBP les plus fréquentes étaient l’infection urinaire (44 %) et la rétention urinaire (40%). Avant l’admission à l’hôpital, 60% des patients ont eu recours à la médecine traditionnelle. Conclusion. L’avènement de la RTUP à Bukavu a permis de déceler que la majorité des patients avec HBP consultent très tardivement au stade de sevérité symptomatique et des complications. Une campagne d’éducation, information et communication de la population sur le dépistage précoce de l’HBP est à envisager

Evaluation of a turbidimetric C-reactive protein assay to monitor early-onset neonatal sepsis in South Kivu (Democratic Republic of the Congo)

Objectives: Neonatal sepsis, a condition defined as bacteremia within the first month of life accompanied by signs of systemic infection, is the most preventable cause of infant mortality in sub-Saharan Africa. Despite the development of new infection markers, C-reactive protein (CRP) is the most extensively studied acute phase reactant so far and the preferred index in many neonatal intensive care units (NICUs). The aim of the present study was to evaluate an affordable, non-commercial turbidimetric CRP assay for monitoring early-onset neonatal sepsis (EOS). Methods: A total of 148 neonates admitted at the NICU of the Hopital Provincial General de Reference de Bukavu to diagnose and to monitor EOS were enrolled in the study. CRP was assayed using a functional turbidimetric assay based on the interaction of CRP with phosphocholine containing particles (Intralipid (R)). Results: In total, 62/148 (41.9%) cases were identified as blood culture-proven EOS. Different serum CRP slopes were observed among the different birth weight categories. Moreover, the serum (CRP 48 h-CRP 12 h) difference and the birth weight predicted the outcome of these septic newborns. Conclusions: Our turbidimetric CRP assay is a potential novel tool that can be used in the management of EOS in sub-Saharan Africa. The simplicity of the assay and the extremely low price make the CRP method very well suited for developing countries