Evaluation de la qualité des soins aux Cliniques Universitaires de Kinshasa : étude de satisfaction des patients hospitalisés: Assessment of the quality of care at the Kinshasa University Hospital: perception of attending

Context and objective. Assessing the quality of are is a valid indicator of health systems effectiveness. This concept is increasingly used in health planning. However, developing countries are slow in integrating these principles. The present work reports the quality of care assessment as perceived by patients hospitalized in the Kinshasa University Hospital (KUH). Methods. This was a descriptive study using a selfadministered questionnaire to hospitalized patients on the day of discharge. Questions were focused on the patient reception, privacy protection, patient information and nursing care. Results. Eighty women (54%) and 68 men (46%) in total were surveyed.  Patient's reception, specifically their admission and units of care were badly assessed by eight patients out of ten. Similarly, comfort in rooms was badly assessed in 75% of case due to heat, dirt, and noise prevailing inside. In contrast, data on confidentiality (86%) and quality of health information (90%), treatment received and assistance to routine life activities (88%) were greatly appreciated. The overall satisfaction level was high and the majority of patients (75%) declared to be ready to come back to CUK for consultation. 77% would recommend their relatives to this structure if needed. Conclusion. This patient satisfaction survey in KUH showed some concerning evidences which shall challenge care managers and providers in this institution. Contexte et objectif. L’évaluation de la qualité des soins offerts est un indicateur validé de l’efficacité d’un système de santé. Le concept est de plus en plus utilisé dans la planification sanitaire. Cependant, les pays en développement tardent à intégrer ces principes. Ce travail rapporte l’appréciation des soins telle que perçue par les patients hospitalisés aux Cliniques Universitaires de Kinshasa. Méthodes. Une étude descriptive a été menée à l’aide d’un questionnaire auto administré à des sujets à la sortie d’hospitalisation. Les questions étaient articulées autour de l’accueil, du respect de l’intimité, de l’information et des soins proprement-dits. Résultats. Au total, 80 femmes (54%) et 68 hommes (46%) ont été interrogés. Le service d’accueil réservé à la réception ainsi qu’aux unités des soins a été mal apprécié par huit malades sur dix. Il en est de même du confort dans les chambres (75%) à cause de la chaleur, de la saleté et du bruit qui y régnaient. Par contre, ils ont apprécié le respect de l’intimité, la qualité de l’information reçue sur leur maladie, le traitement reçu ainsi que l’aide aux activités de la vie courante. Le niveau global de satisfaction a été élevé et la majorité des personnes (75%) ont déclaré être prêtes à revenir consulter aux CUK et y recommanderaient leurs proches en cas de besoin (77%). Conclusion. L’enquête de satisfaction révèle des données préoccupantes et qui devraient interpeller les organisateurs des prestations de soins dans notre institution

Fréquence et déterminants de l’édentement partiel des adultes dans les institutions médicodentaires de Kinshasa, en République Démocratique du Congo

Contexte et objectifs. La perte de dents appelée édentement affecte la mastication, la parole, l’esthétique, le comportement social et la qualité de vie. L’objectif de la présente étude était d’évaluer la fréquence et les determinants de l’édentement partiel (EP) chez les adultes dans les institutions médico-dentaires de Kinshasa. Méthodes. C’était étude transversale analytique conduite entre octobre 2019 et juillet 2021 dans quelques institutions médico-dentaires de Kinshasa auprès des patients adultes congolais. Les variables d’intérêts étaient la fréquence et les causes de l’EP, les facteurs sociodémographiques et la présence du diabète et/ou de l’hypertension artérielle (HTA). Les déterminants de l’EP ont été recherchés par l’analyse de régression logistique multivariée. Résultats. Quatre cent vingt sept patients ont été inclus. Leur âge moyen était de 37,9 ±15,4 ans. La fréquence de l’EP était de 71%. Seul le statut diabète et/ou hypertension a été indépendamment associé à l’EP (ORa : 23,8 ; IC 95% : 3,2-174,8). Conclusion. La fréquence de l’EP était très élevée chez les adultes, influencée par la presence du diabète et/ou HTA. English title: Frequency and determinants of partial edentulism in adults in medico-dental institutions in Kinshasa, the Democratic Republic of the Congo Context and objectives. Tooth loss called edentulism affects people chewing, speech, aesthetic, social behavior and quality of life. The objective of this study was to assess the prevalence and determinants of partial edentulism (PE) of adults in medico-dental centers in Kinshasa. Methods. This analytic cross-sectional was conducted between October 2019 and July 2021 in sole medico-dental centers of Kinshasa with Congolese adult patients. Variables of interest were prevalence and cause of PE, sociodemographic status, and the presence of diabetes and/or high blood pressure (HBP). PE determinants were sought by multiple logistic regression. The significant threshold was p<0,05. Results. Four hundred twenty-seven patients were involved. The mean age was 37,9±15,4 years. The prevalence of PE was 71%. Diabetes and/or HBP were the sole determinant independently associated with PE (ORa: 23.8; CI 95 %: 3.2- 174.8). Conclusion. The prevalence of PE was very high among adults, influenced by diabetes and/or HBP. Keywords: Congolese adults, Determinants, Partial edentulou

Parasitémie asymptomatique chez les enfants de moins de 5 ans, enfants en âge scolaire et prise en charge des épisodes fébriles dans les ménages de Lubumbashi, République Démocratique du Congo

Introduction: longtemps négligé, le paludisme asymptomatique est actuellement reconnu comme potentielle menace et frein au contrôle du paludisme. En RD Congo, la prévalence de cette parasitémie est peu documentée. L'objectif de cette étude était de déterminer la prévalence de la parasitémie asymptomatique aussi bien chez les enfants de moins de 5 ans que ceux âgés de plus de cinq ans aux regards des interventions de masse en cours (MILDS). Méthodes: il s'agit d'une étude transversale menée chez les écoliers et chez les enfants de moins de cinq ans dans les ménages de Lubumbashi. Les écoles, les écoliers et les enfants de moins de 5 ans avaient été sélectionnés aléatoirement. Les frottis, gouttes épaisses et les tests rapides avaient été prélevés et lues. Résultats: sur 350 écoliers examinés, 43 soit une prévalence de 12,3%, IC 95% (9,14-16,04) avaient une goutte épaisse positive. Dans tous les 43 cas, seul le Plasmodium falciparum a été identifié.314 ménages, soit 90,5 % ont déclaré avoir recouru aux antipaludéens pour soigner la fièvre de leurs enfants à domicile. Plus d'1/3 des enfants dans les ménages, soit 39,9% des interviewés avait avoué avoir recouru aux antipyrétiques pour soulager la fièvre de leurs enfants, 19,7 % à la quinine et seulement moins de 2% aux ACT à base de Lumefantrine. En considérant l'utilisation des TDR, la prévalence due à la parasitémie asymptomatique est de 3% IC 95% (2,075-4,44), mais quand on considère la microscopie comme le gold standard, cette prévalence est de 1,9%, IC 95% (1,13-3,01). Conclusion: le paludisme asymptomatique n'est pas exempt de toute conséquence sur la santé, il est donc important de mener des enquêtes pareilles pour identifier les nouvelles stratégies de contrôle du paludisme.The Pan African Medical Journal 2016;2

COVID-19 Vaccine Coverage and Factors Associated with Vaccine Hesitancy: A Cross-Sectional Survey in the City of Kinshasa, Democratic Republic of Congo

Vaccination against COVID-19 has been the main strategy used by most countries to limit the spread of the virus. However, vaccine uptake has been low in Africa, leading to the implementation of several interventions in order to improve vaccine coverage. This study was conducted due to the lack of information about COVID-19 vaccine coverage and the factors associated with vaccine hesitancy. This cross-sectional study was carried out in Kinshasa city using multi-stage random sampling. A total of 2160 households were included in this study. The data were analyzed using Stata 17 software. The means and standard deviations were computed for continuous data that followed a normal distribution, whereas proportions together with their 95% confidence intervals (CIs) were computed for categorical variables. The connections between dependent variables and each independent variable were tested using either Pearson's chi-square test or Fisher's exact test. The logistic regression method was employed to determine the factors that are linked to hesitation in obtaining the COVID-19 immunization. The majority of respondents were aged between 25 and 34 and 35 and 49 (28.9%). During this study, 15% (95% CI [13.25–17.9]) of respondents had received at least one dose of the COVID-19 vaccine. The prevalence of vaccine hesitancy was 67% (CI95%:64.9–69.1). Among the reasons given for refusing to be vaccinated, most respondents cited concerns about the vaccine being unsafe or causing adverse reactions (45%). Among the reasons given for accepting the vaccine, 26% thought that the vaccine prevented superinfection. The factors associated with hesitancy toward the COVID-19 vaccine were female gender, an age of less than 35 years, and living in non-slum households. Despite the interventions implemented across the country, the reluctance to be vaccinated remains a problem; this could lead to poor health outcomes, especially among the elderly and those with pre-existing conditions. It is important to step up awareness-raising campaigns in the community in order to increase the uptake of vaccination

Knowledge regarding breast cancer among Congolese women in Kinshasa, Democratic Republic of the Congo

Abstract Introduction Breast cancer is the most frequent type of cancer in women and is characterized by late clinical signs in developing countries, including the Democratic Republic of the Congo. One of the main reasons of death from breast cancer is lack of awareness and screening, which has led to late diagnosis (at an advanced stage). This study aims to measure women's knowledge regarding breast cancer in Kinshasa, in the Democratic Republic of the Congo. Materials and Methods A cross‐sectional study of 489 women aged 20–65 years was conducted. Data was collected using a predesigned, tested, self‐administered questionnaire. The questionnaire included specific sections to test the participants' knowledge related to breast cancer and its screening, and practices related to breast self‐examination (BSE). Bivariate and multivariate analyzes were used. Results Our results indicated that 22.09% of the participants had good breast cancer knowledge and 77.91% had poor breast cancer knowledge. Overall, 322 (65.85%) participants recognized that BSE is a valuable method for early screening of BSE. In total, 136 (27.81%) respondents had learned to do the BSE and 216 (44.17%) had reported doing it. Two hundred and ninety‐two (59.71%) respondents mentioned that any woman was at risk for breast cancer and 357 (71.78%) mentioned that it was possible to prevent breast cancer. Determinants of an adequate level of knowledge were higher/university educational level (adjusted odds ratio = 2.70; 95% confidence interval: 1.27–5.73; p = .010) and having previously been screened for breast cancer (adjusted odds ratio = 2.31; 95% confidence interval: 1.40–3.83; p = .001). Conclusion The majority (77.91%) of women have demonstrated poor knowledge of signs/symptoms, risk factors, and screening methods of breast cancer. Additional efforts should be made through women's healthcare workers to raise knowledge of breast cancer screening

Profil épidémiologique et évolutif des traumatismes de l’appareil urogénital de l’homme aux Cliniques Universitaires de Kinshasa: Epidemiological and evolutionary profile of the male urogenital system traumas at the Kinshasa University Hospital

Context and objectives. Traumatic urogenital lesions usually occur in severe traumas. But, little is known on their burden. The aim of this study was to describe the epidemiological aspects of the male urogenital traumas. Methods. A retrospective study covering the period from January 1st, 2010 to December 31st, 2015, was conducted on the urogenital traumas in the Urology Unit of the Surgery Department of the Kinshasa University Hospital. Parameters of interest included clinical data (age, admission complaints, causes and site of lesions), paraclinical status, therapeutic data (medical and surgical treatment) and outcome. Results. Of the 1971 patients admitted in Surgery Department, 44 (2%; main age: 46 ± 29 years, range: 9-76 years) had post-traumatic urogenital lesions. Main causes were iatrogenic medicosurgical procedures (48%), road traffic accidents (27%) and erotic acts (5%). The traumas involved mainly the urethra (61%), external genitals (11%), bladder (9%) and kidney (2%). Multiple lesions accounted for 16% of cases. Therapeutic management was mainly surgical in 70% of conditions. The rate of success, treatment failure, complications, sequelae and mortality were 48%, 30%, 14%, 7% and 2% respectively. Conclusion. The traumas of the urogenital system of man seem relatively uncommon in our environment and most often affecting the urethra, the  genitals, kidney and the bladder. Iatrogenic medical acts and road traffic accidents are the major causes of these traumas.  Contexte et objectif. Les lésions traumatiques urogénitales surviennent habituellement dans le traumatisme grave. Mais, leur ampleur reste peu connue. L’objectif de la présente étude a été de décrire les aspects épidémiologiques des traumatismes urogénitaux survenus chez l’homme. Méthodes. Etude documentaire couvrant la période du 1er janvier 2010 au 31 décembre 2015, a été menée dans le service d’urologie des Cliniques Universitaires de Kinshasa, sur les traumatismes urogénitaux. Les paramètres d’intérêt incluaient les données cliniques (âge, plaintes à l’admission, causes et site de lésions), le bilan paraclinique, les données thérapeutique (traitement médical et chirurgical) et évolutive (issue vitale). Résultats. De 1971 patients admis ou suivis en Chirurgie, 44 souffraient d’une lésion urogénitales post traumatique, soit une fréquence de 2%. Leur âge moyen des patients était de 46 ans ± 29 avec des extrêmes de 19 et 76 ans. Les actes médico-chirurgicaux iatrogènes (48%), les accidents de trafic routier (27%) et les actes érotiques (5%) étaient les principales étiologies. Ces traumatismes portaient essentiellement sur l’urètre (61%), les organes génitaux externes (11%), la vessie (9%) et le rein (2%). Les lésions multiples ont représenté 16% des cas. La prise en charge thérapeutique était essentiellement chirurgicale dans 70% de cas. Le taux de guérison, d’échec thérapeutique, de complications, de séquelles et de mortalité était respectivement de : 48%, 30%, 14%, 7% et de 2%. Conclusion. Les traumatismes de l’appareil urogénital de l’homme semblent être relativement peu fréquents dans notre milieu et concernent le plus souvent l’urètre, les organes génitaux externes, le rein et la vessie. Les actes médicaux iatrogènes et les accidents du trafic routier en sont les grands pourvoyeurs

Factors associated with residual urine volume preservation in patients undergoing hemodialysis for end-stage kidney disease in Kinshasa

Abstract Background Decreased residual urine volume (RUV) is associated with higher mortality in hemodialysis (HD). However, few studies have examined RUV in patients on HD in Sub-Saharan Africa. The aim of this study was to identify predictors of RUV among incident hemodialysis patients in Kinshasa. Methods This historical cohort study enrolled 250 patients with ESRD undergoing hemodialysis between January 2007 and July 2013 in two hemodialysis centers in Kinshasa. RUV were collected over 24 h at the initiation of HD and 6 and 12 months later during the interdialytic period. We compared the baseline characteristics of the patients according to their initial RUV (≤ 500 ml/day vs >  500 ml/day) using Student’s t, Mann-Whitney U and Chi2 tests. Linear mixed-effects models were used to search for predictors of decreased RUV by adding potentially predictive baseline covariates of the evolution of RUV to the effect of time: age, sex, diabetes mellitus, hypertension, diastolic blood pressure, diuretics, angiotensin conversion enzyme inhibitors (ACEI), angiotensin receptor blockers, hypovolemia, chronic tubulointerstitial nephropathy, left ventricular hypertrophy and initial hemodialysis characteristic. A value of p < 0.05 was considered the threshold of statistical significance. Results The majority of hemodialysis patients were male (68.8%, sex ratio 2.2), with a mean age of 52.5 ± 12.3 years. The population’s RUV decreased with time, but with a slight deceleration. The mean RUV values were 680 ± 537 ml/day, 558 ± 442 ml/day and 499 ± 475 ml/day, respectively, at the initiation of HD and at 6 and 12 months later. The use of ACEI at the initiation of HD (beta coefficient 219.5, p < 0.001) and the presence of chronic tubulointerstitial nephropathy (beta coefficient 291.8, p = 0.007) were significantly associated with RUV preservation over time. In contrast, the presence of left ventricular hypertrophy at the initiation of HD was significantly associated with decreased RUV over time (beta coefficient − 133.9, p = 0.029). Conclusions Among incident hemodialysis patients, the use of ACEI, the presence of chronic tubulointerstitial nephropathy and reduced left ventricular hypertrophy are associated with greater RUV preservation in the first year of dialysis