Facteurs d’affiliation aux pairs sont étroitement associés à la criminalité des jeunes incarcérés à la prison centrale de Kinshasa : Affiliation Factors to Peers are strongly associated to the Criminality among the Youth of the Central Prison of Kinshasa

Context and objective. Increasing crime is one of the major social problems facing in the context of armed conflicts of various kinds. The objective of this study is to investigate the determinants of the peer affiliation domain of criminal and violent criminal behavior. Methods. We undertook a case-control study included 500 subjects: 297 incarcerated criminals (189 violent criminals, as crime against a person and 108 non-violent criminals, as crime against property) against 203 noncriminal subjects, between August 2015 and December 2016. We selected control subjects from general population of the city of Kinshasa and matched them with cases according to gender, age (± 2 years) and geographical origin. Logistic regression analysis was used to investigate the determinants of criminality and of violent criminality. Results. Compared to noncriminals, criminals were significantly gang members (55.6% versus 4.9%, p<0.001), carry guns (40.1% versus 7.9%, p<0.001), attend parties with friends without parental supervision (69.7% versus 34%, p<0.001), and have friends who sell drugs (44.4% versus 14.8%, p<0.001). Compared to non-violent criminals, violent criminals were significantly more likely to be gang members (60.8% versus 46.3%, p=0.015), carry weapons (46.6% versus 28.7%, p=0.003) and have friends who sell heroin (50.3% versus 34.3%, p=0.008). In multivariate logistic regression analyse, being a gang member (ORa 13.6; 95% CI: 6.76-27.67), carrying a weapon (ORa 2.85; 95% CI: 1.5-5.42) and unsupervised parties (ORa 1.95; 95% CI: 1.25-3.02) were the independently associated with crime. Only carrying weapons (ORa 1.87; 95% CI: 1.05-3.32) emerged as an independent determinant of violent crime. Conclusion. Violent and non-violent crime is a continuum in which the former differs from the latter in terms of carrying a weapon. Gang involvement, social gatherings with friends and carrying weapons are the common threads of their criminal behavior. Contexte et objectif. La criminalité croissante compte parmi les problèmes sociaux majeurs en République Démocratique du Congo aux prises à des conflits armés de diverse nature. Cette étude a pour objectif de rechercher les déterminants du domaine d’affiliation aux pairs du comportement criminel et criminel violent. Méthodes. Nous avons entrepris une étude cas-témoin enrôlant 500 sujets : 297 criminels incarcérés (189 criminels violents, crime contre la personne et 108 criminels non violents, crime contre la propriété) contre 203 sujets non criminels, entre août 2015 et décembre 2016. Les témoins ont été recrutés dans la population générale de la ville de Kinshasa et appariés aux cas, selon le sexe (même), l’âge (± 2 ans) et la provenance géographique. L’analyse de régression logistique a été utilisée pour rechercher les déterminants de la criminalité. Résultats. Comparés aux non criminels, les criminels étaient significativement membres de gang (55,6% versus 4,9%, p < 0,001), porteurs des armes (40,1% versus 7,9% ; p <0,001), dans des soirées entre amissans supervision parentale (69,7% versus 34%, p<0,001), et  avaient des amis vendeurs de drogues (44,4% versus 14,8%, p<0,001). Par rapport aux criminels non violents, les criminels violents étaient significativement membres de gang (60,8% versus 46,3%, p=0,015), porteurs des armes (46,6% versus 28,7%, p=0,003) et avaient des amis vendeurs de drogues (50,3% versus 34,3%, p=0,008). En analyse de régression logistique multivariée, être membre de gang (ORa 13,6; IC 95% : 6,76-27,67), porter une arme (ORa 2,85; IC 95% : 1,5-5,42) et assister dans les soirées sans supervision (ORa 1,95; IC 95% : 1,25-3,02) constituaient les déterminants indépendamment associés à la criminalité. Seul porter des armes (ORa 1,87; IC 95% : 1,05-3,32) a émergé comme déterminant indépendant de la criminalité violente. Conclusion. La criminalité violente et non violente constitue un continuum dans lequel la première se différencie de la deuxième par le port d’arme. La participation à un gang, les soirées entre amis et le port d’arme constituent le fils conducteur de leur comportement criminel. &nbsp

Stress, anxiété, dépression et qualité de vie des patients tuberculeux pharmacorésistants à Kinshasa, République Démocratique du Congo: Stress, anxiety, depression and quality of life of drug-resistant tuberculosis patients in Kinshasa, Democratic Republic of the Congo

Contexte & objectif. La prise en charge médicale de la tuberculose pharmacorésistante connaît des progrès dans le monde. Mais, le volet psychosocial a été peu exploré en République Démocratique du Congo. La présente étude a évalué la qualité de vie des patients tuberculeux pharmacorésistants (PTP) suivis au Centre d’Excellence Damien (CEDA) à Kinshasa. Méthodes. L’échelle de stress perçu (PSS), l’Hospital Anxiety and Depression Scale (HADS) et l’Indicateur de Santé Perceptuelle de NOTTINGHAM (ISPN) ont été utilisés dans une étude transversale réalisée du 1er avril au 31 décembre 2018 sur 81 PTP hospitalisés au CEDA de Kinshasa. La méthode de régression logistique a recherché les déterminants de la qualité de vie. Résultats. Au cours de la période de l’étude, 81 PTP étaient reçus dont 62 TB multirésistants (TB MR, 76,5%) contre 19 TB ultrarésistants (TBUR, 23,5%), constituant les deux groupes d’étude. L’âge moyen des sujets était de 34,7±14,3 ans. Les hommes étaient légèrement prépondérants (53 %) avec un sex ratio H/F de 1,1. La tranche d’âge de 21 à 30 ans était plus représentée (35%). Trois-quarts des sujets étaient solitaires (75%), plus de deuxtiers avaient un niveau secondaire (69%), plus de la moitié n’avait pas d’occupation (56%), près de deux-tiers fréquentaient les Eglises indépendantes (60%). Trente-cinq pourcents des patients avaient une mauvaise qualité de vie. Celle-ci était liée à l’âge >40 ans, au type TBMR, au retard d’accompagnement psychosocial, au niveau d’étude primaire, à la présence de la co-infection tuberculoseVIH/SIDA, au stress perçu et à l’anxiété-dépression. Conclusion. Les patients tuberculeux pharmacorésistants à Kinshasa ont une qualité de vie altérée. Cette situation est favorisée par l’âge >40 ans, le type de tuberculose pharmacorésistante, le retard d’accompagnement psychosocial, le faible niveau d’étude, la présence de la coinfection tuberculose-VIH/SIDA, le stress perçu,  l’anxiété et la dépression.  Context and objective. Despite many progress in the treatment of drug-resistant tuberculosis, psychosocial aspects remain poorly adressed in the Democratic Republic of Congo. This study aimed to evaluate the quality of life of drug-resistant tuberculosis patients. Methods. A cross-sectional survey was conducted in hospitalized drug-resistant tuberculosis patients at CEDA Kinshasa, during the period from April 1 to December 31th, 2018, through the perceived stress scale (PSS), the Hospital Anxiety and Depression Scale (HADS) and the NOTTINGHAM Health Profil (NHP) tools. Data from 62 multdrug rerestitant TB patients (MDR TB, 76,5%) were compared with 19 ultraresistant (PXDR, 23.5 %) and analyzed, using a multivariate logistic regression analysis to assess the determinants of quality of life. Results. Among a total of 81 pharmaco-resistant TB patients, average age 34.7 ± 14.3 years, with a slight man preponderance (53 %), 35% had a poor quality of life. This was linked to age > 40 years, MDRTB type, delayed psychosocial support, primary education, the presence of TB/HIV co-infection, and perceived stress and anxiety-depression. Conclusion. The study reveals an impaired quality of life in Drug-resistant tuberculosis patients in Kinshasa, with some identified correlates. Targeted measures are needed to improve the management of these patients

Right to health and sustainable health development: Improving psychosocial strategies in HIV-related stress

SCOPUS: ch.binfo:eu-repo/semantics/publishe

Facteurs d’affiliation aux pairs sont étroitement associés à la criminalité des jeunes incarcérés à la prison centrale de Kinshasa

info:eu-repo/semantics/publishe

Stress syndrome in patients receiving outpatient treatment at the General Hospital, in Bangui, in a context of armed conflict

peer reviewedContext: in Africa's zones of conflict, recent studies report a high frequency of post-traumatic stress disorder (PTSD) particularly in community settings. Objective: this study aimed to contribute to a better management of patients experiencing violence subsequent to the Central African Republic socio-political conflict. Material and methods: we conducted a cross-sectional study of the medical records of patients receiving outpatient treatment in the Doctors Without Borders/Médecins Sans Frontières (France) Trauma Center, Bangui. Results: 33.33% (n=35) of patients had PTSD, while 17.14% (n=18) of patients had acute stress syndrome. Stress syndrome (SS) was associated with female sex, rape, anxiety and depression. Rape multiplied the risk of SS occurrence by 8. The average age was 30 years (P25:22 years; P75:40 years). The majority of patients had mood disorder (63.81%; n=67). Insomnia was present in 62.83% (n=66) of patients. Hospital Anxiety and Depression Scale (HADS) was present in 44.76 % of patients. Depression was found in 40.95% (n=43) of patients. Conclusion: the obtained results show how the society, apart from militia members, is affected by conflict-related violence in the country. These results can enrich the reflections on health organisation and on the management of patients in Central African, by considering the impact of conflict-related acute stress syndome in the short, medium and long term

États de stress en consultation externe à l’hôpital général de Bangui dans un contexte de conflit arme: étude transversale descriptive

Introduction: dans les zones de conflit en Afrique les récentes études rapportent des fréquences élevées des états de stress posttraumatiques (ESPT) notamment en milieu communautaire. L'objectif général de cette étude est de contribuer à une meilleure prise en charge des patients confrontés à la violence subséquente au conflit sociopolitique en cours en République centrafricaine. Méthodes: il s'agit d'une étude transversale portant sur les dossiers des patients reçus en consultation externe Trauma center de Médecins sans Frontières/France à Bangui. Résultats: l'ESPT était présent chez 33.33 % (n = 35) alors que l'état de stress aigu était présent chez 17.14 % (n = 18) des patients. Les états de stress (ES) étaient associés au sexe féminin, au viol, à l'anxiété et à la dépression. Le viol multipliait par 8 le risque de survenue d'un ES. L'âge médian observé était de 30 ans (P25: 22 ans; P75: 40 ans). La majorité des patients présentait un trouble de l'humeur (63.81 %; n = 67). L'insomnie était présente chez 62.83 % (n = 66). L'anxiété (HADS) était présente chez 44.76 % des patients (n = 47). La dépression a été retrouvée chez 40.95 % (n = 43). Conclusion: les résultats obtenus montrent à quel point, au-delà des membres de milices, la société est touchée par la violence du conflit que traverse le pays. Ces résultats pourraient nourrir la réflexion sur l'organisation des soins et la prise en charge de la population centrafricaine considérant l'impact à court, moyen et long terme des états de stress aigus en situation de conflit

Factors associated with behavioral problems and cognitive impairment in children with epilepsy of Kinshasa, Democratic Republic of the Congo.

BACKGROUND: Behavioral problems and cognitive impairment are common in children with epilepsy (CWE). In sub-Saharan Africa, little is known about these comorbidities particularly their relationships with socioeconomic features. The goal of this study was to identify clinical and socioeconomic factors associated with behavioral problems and cognitive impairment in CWE of Kinshasa (Democratic Republic of the Congo). METHODS: This cross-sectional hospital-based study had included 104 CWE aged 6 to 17years. Behavioral problems were assessed by the child behavior checklist. The Wechsler nonverbal scale of ability was used to assess cognitive impairment. RESULTS: At least one behavioral problem was found in 34.6% of CWE. Internalized problems were increasing with father's age (p=0.034). Externalized problems were increasing with the decreased of mother's age (p=0.009) and with a previous antiepileptic treatment (p=0.032). Total behavioral problems were increasing with a previous antiepileptic treatment (p=0.029). Cognitive impairment was present in 73.3% of CWE. It was more common in boys (p=0.013), and it was increasing with a low household daily expenses (p=0.034), with a previous antiepileptic treatment (p=0.041), with an early onset of epileptic seizures (p=0.042), and with a high frequency of epileptic seizures (p=0.011). CONCLUSION: Behavioral problems and cognitive impairment are common in CWE. Multivariate analysis has shown that behavioral problems were associated with socioeconomic features only. Contrariwise, cognitive impairment was associated with both socioeconomic factors and clinical features. There is a need of more studies to improve knowledge of these comorbidities in the sub-Saharan Africa context

Therapeutic itinerary of children living with epilepsy in Kinshasa: Features, determinants, and relationships with behavioral problems and cognitive impairment.

Epilepsy mostly affects children in sub-Saharan Africa. However, little is known about the therapeutic itinerary of these children living with epilepsy (CWE). This study aimed to describe the therapeutic itinerary of CWE in Kinshasa and to analyze its relationships with clinical features, behavioral problems, and cognitive impairment. This hospital-based study has included 104 CWE aged 6 to 17  years. The features of their therapeutic itinerary and their relationship with clinical features, behavioral problems, and cognitive impairment were analyzed. The vast majority of CWE (87%) has started their therapeutic itinerary by the Western medicine. The first source of information about epilepsy as well as the type of antiepileptic treatment varied with the socioeconomic status of families of CWE. The total duration of the therapeutic itinerary was shorter for the CWE who were living with both their parents (P = .038), who had generalized seizures (P = .0073) or who had no family history of epileptic seizures (P = .019). The CWE who had total behavioral problem, compared with the others, were putting more time (P = .021) to reach the Centre de Santé Mentale Telema (CSMT) after the suspicion or the diagnostic of epilepsy. The total duration of CWE who had cognitive impairment (P = .021) was longer than that of CWE who had not cognitive impairment. The therapeutic itinerary of CWE in Kinshasa began with Western medicine. The remainder of this therapeutic itinerary looks like what is described in sub-Saharan literature with the majority of CWE seeking the healing based on beliefs. This study also shows that the therapeutic itinerary of CWE was associated with socioeconomic conditions, clinical features, behavioral problems, and cognitive impairment

Are the children with epilepsy treated traditionally a disadvantaged group? A pilot study

peer reviewedIntroduction: in sub-Saharan Africa, the proportion of persons with epilepsy who seek traditional treatment is estimated at 80%. Despite that children are the firsts concerned by epilepsy, the characteristics and particularities of the children with epilepsy (CWE) who resort to traditional treatment are not known. The aim of this pilot study was to identify clinical particularities of the CWE who resort to traditional treatment. Methods: CWE between 6 to 17 years were included in the study based on their histories of previous antiepileptic treatments. The CWE previously treated by traditional healers were compared to others CWE. Results: data from 140 CWE whose previous treatments had been documented were selected. The duration of epilepsy (7 [3.0-9.8] years versus 3 [1.0-7.0] years, p=0.013) was higher for the CWE traditionally treated compared to the CWE without any antiepileptic treatment. The seizure frequency (8.7 [1.5-91.3]/month versus 1 [3-30.4]/month, p=0.036) was higher for the CWE traditionally treated compared to the CWE without any antiepileptic treatment, but the p-value was under the Bonferroni correction (p=0.017). There was no differences between the CWE traditionally treated and the CWE previously treated with antiepileptic drugs. Conclusion: compared to others, the CWE who resort to traditional medicine spend much time before consulting health facilities and could have a more serious epilepsy. We have discussed on factors that could explain these differences