Frequency and determinants of ocular trauma in the Kimpese Rural Health Zone, Kongo Central, Democratic Republic of Congo: Fréquence et Déterminants des traumatismes oculaires dans la Zone de santé de Kimpese, Kongo Central, RDC

Context and objective. Ocular trauma is very common and its etiological factors vary by region and age group. This study aims to describe the magnitude and determinants of ocular trauma complications in rural areas.  Methods. We conducted a retrospective study of patients admitted for ocular trauma at Kimpese Hospital between January 2014 and December 2016. Univariate logistic regression was used to assess the determinants of ocular trauma complications. The statistical significance level is p˂ 0.05.  Results. A total of 223 patients were included. The majority of participants were men (69.5%), over 18 years of age (70%), with poor visual acuity (57.8%) and bilateral ocular involvement (51.1%). Plant objects (44.8%) and metal objects (15.2%) were the most common traumatic agents. After treatment, an improvement in visual acuity was observed in 64.3% of patients with previously poor visual acuity (p < 0.001). The delay of care > 7 days [aOR: 2.286 (95% CI: 1.302-4.012), p=0.004] and the poor visual acuity on admission [aOR: 5.906 (95% CI: 3.231-10.796), p< 0.0001] emerged as determinants of the onset of complications. Conclusion. Awareness-raising efforts for early consultation after ocular trauma and integration of eye care at the primary level should be promoted for efficiency in care. Contexte et objectifs. Les traumatismes oculaires sont très fréquents et ses facteurs étiologiques varient selon les régions et les tranches d’âge. Cette étude a pour objectifs de décrire le fardeau et rechercher les déterminants des complications des traumatismes oculaires en milieu rural. Méthodes. Nous avons mené une étude documentaire sur les patients admis à l’hopital de Kimpese pour un traumatisme oculaire entre janvier 2014 et décembre 2016. La régression logistique univariée a été utilisée pour rechercher les déterminants des complications des traumatismes oculaires. Le seuil de signification statistique est p˂0.05. Résultats. La majorité des participants était des hommes (69,5%), de la tranche de plus de 18 ans (70 %), avec une mauvaise acuité visuelle (57,8%) et une atteinte oculaire bilatérale (51,1%). Les objets de nature végétale (44,8%) et les objets métalliques (15,2%) ont constitué les agents traumatiques les plus rencontrés. Après traitement, une amélioration de l’acuité visuelle a été constatée chez 64,3% des patients ayant précédemment une acuité visuelle mauvaise (p< 0,001). Le délai de prise en charge > 7 jours [ORa : 2 ,286 (IC 95% : 1,302-4,012), p= 0,004] et la mauvaise acuité visuelle à l’admission [ORa : 5,906 (IC 95%: 3,231-10,796), p < 0,0001] ont émergé comme déterminants de la survenue des complications. Conclusion. Les efforts de sensibilisation en faveur de la consultation précoce après les traumatismes oculaires et une intégration des soins oculaires au niveau primaire sont à promouvoir pour une efficience dans la prise en charge

Efficacy, safety, and dose of Pafuramidine, a new oral drug for treatment of first stage sleeping sickness, in a phase 2a clinical study and phase 2b randomized clinical studies

Sleeping sickness (human African trypanosomiasis [HAT]) is caused by protozoan parasites and characterized by a chronic progressive course, which may last up to several years before death. We conducted two Phase 2 studies to determine the efficacy and safety of oral pafuramidine in African patients with first stage HAT.; The Phase 2a study was an open-label, non-controlled, proof-of-concept study where 32 patients were treated with 100 mg of pafuramidine orally twice a day (BID) for 5 days at two trypanosomiasis reference centers (Angola and the Democratic Republic of the Congo [DRC]) between August 2001 and November 2004. The Phase 2b study compared pafuramidine in 41 patients versus standard pentamidine therapy in 40 patients. The Phase 2b study was open-label, parallel-group, controlled, randomized, and conducted at two sites in the DRC between April 2003 and February 2007. The Phase 2b study was then amended to add an open-label sequence (Phase 2b-2), where 30 patients received pafuramidine for 10 days. The primary efficacy endpoint was parasitologic cure at 24 hours (Phase 2a) or 3 months (Phase 2b) after treatment completion. The primary safety outcome was the rate of occurrence of World Health Organization Toxicity Scale Grade 3 or higher adverse events. All subjects provided written informed consent.; Pafuramidine for the treatment of first stage HAT was comparable in efficacy to pentamidine after 10 days of dosing. The cure rates 3 months post-treatment were 79% in the 5-day pafuramidine, 100% in the 7-day pentamidine, and 93% in the 10-day pafuramidine groups. In Phase 2b, the percentage of patients with at least 1 treatment-emergent adverse event was notably higher after pentamidine treatment (93%) than pafuramidine treatment for 5 days (25%) and 10 days (57%). These results support continuation of the development program for pafuramidine into Phase 3

Consensus on potential interventions for improving glycaemic control among patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a Delphi study

Background Poor glycaemic control is a multifactorial and complex problem with dire clinical and economic implications. In the Democratic Republic of the Congo, recent studies have shown alarming poor control rates. There is no policy framework to guide corrective actions. Objectives To build a consensus on interventions to improve glycaemic control among patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo. Methods This was a two-round electronic Delphi study involving 31 local and 5 international experts. The experts rated proposed interventions from previous studies on glycaemic control in sub-Saharan Africa and Kinshasa on a 4-Likert scale questionnaire. Additionally, the experts were asked to suggest other recommendations useful for the purpose. The mode, mean and standard deviation of each statement were calculated for each round. Results Participants reached consensus in five domains that included 39 statements on how to improve glycaemic control in Kinshasa: strengthening the health system, enhancing the awareness of diabetes, alleviating the financial burden of diabetes, enhancing the adoption of lifestyle modifications, and reducing the proportion of undiagnosed diabetes. Conclusions Improved glycaemic control needs to be considered within the broader framework of managing noncommunicable diseases in a more integrated, coordinated and better financed healthcare system. Further studies are needed to operationalise the interventions identified for successful implementation

Additional file 9 of Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Additional file 9. List of references of excluded studies. The list of excluded reference

Additional file 8 of Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Additional file 8: Table S8. Assessment of methodological quality of cohort study. Assessment of the risk of bias for cohort study through the Joanna Briggs checklist

Additional file 2 of Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Additional file 2: Table S2. General characteristics of excluded studies and reason for exclusion. A description of the excluded studies and the reason for their exclusion

Additional file 4 of Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Additional file 4: Table S4. Assessment of methodological quality for included cross-sectional studies. Assessment of the risk of bias for cross-sectional studies with the Joanna Briggs checklist

Additional file 3 of Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Additional file 3: Table S3. Data for metanalysis of proportions of glycaemic control in included studies. Data extracted for metaanalysis in the individual studies

Additional file 5 of Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis

Additional file 5: Table S5. Assessment of methodological quality of quasi-experimental studies. Assessment of the risk of bias for quasi-experimental studies with the Joanna Briggs checklist