Profil de sensibilisation aux allergènes des asthmatiques adultes à Kinshasa, RDC : Etude transversale par prick-tests: Allergen sensitization profile of adult asthmatics in Kinshasa, DRC: Cross-sectional study by prick-tests

Context. Atopy is a common feature of asthma, involving near 80% of patients. Allergen sensitization shows environmental and geographical variability worldwide. Objective. To determine the common allergen sensitization profile of adult asthmatics in Kinshasa. Methods. From June 2017 to February 2018, 216 asthmatics aged 18 and over, of both sexes, were consecutively recruited at the University Clinics of Kinshasa and in some parishes and churches around the same town. The socio-demographic variables were registered using a validated questionnaire. The prick-test was performed relaying on five standardized commercial extracts of dog and cat dander, house dust mite (Blomia tropicalis, Bt), molds (Alternaria alternata), and egg yolk. Results. The population, average age of 45.23 (SD=17.56) years, 74% female, was sensitized at least to one allergen (53%) and non -sensitized in 47%. Twenty-five percent were monosensitized and 27% plurisensitized. The sensitization profile was respectively to Blomia tropicalis (72%), cat dander (46%), dog dander (34%), Alternaria alternata (13%) and egg yolk (11%). Conclusion. The present study indicates a plurisentisization feature in many asthmatics in our milieu ; mainly to dust mites and cat dander. Futher investigations involving a larger number of subjects and using broader test batteries are needed to improve diagnostic and therapeutic approaches in our context. Contexte. Environ 80% des asthmatiques sont atopiques. La sensibilisation aux allergènes communs présente certaines variabilités environnementales et géographiques. Objectif. Déterminer le profil de sensibilisation aux allergènes communs des asthmatiques adultes de la ville de Kinshasa. Méthodes. De juin 2017 à février 2018, 216 asthmatiques de 18 ans et plus, des 2 sexes, ont été consécutivement recrutés aux Cliniques Universitaires de Kinshasa et dans certaines paroisses et églises de réveil de la ville de Kinshasa. A l’aide d’un questionnaire validé, les variables sociodémographiques ont été précisées. Le prick-test a été réalisé avec cinq extraits commerciaux standardisés de phanères de chien et chat, l’acarien de poussière de maison (Blomia tropicalis, Bt), les moisissures (Alternaria alternata), et le jaune d’oeuf. Résultats. L’âge moyen de la population était de 45,23 (ET=17,56) ans, 74% de sexe féminin, 47 % non sensibilisés et 53% sensibilisés à au moins un allergène. Vingt-cinq pourcent étaient monosensibilisées et 27% plurisensibilisées. Le profil de sensibilisation était Blomia tropicalis (72%), phanères de chat (46%), phanères de chien (34%), Alternaria alternata (13%) et jaune d’oeuf (11%). Conclusion. Une plurisensibilisation aux allergènes communs chez les asthmatiques dans notre milieu est présente dont le profil dominé par les acariens et les phanères de chats. Des enquêtes futures incluant un plus grand nombre de sujets et recourant à des batteries de tests plus élargies s’imposent en vue d’une définition d’options diagnostiques et thérapeutiques dans notre contexte

Factors associated with uncontrolled asthma in adult asthmatics in Kinshasa, Democratic Republic of Congo.

BackgroundThe ultimate goal of asthma treatment is long-term control. Uncontrolled asthma is a major public health problem worldwide, but there is a lack of data on asthma control and its causes in the Democratic Republic of Congo (DRC).ObjectiveTo determine the socio-demographic, environmental, clinical, and biological factors and comorbidities associated with uncontrolled adult asthma in Kinshasa, DRC.MethodsWe performed a cross-sectional study of 216 male and female asthmatics aged 18 and over consecutively recruited from tertiary clinics and the community in Kinshasa between June 2017 and February 2018. For each subject, socio-demographic, clinical, para clinical and environmental data were recorded. Forced Expiratory Volume in one second (FEV1) values were obtained by Spirometry, allergen testing performed using the skin prick test, serum vitamin D levels measured by radioimmunoassay, and asthma control assessed using the asthma control test (ACT) score. Multiple logistic regression identified factors associated with uncontrolled asthma.ResultsThe average age of participants was 45.2 (SD 17.6) years, 74% were female, and 42% had a low educational level. Among all asthmatics, the prevalence of uncontrolled asthma was 56%, abnormal serum vitamin D level 95%, abnormal FEV1 65%, sensitization to two allergens (cat dander and dust mites) 18%, sleep disorders 37%, and heartburn 60%. Male (aOR 2.24; 95% CIs 1.04-4.79), low educational level (aOR 3.26; 95% CIs 1.54-6.67), sensitization to both cat dander and dust mites (aOR 2.67; 95% CIs 1.16-6.14), FEV1 ≤80% (aOR 2.07; 95% CIs 1.08-3.96), abnormal serum vitamin D level (aOR 5.11; 95% CIs 1.17-22.33), sleep disorders (aOR 1.96; 95% CIs 1.04-3.71), and heartburn (aOR 2.02; 95% CIs 1.04-3.92) were significantly associated with uncontrolled asthma.ConclusionUncontrolled asthma is common in Kinshasa, and these factors associated with uncontrolled asthma may be considered as targets for future intervention strategies

Prevalence and determinants of asthma in adults in Kinshasa

<div><p>Background</p><p>Epidemiological data on asthma among adults in sub-Saharan Africa are sparse.</p><p>Objective</p><p>To determine the prevalence of and factors associated with asthma among adults in Kinshasa.</p><p>Methods</p><p>A previously validated asthma questionnaire was administered to an adult population aged ≥18 years in urban and peri-urban suburbs of Kinshasa. A random stratified multi-stage sampling plan was used to select the study participants. Logistic regression was used to identify factors associated with asthma.</p><p>Results</p><p>The mean age of respondents was 36.7 (SD 15.36) years, 75% lived in an urban environment, and 57% were women. The prevalence of asthma-ever was 6.9% (95% CI: 5.4–8.4). Among asthmatic patients, intermittent asthma was estimated at 75.7% and severe asthma at 9.3%. Family atopy (OR: 3.97; 95% CI: 2.42–6.50; p<0.001), and the presence of a cat in the house (OR: 1.82; 95% CI: 1.01–3.28; p = 0.045) were associated with self-reported asthma.</p><p>Conclusion</p><p>Asthma is relatively frequent in adults in Kinshasa, a prevalence similar to those reported elsewhere in Africa. Family atopy and the presence of a cat in the house could be the most common determinants to be confirmed with national survey in order to design guidelines for the control of asthma.</p></div

Distribution of asthma declared in the population of the city of Kinshasa, 2016.

<p>Distribution of asthma declared in the population of the city of Kinshasa, 2016.</p

Sociodemographic characteristics of the study population.

<p>Sociodemographic characteristics of the study population.</p

Factors associated with the presence of asthma in Kinshasa.

<p>Factors associated with the presence of asthma in Kinshasa.</p

Symptoms suggestive of asthma according to gender.

<p>Symptoms suggestive of asthma according to gender.</p

The African Network for Improved Diagnostics, Epidemiology and Management of common infectious Agents

Background!#!In sub-Saharan Africa, acute respiratory infections (ARI), acute gastrointestinal infections (GI) and acute febrile disease of unknown cause (AFDUC) have a large disease burden, especially among children, while respective aetiologies often remain unresolved. The need for robust infectious disease surveillance to detect emerging pathogens along with common human pathogens has been highlighted by the ongoing novel coronavirus disease 2019 (COVID-19) pandemic. The African Network for Improved Diagnostics, Epidemiology and Management of Common Infectious Agents (ANDEMIA) is a sentinel surveillance study on the aetiology and clinical characteristics of ARI, GI and AFDUC in sub-Saharan Africa.!##!Methods!#!ANDEMIA includes 12 urban and rural health care facilities in four African countries (Côte d'Ivoire, Burkina Faso, Democratic Republic of the Congo and Republic of South Africa). It was piloted in 2018 in Côte d'Ivoire and the initial phase will run from 2019 to 2021. Case definitions for ARI, GI and AFDUC were established, as well as syndrome-specific sampling algorithms including the collection of blood, naso- and oropharyngeal swabs and stool. Samples are tested using comprehensive diagnostic protocols, ranging from classic bacteriology and antimicrobial resistance screening to multiplex real-time polymerase chain reaction (PCR) systems and High Throughput Sequencing. In March 2020, PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and analysis of full genomic information was included in the study. Standardised questionnaires collect relevant clinical, demographic, socio-economic and behavioural data for epidemiologic analyses. Controls are enrolled over a 12-month period for a nested case-control study. Data will be assessed descriptively and aetiologies will be evaluated using a latent class analysis among cases. Among cases and controls, an integrated analytic approach using logistic regression and Bayesian estimation will be employed to improve the assessment of aetiology and associated risk factors.!##!Discussion!#!ANDEMIA aims to expand our understanding of ARI, GI and AFDUC aetiologies in sub-Saharan Africa using a comprehensive laboratory diagnostics strategy. It will foster early detection of emerging threats and continued monitoring of important common pathogens. The network collaboration will be strengthened and site diagnostic capacities will be reinforced to improve quality management and patient care