Diabetes and COVID-19 in Congolese patients

Background: The global pandemic Coronavirus Disease 2019 (COVID-19) due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is reported to be potentially severe in patients with morbid conditions. One common reported comorbidities is diabetes. We aimed in this study to precise the clinical characteristics and outcomes in a series of congolese diabetic patients affected by COVID-19 infection. Patients and methods: We retrospectely studied from 256 COVID-19 patients, a cohort of 30 persons with previously known diabetes. The glycaemia controls have been obtained by plasma glucose assay. All patients have been tested positive to SARS-CoV-2 by RT-PCR method. Results: The COVID-19 diabetic patients represented 11,7% of all COVID-19 patients with confidence interval of 95% [7,77-15,65]. Older individuals and male sex were predominent. Dyspnea and sauration of oxygen < 90 were significatives and added risk factors were noted in 63.3% of patients, particulary hyperglycaemia with hypertension or obesity. The mortality rate at the percentage of 36.7% was more prevalent in patients with added comorbidities (30%) versus without comorbidities (6.7%). Conclusion: Congolese COVID-19 diabetic patients of male sex and older age exhibiting arterial hypertension and obesity are the most exposed to severe COVID-19 and increasead mortality rate

Chikungunya Outbreak in the Republic of the Congo, 2019—Epidemiological, Virological and Entomological Findings of a South-North Multidisciplinary Taskforce Investigation

The Republic of Congo (RoC) declared a chikungunya (CHIK) outbreak on 9 February 2019. We conducted a ONE-Human-Animal HEALTH epidemiological, virological and entomological investigation. Methods: We collected national surveillance and epidemiological data. CHIK diagnosis was based on RT-PCR and CHIKV-specific antibodies. Full CHIKV genome sequences were obtained by Sanger and MinION approaches and Bayesian tree phylogenetic analysis was performed. Mosquito larvae and 215 adult mosquitoes were collected in different villages of Kouilou and Pointe-Noire districts and estimates of Aedes (Ae.) mosquitos’ CHIKV-infectious bites obtained. We found two new CHIKV sequences of the East/Central/South African (ECSA) lineage, clustering with the recent enzootic sub-clade 2, showing the A226V mutation. The RoC 2019 CHIKV strain has two novel mutations, E2-T126M and E2-H351N. Phylogenetic suggests a common origin from 2016 Angola strain, from which it diverged around 1989 (95% HPD 1985–1994). The infectious bite pattern was similar for 2017, 2018 and early 2019. One Ae. albopictus pool was RT-PCR positive. The 2019 RoC CHIKV strain seems to be recently introduced or be endemic in sylvatic cycle. Distinct from the contemporary Indian CHIKV isolates and in contrast to the original Central-African strains (transmitted by Ae. aegypti), it carries the A226V mutation, indicating an independent adaptive mutation in response to vector replacement (Ae. albopictus vs Ae. aegypti)

Facteurs explicatifs des maladies hydriques chez les enfants de 0 à 5 ans dans l’aire de santé du dispensaire urbain d’ebolowa - Cameroun

Introduction : Les maladies hydriques sont des troubles de l’organisme liés à l’eau. Elles constituent un problème de santé publique. Elles sont responsables de 60% de la mortalité infantile dans nos pays en développement. Il y a peu d’études dans le Sud Cameroun sur le sujet. L’objectif général était d’étudier les facteurs explicatifs aux maladies hydriques chez les enfants de 0 à 5 ans, dans l’aire de santé du dispensaire urbain (ASDU), à Ebolowa au Cameroun en 2020. Méthodologie : Il s’est agi d’une étude transversale analytique comparant deux groupes d’enfants (groupe 1 : enfants affectés par les maladies hydriques, groupe 2 : enfants non affectés par les maladies hydriques) au sein de l’ASDU. Elle a duré 21 mois et la période d’étude est allée du 28 Décembre 2020 au 22 Janvier 2021. Nous avons inclus les enfants de 0 à 5 ans, présents dans les ménages dont les parents /tuteurs ont donné leur consentement éclairé. Les enfants ayant souffert de maladies hydriques, les 6 derniers mois, étaient considérés comme affectés. Nous avons pris en compte les carnets de santé et les définitions de cas. L’échantillonnage était probabiliste et en grappes. Grâce à la formule de Kelsey, nous avons obtenu un échantillon de 420 ménages et 566 enfants. Les données ont été collectées à l’aide d’un questionnaire et stockées dans le tableur Excell 2016 et analysées avec le logiciel EPI INFO CDC USA 7.2.2.6. Le calcul des rapports de cote et p value a été fait avec STAT CALC au seuil de significativité de 0,05. Le test statistique utilisé était le test de chi carré de Wald au seuil de significativité de 0,2. Résultats : Les enfants ayant souffert de ces pathologies avaient un âge médian de 36 mois (24 ; 60). Il ressort que les facteurs explicatifs des maladies hydriques, dans les ménages sélectionnés de l’ASDU, en 2020 chez les enfants de 0 à 5 ans étaient : l’hygiène des mains OR 3,21(1,09 -9,42) p value 0,025. ; faible utilisation de MIILDA (Moustiquaire Imprégnée d’Insecticide à Longue durée d’Action) : OR 10,78 (1,41-81,87.) p value 0,004. L’allaitement alternatif : les maladies hydriques se manifestaient 5 fois plus si l’enfant était sous allaitement alternatif (diarrhée) OR 5,00 (1,42 -17,59) p value 0, 006. Les revenus : dans les ménages avec des revenus déclarés comme étant moins de cent cinquante mille FCFA, la maladie hydrique se manifestait 5 fois plus que chez ceux ayant des revenus mensuels supérieurs OR 5,93(1,93 -17,77) p value 0,003. Conclusion : Il ressort que cinq facteurs peuvent expliquer les maladies hydriques. Nous proposons de renforcer la sensibilisation des mères/tutrices sur les bonnes pratiques ; également rendre les MIILDA disponibles dans les ménages qui n’en n’ont pas ; enfin accentuer la promotion de la santé concernant la lutte contre les maladies hydriques.   English title: Explanatory factors for water-borne diseases in children aged 0 to 5 years in the health area of the urban dispensary of Ebolowa, Cameroon Introduction: Water-related disorders of the body are a public health problem. They are responsible for 60% of infant mortality in developing countries. There are few studies in South Cameroon on the subject. The main aim was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in Ebolowa urban center health area in Cameroon in 2020. Methodology: This is an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases). It lasted for 21 months, we included children aged 0 to 5 years of households where parents/guardians gave their consent. On one hand children who were affected by waterborne disease in the last six months were selected. On the other -hand, taking into consideration the health books and the case defined. Sampling was probabilistic and cluster sampling. We obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and analyzed with CDC USA's EPI INFO SOFTWARE 7.2.2.6. The calculation of the odds ratio and p value was done with STAT CALC and the significance threshold of 0.05. The statistical test used was Wald's chi-square test and the significance level of 0.2. Results: The median age of children suffering from these pathologies was 36 months (24; 60). It appears that the explanatory factors for waterborne diseases in selected households in the urban area in 2020 among children aged 0-5 years were: hand hygiene OR 3.21(1.09 - 9.42) p value 0.025, low use of LLIINs: OR 10.78 (1.41-81.87.) p value 0.004. Water-borne diseases were 5 times more frequent if the child was under alternative breastfeeding (diarrhea) OR 5.00 (1.42 -17.59) p value 0.006.; in households with an income declared as less than one hundred and fifty thousand FCFA, waterborne disease manifested itself 5 times more than in those with a higher monthly income OR 5.93 (1.93 -17.77) p value 0.003. Conclusion: It emerges that five factors can explain water-borne diseases. These are hand hygiene, breastfeeding behavior, low use of LLIINs, use of latrines and low income. We propose to increase the awareness of mothers/guardians on good practices; also, to make LLIINs available in households that do not have them; and finally, to increase health promotion in the fight against waterborne diseases

Epidemiologic and Ecologic Investigations of Monkeypox, Likouala Department, Republic of the Congo, 2017

Monkeypox, caused by a zoonotic orthopoxvirus, is endemic in Central and West Africa. Monkeypox has been sporadically reported in the Republic of the Congo. During March 22–April 5, 2017, we investigated 43 suspected human monkeypox cases. We interviewed suspected case-patients and collected dried blood strips and vesicular and crust specimens (active lesions), which we tested for orthopoxvirus antibodies by ELISA and monkeypox virus and varicella zoster virus DNA by PCR. An ecologic investigation was conducted around Manfouété, and specimens from 105 small mammals were tested for anti-orthopoxvirus antibodies or DNA. Among the suspected human cases, 22 met the confirmed, probable, and possible case definitions. Only 18 patients had available dried blood strips; 100% were IgG positive, and 88.9% (16/18) were IgM positive. Among animals, only specimens from Cricetomys giant pouched rats showed presence of orthopoxvirus antibodies, adding evidence to this species’ involvement in the transmission and maintenance of monkeypox virus in nature