Uterine Leiomyoma in Kinshasa, the Capital of the Democratic Republic of Congo

The aim of the present study was to determine the particularities of Uterine Leiomyomas among Congolese in Kinshasa the capital of the Democratic Republic of Congo (DRC) in the present conditions of medical practices. A sample of 644 patients with uterine leiomyoma were selected from 6440 cases of uterine leiomyoma among 30395 patients treated in gynecology units of three medical institutions of Kinshasa (University hospital of Kinshasa, Saint joseph hospital and Edith medical center) from January Ist ,2003 to December 31,2012. The study is a descriptive one. The following variables were taken account: medical history [age, age at menarche, parity, education, civil state, history of UL, symptoms and body mass index (BMI)]; lifestyle (smoking, alcohol intake); ultrasounds characteristics; hysteroslpingographies characteristics, treatment, and direct cost of treatment. Statistical analysis were performed using Excel 12.0 software. Demographic, clinical, ultrasound, hysterosalpingography and treatment data were evaluated using descriptive statistics: mean, standard deviation (SD), and percentage (%) as appropriate. The frequency of uterine leiomyoma was 21, 18%. That one concern mainly patients at 35 years old or more [49, 6% (35-44years), ?45years (20, 6%)], singles (70, 4%), null parous (59,4%), having a high level of study (university: 54, 6%), history of UL (56, 7%), and alcohol intake (75, 5%). Hemorrhage (33, 2%) and pelvic pain (31, 6%) are the most frequent expression of those tumors. The most of those patients have excess weight (43, 1%) or obesity (46, 5%). The majority of uterine leiomyoma was corporeal (82, 9%) intramuscular (42, 4%) and their number didn’t overtake five by patient (70, 8%) in majority of cases. Majoration of the uterine cavity (46, 5%) and Fallopian tubes obstructions (30, 6%) are the most frequent abnormalities in hysterosalpingography. Myomectomy is the main treatment (65, 2%). The mean of direct cost were 803$USA and 884$ USA for myomectomy and hysterectomy respectively

A possible case of spontaneous Loa loa encephalopathy associated with a glomerulopathy

It is well known that renal and neurological complications may occur after antifilarial treatment of patients infected with Loa loa. Conversely, spontaneous cases of visceral complications of loiasis have been rarely reported. A 31-year-old Congolese male patient who had not received any antifilarial drug developed oedema of the lower limbs, and then transient swellings of upper limbs. Two months after, he developed troubles of consciousness within several hours. At hospital, the patient was comatose with mild signs of localization. Laboratory tests and an abdominal echography revealed a chronic renal failure due to a glomerulopathy. Three weeks after admission, Loa microfilariae were found in the cerebrospinal fluid, and a calibrated blood smear revealed a Loa microfilaraemia of 74,200 microfilariae per ml. The level of consciousness of the patient improved spontaneously, without any specific treatment, but several days after becoming completely lucid, the patient died suddenly, from an undetermined cause. Unfortunately, no biopsy or autopsy could be performed. The role of Loa loa in the development of the renal and neurological troubles of this patient is questionable. But the fact that such troubles, which are known complications of Loa infection, were found concomitantly in a person harbouring a very high microfilarial load suggests that they might have been caused by the filarial parasite. In areas endemic for loiasis, examinations for a Loa infection should be systematically performed in patients presenting an encephalopathy or a glomerulopathy

Prevalence of arterial hypertension in the work place in Kinshasa, Democratic Republic of Congo

© 2018 Elsevier Masson SAS Background: Arterial hypertension (AHT) is a major cardiovascular risk factor in the occurrence of stroke, heart failure, renal insufficiency and coronary heart disease, which are the leading causes of death worldwide. Insufficient data on high blood pressure in the workplace in the Democratic Republic of Congo, led us to carry out an analytical cross-sectional study in November 2015. Objective: The objective of this study was to determine the prevalence and determinants of hypertension among employees of the Multimodal Freight Management Office of the City of Kinshasa, Democratic Republic of Congo. Methodology: Analytical cross-sectional study of 210 workers, 119 (56.7%) men and 91 (43.3%) women, randomly selected. PA was measured, after 5 min of sitting relaxation, on the left arm at the heart with a mercury sphygmomanometer. Three consecutive measures atone-minute interval were taken and their mean defines the worker's PA. SBP and DBP corresponded to KorotkoffI and V sounds, respectively. AHT was defined as BP ≥ 140/90 mm Hg or history of antihypertensive therapy regardless of BP levels. Logistic regression was used to identify the independent determinants of hypertension. P < 0.05 defined the level of statistical significance. Results: The overall prevalence of hypertension was 41.9% with 45.4% men and 37.4% women afflicted (P < 0.153). The likelihood of having hypertension was 5 [aOR = 5,327 95% CI (1,298–21,862), P = 0,020)] and 3 [aOR = 3,44 95% CI (1,432–8.28), P = 0.007)] times greater among obese workers and those with central obesity. Conclusion: Hypertension is a common finding in the present case series and obesity emerged as its main associated risk factor. The present study highlights the need for a comprehensive program targeting prevention and care of high blood pressure in the workplace.status: publishe

The Atherogenic Dyslipidemia Ratio Log (Tg)/Hdl-C Was Not Associated with Urinary Albumin Excretion Rate (Uaer) and In-creased Cardiovascular Risk in Black Patients with Type 2 Diabetes

Abstract Objective: The objective is to assess the relationship of Log (TG)/HDL-c as surrogate estimate of atherogenic dyslipidemia with urinary albumin excretion rate and cardiovascular risk among black patients with type 2 diabetes. Patients and methods: A post-hoc analysis of data from 181 type 2 diabetes patients enrolled in a cross-sectional study of urinary albumin excretion rate seen at a tertiary healthcare. Microalbuminuria and macroalbuminuria were defined as ACR 30 -299.9 mg/g and ACR ≥ 300 mg/g, respectively. Quartiles of Log (TG)/HDL-c were used as surrogate estimates of atherogenic dyslipidemia. Cardiovascular risk was assessed using WHO chart for estimation of CV risk in low and middle income countries. Comparisons across Log (TG)/HDL-c quartiles were performed using one way ANOVA and Chi square for trend as appropriate. P &lt; 0.05 defined the level of statistical significance. Results: A high prevalence (69%) of atherogenic dyslipidemia (AD) was observed in the present case series of Black Africans with type 2 diabetes. Average total cholesterol levels showed significant (p = 0.010) trends towards lower values across quartiles of Log (TG)/ HDL-c. No significant trends were observed for average UAER and cardiovascular risk across quartiles of Log (TG)/HDL-c. Conclusion: Log (TG)/HDL-c as a surrogate estimate of atherogenic failed to predict cardiovascular risk in the present case series of black patients with type 2 diabetes

Facteurs prédictifs de la mortalité des patients admis aux urgences médicales des cliniques universitaires de Kinshasa

Background: The management of medical emergencies is poorly organized in the Democratic Republic of Congo. In addition, the mortality of patients attending the medical emergency unit of Kinshasa University Hospital is relatively high, with death of patients occurring rather early. To date, factors associated with this mortality have been poorly elucidated. This study aimed to identify predictive factors of all-cause mortality in patients admitted to the medical emergency unit of the Kinshasa University Hospital. Methods: Analytical prospective study of all patients admitted from 15th January to 15th February 2011 in the emergency unit of the internal medicine department of Kinshasa University Hospital (427 patients). Among these patients, 13 were dead at arrival and were excluded from this study. The 414 patients included were followed until discharge from the hospital. Demographic, clinical, biological, diagnostic, therapeutical and evolutive data were collected. Four multivariate logistic regression models were used to identify risk factors associated with mortality. Results: Patients' median age was 40. years (interquartile range, 28-58 years), 54.5% were male, and 15.9% had a life-threatening pathological condition on admission. The overall mortality was 12.3%. According to multivariate analyses, transfer from other health care structures (OR: 3.5; 95% CI: 1.7-7.1), Glasgow Coma Scale score less than 14 on admission (OR: 11.1; 95% CI: 4.7-26.3), high creatinine level (OR: 4.2; 95% CI: 1.8-9.7), presence of cardiovascular (OR: 2.9; 95% CI: 1.5-5.7), renal (OR: 7.4; 95% CI: 3.2-17.3), hematologic and/or respiratory (OR: 6.1; 95% CI: 1.7-21.4) diseases, presence of sepsis and/or meningitis and encephalitis (OR: 5.2; 95% CI: 1.6-17.0) were significantly associated with a high risk of death. However, the Glasgow Coma Scale score less than 14 on admission and renal disease were the only predictive factors of mortality remaining after including demographic, clinical, diagnostic and therapeutical variables in the logistic regression model. Conclusion: Our study showed that transfer from another health care structure, low Glasgow Coma Scale score on admission, high creatinine level, cardiovascular, renal, hematologic and/or respiratory diseases, sepsis and/or meningitis and encephalitis were associated with an increased risk of death in Kinshasa University Hospital patients admitted in the medical emergency unit. © 2013 Elsevier Masson SAS.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

HIV and other sexually transmitted infections among female sex workers in Kinshasa, Democratic Republic of Congo, in 2002

OBJECTIVE: The objective of this study was to determine the prevalence and risk factors of HIV and other sexually transmitted infections (STIs) among female sex workers (FSWs) in Kinshasa, Democratic Republic of the Congo, in 2002. STUDY DESIGN: A cross-sectional study was conducted among FSWs presenting for the first time at the STI clinic of Matonge, Kinshasa. The women were interviewed about sociodemographic characteristics, type of sex work, and sexual behavior. Blood was taken for HIV, syphilis, and herpes simplex virus type 2 serology. Vaginal secretions were collected on swabs for the diagnosis of gonorrhea, chlamydia, and trichomoniasis. RESULTS: The overall HIV prevalence was 12.4% but varied within the different categories of FSWs: 11.8% in hotel-based, 24.0% in home-based, and 20.0% in street-based FSWs; 10.0% in homeless FSWs; and 6.6% in Masquées (clandestine sex workers). The overall herpes simplex virus type 2 seroprevalence was 58.5%. CONCLUSIONS: The prevalence of HIV and other STIs seems to have stabilized since the beginning of the project in 1988