Fréquence du virus d’Epstein-Barr dans les lymphomes B agressifs en République Démocratique du Congo: Prevalence of Epstein – Barr virus in aggressive B lymphomas in the Democratic Republic of the Congo

Context and objective. Although Epstein-Barr virus (EBV) is known associated with several subtypes of aggressive non-Hodgkin lymphoma (NHL), data related from sub-Saharan Africa are paradoxically scarce. The aim of this study was to investigate the frequency of the different types of NHL and their association with latent EBV. Methods. We collected 88 biopsies having NHL obtained from Congolese patients between June 2005 and June 2018 in three laboratories (Kinshasa university hospital, INRB and LEBOMA). All specimens were reviewed using the 2008 and 2016 WHO classification of lymphoid neoplasms encompassing classic histopathology, immunohistochemistry and in situ hybridization. Results. Aggressive B cell lymphomas were the most frequent NHL (58 cases, 65.9%) encountered, mainly Diffuse Large B Cells Lymphomas (DLBCL) and Burkitt lymphoma (BL). The frequency of EBV was 64.3% and 23.3% in BL and DLBCL, respectively. Conclusion. More than half of aggressive NHL, particularly BL in DRC exhibit EBV. This study will served as a basis for a more extensive study of the NHL in DRC in patients with or without AIDS. Contexte et objectif. Certes, le virus d’Epstein-Barr (VEB) soit bien connu associé à plusieurs types de lymphome B agressifs non- hodgkinien (LNH), les données y relatives sont paradoxalement rares en Afrique sub-Saharienne. La présente étude avait pour objectif de rechercher la fréquence de types des lymphomes B agressifs et leur relation avec du VEB. Méthodes. Nous avons colligé 88 biopsies de lymphomes chez des patients originaires de RDC, entre juin 2005 et juin 2018, dans trois laboratoires d’Anatomie pathologique (CUK, INRB et LEBOMA). Cette étude documentaire est essentiellement basée sur la classification d’OMS 2008 révisée en 2016. Les analyses histopathologiques, immunohistochimiques et d’hybridation in situ ont été réalisées sur tous les blocs de paraffine. Résultats. Les lymphomes B agressifs sont les plus fréquents (58 cas) rendant compte de 65,9% des cas. La fréquence du VEB dans le lymphome de Burkitt (LB) et les lymphomes B agressifs diffus à grandes cellules (LDGCB) est respectivement de 64,3% et 23,3% des cas. Conclusion. Plus de la moitié des patients avec LNH sont infectés par le VEB. Ils vont servir de base pour une étude prospective plus étendue des LNH en RDC chez des patients ayant ou non le Sida. &nbsp

Abdominal and pelvic adhesions: are blacks different?

Studies conducted mostly in the United States bring evidence on racial disparities between blacks and whites in various pathologies including asthma and other allergies whose pathophysiology relates in part to innate immunological characteristics such as variation in host defense genes. There are various other pathologies evoking that black people could have an immune overreaction in response to diverse aggressions. For example, the prevalence of systemic lupus erythematous and systemic sclerosis has been found to be higher in black Americans compared to Caucasians suggesting, at least in part, racial disparities in immunological reactions. So, these arguments borrowed from other fibrotic disorders suggest a hypothetic racial disparity in abdominal and pelvic adhesions. Data on this condition according to racial disparity are scarce and should incite further researches to bring new findings on that question. As a result, a disparity between races will motivate the identification of genetic support which will give new insights in prevention and therapy of adhesions.Pan African Medical Journal 2016; 2

Histopathology of peritoneal adhesions in a Congolese female population: Histopathologie des adhérences péritonéales dans une population féminine congolaise

Context and objective. The composition of peritoneal adhesions remains a concern for the practitioner. The environmental components, in conjunction with the epidemiology of certain conditions such as endometriosis, pelvic and the use of some treatments such as peritoneal dialysis and radiotherapy, may alter this composition. The study of adhesion histopathology in our environment could make it possible to determine the place of certain pathologies such as endometriosis, but also the involvement of some factors in their composition. The objective was to describe the histopathology of peritoneal adhesions and to identify associated factors in our practice. Methods. A cross-sectional study was conducted at the Department of Obstetrics and Gynecology of the Kinshasa University Hospital from 1st March to 30th June 2013 including women who underwent laparotomy or laparoscopy and who presented peritoneal adhesions. The statistics were performed using the SPSS 21 software. The comparison between means was analyzed using Student t-test and between proportions using the Pearson Chi-square and Fisher Exact tests. For non-parametric data, the Mann-Whitney U-test was used. Results. The mean age ± standard deviation of 45 patients was 34.5 ± 6.9 years. Inflammation was found in 84.4% of adhesions. The foreign body reaction was present in 8.9%. Patients without a prior laparotomy had statistically more inflammation in their adhesions (p = 0.003), and those with hypertrophic scars had fewer cells in their adhesions (0.023). Conclusion. The histology of adhesions is marked by inflammatory elements; more predominant in patients without prior laparotomy, suggesting an infectious origin of these adhesions. This composition also varies according to the presence or not of a hypertrophic scar. Contexte et objectif. La composition des adhérences péritonéalesest une préoccupation en pratique courante. L’histopathologie permet toutefois d’élucider ce mystère en orientant le diagnostic étiologique, notamment l’endométriose et d’autres déterminants. L’étude  a décrit le profil histopathologique des adhérences péritonéales et identifier les facteurs associés dans notre milieu. Méthodes. Etude transversale, menée aux CUK du 1er mars au 30 juin 2013, incluant les femmes ayant subi une laparotomie ou une laparoscopie et qui présentaient des adhérences péritonéales. La comparaison entre les moyennes a été faite à l’aide du  test t de Student, et celle entre les proportions par les tests Chi-carré de Pearson et Exact de Fisher. Pour les données non-paramétriques, le test U de Mann-Whitney a été utilisé. Résultats. Au total 45 patientes  (34,5 ± 6,9 ans) étaient examinées. L’âge moyen des adhérences était de 2,7 ans avec des extrêmes allant de 0,1 à 26,9 ans. L’inflammation était retrouvée dans 84,4 % d’adhérences. La réaction à corps étranger était présente dans 8,9 % d’adhérences. Les patientes sans antécédent de laparotomie avaient statistiquement plus d’inflammation dans leurs adhérences que les autres patientes (p=0,003), et celles qui présentaient une cicatrice hypertrophique avaient moins de cellules dans leurs adhérences que les autres (p=0,023). Conclusion. L’histologie des adhérences est dominée par les éléments inflammatoires ; plus prédominants chez les opérées sans antécédent de laparotomie, suggérant une origine infectieuse de ces adhérences. Cette composition varie aussi en fonction de l’existence ou non d’une cicatrice hypertrophique

Déterminants Du Vieillissement En Sante Chez Les Personnes De Troisième Age De La Ville De Buta

The main purpose of our study is to identify the determinants of healthy aging among elderly people in the city of Buta; to improve lifestyle habits/behaviours and promote their health. We opted for a cross-sectional analytical estimate, in order to allow us to identify the determinants of healthy aging among the elderly inhabitants of the city of Buta, from 03/17/2021 to 07/25/2021. A total of 471 senior citizens (55 years or older) were surveyed. The association between health-promoting factors and cumulative chronic health problems (3 or more problems, 0 problems) was verified using a logistic regression model adjusted for age, sex, and level of health. education of our respondents, because all study characteristics are strongly linked to the variables studied (p<0.05 each). Daily consumption of leaves/vegetables, beans, meat, rice + fruits; the practice of a physical activity; a good body weight index; a cumulative index of 4 health-promoting factors; are factors that protect the elderly person from a chronic health problem and this is significant (p<0.05 significant at the conventional threshold of 5%)

Caractérisation anatomoclinique et immunohistochimique des lymphadénopathies non tumorales à Kinshasa: Anatomoclinical and immunohistochemical caracterisation of non-malignant lymphadenitis in Kinshasa

Context and objective. Non-malignant lymphadenitis are the most prevalent hemopathies in sub-Saharan Africa. We determined the frequency and histological pattern of non-malignant lymphadenitis. Methods. A retrospective study was undertaken within 5 main pathology laboratories in Kinshasa during a 5-year period spanning from 2011 to 2015. Lymph node specimens were stained with hematoxylin eosin and specific antibodies for immunochemistry (IHC). Results. Lymph node specimens constituted about only 3% of all the biopsies done through Kinshasa. Among 413 (64%) non-malignant lymph node specimens analyzed, 52% were from female patients with a male-to-female sex ratio of 0.96. Patient age ranged from 1 to 81 years, with a median of 25 (16-40) years old. The commonest site of biopsy was cervical (67%) followed by inguinal (11%) and axillary (9%).&nbsp;Mycobacterium tuberculosis&nbsp;(54%) was the main cause of non-malignant lymph node enlargement, followed by reactive lymphadenitis (38%) and nodular lymphadenitis with abscess (4%). Some rare cases such as Castelman disease (1.4%) and Rosai-Dorfman (0.2%) diseases were encountered. Of the 20 reactive lymphadenitis specimens analyzed by IHC, 10 were positive for Epstein Barr virus (EBV), 6 for cytomégalovirus (CMV) and 4 for Herpes virus. Conclusion. In Kinshasa, Mycobacterium tuberculosis and reactive type were the main cause of non-malignant lymphadenitis. The reactive viral lymphadenitis was caused by EBV. Immunohistochemistry staining should be performed for any case of reactive lymphadenitis in order to provide the accurate etiology and consequently an appropriate treatment. Contexte et objectif. Les lymphadénopathies non tumorales sont l’une des hémopathies fréquentes en Afrique subsaharienne. La présente étude a pour objectif de décrire le profil histo-pathologique et immunohistochimique des lymphadénopathies non tumorales. Méthodes. Etude rétrospective et descriptive réalisée dans cinq laboratoires d’Anatomie Pathologique de la ville de Kinshasa durant 5 ans. Les paramètres d’intérêt étaient : la fréquence, l’âge, le sexe, le siège du prélèvement, les aspects histopathologiques et immunohistochimiques. Résultats. 413 cas de lymphadénopathies non tumorales ont été recensés soit 3% de toutes les affections de la période d’étude. L’âge médian était de 25 ans et le sexe-ratio Homme / Femme était de 0,96. Les principaux types histologiques étaient les lymphadénites tuberculeuses (54%), les lymphadénites réactionnelles (38%), les lymphadénites nodulaires abcédées (4%), les lymphadénopathies dermatopathiques (3%), la maladie de Castelman (1%) et la maladie de Rosaï Dorfman (0,2%). Le ganglion cervical était le site le plus fréquent (67%). Sur les 20 cas des lymphadénites réactionnelles d’étiologies virales, les lymphadénites à EBV ont représenté 10 cas (50%), les lymphadénites à Herpès virus et CMV ont représenté respectivement 6 cas (30%) et 4 cas (20%). Conclusion. Les lymphadénopathies non tumorales sont fréquentes dans notre milieu. Hormis la tuberculose ganglionnaire qui est la pathologie la plus fréquente, ils existent d’autres types nécessitant l’apport de certaines techniques ancillaires pour rechercher les étiologies précises

Néoplasies intraépithéliales du col utérin chez la congolaise à Kinshasa : intérêt des biomarqueurs immunohistochimiques: Intraepithelial neoplasias of the uterine cervix in the Congolese in Kinshasa : interest of immunohistochemical biomarkers

Context and objective. Although cervical cancer remains the second most frequent in women in Africa, immunohistochemical biomarkers for its diagnosis is rarely used in sub-Saharan Africa. The aim of this study was to demonstrate the contribution of biomarkers p16 and Ki-67 in the diagnosis of cervical intraepithelial neoplasia.&nbsp;Methods.&nbsp;This was a retrospective study carried out in five Pathology laboratories in Kinshasa. Biopsy slides were reread and reclassified by at least two independent pathologists in Kinshasa University Hospital based on the nomenclature of Bethesda/WHO. Immunolabelling (p16 and Ki-67) was carried out with external quality control in Europe.&nbsp;Results. A total of 70 cases were included. All 24 cases of high grade intraepithelial neoplasia (CIN2, CIN3 and CIS) were positively marked by p16 and Ki-67 whereas low grade lesions were positively marked for 41 cases of CIN1 and negatively marked for 5 cases (3 of CIN1 and 2 of CP). Certain lesions have been reclassified. Immunohistochemical labeling was significantly associated with the grade of intraepithelial neoplasia for p16 (p = 0.001) and for Ki-67 (p = 0.004).&nbsp;Conclusion.&nbsp; p16 and Ki-67 are specific and reliable biomarkers for an optimal diagnosis of intraepithelial neoplasia of the cervix. Contexte&nbsp;et objectif.&nbsp;&nbsp;Bien que le cancer du col utérin soit le deuxième cancer plus fréquent chez la femme en Afrique, le recours aux biomarqueurs immunohistochimiques reste exceptionnel en Afrique subsaharienne. La présente étude avait pour objectif de montrer l’apport des biomarqueurs p16 et Ki-67 dans le diagnostic des néoplasies intra-épithéliales du col utérin.&nbsp;Méthodes.&nbsp;C’était une étude rétrospective réalisée dans cinq laboratoires d’Anatomie Pathologique de Kinshasa. Des lames biopsiques ont été relues et reclassées par au moins deux pathologistes indépendants aux Cliniques Universitaires de Kinshasa en suivant la nomenclature de Bethesda/OMS. L’immunomarquage (p16 et Ki-67) a été réalisé avec un contrôle qualité externe en Europe.&nbsp;Résultats.&nbsp;70 cas ont été inclus. Les 24 cas des néoplasies intra-épithéliales de haut grade (CIN2, CIN3 et CIS) étaient marquées positivement par p16 et Ki-67 alors que celles de bas grade étaient marquées positivement pour 41 cas de CIN1 et négativement pour 5 cas (3 de CIN1 et 2 de CP). Certaines lésions ont été requalifiées. L’immunomarquage était significativement associé au grade des néoplasies pour la p16 (p=0,001) et pour le Ki-67 (p=0,004).&nbsp;Conclusion.&nbsp;P16 et Ki-67 sont des biomarqueurs spécifiques et efficaces pour un diagnostic optimal des néoplasies intra-épithéliales du col utérin. &nbsp

Knowledge regarding breast cancer among Congolese women in Kinshasa, Democratic Republic of the Congo

Abstract Introduction Breast cancer is the most frequent type of cancer in women and is characterized by late clinical signs in developing countries, including the Democratic Republic of the Congo. One of the main reasons of death from breast cancer is lack of awareness and screening, which has led to late diagnosis (at an advanced stage). This study aims to measure women's knowledge regarding breast cancer in Kinshasa, in the Democratic Republic of the Congo. Materials and Methods A cross‐sectional study of 489 women aged 20–65 years was conducted. Data was collected using a predesigned, tested, self‐administered questionnaire. The questionnaire included specific sections to test the participants' knowledge related to breast cancer and its screening, and practices related to breast self‐examination (BSE). Bivariate and multivariate analyzes were used. Results Our results indicated that 22.09% of the participants had good breast cancer knowledge and 77.91% had poor breast cancer knowledge. Overall, 322 (65.85%) participants recognized that BSE is a valuable method for early screening of BSE. In total, 136 (27.81%) respondents had learned to do the BSE and 216 (44.17%) had reported doing it. Two hundred and ninety‐two (59.71%) respondents mentioned that any woman was at risk for breast cancer and 357 (71.78%) mentioned that it was possible to prevent breast cancer. Determinants of an adequate level of knowledge were higher/university educational level (adjusted odds ratio = 2.70; 95% confidence interval: 1.27–5.73; p = .010) and having previously been screened for breast cancer (adjusted odds ratio = 2.31; 95% confidence interval: 1.40–3.83; p = .001). Conclusion The majority (77.91%) of women have demonstrated poor knowledge of signs/symptoms, risk factors, and screening methods of breast cancer. Additional efforts should be made through women's healthcare workers to raise knowledge of breast cancer screening

A rare occurrence of neonatal nephroblastoma in sub-Saharan Africa: a case report and management in a resource-constrained region

Neonatal nephroblastoma has been rarely reported in African neonate. A premature newborn (a 5-day-old male) was transferred with a history of neonatal abdominal mass. Ultrasonography revealed 75×46 mm, well-defined mass with mixed echogenicity replacing the right kidney. The patient underwent right radical nephrectomy and the tumor was confirmed to be a blastemal predominant Wilms’ tumor by the histopathological examination and has an unfavorable prognosis. The child died secondary to multiple organ failure, three days after surgery. Our case report serves to remind us the need to bear in mind the possibility of the diagnosis of neonatal nephroblastoma in neonate with renal mass

Caractéristiques épidémiologiques et histopathologiques de 1280 cancers du col utérin à Kinshasa

OBJECTIF : Vu le manque de registre du cancer et de programme de dépistage à grande échelle du cancer du col utérin dans la plupart des pays africains, des modèles mathématiques sont à la base des données disponibles. Cette étude vise à cerner concrètement les particularités épidémiologiques et histopathologiques du cancer du col utérin. MÉTHODES : Parmi les cancers (n = 5801) diagnostiqués dans cinq laboratoires d’anatomie pathologique de Kinshasa durant 10 ans, les lames histologiques des cancers du col ont fait l’objet d’une relecture et d’une classification selon l’OMS 2014. RÉSULTATS : Les cancers du col utérin (n = 1280) ont représenté 22 % de l’ensemble des cancers et 40,4 % des cancers mammaires et gynécologiques. La tranche d’âge la plus touchée était celle de 49 à 58 ans. Le carcinome malpighien correspond à 73,2 %, l’adénocarcinome à 18,4 % et le carcinome adénosquameux à 8,4 % des cancers cervicaux. Les sous-types se distribuaient comme suit : le carcinome kératinisant 47,2 %, le non kératinisant 20,8 %, l’adénocarcinome usuel 9,6 % et le villoglandulaire 5,3 %. Dans le sous-type des carcinomes mucineux, seul le variant à cellules en bague à chaton (1,3 %) était représenté. Parmi les cancers du col utérin, 69 % étaient de grade histologique I, 20 % de grade II et 11 % de grade III. CONCLUSION : Cette étude des particularités épidémiologiques et histopathologiques du cancer du col utérin à Kinshasa fournit une base de données concrètes pour initier un registre du cancer et des campagnes de dépistage et de vaccination contre le HPV.[Epidemiologic and histopathologic characteristics of 1280 uterine cervical cancers in Kinshasa]. OBJECTIVE: Due to the lack of both cancer registry and large scale cervical screening in most african countries, only theoretical studies are available. The objective of our work was to provide epidemiological and histopathological characteristics of cervical cancer based on concrete observations. METHODS: This study was carried out on all cancers (n=5801) collected in the last 10 years from 5 pathology laboratories of Kinshasa; the histologic slides of the cervical cancers (n=1280) were reviewed by at least two pathologists and classified according to the 2014 OMS classification. RESULTS: The cervical cancers accounted for 22% of all cancers and 40,4% of breast and gynecological cancers. The cervical cancer was the most common among women aged 49-58. Squamous cell carcinomas were the most observed type (73,2%) followed by adenocarcinomas (18,4%) and adenosquamous carcinomas (8,4%). Keratinized (47,2%) and non keratinized squamous carcinoma (20,8%) were the most frequent subtypes among squamous carcinomas and the usual adenocarcinoma among adenocarcinomas (9,6%). In the mucinous adenocarcinoma subtype, only the signet ring cells (1,3%) variant was found. Among cervical cancers, 69% were grade I, 20% grade II and 11% grade III. CONCLUSION: Our study provides a concrete database of epidemiological and histopathological cervical cancer particularities in Kinshasa, useful to initiate a cancer register, as well as cervical screening and HPV vaccine campaigns