Bilateral paediatric cataract surgery - outcomes of 298 children from Kinshasa, the Democratic Republic of the Congo

Introduction: The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and to diminish the burden of childhood blindness. Objective: To report in a retrospective observational cohort study the long-term outcomes of 298 children who had bilateral cataract surgery with IOL implantation from 2001-2016 in Kinshasa. Methods: A standardized surgical treatment of paediatric cataract was practiced on 298 children. Patient\u2019s follow-up, complications, and visual outcomes were recorded and analysed. Results: The mean age was 5.7 \ub1 4.3 years and males were predominant (64.9%). Most of children were living mainly in urban poorest areas (96.3%). Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7% of children, respectively. Using WHO criteria most of patients were classified as blind preoperatively and 81.9% of them had improved visual outcomes after surgery. Main reasons for reduced vision during follow-up were secondary cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and secondary glaucoma (1.5%). Conclusion: In spite of the post conflict challenges, elimination of cataract blindness in children remains a priority. Children present at a late age for surgery and long term follow-up is poor. There is need for program strengthening in these areas

Ophthalmic Ultrasonography in Sub-Saharan Africa—A Kinshasa Experience

The aim of this study was to analyze the use of the diagnostic B-scan ultrasound. Should it be made accessible to all surgical centers in Sub-Saharan Africa in order to (i) avoid unnecessary cataract surgery and (ii) evaluate extraocular pathology? This study was conducted in Kinshasa from 2006 to 2019. Three hundred and twenty-three patients were included and separated into two groups. Group 1 included 262 patients with dense cataract. Group 2 consisted of 61 patients with pathologies of the ocular adnexa, and all were examined with a B-scan ultrasound. In group 1, there were 437 systematically screened eyes. Three hundred and ninety-eight eyes (91.08%) showed no abnormalities, 13 (2.97%) retinal detachments were identified, and 15 (3.43%) demonstrated a detached posterior hyaloid membrane. In the second group, 61 patients were examined (group 2). In 20 of them, surgery was performed for biopsy, tumor excision, mucoceles drainage, and palliative treatment. The need for routine B-scan examinations in dense cataract patients seems to be limited and can most likely be replaced by a thorough application of locally available examination techniques. B-scan application is recommended to manage orbital patients in the most cost-effective way

Consommation de légumes et risques sanitaires à Kinshasa : une évaluation appliquée aux amarantes

Market gardening is very important for the food security and the socio-economic life of the population of the city of Kinshasa. They provide more than 70% of the fresh vegetables consumed in the city. However, the production practices of these vegetables can lead to their contamination by micropollutants such as toxic metals with potential health risks for consumers to be assessed. This research examines the accumulation of toxic metals in amaranth (Amaranthus viridis) leaves sold in four markets in the city of Kinshasa in order to assess the potential risks to consumers. The results show that concentrations of toxic metals in amaranth leaves during the dry and rainy seasons are very high. The contamination of vegetables can be explained by several factors, including chemicals used to prevent amaranth diseases, emissions from vehicles and motorcycles in fields located near major roads, and watering. Given the concentrations of toxic metals in pigweed leaves compared to the FAO/WHO limits, and the results of our risk calculations, excessive consumption of this vegetable may pose potential health risks to consumers.Les cultures maraichères jouent un rôle très important pour la sécurité alimentaire et la vie socio-économique de la population de la ville de Kinshasa. Elles permettent l’approvisionnement de plus de 70% de légumes frais consommés dans la ville. Toutefois, les pratiques de production de ces légumes peuvent entrainer leur contamination par les micropolluants tels que les métaux toxiques avec des risques potentiels pour la santé des consommateurs à évaluer. Cette recherche examine l’accumulation des métaux toxiques dans les feuilles d’amarante (Amaranthus viridis) vendues dans 4 marchés de la ville de Kinshasa afin d’évaluer les risques potentiels pour les consommateurs. Les résultats montrent que les concentrations des métaux toxiques dans les feuilles d’amarante pendant les saisons sèche et de pluie sont très élevées. La contamination des légumes peut s’expliquer par plusieurs facteurs, notamment, les produits chimiques utilisés pour prévenir les maladies d’amarante, les émissions à partir des véhicules et des motos pour les champs situés aux alentours des grands axes routiers, ainsi que les eaux d’arrosage. Vu les valeurs des concentrations des métaux toxiques dans les feuilles d’amarantes comparativement aux valeurs limites fixés par FAO/WHO, et nos résultats de calculs des risques, la consommation excessive de ce légume peut avoir des risques potentiels pour la santé des consommateurs

Contamination Levels of Toxic Metals in Marketed Vegetable (Amaranthus Viridis) at Kinshasa, Democratic Republic of the Congo

The contamination of food chain by toxic metals constitutes a major concern worldwide because of human health potential risks. Amaranthus viridis (A. viridis) is one of the most consumed vegetables in South Asian and Sub-Saharan African countries. However, the accumulation of pollutants, such as toxic metals in this plant is still little investigated. Consequently, this research investigates the level of toxic metals in A. viridis collected from four major markets of Kinshasa, Capital City of the Democratic Republic of the Congo, according to the seasonal variation in order to determine potential health risk for the consumers. The results revealed high metal concentrations in edible leaf vegetables during both dry and wet seasons. Metal concentration reaching the values (in mg kg-1) of 3.6 (Cr), 1.5 (Co), 29.7 (Cu), 348.2 (Zn), 1.7 (As), 1.5 (Cd), 18.3 (Pb) and 0.2 (Hg). Except for Cu, the analyzed metal concentrations in leafy vegetables exceeded the permissible levels set by Food and Agriculture Organization/World Health Organization (FAO/WHO) for human consumption. Given the level of toxic metals in A. viridis leaf according to the regulation of FAO/WHO, human health consequences are likely to occur on continuous vegetable consumption. Our results recommend implementation of measures and efforts to improve the quality of this most consumed vegetable in order to minimize potential health risk for the consumers

Hospital wastewaters: A reservoir and source of clinically relevant bacteria and antibiotic resistant genes dissemination in urban river under tropical conditions

The occurrence and dissemination of antibiotic resistant genes (ARGs) that are associated with clinical pathogens and the evaluation of associated risks are still little investigated in developing countries under tropical conditions. In this context, cultivable and molecular approaches were performed to assess the dissemination of bacteria and their antibiotic resistance genes in aquatic environment in Kinshasa, Democratic Republic of the Congo. Cultivable approach quantified β-lactam, carbapenem resistant, and total Escherichia coli (E. coli) and Enterbacteriaceae (Ent) in river sediments and surface waters that receive raw hospital effluents. The molecular approach utilized Quantitative Polymerase Chain Reaction (qPCR) to quantify the total bacteria and the richness of relevant bacteria (Escherichia coli (E. coli), Enterococcus, and Pseudomonas (P. spp)), and antibiotic resistance genes (ARGs: blaOXA-48, blaCTX-M, blaIMP, blaTEM) in sediment samples. Statistical analysis (ANOVA method, principle component analysis, and correlation matrix) were used to explore the significance of hospital contribution and seasonal variation of bacteria and ARGs into explored aquatic ecosystems in suburban municipalities of Kinshasa, Democratic Republic of the Congo. The contribution of hospitals to antibiotic resistance proliferation is higher in the dry season than during the wet season (P value<0.05). Hospital similarly contributed significantly fecal bacteria and Pseudomonas (P. spp) and ARGs to the sediments in both seasons (P value<0.05). The organic matter content correlated positively with E. coli (r=0.50, P value<0.05). The total bacterial load correlated with Enterococcus, and Pseudomonas (0.49<r<0.69, P value<0.05). Each ARG correlated with the total bacterial load or at least one relevant bacteria (0.41<r<0.81, P value<0.05). Our findings confirms that hospital wastewaters contributed significantly to antibiotic resistance profile and the significance of this contribution increased in dry season. Moreover, our analysis highlights this risk from untreated hospital wastewaters in developing countries, which presents a great threat to public health

Toxic metal concentration and ecotoxicity test of sediments from dense populated areas of Congo River, Kinshasa, Democratic Republic of the Congo

The objective of the present research was to evaluate the contamination level and potential risks at a part of a large and important river in Central Africa, the Congo River. Surface sediments were collected from seven stations located in Maluku-Kinsuka section, at the vicinity of Kinshasa, capital city of Democratic Republic of the Congo. The concentration of toxic metals (Cr, Co, Ni, Cu, Zn, As, Cd and Pb) in sediment samples were determined using Inductive Coupled Plasma-Mass Spectroscopy (ICP-MS). The Hg analysis was carried out using Advanced Mercury Analyzer (AMA). The evaluation of the pollution degree was based on Sediment Quality Guidelines (SQGs), Enrichment Factor (EF), Geoaccumulation Index (Igeo), and using toxicity test based on exposing Ostracods to the sediment samples. The result revealed high metal concentrations in sediments from the 4 densely populated areas (Kinkole, Kauka fishermen, Demoulin, Chanic), reaching the values (mg kg-1) of of 95.5, 14.3, 37.1, 139.9, 281.5, 4.8, 6.6, 200.9 and 4.9 mg kg-1 for Cr, Co, Ni, Cu, Zn, As, Cd, Pb and Hg, respectively. These values are above SQGs and probable effect levels. In these sites, Igeo and EF values showed heavily to extremely polluted and severe enrichment to extremely severe enrichment for analysed metals. Additionally, Ostracods exposed to sediments resulted in 100% mortality rates after 6 days of incubation, demonstrating the sediment toxicity as well as potential risks for aquatic living organisms. The pollution in these sites may be explained by local intense human activities with various commercial, presence of uncontrolled landfills in riverbank and industrial settlements, as well as by the construction of boats for the regular navigation along the river. This research presents useful tools for evaluating sediments quality and risk, which can be applied to similar environments

Occurrence of organic micropollutants and human health risk assessment based on consumption of Amaranthus viridis, Kinshasa in the Democratic Republic of the Congo

The contamination of water resource and food chain by persistent organic pollutants (POPs) constitutes a major environmental and human health concern worldwide. The aim of this study was to investigate the levels of POPs in irrigation water, soil and in Amaranthus viridis (A. viridis) from different gardening sites in Kinshasa to evaluate the potential environmental and human health risks. A survey study for the use of pesticides and fertilizers was carried out with 740 market gardeners. The levels of POPs (including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs)), and polycyclic aromatic hydrocarbons (PAHs)) were analyzed in irrigation water and 144 vegetable samples collected from different gardening sites. The assessment of potential human health risk was estimated by calculating daily intake and toxic equivalency to quantify the carcinogenicity. The results show highest PAH levels in A. viridis from all studied sites. The concentrations of the sum of seven PCBs (7PCBS) congeners in analyzed plants ranged between 15.89 and 401.36 ng g-1. The distributions of OCPs in both water and A. viridis were congener specific, chlorpyrifos-ethyl and p,p'-DDE were predominantly detected. Among PBDEs, only BDE47 was quantified with noticeable concentration in A. viridis, while no PBDEs were detected in irrigation water. Higher estimated daily intake values indicate that consuming leafy vegetables might associate with increased human health risks. However, calculated incremental lifetime cancer risk values indicates no potential carcinogenic risk for the local population. The results of this study provide important information on A. viridis contamination by POPs and strongly recommend implementing the appropriate measures to control the use of chemicals used in studied gardening areas. Thus in Kinshasa, urban agriculture control programs for POPs and fertilizers is very important in order to protect the public health through direct and dietary exposure pathways

Heavy metal concentration in irrigation water, soil and dietary risk assessment of Amaranthus viridis grown in peri-urban areas in Kinshasa, Democratic Republic of the Congo

The urban agriculture in developing countries plays a huge important socioeconomic role in confronting the challenge of eradicating hunger, improving food security and the social daily life of the population. However, the quality evaluation of water used for urban agriculture irrigation as well as the accumulation of pollutants such as heavy metals in fresh produces are still largely unstudied. The purpose of this study was to investigate the concentration of metals (Cr, Co, Ni, Cu, Zn, As, Cd, Pb and Hg) in irrigation water from rivers, soil and Amaranthus viridis (A. viridis), in order to evaluate the potential human dietary risks. The research was conducted in eight sites characterized by intensive agriculture performed in watersheds in Kinshasa, capital of Democratic Republic of the Congo. The results showed high metal concentrations in A. viridis leaf varying considerably among sampling sites (P<0.05), reaching the values (in mg kg-1 wet weight) of 2.97 (Cr), 1.73 (Co), 12.30 (Ni), 16.11 (Cu), 652.91 (Zn), 0.10 (As), 1.62 (Cd), 8.91 (Pb), and 0.1 (Hg). These values exceeded safe limits set by Food and Agriculture Organization/World Health Organization for human consumption (WHO/FAO) for human consumption. The assessment of human health risks using the targeted risk quotient and estimated dietary intake showed potential health hazards to consumers due to the levels of Cd and Pb in leafy vegetables from several studied sites. The vegetable contamination can be explained by chemicals used to combat and prevent A. viridis diseases, and the vehicle and motorcycle emissions around. Thus, given the concentrations of metals in A. viridus leaf, human health implications are likely to occur on heavy continuous consumption