Relation entre composition corporelle et valeurs spirométriques dans la population adulte de Kinshasa de 20 à 70 ans: Body composition and spirometric values in an adult population of Kinshasa, aged 20-70 years

Context. Impact of individual anthropometric measures on spirometric values has been previously established. The relevance of body mass indices (BMI) is increasingly being considered, especially in the establishment of reference spirometric equations. Objective. To assess the influence of body composition on spirometric values in healthy adults. Methods. In a cross-sectional survey, spirometric and body composition data of participants were analyzed. Spirometry was performed using a SPIROBANK A23-OU and body indices measured with an OMRON brand impedance meter, type BF 511. Multivariate linear regression helped to determine association between studied parameters, stratified by sex and age groups. Results. A total of 7443 subjects (males, 56.9 %), median age of 37 years for men and 39 years for women were included. A negative correlation regardless of gender, was observed between spirometric values (FEV1, FVC, PEF° and body mass indices including: fat mass (Men vs Women: r= 0.009, P < 0.001 vs r= 0.003, P=0.148), visceral fat, waist size and BMI. Differences were significantely linked to the proportion of fat mass and/or a BMI ≥ 30 Kg/m². Lean mass, on the other hand, appeared to positively influence respiratory function in both genders (r= 0.003; P=0.218 vs r=0.018, P< 0.0001). Conclusion. The study emphasizes the relevance of integrating anthropometric and body composition data in the determination of spirometric reference values. Larger community based surveys are needed to validate the reference equations for futher use. Contexte. Les données anthropométriques influencent les valeurs spirométriques d’un individu. La contribution des indices de masse corporelle est de plus en plus considérée, surtout dans l’établissement des équations de référence pour une population donnée. Objectif. Evaluer l’impact de la composition corporelle sur les valeurs spirométriques dans une population des sujets sains. Méthodes. L’enquête transversale a analysé les données spirométriques et les indices de la composition corporelle (IMC) de participants. Les valeurs spirométriques ont été mesurées à l’aide d’un spiromètre de marque SPIROBANK A23-0U, et les indices de masse corporelle, à l’aide d’un impédancimètre de marque OMRON, type BF 511. Les associations ont été recherchées entre paramètres étudiés stratifiés par sexe et en groupes d’âge, à l’aide d’une analyse multivariée par régression linéaire. Résultats. Au total, 7443 sujets (sexe masculin, 56,9%), d’âge médian de 37 ans chez les hommes et 39 ans chez les femmes ont été inclus. Une corrélation négative, indépendamment du sexe, a été observée entre les valeurs spirométriques (VEMS, CVF, DEP) et les indices de masse corporelle dont : la masse grasse (Hommes vs Femmes : r =0,009, P<0,0001 vs r=0,003, P=0,148), la graisse viscérale, le tour de taille et l’IMC. Cette dernière était plus marquée chez les sujets avec proportion plus importante de masse grasse et/ou un IMC ≥ 30 Kg par m². La masse maigre quant à elle, semblait positivement influencer la fonction respiratoire et ce, indépendamment du sexe (r= 0,003 ; P= 0,218 vs r=0,018, P < 0,0001). Conclusion : Cette étude renforce la pertinence d’intégrer les données anthropométriques et de la composition corporelle dans la détermination des valeurs spirométriques de référence. Des enquêtes multicentriques s’imposent, en vue de la validation des équations de référence. &nbsp

Inequalities in child mortality in ten major African cities

Background: The existence of socio-economic inequalities in child mortality is well documented. African cities grow faster than cities in most other regions of the world; and inequalities in African cities are thought to be particularly large. Revealing health-related inequalities is essential in order for governments to be able to act against them. This study aimed to systematically compare inequalities in child mortality across 10 major African cities (Cairo, Lagos, Kinshasa, Luanda, Abidjan, Dar es Salaam, Nairobi, Dakar, Addis Ababa, Accra), and to investigate trends in such inequalities over time. Methods: Data from two rounds of demographic and health surveys (DHS) were used for this study (if available): one from around the year 2000 and one from between 2007 and 2011. Child mortality rates within cities were calculated by population wealth quintiles. Inequality in child mortality was assessed by computing two measures of relative inequality (the rate ratio and the concentration index) and two measures of absolute inequality (the difference and the Erreyger's index). Results: Mean child mortality rates ranged from about 39 deaths per 1,000 live births in Cairo (2008) to about 107 deaths per 1,000 live births in Dar es Salaam (2010). Significant inequalities were found in Kinshasa, Luanda, Abidjan, and Addis Ababa in the most recent survey. The difference between the poorest quintile and the richest quintile was as much as 108 deaths per 1,000 live births (95% confidence interval 55 to 166) in Abidjan in 2011-2012. When comparing inequalities across cities or over time, confidence intervals of all measures almost always overlap. Nevertheless, inequalities appear to have increased in Abidjan, while they appear to have decreased in Cairo, Lagos, Dar es Salaam, Nairobi and Dakar. Conclusions: Considerable inequalities exist in almost all cities but the level of inequalities and their development over time appear to differ across cities. This implies that inequalities are amenable to policy interventions and that it is worth investigating why inequalities are higher in one city than in another. However, larger samples are needed in order to improve the certainty of our results. Currently available data samples from DHS are too small to reliably quantify the level of inequalities within cities

Human Immunodeficiency Virus Nephropathy in Central Africa: The Value of Renal Ultrasound

Introduction: HIV-Associated Nephropathy may shorten the life expectancy of affected patients. Its early detection is beneficial for the indication of treatment and hence prevention of progression to the end-stage of renal failure. The final diagnosis requires renal biopsy which may be difficult in some African area; clinical and ultrasound criteria may be helpful. The aim of this study was twofold: to characterize renal sonographic changes in HIV-positive patients with HIV associated Nephropathy and to investigate the correlation between renal sonographic changes and histological lesions in central Africa.Methods: A prospective and multi-center study conducted from January 2013 to July 2015 included, for renal ultrasound evaluation of the length, thickness and echogenicity, forty two of the 334 biologically confirmed HIV-positive patients who presented with significant proteinuria suggestive of HIV associated Nephropathy. And transcutaneous renal biopsy with histopathology has been performed in 16 patients of them. Statistical analyzes were used.Results: There were 100 men and 234 women; proteinuria was positive in 42 patients, (12.6%). The average length of the kidneys was 111 ± 8 mm (normal), with 10% of patients with pathological values (5% with kidneys of reduced size and 5%, increased size). The kidneys had an average thickness of 44 ± 5 mm (normal), with 21% of patients presenting an increase in renal thickness. Quantitative echogenicity was calculated at 1.492 ± 0.793 (normal), with 79% of patients with increased quantitative echogenicity. Of the 16 patients biopsied, all had tubulo-interstitial lesions, and 75% of them associated with glomerular lesions. In simple correlation analysis, tubular dilatation was positively and significantly related to quantitative echogenicity (r = 0.67, p < 0.01) and to renal parenchyma thickness (r = 0.67; 0.85, p ? 0.05). The relationship between the other parameters studied did not reach statistical significance. In multiple linear regression, glomerular hyalinosis, glomerular proliferation, tubular dilatation, tubular atrophy, interstitial fibrosis, and interstitial inflammation emerged as the main determinants of quantitative echogenicity; however, the relationship was statistically significant only for tubular dilatation (? = 0.305, p = 0.034).Conclusion: The present study showed the characteristic of renal change and the relation with histology found in central Africans patients

Food insecurity is associated with increased risk of non-adherence to antiretroviral therapy among HIV-infected adults in the Democratic Republic of Congo: a cross-sectional study.

BACKGROUND: Food insecurity is increasingly reported as an important barrier of patient adherence to antiretroviral therapy (ART) in both resource-poor and rich settings. However, unlike in resource rich-settings, very few quantitative studies to date have investigated the association of food insecurity with patient adherence to ART in Sub-Saharan Africa. The current study examines the association between food insecurity and adherence to ART among HIV-infected adults in the Democratic Republic of Congo (DRC). METHODS AND FINDINGS: This is a cross-sectional quantitative study of patients receiving ART at three private and one public health facilities in Kinshasa, DRC. Participants were consecutively recruited into the study between April and November 2012. Adherence was measured using a combined method coupling pharmacy refill and self-reported adherence. Food insecurity was the primary predictor, and was assessed using the Household Food Insecurity Access Scale (HFIAS). Of the 898 participants recruited into the study, 512 (57%) were food insecure, and 188 (20.9%) were not adherent to ART. Food insecurity was significantly associated with non-adherence to ART (AOR, 2.06; CI, 1.38-3.09). We also found that perceived harmfulness of ART and psychological distress were associated respectively with increased (AOR, 1.95; CI, 1.15-3.32) and decreased (AOR, 0.31; CI, 0.11-0.83) odds of non-adherence to ART. CONCLUSION: Food insecurity is prevalent and a significant risk factor for non-adherence to ART among HIV-infected individuals in the DRC. Our findings highlight the urgent need for strategies to improve food access among HIV-infected on ART in order to ensure patient adherence to ART and ultimately the long-term success of HIV treatment in Sub-Saharan Africa

Analyse qualitative de l'intégration de l'éducation sexuelle des jeunes dans les médias audio-visuels à Kinshasa en République Démocratique du Congo.

L'éducation sexuelle par les médias de masse contribue positivement à la prévention des infections sexuellement transmissibles (IST)/VIH et des grossesses précoces auprès des jeunes. L'objectifs de cette étude sont d'appréhender le niveau d'intégration de l'éducation sexuelle dans les émissions de santé à Kinshasa en République Démocratique du Congo et d'identifier les facteurs facilitant et limitant l'éducation sexuelle des jeunes dans les programmes audio-visuels congolais. Une triangulation des données provenant de la revue documentaire, de l'observation directe de quatre émissions de santé et des entretiens semi-directifs auprès des 15 responsables de programme audiovisuels, a été exploitée. Une étude de cas d'une expérience réussie dans le domaine a été complétée. Bien qu'il soit observé une programmation de quelques émissions de santé dans les grands médias audiovisuels de Kinshasa, leur potentiel pour l'éducation sexuelle n'est que très faiblement exploité. Dans les quatre médias observés, les émissions de santé sont diffusées à des heures de faible audience, et effleurent superficiellement l'éducation sexuelle dans un contexte de prévention des IST/VIH. La participation d'experts n'est pas systématique ;le cas échéant, leur expression n'est pas souvent adaptée à la compréhension du grand public. De plus en plus, ces programmes offrent les possibilités d'interactivité avec la communauté via le téléphone mobile. Parmi les obstacles à l'éducation sexuelle dans les média audiovisuels, il a été identifié le manque de clarté de la loi relative à la liberté de la presse, associée à la peur de la répression ;les freins liés aux considérations socioculturelles, la faible disponibilité de l'expertise, les préjugés sur la non préférence de ces types d'émissions par le public et le manque de retombées financières de ces programmes. Au regard des bénéfices de l'éducation sexuelle sur la vie et le bien-être des jeunes, une meilleure interprétation de la loi, une fédération des acteurs techniques du gouvernement, des partenaires et des médias autour d'un plan conjoint et le focus sur l'éducation aux médias dans le cursus de formation scolaire et universitaire, s'avèrent nécessaires et appropriés pour la protection des générations à venir.JOURNAL ARTICLESCOPUS: ar.jinfo:eu-repo/semantics/publishe

Cognitive and behavioral effects of participatory sex education on the dual prevention of STI/HIV/AIDS and unwanted pregnancies among adolescents in Kinshasa high schools, DRCongo

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Utilisation du téléphone portable et de la radio pour identifier les préoccupations sexuelles des jeunes en République Démocratique du Congo

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An innovative approach to using both cellphones and the radio to identify young people's sexual concerns in Kinshasa, Democratic Republic of Congo

Background: As teenagers have easy access to both radio programs and cell phones, the current study used these tools so that young people could anonymously identify questions about sex and other related concerns in the urban environment of the Democratic Republic of Congo. The purpose of this healthcare intervention was to identify and address concerns raised by young people, which are related to sexual health, and which promote youth health. Methods: This healthcare intervention was conducted over a six month period and consisted of a survey carried out in Kinshasa. This focused on 14 to 24 old young people using phone calls on a radio program raising concerns related to sexuality. The radio program was jointly run by a journalist and a health professional who were required to reply immediately to questions from young people. All sexual health concerns were recorded and analyzed. Results: Forty programs were broadcast in six months and 1,250 messages and calls were recorded: 880 (70%) from girls and 370 (30%) from boys, which represents an average of 32 interventions (of which 10 calls and 22 messages) per broadcast. Most questions came from 15-19- and 20-24-year-old girls and boys. Focus of girls' questions: menstrual cycle calculation and related concerns accounted for the majority (24%); sexual practices (16%), love relationships (15%) and virginity (14%). Boys' concerns are masturbation (and its consequences) (22%), sexual practices (19%), love relationships (18%) and worries about penis size (10%). Infections (genital and STI) and topics regarding HIV represent 9% and 4% of the questions asked by girls against 7% and 10% by boys. Concerns were mainly related to knowledge, attitudes and competences to be developed. Conclusions: Concerns and sexual practices raised by teens about their sexual and emotional life have inspired the design of a practical guide for youth self-training and have steered the second phase of this interactive program towards supporting their responsible sexuality.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Déterminants associés à la pratique de la double prévention des IST/VIH/SIDA et des grossesses précoces chez les adolescents en milieu scolaire à Kinshasa, RD Congo

info:eu-repo/semantics/publishe