Obesity and diabetes mellitus association in rural community of Katana, South Kivu, in Eastern Democratic Republic of Congo : Bukavu Observ Cohort study results

Background: Factual data exploring the relationship between obesity and diabetes mellitus prevalence from rural areas of sub-Saharan Africa remain scattered and are unreliable. To address this scarceness, this work reports population study data describing the relationship between the obesity and the diabetes mellitus in the general population of the rural area of Katana (South Kivu in the Democratic Republic of the Congo). Methods: A cohort of three thousand, nine hundred, and sixty-two (3962) adults (>15 years old) were followed between 2012 and 2015 (or 4105 person-years during the observation period), and data were collected using the locally adjusted World Health Organization's (WHO) STEPwise approach to Surveillance (STEPS) methodology. The hazard ratio for progression of obesity was calculated. The association between diabetes mellitus and obesity was analyzed with logistic regression. Results: The diabetes mellitus prevalence was 2.8 % versus 3.5 % for obese participants and 7.2 % for those with metabolic syndrome, respectively. Within the diabetes group, 26.9 % had above-normal waist circumference and only 9.8 % were obese. During the median follow-up period of 2 years, the incidence of obesity was 535/100,000 person-years. During the follow-up, the prevalence of abdominal obesity significantly increased by 23 % (p < 0.0001), whereas the increased prevalence of general obesity (7.8 %) was not significant (p = 0.53). Finally, diabetes mellitus was independently associated with age, waist circumference, and blood pressure but not body mass index. Conclusion: This study confirms an association between diabetes mellitus and abdominal obesity but not with general obesity. On the other hand, the rapid increase in abdominal obesity prevalence in this rural area population within the follow-up period calls for the urgent promoting of preventive lifestyle measures

A cross-sectional study on water access within the Healthy Villages and Schools (VEA) program in the DRC

In DRC, the Healthy Villages and Schools (VEA) National Program consists of a community participatory process towards sustainable access to improved water services, hygiene and sanitation where villages and schools are certified “healthy” once they comply with 7 WASH specific norms. Through a mixed-methods survey of household questionnaires, water quality testing of source and stored water samples, mapping of water sources, and discussions with key informants, this study looked at VEA implementation in the Katana health zone, South Kivu province, to ascertain lessons learnt from the program. From 206 household surveys and 71 focus group discussions, it was determined that there are two primary barriers to effective water supply coverage: accessibility to a source within 30 minutes and delivery of water that conforms to WHO guidelines of <1 E. coli CFU/100mL. Additional demographic and WASH knowledge, attitudes, and practices outcomes as well as challenges associated with the VEA are discussed

Operational research on water safety plans: implementations in India, DRC, Fiji, and Vanuatu

Despite the promotion of Water Safety Plans (WSPs) as a comprehensive risk assessment and management strategy for water delivery, there is a lack of documented outcomes and impacts from this approach, particularly for community-managed supplies. Through a mixed-methods protocol of household surveys, water quality testing of source and stored water samples, key informant interviews, and focus group discussions, this study looked at WSP implementation in four countries to ascertain lessons learnt from these programs. From 817 household surveys and 256 key informant discussions, it was determined that there was no clear evidence linking WSPs to improvements in water quality. However, interviews indicated improved capacity of local committees in understanding their water supply systems and in identifying key risks to the delivery of safe water. Additional outcomes of WSPs and challenges associated with their implementation are discussed

Efficacy of Disinfectants for Monkeypox Virus Inactivation on High Touch Surface Materials in Low-Resource Settings

Disinfection efficacy tests were conducted on surface carriers inoculated with the monkeypox virus (MPXV) by applying six disinfectant solutions (and three controls) on six surfaces common in low-resource settings: four nonporous surfaces (stainless steel, glass, plastic, and latex) and two porous surfaces (ceramic and wood). Disinfectants were wiped on carriers in triplicate, with a 1 min contact time: 0.05 and 0.5% sodium hypochlorite, 70% ethanol, two quaternary ammonium compound (QAC)-based disinfectants, and 1.4% hydrogen peroxide. MPXV was then quantified, and log10 removal values were calculated. Sodium hypochlorite (0.05 and 0.5%) and ethanol (70%) removed MPXV to below detection level, ≥ 99.97% reduction for nonporous surfaces, and ≥99.40% for wood, QAC-based disinfectants were efficacious on nonporous surfaces (≥99.97% inactivation) but had diminished efficacy on wood, a porous surface, and 1.4% H2O2 had limited efficacy across all tested surfaces. Results varied by disinfectant type and surface type. Based on our results, we recommend using 0.05% sodium hypochlorite or 70% ethanol with 1 min contact time to inactive MPXV on clean nonporous and porous surfaces. As MPXV is evolving, future research with additional disinfectants, application methods, and environmental conditions and research to understand adsorption, disinfection efficacy, and transmission risk on porous surfaces are needed to develop practical disinfection recommendations

Efficacy of laundry practices in eliminating monkeypox virus (MPXV) from fabrics

Background The declaration of mpox as a public health emergency of international concern highlights the need for interventions to interrupt virus transmission, including transmission via fabrics. Current World Health Organization (WHO) guidance on clothes washing is based on a general consensus of virus inactivation; however, there is uncertainty about the efficacy of laundry detergents and disinfectants or the reduction of risk achieved by washing clothes for mpox virus (MPXV) specifically. Methods This study investigates the efficacy of manual washing for inactivating MPXV from clothes. Using a simulated washing method, we evaluated the efficacy of commonly used laundry products and high temperature water for inactivating MPXV on fabrics. Cotton and polyester fabrics were inoculated with MPXV for 1 minute, placed in a microcentrifuge tube containing water or water with test product for 20 minutes, with agitation every 5 minutes to simulate manual washing. Results Sodium hypochlorite, liquid sanitizer, and 2 powdered laundry detergents dissolved in room temperature water, as well as 70°C water alone, completely inactivated MPXV (>3 log10 reduction or >99.9% inactivation) on both cotton and polyester fabrics. Conclusions Given the expected concentrations of MPXV on fabrics, the low transfer rate of viruses from porous surfaces to skin, the effective inactivation of laundry processes, and the expected doses required for infection, we expect the risk of transmission after laundering contaminated fabrics to be low. This study provides evidence to support WHO guidance for MPXV inactivation, reducing the viral load on fabrics to prevent the spread of mpox in both health care and household settings

Glycated nail proteins as a new biomarker in management of the South Kivu Congolese diabetics

Introduction: Diagnosis and monitoring of diabetes mellitus in sub-Saharan Africa, based on blood analyses, are hampered by infrastructural and cultural reasons. The first aim of this study was to evaluate the diagnostic accuracy of glycated nail proteins for diabetes mellitus. The second aim was to compare the course of short- and long-term glycemic biomarkers after 6 months of antidiabetic treatment. These objectives should support our hypothesis that glycated nail proteins could be used as an alternative glycemic biomarker. Materials and methods: This case-control study consisted of 163 black diabetics and 67 non-diabetics of the South Kivu (Democratic Republic of Congo). Diagnostic accuracy of glycated nail proteins was evaluated using ROC curve analysis. At the start of the study, glycated nail protein concentrations were compared between diabetics and non-diabetics, using a nitro blue tetrazolium (NBT) colorimetric method. In a subgroup of 30 diabetics, concentrations of glycated nail proteins, fasting glucose (Accu-Chek® Aviva), serum fructosamine (NBT) and HbA1c (DCA-2000+®) were measured at start and after 6 months. Results: ROC analysis yielded an AUC of 0.71 (95% confidence interval (CI): 0.65-0.76) and a cut-off point of 3.83 µmol/g nail. Concentration of glycated nail proteins was significantly higher (P < 0.001) in diabetics in comparison with non-diabetics. After 6 months of antidiabetic treatment, a significant drop in the fasting glucose concentration (P = 0.017) and concentration of glycated nail proteins (P = 0.008) was observed in contrast to serum fructosamine and HbA1c. Conclusions: Measurement of glycated nail proteins could be used to diagnose and monitor diabetes mellitus in sub-Saharan Africa

Unexpected large photosynthetic thermal plasticity of montane Andean trees

Tropical forests play a significant role in global carbon sequestration. However, our understanding of how tropical tree species adjust to climate warming remains limited to studies on seedlings grown in pots and highly controlled growth conditions. To reduce this knowledge gap, we used a field experiment with 5‐year‐old juvenile trees of 12 naturally co‐occurring dominant tropical Andean montane and lowland species growing in three common gardens established along a natural thermosequence in the tropical Andes. Based on a few previous studies, we hypothesized that montane species would exhibit a weaker photosynthetic thermal acclimation capacity compared to lowland counterparts. Our results showed that montane tree species can thermally acclimate net photosynthesis by shifting their thermal optimum ( T opt ) by 0.6°C per 1°C of warming. This strong shift in T opt was correlated to simultaneous strong shifts in T opt of apparent photosynthetic capacity parameters ( V cmax and J max ), which increased by 0.7°C per 1°C of warming. This strong thermal acclimation resulted in similar rates of net CO 2 assimilation between montane and lowland species across different thermal environments. At last, rates of net photosynthesis at growth temperature explained 30% of the variation in the relative tree growth rates across the two species groups and thermal environments. Our results suggest that the strong physiological acclimation of photosynthesis to warming among montane Andean tree species should be considered when predicting future impacts of warming on Andean plant communities

Photosynthesis of tropical Andean tree species: insights from mechanistic modelling and sensitivity analysis

Andean tropical montane forests are highly biodiverse ecosystems with a carbon storage capacity comparable to lowland forests. However, their response to climate change remains uncertain, as species photosynthesis depends on their thermal acclimation capacity. This study evaluates the variability of photosynthetic traits across montane and lowland tree species using a leaf level photosynthesis model and data from a transplant experiment across three elevations (14 °C, 22 °C, and 26 °C) in the tropical Andes. Six montane species and two lowland species were analyzed to assess photosynthetic responses to environmental conditions. We find that intraspecific variability in photosynthetic parameters, such as the apparent maximum carboxylation capacity (Vcmax) and the apparent maximum electron transport rate (Jmax), is key to accurately model photosynthesis in these ecosystems. Apparent Vcmax was identified as the primary determinant of diurnal variations in photosynthesis, especially under varying thermal environments. Additionally, stomatal conductance (g1) was highly variable and responded to vapor pressure deficit (VPD), suggesting that stomatal regulation is crucial for adaptation to environmental changes. Sensitivity analysis revealed that at higher altitudes (14 °C), photosynthetically active radiation (PAR) and temperature were the main limiting factors for photosynthesis, while at lower altitudes (22 °C), VPD was the dominant factor. Finally, the study demonstrates that the common use, within global vegetation models, of average parameters from lowland species to simulate montane forest is inadequate as such parameterizations tend to underestimate montane forest photosynthesis by up to 65 %. It is also recommended that vegetation models incorporate both intra- and interspecific variability to improve predictions of the carbon cycle in tropical Andean forests and their response to climate change

The illicit cigarette market in the Democratic Republic of the Congo (DRC): findings from a cross-sectional study of empty cigarette packs

This study aimed to estimate the proportion of cigarettes consumed in the Democratic Republic of the Congo (DRC) that are illicit and the extent of cigarette tax evasion; and to identify the origins of and factors associated with illicit cigarettes. Data were collected from May 15 to June 9, 2023. Stratified, multistage sampling was used to select 32 health areas from which empty cigarette packs were collected. Each collected pack was examined and classified as licit if it complied, or illicit if it did not comply, with the DRC’s tax stamp or written health warning requirements, or the requirements to have a notice indicating the prohibition of sale by/to minors or information on tar and nicotine content. We reported frequencies as numbers and percentages, and continuous variables as means or medians. We performed regression analysis and used adjusted odds ratios (aOR) and their 95% confidence intervals (CI) to measure associations. 8.6% (95% CI: 8.1, 9.2) of the 10622 empty cigarette packs collected were illicit, and had also evaded cigarette tax. 8.0% of the collected packs did not comply with written health warning requirements, 5.6% did not indicate the prohibition of sale by/to minors, and 4.5% did not have information on tar and nicotine content. Packs from low-income areas were more likely to be illicit than those collected from high-income areas (aOR 1.90; [95% CI: 1.48-2.43]). The likelihood of being an illicit cigarette increased with increasing susceptibility to armed conflict/insecurity. Packs from border provinces were less likely to be illicit than those from non-border provinces (aOR 0.48; [95% CI: 0.25-0.90]). All illicit cigarettes were imports from other countries. There is, therefore, a need to secure the cigarette supply chain, strengthening border controls and enforcement and compliance monitoring, and strengthening political commitment by Ratifying the WHO Protocol on Illicit Tobacco Trade