5 research outputs found
Editorial : 2009-2019, AFMED-UNIKIN : 10 ans déjà !
LâAssociation des Anciens et Amis de la FacultĂ© de MĂ©decine de lâUniversitĂ© de Kinshasa, AFMED- UNIKIN, vient de tenir, du 04 au 8 novembre dernier, dans le somptueux cadre de lâhĂŽtel du Fleuve son 8Ăšme congrĂšs annuel, coĂŻncidant avec ses 10 ans dâexistence.
Plusieurs intervenants ont saisi lâoccasion pour rappeler les nombreuses rĂ©alisations de cette association des anciens qui viennent soutenir leur alma mater formatrice, la facultĂ© de mĂ©decine de lâUNIKIN. Parmi les rĂ©alisations, nous pouvons citer la rĂ©habilitation de la salle de cours pratiques dâanatomie et de dissection, la rĂ©habilitation de la façade de notre chĂšre et belle facultĂ©, le soutien Ă des programmes dâĂ©changes, ciblant les jeunes mĂ©decins en particulier, pour complĂ©ter et renforcer leur formation Ă lâĂ©tranger, ainsi que de nombreuses missions de grande valeur mĂ©dico-sociale au bĂ©nĂ©fice de nos compatriotes.
Le programme scientifique de cette Ă©dition a Ă©tĂ© de haute facture et Ă la hauteur de lâĂ©vĂ©nement. Plusieurs participants, nationaux et internationaux ont, en effet, tĂ©moignĂ© de la qualitĂ© et du haut niveau scientifique des communications et des Ă©changes, dans des domaines aussi variĂ©s que spĂ©cialisĂ©s, intĂ©ressant (presque) tous les domaines de la santĂ© dans notre pays. Les participants avaient lâembarras pour choisir parmi, notamment, les 13 mini-confĂ©rences, 273 communications, 4 tables rondes et 2 ateliers pratiques quotidiens.
Le thĂšme principal « MĂ©decine dâici, mĂ©decine dâailleurs », reste, plus que jamais, dâactualitĂ©, ayant ainsi servi de fil conducteur pour les diffĂ©rents sous-thĂšmes quâĂ©taient lâaccessibilitĂ© aux services et soins de qualitĂ©, la sĂ©curitĂ© transfusionnelle et les cancers en RĂ©publique DĂ©mocratique du Congo.
Avec prĂšs de 600 participants le premier jour, rĂ©unissant plus de 41 nationalitĂ©s, et une moyenne de 450 pour les deux autres jours de plĂ©niĂšres, lâimpeccable organisation de ce congrĂšs a montrĂ©, sâil en est encore besoin, quâelle a atteint une certaine maturitĂ©.
Parmi les innovations, notons lâintroduction dâune journĂ©e de formation continue des infirmiĂšres de bloc opĂ©ratoire, la formation pratique aux gestes dâurgence et de rĂ©animation, une session spĂ©ciale sur le rĂ©seau congolais de prise en charge des traumatisĂ©s (RECOTRAUMA).
Les ateliers pratiques ont ensuite Ă©tĂ© organisĂ©s aux Cliniques universitaires de Kinshasa, Ă lâHĂŽpital Biamba Mutombo, la clinique Ngaliema et Ă Tatete Vein Center, oĂč de lourdes interventions chirurgicales ont Ă©tĂ© rĂ©alisĂ©es par des Ă©quipes mixtes, dâici et dâailleurs. Le succĂšs de ces ateliers est indiscutable.
Dâautres faits majeurs lors de ce congrĂšs doivent Ă©galement ĂȘtre citĂ©s notamment :
tenue du 3° CongrĂšs international de la dynamique sociĂ©tĂ© de Neurochirurgie, sous lâĂ©gide de LâAFMED ;
participation de la DistinguĂ©e PremiĂšre dame Ă une session sur la prise en charge des cancers en RDC, mais Ă©galement participation de leurs Excellences Ministres dâĂtat, ministre Ă la santĂ©, du Ministre prĂšs du PrĂ©sident, du conseiller spĂ©cial du Chef de lâEtat en matiĂšres de santĂ© ;
rĂ©ception par SEM Le PrĂ©sident de la RĂ©publique, Chef de lâEtat, dâune dĂ©lĂ©gation composĂ©e de quelques membres de la direction AFMED et de la sociĂ©tĂ© de NEUROCHIRURGIE, parmi lesquels le PrĂ©sident de la fĂ©dĂ©ration mondiale de Neurochirurgie, le PrĂ©sident mondial des sociĂ©tĂ©s Francophones de Neurochirurgie, le PrĂ©sident de la Neurochirurgie africaine.
SEM le PrĂ©sident de la RĂ©publique a apprĂ©ciĂ© la qualitĂ© et lâexcellence du congrĂšs, a relevĂ© son impact sur lâamĂ©lioration de la prise en charge de la santĂ© des congolais et de son indĂ©niable apport sur la visibilitĂ© scientifique de la RDC; il a promis de lui faciliter le fonctionnement, pour le plus grand intĂ©rĂȘt de tous.
participation de la grande star mondiale du basket, Mutombo Dikembe, venu parrainer les RECOTRAUMA.
La 8Ăšme Ă©dition du congrĂšs international AFMED UNIKIN a baissĂ© ses rideaux dans une ambiance enthousiaste et optimiste, notamment dans lâapplication effective des recommandations retenues.
Rendez-vous est dâores et dĂ©jĂ pris pour la 9Ăšme Ă©dition, qui se dĂ©roulera, selon le principe retenu, la premiĂšre semaine de novembre, câest-Ă -dire du 02 au 06 novembre 2020
Vaccination anticovid-19 : foncez, chĂšre Afrique! / Anticovid-19 vaccination: go for it, dear Africa!
Since its characterization as a pandemic, COVID-19, which began in Wuhan, China late December 2019 has brought unspeakable distaters unevenly across the world. The World Health Organization (WHO) is communicating figures, as the days go by, ever more dizzying and frightening. As of May 3, 2021, 3.2 million deaths have been tallied across the world from more than 154 million infected people. With 121,000 dead and 4.5 million infected people, Africa seems, for the moment, spared as the number of contaminations remains relatively low. It is difficult to predict the future, especially when one observes, almost helplessly, the current health tragedy in India, relatively untouched for a time but reporting more than 350,000 new cases of infection per day. The global socio-economic damage also remains indescribable.
Vaccination quickly established itself as one of the major means in the fight against this killer pandemic. Taking advantage of the knowledge acquired after the first applications, in 2002, in the implementation ofa messenger RNA vaccine against cancers (1) and after epidemics with 2 related viruses, SARS-CoV in 2002 and MERS-CoV in 2013, several vaccines were rapidly developed (2). The most successful are the messenger RNA vaccines (the vaccine from Pfizer / BioNTech and the vaccine from Moderna), the viral vector vaccines (AstraZeneca vaccine and the Covishield vaccine from the Serum Institute of India-SII) and the subunit protein vaccines. These vaccines work through the S protein and none contain the entire virus.
Messenger RNA vaccines
These vaccines do not contain the virus and therefore cannot transmit COVID-19. They do not affect, interact with or alter DNA (deoxyribonucleic acid) as long as messenger RNA does not enter the nucleus of cells. They use the bodyâs natural defense response by providing harmless genetic instructions given by messenger RNA.
Messenger RNA vaccines contain a portion of the virus RNA (ribonucleic acid), a molecule used to make proteins. Messenger RNA is surrounded by lipids to prevent its too rapid degradation and thus allow it to enter cells.
Viral vector vaccines
These vaccines contain a weakened version of a virus used as a vector that is harmless to humans and into which some of the coronavirus genetic material has been introduced. When the viral vector enters human cells, it gives instructions to make the coronavirus S protein. The cells then make copies of this protein. The human immune system recognizes this foreign protein and produces T cells and B cells to neutralize it. AstraZeneca and Covishield vaccines contain a tiny amount of adenovirus and are considered equivalent since they are produced using the same formulation that was provided by AstraZeneca, following a technology transfer to the company SII, manufacturer of the Covishield vaccine. These vaccines do not contain cells or tissues derived from humans or animals.
Subunit protein vaccines
These vaccines are, to date, not licensed.
Several countries launched their vaccination campaigns in summer and then at the end of 2020, including China first, Russia, United Kingdom, France and USA. However, Africa, particularly sub-Saharan Africa, was lagging behind as often! The global imbalance in access to these different vaccines was quickly denounced, prompting the WHO to find a compromise with manufacturing laboratories so that part of the production of vaccine doses should be reserved for non-manufacturing countries, especially in Africa. The AstraZeneca vaccine was chosen for this program called COVAX, the objective of which is to achieve a fair, equitable and free distribution of vaccines among all countries, the only global initiative of its kind.
Several African countries, including Ghana, Ivory Coast and the Democratic Republic of Congo, in particular, which are on the first list of countries served by the COVAX system, have planned their vaccination campaigns during the first quarter of 2021. But very quickly, a wave of serious side effects described, or criticized, around the world, with the AstraZeneca vaccine, in particular the appearance of thromboembolic effects, sowed doubt in the population in fear of serious side effects. This gave ammunition to the proponents of conspiracy theoriesin the media and social networks (3). Several countries around the world, including African countries, have had no choice but to suspend or cancel their vaccination campaigns. This was the case for Austria, Italy, Denmark, Sweden, Norway, Thailand, Democratic Republic of Congo and the list kept growing, reaching more than 28 countries (4).
Fear of the vaccine
Fear of the vaccine is as old a school of thought as vaccination. Smallpox was the occasion for the first vaccine experiments and the first reservations. The idea, at the time, of inoculating an animal disease into humans had appeared inconceivable to many and had led to the first large-scale anti-vaccine movement, especially in England, from the eighteenth century to the work of Louis Pasteur in the 19th century, work whose success is indisputable today. At the time, the vaccine, a disease of the cow (Vacca in Latin which gave Vaccin) due to a smallpox-like virus, was used to obtain an effective a vaccine against smallpox after strenuous steps. And over time, the anti-vaccine movement has been able to adapt its discourse to technical developments, leading to conspiracy theories of a possible takeover of peoples, or even enslavement, contamination by an inoculation, etc. Almost the same fears are being broadcast nowadays about the COVID-19 vaccine.
The two main reasons for refusing vaccination have been clearly identified for influenza. These are the fear of side effects (real or fantasized) reported in 60% of cases in people with a higher level of education and a serious doubt about the effectiveness of vaccination in preventing disease in 44% of cases in others (5).
However, several data confirm the effectiveness of vaccines and echo potential side effects, some of which are rare but can be severe.
However, it should be rationally stated that:
Vaccination is one of the essential means in the fight against the covid-19 pandemic as stated by the WHO;
The effectiveness of vaccines is, to this day and in this period of health crisis, indisputable. For example, the AstraZeneca vaccine, used as part of the COVAX system and subject to many pitfalls, has an efficacy that varies from 62 to 90% depending on the regimens used (6);
Thromboembolic diseases are recognized as serious but rare side effects reported after vaccination with currently available anti-covid 19 vaccines including AstraZĂ©neca;
Concerning the AstraZeneca vaccine, 37 cases of thrombosis in Europe (including Great Britain) were reported, as of March 8th, out of 17 million vaccinated people in 2 months, i.e. an average of 2.2 cases per million. The expected benefit of the AstraZeneca vaccine is, to date, greater than the potential side effects (7);
Taking into account the infodemic (management of false information that spreads through the media, social networks and others) and promoting reliable communication must be integrated in the strategies of raising public awareness (8);
There is a need for active pharmacovigilance in Africa, the interest of which is to list all the reported side effects;
Continued compliance with barrier measures remains essential in order to limit the spread of infection and prevent further waves.
In fact, more than a billion doses of vaccines have already been administered worldwide as of April 28, 2021. There is no reason to hesitate to protect populations from potential disasters. Anticovid-19 vaccination should be encouraged. To date, there is nothing to prevent the use of approved vaccines, in particular the AstraZeneca vaccine, which was selected in the COVAX system. Anticovid-19 vaccine benefits far outweigh the risk of side effects that are potentially serious, but rare. So go for it, Dear Africa!
La pandĂ©mie Ă COVID-19, dĂ©clarĂ©e le 30 dĂ©cembre 2019 et qui a dĂ©butĂ© Ă Wuhan, continue ses dĂ©sastres innommables, de façon inĂ©gale, Ă travers le monde. LâOrganisation mondiale de la SantĂ© (OMS) communique des chiffres, au fil des jours, toujours plus vertigineux et effrayants. Au 3 mai 2021, il Ă©tait comptĂ©, Ă travers le monde, plus de 3,2 millions de morts parmi plus de 154 millions des personnes infectĂ©es. LâAfrique, avec 121000 morts et les 4,5 millions de personnes contaminĂ©es, semble, pour lâinstant, Ă©pargnĂ©e tant le nombre de contaminations reste faible. Il est difficile de prĂ©dire lâavenir, surtout lorsquâon constate, presque impuissant, la tragĂ©die sanitaire actuelle en Inde, relativement Ă©pargnĂ©e pendant un temps ; il y est notĂ© plus de 350 mille nouveaux cas dâinfection par jour. Les dĂ©gĂąts mondiaux sur le plan socioĂ©conomique restent Ă©galement indescriptibles.
La vaccination sâest rapidement imposĂ©e comme un des moyens majeurs de lutte contre cette pandĂ©mie tueuse. Profitant des connaissances acquises aprĂšs les premiĂšres applications, en 2002, dans la mise en place dâun vaccin Ă ARN contre les cancers (1) et aprĂšs les Ă©pidĂ©mies Ă 2 virus proches, le SRAS-CoV en 2002 et le MERS-CoV en 2013, plusieurs vaccins ont pu ĂȘtre rapidement dĂ©veloppĂ©s (2). Les plus aboutis sont les vaccins Ă ARN Messager (le vaccin de Pfizer/BioNTech et le vaccin de Moderna), les vaccins Ă vecteur viral (Vaccin AstraZeneca et le vaccin Covishield du Serum Institute of India- SII) et les vaccins Ă protĂ©ines sous unitaires. Ces vaccins agissent par le biais de la protĂ©ine S et aucun dâentre eux ne contient le virus en entier.
Vaccins Ă ARN messager
Ces vaccins ne contiennent pas le virus et ne peuvent donc pas transmettre la COVID-19. Ils nâaffectent pas, nâinteragissent pas et nâaltĂšrent pas lâADN (acide dĂ©soxyribonuclĂ©ique) dans la mesure oĂč lâARN messager ne pĂ©nĂštre pas dans le noyau des cellules. Ils utilisent la rĂ©ponse de dĂ©fense naturelle du corps en fournissant des instructions gĂ©nĂ©tiques inoffensives donnĂ©es par lâARN messager.
Les vaccins Ă ARN messager contiennent une portion de lâARN (acide ribonuclĂ©ique) du virus, molĂ©cule du mode dâemploi pour fabriquer des protĂ©ines. LâARN messager est entourĂ© de lipides pour empĂȘcher sa dĂ©gradation trop rapide et lui permettre ainsi de pĂ©nĂ©trer dans les cellules.
Vaccins Ă vecteur viral
Ces vaccins contiennent une version affaiblie dâun virus inoffensif pour lâhumain dans lequel une partie du matĂ©riel gĂ©nĂ©tique du virus a Ă©tĂ© introduit. Lorsque le vecteur viral pĂ©nĂštre dans les cellules humaines, il donne des instructions pour fabriquer la protĂ©ine S. Les cellules font alors des copies de cette protĂ©ine. Le systĂšme immunitaire humain reconnaĂźt cette protĂ©ine Ă©trangĂšre et produit des lymphocytes T et des lymphocytes B pour la neutraliser. Ces deux vaccins contiennent une infime quantitĂ© dâadĂ©novirus et sont considĂ©rĂ©s Ă©quivalents puisquâils sont produits selon la mĂȘme formulation, celle fournie par AstraZeneca, Ă la suite dâun transfert technologique Ă la compagnie SII. Ils ne contiennent pas de cellules ou de tissus dĂ©rivĂ©s dâhumains ou dâanimaux.
Vaccins à protéines sous unitaires
Ces vaccins sont, à ce jour, non homologués.
Plusieurs pays ont lancĂ©, dĂšs lâĂ©tĂ© puis fin 2020, leurs campagnes de vaccination dont La Chine en premiĂšre, la Russie, Le Royaume-Uni, La France, Les USA. LâAfrique, particuliĂšrement lâAfrique subsaharienne (ASS), est, comme souvent, Ă la traĂźne ! Le dĂ©sĂ©quilibre mondial dâaccĂšs Ă ces diffĂ©rents vaccins a vite Ă©tĂ© dĂ©noncĂ©, poussant lâOMS Ă trouver un compromis avec les laboratoires fabricants pour quâune partie de la production des doses des vaccins soit rĂ©servĂ©e aux pays non fabricants, notamment africains. Le vaccin AstraZeneca a Ă©tĂ© retenu pour ce programme appelĂ© COVAX, dont lâobjectif est dâobtenir une rĂ©partition juste, Ă©quitable et gratuite des vaccins entre tous les pays, seule initiative mondiale du genre.
Plusieurs pays africains, dont Le Ghana, La CĂŽte-dâIvoire, La RĂ©publique DĂ©mocratique du Congo, notamment, faisant partie de la premiĂšre liste des pays servis par le dispositif COVAX, ont planifiĂ©, courant premier trimestre 2021, leurs campagnes de vaccination. Mais trĂšs vite, une vague dâeffets secondaires graves dĂ©crits, ou dĂ©criĂ©s, Ă travers le monde, avec le vaccin AstraZeneca, en particulier lâapparition des effets thromboemboliques, a installĂ© le doute ou la crainte dâeffets secondaires graves auprĂšs des populations, renforçant, au passage, les dĂ©fenseurs de la thĂ©orie complotiste dĂ©veloppĂ©e par certains mĂ©dias ou rĂ©seaux sociaux (3). Plusieurs pays Ă travers le monde, dont des pays africains, nâont pas eu de choix que de suspendre ou annuler leurs campagnes de vaccination tels lâAutriche, lâItalie, Le Danemark, La SuĂšde, La NorvĂšge, La ThaĂŻlande, La RĂ©publique DĂ©mocratique du Congo et la liste nâen finissait pas de sâallonger, jusquâĂ atteindre plus de 28 pays concernĂ©s (4).
La peur du vaccin
La peur du vaccin est un courant de pensĂ©e aussi vieux que la vaccination. La variole a Ă©tĂ© lâoccasion des premiĂšres expĂ©riences vaccinales et des premiĂšres rĂ©ticences. LâidĂ©e, Ă lâĂ©poque, dâinoculer une maladie animale Ă des humains Ă©tait apparue inconcevable Ă beaucoup et avait entraĂźnĂ© le premier mouvement anti-vaccinal dâampleur, notamment en Angleterre, avec des passions, du XVIIIe siĂšcle aux travaux de Louis Pasteur au XIXe siĂšcle, des travaux dont le succĂšs est aujourdâhui indiscutable. A lâĂ©poque, on eut recours Ă la vaccine, une maladie de la vache (Vacca en latin qui donna Vaccin) causĂ©e par un virus proche de celui de la variole pour aboutir, aprĂšs de difficiles Ă©tapes, Ă un vaccin efficace contre la variole. Et Au fil du temps, le mouvement anti-vaccinal a su adapter son discours aux Ă©volutions techniques, aboutissant Ă des thĂ©ories du complot, avec la peur dâun possible prise de contrĂŽle des peuples, voire dâasservissement, de la contamination par une inoculation, etc. Les mĂȘmes peurs, ou presque, sont diffusĂ©es pour le vaccin anti-COVID-19.
Les deux raisons principales du refus de la vaccination ont Ă©tĂ© parfaitement identifiĂ©es pour la grippe. Ce sont la crainte des effets secondaires (rĂ©els ou fantasmĂ©s) rapportĂ©s dans 60 % des cas chez les personnes ayant un niveau dâĂ©ducation supĂ©rieur et un doute sĂ©rieux sur lâefficacitĂ© de la vaccination Ă prĂ©venir la maladie dans 44 % des cas chez les autres (5).
Pourtant, plusieurs donnĂ©es viennent confirmer lâefficacitĂ© des vaccins et faire Ă©cho de potentiels effets secondaires ; certains, rares, pouvant ĂȘtre graves.
Il convient cependant dâaffirmer rationnellement que :
comme lâaffirme lâOMS, la vaccination est un des moyens incontournables dans la lutte contre la pandĂ©mie COVID-19 ;
lâefficacitĂ© des vaccins est, Ă ce jour et dans cette pĂ©riode de guerre sanitaire, indiscutable. A titre dâexemple, le vaccin AstraZeneca, utilisĂ© dans le cadre du dispositif COVAX et objet de beaucoup dâĂ©cueils, a une efficacitĂ© qui varie de 62 Ă 90% selon les schĂ©mas utilisĂ©s (6) ;
des maladies thromboemboliques sont reconnus comme des effets secondaires graves mais rares, décrits aprÚs vaccination anti-covid 19 par différents vaccins actuellement disponibles dont AstraZéneca ;
concernant le vaccin AstraZeneca, 37 cas de thromboses en Europe (incluant la Grande-Bretagne) étaient signalés, en date du 8 mars, Sur 17 millions de personnes vaccinées en 2 mois, soit une moyenne de 2,2 cas par million. Le bénéfice attendu du vaccin AstraZeneca est, à ce jour, supérieur, aux potentiels effets secondaires (7) ;
la prise en compte de lâinfodĂ©mie (gestion de fausses informations qui fusent Ă travers les mĂ©dias, rĂ©seaux sociaux et autres) et la promotion dâune communication fiable doivent ĂȘtre intĂ©grĂ©es dans les politiques de sensibilisation des populations (9) ;
il faut une pharmacovigilance active en Afrique, dont lâintĂ©rĂȘt est de rĂ©pertorier tous les effets secondaires signalĂ©s ;
la poursuite du respect des mesures-barriĂšres reste de mise afin de limiter la propagation de lâinfection et Ă©viter de nouvelles vagues.
En fait, plus dâun milliard des doses de vaccins ont dĂ©jĂ Ă©tĂ© administrĂ©es Ă travers le monde au 28 avril 2021. Il nây a pas de raison pour hĂ©siter de mettre les populations Ă lâabri de potentiels catastrophes. La vaccination anticovid-19 doit ĂȘtre encouragĂ©e. A ce jour, rien ne sâoppose Ă lâutilisation des vaccins homologuĂ©s, notamment le vaccin AstraZeneca, retenu dans le dispositif COVAX. Leurs bĂ©nĂ©fices sont largement supĂ©rieurs au risque dâeffets secondaires, certes potentiellement graves, mais rares. Alors foncez, ChĂšre Afrique
The Helicobacter pylori Genome Project : insights into H. pylori population structure from analysis of a worldwide collection of complete genomes
Helicobacter pylori, a dominant member of the gastric microbiota, shares co-evolutionary history with humans. This has led to the development of genetically distinct H. pylori subpopulations associated with the geographic origin of the host and with differential gastric disease risk. Here, we provide insights into H. pylori population structure as a part of the Helicobacter pylori Genome Project (HpGP), a multi-disciplinary initiative aimed at elucidating H. pylori pathogenesis and identifying new therapeutic targets. We collected 1011 well-characterized clinical strains from 50 countries and generated high-quality genome sequences. We analysed core genome diversity and population structure of the HpGP dataset and 255 worldwide reference genomes to outline the ancestral contribution to Eurasian, African, and American populations. We found evidence of substantial contribution of population hpNorthAsia and subpopulation hspUral in Northern European H. pylori. The genomes of H. pylori isolated from northern and southern Indigenous Americans differed in that bacteria isolated in northern Indigenous communities were more similar to North Asian H. pylori while the southern had higher relatedness to hpEastAsia. Notably, we also found a highly clonal yet geographically dispersed North American subpopulation, which is negative for the cag pathogenicity island, and present in 7% of sequenced US genomes. We expect the HpGP dataset and the corresponding strains to become a major asset for H. pylori genomics
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 crossâsectional study of 489 women aged 20â65âyears was conducted. Data was collected using a predesigned, tested, selfâadministered questionnaire. The questionnaire included specific sections to test the participants' knowledge related to breast cancer and its screening, and practices related to breast selfâexamination (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 ninetyâtwo (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: 1.27â5.73; p =â.010) and having previously been screened for breast cancer (adjusted odds ratio = 2.31; 95% confidence interval: 1.40â3.83; p =â.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
Prevalence and determinants of Hepatitis C Virus Infection and Genotypes in Chronic Hemodialysis Patients in Kinshasa: PrĂ©valence et dĂ©terminants de lâinfection par le virus de lâhĂ©patite C et gĂ©notypes chez les hĂ©modialysĂ©s chroniques, Ă Kinshasa
Contexte et Objectifs. Le nombre des patients hĂ©modialisĂ©s en Afrique subsaharienne en constante augmentation ; justifiant de ce fait une meilleure prise en charge de ces patients. La prĂ©sente Ă©tude dĂ©termine la prĂ©valence de lâinfection par le virus de lâhĂ©patite C en en determinant les gĂ©notypes ainsi que les facteurs y associĂ©s dans ce groupe de patients. MĂ©thodes. 127 patients hĂ©modialisĂ©s chroniques ont subis des tests sĂ©rologiques Ă la recherche des anticorps anti-VHC dans plusieurs centres de Kinshasa de fĂ©vrier Ă juin 2018. Le gĂ©notype viral a Ă©tĂ© dĂ©terminĂ© par la RT-PCR. RĂ©sultats. La frĂ©quence des anticorps anti-VHC a variĂ© de 0 Ă 52,9 % dans ce groupe. Les gĂ©notypes le plus frĂ©quents ont Ă©tĂ© le 4 (18/22) et le 2 (2/22) ; Ă©tant sumultanĂ©ment rĂ©trouvĂ© chez un patient, et indĂ©terminĂ© chez un autre sujet. Avoir reçu au moins 4 transfusions [7,21 (1,09-10,61; p=0.040)], ne pas ĂȘtre sous EPO [5,81(1,47-12,96); p=0.012)], ĂȘtre en hĂ©modialyse depuis au moins 14 mois [3,63(1,60-5,05); p=0.035)] et ĂȘtre dialysĂ© dans un centre surchargĂ© [2,06 (0,83-5,86); p=0.073)] Ă©taient associĂ©s Ă un risque plus Ă©levĂ© dâinfection par le VHC. Conclusion. Ses principaux dĂ©terminants sont : le nombre des transfusions sanguines et la durĂ©e d'HD ; dâoĂč la nĂ©cessitĂ© de rĂ©duire les transfusions sanguines chez les sujets dialysĂ©s par l'administration d'EPO, Ă©tant donnĂ© le coĂ»t prohibitif du traitement contre le VHC dans notre contexte.
Context and objective. The steady increase in the number of chronic hemodialysis patients in sub-Saharan Africa (SSA) calls for improved management of those patients. The present study aimed to determine the frequency of hepatitis C virus (HCV) infection, the prevalent genotypes, and the risk factors associated with HCV in hemodialysis patients in Kinshasa (DR Congo). Methods. A cross-sectional study was conducted from February to June 2018 in all hemodialysis centers in Kinshasa. Blood samples were collected from 127 chronic hemodialysis patients and tested for the presence of antibodies against HCV. The HCV genotype was identified by real-time polymerase chain reaction (RT- PCR). Results. Twenty-two (17.3 %) patients were positive for anti-HCV antibodies, ranging from 0 % to 52.9 % in different centers. Genotype 4 was detected in 18/22 (81.8 %), followed by genotype 2 in 2/22 (9.1%), and both genotypes 2 and 4 in one patient (4.5%). One patient had an undetermined genotype (4.5 %). Having received at least 4 transfusions [7,21 (1,09-10,61); p=0.040)], not being under EPO treatment [5,81(1,47-12,96); p=0.012)], being on hemodialysis for at least 14 months [3,63(1,60-5,05); p=0.035)]and being dialyzed in an overloaded center [2,06(0,83-5,86); p=0.073)] were associated with a greater risk of HCV infection. Conclusion. This high HCV prevalence (17.3 %) represents a substantial health burden in HD patients from Kinshasa, DR Congo. It is largely driven by the number of blood transfusions, the duration time in hemodialysis. Observations from the present study underscore the need of reducing the number of blood transfusions in people on dialysis through the administration of erythropoietin, given the unaffordable cost of HCV therapy for most individuals in DR Congo