Kindu, Democratic Republic of the Congo
Kindu, Democratic Republic of the Congo

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PubMed | University of Zimbabwe, Catholic University of Bukavu and University of Cape Town
Type: Journal Article | Journal: Germs | Year: 2017

Here we describe a case of a 16 months-old malnourished child with pneumonia due to Although our investigations confirmed

Prevalences of human herpesvirus-8 (HHV-8) infection and diabetes mellitus are very common in certain parts of Africa, containing iron-rich soils. We hypothesized that some genetic factors could have a link with susceptibility to HHV-8 infection. We focused on ferroportin Q248H mutation (rs11568350), transferrin (TF) polymorphism and fructosamine-3 kinase (FN3K) 900C/G polymorphism (rs1056534). The study population consisted of 210 type 2 diabetic adults and 125 healthy controls recruited in Bukavu (South Kivu). In the whole study population (diabetics+healthy controls), ferroportin Q248H mutation was detected in 47 subjects (14.0%) with 43 heterozygotes and 4 homozygotes. TF phenotype frequencies were 88.1% (CC), 10.4% (CD) and 1.5% (BC). Genotype frequencies of FN3K 900C/G polymorphism were respectively 9,3% (CC), 43.3% (GC) and 47.4% (GG). Prevalence of HHV8-infection in the study population was 77.3%. HHV-8 infection rate and HHV-8 IgG antibody titer were significantly higher in diabetics then in controls (p<0.0001). Significant differences were observed in HHV-8 infection rate and in HHV-8 IgG antibody titer according to FN3K rs1056534 (p<0.05 and p<0.05, respectively) and TF polymorphism (p<0.05 and p=0.005, respectively). No significant differences in HHV-8 infection rate and in HHV-8 IgG antibody titer were observed in the ferroportin Q248H mutation carriers (rs11568350) in comparison with ferroportin wild type. In a multiple regression analysis, FN3K rs1056534, TF polymorphism and presence of diabetes mellitus were predictors for HHV-8 infection. In contrast to these findings, ferroportin Q248H mutation (rs11568350) did not influence the susceptibility for an HHV-8 infection in sub-Saharan Africans.

Katchunga P.B.,Faculte Of Medecine Of Luniversite Catholique Of Bukavu | Hermans M.,Service dendocrinologie et nutrition des Cliniques Universitaires St Luc a Bruxelles | Bamuleke B.A.,Faculte Of Medecine Of Luniversite Catholique Of Bukavu | Katoto P.C.,Faculte Of Medecine Of Luniversite Catholique Of Bukavu | Kabinda J.M.,Catholic University of Bukavu
Pan African Medical Journal | Year: 2013

Introduction: The criteria of positivity of waist circumference to define the metabolic syndrome as currently recommended for the population of sub-Saharan Africa do not take into account specific ethnic or regional variation. Methods: The predictive value of different values of waist circumference compared with visceral fat as determined by OMRON BF510 body composition in 360 indigenous patients from Bukavu city between June 1, 2010 and May 30, 2011 was studied. Results: The prevalence was higher in women for enlarged waist circumference according to the pathological IDF or NCEP/ATP III threshold (p < 0.0001) contrasting with lower rates for pathological accumulation of visceral fat in men (p = 0.0001). The highest values for sensitivity and specificity were obtained for a threshold value of 95 cm for men (sensitivity = 72.4%, specificity = 91.1%, area under the curve (99% CI) = 0.899 (0.833 to 0.965)) and 99 cm in women (sensitivity = 75.0%, specificity = 78.3%, AUC (99% CI) = 0.844 (0.777 to 0.911)). This test also showed an independent effect on the probability of accumulation of visceral fat (Odd adjusted OR = 5.0 (99% CI: 2.1 to 11.7), p <0.0001) after adjustment for other confounding factors. Conclusion: The threshold value for pathological waist circumference currently used for black African populations may overpredict abdominal fat excess in women. Further studies are needed to provide adequate cutoffs in sub-Saharan populations. © Philippe Bianga Katchunga et al.

Munyuli M.B.T.,Health Innovation Technologies | Kavuvu J.-M.M.,Bukavu Institute of Higher Education in Medical Techniques ISTM Bukavu | Mulinganya G.,Catholic University of Bukavu | Bwinja G.M.,Catholic University of Bukavu
Iranian Journal of Public Health | Year: 2013

Background: Cholera epidemics have a recorded history in eastern Congo dating to 1971. A study was conducted to find out the linkage between climate variability/change and cholera outbreak and to assess the related economic cost in the management of cholera in Congo. Methods: This study integrates historical data (20 years) on temperature and rainfall with the burden of disease from cholera in South-Kivu province, eastern Congo. Results: Analyses of precipitation and temperatures characteristics in South-Kivu provinces showed that cholera epidemics are closely associated with climatic factors variability. Peaks in Cholera new cases were in synchrony with peaks in rainfalls. Cholera infection cases declined significantly (P<0.05) with the rise in the average temperature. The monthly number of new Cholera cases oscillated between 5 and 450. For every rise of the average temperature by 0.35 °C to 0.75 °C degree Celsius, and for every change in the rainfall variability by 10-19%, it is likely cholera infection risks will increase by 17 to 25%. The medical cost of treatment of Cholera case infection was found to be of US$50 to 250 per capita. The total costs of Cholera attributable to climate change were found to fall in the range of 4 to 8% of the per capita in annual income in Bukavu town. Conclusion: It is likely that high rainfall favor multiplication of the bacteria and contamination of water sources by the bacteria (Vibrio cholerae).The consumption of polluted water, promiscuity, population density and lack of hygiene are determinants favoring spread and infection of the bacteria among human beings living in over-crowded environments.

Katchunga P.,Catholic University of Bukavu | Masumbuko B.,Provincial Health Inspection of South Kivu | Belma M.,Leuven development cooperation in Central Africa | Kashongwe Munogolo Z.,Catholic University of Bukavu | And 2 more authors.
Diabetes and Metabolism | Year: 2012

Objectives: This study aimed to determine the risk factors for diabetes mellitus (DM) in the eastern part of the Democratic Republic of Congo. Methodology: Multilevel sampling identified 200 households (444 adults aged ≥ 20 years) from 20 neighbourhoods in the city of Bukavu, and 90 households (255 adults aged ≥ 20 years) from 10 villages in the Kaziba (South Kivu) chiefdom (the South Kivu VITARAA study). DM was defined as a personal history of the disorder or a casual glycaemia greater or equal to 200. mg/dL. Standardization according to age and sample readjustment based on the urban-rural distribution of the population was applied accordance with the typical Congolese population. The probability of DM was assessed by multiple logistic regressions. Results: Total prevalence of DM was 3.5%. DM was significantly more prevalent in urban areas (age-standardized prevalence: 4.0%) than in rural areas (1.7%). City-dwelling DM patients were characterized by higher rates of indices of abdominal obesity (P<0.05) whereas, in rural areas, no patients were obese. In the study group as a whole, only 25.0% of diabetic patients were obese. On multivariate analyses, only age [adjusted OR (95% CI): 4.79 (1.60-14.25); P=0.004] was independently associated with the prevalence of DM, while the effect of obesity was not significant [2.64 (0.99-7.02); P=0.051]. Conclusion: Age and living in an urban environment appeared to be major determinants of DM in South Kivu. Also, obesity prevalence was relatively low in these diabetic patients, confirming the peculiar, relatively lean, phenotype of type 2 DM in indigenous sub-Saharan Africans. © 2012 Elsevier Masson SAS.

Wilfried B.N.,Catholic University of Bukavu | Kamdjoug J.R.K.,University Catholique dAfrique Centrale | Wamba S.F.,NEOMA Business School
AMCIS 2016: Surfing the IT Innovation Wave - 22nd Americas Conference on Information Systems | Year: 2016

Information and communication technologies (ICT) are very important to the persons and organizations that used them, because of the services they provide. They give them the possibility to automate and improve the performance of their activities. With the Web 2.0, it was possible to create a particular type of ICT known as a Social Network with Facebook, Whatsapp, Twitter, YouTube and Skype as examples. The usage and the speed of the Social Networks give the opportunity to guaranty a better ways of sharing information between users. During this study, our focus was on the Facebook social network. The recognized functionalities of this particular social network makes him popular in our society. The phenomenon is very present in the Cameroonian professional sector where people are using it. The goal of this study is to analyze the factors that influence the usage of this social network on the Cameroonian professional environment.

Manwa B.,Catholic University of Bukavu | Kashongwe Z.,Catholic University of Bukavu | Bahindwa B.,Catholic University of Bukavu | Kolanowski J.,Catholic University of Louvain | Hermans M.P.,Catholic University of Louvain
Diabetes and Metabolism | Year: 2010

Objective: Cassava, a major carbohydrate source in Africa, contains potentially diabetogenic chemicals, although its consumption is not associated with incident diabetes. As it is not known whether cassava intake impairs residual β-cell function in patients with type 2 diabetes (T2D), our study compared the metabolic phenotypes of diet- and/or oral antidiabetic drug (OAD)-treated T2D patients in South Kivu (Democratic Republic of the Congo) with [Cassava (+); n = 147] and without [Cassava (-); n = 46] self-reported cassava consumption. Design & methods: A total of 193 patients [male:female (%) 37:63; mean ± 1 SD age: 56 ± 11 years] were interviewed to determine the frequency and distribution of eight major dietary carbohydrate (CHO) sources (cassava, plantain, rice, maize, bread, sorghum, potatoes and legumes). Fasting glucose, insulin and lipid levels were obtained after an overnight fast and OAD discontinuation. Cassava (+) and Cassava (-) groups were compared for HOMA indices of insulin sensitivity (S), beta-cell function (B), hyperbolic product (B × S) and B × S loss rate (B × S LR). Results: Diabetes duration was 6 ± 7 years, age at diabetes diagnosis was 51 ± 11 years and BMI was 25 ± 5 kg/m2. Cassava intake was reported by 76% of patients, and amounted to 29 ± 11% of their daily CHO intake. The Cassava (-) group ate more plantain, maize, bread and potatoes, and less sorghum. Age, gender and age at diabetes diagnosis did not differ between Cassava (+) and (-) patients, nor did BMI, fat mass, waist circumference, lipid profile and metabolic syndrome prevalence. HOMA indices of S, B, B × S and B × S LR did not differ significantly between groups-Cassava (+) vs (-): S, 114 ± 56% vs 114 ± 60%; B, 34 ± 30% vs 39 ± 32%; B × S, 38 ± 35% vs 40 ± 31%; and B × S LR, 1.19 ± 0.84% vs 1.09 ± 0.65% per year-nor did the glucose-lowering modalities. Conclusion: Cassava consumption in South Kivu is not associated with changes in T2D phenotype or in the glucose homoeostasis determinants S, B, B × S and B × S LR. Cassava consumption does not accelerate β-cell function loss in such a population, whose markedly compromised glucose homoeostasis renders them vulnerable to environmentally acquired β-cell impairment. © 2009 Elsevier Masson SAS. All rights reserved.

Pypers P.,Tropical Soil Biology And Fertility Institute of CIAT | Sanginga J.-M.,Centro Internacional Of Agricultura Tropical | Kasereka B.,Centro Internacional Of Agricultura Tropical | Walangululu M.,Catholic University of Bukavu | Vanlauwe B.,Tropical Soil Biology And Fertility Institute of CIAT
Field Crops Research | Year: 2011

Smallholder farmers in sub-Saharan Africa are confronted by low productivity and limited investment capacity in nutrient inputs. Integrated soil fertility management (ISFM) aims at increased productivity through the combined use of improved germplasm, judicious fertilizer application and organic matter management, adapted to the local farming conditions. We hypothesize that the application of these different ISFM components can result in significant increases in productivity and economic benefits of cassava-legume intercropping systems. Participatory demonstration trials were conducted in the highlands of Sud-Kivu, DR Congo with 12 farmer groups during 3 seasons. Treatments included the farmers' common practice (local common bean and cassava varieties, seed broadcast and manure addition) and sequentially added ISFM components: improved bean and cassava germplasm, modified crop arrangements, compound NPK fertilizer application and alternative legume species (groundnut or soybean). The use of improved germplasm did not result in yield increases without simultaneous implementation of other ISFM components. Modifying the crop arrangement by planting cassava at 2m between rows and 0.5m within the row, intercropped with four legume lines, increased bean yields during the first season and permits a second bean intercrop, which can increase total legume production by up to 1tha -1 and result in an additional revenue of almost 1000USDha -1. Crop arrangement or a second legume intercrop did not affect cassava storage root yields. Fertilizer application increased both legume and cassava yield, and net revenue by 400-700USDha -1 with a marginal rate of return of 1.6-2.7. Replacing the common bean intercrop by groundnut increased net revenue by 200-400USDha -1 partly because of the higher market value of the grains, but mostly due to a positive effect on cassava storage root yield. Soybean affected cassava yields negatively because of its high biomass production and long maturity period; modifications are needed to integrate a soybean intercrop into the system. The findings demonstrate the large potential of ISFM to increase productivity in cassava-legume systems in the Central-African highlands. Benefits were, however, not observed in all study sites. In poor soils, productivity increases were variable or absent, and soil amendments are required. A better understanding of the conditions under which positive effects occur can enable better targeting and local adaptation of the technologies. © 2010 Elsevier B.V.

Karemere H.,Catholic University of Bukavu | Ribesse N.,Catholic University of Louvain | Kahindo J.-B.,Cemubac Center Scientifique Et Medical Of Luniversite Libre Of Bruxelles Pour Ses Activites Of Cooperation | Macq J.,Catholic University of Louvain
Pan African Medical Journal | Year: 2015

Introduction: In many African countries, first referral hospitals received little attention from development agencies until recently. We report the evolution of two of them in an unstable region like Eastern Democratic Republic of Congo when receiving the support from development aid program. Specifically, we aimed at studying how actors' network and institutional framework evolved over time and what could matter the most when looking at their performance in such an environment. Methods: We performed two cases studies between 2006 and 2010. We used multiple sources of data: reports to document events; health information system for hospital services production, and "key-informants" interviews to interpret the relation between interventions and services production. Our analysis was inspired from complex adaptive system theory. It started from the analysis of events implementation, to explore interaction process between the main agents in each hospital, and the consequence it could have on hospital health services production. This led to the development of new theoretical propositions. Results: Two events implemented in the frame of the development aid program were identified by most of the key-informants interviewed as having the greatest impact on hospital performance: the development of a hospital plan and the performance based financing. They resulted in contrasting interaction process between the main agents between the two hospitals. Two groups of services production were reviewed: consultation at outpatient department and admissions, and surgery. The evolution of both groups of services production were different between both hospitals. Conclusion: By studying two first referral hospitals through the lens of a Complex Adaptive System, their performance in a context of development aid takes a different meaning. Success is not only measured through increased hospital production but through meaningful process of hospital agents'" network adaptation. Expected process is not necessarily a change; strengthened equilibrium and existing institutional arrangement may be a preferable result. Much more attention should be given in future international aid to the proper understanding of the hospital adaptation capacities. © Hermès Karemere et al.

Malnutrition is a backdrop on which several infections are grafted. The aim of this study is to determine the most lethal infections, the median length of stay and the median daily weight gain of malnourished children.A retrospective cohort study of malnutrition in children aged 0-59 months hospitalized in the Therapeutic Nutritional Center in Bukavu from 1 January 2011 to 31 December 2013. The evaluation of the risk of deaths related to infectious complication was made measuring the relative risk. Mann-Whitney test was used for comparing the medians. Adjusted odd ratios using logistic regression and 95% confidence interval for the risk of mortality were given for each infectious cause.A total of 574 children were included in the study. Five hundred twenty-one (90.8%) children were cured, 10 (1.7%) had discontinued treatment and 43 (7.5%) had died. The median length of stay was 19 (13-26) days and the median daily weight gain was 7 (3-13) g/kg/j. There was a statistically significant association between mortality and sepsis/septic shock (p = 0.0004), meningitis (p = 0.00001) and HIV infection (p = 0.02).A better management of acute malnutrition in our region should be based on the establishment of specialized and well equipped units for the treatment of malnutrition associated with severe infections.

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