Center Hospitalier Monkole

Kinshasa, Democratic Republic of the Congo

Center Hospitalier Monkole

Kinshasa, Democratic Republic of the Congo

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PubMed | University of Rome La Sapienza, University of Udine, University of Trieste, Biomedical University of Rome and 5 Hospital Divina Providencia
Type: Journal Article | Journal: American journal of respiratory and critical care medicine | Year: 2016

Despite the high burden of respiratory disease, no spirometry reference values for African children are available.Investigate whether the Global Lung Initiative (GLI-2012) reference values for spirometry are appropriate for children in sub-Saharan Africa and assess the impact of malnutrition on lung function.Anthropometry and spirometry were obtained in children aged 6 to 12 years from urban and semiurban schools in three African countries. Spirometry z-scores were derived using the GLI-2012 prediction equations for African Americans. Thinness (body mass index z-score<-2) was a surrogate for malnutrition. Spirometry outcomes were compared with those of African American children from the third National Health and Nutrition Survey.Spirometry data were analyzed from 1,082 schoolchildren (51% boys) aged 6.0 to 12.8 years in Angola (n=306), Democratic Republic of the Congo (n=377), and Madagascar (n=399). GLI-2012 provided a good fit with mean (SD) z-scores of -0.11 (0.83) for FEVThe results of this study support the use of GLI-2012 reference values for schoolchildren in sub-Saharan Africa. Malnutrition affects body growth, leading to a proportionately smaller FEV


Amisi C.,Center Hospitalier Monkole | Mputu L.,Cliniques Universitaires Of Kinshasa | Mboloko E.,Cliniques Universitaires Of Kinshasa | Bieleli E.,Cliniques Universitaires Of Kinshasa | Pozzili P.,Biomedical University of Rome
Gynecologie Obstetrique Fertilite | Year: 2013

Objectives Metabolic features of polycystic ovary syndrome (PCOS) have been poorly investigated in African women where environmental factors are different from those occurring in developed countries. This study aimed to determine the frequency and features of insulin resistance (IR) in Congolese women affected by polycystic ovary syndrome (PCOS). Patients and methods This was a case-control study conducted in women received in three hospital institutions in Kinshasa from 2006-2007. Blood samples were taken to measure HDL and LDL cholesterol, triglycerides, fasting insulin and glucose levels, and the homeostatic model (HOMA-IR) was used to assess IR under basal conditions. Results Fifty-five Congolese women with PCOS and forty-four normal women (mean age 24 ± 6.8 years) were included in the study. Although body mass index was not statistically different between PCOS and control women, IR evaluated by the HOMA-IR was detected in 39.3% of PCOS women. Fasting insulin level was the most significant determinant of IR in the Congolese women with PCOS (OR 2.134 [1.360-3.348]; P < 0.001). Conclusions Nearly one in two women from Congo affected by PCOS is IR and this feature is independent of overweight and central fat distribution. HOMA-IR is the most suitable index than the clinical parameters for detecting IR in these women.


Tshilolo L.,Center Hospitalier Monkole | Summa V.,Biomedical University of Rome | Gregorj C.,Biomedical University of Rome | Kinsiama C.,Center Hospitalier Monkole | And 3 more authors.
Anemia | Year: 2012

High HbF levels and F cells are correlated with reduced morbidity and mortality in sickle cell disease (SCD). This paper was designed to determine the HbF and F cells levels in Congolese sickle cell anemia (SCA) patients in order to determine their impact on the expression of SCD. Population and Method. HbF levels were measured in 89 SCA patients (mean age 11.4 yrs) using a standard HPLC method. F cell quantitation was done in a second group of SCA patients (n = 42, mean age 8.9 yrs) and compared with a control group (n = 47, mean age 5 yrs). F cells were quantified by a cytofluorometric system (MoAb-HbF - FITC; cut off at 0.5%). Results. The mean value of HbF was 7.2% ± 5.0 with heterogeneous distribution, most patients (76%) having HbF < 8%. Mean values of F-cells in SCA patients and control group were 5.4% ± 7.6 (median: 2.19%; range 0,0-30,3%) and 0.5% ± 1.6 (median 0.0, range 0-5.18), respectively. SCA patients with F cells >4.5% developed less painful crisis and had higher percentage of reticulocytes. Conclusion. Congolese SCA patients displayed low levels of HbF and F-cells that contribute to the severity of SCD. © 2012 L. Tshilolo et al.


Kaba M.,Jean Moulin University Lyon 3 | Colson P.,Jean Moulin University Lyon 3 | Musongela J.-P.,Programme National de lHygiene aux Frontieres PNHF | Tshilolo L.,Center Hospitalier Monkole | And 2 more authors.
Infection, Genetics and Evolution | Year: 2010

Autochthonous hepatitis E is an emerging disease in industrialized countries where a growing body of data indicates that pigs represent a reservoir for hepatitis E virus (HEV) of genotype 3 or 4. In Africa, only HEV genotypes 1 and 2 have been identified in hepatitis E outbreaks as well as in sporadic cases. We aimed to investigate whether commercial pigs in sub-Saharan Africa might represent an HEV reservoir using molecular assays. Faecal samples from 40 pigs of the Pietrain race housed in a farm in Kinshasa (Democratic Republic of the Congo) were tested using in-house real-time reverse transcription (RT)-PCR and sequencing assays. HEV RNA was detected in faeces of one (2.5%) pig, and the HEV sequence obtained from this pig was classified genotype 3c, and was genetically related to human HEV sequences from France (89-92% nucleotide similarity) and pig HEV sequences from The Netherlands (88-91% nucleotide similarity). Epidemiological investigations revealed that Kinshasa farm pigs tested in the present study are descendants of pigs imported from Belgium in 2002, suggesting that pig HEV genotype 3c recovered in our study may have been imported from Belgium to Democratic Republic of the Congo. Our findings, although needing to be confirmed in further studies, also suggest that pigs in sub-Saharan Africa may be an HEV reservoir. © 2009 Elsevier B.V. All rights reserved.


McGann P.T.,Cincinnati Childrens Hospital Medical Center | Tshilolo L.,Center Hospitalier Monkole | Santos B.,Hospital Pediatrico David Bernardino | Tomlinson G.A.,University of Toronto | And 9 more authors.
Pediatric Blood and Cancer | Year: 2016

Background: Sickle cell anemia (SCA) is an inherited hematological disorder that causes a large but neglected global health burden, particularly in Africa. Hydroxyurea represents the only available disease-modifying therapy for SCA, and has proven safety and efficacy in high-resource countries. In sub-Saharan Africa, there is minimal use of hydroxyurea, due to lack of data, absence of evidence-based guidelines, and inexperience among healthcare providers. Procedure: A partnership was established between investigators in North America and sub-Saharan Africa, to develop a prospective multicenter research protocol designed to provide data on the safety, feasibility, and benefits of hydroxyurea for children with SCA. Results: The Realizing Effectiveness Across Continents with Hydroxyurea (REACH, ClinicalTrials.gov NCT01966731) trial is a prospective, phase I/II open-label dose escalation study of hydroxyurea that will treat a total of 600 children age 1-10 years with SCA: 150 at each of four different clinical sites within sub-Saharan Africa (Angola, Democratic Republic of Congo, Kenya, and Uganda). The primary study endpoint will be severe hematological toxicities that occur during the fixed-dose treatment phase. REACH has an adaptive statistical design that allows for careful assessment of toxicities to accurately identify a safe hydroxyurea dose. Conclusions: REACH will provide data that address critical gaps in knowledge for the treatment of SCA in sub-Saharan Africa. By developing local expertise with the use of hydroxyurea and helping to establish treatment guidelines, the REACH trial results will have the potential to transform care for children with SCA in Africa. © 2015 Wiley Periodicals, Inc.


Musumari P.M.,Kyoto University | Wouters E.,University of Antwerp | Kayembe P.K.,University of Kinshasa | Nzita M.K.,University of Kinshasa | And 8 more authors.
PLoS ONE | Year: 2014

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. Copyright: © 2014 Musumari et al.


PubMed | Hospital Pediatrico David Bernardino, The Hospital for Sick Children, Center Hospitalier Monkole, Cincinnati Childrens Hospital Medical Center and 5 more.
Type: Journal Article | Journal: Pediatric blood & cancer | Year: 2015

Sickle cell anemia (SCA) is an inherited hematological disorder that causes a large but neglected global health burden, particularly in Africa. Hydroxyurea represents the only available disease-modifying therapy for SCA, and has proven safety and efficacy in high-resource countries. In sub-Saharan Africa, there is minimal use of hydroxyurea, due to lack of data, absence of evidence-based guidelines, and inexperience among healthcare providers.A partnership was established between investigators in North America and sub-Saharan Africa, to develop a prospective multicenter research protocol designed to provide data on the safety, feasibility, and benefits of hydroxyurea for children with SCA.The Realizing Effectiveness Across Continents with Hydroxyurea (REACH, ClinicalTrials.gov NCT01966731) trial is a prospective, phase I/II open-label dose escalation study of hydroxyurea that will treat a total of 600 children age 1-10 years with SCA: 150 at each of four different clinical sites within sub-Saharan Africa (Angola, Democratic Republic of Congo, Kenya, and Uganda). The primary study endpoint will be severe hematological toxicities that occur during the fixed-dose treatment phase. REACH has an adaptive statistical design that allows for careful assessment of toxicities to accurately identify a safe hydroxyurea dose.REACH will provide data that address critical gaps in knowledge for the treatment of SCA in sub-Saharan Africa. By developing local expertise with the use of hydroxyurea and helping to establish treatment guidelines, the REACH trial results will have the potential to transform care for children with SCA in Africa.


PubMed | Center hospitalier Monkole
Type: Journal Article | Journal: Gynecologie, obstetrique & fertilite | Year: 2013

Metabolic features of polycystic ovary syndrome (PCOS) have been poorly investigated in African women where environmental factors are different from those occurring in developed countries. This study aimed to determine the frequency and features of insulin resistance (IR) in Congolese women affected by polycystic ovary syndrome (PCOS).This was a case-control study conducted in women received in three hospital institutions in Kinshasa from 2006-2007. Blood samples were taken to measure HDL and LDL cholesterol, triglycerides, fasting insulin and glucose levels, and the homeostatic model (HOMA-IR) was used to assess IR under basal conditions.Fifty-five Congolese women with PCOS and forty-four normal women (mean age 24 6.8 years) were included in the study. Although body mass index was not statistically different between PCOS and control women, IR evaluated by the HOMA-IR was detected in 39.3% of PCOS women. Fasting insulin level was the most significant determinant of IR in the Congolese women with PCOS (OR 2.134 [1.360-3.348]; P<0.001).Nearly one in two women from Congo affected by PCOS is IR and this feature is independent of overweight and central fat distribution. HOMA-IR is the most suitable index than the clinical parameters for detecting IR in these women.


High HbF levels and F cells are correlated with reduced morbidity and mortality in sickle cell disease (SCD). This paper was designed to determine the HbF and F cells levels in Congolese sickle cell anemia (SCA) patients in order to determine their impact on the expression of SCD. Population and Method. HbF levels were measured in 89 SCA patients (mean age 11.4 yrs) using a standard HPLC method. F cell quantitation was done in a second group of SCA patients (n = 42, mean age 8.9 yrs) and compared with a control group (n = 47, mean age 5 yrs). F cells were quantified by a cytofluorometric system (MoAb-HbF-FITC; cut off at 0.5%). Results. The mean value of HbF was 7.2%5.0 with heterogeneous distribution, most patients (76%) having HbF <8%. Mean values of F-cells in SCA patients and control group were 5.4%7.6 (median: 2.19%; range 0,0-30,3%) and 0.5%1.6 (median 0.0, range 0-5.18), respectively. SCA patients with F cells >4.5% developed less painful crisis and had higher percentage of reticulocytes. Conclusion. Congolese SCA patients displayed low levels of HbF and F-cells that contribute to the severity of SCD.

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