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Bakers are at high risk of rhinitis and asthma, but the prevalence of these occupational diseases is not well known in Sub-Saharan Africa. We investigated the prevalence of occupational rhinitis and asthma among industrial bakers in the former province of Katanga. In a cross-sectional study conducted in eight towns from October 2018 to September 2019, we included 276 male workers from 18 industrial bakeries and 113 male controls (35 butchers and 78 bread sellers), all nonsmokers. Participants replied to a validated questionnaire (European Community of Respiratory Health Survey II), administered face to face, and performed spirometry at the work place. In 15 bakers with symptoms of work-related asthma, records of self-measured peak expiratory flow (PEF) 4 times per day during 4 weeks were analyzed by the OASYS (Occupational Asthma System) protocol. The bakers and controls did not differ by age (32.2 ± 7.3 y vs 32.8 ± 10.3 y). According to the questionnaire, work-related rhinitis and asthma were significantly more prevalent among bakers (31% and 5%, respectively) than among controls (2% and 0%, respectively). However, the groups did not differ significantly with regard to spirometric parameters. Based on PEF records, 10 out of 15 were positive for occupational asthma (OASYS score > 2.5), so the rate of occupational asthma was 3.6% in this study. This first study in DR Congo demonstrates the existence of occupational rhinitis and asthma among industrial bakers in Katanga. Further epidemiological studies are needed to clarify the extent and risk factors of baker’s asthma in the area. In the meantime, advocacy and implementation of appropriate occupational hygiene measures are warranted to protect bakery workers in DR Congo.

Bakers are at high risk of rhinitis and asthma, but the prevalence of these occupational diseases is not well known in Sub-Saharan Africa. We investigated the prevalence of occupational rhinitis and asthma among industrial bakers in the former province of Katanga.In a cross-sectional study conducted in eight towns from October 2018 to September 2019, we included 276 male workers from 18 industrial bakeries and 113 male controls (35 butchers and 78 bread sellers), all nonsmokers. Participants replied to a validated questionnaire (European Community of Respiratory Health Survey II), administered face to face, and performed spirometry at the work place. In 15 bakers with symptoms of work-related asthma, records of self-measured peak expiratory flow (PEF) 4 times per day during 4 weeks were analyzed by the OASYS (Occupational Asthma System) protocol.The bakers and controls did not differ by age (32.2 ± 7.3 y vs 32.8 ± 10.3 y). According to the questionnaire, work-related rhinitis and asthma were significantly more prevalent among bakers (31% and 5%, respectively) than among controls (2% and 0%, respectively). However, the groups did not differ significantly with regard to spirometric parameters. Based on PEF records, 10 out of 15 were positive for occupational asthma (OASYS score 2.5), so the rate of occupational asthma was 3.6% in this study.This first study in DR Congo demonstrates the existence of occupational rhinitis and asthma among industrial bakers in Katanga. Further epidemiological studies are needed to clarify the extent and risk factors of baker's asthma in the area. In the meantime, advocacy and implementation of appropriate occupational hygiene measures are warranted to protect bakery workers in DR Congo.

The impact of concurrent exposure to neurotoxic metals is a significant threat to brain function, mostly in contexts of multiple exposures as seen in the developing world. Ninety-five children (46 boys and 49 girls, 6 to 11-year old) from Congo-Kinshasa were assessed for cognition using the Kaufman Assessment Battery for Children (2nd edition) and exposure to Cr, Cu, Zn, Co, Mn, As, Cd, Se, Hg, Fe, and Pb by inductively coupled plasma mass spectrometry (ICPMS) in serum and urine collections. Concentrations of elements were all above normal ranges except for Cd, Se and Hg. General linear mixed effects models were used to predict neurocognitive outcomes with variable selection methods including backward elimination, elastic net, or subsets identified based on subject matter expertise. After adjusting for sex, age, and SES, urinary Co > 5 μg/l was associated with poor simultaneous processing (memory) (p = 0.0237). Higher excretion but normal concentration of Cd in serum was associated with better memory (p = 0.03), planning (p = 0.05), and overall performance scores (p < 0.01); thus appeared to be neuroprotective. However, higher excretion of Zn had negative influence on the overall performance scores (p = 0.02). Predictive neurotoxicology is a challenging task in contexts of multiple and concurrent exposures. Urinary Co > 5 μg/l is a risk factor for poor neurodevelopmental outcomes in such contexts. The impact of heavy metals on cognition is dependent on concentrations of and interactions between toxic and essential elements.

Introduction L’Organisation mondiale de la sante (OMS) estime que des handicaps et deux a trois millions de deces d’enfants par an sont evites dans le monde par la vaccination. En 2019, 14 millions de nourrissons au monde n’avaient pas beneficie de DTC initial. Et 5,7 millions de nourrissons n’etaient que partiellement vaccines. Cet etat concernait 10 pays, dont la Republique Democratique du Congo. Or, la vaccination est declaree par l’OMS comme l’intervention de sante publique la plus efficace pour prevenir la morbidite, les complications et la mortalite dues aux infections chez l’enfant. Pourtant, la couverture vaccinale complete varie selon le contexte. Notre etude avait pour objectif d’identifier les determinants de la couverture vaccinale complete des enfants âges de 12 a 23 mois de l’Aire de sante Agetraf de Lubumbashi. Methodes Par une etude transversale analytique menee en aout 2019, 509 enfants ont ete recrutes. La vaccination complete de l’enfant comprenait : BCG, trois doses de Pentavalent (DTC + HiB, HepB), Polio oral, vaccin anti pneumococcique, vaccin anti poliomyelite injectable, vaccin anti-rougeoleux et vaccin anti-amaril avant l’âge de 12 mois. Des donnees d’autres variables liees au foyer et au centre de sante ont ete collectees. Une regression logistique a ete realisee grâce au logiciel Stata 16.1. Resultats Parmi les 509 sujets enquetes, 369 enfants etaient completement vaccines (72,5 %). Les repondants connaissaient le calendrier ainsi que l’interet de la vaccination a raison de 18,5 % et 90,0 %, respectivement. La principale source d’information pour le rendez-vous de vaccination etait le personnel de sante (86,9 %). Les raisons de non vaccination etaient dominees par l’indisponibilite de la mere (42,4 %) et le manque d’argent (8,3 %). En analyse multivariable, l’enfant de sexe feminin, la mere instruite, la connaissance de l’avantage du vaccin et l’enfant d’un tuteur informe par les agents de sante sur le calendrier vaccinal etaient associes a une vaccination complete des enfants (Tableau I). Conclusion Ces determinants devraient etre integres dans les actions de sante publique. Des mesures visant l’amelioration de l’offre et la demande des soins permettraient de renforcer la completude vaccinale et contribuer a la sante de l’enfant. Tableau 1 : http://extranet.insight-outside.fr/upload/compte1352/Base/inscriptions_projets/image/99863-image.pdf

Introduction La pratique de l’electroneurographie (ENG) est tres rare en clinique neurologique en Republique Democratique du Congo. Pourtant l’exposition aux facteurs de risque de neuropathies peripheriques est courante. Il s’agit notamment du diabete et de l’exposition aux elements traces metalliques (ETM). La co-exposition a ces deux facteurs de risque augmente logiquement le risque de neuropathies peripheriques chez les diabetiques. Ces neuropathies peuvent etre objectivees par des mesures electroneurographiques. Cette etude avait pour objectif d’identifier les caracteristiques de l’ENG chez les patients diabetiques et non diabetiques exposes aux ETM a Lubumbashi. Methodes Une etude cas-temoin a ete menee de septembre 2018 a decembre 2019 aupres de 25 diabetiques et 26 non diabetiques a Lubumbashi dans la province du Haut-Katanga. Les biomarqueurs du diabete, les traces ENG et les concentrations urinaire et sanguine des ETM ont ete mesures puis les associations ont ete estimees par la correlation ou le test de Mann-Whitney. Les traces ENG ont ete collectes grâce a l’appareil Neuro-MEP Micro version 3. Le Laboratoire agree de toxicologie industrielle et pharmacologie applique de l’Universite Catholique de Louvain en Belgique a mesure la concentration des ETM dans les urines et dans le sang. Resultats Les caracteristiques sociodemographiques, excepte l’âge (53,5 ± 10,7 ans pour les diabetiques et 45,5 ± 5,7 ans pour les non diabetiques, p Conclusion Les resultats de cette etude demontrent l’impact negatif de la co-exposition aux elements traces-metalliques et au diabete sur le systeme nerveux peripherique. Et nous recommandons une etude plus elaboree sur l’implication des ETM dans le developpement des neuropathies peripheriques ainsi que la definition des normes locales de l’ENG.

Introduction L’enfant dans la Province du Haut-Katanga est expose aux facteurs de risques des troubles neurocomportementaux et neurocognitifs tels que la malnutrition et l’exposition aux elements-traces metalliques (ETM). Mais ces risques sont encore peu documentes. L’objectif de la presente etude etait de mettre en evidence les effets de l’exposition aux ETM sur le developpement neurocomportemental en lien avec le developpement cognitif chez l’enfant en âge scolaire dans le Haut-Katanga. Methodes Une etude transversale avec un groupe de comparaison a ete menee de mai 2020 a juillet 2020 aupres de 30 enfants, en âge scolaire de 6 a 11 ans, consideres exposes aux ETM et residant dans la ville de Lubumbashi et 22 enfants, du meme âge mais vivant en milieu rural (milieu presume non expose). Les evaluations neuro-somatique, nutritionnelle, neuropsychologique avec la batterie de tests NEPSY-II ont ete realises pour tous les enfants. Les dosages sanguins et urinaires des ETM ont ete faits au laboratoire agree de toxicologie industrielle et pharmacologie appliquee de l’universite Catholique de Louvain grâce a l’appui de l’ARES. Les tests de Chi2, Mann–Whitney et la regression lineaire multiple ont ete appliques dans l’analyse statistique. Resultats Les etats nutritionnels etaient degrades chez les enfants vivant en milieu rural (p = 0,002). Les troubles neurocomportementaux observes predominaient en milieu rural, avec 72,7 % contre 36,7 % pour le total des difficultes (p = 0,010). En milieu urbain, la gravite des troubles neurocomportementaux diminuait avec l’âge (r = −0,549 ; p = 0,002 pour le total des difficultes) et augmentait avec le statut nutritionnel staturoponderal (r = 0,455 ; p = 0,011 pour le score d’impact). En milieu rural, la diminution de la gravite des troubles diminuait avec le statut nutritionnel staturoponderal (r = −0,471 ; p = 0,271 pour les troubles de l’hyperactivite). Les performances cognitives dans la reconnaissance des affects par le visage [s = −0,887 ; IC95 % : −1,377 a −0,397, p = 0,001] et le statut nutritionnel de croissance [s = 1,095 0,025 ; IC95 % : −2,044 a −0,146 ; p = 0,025] etaient les determinants independants de la reduction du total des difficultes comportementales. Les elements-traces metalliques significativement associes aux troubles neurocomportementaux etaient, d’une part, le cadmium (p = 0,008), le cobalt (p = 0,019), le mercure (p = 0,008) et le plomb (p = 0,007) dans le sang, et d’autre part, l’alumimium (p = 0,049), le selenium (p = 0,024), le cobalt (p = 0,026), le titane (p = 0,011) le cuivre (p = 0,024), le molybdene (p = 0,005), le chrome (p = 0,023) dans les urines. Les taux sanguins de plomb etaient le determinant de l’augmentation de l’impact des difficultes comportementales (s = 0,232, IC95 % : 0,096–0,367 ; p = 0,001). Conclusion Dans cette etude, l’association des troubles neurocomportementaux chez l’enfant en âge scolaire aux troubles nutritionnels, aux performances cognitives et aux taux sanguins et urinaires des metaux avec des variations liees au milieu, indiquent que ces troubles ont une origine multfactorielle dont la malnutrition et l’exposition aux ETM.

Background The prevalence of HIV-serodiscordant couples is increasing. In these couples, one member is infected with HIV and the other one is not, so HIV testing for both members of the couple remains one of the significant challenges in the prevention of sexual transmission of HIV within the couple. The aim of this study was to analyze couples’ attitudes toward HIV testing after prenatal HIV testing offered to pregnant women and analyze the males’ behavior with regard to their own HIV testing. Methods One hundred and forty-three pregnant women and their partners were interviewed in the Lubumbashi health district in the Democratic Republic of the Congo. The usual descriptive statistics were applied. Results Seventy-one percent of the couples declared that they accepted the HIV testing proposed to the woman and approximately 64% of the couples said they had discussed the HIV testing proposed in prenatal healthcare clinics. However, this dialogue seemed to have a poor impact on the HIV testing of the male partner: no male partner was tested in spite of the high proportion of men encouraged to do so. Nearly 30% and 50% of the couples disagreed on systematic condom use and the need for the husband's permission to undergo HIV testing, respectively. Twenty-nine percent of the couples did not wish to have the male sexual partner present at the prenatal consultation. Conclusion The majority of men considered that their wife's HIV testing gives them information about their own HIV status and this makes HIV testing difficult for both members of the couple. Better management of the couple in HIV screening and prevention programs therefore seems necessary.

Background HIV-1 testing and counselling are essential activities that must be integrated into mother-to-child HIV transmission prevention programs (PMTCT) in order to identify women who can benefit from the treatment, immediately or later and from interventions that can prevent HIV in their infants. The aim of this study was to describe how women's attitudes influence acceptance of HIV-1 testing in the context of antenatal care. Methods Four hundred and thirty-nine women attending antenatal care clinics offering HIV-1 testing in the health district of Lubumbashi in Democratic Republic of Congo were included in the study. Data were collected through interviewer-administered questionnaire. Women were asked to give their consent for a home visit and interview of their partners; 143 agreed to participate. Statistical analyses were carried out using Chi-square test and logistic regression. Results The proportion of pregnant women who declared that they would accept HIV testing was 76.5%. Non-married women (p = 0.046), women who had never carried out a former HIV test (p Conclusion Improving counselling and a policy of HIV counselling and testing integrating a couple components could help to overcome obstacles to the integration of the women within PMTCT programs and help improve acceptance of HIV testing.

Introduction:l'onchocercose constitue un problème majeur de santé publique et l'on a noté environ 13 millions de personnes affectées et 26 millions exposées au cours de l'année 2012 en RDC. L'objectif de notre étude est fournir les données sur le niveau de connaissance, d'attitudes et des pratiques de la communauté huit ans après le lancement de la distribution de l'ivermectine sous directives communautaires. Méthodes:il s'agit d'une étude descriptive transversale dans la communauté de l'aire de santé SAMBWA de la zone de santé de KAFUBU. La population cible de l'étude est toute personne de la communauté âgée de 15 à 65 ans. Les paramètres étudiés sont: âge, niveau d'instruction, connaissance de la maladie en langue locale et des signes, attitudes devant les personnes atteintes, perception de la maladie, utilisation des pratiques traditionnelles, association entre le niveau d'instruction et la connaissance de savoir si l'on peut suivre un traitement. Résultats:la moyenne d'âge des répondants était de 38±14 ans et 67,54% des enquêtés étaient de niveau primaire. L'étude a montré que 99,53 % des répondants connaissaient le terme onchocercose en langue locale (UBUMFUKU) et un niveau moyen de connaissance en ce qui concerne les lésions de la peau (66,9%) était noté. 1,9% des répondants craignaient les personnes atteintes et 42,2% des répondants percevaient l'onchocercose comme une maladie. Une proportion de 55% qui prenaient les plantes comme médicament. Il y avait association significative entre le niveau d'instruction et la connaissance de suivre un traitement contre l'onchocercose (p: 0,008). Conclusion:ces résultats interpellent en ce qui concerne la sensibilisation de la communauté sur l'onchocercose. Les stratégies de lutte contre l'onchocercose devraient prendre en compte ces différentes insuffisances de la communauté pour améliorer le traitement des masses par l'ivermectine tant au niveau du ménage que des coordinations de programme de lutte.

HIV-1 testing and counselling are essential activities that must be integrated into mother-to-child HIV transmission prevention programs (PMTCT) in order to identify women who can benefit from the treatment, immediately or later and from interventions that can prevent HIV in their infants. The aim of this study was to describe how women's attitudes influence acceptance of HIV-1 testing in the context of antenatal care.Four hundred and thirty-nine women attending antenatal care clinics offering HIV-1 testing in the health district of Lubumbashi in Democratic Republic of Congo were included in the study. Data were collected through interviewer-administered questionnaire. Women were asked to give their consent for a home visit and interview of their partners; 143 agreed to participate. Statistical analyses were carried out using Chi-square test and logistic regression.The proportion of pregnant women who declared that they would accept HIV testing was 76.5%. Non-married women (p=0.046), women who had never carried out a former HIV test (p0.001), who had mentioned that they would wish to share the results of the test with their partner or would wish to be accompanied at least once by their partner at the antenatal clinic (p0.001), those whose partner agreed to participate in the study (p=0.010) and those who knew at least one mode of HIV transmission (p=0.025) were more likely to accept the HIV testing.Improving counselling and a policy of HIV counselling and testing integrating a couple components could help to overcome obstacles to the integration of the women within PMTCT programs and help improve acceptance of HIV testing.