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BackgroundLoiasis (Loa loa filariasis) is considered a benign disease and is currently not included in the World Health Organization’s (WHO's) list of Neglected Tropical Diseases, despite mounting evidence suggesting significant disease burden in endemic areas. We conducted a retrospective cohort study to assess the mortality associated with L. loa microfilaremia in the Southwestern Republic of Congo.MethodsThe cohort included 3329 individuals from 53 villages screened for loiasis in 2004. We compared mortality rates in 2021 for individuals initially diagnosed as with or without L. loa microfilariae 17 years earlier. Data were analyzed at the community level to calculate crude mortality rates. Survival models were used to estimate the effect of L. loa microfilaremia on mortality in the population.ResultsAt baseline, prevalence of microfilaremia was 16.2%. During 17.62 years of cohort follow-up, 751 deaths were recorded, representing a crude mortality rate of 15.36 (95% CI, 14.28–16.50) per 1000 person-years. Median survival time was 58.5 (95% CI, 49.7–67.3) years and 39.2 (95% CI, 32.6–45.8) years for amicrofilaremic and microfilaremic indiviudals, respectively.ConclusionsA significant reduction in life expectancy was associated with L. loa microfilaremia, confirming previous observations from Cameroon. This adds to the evidence that loiasis is not a benign disease and deserves to be included in the WHO's list of Neglected Tropical Diseases.

Background: COVID-19 is responsible for high morbidity and mortality. Vaccination is the main response strategy. Vaccination coverage remains low. This study investigated the factors for refusal of COVID-19 vaccination among health sciences students. Methodology: This was an analytical cross-sectional study conducted from July to October 2021. The cluster method was used and the Schwartz formula was used to obtain the minimum sample size. Socio-demographic, socio-cultural and vaccination status variables were collected. Statistical analysis was performed with Epi Info 7.2.2.6 software. The significance level was set at 5% Results: A total of 423 students were included. Vaccination coverage was 12.77%. The rate of students refractory to vaccination was 45.62%. Females were in the majority (54.40% vs 54.60%). The factors associated with refusal of the COVID-19 vaccination in our study were: lack of knowledge of the vaccines available in Congo (ORa=1.601 [1.009-2.539]; p=0.0453), perception of the uselessness of the vaccine (ORa=6.055 [3.646-10.055]; p < 0.0001) and the unavailability of the vaccine the student wishes to receive (ORa=2.652 [1.365-5.152]; p = 0.004). Conclusion: This study reveals low vaccination coverage and almost half of the students were refractory to vaccination against COVID-19. Awareness and involvement of students in health sciences who are public health actors are necessary to improve this vaccination coverage.

BackgroundThe long-term survival of patients on antiretroviral treatment in Congo remains less documented. Our study aimed to analyze the long-term survival of adults living with HIV on ART (Antiretroviral Therapy).MethodsWe conducted a historical cohort study on 2,309 adult PLHIV (People Living with HIV) followed between January 1, 2003 and December 31, 2017 whose viral load and date of initiation of ART were known. The Kaplan Meier method was used to estimate the probability of survival and the Cox regression model to identify factors associated with death.ResultsThe median age was 49 years; the female sex was predominant with 68.56%. The probability of survival at 14 years was 83%, (95% CI (Confidence Interval) [78-87]). On the other hand, when the lost to follow-up died, it was 66% (95% CI [62-70]) in the worst scenario. Stratified cox regression analysis showed that: being male, AHR (Adjusted Hazard Ratio) = 1.65 (95% CI [1.26-2.17]) was significantly associated with death, p-value 1000 copies / ml, AHR = 2.56 (95% CI [1.93-3.40]), be in the advanced WHO clinical stage, in particular: stage II, AHR = 4.07 (95% CI [2.36-7.01]); stage III, AHR = 13.49 (95% CI [8.99-20.27]) and stage IV, AHR = 34.45 (95% CI [23.74-50]) were also significantly associated with death; p-value ConclusionThe long-term survival of PLHIV is worrying despite the offer of ARVs.

Background: Viral load is the key indicator of the effectiveness of antiretroviral treatment in HIV patients. Study aimed to determine antiretroviral treatments failure rates and associated risk factors among HIV-infected adult patients in Congo. Methods: Data from the Congolese AIDS and Epidemics Control Council were combined to create a historical cohort. Patients were followed up between 2003 to 2017. Mixed logistic regression was used to identify treatment failure associated-factors. Intercooled Stata 10 (StataCorp LP, College Station, Texas, USA) software packages was used for analysis. Results: Over 14 years of follow-up, a total of 25,500 visits for 6391 adult patients were reported. Among them, 88% i.e. 22,328 visits (for a total of 6127 patients) were visits with treatment failure. In the multivariate analysis, being aged >26 years, having primary education level, being student, others nationality, unspecifiedmarital status and being worker in informal sector were found associated with a higher risk of treatment failure. Conversely, being pensioners, receiving second line therapeutic protocols and having good adherence to treatment were found significantly associated with a lower risk of treatment failure. Conclusion: Antiretroviral treatments failure among HIV-treated patients is common in Congo. Developing treatment adherence-centered interventions with focus in patients who have low socio-economic status needed to reduced treatments failure. As treatment failure is not only determined by individual factors, psychosocial supports and availability of antiretroviral drugs needs to be taken into account.

Introduction:les avortements clandestins augmentent la morbi-mortalité maternelle en Afrique sub-Saharienne et sont favorisés par les législations restrictives et la faiblesse prévalence contraceptive. A Brazzaville l´automédication par les « médicaments de la rue » semble être un procédé abortif fréquent. L´étude visait à déterminer la proportion des « médicaments de la rue » et le profil sociodémographique des patientes impliquées. Méthodes:nous avons réalisé une étude longitudinale de Juillet à Décembre 2018, 67 patientes admises pour complications d´avortement provoqués ont été recrutées à l´hôpital de Talangaï. Leurs (i) caractéristiques socio démographiques, (ii) obstétricales et (iii) les caractéristiques de l´avortement (procédé, implication du manganguiste, rang et coût de l´avortement) ont été collecltées et analysées avec le logiciel Epi info 7. Nous avons comparé les moyennes avec le test de student, les proportions avec le CHI-2, p était fixé à

En l’absence des mecanismes institutionnels efficaces de redistribution des richesses comme c’est le cas dans la plupart des pays d’Afrique, l’assurance maladie universelle (AMU) se pose en seul veritable rempart de lutte contre la pauvrete et la justice sociale. C’est ainsi que sous l’influence des recommandations des institutions internationales, plusieurs pays s’inscrivent dans cette ligne de financement solidaire des depenses de sante. Cependant, mettre en place et soutenir cette politique implique une definition claire du panier de soins adapte a la fois aux besoins de sante, a la capacite de leur financement et a la participation des populations. Car un panier de soins insolvable hypothequerait la perennite et la viabilite d’une politique d’AMU, consideree comme facteur protecteur de la pauvrete liee aux depenses de sante en Afrique. Ce travail tire son idee des efforts et recherches de pistes que deploie actuellement la Republique du Congo pour parvenir a l’AMU. Il s’agit ici de promouvoir la protection sociale sous l’angle de l’AMU, et d’examiner l’interet de definir le panier de soins, en proposant des aspects methodologiques fondes sur des criteres simples mais pertinents que sont : l’analyse cout-efficacite, la protection financiere, la charge de morbidite, les preferences des citoyens et les valeurs societales. Cet article plaide donc en faveur de la prise en compte de ces criteres qui servent d’elements methodologiques precieux permettant d’etablir un equilibre entre l’offre et la demande des soins de facon durable.

Background: Poor nutrition during a child's early years can have irreversible consequences for their health. The objective of our study was to identify the factors associated with exclusive breastfeeding (EBF) among mothers of children 0 to 6 months in the Talangai Health District (THD). Methods: This was a cross-sectional analytical study carried out from April 17 to July 17, 2018 in the THD. Our study involved 256 mothers of children 0-6 months old in THD Health Facilities (HF). The logistic regression was used to identify factors associated with EBF. Epi Info software version 3.5.4 was used for data entry and the STATA 14 program for data analysis. Results: The average age of the mothers was 27 years old. More than half of the mothers were between 15-25 years old or 53.9%. The majority of mothers were housewives (63.3%) and more than half had a secondary education (60.9%). There was a predominance of separated or divorced mothers, 71.1% and the third rank of the child, 38.3%. The prevalence of exclusive breastfeeding was 36.7%. Being a middle or senior manager was significantly associated with breastfeeding, AOR=2.9 [1.5, 5.3], p-value