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Tshongo C, Baguma M, Mateso G, Makali SL, Bedha A, Mwene‐Batu P, Mihigo M, Nzabara F, Balola C, Kabuya P, Bapolisi A, Masimango MI, Bahizire E, Maheshe‐Balemba G, Shindano TA, Cirhuza C. Hyperglycemia and elevated C-reactive protein are independent predictors of hospital mortality in hospitalized COVID-19 patients in South-Kivu, eastern Democratic Republic of the Congo: A cross-sectional study. Health Sci Rep 2024; 7:e1803. [PMID: 38213779 PMCID: PMC10782469 DOI: 10.1002/hsr2.1803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/29/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024] Open
Abstract
Background and Aim The coronavirus disease 2019 (COVID-19) pandemic was a priority public health problem because of its high mortality rate. This study mainly aimed to determine factors associated with a poor outcome in COVID-19 hospitalized patients in South-Kivu, an eastern province of the Democratic Republic of the Congo (DRC). Methods This observational study retrospectively evaluated medical records of patients consecutively admitted for probable or confirmed COVID-19 between May 01 and July 31, 2020 at the Hôpital Provincial Général de Référence de Bukavu (HPGRB), a tertiary hospital located in South-Kivu. A binary logistic regression model was performed to determine the predictors of mortality. Results A total of 157 hospitalized COVID-19 patients aged 57.7 (13.2) years were included in this study. Male gender (69.4%), older age (52.9%), medical history of diabetes (38.2%), and arterial hypertension (35.1%) were the most frequent risk factors. Most patients presented with fever (73.3%), cough (72.6%), and dyspnea (66.2%). Overall, 45.1% of patients died. Intrahospital mortality was significantly associated with advanced age [odds ratio, OR (95% confidence interval, CI) = 2.34 (1.06-5.38)], hypoxemia [OR (95% CI) = 4.67 (2.02-10.77)], hyperglycemia [OR (95% CI) = 2.14 (1.06-4.31)], kidney failure [OR (95% CI) = 2.82 (1.4-5.68)], hyperleukocytosis [OR (95% CI) = 3.33 (1.67-6.66)], and higher C-reactive protein (CRP) levels [OR (95% CI) = 3.93 (1.93-8.01)]. After adjustment for various covariates, only higher CRP levels [OR (95% CI) = 3.23 (1.23-8.5)] and hyperglycemia [OR (95% CI) = 2.5 (1.02-6.11)] at admission were independently associated with mortality. Conclusion Hyperglycemia and marked inflammatory syndrome were the major predictors of poor outcomes in patients hospitalized for COVID-19 in South-Kivu. These two factors should be quantified at hospital admission to establish the patient's prognosis.
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Affiliation(s)
- Christian Tshongo
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Marius Baguma
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Guy‐Quesney Mateso
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Samuel Lwamushi Makali
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Aline Bedha
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pacifique Mwene‐Batu
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Martine Mihigo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Fabrice Nzabara
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Cordule Balola
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Pierre Kabuya
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Achille Bapolisi
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Mannix I. Masimango
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
| | - Esto Bahizire
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Ghislain Maheshe‐Balemba
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- École Régionale de Santé PubliqueUniversité Catholique de BukavuBukavuDemocratic Republic of the Congo
| | - Tony A. Shindano
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
| | - Cikomola Cirhuza
- Faculty of MedicineUniversité Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
- Department of Internal MedicineHôpital Provincial Général de Référence de Bukavu (HPGRB)BukavuDemocratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH)Université Catholique de Bukavu (UCB)BukavuDemocratic Republic of the Congo
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Balola C, Nzabara F, Tshongo Muhindo C, Cikomola C, Maheshe GB, Baguma M. Epilepsia partialis continua associated with ketotic hyperglycemia and tuberculous meningoencephalitis: A case report. Clin Case Rep 2022; 10:e05460. [PMID: 35223017 PMCID: PMC8847411 DOI: 10.1002/ccr3.5460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/29/2022] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Cordule Balola
- Neurology Ward Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo
| | - Fabrice Nzabara
- Radiology Ward Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo
| | - Christian Tshongo Muhindo
- Diabetology and Endocrinology Ward Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo
- Faculty of Medicine Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo
| | - Cirhuza Cikomola
- Diabetology and Endocrinology Ward Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo
- Faculty of Medicine Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH) Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo
| | - Ghislain Balemba Maheshe
- Radiology Ward Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo
- Faculty of Medicine Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo
| | - Marius Baguma
- Neurology Ward Department of Internal Medicine Hôpital Provincial Général de Référence de Bukavu (HPGRB) Bukavu Democratic Republic of the Congo
- Faculty of Medicine Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo
- Center for Tropical Diseases and Global Health (CTDGH) Université Catholique de Bukavu (UCB) Bukavu Democratic Republic of the Congo
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Baguma M, Nzabara F, Maheshe Balemba G, Malembaka EB, Migabo C, Mudumbi G, Bito V, Cliff J, Rigo JM, Chabwine JN. Konzo risk factors, determinants and etiopathogenesis: What is new? A systematic review. Neurotoxicology 2021; 85:54-67. [PMID: 33964344 DOI: 10.1016/j.neuro.2021.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/01/2021] [Accepted: 05/03/2021] [Indexed: 12/13/2022]
Abstract
Konzo is a toxico-nutritional upper motor neuron disease causing a spastic paraparesis in schoolchildren and childbearing women in some African countries. Almost a century since the first description of konzo, its underlying etiopathogenic mechanisms and causative agent remain unknown. This paper aims at refreshing the current knowledge of konzo determinants and pathogenesis in order to enlighten potential new research and management perspectives. Literature research was performed in PubMed and Web of Science databases according to the PRISMA methodology. Available data show that cassava-derived cyanide poisoning and protein malnutrition constitute two well-documented risk factors of konzo. However, observational studies have failed to demonstrate the causal relationship between konzo and cyanide poisoning. Thiocyanate, the current marker of choice of cyanide exposure, may underestimate the actual level of cyanide poisoning in konzo patients as a larger amount of cyanide is detoxified via other unusual pathways in the context of protein malnutrition characterizing these patients. Furthermore, the appearance of konzo may be the consequence of the interplay of several factors including cyanide metabolites, nutritional deficiencies, psycho-emotional and geo-environmental factors, resulting in pathophysiologic phenomena such as excitotoxicity or oxidative stress, responsible for neuronal damage that takes place at sparse cellular and/or subcellular levels.
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Affiliation(s)
- Marius Baguma
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo; Biomedical Research Institute (BIOMED), UHasselt - Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium.
| | - Fabrice Nzabara
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo; École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Ghislain Maheshe Balemba
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Espoir Bwenge Malembaka
- École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Christiane Migabo
- Faculty of Agronomy, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo; Department of Geography and Environmental Studies, College of Social Sciences and Humanities, Jimma University, Jimma, Ethiopia
| | - Germain Mudumbi
- Department of Pediatrics, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Virginie Bito
- Biomedical Research Institute (BIOMED), UHasselt - Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium
| | - Julie Cliff
- Faculty of Medicine, Department of Community Health, Eduardo Mondlane University, Maputo, Mozambique
| | - Jean-Michel Rigo
- Biomedical Research Institute (BIOMED), UHasselt - Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium
| | - Joëlle Nsimire Chabwine
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo; Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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Mateso GQ, Baguma M, Mwene-Batu P, Balemba GM, Nzabara F, Makali S, Bedha A, Furaha B, Minani J, Muhindo CT, Malembaka EB, Masimango MI, Shindano TA, Cikomola JC, Mubagwa K. Atypical respiratory distress in eastern Democratic Republic of the Congo prior to the COVID-19 pandemic. A case report. Trop Dis Travel Med Vaccines 2021; 7:9. [PMID: 33823942 PMCID: PMC8022307 DOI: 10.1186/s40794-021-00134-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/23/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Predictions have been made that Africa would be the most vulnerable continent to the novel Coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to have been delayed and initially slower than in many parts of the world. Here we report on two cases of respiratory distress in our region before the official declaration of the disease in December 2019, cases which in the present times would be suspect of COVID-19. CASE PRESENTATION These two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia were seen in Bukavu, in Eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-ray series of the first patient showed lesions (reticulations, ground glass, and nodules ≤6 mm) similar to those currently found in COVID-19 patients. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death. CONCLUSION These cases bring to the attention the fact that COVID-19-like syndromes may have already been present in the region months before the official beginning of the pandemic. This also brings to question whether a prior presence of the disease or infections with related virus may account for the delayed and less extensive development of the pandemic in the region.
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Affiliation(s)
- Guy-Quesney Mateso
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo
| | - Marius Baguma
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo. .,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.
| | - Pacifique Mwene-Batu
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Ghislain Maheshe Balemba
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Fabrice Nzabara
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Samuel Makali
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Aline Bedha
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Bonheur Furaha
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo
| | - Jimmy Minani
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo
| | - Christian Tshongo Muhindo
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Espoir Bwenge Malembaka
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo.,École Régionale de Santé Publique (ERSP), Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Mannix Imani Masimango
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Tony Akilimali Shindano
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Justin Cirhuza Cikomola
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB), Bukavu, Democratic Republic of the Congo.,Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
| | - Kanigula Mubagwa
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu, Democratic Republic of the Congo
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