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Taty N, Bompangue D, Moore S, Muyembe JJ, de Richemond NM. Spatiotemporal dynamics of cholera hotspots in the Democratic Republic of the Congo from 1973 to 2022. BMC Infect Dis 2024; 24:360. [PMID: 38549076 PMCID: PMC10976723 DOI: 10.1186/s12879-024-09164-9] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/22/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Since the early 1970s, cholera outbreaks have been a major public health burden in the Democratic Republic of Congo (DRC). Cholera cases have been reported in a quasi-continuous manner in certain lakeside areas in the Great Lakes Region. As these cholera-endemic health zones constitute a starting point for outbreaks and diffusion towards other at-risk areas, they play a major role in cholera dynamics in the country. Monitoring the spatiotemporal dynamics of cholera hotspots and adjusting interventions accordingly thus reduces the disease burden in an efficient and cost-effective manner. METHODS A literature review was conducted to describe the spatiotemporal dynamics of cholera in the DRC at the province level from 1973 to 1999. We then identified and classified cholera hotspots at the provincial and health zone levels from 2003 to 2022 and described the spatiotemporal evolution of hotspots. We also applied and compared three different classification methods to ensure that cholera hotspots are identified and classified according to the DRC context. RESULTS According to all three methods, high-priority hotspots were concentrated in the eastern Great Lakes Region. Overall, hotspots largely remained unchanged over the course of the study period, although slight improvements were observed in some eastern hotspots, while other non-endemic areas in the west experienced an increase in cholera outbreaks. The Global Task Force on Cholera Control (GTFCC) and the Department of Ecology and Infectious Disease Control (DEIDC) methods largely yielded similar results for the high-risk hotspots. However, the medium-priority hotspots identified by the GTFCC method were further sub-classified by the DEIDC method, thereby providing a more detailed ranking for priority targeting. CONCLUSIONS Overall, the findings of this comprehensive study shed light on the dynamics of cholera hotspots in the DRC from 1973 to 2022. These results may serve as an evidence-based foundation for public health officials and policymakers to improve the implementation of the Multisectoral Cholera Elimination Plan, guiding targeted interventions and resource allocation to mitigate the impact of cholera in vulnerable communities.
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Affiliation(s)
- Nadège Taty
- Department of Infectious Disease Ecology and Control, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
- Montpellier Geography and Spatial Planning Laboratory, Paul Valéry Montpellier 3 University, Montpellier, France.
- National Program for the Elimination of Cholera and the Fight against Other Diarrheal Diseases, Ministry of Health, Hygiene and Prevention, Kinshasa, Democratic Republic of the Congo.
| | - Didier Bompangue
- Department of Infectious Disease Ecology and Control, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
- National Program for the Elimination of Cholera and the Fight against Other Diarrheal Diseases, Ministry of Health, Hygiene and Prevention, Kinshasa, Democratic Republic of the Congo
- Chrono-Environment Laboratory, UMR 6249, University of Bourgogne Franche-Comté, Besançon, France
| | | | - J J Muyembe
- National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Nancy Meschinet de Richemond
- Montpellier Geography and Spatial Planning Laboratory, Paul Valéry Montpellier 3 University, Montpellier, France
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Wood R, Tembele W, Hema A, Somé A, Kinganda-Lusamaki E, Basilubo C, Lumembe R, Alama N, Mbunsu G, Zongo A, Ahuka S, Muyembe JJ, Leendertz F, Eckmanns T, Schubert G, Kagoné T, Makiala S, Tomczyk S. Implementation of the WHO core components of an infection prevention and control programme in two sub-saharan African acute health-care facilities: a mixed methods study. Antimicrob Resist Infect Control 2024; 13:4. [PMID: 38221629 PMCID: PMC10789048 DOI: 10.1186/s13756-023-01358-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND The coronavirus pandemic again highlighted the need for robust health care facility infection prevention and control (IPC) programmes. WHO guidelines on the core components (CCs) of IPC programmes provides guidance for facilities, but their implementation can be difficult to achieve in resource-limited settings. We aimed to gather evidence on an initial WHO IPC implementation experience using a mixed methods approach. METHODS A five-day training on the WHO IPC CCs was conducted at two reference acute health care facilities in the Democratic Republic of Congo and Burkina Faso. This was accompanied by a three-part mixed-methods evaluation consisting of a: (1) baseline and follow-up survey of participants' knowledge, attitudes and practices (KAP), (2) qualitative assessment of plenary discussion transcripts and (3) deployment of the WHO IPC assessment framework (IPCAF) tool. Results were analysed descriptively and with a qualitative inductive thematic approach. RESULTS Twenty-two and twenty-four participants were trained at each facility, respectively. Baseline and follow-up KAP results suggested increases in knowledge related to the necessity of a dedicated IPC focal person and annual evaluations of IPC training although lack of recognition on the importance of including hospital leadership in IPC training and hand hygiene monitoring recommendations remained. Most participants reported rarely attending IPC meetings or participating in IPC action planning although attitudes shifted towards stronger agreement with the feeling of IPC responsibility and importance of an IPC team. A reocurring theme in plenary discussions was related to limited resources as a barrier to IPC implementation, namely lack of reliable water access. However, participants recognised the importance of IPC improvement efforts such as practical IPC training methods or the use of data to improve quality of care. The facilities' IPCAF scores reflected a 'basic/intermediate' IPC implementation level. CONCLUSIONS The training and mixed methods evaluation revealed initial IPC implementation experiences that could be used to inform stepwise approaches to facility IPC improvement in resource-limited settings. Implementation strategies should consider both global standards such as the WHO IPC CCs and specific local contexts. The early involvement of all relevant stakeholders and parallel efforts to advocate for sufficient resources and health system infrastructure are critical.
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Affiliation(s)
- R Wood
- Robert Koch Institute, Berlin, Germany.
| | - W Tembele
- School of Public Health in Kinshasa, Hospital Saint Luc of Kisantu, Kisantu, Democratic Republic of Congo
| | - A Hema
- Centre Hospital University Sourou Sanou (CHUSS), Bobo-Dioulasso, Burkina Faso
| | - A Somé
- Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - E Kinganda-Lusamaki
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
- Institute of Developmental Research, University of Montpellier, Montpellier, France
| | - C Basilubo
- Public health and Infection prevention control independent expert consultant, Kinshasa, Democratic Republic of Congo
| | - R Lumembe
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - N Alama
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - G Mbunsu
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - A Zongo
- Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - S Ahuka
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - J J Muyembe
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - F Leendertz
- Robert Koch Institute, Berlin, Germany
- Helmholtz Institute for One Health, Greifswald, Germany
| | | | | | - T Kagoné
- Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - S Makiala
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
- Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - S Tomczyk
- Robert Koch Institute, Berlin, Germany
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Makuntima NT, Bompangue D, Moore S, de Richemond NM, Vandevelde T, Mwamba D, Colwell R, Muyembe JJ. Cholera resurgence potentially induced by the consequences of climate in the El Niño phenomenon: an urgent call for strengthened cholera elimination in Africa. Pan Afr Med J 2023; 46:96. [PMID: 38405090 PMCID: PMC10891368 DOI: 10.11604/pamj.2023.46.96.42258] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 02/27/2024] Open
Abstract
A resurgence in cholera cases has been observed throughout Africa during the first half of 2023. Among the many factors that drive cholera transmission, the ongoing climate phenomenon El Niño is likely to continue until March to May 2024. To prevent further cholera spread, it is critical to strengthen cholera control efforts in Africa.
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Affiliation(s)
- Nadège Taty Makuntima
- Service d'Ecologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, République démocratique du Congo
- Laboratoire de Géographie et d´Aménagement de l´Espace de Montpellier, Université Paul Valéry Montpellier 3, France
- Programme National d´Elimination du Choléra et de Lutte Contre les Autres Maladies Diarrhéiques, Ministère de la Santé, Hygiène et Prévention, République démocratique du Congo
| | - Didier Bompangue
- Service d'Ecologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, République démocratique du Congo
- Programme National d´Elimination du Choléra et de Lutte Contre les Autres Maladies Diarrhéiques, Ministère de la Santé, Hygiène et Prévention, République démocratique du Congo
- Laboratory Chrono-Environnement, UMR 6249, University of Bourgogne Franche-Comté, France
| | | | - Nancy Meschinet de Richemond
- Laboratoire de Géographie et d´Aménagement de l´Espace de Montpellier, Université Paul Valéry Montpellier 3, France
| | | | - Dieudonné Mwamba
- Institut National de Santé Publique, Kinshasa, République démocratique du Congo
| | - Rita Colwell
- Maryland Pathogen Research Institute, University of Maryland, MD, College Park, United States of America
- University of Maryland Institute for Advanced Computer Studies, University of Maryland, College Park, MD, United States of America
- CosmosID Inc, Rockville, MD, United States of America
| | - Jean Jacques Muyembe
- Institut National des Recherches Biomédicales, Kinshasa, République démocratique du Congo
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Taty N, Bompangue D, de Richemond NM, Muyembe JJ. Spatiotemporal dynamics of cholera in the Democratic Republic of the Congo before and during the implementation of the Multisectoral Cholera Elimination Plan: a cross-sectional study from 2000 to 2021. BMC Public Health 2023; 23:1592. [PMID: 37608355 PMCID: PMC10463990 DOI: 10.1186/s12889-023-16449-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 08/03/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The Democratic Republic of the Congo (DRC) implemented the first strategic Multisectoral Cholera Elimination Plan (MCEP) in 2008-2012. Two subsequent MCEPs have since been implemented covering the periods 2013-2017 and 2018-2021. The current study aimed to assess the spatiotemporal dynamics of cholera over the recent 22-year period to determine the impact of the MCEPs on cholera epidemics, establish lessons learned and provide an evidence-based foundation to improve the implementation of the next MCEP (2023-2027). METHODS In this cross-sectional study, secondary weekly epidemiological cholera data covering the 2000-2021 period was extracted from the DRC Ministry of Health surveillance databases. The data series was divided into four periods: pre-MCEP 2003-2007 (pre-MCEP), first MCEP (MCEP-1), second MCEP (MCEP-2) and third MCEP (MCEP-3). For each period, we assessed the overall cholera profiles and seasonal patterns. We analyzed the spatial dynamics and identified cholera risk clusters at the province level. We also assessed the evolution of cholera sanctuary zones identified during each period. RESULTS During the 2000-2021 period, the DRC recorded 520,024 suspected cases and 12,561 deaths. The endemic provinces remain the most affected with more than 75% of cases, five of the six endemic provinces were identified as risk clusters during each MCEP period (North Kivu, South Kivu, Tanganyika, Haut-Lomami and Haut-Katanga). Several health zones were identified as cholera sanctuary zones during the study period: 14 health zones during MCEP-1, 14 health zones during MCEP-2 and 29 health zones during MCEP-3. Over the course of the study period, seasonal cholera patterns remained constant, with one peak during the dry season and one peak during the rainy season. CONCLUSION Despite the implementation of three MCEPs, the cholera context in the DRC remains largely unchanged since the pre-MCEP period. To better orient cholera elimination activities, the method used to classify priority health zones should be optimized by analyzing epidemiological; water, sanitation and hygiene; socio-economic; environmental and health indicators at the local level. Improvements should also be made regarding the implementation of the MCEP, reporting of funded activities and surveillance of cholera cases. Additional studies should aim to identify specific bottlenecks and gaps in the coordination and strategic efforts of cholera elimination interventions at the local, national and international levels.
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Affiliation(s)
- Nadège Taty
- Laboratoire de géographie et d'aménagement de Montpellier, Université Paul Valéry Montpellier 3, Montpellier, France.
- Service d'Ecologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, République démocratique, Congo.
- Programme National d'Elimination du choléra et de lutte contre les autres maladies diarrhéiques, Ministère de la Santé, Hygiène et Prévention, République démocratique, Congo.
| | - Didier Bompangue
- Service d'Ecologie et Contrôle des Maladies Infectieuses, Faculté de Médecine, Université de Kinshasa, République démocratique, Congo
- Programme National d'Elimination du choléra et de lutte contre les autres maladies diarrhéiques, Ministère de la Santé, Hygiène et Prévention, République démocratique, Congo
- Laboratory Chrono-Environnement, UMR 6249, University of Bourgogne Franche-Comté, Besançon, France
| | - Nancy Meschinet de Richemond
- Laboratoire de géographie et d'aménagement de Montpellier, Université Paul Valéry Montpellier 3, Montpellier, France
| | - J J Muyembe
- Institut National des Recherches Biomédicales, Kinshasa, Democratic Republic of the Congo
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Jaspard M, Mulangu S, Juchet S, Serra B, Dicko I, Lang HJ, Baka BM, Komanda GM, Katsavara JM, Kabuni P, Mambu FM, Isnard M, Vanhecke C, Letord A, Dieye I, Patterson-Lomba O, Mbaya OT, Isekusu F, Mangala D, Biampata JL, Kitenge R, Kinda M, Anglaret X, Muyembe JJ, Kojan R, Ezzedine K, Malvy D. Development of the PREDS score to predict in-hospital mortality of patients with Ebola virus disease under advanced supportive care: Results from the EVISTA cohort in the Democratic Republic of the Congo. EClinicalMedicine 2022; 54:101699. [PMID: 36263398 PMCID: PMC9574409 DOI: 10.1016/j.eclinm.2022.101699] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND As mortality remains high for patients with Ebola virus disease (EVD) despite new treatment options, the ability to level up the provided supportive care and to predict the risk of death is of major importance. This analysis of the EVISTA cohort aims to describe advanced supportive care provided to EVD patients in the Democratic Republic of the Congo (DRC) and to develop a simple risk score for predicting in-hospital death, called PREDS. METHODS In this prospective cohort (NCT04815175), patients were recruited during the 10th EVD outbreak in the DRC across three Ebola Treatment Centers (ETCs). Demographic, clinical, biological, virological and treatment data were collected. We evaluated factors known to affect the risk of in-hospital death and applied univariate and multivariate Cox proportional-hazards analyses to derive the risk score in a training dataset. We validated the score in an internal-validation dataset, applying C-statistics as a measure of discrimination. FINDINGS Between August 1st 2018 and December 31th 2019, 711 patients were enrolled in the study. Regarding supportive care, patients received vasopressive drug (n = 111), blood transfusion (n = 101), oxygen therapy (n = 250) and cardio-pulmonary ultrasound (n = 15). Overall, 323 (45%) patients died before day 28. Six independent prognostic factors were identified (ALT, creatinine, modified NEWS2 score, viral load, age and symptom duration). The final score range from 0 to 13 points, with a good concordance (C = 86.24%) and calibration with the Hosmer-Lemeshow test (p = 0.12). INTERPRETATION The implementation of advanced supportive care is possible for EVD patients in emergency settings. PREDS is a simple, accurate tool that could help in orienting early advanced care for at-risk patients after external validation. FUNDING This study was funded by ALIMA.
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Affiliation(s)
- Marie Jaspard
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Sabue Mulangu
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Sylvain Juchet
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Beatrice Serra
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Ibrahim Dicko
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Hans-Joeg Lang
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | | | | | | | - Patricia Kabuni
- Kinshasa University Hospital, Democratic Republic of the Congo
| | - Fabrice Mbika Mambu
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | | | | | - Alexia Letord
- Surgical Intensive Care Unit, Henri Mondor University Hospital, Créteil, France
| | | | | | - Olivier Tshiani Mbaya
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Fiston Isekusu
- Kinshasa University Hospital, Democratic Republic of the Congo
| | | | - Jean Luc Biampata
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Richard Kitenge
- Ministry of Health, National Emergency and Humanitarian Action Program, Democratic Republic of the Congo
| | - Moumouni Kinda
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Xavier Anglaret
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
| | - Jean Jacques Muyembe
- National Biomedical Research Institute (INRB), Kinshasa, Democratic Republic of the Congo
| | - Richard Kojan
- Alliance for International Medical Action (ALIMA), Dakar, Senegal
| | - Khaled Ezzedine
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
- Department of Dermatology, AP-HP, Henri Mondor University Hospital, Créteil, France and Université Paris Est (UPEC), EpiDermE research unit, Paris, France
| | - Denis Malvy
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France
- Department of Infectious Diseases and Tropical Medicine, Tropical Medicine and Clinical International Health Unit, Hôpital Pellegrin Bordeaux University Hospital, Bordeaux, France
- Corresponding author at: Department of Infectious Diseases and Tropical Medicine, Tropical Medicine and Clinical International Health Unit, Hôpital Pellegrin Bordeaux University Hospital, Bordeaux, France.
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Ditekemena JD, Mavoko HM, Obimpeh M, Van Hees S, Siewe Fodjo JN, Nkamba DM, Tshefu A, Van Damme W, Muyembe JJ, Colebunders R. Adherence to COVID-19 Prevention Measures in the Democratic Republic of the Congo, Results of Two Consecutive Online Surveys. Int J Environ Res Public Health 2021; 18:ijerph18052525. [PMID: 33806286 PMCID: PMC7967309 DOI: 10.3390/ijerph18052525] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 01/12/2023]
Abstract
Adherence to preventive measures is essential to reduce the risk of COVID-19 transmission. Two online surveys were conducted in the Democratic Republic of the Congo (DRC) from 23 April to 8 June 2020, and from August 24th to September 8th, respectively. A total of 3268 (round 1) and 4160 (round 2) participants were included. In both surveys, there was a moderate level of adherence to regular handwashing (85% and 77%, respectively), wearing of facemasks (41.4% and 69%, respectively), and respecting physical distancing (58% and 43.4%, respectively). The second survey found that, working in private (OR = 2.31, CI: 1.66-3.22; p < 0.001) and public organizations (OR = 1.61, CI: 1.04-2.49; p = 0.032) and being a healthcare worker (OR = 2.19, CI: 1.57-3.05; p < 0.001) significantly increased the odds for better adherence. However, a unit increase in age (OR = 0.99, CI: 0.98-0.99; p < 0.026), having attained lower education levels (OR = 0.60, CI: 0.46-0.78; p < 0.001), living in a room (OR = 0.36, CI: 0.15-0.89; p = 0.027), living in a studio (OR = 0.26, CI: 0.11-0.61; p = 0.002) and apartment (OR = 0.29, CI: 0.10-0.82; p = 0.019) significantly decreased the odds for better adherence. We recommend a multi-sectorial approach to monitor and respond to the pandemic threat. While physical distancing may be difficult in Africa, it should be possible to increase the use of facemasks.
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Affiliation(s)
- John D. Ditekemena
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa 834, Democratic Republic of the Congo; (D.M.N.); (A.T.)
- Correspondence:
| | - Hypolite M. Mavoko
- Department of Tropical Medicine, Faculty of Medicine, University of Kinshasa, Kinshasa 834, Democratic Republic of the Congo;
| | - Michael Obimpeh
- Global Health Institute, University of Antwerp, 2610 Antwerp, Belgium; (M.O.); (S.V.H.); (J.N.S.F.); (R.C.)
| | - Stijn Van Hees
- Global Health Institute, University of Antwerp, 2610 Antwerp, Belgium; (M.O.); (S.V.H.); (J.N.S.F.); (R.C.)
| | - Joseph Nelson Siewe Fodjo
- Global Health Institute, University of Antwerp, 2610 Antwerp, Belgium; (M.O.); (S.V.H.); (J.N.S.F.); (R.C.)
| | - Dalau M. Nkamba
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa 834, Democratic Republic of the Congo; (D.M.N.); (A.T.)
- Pôle d’Épidémiologie et Biostatistique, Université Catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), 1348 Brussels, Belgium
| | - Antoinette Tshefu
- Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa 834, Democratic Republic of the Congo; (D.M.N.); (A.T.)
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, 2600 Antwerp, Belgium;
| | - Jean Jacques Muyembe
- Institut National de Recherche Biomédicale and Faculty of Medicine, University of Kinshasa, Kinshasa 834, Democratic Republic of the Congo;
| | - Robert Colebunders
- Global Health Institute, University of Antwerp, 2610 Antwerp, Belgium; (M.O.); (S.V.H.); (J.N.S.F.); (R.C.)
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Ditekemena JD, Nkamba DM, Muhindo HM, Siewe JNF, Luhata C, Van den Bergh R, Tshefu Kitoto A, Van Damme W, Muyembe JJ, Colebunders R. Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey. BMJ Open 2021; 11:e043356. [PMID: 33462101 PMCID: PMC7813390 DOI: 10.1136/bmjopen-2020-043356] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES We aimed to assess the level of adherence to COVID-19 preventive measures in the Democratic Republic of the Congo (DRC) and to identify factors associated with non-adherence. DESIGN A cross-sectional population-based online survey. SETTINGS The study was conducted in 22 provinces of the DRC. Five provinces with a satisfactory number of respondents were included in the analysis: Haut Katanga, Kasaï-Central, Kasaï-Oriental, Kinshasa and North Kivu. PARTICIPANTS The participants were people aged ≥18 years, living in the DRC. A total of 3268 participants were included in the study analysis. INTERVENTIONS Both convenience sampling (surveyors themselves contacted potential participants in different districts) and snowball sampling (the participants were requested to share the link of the questionnaire with their contacts) methods were used. PRIMARY AND SECONDARY OUTCOME MEASURES We computed adherence scores using responses to 10 questions concerning COVID-19 preventive measures recommended by the WHO and the DRC Ministry of Health. We used logistic regression analysis with generalised estimating equations to identify factors of poor adherence. We also asked about the presence or absence of flu-like symptoms during the preceding 14 days, whether a COVID-19 test was done and the test result. RESULTS Data from 3268 participants were analysed. Face masks were not used by 1789 (54.7%) participants. Non-adherence to physical distancing was reported by 1364 (41.7%) participants. 501 (15.3%) participants did not observe regular handwashing. Five variables were associated with poor adherence: lower education level, living with other people at home, being jobless/students, living with a partner and not being a healthcare worker. CONCLUSION Despite compulsory restrictions imposed by the government, only about half of the respondents adhered to COVID-19 preventive measures in the DRC. Disparities across the provinces are remarkable. There is an urgent need to further explore the reasons for these disparities and factors associated with non-adherence.
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Affiliation(s)
- John Dinanga Ditekemena
- Ecole de Santé Publique, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo
| | - Dalau Mukadi Nkamba
- Ecole de Santé Publique, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo
- Pôle d'Épidémiologie et Biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Brussels, Belgium
| | - Hypolite Mavoko Muhindo
- Department of Tropical Medicine, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo
| | | | - Christophe Luhata
- Ecole de Santé Publique, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo
| | | | - Antoinette Tshefu Kitoto
- Ecole de Santé Publique, Universite de Kinshasa Faculte de Medecine, Kinshasa, Democratic Republic of the Congo
| | - Wim Van Damme
- Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jean Jacques Muyembe
- Direction of the institute, Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
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Batumbo Boloweti D, Giraudoux P, Deniel C, Garnier E, Mauny F, Kasereka CM, Kizungu R, Muyembe JJ, Bompangue D, Bornette G. Volcanic activity controls cholera outbreaks in the East African Rift. PLoS Negl Trop Dis 2020; 14:e0008406. [PMID: 32776919 PMCID: PMC7441828 DOI: 10.1371/journal.pntd.0008406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 08/20/2020] [Accepted: 05/21/2020] [Indexed: 11/18/2022] Open
Abstract
We hypothesized that Cholera (Vibrio cholerae) that appeared along Lake Kivu in the African Rift in the seventies, might be controlled by volcano-tectonic activity, which, by increasing surface water and groundwater salinity and temperature, may partly rule the water characteristics of Lake Kivu and promote V. cholerae proliferation. Volcanic activity (assessed weekly by the SO2 flux of Nyiragongo volcano plume over the 2007-2012 period) is highly positively correlated with the water conductivity, salinity and temperature of the Kivu lake. Over the 2007-2012 period, these three parameters were highly positively correlated with the temporal dynamics of cholera cases in the Katana health zone that border the lake. Meteorological variables (air temperature and rainfall), and the other water characteristics (namely pH and dissolved oxygen concentration in lake water) were unrelated to cholera dynamics over the same period. Over the 2016-2018 period, we sampled weekly lake water salinity and conductivity, and twice a month vibrio occurrence in lake water and fish. The abundance of V. cholerae in the lake was positively correlated with lake salinity, temperature, and the number of cholera cases in the population of the Katana health zone. V. cholerae abundance in fishes was positively correlated with V. cholerae abundance in lake water, suggesting that their consumption directly contaminate humans. The activity of the volcano, by controlling the physico-chemical characteristics of Lake Kivu, is therefore a major determinant of the presence of the bacillus in the lake. SO2 fluxes in the volcano plume can be used as a tool to predict epidemic risks.
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Affiliation(s)
| | - Patrick Giraudoux
- UMR CNRS 6249 Chrono-Environnement, University of Bourgogne Franche
Comté, Besançon, France
| | - Catherine Deniel
- UMR CNRS 6524 Laboratoire Magmas et Volcans, University of Blaise
Pascal-CNRS-IRD, Clermont Ferrand, France
| | - Emmanuel Garnier
- UMR CNRS 6249 Chrono-Environnement, University of Bourgogne Franche
Comté, Besançon, France
| | - Frederic Mauny
- UMR CNRS 6249 Chrono-Environnement, University of Bourgogne Franche
Comté, Besançon, France
| | | | - Roger Kizungu
- Faculty of Agronomy, University of Kinshasa, Kinshasa, Democratic
Republic of Congo
| | - Jean Jacques Muyembe
- Department of Microbiology, Faculty of Medicine, University of Kinshasa,
Kinshasa, Democratic Republic of Congo
| | - Didier Bompangue
- UMR CNRS 6249 Chrono-Environnement, University of Bourgogne Franche
Comté, Besançon, France
| | - Gudrun Bornette
- UMR CNRS 6249 Chrono-Environnement, University of Bourgogne Franche
Comté, Besançon, France
- * E-mail:
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9
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Mandoko PN, Mbongi DM, Mumba DN, Bi Shamamba SK, Tshilolo LM, Muyembe JJ, Parzy D, Sinou V. Evaluation of the application of national malaria treatment guidelines in private pharmacies in a rural area in the Democratic Republic of Congo. Med Sante Trop 2019; 29:392-398. [PMID: 31884993 DOI: 10.1684/mst.2019.0925] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In the Democratic Republic of the Congo, the first recourse in case of suspected malaria in the health system is the private pharmacy sector. This study was therefore designed to assess private provider adherence to national case management guidelines in Kimpese, a rural area of Central Kongo province. A descriptive cross-sectional survey of 103 pharmacies took place in March 2016. The study included 97 pharmacies. The artemether-lumefantrine combination recommended as the first-line treatment for uncomplicated P. falciparum malaria was available in 100% of pharmacies but only 3% stocked quality-assured medicines. The sulfadoxine-pyrimethamine recommended for intermittent preventive treatment of malaria in pregnant women and quinine, which is no longer part of national policy, were widely available (>97.0% of pharmacies). Among providers, fewer than 20% were aware of the national malaria treatment guidelines. The main reasons for non-adherence to national guidelines among private dispensers was the high cost (up to 10 times more expensive than sulfadoxine-pyrimethamine treatment) and adverse effects of artemisinin-based combination therapies. Governmental interventions to improve private sector engagement in implementation of the national guidelines and to prevent the spread of ineffective and non-quality assured antimalarial medicines must be intensified.
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Affiliation(s)
- P N Mandoko
- Institut national de recherche biomédicale, Kinshasa, Congo, RDC
| | - D M Mbongi
- Centre de formation et d'appui sanitaire, Kinshasa, Congo, RDC
| | - D N Mumba
- Institut national de recherche biomédicale, Kinshasa, Congo, RDC
| | - S K Bi Shamamba
- Institut national de recherche biomédicale, Kinshasa, Congo, RDC
| | - L M Tshilolo
- Centre de formation et d'appui sanitaire, Kinshasa, Congo, RDC
| | - J J Muyembe
- Institut national de recherche biomédicale, Kinshasa, Congo, RDC
| | | | - V Sinou
- Inserm, SSA, IRBA, MCT, Aix-Marseille Université, Marseille, France
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10
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Kavunga-Membo H, Nkwembe E, Simulundu E, Karhemere S, Babakazo P, Manya L, Kabamba J, Okitolonda E, Ahuka-Mundeke S, Muyembe JJ. Epidemiology of circulating human influenza viruses from the Democratic Republic of Congo, 2015. PLoS One 2018; 13:e0203995. [PMID: 30265699 PMCID: PMC6161844 DOI: 10.1371/journal.pone.0203995] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/31/2018] [Indexed: 11/29/2022] Open
Abstract
Introduction The establishment of the influenza sentinel surveillance system in Kinshasa, Bas Congo, Maniema, Katanga, and Kasai Provinces allowed generation of important data on the molecular epidemiology of human influenza viruses circulating in the Democratic Republic of Congo (DRC). However, some challenges still exist, including the need for extending the influenza surveillance to more provinces. This study describes the pattern of influenza virus circulating in DRC during 2015. Methodology Nasopharyngeal swabs were collected from January to December 2015 from outpatients with influenza-like illness (ILI) and in all hospitalized patients with Severe Acute Respiratory Infection (SARI). Molecular analysis was done to determine influenza type and subtype at the National Reference Laboratory (NRL) in Kinshasa using real time reverse transcription-polymerase chain reaction (rRT-PCR). Analysis of antiviral resistance by enzyme inhibition assay and nucleotide sequencing was performed by the Collaborating center in the USA (CDC, Atlanta). Results Out of 2,376 nasopharyngeal swabs collected from patients, 218 (9.1%) were positive for influenza virus. Among the positive samples, 149 were characterized as influenza virus type A (Flu A), 67 as type B (Flu B) and 2 mixed infections (Flu A and B). Flu A subtypes detected were H3N2 and H1N1. The Yamagata strain of Flu B was detected among patients in the country. Individuals aged between 5 and 14 years accounted for the largest age group affected by influenza virus. All influenza viruses detected were found to be sensitive to antiviral drugs such as oseltamivar, zanamivir, peramivir and laninamivar. Conclusion The present study documented the possible involvement of both circulation of Flu A and B viruses in human respiratory infection in certain DRC provinces during 2015. This study emphasises the need to extend the influenza surveillance to other provinces for a better understanding of the epidemiology of influenza in DRC. It is envisioned that such a system would lead to improved disease control and patient management.
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MESH Headings
- Adolescent
- Adult
- Child
- Child, Preschool
- Democratic Republic of the Congo/epidemiology
- Drug Resistance, Viral/genetics
- Female
- Humans
- Infant
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/drug effects
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H3N2 Subtype/classification
- Influenza A Virus, H3N2 Subtype/drug effects
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A virus/classification
- Influenza A virus/drug effects
- Influenza A virus/genetics
- Influenza B virus/classification
- Influenza B virus/drug effects
- Influenza B virus/genetics
- Influenza, Human/epidemiology
- Influenza, Human/virology
- Male
- Middle Aged
- Molecular Epidemiology
- Phylogeny
- Sentinel Surveillance
- Young Adult
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Affiliation(s)
- Hugo Kavunga-Membo
- Département de Virologie, Institut National de Recherche Biomédicale (INRB), République Démocratique du Congo, RDC
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
- * E-mail:
| | - Edith Nkwembe
- Département de Virologie, Institut National de Recherche Biomédicale (INRB), République Démocratique du Congo, RDC
| | - Edgar Simulundu
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Stomy Karhemere
- Département de Virologie, Institut National de Recherche Biomédicale (INRB), République Démocratique du Congo, RDC
| | - Pélagie Babakazo
- Ecole de Santé Publique, Université de Kinshasa (UNIKIN), Kinshasa, RDC
| | - Léonie Manya
- Direction de lutte contre les Maladies, Ministère de la santé Publique, Kinshasa, RDC
| | - Joelle Kabamba
- Direction de lutte contre les Maladies, Ministère de la santé Publique, Kinshasa, RDC
| | - Emile Okitolonda
- Ecole de Santé Publique, Université de Kinshasa (UNIKIN), Kinshasa, RDC
| | - Steve Ahuka-Mundeke
- Département de Virologie, Institut National de Recherche Biomédicale (INRB), République Démocratique du Congo, RDC
| | - Jean Jacques Muyembe
- Département de Virologie, Institut National de Recherche Biomédicale (INRB), République Démocratique du Congo, RDC
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11
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Kavunga-Membo H, Ilombe G, Masumu J, Matangila J, Imponge J, Manzambi E, Wastenga F, Ngoyi DM, Van Geetruyden JP, Muyembe JJ. Molecular identification of Plasmodium species in symptomatic children of Democratic Republic of Congo. Malar J 2018; 17:334. [PMID: 30236117 PMCID: PMC6149035 DOI: 10.1186/s12936-018-2480-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 02/21/2018] [Accepted: 09/10/2018] [Indexed: 11/20/2022] Open
Abstract
Background Worldwide, the highest malaria mortality is due to Plasmodium falciparum infection. However, other species of Plasmodium (Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi) can also cause malaria. Therefore, accurate identification of malaria species is crucial for patient management and epidemiological surveillance. This study aimed to determine the different Plasmodium species causing malaria in children under 5 years old in two provinces (Kinshasa and North Kivu) of the Democratic Republic of Congo (DRC). Methods From October to December 2015, a health-facility based cross-sectional study was conducted in General Reference Hospitals in Kinshasa and North Kivu. Four hundred and seven blood samples were collected from febrile children aged ≤ 5 years. Nested polymerase chain reaction assays were performed for Plasmodium species identification. Results Out of 407 children, 142 (34.9%) were infected with Plasmodium spp. and P. falciparum was the most prevalent species (99.2%). Among those infected children, 124 had a mono infection with P. falciparum and one with P. malariae. Mixed infections with P. falciparum/P. malariae and P. falciparum/P. vivax were observed in 6 (1.5%) and 8 (2.0%) children, respectively. The prevalence of infection was higher in females (64.8%) than in males (35.2%), p < 0.001. The age-specific distribution of infection showed that children of less than 2 years old were less infected (18.4%) compared to those aged above 2 years (81.6%), p < 0.001. Conclusion Although this study showed clearly that the most prevalent species identified was P. falciparum, the findings demonstrate the existence of non-falciparum malaria, especially P. malariae and P. vivax among children aged ≤ 5 years living both Kinshasa and North Kivu Provinces in DRC.
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Affiliation(s)
- Hugo Kavunga-Membo
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.
| | - Gillon Ilombe
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo
| | - Justin Masumu
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Université Pédagogique National (UPN), Kinshasa, Democratic Republic of the Congo.,Laboratoire Vétérinaire de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Junior Matangila
- Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | - Joël Imponge
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo
| | - Emile Manzambi
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo
| | - Francis Wastenga
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | - Dieudonné Mumba Ngoyi
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
| | | | - Jean Jacques Muyembe
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197, Kinshasa 1, Kinshasa, Democratic Republic of the Congo.,Universite de Kinshasa (UNIKIN), Kinshasa, Democratic Republic of the Congo
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12
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Villabona Arenas CJ, Vidal N, Ahuka Mundeke S, Muwonga J, Serrano L, Muyembe JJ, Boillot F, Delaporte E, Peeters M. Divergent HIV-1 strains (CRF92_C2U and CRF93_cpx) co-circulating in the Democratic Republic of the Congo: Phylogenetic insights on the early evolutionary history of subtype C. Virus Evol 2017; 3:vex032. [PMID: 29250430 PMCID: PMC5724398 DOI: 10.1093/ve/vex032] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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] [Indexed: 11/20/2022] Open
Abstract
Molecular epidemiological studies revealed that the epicenter of the HIV pandemic was Kinshasa, the capital city of the Democratic Republic of the Congo (DRC) in Central Africa. All known subtypes and numerous complex recombinant strains co-circulate in the DRC. Moreover, high intra-subtype diversity has been also documented. During two previous surveys on HIV-1 antiretroviral drug resistance in the DRC, we identified two divergent subtype C lineages in the protease and partial reverse transcriptase gene regions. We sequenced eight near full-length genomes and classified them using bootscanning and likelihood-based phylogenetic analyses. Four strains are more closely related to subtype C although within the range of inter sub-subtype distances. However, these strains also have small unclassified fragments and thus were named CRF92_C2U. Another strain is a unique recombinant of CRF92_C2U with an additional small unclassified fragment and a small divergent subtype A fragment. The three remaining strains represent a complex mosaic named CRF93_cpx. CRF93_cpx have two fragments of divergent subtype C sequences, which are not conventional subtype C nor the above described C2, and multiple divergent subtype A-like fragments. We then inferred the time-scaled evolutionary history of subtype C following a Bayesian approach and a partitioned analysis using major genomic regions. CRF92_C2U and CRF93_cpx had the most recent common ancestor with conventional subtype C around 1932 and 1928, respectively. A Bayesian demographic reconstruction corroborated that the subtype C transition to a faster phase of exponential growth occurred during the 1950s. Our analysis showed considerable differences between the newly discovered early-divergent strains and the conventional subtype C and therefore suggested that this virus has been diverging in humans for several decades before the HIV/M diversity boom in the 1950s.
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Affiliation(s)
- C J Villabona Arenas
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, INSERM U1175, Université de Montpellier, 911 Avenue Agropolis, Montpellier, 34394, France
| | - N Vidal
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, INSERM U1175, Université de Montpellier, 911 Avenue Agropolis, Montpellier, 34394, France
| | - S Ahuka Mundeke
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, INSERM U1175, Université de Montpellier, 911 Avenue Agropolis, Montpellier, 34394, France.,Institut National de Recherche Biomédicale, Av. De la Démocratie 5345, Kinshasa, Democratic Republic of the Congo.,Cliniques Universitaires de Kinshasa, Route de Kimwenza, Kinshasa, Congo, Democratic Republic of Congo
| | - J Muwonga
- Cliniques Universitaires de Kinshasa, Route de Kimwenza, Kinshasa, Congo, Democratic Republic of Congo.,Laboratoire National de Référence du SIDA, Kinshasa, Democratic Republic of Congo
| | - L Serrano
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, INSERM U1175, Université de Montpellier, 911 Avenue Agropolis, Montpellier, 34394, France
| | - J J Muyembe
- Institut National de Recherche Biomédicale, Av. De la Démocratie 5345, Kinshasa, Democratic Republic of the Congo.,Cliniques Universitaires de Kinshasa, Route de Kimwenza, Kinshasa, Congo, Democratic Republic of Congo
| | - F Boillot
- Alter-Santé Internationale and Développement, Montpellier, 34090, France
| | - E Delaporte
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, INSERM U1175, Université de Montpellier, 911 Avenue Agropolis, Montpellier, 34394, France
| | - M Peeters
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, INSERM U1175, Université de Montpellier, 911 Avenue Agropolis, Montpellier, 34394, France
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13
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Nkwembe E, Cintron R, Sessions W, Kavunga H, Babakazo P, Manya L, Muyembe JJ. Molecular Analysis of Influenza A(H3N2) and A(H1N1)pdm09 Viruses circulating in the Democratic Republic of Congo, 2014. J Harmon Res Med Health Sci 2016; 3:247-264. [PMID: 29569652 PMCID: PMC5858567] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Very little is known about influenza viruses circulating in the Democratic Republic of Congo (DRC). We aim to characterize genetically and antigenically Influenza A(H3N2) and A(H1N1)pdm09 viruses circulating in the country. METHODS From August to December 2014, specimens were collected from patients with influenza like-illness (ILI) or severe acute respiratory infection (SARI) in various surveillance sites. Specimens were tested using real time reverse transcription polymerase chain reaction (RT-PCR) method for the detection of influenza viruses. Positive influenza samples with a cycle threshold (Ct) <30 were genetically and antigenically characterized. RESULTS 32 samples tested were found positive to influenza A with Ct <30. At CDC Atlanta, 28 out of 32 samples (88%) were tested positive for influenza A virus, including 26 seasonal influenza A viruses subtype H3N2 and 2 pandemic influenza A viruses subtype H1N1pdm 2009. The majority of influenza A(H3N2) viruses were antigenically related to the A/Switzerland/9715293/2013 vaccine virus, while two influenza A(H1N1)pdm09 isolates were antigenically characterized as A/California/07/2009-like. All A(H3N2) and A(H1N1)pdm09 virus isolates characterized were sensitive to oseltamivir and zanamivir. CONCLUSION Two genetically distinct influenza subtypes were co-circulating in the DRCongo. Effective measures against influenza have been suggested.
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Affiliation(s)
| | - Roxana Cintron
- Influenza Division, Centers for Disease Control and Prevention,
Atlanta, USA
- Battelle Memorial Institute, TOPS Atlanta, USA
| | - Wendy Sessions
- Influenza Division, Centers for Disease Control and Prevention,
Atlanta, USA
| | - Hugo Kavunga
- Institut National de recherches Biomédicales, INRB
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14
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Membo HK, Mweene A, Sadeuh-Mba SA, Masumu J, Yogolelo R, Ngendabanyikwa N, Sokolua E, Sagamiko F, Simulundu E, Ahuka S, Muyembe JJ. Acute flaccid paralysis surveillance indicators in the Democratic Republic of Congo during 2008-2014. Pan Afr Med J 2016; 24:154. [PMID: 27642491 PMCID: PMC5012780 DOI: 10.11604/pamj.2016.24.154.8747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/29/2015] [Accepted: 05/18/2016] [Indexed: 12/31/2022] Open
Abstract
Introduction The last wild poliovirus (WPV) case in Africa was reported in July 2014, thus underscoring the tremendous progress towards polio eradication worldwide. This study aimed to analyze the results of a seven-year surveillance of Acute Flaccid Paralysis (AFP) in the Democratic Republic of Congo (DRC) and to identify potential gaps that need to be addressed. Methods Epidemiological and virological data obtained from AFP surveillance among AFP cases less than 15 years from January 2008 to December 2014 in DRC were retrospectively considered and analyzed in this study. Results Of the 13,749 AFP cases investigated, 58.9% received at least three doses of oral polio vaccine (OPV), 7.3% never received OPV, while the status of 18.3% was unknown. Analysis of surveillance performances showed that all, but two, indicators were below the required WHO-specified targets. Non-polio enterovirus (NPEV) isolation rate was consistently below the minimum requirement at ≥10% and the proportions of stool specimens that reached the laboratory within 72 hours of being sent were always below 15% (WHO target is ≥80%). Virus isolation and differentiation showed that 1.5% of AFP cases were infected by WPVs, 5.5% by Sabin strains, 0.5% by vaccine-derived polioviruses (VDPVs) and 7.2% by NPEVs. Conclusion Our findings indicate that additional efforts are needed to address the timeliness of adequate stool specimens’ arrival to the laboratory. It remains essential to maintain high polio vaccine coverage and high AFP surveillance standards to ensure rapid detection and containment of either WPV importation or VDPV re-emergence in DRC.
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Affiliation(s)
- Hugo Kavunga Membo
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197 Kinshasa 1, Kinshasa, Democratic Republic of Congo; Department of Disease Control, School of Veterinary Medicine, University of Zambia, P.O Box 32379, Lusaka, Zambia
| | - Aaron Mweene
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, P.O Box 32379, Lusaka, Zambia
| | - Serge Alain Sadeuh-Mba
- Service de Virologie, Centre Pasteur du Cameroun (CPC), rue Henri Dunant P.O Box 1274, Yaoundé, Cameroun
| | - Justin Masumu
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197 Kinshasa 1, Kinshasa, Democratic Republic of Congo
| | - Riziki Yogolelo
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197 Kinshasa 1, Kinshasa, Democratic Republic of Congo
| | | | - Eddy Sokolua
- World Heath Organization (WHO), Central African Inter-country Bureau, Libreville, Gabon
| | - Fred Sagamiko
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, P.O Box 32379, Lusaka, Zambia
| | - Edgar Simulundu
- Department of Disease Control, School of Veterinary Medicine, University of Zambia, P.O Box 32379, Lusaka, Zambia
| | - Steve Ahuka
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197 Kinshasa 1, Kinshasa, Democratic Republic of Congo
| | - Jean Jacques Muyembe
- Institut National de Recherche Biomédicale (INRB), P.O Box 1197 Kinshasa 1, Kinshasa, Democratic Republic of Congo
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15
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Iles JC, Raghwani J, Harrison GLA, Pepin J, Djoko CF, Tamoufe U, LeBreton M, Schneider BS, Fair JN, Tshala FM, Kayembe PK, Muyembe JJ, Edidi-Basepeo S, Wolfe ND, Simmonds P, Klenerman P, Pybus OG. Phylogeography and epidemic history of hepatitis C virus genotype 4 in Africa. Virology 2014; 464-465:233-243. [PMID: 25105489 PMCID: PMC4162651 DOI: 10.1016/j.virol.2014.07.006] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/04/2014] [Accepted: 07/05/2014] [Indexed: 12/18/2022]
Abstract
HCV genotype 4 is prevalent in many African countries, yet little is known about the genotype׳s epidemic history on the continent. We present a comprehensive study of the molecular epidemiology of genotype 4. To address the deficit of data from the Democratic Republic of the Congo (DRC) we PCR amplified 60 new HCV isolates from the DRC, resulting in 33 core- and 48 NS5B-region sequences. Our data, together with genotype 4 database sequences, were analysed using Bayesian phylogenetic approaches. We find three well-supported intra-genotypic lineages and estimate that the genotype 4 common ancestor existed around 1733 (1650-1805). We show that genotype 4 originated in central Africa and that multiple lineages have been exported to north Africa since ~1850, including subtype 4a which dominates the epidemic in Egypt. We speculate on the causes of the historical intra-continental spread of genotype 4, including population movements during World War 2.
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Affiliation(s)
- James C Iles
- Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, UK
| | - Jayna Raghwani
- Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, UK
| | - G L Abby Harrison
- Department of Infection & Immunity, Walter & Eliza Hall Institute, Victoria 3052, Australia
| | - Jacques Pepin
- Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Canada
| | | | | | | | | | | | - Felix M Tshala
- Department of Military Health, Ministry of Defense, Kinshasa, Democratic Republic of the Congo
| | - Patrick K Kayembe
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Jean Jacques Muyembe
- National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Samuel Edidi-Basepeo
- National AIDS Control Program, Reference Laboratory, Kinshasa, Democratic Republic of the Congo
| | - Nathan D Wolfe
- Metabiota, San Francisco, USA; Stanford University Program in Human Biology, Stanford, USA
| | - Peter Simmonds
- Roslin Institute, University of Edinburgh, Edinburgh, UK
| | - Paul Klenerman
- Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK
| | - Oliver G Pybus
- Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, UK.
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16
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Rimoin AW, Hoff NA, Djoko CF, Kisalu NK, Kashamuka M, Tamoufe U, LeBreton M, Kayembe PK, Muyembe JJ, Kitchen CR, Saylors K, Fair J, Doshi R, Papworth E, Mpoudi-Ngole E, Grillo MP, Tshala F, Peeters M, Wolfe ND. HIV infection and risk factors among the armed forces personnel stationed in Kinshasa, Democratic Republic of Congo. Int J STD AIDS 2014; 26:187-95. [PMID: 24828556 DOI: 10.1177/0956462414533672] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite recent declines in HIV incidence, sub-Saharan Africa remains the most heavily affected region in the global HIV/AIDS epidemic. Estimates of HIV prevalence in African military personnel are scarce and inconsistent. We conducted a serosurvey between June and September 2007 among 4043 Armed Forces personnel of the Democratic Republic of Congo (FARDC) stationed in Kinshasa, Democratic Republic of Congo (DRC) to determine the prevalence of HIV and syphilis infections and describe associated risk behaviours. Participants provided blood for HIV and syphilis testing and responded to a demographic and risk factor questionnaire. The prevalence of HIV was 3.8% and the prevalence of syphilis was 11.9%. Women were more likely than men to be HIV positive, (7.5% vs. 3.6% respectively, aOR: 1.66, 95% C.I: 1.21-2.28, p < 0.05). Factors significantly associated with HIV infection included gender and self-reported genital ulcers in the 12 months before date of enrollment. The prevalence of HIV in the military appears to be higher than the general population in DRC (3.8% vs. 1.3%, respectively), with women at increased risk of infection.
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Affiliation(s)
- A W Rimoin
- Department of Epidemiology, Los Angeles Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - N A Hoff
- Department of Epidemiology, Los Angeles Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - C F Djoko
- Global Viral Forecasting (now known as Metabiota) San Francisco, California, USA, and Yaoundé, Cameroon
| | - N K Kisalu
- Vaccine Research Center, NIAID/NIH, Bethesda, MD, USA
| | - M Kashamuka
- Kinshasa School of Public Health, University of Kinshasa, Democratic Republic of Congo
| | - U Tamoufe
- Global Viral Forecasting (now known as Metabiota) San Francisco, California, USA, and Yaoundé, Cameroon
| | - M LeBreton
- Global Viral Forecasting (now known as Metabiota) San Francisco, California, USA, and Yaoundé, Cameroon
| | - P K Kayembe
- Kinshasa School of Public Health, University of Kinshasa, Democratic Republic of Congo
| | - J J Muyembe
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - C R Kitchen
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - K Saylors
- Global Viral Forecasting (now known as Metabiota) San Francisco, California, USA, and Yaoundé, Cameroon
| | - J Fair
- Global Viral Forecasting (now known as Metabiota) San Francisco, California, USA, and Yaoundé, Cameroon
| | - R Doshi
- Department of Epidemiology, Los Angeles Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - E Papworth
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - M P Grillo
- Department of Defense HIV/AIDS Prevention Program (DHAPP), Naval Health Research Center, San Diego, CA, USA
| | - F Tshala
- Military Health Services, Ministry of Defense, Kinshasa, Democratic Republic of the Congo
| | - M Peeters
- Laboratoire Retrovirus, UMR 145, Institute for Research and Development (IRD) and University of Montpellier 1, Montpellier, France
| | - N D Wolfe
- Global Viral Forecasting (now known as Metabiota) San Francisco, California, USA, and Yaoundé, Cameroon Program in Human Biology, Stanford University, Stanford, CA, USA
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17
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Kaswa MK, Bisuta S, Kabuya G, Lunguya O, Ndongosieme A, Muyembe JJ, Van Deun A, Boelaert M. Multi drug resistant tuberculosis in Mosango, a rural area in the Democratic Republic of Congo. PLoS One 2014; 9:e94618. [PMID: 24732233 PMCID: PMC3986213 DOI: 10.1371/journal.pone.0094618] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/18/2014] [Indexed: 11/18/2022] Open
Abstract
Multidrug Resistant Tuberculosis (MDR-TB) is a serious threat which jeopardizes the worldwide efforts to control TB. The Democratic Republic of Congo (DRC) is one of 27 countries with a high burden of MDR-TB. Data on the magnitude, trends, and the distribution of MDR-TB in DRC are scanty. Kinshasa, the capital city of DRC which accounts for 20% of all TB cases nationwide, is notifying more than 80% of all MDR suspects. We report here a cluster of MDR-TB cases that was investigated in the Mosango health district, in the Bandundu south Province, DRC in 2008. Phenotypic Drug Sensitivity Testing and DNA sequencing were performed on 18 sputum specimens collected from 4 MDR-TB suspects and 5 household contacts. Sequencing data confirmed that the 4 suspects were indeed Rifampicin resistant cases. Sequencing of the rpoB gene showed that 3 cases (patients A, B and D) had a single mutation encoding a substitution to 526Tyr, 531Trp and 526Leu respectively. Patient C had a double mutation encoding a change to 531Leu and 633Leu. Two of the investigated cases died within 4 months of a second-line treatment course. Results highlight the need to enhance adequate laboratory services within the country for both clinical as well as surveillance purposes.
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Affiliation(s)
- Michel Kayomo Kaswa
- National Tuberculosis Program, Kinshasa, Democratic Republic of Congo
- Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo
- Institute of Tropical Medicine, Antwerp, Belgium
- * E-mail:
| | - Serge Bisuta
- National Tuberculosis Program, Kinshasa, Democratic Republic of Congo
| | - Georges Kabuya
- National Tuberculosis Program, Kinshasa, Democratic Republic of Congo
| | - Octavie Lunguya
- Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo
| | - André Ndongosieme
- National Tuberculosis Program, Kinshasa, Democratic Republic of Congo
| | - Jean Jacques Muyembe
- Institut National de Recherche Bio-Médicale, Kinshasa, Democratic Republic of Congo
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18
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Muyembe JJ, Bompangue D, Mutombo G, Akilimali L, Mutombo A, Miwanda B, Mpuruta JDD, Deka KK, Bitakyerwa F, Saidi JM, Mutadi AL, Kakongo RS, Birembano F, Mengel M, Gessner BD, Ilunga BK. Elimination of Cholera in the Democratic Republic of the Congo: The New National Policy. J Infect Dis 2013; 208 Suppl 1:S86-91. [DOI: 10.1093/infdis/jit204] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Iles JC, Abby Harrison G, Lyons S, Djoko CF, Tamoufe U, Lebreton M, Schneider BS, Fair JN, Tshala FM, Kayembe PK, Muyembe JJ, Edidi-Basepeo S, Wolfe ND, Klenerman P, Simmonds P, Pybus OG. Hepatitis C virus infections in the Democratic Republic of Congo exhibit a cohort effect. Infection, Genetics and Evolution 2013; 19:386-94. [DOI: 10.1016/j.meegid.2013.01.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 01/24/2013] [Accepted: 01/25/2013] [Indexed: 12/26/2022]
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20
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Albariño CG, Shoemaker T, Khristova ML, Wamala JF, Muyembe JJ, Balinandi S, Tumusiime A, Campbell S, Cannon D, Gibbons A, Bergeron E, Bird B, Dodd K, Spiropoulou C, Erickson BR, Guerrero L, Knust B, Nichol ST, Rollin PE, Ströher U. Genomic analysis of filoviruses associated with four viral hemorrhagic fever outbreaks in Uganda and the Democratic Republic of the Congo in 2012. Virology 2013; 442:97-100. [PMID: 23711383 DOI: 10.1016/j.virol.2013.04.014] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 04/07/2013] [Accepted: 04/18/2013] [Indexed: 11/28/2022]
Abstract
In 2012, an unprecedented number of four distinct, partially overlapping filovirus-associated viral hemorrhagic fever outbreaks were detected in equatorial Africa. Analysis of complete virus genome sequences confirmed the reemergence of Sudan virus and Marburg virus in Uganda, and the first emergence of Bundibugyo virus in the Democratic Republic of the Congo.
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Affiliation(s)
- C G Albariño
- Centers for Disease Control and Prevention, Atlanta, USA
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21
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Djoko CF, Rimoin AW, Vidal N, Tamoufe U, Wolfe ND, Butel C, LeBreton M, Tshala FM, Kayembe PK, Muyembe JJ, Edidi-Basepeo S, Pike BL, Fair JN, Mbacham WF, Saylors KE, Mpoudi-Ngole E, Delaporte E, Grillo M, Peeters M. High HIV type 1 group M pol diversity and low rate of antiretroviral resistance mutations among the uniformed services in Kinshasa, Democratic Republic of the Congo. AIDS Res Hum Retroviruses 2011; 27:323-9. [PMID: 20954909 DOI: 10.1089/aid.2010.0201] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
For the first time the genetic diversity among the uniformed personnel in Kinshasa, the capital city of the Democratic Republic of Congo (DRC), a country that has experienced military conflicts since 1998 and in which the global HIV-1/M pandemic started, has now been documented. A total of 94 HIV-1-positive samples, collected in 2007 in Kinshasa garrison settings from informed consenting volunteers, were genetically characterized in the pol region (protease and RT). An extensive diversity was observed, with 51% of the strains corresponding to six pure subtypes (A 23%, C 13.8%, D, G, H, J, and untypable), 15% corresponding to nine different CRFs (01, 02, 11, 13, 25, 26, 37, 43, and 45), and 34% being unique recombinants with one-third being complex mosaic viruses involving three or more different subtypes/CRFs. Only one strain harbored a single mutation, I54V, associated with drug resistance to protease inhibitors. Due to their high mobility and potential risk behavior, HIV infections in military personnel can lead to an even more complex epidemic in the DRC and to a possible increase of subtype C.
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Affiliation(s)
- Cyrille F. Djoko
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
- Biotechnology Center and Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Nicole Vidal
- Laboratoire Retrovirus, UMR 145, Institute for Research and Development (IRD) and University of Montpellier 1, Montpellier, France
| | - Ubald Tamoufe
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
| | - Nathan D. Wolfe
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
- Stanford University, Program in Human Biology, Stanford, California
| | - Christelle Butel
- Laboratoire Retrovirus, UMR 145, Institute for Research and Development (IRD) and University of Montpellier 1, Montpellier, France
| | - Matthew LeBreton
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
| | - Felix M. Tshala
- Military Health Services, Ministry of Defence, Kinshasa, Democratic Republic of the Congo
| | - Patrick K. Kayembe
- Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Jean Jacques Muyembe
- National Institute for Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Samuel Edidi-Basepeo
- National AIDS Control Program Laboratory, Kinshasa, Democratic Republic of the Congo
| | - Brian L. Pike
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
| | - Joseph N. Fair
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
| | - Wilfred F. Mbacham
- Biotechnology Center and Department of Biochemistry, University of Yaoundé I, Yaoundé, Cameroon
| | - Karen E. Saylors
- Global Viral Forecasting Initiative (GVF), San Francisco, California, and Yaoundé, Cameroon
| | | | - Eric Delaporte
- Laboratoire Retrovirus, UMR 145, Institute for Research and Development (IRD) and University of Montpellier 1, Montpellier, France
- Department of Infectious Diseases, CHU, Montpellier, France
| | - Michael Grillo
- Department of Defense HIV AIDS Prevention Program (DHAPP), San Diego, California
| | - Martine Peeters
- Laboratoire Retrovirus, UMR 145, Institute for Research and Development (IRD) and University of Montpellier 1, Montpellier, France
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22
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Hutse V, Van Hecke K, De Bruyn R, Samu O, Lernout T, Muyembe JJ, Brochier B. Oral fluid for the serological and molecular diagnosis of measles. Int J Infect Dis 2010; 14:e991-7. [PMID: 20851015 DOI: 10.1016/j.ijid.2010.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 06/02/2010] [Accepted: 06/09/2010] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Since measles presents mostly in children, a non-invasive sample collection technique such as oral fluid sampling would be very useful in the early detection of measles RNA and antibodies. The aim of this study was to validate the detection of anti-measles IgM and measles virus RNA in oral fluid and to make a comparison with the gold standard methods of ELISA using serum (Enzygnost(®) anti-Measles IgM) and in-house nested reverse transcriptase polymerase chain reaction (RT-PCR) using nasopharyngeal secretions. METHODS Three samples each from 73 measles-positive and 44 measles-negative subjects (serum, oral fluid, and nasopharyngeal secretions) were analyzed. RESULTS The anti-measles IgM ELISA (MicroImmune) on oral fluid was validated against the IgM ELISA (Siemens) for serum and this resulted in a sensitivity of 92% and specificity of 100%. A molecular nested RT-PCR using oral fluid was validated against the standard assay on nasopharyngeal secretions and gave a sensitivity of 100% and specificity of 100%. CONCLUSIONS The results confirm that both serological and molecular oral fluid assays are suitable for routine use. The use of oral fluid samples for the detection of measles virus may encourage patients, general practitioners, and pediatricians to participate in the Belgian measles surveillance system and other epidemiological studies in the framework of the World Health Organization elimination program.
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Affiliation(s)
- V Hutse
- Viral Diseases, Scientific Institute of Public Health, Rue Juliette Wytsmanstraat 14, 1050 Brussels, Belgium.
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23
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Hasker E, Lutumba P, Mumba D, Lejon V, Büscher P, Kande V, Muyembe JJ, Menten J, Robays J, Boelaert M. Diagnostic accuracy and feasibility of serological tests on filter paper samples for outbreak detection of T.b. gambiense human African trypanosomiasis. Am J Trop Med Hyg 2010; 83:374-9. [PMID: 20682885 DOI: 10.4269/ajtmh.2010.09-0735] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Control of human African trypanosomiasis (HAT) in the Democratic Republic of Congo is based on mass population screening by mobile teams; a costly and labor-intensive approach. We hypothesized that blood samples collected on filter paper by village health workers and processed in a central laboratory might be a cost-effective alternative. We estimated sensitivity and specificity of micro-card agglutination test for trypanosomiasis (micro-CATT) and enzyme-linked immunosorbent assay (ELISA)/T.b. gambiense on filter paper samples compared with parasitology-based case classification and used the results in a Monte Carlo simulation of a lot quality assurance sampling (LQAS) approach. Micro-CATT and ELISA/T.b. gambiense showed acceptable sensitivity (92.7% [95% CI 87.4-98.0%] and 82.2% [95% CI 75.3-90.4%]) and very high specificity (99.4% [95% CI 99.0-99.9%] and 99.8% [95% CI 99.5-100%]), respectively. Conditional on high sample size per lot (> or = 60%), both tests could reliably distinguish a 2% from a zero prevalence at village level. Alternatively, these tests could be used to identify individual HAT suspects for subsequent confirmation.
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Affiliation(s)
- Epco Hasker
- Institute of Tropical Medicine Antwerp, Belgium.
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24
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Lévêque N, Amine IL, Amine IL, Cartet G, Hammani AB, Khazraji YC, Lina B, Muyembe JJ, Norder H, Chomel JJ. Two outbreaks of acute hemorrhagic conjunctivitis in Africa due to genotype III coxsackievirus A24 variant. Eur J Clin Microbiol Infect Dis 2007; 26:199-202. [PMID: 17294159 DOI: 10.1007/s10096-007-0265-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Reported here are two outbreaks of acute hemorrhagic conjunctivitis that occurred in the Democratic Republic of the Congo and in Morocco in the summers of 2003 and 2004, respectively, with a large impact on public health. Virus was isolated from the conjunctival swabs of 30 Congolese and 20 Moroccan patients. Enterovirus-specific cytopathic effect was observed in all samples. None of the strains could be typed using a conventional neutralization assay with the Melnick intersecting pools; however, by sequencing the VP1 region, the viruses could be identified as coxsackie A24 variants. Phylogenetic analysis of the 3C protease region revealed that these strains were closely related to each other as well as to genotype III isolates detected in Korea in 2002, thus proving their worldwide spread. This is the first report of an epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Africa since 1987 and the first ever from Morocco.
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Affiliation(s)
- N Lévêque
- Centre National de Référence des Entérovirus, Hôpital E. Herriot, Hospices Civils de Lyon, Lyon, France.
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25
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Muyembe JJ, Billiau A, De Somer P. Mechanism of resistance to virus challenge in mice infected with Brucella abortus. Arch Gesamte Virusforsch 1972; 38:290-6. [PMID: 4343370 DOI: 10.1007/bf01262819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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26
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Billiau A, Muyembe JJ, De Somer P. Interferon-inducing polycarboxylates: mechanism of protection against vaccinia virus infection in mice. Infect Immun 1972; 5:854-7. [PMID: 4344092 PMCID: PMC422452 DOI: 10.1128/iai.5.6.854-857.1972] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The present study was undertaken to examine possible correlations between long-term protection of mice treated with polycarboxylates and infected with vaccinia virus, and the presence of subdetectable amounts of interferon in the tissues, as determined by tissue or organ resistance to replication of viruses. After a single dose of polycarboxylate, splenic resistance to virus replication could be detected. It persisted for 7 to 14 days, but no attempt was made to prove that it was due to subdetectable amounts of interferon. Whole-animal protection lasted longer than splenic resistance. Moreover, when different polycarboxylates and different virus strains were used, patterns of early protection were not correlated with those of splenic resistance. These data, as others presented earlier, suggest that, in addition to interferon, other antiviral mechanisms are stimulated by polycarboxylates.
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27
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Billiau A, Muyembe JJ, De Somer P. Mechanism of antiviral activity in vivo of polycarboxylases which induce interferon production. Nat New Biol 1971; 232:183-6. [PMID: 4998865 DOI: 10.1038/newbio232183a0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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28
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Abstract
Intraperitoneally administered chlorite-oxidized oxyamylose (COAM) provided protection of mice against intranasal infection with several influenza virus strains. Treated animals invariably showed a reduced consolidation of the lungs and, in the case of infection with lethal strains of virus, also a delay in mortality. With a small dose of influenza A/PR8 virus, an increase in final survival rate could be observed. The effect of COAM on influenza virus infection lasted for at least 4 to 8 days. Inhibition of lung consolidation was not paralleled by a decrease in virus multiplication in the lung. The significance of this finding in relation to the mechanism of the antiviral action of COAM is discussed.
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