University of Kamina

Background Malaria remains the leading cause of morbidity and mortality in the Democratic Republic of Congo (DRC), particularly among children under five years of age, who account for 67% of malaria-related deaths. Given the stationary trend in incidence despite current efforts, the National Strategic Plan (NSP) 2024–2028 introduces innovative interventions requiring rigorous prospective evaluation. This study aims to model transmission dynamics under different coverage scenarios to guide resource allocation for disease control and elimination in this vulnerable group. Methods We developed a deterministic discrete-time compartmental model of SEIR (Humans) and SEI (Mosquitoes) type, parameterized using data from the District Health Information Software 2 (DHIS2) from 2017 to 2023, covering 519 health zones. Transmission intensity was quantified by the basic reproduction number (R0), calculated using the next-generation matrix method, after adjusting the crude incidence for reporting, testing, and care-seeking. Results In the absence of intervention scale-up, morbidity saturates at critical endemic levels. With current coverage rates (21% for vaccine and chemoprevention), R0 values remain well above unity: R21 vaccine (R0 = 4.55), IPTi/PMC (R0 = 4.66), and ITNs (R0 = 3.71). Achieving 80% coverage for individual interventions is insufficient to interrupt transmission. Only the combined scenario ("Mix-intervention") at 80% coverage achieves an R0 of 0.48. Conclusion Interrupting malaria transmission among children under five in the DRC is mathematically feasible. However, it requires a synergy of innovative interventions reaching a critical coverage threshold.

BackgroundBlood exposure accidents (BEAs) remain a major occupational hazard for health care providers, particularly in low‑resource settings. Despite their preventable nature, BEAs continue to occur frequently due to gaps in compliance with standard precautions and limited institutional surveillance. ObjectiveThis study aimed to determine the prevalence and factors associated with BEAs among health care providers in Kalemie, Tanganyika Province, Democratic Republic of the Congo. MethodsA cross-sectional study was conducted in March 2024 among 316 health care providers randomly selected from 34 health facilities: public facilities (20/34, 58.8%), private facilities (9/34, 26.5%), and faith‑based facilities (5/34, 14.7%). Data were collected using a structured questionnaire adapted from World Health Organization and Centers for Disease Control and Prevention tools. Logistic regression was performed to identify predictors of BEAs, with adjusted odds ratios (AORs), 95% CIs, and P values reported. ResultsThe lifetime prevalence of BEAs was 65.8% (208/316), and the 12-month prevalence was 60.4% (191/316). The most frequent causes were unexpected patient movement (81/191, 42.4%) and lack of attention (66/191, 34.6%). Needlestick injuries accounted for 59.2% (113/191) of exposures. Only 36.1% (69/191) of incidents were formally reported. Multivariate analysis identified two independent predictors: (1) noncompliance with standard precautions (AOR 2.921, 95% CI 1.503-5.677; P=.001) and (2) facility type (working in secondary‑level facilities was protective; AOR 0.310, 95% CI 0.144-0.670; P=.003). ConclusionsBEAs were highly prevalent among health care providers in Kalemie. Most incidents were preventable, and noncompliance with standard precautions significantly increased risk. Strengthening infection prevention and control measures, ensuring consistent availability of personal protective equipment, and establishing effective surveillance systems are urgently needed to protect health care workers and reinforce health system resilience.

Millions of healthcare workers experience percutaneous exposure to bloodborne communicable infectious disease pathogens annually, with the risk of contracting occupationally acquired infections. In this study, we aimed to assess the status of occupational safety and outbreak preparedness in Congolese nurses and laboratory technicians in Kongo central and the Katanga area, amidst multiple ongoing public health emergencies in the Democratic Republic of the Congo (DRC). This was a multicenter analytical cross-sectional study conducted in five referral hospitals located in Kongo central province and the Katanga area between 2019 and 2020 amidst Ebola, Yellow fever, Cholera and Chikungunya outbreaks. Participants were adult A0 grade nurses, A1 nurses, A2 nurses and medical laboratory technicians (N = 493). They answered a structured, self-administered questionnaire related to hospital hygiene and standard precautions for occupational infection prevention. The majority of the respondents were females (53.6%), and 30.1% of them have never participated in a training session on hospital infection prevention during their career. The proportions of those who have been immunized against hepatitis B virus (HBV) was markedly low, at 16.5%. Of the respondents, 75.3% have been using safety-engineered medical devices (SEDs), whereas 93.5% consistently disinfected medical devices after use. Moreover, 78% of the respondents used gloves during medical procedures and 92.2% wore masks consistently. A large majority of the respondents, 82.9%, have been recapping the needles after use. Regarding participation in outbreak response, 24.5% and 12.2% of the respondents were Chikungunya and Cholera epidemic responders, respectively; 1.8% have served in Ebola outbreak sites. The proportion of the respondents who sustained at least one percutaneous injury by needlestick or sharp device, blood/body fluid splash or both in the previous 12-month period was high, 89.3% (41.8% for injury, 59.2% for BBF event), and most of them (73%) reported over 11 events. Compared to laboratory technicians, nurses had higher odds for sustaining percutaneous injury and BBF events [OR = 1.38 (0.16); p < 0.01], whereas respondents with longer working experience were less likely to sustain those events [OR = 0.47 (0.11); p < 0.001]. Findings from this study suggest that Congolese nurses and laboratory technicians experience a high frequency of injury and BBF events at work, and remain at high risk for occupationally acquired infection. There is a need for periodic capacity-building training for the healthcare workforce to improve infection prevention in health settings, the provision of sufficient and appropriate PPE and SEDs, post-exposure follow-up and keeping records of occupational injuries in hospitals in Congolese healthcare settings.

Introduction: Self-medication constitutes a major public health problem, particularly in malaria management in sub-Saharan Africa, where it contributes to treatment delays, complications, and increased mortality associated with severe forms of the disease. This study aimed to determine the prevalence and identify the determinants of self-medication in the management of severe malaria in the Kamina Health Zone. Methods This was a cross-sectional analytical study conducted from January 20 to May 20, 2024, among 231 patients who had suffered from severe malaria and had been admitted to Kamina General Referral Hospital, BUMI Referral Health Center, and Bon Berger Polyclinic during the study period. The patient themselves responded when they were able to do so, or their parent/guardian/caregiver when the patient was a minor or unable to respond. Data were collected through face-to-face interviews using a pre-tested questionnaire configured on the Kobotoolbox platform. Statistical analyses were performed using SPSS version 23. Associations were tested using Pearson's Chi-square test or Fisher's exact test, as appropriate. Binary logistic regression was used to identify determinants of self-medication (P < 0.05). Results The results of this study showed that the prevalence of self-medication in the management of severe malaria in our study setting was 33.3%. The determinants of self-medication in our study setting were: lack of information about the prohibition of self-medication; poor assessment of the quality of care provided at the health facility; lack of education; and low socioeconomic status. Conclusion Self-medication in the management of severe malaria remains common in Kamina and is strongly influenced by informational, educational, and socioeconomic factors, as well as by perceptions of the quality of healthcare.

Les organisations à assise communautaire (OAC) constituent un pilier essentiel de la riposte au VIH en renforçant la prévention, le dépistage, l'observance thérapeutique, le soutien psychosocial et le maintien des personnes vivant avec le VIH (PVVIH) dans les soins. Malgré leur contribution reconnue, peu d'études ont évalué leur apport dans les provinces de l'intérieur de la République Démocratique du Congo, notamment au Kasaï Oriental. Cette étude avait pour objectif d'évaluer le niveau des interventions communautaires reçues par les bénéficiaires des OAC et d'identifier les facteurs sociodémographiques, cliniques et organisationnels qui y sont associés. Une étude transversale analytique a été menée du 24 avril 2026 au 24 juin 2026 auprès de 136 personnes vivant avec le VIH, suivies par 10 organisations à assise communautaire de la province du Kasaï Oriental. Les données ont été recueillies à l'aide d'un questionnaire structuré administré sur KoboToolbox. Les analyses statistiques ont été réalisées avec IBM SPSS Statistics version 26. Les caractéristiques des participants ont été décrites à l'aide de statistiques descriptives. Les facteurs associés au niveau des interventions communautaires ont été recherchés par le test du χ², suivi d'une régression logistique bivariée puis multivariée. Le seuil de significativité statistique a été fixé à 5 %. Au total, 136 bénéficiaires ont été inclus dans l'étude. La majorité étaient des femmes (67,6 %), âgées de 40 ans ou plus (72,1 %), non mariées (52,2 %) et avaient un niveau d'instruction secondaire ou supérieur (62,5 %). Plus de la moitié vivaient avec le VIH depuis au moins 120 mois (55,1 %) et étaient sous traitement antirétroviral depuis au moins 120 mois (51,5 %). Après construction du score composite, 55,9 % des bénéficiaires présentaient un bon niveau d'interventions communautaires contre 44,1 % un faible niveau. En analyse multivariée, aucun facteur n'était statistiquement associé au niveau des interventions communautaires. Toutefois, les participants âgés de 40 ans ou plus (ORa = 0,46; IC95 % : 0,21–1,02; p = 0,057) ainsi que ceux ayant un niveau d'instruction secondaire ou supérieur (ORa = 0,53; IC95 % : 0,26–1,10; p = 0,090) présentaient une tendance à recevoir un bon niveau d'interventions communautaires moins fréquemment que leurs homologues. Les organisations à assise communautaire jouent un rôle déterminant dans la prise en charge communautaire des personnes vivant avec le VIH au Kasaï Oriental. Toutefois, près d'un bénéficiaire sur deux reçoit encore un niveau d'interventions communautaires insuffisant. Le renforcement des capacités institutionnelles des OAC, la pérennisation de leur financement et leur meilleure intégration dans le système de santé sont indispensables pour améliorer la qualité des interventions communautaires et accélérer l'atteinte des objectifs nationaux et internationaux de lutte contre le VIH.