The University of Kamina (UNIKAM) is a public university in the Democratic Republic of the Congo, located in the province of Katanga, city of Kamina. At its creation, it was an Extension of the University of Lubumbashi, then called University Centre of Kamina (C.U.K.). Instruction is in French.U.K.
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.
BACKGROUND:Blood 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. OBJECTIVE:This study aimed to determine the prevalence and factors associated with BEAs among health care providers in Kalemie, Tanganyika Province, Democratic Republic of the Congo. METHODS:A 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. RESULTS:The 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). CONCLUSIONS:BEAs 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.
Guelord Kahinga Mukwiza,1,2 Yves Isango Idi,1 Roger Munan mwazaz,1 Blaise Kaki Bal’olam,1 Justin Biayi Mukendi,1 Paul Tshisola Kashala,3 Freddy Mbiya Kabukwa Bafwindisoni,3 Yvette Yowa Malemba,3 Patrick Tshinawej Mukinyi,3 John Katshunga omalosombe,1,2 Nadine Mambue Mwepu,4 Eric Kiwele Zongwe,5 Joseph Chola Mwansa,1 Michel Kabamba nzaji,6 Xavier Kinenkinda kalume1 1Department of Gynecology and Obstetrics, Faculty of Medicine, University of Lubumbashi, Lubumbashi, Democratic Republic of Congo; 2Department of Midwifery and Reproductive Health, Higher Institute of Medical Techniques of Kolwezi, Kolwezi, Democratic Republic of the Congo; 3Department of Gynecology and Obstetrics, Faculty of Medicine, University of Kolwezi, Kolwezi, Democratic Republic of Congo; 4Department of Anesthesia and Resuscitation, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of the Congo; 5Department of Gynecology and Obstetrics, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of Congo; 6Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of CongoCorrespondence: Michel Kabamba nzaji, Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of Congo, Email michelnzaji@yahoo.frBackground: Cesarean myomectomy remains a controversial procedure because of concerns regarding severe hemorrhage and peripartum hysterectomy. Recent reports suggest that it may be performed safely in carefully selected patients; however, the certainty of the available evidence remains very low, and reports describing its use for refractory uterine atony in women with eclampsia are scarce.Case Presentation: We report the case of a 38-year-old Congolese woman, gravida 3 para 0 abortus 2, admitted to the University Clinics of Lubumbashi with generalized tonic-clonic seizures, severe hypertension (180/120 mmHg), and marked proteinuria, leading to a diagnosis of eclampsia. No ultrasound examination was performed before surgery because of the maternal emergency. After stabilization with magnesium sulfate and nicardipine, an emergency cesarean section was performed. A live female infant weighing 2030 g was delivered but died 30 minutes after birth in the neonatal intensive care unit.Operative Findings and Management: Extensive uterine fibromyomatosis was identified, including nine fibroids, the largest measuring 16 × 10 × 8 cm and weighing approximately 1050 g. After hysterorrhaphy, severe uterine atony persisted despite uterine massage and oxytocin administration. Considering the patient’s nulliparity and the wish to preserve the uterus, a conservative cesarean myomectomy was undertaken. Five major fibroids were removed, including the giant lower-segment fibroid. Progressive restoration of uterine tone was observed after myomectomy, with satisfactory hemostasis. Estimated blood loss was 900 mL, and total operative time was 90 minutes. Postoperatively, the patient received blood transfusion and recovered without complications. She was discharged in stable condition on postoperative day five.Conclusion: In this patient, removal of the dominant fibroids was temporally associated with restoration of uterine tone and allowed emergency hysterectomy to be avoided. This single observation does not establish the safety or efficacy of the procedure, but suggests that cesarean myomectomy may be considered as a uterus-preserving option in carefully selected patients with refractory uterine atony related to extensive fibromyomatosis, provided that surgical expertise and blood transfusion capacity are available.Keywords: cesarean myomectomy, uterine fibroids, refractory uterine atony, eclampsia, postpartum hemorrhage, fertility preservation, case report
