Background: A majority of women in the Democratic Republic of the Congo (DRC) give birth in a health facility, but maternal and newborn mortality remains high. In rural areas, the quality of facility-based delivery care is often low. This study examines clinical quality of intrapartum care in two provinces of the DRC.
View Article and Find Full Text PDFBackground: Despite increasing access to health care, under-5 mortality remains high in many parts of Sub-Saharan Africa. Interventions to improve quality of care have mostly focused on additional training for medical staff, but generally shown little impact. We will assess the impact of financially incentivized quarterly provider knowledge assessment on compliance with Integrated Management of Childhood Illness (IMCI) protocols in Congo, DRC.
View Article and Find Full Text PDFObjectives: Recently, improvements have been made to diagnostics for gambiense sleeping sickness control but their performance remains poorly documented and may depend on specimen processing prior to examination. In a prospective study in the Democratic Republic of the Congo, we compared the diagnostic performance of several parasite detection techniques, immune trypanolysis and of m18S PCR on whole blood stored in a stabilisation buffer or dried on filter paper.
Methods: Individuals with CATT whole blood (WB) titer ≥1∶4 or with clinical signs indicative for sleeping sickness were examined for presence of trypanosomes in lymph node aspirate (LNA) and/or in blood.
Haptoglobin, coded by the HP gene, is a plasma protein that acts as a scavenger for free heme, and haptoglobin-related protein (coded by the HPR gene) forms part of the trypanolytic factor TLF-1, together with apolipoprotein L1 (ApoL1). We analyse the polymorphic small intragenic duplication of the HP gene, with alleles Hp1 and Hp2, in 52 populations, and find no evidence for natural selection either from extended haplotype analysis or from correlation with pathogen richness matrices. Using fiber-FISH, the paralog ratio test, and array-CGH data, we also confirm that the HPR gene is copy number variable, with duplication of the whole HPR gene at polymorphic frequencies in west and central Africa, up to an allele frequency of 15 %.
View Article and Find Full Text PDFTrypanosoma brucei gambiense (Tbg) is responsible for the chronic form of Human African trypanosomiasis (HAT), classically lasting for years. Clinical evolution of HAT cases seems to be complex and reports on asymptomatic carriers and spontaneous cure have been published recently, strengthening the likely existence of the phenomenon of human trypanotolerance. Host's genetic factors could be involved in both the control of infection levels and the mortality rates, as clearly shown in experimental models, but also in human.
View Article and Find Full Text PDFA retrospective chart review of 4,925 human African trypanosomiasis patients treated with melarsoprol in 2001-2003 in Equateur Nord Province of the Democratic Republic of Congo showed a treatment failure rate of 19.5%. This rate increased over the 3 years.
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