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Abstract Background Understanding and improving access to essential services in (post)-conflict settings requires paying particular attention to the actors who occupy the space left ‘empty’ by weak or deficient State institutions. Religious institutions often play a fundamental role among these actors and typically benefit from high trust capital, a rare resource in so-called ‘fragile’ states. While there is a literature looking at the role faith organisations play to mobilise and sensitise communities during emergencies, our focus is on a different dimension: the reconfiguration of the relationship between religion and health authorities impelled by health crises. Methods We analyse observations, interviews, and focus group discussions with 21 leaders from eight different religious groups in Ituri province in 2020–2021. Results Faith institutions handled the Covid-19 lockdown period by using and redeploying structures at the grassroots level but also by responding to health authorities’ call for support. New actors usually not associated with the health system, such as revivalist churches, became involved. The interviewed religious leaders, especially those whose congregations were not previously involved in healthcare provision, felt that they were doing a favour to the State and the health authorities by engaging in community-level awareness-raising, but also, crucially, by ‘depoliticising’ Covid-19 through their public commitment against Covid-19 and work with the authorities in a context where the public response to epidemics has been highly contentious in recent years (particularly during the Ebola outbreak). The closure of places of worship during the lockdown shocked all faith leaders but, ultimately, most were inclined to follow and support health authorities. Such experience was, however, often one of frustration and of feeling unheard. Conclusion In the short run, depoliticization may help address health emergencies, but in the longer run and in the absence of a credible space for discussion, it may affect the constructive criticism of health system responses and health system strengthening. The faith leaders are putting forward the desire for a relationship that is not just subordination of the religious to the imperatives of health care but a dialogue that allows the experiences of the faithful in conflict zones to be brought to the fore.

Waldenström macroglobulinemia (WM) is a rare B-cell Non-Hodgkin Lymphoma. There are only few prospective randomized clinical trials to guide treatment recommendations and there is no international consensus on a preferred first line treatment approach. In the recently revised Dutch guideline for WM, we describe recommendations for practice based as much as possible on the known data. Here, we summarize the considerations for first-line treatment based on these Dutch guidelines. Available evidence is summarized, including efficacy and toxicity data. Combinations of Rituximab with chemotherapy, proteasome inhibition or BTK-inhibition are all valid first line treatment options. The Dutch WM working group considers Dexamethasone/Rituximab/Cylofosfamide (DRC) a suitable first-line treatment for many WM patients, given the efficacy, the relatively mild toxicity profile and the extensive experience with this regimen. However, the long-term toxicities of DRC are unclear and need further clarification. Other regimens such as R-bendamustine, R-Bortezomib-dexamethason are also effective options, however with specific toxicities. BTK-inhibitors are not a preferred option in first line for most patients in the Dutch WM guidelines because of the need for longterm treatment and toxicities. Based on patient preferences research, future clinical trials should focus on effective fixed-duration regimens with non-cytotoxic therapies that have a favorable toxicity profile. Further development of (combinations with) BCL-2 inhibititors, novel proteasome inhibitors and BTK-inhibition could be interesting. In addition T-cell-directed treatments including bispecific antibodies as a monotherapy or combined with other novel agents deserve further study in WM.

To date, no study has been done yet on the distribution of Hepatitis C virus genotypes in Lubumbashi, Democratic Republic of Congo. The objective of this work was to determine the seroprevalence and study the distribution of hepatitis C virus (HCV) genotypes among blood donors in Lubumbashi, DRC. This was a cross-sectional descriptive study among blood donors. The detection of anti-HCV antibodies was carried out by rapid diagnostic test (RDT) then confirmed by Chemiluminescent immuno-assay (CLIA). Viral load was determined by Nucleic Acid Amplification test (NAT) on Panther system and genotyping by Next Generation Sequencing (NGS) on Sentosa platform. The obtained seroprevalence was 4.8%. Genotypes 3a (5.0%), 4 (90.0%) and 7 (5.0%) and a few drug resistance mutations were identified in the study population. Significant disturbances of some studied biochemical parameters (HDL-cholesterol, direct bilirubin, transaminases, ALP, GGT and albumin) have been observed in positive HCV blood donors. Irregular family and volunteer donors have been found as the socio-demographic characteristics associated with hepatitis C. With a seroprevalence of 4.8% obtained among blood donors, Lubumbashi is in an area with medium endemicity for HCV, highlighting the need to implement strategies aiming to improve transfusion safety among blood recipients in Lubumbashi. This study reports for the first time the presence of HCV strains of genotypes 3a, 4 and 7. These results might allow better therapeutic management of HCV infections and contribute to the development of the mapping of HCV genotypes in Lubumbashi and DRC as well. [ABSTRACT FROM AUTHOR]

Missionaries played a central role in the colonial system in Congo – they were a key part of the well-known triad consisting of state, church, and corporations. During the Belgian Congo period (1908–1960), missionaries of diverse congregations were in charge of health care and education, and their religious services were the only ones officially recognized. Narratives have strongly shaped how these missionaries operated. One could even say that the conversion and missionary narrative define what it means to set up a successful 'mission'. In my contribution, I explore how these narratives surface in two novels written in the two decades after Congo's Independence in 1960. Entre les eaux (1973) by V.Y. Mudimbe and Het stigma (1970) by Jacques Bergeyck both refer to the missionary activities in mid-century Congo but their use of the conversion and missionary narrative complicates the common-sense understanding of them. By comparing a Flemish and a Congolese novel, this article aims to decentre the Flemish literary world as the locus where these narratives gain their meaning. By taking a more transnational, multilingual context as a starting point, it wants to shed new light on the ways in which the European missionary presence in Congo has been imagined. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Hepatitis C virus (HCV) infection and diabetes mellitus (DM) are two frequent diseases in the Democratic Republic of the Congo (DRC) and several studies seem to show a link between the two diseases worldwide. However, no study has evaluated this link in our country. The present study aimed at determining the seroprevalence of HCV in diabetic patients as well as associated risk factors. Methodology A multicenter cross‐sectional study allowed us to sample diabetic patients in two diabetic healthcare centers of Bukavu city in the eastern part of the DRC, from December 2020 to December 2022. A questionnaire was submitted to the diabetic patients to collect sociodemographic data, anamnestic data on risk factors for HCV infection, and clinical data on DM. These factors were analyzed based on anti‐HCV serological results. Results Among the 180 selected patients, 19 (10.6%) were tested positive for anti‐HCV antibodies. After multivariate analysis, the identified factors influencing these outcomes were male sex (adjusted odds ratio [aOR]: 3.5, p = 0.027), dental extraction (aOR: 7.6, p = 0.001), and living in a privileged environment (aOR: 0.29, p = 0.03). The factors related to DM such as the type, the disease duration, or the usual type of treatment did not influence the serological results. Conclusion This study shows that HCV seroprevalence in diabetic patients is very high compared with the general population. This suggests combined screening and management policies in this population.

Diaconate and youth in Afrikaans-speaking Reformed congregations in South Africa. South Africa is characterised by various socio-economic and socio-political challenges (fractures) not easily met (or healed). ‘Fractures’ refer to social, economic, religious, spatial, ecological, environmental, and economic injustices and other issues. Within this context, the church is confronted with her vocation. The unique vocation of a congregation is that the members become a ‘new community’ (koinonia) in which they not only care for one another but also develop relationships featuring care for, and mercy and solidarity (diakonia) with the weak, poor, and marginalised in society. Several researchers prove that the current South African youth could be classified as vulnerable and marginalised. Since the church does not preach the gospel in a vacuum but in relation to specific human realities, the theme of the youth and diaconate in the Afrikaans-speaking Reformed churches in South Africa is examined in this study, based on Osmer’s Practical Theological Interpretation. Interdisciplinary and/or interdisciplinary implications: The interdisciplinary nature of this contribution is spread across the two fields of youth ministry and diaconate. The sub-disciplines of both the youth in general, and youth ministry and youth work within the academic discourse of the diaconate are studied, specifically in the Afrikaans-speaking Reformed denomination.

This study sought to generate, evaluate, and recommend possible national policies for the government of the Democratic Republic of the Congo (DRC) to implement to most effectively boost growth and investment in renewable energy technologies (RETs) through 2065 using Open Source Energy Modelling System (OSeMOSYS). The novelty of this study stems in-part from the scarcity of RET modelling completed for specific West African countries rather than for broader regions. Market-based instruments were identified as the policy type most practical for DRC. From modelling the resulting energy systems for policy pathways involving a 16% RET subsidy, a 70% fossil fuel tax, and both in combination relative to no-policy baseline scenarios, the scenarios including the tax had the lowest net costs (USD304–306 B) and the highest proportion of RETs (above 90%). Additionally, despite the current reliance on hydropower to fulfil 98% of its energy needs, hydropower played a very minor role in all of a modelled scenarios (no future investment beyond residual capacity). Finally, a post-modelling market potential assessment was performed on the technology that dominated off-grid supply across policy pathways: a 0.3 kW small solar home system (SHS). Based on learning rates for solar photovoltaics (PV), demand for a small SHS in DRC (>160 million units in total) was found to be sufficient to substantially reduce the unit cost as deployment scales. Ultimately, this study yielded four recommendations for the DRC government: (1) Pursue financial incentives to catalyse DRC’s renewable energy supply. (2) Tax fossil fuel energy production. (3) Re-evaluate focus on hydropower. (4) Promote DRC as a healthy market for solar home systems.

Aim: The purpose of the study was to identify common descriptors and publication hotspots that may form reference themes for future monkey pox research. Method: Bibliometric analysis of monkeypox related studies between 1962 and 2022 was carried out to ascertain and describe this body of literature. Results and conclusion: A total of 1,134 documents were analysed for bibliometric indicators. The studies had 3,478 authors, an average of 5.72 co-authors per publication and a 3.73 author collaboration index. Annual scientific production peaked in 2004 (5.5%) and 2020 (5.3%). Monkeypox research accumulated 128 grants, 68 policy documents, 9 clinical trials, and 50 patents. The United States placed first in terms of the number of documents and citations, followed by Germany with 73, United Kingdom with 53, Russia and the Democratic Republic of the Congo (DRC) with 34 documents each. The DRC and Nigeria had the most documents among African countries. Text mining showed researchers have put their efforts into studies related to infectious disease ‘epidemiology’: the ‘emergence’, ‘Case diagnosis and ‘surveillance’ of ‘outbreaks’. The top keywords were ‘monkeypox’ (570 times), ‘monkeypox virus’ (411 times), ‘poxviridae infections’ (332 times), ‘small pox’ (266 times), ‘orthopox virus’ (248 times), ‘vaccinia virus’ (203 times), and ‘disease outbreaks’ (179 times). The most cited treatment related noun phrases were ‘tecovirimat’ (brand name Tembexa), ‘Cidofovir’/ ‘CMX001’ (Brincidofovir), ‘ACAM2000’ (imvanex vaccine) and ‘Vaccinia’ Immune Globulin (‘VIG’). This result will serve as a foundation for future research, guiding decision-making in monkeypox research and therapy.

Résumé : Cette contribution interroge le bilan de formation aux métiers du numérique de Lisungi Fablab de Kinshasa. Le succès récolté par le Lisungi Fablab installé à Kinshasa en 2018 nous a amené à questionner les pratiques de formation mobilisées et les résultats obtenus en lien avec les attentes des 70 apprenants dans un contexte des défis numériques et éducationnels. Une méthodologie mixte combinant l’approche qualitative et quantitative a permis d’analyser les pratiques de formation, l’environnement matériel d’apprentissage et le niveau d’adéquation entre les pratiques et les attentes des apprenants. Les premiers résultats mettent en lumière des nouvelles formes d’apprentissage, des nouvelles trajectoires professionnelles susceptibles d'alimenter la cartographie des métiers du numérique en RDC.

BackgroundFew studies have assessed the relationship between weight-for-height (WHZ) and mid-upper arm circumference (MUAC) with hospital mortality considering confounders. The particularity of MUAC for age (MUACZ) is less documented.ObjectiveThis study aims to investigate this relationship in a region endemic for severe acute malnutrition (SAM).MethodsThis is a retrospective cohort based on a database of children admitted from 1987 to 2008 in South Kivu, eastern DRC. Our outcome was hospital mortality. To estimate the strength of the association between mortality and nutritional indices, the relative risk (RR) with its 95% confidence interval (95% CI) was calculated. In addition to univariate analyses, we constructed multivariate models from binomial regression.ResultsA total of 9,969 children aged 6 to 59 months were selected with a median age of 23 months. 40.9% had SAM (according to the criteria WHZ

The ichthyofauna of Lake Tanganyika consists of 12 families of fish of which five belong to Siluriformes (catfishes). Studies on Siluriformes and their parasites in this lake are very fragmentary. The present study was carried out to help fill the knowledge gap on the monogeneans infesting the siluriform fishes of Lake Tanganyika in general and, more particularly, Clarias gariepinus. Samples of gills of Clarias gariepinus (Clariidae) were examined for ectoparasites. We identified the monogenean Gyrodactylus transvaalensis (Gyrodactylidae). This is the first time this parasite was found infecting gills. We are the first to observe a large spine in the male copulatory organ of this species and to provide measurements of its genital spines; this completes the description of the male copulatory organ, which is important in standard monogenean identification. This is the first monogenean species reported in C. gariepinus at Lake Tanganyika and the third known species on a representative of Siluriformes of this lake. It brings the total number of species of Gyrodactylus recorded in Lake Tanganyika to four. Knowing that other locations where this species has been reported are geographically remote from Lake Tanganyika, we propose a "failure to diverge" phenomenon for G. transvaalensis. [ABSTRACT FROM AUTHOR]

A systematic and contextualized assessment of the interactions between the Sustainable Development Goals and health in the Democratic Republic of Congo is currently lacking. This study aimed to characterize and classify the linkages between the Sustainable Development Goals in the DRC with a focus on health and well-being. In this semi-qualitative participatory study, 35 experts assessed 240 interactions between 16 of the 17 SDGs during a two-day workshop in Kinshasa, Democratic Republic of the Congo, using a scale from +3 (strongly promoting) to −3 (strongly restricting). SDG 16 (Peace, justice, and strong institutions) had the strongest promoting influence on other goals and was identified as a key priority for the DRC to attain the SDGs. Progress on SDG 3 (good health and well-being) was perceived as promoting progress on most SDGs, and through second-order interactions, a positive feedback loop was identified. Furthermore, progress on the other SDGs was deemed to promote progress on SDG 3, with SDG 16 having the greatest positive potential when second-order interactions were taken into account. Our results show the importance of recognizing synergies and trade-offs concerning the interactions between health and other SDGs and that it is imperative to set up structures bringing together different sectors to accelerate work towards achieving the 2030 Agenda. [ABSTRACT FROM AUTHOR]

This article examines the experience of healthcare professionals working in primary healthcare provision during the first wave of the COVID-19 pandemic in North Kivu, the Democratic Republic of the Congo, and in Kambia District, Sierra Leone. Drawing on ethnographic observation, interviews and focus groups, we explore everyday narratives of 'crisis' in these two regions which had recently seen Ebola epidemics. In describing the impact of COVID-19 on their life, work, and relationships with patients, healthcare workers made sense of the pandemic in relation to broader experiences of structural economic and political crisis, as well as differing experiences of recent Ebola epidemics. There were contradictory experiences of rupture and continuity: whilst COVID-19 disrupted routine health provision and exacerbated tensions with patients, the pandemic was also described as continuity, interacting with broader structural problems and longer-term experiences of 'crisis'. In effect, healthcare workers experienced the COVID-19 pandemic at the crossroads between the exceptional and the everyday, where states of exception brought by emergency measures shed new light on long-standing tensions and structural crisis. [ABSTRACT FROM AUTHOR]

Diaconate and youth in Afrikaans-speaking Reformed congregations in South Africa. South Africa is characterised by various socio-economic and socio-political challenges (fractures) not easily met (or healed). 'Fractures' refer to social, economic, religious, spatial, ecological, environmental, and economic injustices and other issues. Within this context, the church is confronted with her vocation. The unique vocation of a congregation is that the members become a 'new community' (koinonia) in which they not only care for one another but also develop relationships featuring care for, and mercy and solidarity (diakonia) with the weak, poor, and marginalised in society. Several researchers prove that the current South African youth could be classified as vulnerable and marginalised. Since the church does not preach the gospel in a vacuum but in relation to specific human realities, the theme of the youth and diaconate in the Afrikaans-speaking Reformed churches in South Africa is examined in this study, based on Osmer's Practical Theological Interpretation. Interdisciplinary and/or interdisciplinary implications: The interdisciplinary nature of this contribution is spread across the two fields of youth ministry and diaconate. The sub-disciplines of both the youth in general, and youth ministry and youth work within the academic discourse of the diaconate are studied, specifically in the Afrikaans-speaking Reformed denomination. [ABSTRACT FROM AUTHOR]

Questions have abounded as to what Burundi’s motives and interests have been in sending troops and spearheading the intervention in the eastern DRC. With reference to the case of Burundi’s intervention within the framework of the East African Community’s (EAC) response to the growing conflict in the eastern DRC, this article considered a broad range of what Burundi’s motives and interests might be. This included security and stability, both nationally and regionally, regional political dynamics and the position of Burundi within this, and trade and business opportunities. However, this article argues although all of these have explanatory power, some of the complexity and nuance of the intervention is missed if we do not place it within the context of Pan-Africanist considerations, including that of African integration, African self-reliance and agency, and African ownership of and control over its own resources. [ABSTRACT FROM AUTHOR]

The effect of development aid on human development in developing countries has been widely debated in academic circles. This study builds upon this debate and examines the impact of Official Development Assistance (ODA) on human development in the Democratic Republic of the Congo (DRC) post-Millennium Declaration and post-two Congo wars. It determines the state of human development in DRC and analyses the relationship between aid and human development using a combination of quantitative and qualitative methods. The research finds that human development has improved in DRC after the wars, but ODA has not significantly contributed to this improvement. Thus, it is important to enhance accountability mechanisms in donor and state institutions. This study adds to the current discourse surrounding human development and ODA and provides valuable insights for policymakers and practitioners concerning the utilisation of ODA in DRC. [ABSTRACT FROM AUTHOR]

Human resources for health has been the centre of attention for many decades as more African countries fail to meet health targets even though there is no shortage of country-specific policies and strategies to improve these resources. The WHO Africa region has a critical shortage of nurses and midwives, which will remain unresolved as long as funding and policy implementation challenges persist. In the interim, the profession itself must find innovative and collaborative ways to make inroads into the nursing shortages - specifically in areas where advanced clinical skills are needed. Harnessing capacity from within universities in southern Africa is posited as one of the ways to bolster the education of nurses and midwives. Presented in part 1, the New Partnership for Africa's Development project aimed to increase the number and enhance the quality of postgraduate education and clinical training of nurses and midwives to improve the quality of healthcare services with particular reference to the reduction of maternal and neonatal mortality rates. In fulfilling this aim, clinical master's programmes were developed and implemented in seven African countries. In this article, we chose illustrative case studies to describe the master's programme design and roll-out, in line with the health profile of the Democratic Republic of the Congo and the Republic of Mozambique. We explain the programme electives, enrolments and throughput, including outputs and outcomes. From experiences gained and lessons learnt, we extrapolate implications for future cases that employ pan-African and south-to-south university partnerships. [ABSTRACT FROM AUTHOR]

In the Democratic Republic of Congo (DRC), entrepreneurship in the agriculture sector remains for youth a key pillar for income creation. However, few are attracted by agribusiness despite stakeholders' efforts toward engaging youth in agriculture. Therefore, this study examines the relationship between entrepreneurial potential characteristics and youth desirability to start an enterprise in agriculture among 514 young people in Eastern DRC. This study revealed that youth in South Kivu have different entrepreneurship potential features and agribusiness desirability levels according to their gender and living area. Hence, the youth's agribusiness desirability is motivated by an awareness of emerging agripreneurial activities, land ownership, parent involvement in farming activities as a role model, perceived agribusiness as an employment source, management-organizing and opportunistic competencies, market analysis, negotiating, and planning skills. Therefore, efforts to attract youth into agribusiness should focus on the use of media, the creation of awareness of available agribusiness initiatives in their area, and the setup of land policy. This is in addition to putting in place capacity-building programs on entrepreneurial and business skills through incubators, and the formalization of youth agribusiness groups that foster capitalizing experiences between new and accelerated agripreneurial enterprises, with the support of parents and financial institutions, focusing on gender sensitivity, in both rural and urban areas. [ABSTRACT FROM AUTHOR]

Data on coronavirus disease 2019 (COVID-19) prevalence in the Democratic Republic of Congo are scarce. We conducted a cross-sectional study to determine the seroprevalence of antibodies against anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the slum of Kadutu, city of Bukavu, between June and September 2021. The survey participants were all unvaccinated against SARS-CoV-2. The crude seroprevalence rate was adjusted to the known characteristics of the assay. Participants aged 15–49 years old made up 80% of the population enrolled in the study (n = 507; 319 women and 188 men). The overall crude and adjusted seroprevalence rates of antibodies for COVID-19 were 59.7% (95% CI 55.4–63.9%) and 84.0% (95% CI 76.2–92.4%), respectively. This seroprevalence rate indicates widespread dissemination of SARS-CoV-2 in these communities. COVID-19 symptoms were either absent or mild in more than half of the participants with antibodies for COVID-19 and none of the participants with antibodies for COVID-19 required hospitalisation. These results suggest that SARS-CoV-2 spread did not appear to be associated with severe symptoms in the population of these settlements and that many cases went unreported in these densely populated locations. The relevance of vaccination in these communities should be thoroughly investigated. [ABSTRACT FROM AUTHOR]

The Democratic Republic of the Congo (DRC) officially reports low coronavirus disease 19 (COVID-19) prevalence. This cross-sectional study, conducted between September and November 2021, assessed the COVID-19 seroprevalence in people attending Goma's two largest markets, Kituku and Virunga. A similar study in a slum of Bukavu overlapped for 1 month using identical methods. COVID-19-unvaccinated participants (n = 796 including 454 vendors and 342 customers, 60% of whom were women) were surveyed. The median age of vendors and customers was 34.2 and 30.1 years, respectively. The crude and adjusted anti-SARS-CoV-2 antibody seroprevalence rates were 70.2% (95% CI 66.9–73.4%) and 98.8% (95% CI 94.1–100%), respectively, with no difference between vendors and customers. COVID-19 symptoms reported by survey participants in the previous 6 months were mild or absent in 58.9% and 41.1% of participants with anti-SARS-CoV-2 antibodies, respectively. No COVID-19-seropositive participants reported hospitalisation in the last 6 months. These findings are consistent with those reported in Bukavu. They confirm that SARS-CoV-2 spread without causing severe symptoms in densely populated settlements and markets and suggest that many COVID-19 cases went unreported. Based on these results, the relevance of an untargeted hypothetical vaccination programme in these communities should be questioned. [ABSTRACT FROM AUTHOR]

HemoTypeSCTM is one of the immunoassay methods currently used for the early diagnosis of Sickle Cell Disease (SCD) in newborns. Earlier diagnosis remains the key strategy for early preventive care needs and parents' education about the child's future well-being throughout his life. Before considering these children as sick and aligning them for regular medical monitoring, it may be valuable to confirm the HemoTypeSC result with a secondary laboratory testing method. In resource-limited settings, where confirmatory methods are not always available, we propose testing the parents to validate the HemoTypeSC result. This study explored this approach in the city of Kisangani. It was a prospective diagnostic accuracy study using genotype biological parents to evaluate HemoTypeSC's performance in the newborn. Fifty-eight children born to 46 known mothers, and 37 known fathers, have been tested. The phenotyping showed that 41 (70.7%) children were SS, whose 37 were born to a couple AS/AS and 4 to a couple AS/xx. Of the 41 SS children, 8 (19.5%) were newborns and 33 (80.4%) were children; 12 (20.6%) children were AS, one of whom was born to a couple SS/AA and 11 to a couple AA/SS; 5 (8.6%) children were AA. In this population, the probability of offspring born to AS/AS parents being SS rather than AS is high (odds, 1.25). No statistical difference was observed between girls and boys. The pedigree of all 58 children has been confirmed. We demonstrated that testing biological parents with HemoTypeSC is a reliable confirmatory method for newborn screening but it presents some limitations discussed in the present article. [ABSTRACT FROM AUTHOR]

Waldenström macroglobulinemia (WM) is a rare B-cell Non-Hodgkin Lymphoma. There are only few prospective randomized clinical trials to guide treatment recommendations and there is no international consensus on a preferred first line treatment approach. In the recently revised Dutch guideline for WM, we describe recommendations for practice based as much as possible on the known data. Here, we summarize the considerations for first-line treatment based on these Dutch guidelines. Available evidence is summarized, including efficacy and toxicity data. Combinations of Rituximab with chemotherapy, proteasome inhibition or BTK-inhibition are all valid first line treatment options. The Dutch WM working group considers Dexamethasone/Rituximab/Cylofosfamide (DRC) a suitable first-line treatment for many WM patients, given the efficacy, the relatively mild toxicity profile and the extensive experience with this regimen. However, the long-term toxicities of DRC are unclear and need further clarification. Other regimens such as R-bendamustine, R-Bortezomib-dexamethason are also effective options, however with specific toxicities. BTK-inhibitors are not a preferred option in first line for most patients in the Dutch WM guidelines because of the need for longterm treatment and toxicities. Based on patient preferences research, future clinical trials should focus on effective fixed-duration regimens with non-cytotoxic therapies that have a favorable toxicity profile. Further development of (combinations with) BCL-2 inhibititors, novel proteasome inhibitors and BTK-inhibition could be interesting. In addition T-cell-directed treatments including bispecific antibodies as a monotherapy or combined with other novel agents deserve further study in WM. [ABSTRACT FROM AUTHOR]

Data on coronavirus disease 2019 (COVID-19) prevalence in the Democratic Republic of Congo are scarce. We conducted a cross-sectional study to determine the seroprevalence of antibodies against anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the slum of Kadutu, city of Bukavu, between June and September 2021. The survey participants were all unvaccinated against SARS-CoV-2. The crude seroprevalence rate was adjusted to the known characteristics of the assay. Participants aged 15–49 years old made up 80% of the population enrolled in the study (n = 507; 319 women and 188 men). The overall crude and adjusted seroprevalence rates of antibodies for COVID-19 were 59.7% (95% CI 55.4–63.9%) and 84.0% (95% CI 76.2–92.4%), respectively. This seroprevalence rate indicates widespread dissemination of SARS-CoV-2 in these communities. COVID-19 symptoms were either absent or mild in more than half of the participants with antibodies for COVID-19 and none of the participants with antibodies for COVID-19 required hospitalisation. These results suggest that SARS-CoV-2 spread did not appear to be associated with severe symptoms in the population of these settlements and that many cases went unreported in these densely populated locations. The relevance of vaccination in these communities should be thoroughly investigated. [ABSTRACT FROM AUTHOR]

Background: International and market forces are key drivers of deforestation and forest degradation, with transnational and market-based solutions in land-use and forest governance often missing economic, distributive, and environmental targets. Methods: This paper tackles both the framing and effectiveness of transnational initiatives affecting forest lands and peoples in the Global South, and the quality of relationships between institutions in the Global North and the Global South. Through more equitable research partnerships, this paper draws lessons from case studies in Indonesia (legality verification system in different forest property regimes), the Democratic Republic of the Congo (lifting of a moratorium on new logging concession), and Brazil (FSC in the Amazon region and the Amazon Fund). Results: International partnerships have privileged market-based instruments and commodity exchange between Global South and Global North countries, and the benefits of such mechanisms are unevenly distributed. Complementary and alternative policy instruments are discussed for each geography. Conclusions: Glocalizing land-use and forest governance implies in advancing equitable research partnerships between institutions in the Global South and Global North, and strengthening a community of practice for critical enquiry and engagement in partnerships for sustainable development. Land-use, climate and forest governance mechanisms must redress power dynamics, and partnership models, and commit to improving well-being and sustainable livelihood outcomes.

This article develops the idea that late modern war’s relationship with the geos (the ground and the life it sustains) is doubly destructive. While part of this is recognized in a recent focus on slow violence and ecological aftermaths, there is little consideration of the ‘beforemath’, or the sites of extraction that make advanced military technologies possible. Drawing attention to mining in the Democratic Republic of the Congo (DRC), the article connects military technologies to arms manufacturers and their use of extracted minerals (e.g. cobalt, tantalum, copper, uranium). Shared patterns of environmental and public health effects across parts of Iraq, Gaza and the DRC indicate the doubly destructive nature of late modern war’s relationship with the geos: toxic materials threaten life after war as the deposits of bombardment and before war as mineral commodities at the beginning of arms supply chains. The article explicates how a perspective from the beforemath radically refigures the ways we think about war and spatiality, temporality, and the range of bodies affected in ways that promise a fuller understanding of the violence distributed by practices of late modern war. [ABSTRACT FROM AUTHOR]

Abstract Background Diarrhoea is one of the leading causes of death among children under 5 years old in the Democratic Republic of the Congo (DRC). Despite positive effects on prognosis, there is limited literature about the healthcare-seeking behaviours of children with diarrhoea, especially in the DRC. This study used the Andersen Behavioural Model, a theoretical framework, which was commonly adopted to study healthcare utilisation, to investigate and predict factors associated with the use of healthcare to treat diarrhoea in the DRC. Methods Data collected from 2626 under-five children with diarrhoea in the last 2 weeks from the Multiple Indicators Cluster Survey conducted by the National Institute of Statistics in 2017–2018, in collaboration with the United Nations Children’s Fund were used in this study. Both direct and indirect relationships among four latent variables: predisposing traits, enabling resources access, health needs, and health services use were measured using the structural equation modelling to test the Andersen behavioural model. The confirmatory Factor Analysis model was also modified based on the DRC context to explore this further. Results The modified model had the goodness of fit index (GFI) of 0.972, comparative fit index (CFI) of 0.953 and RMSEA of 0.043 (95% CI: 0. 040, 0.047). Health needs (especially diarrhoea) had the largest positive direct effect on healthcare utilisation (standardized regression coefficient [β] = 0.135, P

Abstract Background Overall, 1.8 million children fail to receive the 3-dose series for diphtheria, tetanus and pertussis each year in the Democratic Republic of the Congo (DRC). Currently, an emergency plan targeting 9 provinces including Kinshasa, the capital of the DRC, is launched to reinforce routine immunization. Mont Ngafula II was the only health district that experienced high vaccination dropout rates for nearly five consecutive years. This study aimed to identify factors predicting high immunization dropout rates among children aged 12-23 months in the Mont Ngafula II health district. Methods A cross-sectional household survey was conducted among 418 children in June-July 2019 using a two-stage sampling design. Socio-demographic and perception data were collected through a structured interviewer-administered questionnaire. The distribution of 2017-2018 immunization coverage and dropout rate was extracted from the local health district authority and mapped. Logistic random effects regression models were used to identify predictors of high vaccination dropout rates. Results Of the 14 health areas in the Mont Ngafula II health district, four reported high vaccine coverage, only one recorded low vaccine coverage, and three reported both low vaccine coverage and high dropout rate. In the final multivariate logistic random effects regression model, the predictors of immunization dropout among children aged 12-23 months were: living in rural areas, unavailability of seats, non-compliance with the order of arrival during vaccination in health facilities, and lack of a reminder system on days before the scheduled vaccination. Conclusions Our results advocate for prioritizing targeted interventions and programs to strengthen interpersonal communication between immunization service providers and users during vaccination in health facilities and to implement an SMS reminder system on days before the scheduled vaccination.

One year after a Zaire ebolavirus (EBOV) outbreak occurred in the Boende Health Zone of the Democratic Republic of the Congo during 2014, we sought to determine the breadth of immune response against diverse filoviruses including EBOV, Bundibugyo (BDBV), Sudan (SUDV), and Marburg (MARV) viruses. After assessing the 15 survivors, 5 individuals demonstrated some degree of reactivity to multiple ebolavirus species and, in some instances, Marburg virus. All 5 of these survivors had immunoreactivity to EBOV glycoprotein (GP) and EBOV VP40, and 4 had reactivity to EBOV nucleoprotein (NP). Three of these survivors showed serologic responses to the 3 species of ebolavirus GPs tested (EBOV, BDBV, SUDV). All 5 samples also exhibited ability to neutralize EBOV using live virus, in a plaque reduction neutralization test. Remarkably, 3 of these EBOV survivors had plasma antibody responses to MARV GP. In pseudovirus neutralization assays, serum antibodies from a subset of these survivors also neutralized EBOV, BDBV, SUDV, and Taï Forest virus as well as MARV. Collectively, these findings suggest that some survivors of naturally acquired ebolavirus infection mount not only a pan-ebolavirus response, but also in less frequent cases, a pan-filovirus neutralizing response.

In light of the finalization of the new regulatory framework for market with the adoption of the FRTB at EU level through the publication of CRR III, financial institutions are consolidating the implementations aimed to comply with the new regulatory requirements. The main purpose of this article is to analyze how banks are preparing for the go-live of IMA FRTB reporting – expected to be in January 2024 – focusing on the challenges that they are facing especially in terms of model transformations. In particular, an in-depth analysis will be carried out on the main methodological issues of the new regulatory context technicalities, in order to provide guidelines and market best practices on the Internal Model Approach (IMA) topics shared between Front Office, Risk Management as well as Control Structures.

Two experimental Ebola vaccines were deployed during the tenth Ebola epidemic (2018–20) in the Democratic Republic of the Congo (DRC). The first, the Ervebo vaccine manufactured by Merck, was used as part of a ring vaccination in the epicentre of the epidemic in North Kivu. In 2019, the prime- (Ad26.ZEBOV) and boost- (MVA-BN-Filo) vaccine manufactured by Johnson & Johnson (J&J) became the second vaccine against Ebola, deployed by the DRC-EB-001 vaccine trial in Goma, North Kivu. There was international debate as to the value and ethics of testing a second vaccine in an epidemic context. This article examines how this debate unfolded among actual and potential DRC-EB-001 trial participants in Goma. Drawing on ethnographic observation, interviews and focus groups, it explores how the trial was perceived and contested on the ground and situated in broader debates about the ethics of clinical trials, especially during the COVID-19 pandemic. We illustrate how debates around the ethics of clinical research are not simply centred on bioethical principles but are inseparable from local political dynamics and broader contests about governance, inequality and exclusion.

This article assesses the opinions of youth tomato growers on the accessibility of agricultural credit and factors that influence the accessibility in the Democratic Republic of the Congo (DRC). Data originated from a household survey for the 2019/2020 farming season. We interviewed 218 youth tomato growers from 6 horticulture production zones in the South-Kivu, eastern DRC. The result reveals a low rate of 20.6% on accessing agricultural credit among tomato growers. The topmost nature of agricultural credit received was cash-based, mostly from informal sources of finance (92.7%). The findings reveal that the lack of information on agricultural credit, the fear of credit default, and the absence of Microfinance Institutions in the study areas were the highest-ranking factors hindering tomato growers from accessing agricultural credit services. Our probit model shows that total household income, gender, and tomato growers’ membership in a cooperative were essential factors that explain the probability of accessing agricultural credit. We recommend formalising the agricultural credit system by improving agri-finance extension service delivery to associations of tomato growers among the young to access and use agricultural microcredit services effectively to enhance agricultural production, which is a proxy for rural employment creation and poverty reduction.

Background: Understanding and improving access to essential services in (post)-conflict settings requires paying particular attention to the actors who occupy the space left 'empty' by weak or deficient State institutions. Religious institutions often play a fundamental role among these actors and typically benefit from high trust capital, a rare resource in so-called 'fragile' states. While there is a literature looking at the role faith organisations play to mobilise and sensitise communities during emergencies, our focus is on a different dimension: the reconfiguration of the relationship between religion and health authorities impelled by health crises. Methods: We analyse observations, interviews, and focus group discussions with 21 leaders from eight different religious groups in Ituri province in 2020–2021. Results: Faith institutions handled the Covid-19 lockdown period by using and redeploying structures at the grassroots level but also by responding to health authorities' call for support. New actors usually not associated with the health system, such as revivalist churches, became involved. The interviewed religious leaders, especially those whose congregations were not previously involved in healthcare provision, felt that they were doing a favour to the State and the health authorities by engaging in community-level awareness-raising, but also, crucially, by 'depoliticising' Covid-19 through their public commitment against Covid-19 and work with the authorities in a context where the public response to epidemics has been highly contentious in recent years (particularly during the Ebola outbreak). The closure of places of worship during the lockdown shocked all faith leaders but, ultimately, most were inclined to follow and support health authorities. Such experience was, however, often one of frustration and of feeling unheard. Conclusion: In the short run, depoliticization may help address health emergencies, but in the longer run and in the absence of a credible space for discussion, it may affect the constructive criticism of health system responses and health system strengthening. The faith leaders are putting forward the desire for a relationship that is not just subordination of the religious to the imperatives of health care but a dialogue that allows the experiences of the faithful in conflict zones to be brought to the fore. [ABSTRACT FROM AUTHOR]

The effectiveness of foreign aid in promoting economic growth is one of the most controversial debates yielding different results in literature. Foreign aid has fluctuated to a large extent in Democratic Republic of the Congo (DRC). However, the foreign aid-growth nexus is still inconclusive. The main purpose of this study is to explore the relationship between foreign aid and economic growth in the case of the DRC, more specifically by investigating on both short and long run relationship to test the foreign aid-led growth hypothesis. The study employs the ARDL bounds test proposed by Pesaran, Shin and Smith (2001) which can be used with variables integrated of different orders unlike other cointegration tests. The study uses annual data for the period 1980-2019 sourced from the World Bank's World Development Indicators. GDP growth is used as a proxy for economic growth while the net official development assistance as a measure of foreign aid. Inflation, population growth, exports and oil rents are selected as control variables. The bounds test confirmed the presence of cointegration between the variables while the model passes the diagnostic tests. The study found that foreign aid has a positive and statistically significant impact on economic growth in both the long-run and short-run. The main research findings support the view that foreign aid has been pro-growth in the DRC, but its contribution has been of small magnitude falling in the case of a worse scenario where foreign aid is mismanaged or dilapidated by the government of the recipient country. The control variables reported that inflation has a negative but insignificant effect on economic growth in both the long-run and short-run, oil rents and exports have a positive and significant impact on economic growth. Population growth is negatively and significantly correlated with economic growth. Considering these results, the research recommends that foreign assistance institutions continue to support DRC. A reduction in aid would negatively impact on the growth which is a major determinant of the overall development of the country. However, measures should be put in place to monitor the maximum effective utilization of foreign aid to avoid dilapidation and mismanagement. [ABSTRACT FROM AUTHOR]

Climate-smart agriculture (CSA) is one of the innovative approaches for sustainably increasing the agricultural productivity, improving livelihoods and incomes of farmers, while at the same time improving resilience and contributing to climate change mitigation. In spite of the fact that there is neither explicit policy nor practices branded as CSA in Democratic Republic of Congo (DRC), farmers are utilizing an array of farming practices whose attributes meet the CSA criteria. However, the intensity, distribution, efficiency, and dynamics of use as well as the sources of these technologies are not sufficiently documented. Therefore, this review paper provides a comprehensive evidence of CSA-associated farming practices in DRC, public and private efforts to promote CSA practices, and the associated benefits accruing from the practices as deployed by farmers in the DRC. We find evidence of progress among farming communities in the use of practices that can be classified as CSA. Communities using these practices are building on the traditional knowledge systems and adaptation of introduced technologies to suit the local conditions. Reported returns on use of these practices are promising, pointing to their potential continued use into the future. While progressive returns on investment are reported, they are relatively lower than those reported from other areas in sub-Saharan Africa deploying similar approaches. We recommend for strategic support for capacity building at various levels, including public institutions for policy development and guidance, extension and community level to support uptake of technologies and higher education institutions for mainstreaming CSA into curricula and training a generation of CSA sensitive human resources. [ABSTRACT FROM AUTHOR]

Eastern DRC is seriously affected by a protracted warfare involving illicit exploitation of natural resources, corruption, humanitarian crisis and terrorism carried out by armed groups including the Allied Democratic Forces (ADF) and the Movement of 23 March (M23). According to DRC government, M23 is a terrorist group supported by Rwanda Defence Forces (RDF). Invasion and terrorism drive the war and the chaos. For Rwanda, fighting and chaos derive from ethnic conflicts over land, citizenship, local political power, and state failures. To many observers, ongoing violence and fighting are driven by rent seeking by Congolese military commanders, lack of State authority, distorted rule of law at both national and local levels, the abuse of public office for private gain (corruption), failed defence/security and justice sector reforms, undisciplined civilian armed and unarmed combatants, warlords and opportunist warmongers. Overall, state failures combined with globalized war diseconomy as conducted by multinational companies, failed multiparty system regarding democratic governance system drive ongoing chaos and armed violence, beyond government control and defence capabilities, despite peace agreements and the involvement of international and regional peace peacekeeping initiatives. Our analysis suggests that the war strategy being used resembles to what McKew refers to as the Gerasimov Doctrine, a chaos theory of political warfare which is used by Russia in Ukraine war. [ABSTRACT FROM AUTHOR]

The purpose of this study is to investigate the Itombwe synclinorium formations that were affected by the late Pan-African orogenesis in the nordeastern Congo. A variety of controversies surround Tshondo and Bugoy's tectonic evolution and associated metasedimentary formations. A field-based approach combined with paleostress inversion techniques and petrographic analyses were conducted on 190 structural measurements and 6 rock samples used in this study. The results reveal the presence of four major petrographic facies: conglomeratic facies (conglomerate and diamictite), carbonate facies (travertine), greenschist facies (graphitic black shale and pelite), as well as quatzitic facies (quartzite and sandstone). The mineral assemblages consisting of high contents (>70%) of muscovite/sericite and biotite albite, plagioclase, quartz, and some opaque minerals. With the assistance of Win-Tensor software, the kinematic analysis reveals two major deformation phases, (1) a ductile deformation phase (D1- 2), which is associated with isoclinal folds and strike-slip faults, and (2) a sub meridian brittle deformation phase (D2), which generated extensive faults trending NNW-SSE to NE-SW directions, while reactivating bedding surfaces (NE-SW) in a series of secondary faults. The findings of this research may assist geologistsin conducting core logging operations and provide a baseline for understanding the relationship between rock, minerlization, and tectonics in mineral-rich areas. [ABSTRACT FROM AUTHOR]

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The Democratic Republic of Congo (DRC) is a country with many public health challenges, including those related to the prevention and management of viral hepatitis B. Healthcare workers, who are at the frontline of patient care, are particularly at risk of contracting and spreading this virus, especially given its high prevalence in the general population. This paper examines the level of awareness and preventive measures among Congolese healthcare workers. Overall, the data show that health workers are under-immunized and lack formal training in hepatitis B prevention and management. In addition to limited awareness, health facilities are insufficiently involved in the implementation of standardized infection control protocols, the provision of personal protective equipment and routine hepatitis B vaccination programmes. There also appears to be a lack of clear and effective national policies outlining the main axes of infection control targets by 2030. This calls for urgent policy implementation focusing on mandatory vaccination, training, resource availability, adherence to infection control practices and comprehensive post-exposure management., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Shindano and Horsmans.)