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Background: Few 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. Objective: This study aims to investigate this relationship in a region endemic for severe acute malnutrition (SAM). Methods: This 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. Results: A 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 < -3 and/or MUAC<115 mm and/or the presence of nutritional edema) including 30.2% with nutritional edema and 35.2% had both SAM and chronic malnutrition. The overall hospital mortality was 8.0% and was higher at the beginning of data collection (17.9% in 1987). In univariate analyses, children with a WHZ < -3 had a risk almost 3 times higher of dying than children without SAM. WHZ was more associated with in-hospital mortality than MUAC or MUACZ. Multivariate models confirmed the univariate results. The risk of death was also increased by the presence of edema. Conclusion: In our study, WHZ was the indicator more associated with hospital death compared with MUAC or MUACZ. As such, we recommend that all criteria shall continue to be used for admission to therapeutic SAM programs. Efforts should be encouraged to find simple tools allowing the community to accurately measure WHZ and MUACZ., SCOPUS: ar.j, info:eu-repo/semantics/published

Numerous risk factors have been involved in the pathogenesis of hypertension. The contribution of psychological factors, including post-traumatic stress disorder, remains largely underexplored, despite their potential role in hypertension. We compared the prevalence of trauma, post-traumatic stress and other psychological disorders between hypertensive and normotensive patients from Bukavu (Democratic Republic of Congo), a 25-year war-exposed city. In this case-control study, we assessed past traumatic events with the Stressful-Events-Scale, post-traumatic stress disorder through the post-traumatic diagnostic scale, depression and alcohol use disorder through the MINI-International-Neuropsychiatric-Interview, and emotion regulation through the Emotion-Regulation-Questionnaire in 106 hypertensive and 106 normotensive patients, enrolled at the Bukavu General Hospital. Compared with normotensive controls (73% women, age: 43 ± 14 years, BP: 121 ± 10/75 ± 8 mmHg), hypertensive patients (57% women, age: 42 ± 13 years, BP: 141 ± 12/82 ± 7 mmHg, on a median of two antihypertensive drugs) were exposed to more man-made traumas (61 vs. 13%, P < 0.001), used more expressive suppression (P = 0.05) and less cognitive reappraisal (P = 0.02) as emotional regulation strategies. They developed more frequent post-traumatic stress disorder (36 vs. 7%, P < 0.001) and major depressive disorder (37 vs. 13%, P = 0.001), often in association with alcohol use disorder (23 vs. 4%, P < 0.001). In multivariate logistic regression, post-traumatic stress disorder [OR = 3.52 (1.23-6.54)], man-made trauma [OR = 2.24 (1.15-4.12)], family history of hypertension [OR = 2.24 (1.06-4.44)], fasting blood glucose [OR = 1.85 (1.07-3.08)], BMI [OR = 1.28 (1.12-2.92)], expressive suppression [OR = 1.23 (1.11-2.23)] and cognitive reappraisal [OR = 0.76 (0.63-0.98)] were independent predictors of hypertension. In Congolese populations exposed to war, man-made trauma exposure and post-traumatic stress disorder

Traumatic events are prevalent worldwide and particularly in regions affected by armed conflicts such as the Eastern Democratic Republic of Congo. However, their link with mental and physical health outcomes still needs to be explored. Furthermore, there is a need to identify intrapersonal and interpersonal factors that may influence such relationship. This PhD explored the role of emotion regulation and social support in the occurrence of psychopathological and somatic symptoms in traumatic contexts. Our study populations encompassed three different samples, respectively patients consulting in internal medicine, patients with violence-induced injuries and health workers at frontline in the first wave of the Covid-19 pandemic. Our results showed an association of trauma-related disorders and hypertension with both emotion regulation and social support in the contexts of traumatic events. Our observations point to the necessity to develop interventions in the prevention and treatment of hypertension and trauma related disorders in the aftermath of traumatogenic events, (MED - Sciences médicales) -- UCL, 2022

The olfactory disorders, formerly neglected, were recognized worldwide with the COVID-19 outbreak. Management of olfactory disorders requires appropriate tools of investigation. The Sniffin`Sticks test is widely used in Europe as a standard test to assess olfaction. However, up to now, there is no version adapted to Sub-Saharan African populations. This PhD thesis aimed at assessing the applicability of the Sniffin`Sticks test in the population of South-Kivu. Overall, we conducted three studies. In the first study, we selected odours that were poorly recognised in the identification test with the standard version of the Sniffin'stick test and proposed to replace them with culturally appropriate odours in an adapted version. In the second study, we found that the adapted version led to a higher rate of correctly identified odours and we defined normative values for the South Kivu population. In the third study, using the adapted version, we found that hyposmia predominated when the cause was an upper respiratory tract infection, while anosmia predominated when the cause was non-infectious. Our results point to the necessity of adapting the Sniffin`Sticks test by using both adapted odors and normative values specific to this population., Les troubles olfactifs, autrefois négligés, ont été reconnus dans le monde entier avec l'épidémie de COVID-19. La prise en charge des troubles olfactifs nécessite des outils d'investigation adaptés. Le Sniffin`Sticks test est largement utilisé en Europe comme test standard pour évaluer l'olfaction. Cependant, à ce jour, il n'existe pas de version adaptée aux populations d'Afrique subsaharienne. Cette thèse de doctorat visait à évaluer l'applicabilité du Sniffin`Sticks test dans la population du Sud-Kivu. Dans l'ensemble, nous avons mené trois études. Dans la première étude, nous avons sélectionné des odeurs mal reconnues lors du test d'identification avec la version standard du Sniffin’stick test et avons proposé de les remplacer par des odeurs culturellement appropriées dans une version adaptée. Dans la deuxième étude, nous avons constaté que la version adaptée conduisait à un taux plus élevé d'odeurs correctement identifiées et nous avons défini des valeurs normatives pour la population du Sud-Kivu. Dans la troisième étude, en utilisant la version adaptée, nous avons constaté que l'hyposmie prédominait lorsque la cause était une infection des voies respiratoires supérieures, alors que l'anosmie l'était lorsque la cause était non infectieuse. Nos résultats soulignent la nécessité d'adapter le Sniffin`Sticks test en utilisant à la fois des odeurs adaptées et des valeurs normatives propres à cette population., (MED - Sciences médicales) -- UCL, 2022

BACKGROUND: Long-term impact of different forms of severe acute malnutrition (SAM) in childhood on the emergence of noncommunicable diseases (NCDs) is poorly known. AIM: To explore the association between subtypes of SAM during childhood, NCDs, and cardiovascular risk factors (CVRFs) in young adults 11 to 30 years after post-SAM nutritional rehabilitation. METHODS: In this follow-up study, we investigated 524 adults (mean age 22 years) treated for SAM during childhood in eastern Democratic Republic of the Congo (DRC) between 1988 and 2007. Among them, 142 had a history of marasmus, 175 of kwashiorkor, and 207 had mixed-form SAM. These participants were compared to 407 aged- and sex-matched control adults living in the same community without a history of SAM. Our outcomes of interest were cardiometabolic risk markers for NCDs. Logistic and linear regressions models were sued to estimate the association between subtype of SAM in childhood and risk of NCDs. RESULTS: Compared to unexposed, former mixed-type SAM participants had a higher adjusted ORs of metabolic syndrome [2.68 (1.18; 8.07)], central obesity [1.89 (1.11; 3.21)] and low HDL-C (High-density lipoprotein cholesterol) [1.52 (1.08; 2.62)]. However, there was no difference between groups in terms of diabetes, high blood pressure, elevated LDL-C (low-density lipoprotein cholesterol) and hyper TG (hypertriglyceridemia) and overweightness. Former mixed-type SAM participants had higher mean fasting glucose [3.38 mg/dL (0.92; 7.7)], reduced muscle strength [-3.47 kg (-5.82; -1.11)] and smaller hip circumference [-2.27 cm (-4.24; -0.31)] compared to non-exposed. Regardless of subtypes, SAM-exposed participants had higher HbA1c than unexposed (p < 0.001). Those with a history of kwashiorkor had cardiometabolic and nutritional parameters almost superimposable to those of unexposed. CONCLUSION: The association between childhood SAM, prevalence of NCDs and their CVRFs in adulthood varies according to SAM subtypes, tho

Data were collected as part of the impact evaluation of a large, non-food item voucher program targeting displaced individuals and vulnerable households across 25 villages in seven intervention locations in the province North Kivu. Data include information for a targeted 976 displaced and vulnerable households across those 25 villages, collected in 2017 and 2018. That is, in 2017, a baseline survey, a midline survey and a “six months after treatment” endline survey took place. In 2018, a “one year after treatment” endline survey took place.

Background: Long-term impact of different forms of severe acute malnutrition (SAM) in childhood on the emergence of noncommunicable diseases (NCDs) is poorly known.Aim: To explore the association between subtypes of SAM during childhood, NCDs, and cardiovascular risk factors (CVRFs) in young adults 11 to 30 years after post-SAM nutritional rehabilitation.Methods: In this follow-up study, we investigated 524 adults (mean age 22 years) treated for SAM during childhood in eastern Democratic Republic of the Congo (DRC) between 1988 and 2007. Among them, 142 had a history of marasmus, 175 of kwashiorkor, and 207 had mixed-form SAM. These participants were compared to 407 aged- and sex-matched control adults living in the same community without a history of SAM. Our outcomes of interest were cardiometabolic risk markers for NCDs. Logistic and linear regressions models were sued to estimate the association between subtype of SAM in childhood and risk of NCDs.Results: Compared to unexposed, former mixed-type SAM participants had a higher adjusted ORs of metabolic syndrome [2.68 (1.18; 8.07)], central obesity [1.89 (1.11; 3.21)] and low HDL-C (High-density lipoprotein cholesterol) [1.52 (1.08; 2.62)]. However, there was no difference between groups in terms of diabetes, high blood pressure, elevated LDL-C (low-density lipoprotein cholesterol) and hyper TG (hypertriglyceridemia) and overweightness. Former mixed-type SAM participants had higher mean fasting glucose [3.38 mg/dL (0.92; 7.7)], reduced muscle strength [-3.47 kg (-5.82; -1.11)] and smaller hip circumference [-2.27 cm (-4.24; -0.31)] compared to non-exposed. Regardless of subtypes, SAM-exposed participants had higher HbA1c than unexposed (p < 0.001). Those with a history of kwashiorkor had cardiometabolic and nutritional parameters almost superimposable to those of unexposed.Conclusion: The association between childhood SAM, prevalence of NCDs

Background Malnutrition is a public health problem, but outside the theoretical framework, little is known about the concrete intergenerational effects of malnutrition. Objective The objective of this study is to compare the nutritional status and health indicators of school children born to mothers who were treated for severe acute malnutrition (SAM). Methodology The study took place in Miti-Murhesa health zone in the Democratic Republic of Congo. This is a cohort study assessing the nutritional and health status of school children born to mothers who had been treated for SAM, based on WHZ or edema, in Lwiro hospital between 1988–2002 compared to children born to mothers who were not exposed to SAM. Stunting and thinness were evaluated by Height for Age Z-score (HAZ) and Body Mass Index by Age criteria (BMIAZ) respectively. On admission, blood samples were taken to assess anemia, HIV serology, hemogram and others biological indicators. Stool’s examinations were conducted by using Olympus optical microscope. Parametric and non-parametric tests were applied to compare the different variables in two groups. Results We identified 106 children aged 5–16 years (103 exposed and 58 unexposed) and we received 83.5% and 91.4% children respectively for anthropometric parameters. The mean of age was 7.9 ± 2.4 year in exposed group and 7.4 ± 2.1 year in unexposed group (p = 0.26). The prevalence of stunting was 68.3% in the exposed group and 67.3% in the unexposed group (p = 0.90). The prevalence of thinness was 12.8% in the exposed group and 9.6% in the unexposed group (p = 0.57). The biological profile (glycemia, urea, creatinine and hemogram) and the prevalence of intestinal parasites were similar in the two groups. Conclusion In this sample, in a malnutrition-endemic area, there was no statistically significant difference in nutrition and health indicators between school children born to mothers exposed to SAM and their community controls., SCOPUS: ar.j, info:eu-repo/semantics/published