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Abstract Background In high‐income countries, retinoblastoma is curable in more than 95% of cases, whereas in low‐income countries, mortality remains high, especially when the diagnosis is made late or the treatment is discontinued. Aims To determine the factors associated with adherence to the treatment of retinoblastoma in the Ivory Coast and the Democratic Republic of Congo (DRC). Methods and Results A retro‐prospective cohort study was carried out. Data were collected from patient folders and follow‐up records of parents. Results A total of 175 children with retinoblastoma were registered from January 2013 to December 2015. Seventy‐six children (43%) were 5 years old and above. Care costs were covered by families in 86.9% of cases. Chemotherapy refusal was recorded in 39 cases (22.3%), and enucleation refusal was recorded in 79 cases (45.1%). After 36 months of follow‐up, we recorded 16.6% deaths, 27.4% treatment dropouts, and 18.3% loss to follow‐up after treatment. The commonest cause for enucleation refusal was fear of infirmity, while chemotherapy refusal and absconding treatment were due to financial constraints. Conclusion Poor adherence to retinoblastoma management was due to financial constraints, and a lack of knowledge of the disease and its treatment. Family psychosocial support is needed to improve this condition.

Purpose: The aim of study was to evaluate the use of Antibiotics at the Kimpese EMI hospital in Democratic Republic of Congo, in order to contribute to the fight against antibiotic resistance. On the one hand, they cure even the most severe infections, but on the other hand, they are at the base of the antibiotic resistance. This last, is a scourge of the hour because at the base of morbidity and mortality in many nations. Our research questions were: Is the use of antibiotics effective in EMI hospital? Are they part of the most used drugs? Are they prescribed without bacteriological proof? Methods & Materials: This was a descriptive cross-sectional study of hospitalized patients, from 28 March to 7 June 2020. Information on socio-demographic characteristics, clinical and laboratory results and antibiotic use were recorded. The departments of surgery, gynaeco-obstetrics, internal medicine, ophthalmology, orthotraumatology and paediatrics were involved. The population was 1004 participants during the study period. The analysis was performed with STATA software version 14.1. 4 physicians were recruited to collect data using a questionnaire. Results: Of drugs prescribed to hospitalized patients, with 1004, 53% were antibiotics, followed by antimalarials 10%. Their use was, respectively in Orthotraumatology 27.2%, Gynaeco-obstetrics 19.2%, Surgery 16.9%, Paediatric 16.5%, Internal Medicine 15.9% and in Ophthalmology 4.3%. Of the antibiotics prescribed, the Access group prescribed alone were prescribed for 43% of hospitalized patients and Watch for 32%. The most used antibiotics among the admitted patients were respectively: Penicillins 43.3%, Cephalosporins 33.3% and Imidazoles 14.7%. They were indicated for antibiotic prophylaxis in surgery at 22.2%, trauma at 18.6%, antibiotic therapy in surgery at 6.4%, pneumonia at 5.9%, bone infection 5.2% and finally for gynecological pathology at 5%. Of the hospitalized patients, only 1/10th had a bacteriological examination performed Conclusion: This study allowed, to see the reality and effectiveness of antibiotic use and its preponderance over other drugs. Betalactams were the most prescribed. For a good number of patients, antibiotics were prescribed without any bacteriological evidence.

Purpose: In most low-income countries, the diagnosis of retinoblastoma is delayed, resulting in a severe prognosis. The objectives of this study were to describe the access to diagnosis and care of children diagnosed with retinoblastoma and the challenges in two sub-Saharan African countries: the Republic of Côte d’Ivoire and the Democratic Republic of the Congo. Patients and Methods: A descriptive cross-sectional study was conducted. Data were collected from the medical records of patients admitted during the period of January 1, 2013 to December 31, 2014. Data were entered and analyzed using Epi Info7.1 software and SAS 9.3. Results: One hundred sixteen cases of retinoblastoma were collected, including 60 boys and 56 girls. The median diagnosis age was 3 years for both countries. Ninety-eight patients (84%) had unilateral retinoblastoma. Most of the patients presented with advanced disease (76% had extraocular retinoblastoma). Median time between initial symptoms and diagnosis was 8.5 months (range, 0.4 to 116.7 months). Median time between diagnosis and treatment initiation was 31 days (range, 0 to 751 days). The median cost for the treatment of the disease was estimated at $1,954 per patient. Conclusion: Late diagnosis of retinoblastoma, with extraocular disease, occurs frequently in both African countries. It is associated with delay in initiating treatment, and the cost of the treatment remains unaffordable for most of the families. Support groups for parents of affected children and the support of the Franco-African Pediatric Oncology Group remain important in improving early diagnosis and providing treatment in sub-Saharan African countries.

In the Democratic Republic of Congo, the incidence of sickle cell anemia (SCA) is estimated to affect 30,000 to 40,000 neonates per year. However, there is paucity of data on acute clinical manifestations in sickle cell children. In these circumstances, it is difficult to develop a health care policy for an adequate management of sickle cell patients. This was a seven years’ retrospective study of children admitted with acute sickle cell crisis in the Department of Pediatrics in University Hospital of Kinshasa, Kinshasa, the Democratic Republic of Congo. A total of 108 patients were identified as having SCA. There were 56 (51%) girls and 52 (49%) boys. Median age was 10.5 years (range 1-24 years). No child was diagnosed by neonatal screening. The median age of diagnosis of sickle cell anemia was 90 months (range: 8-250 months). The median age at the first transfusion was 36 months (range 4-168). In this series, 61 (56.5%) patients were eligible for hydroxyurea. However, this treatment was only performed in 4 (6.6%) of them. Pain episodes, acute anemic crisis and severe infection represent respectively 38.2%, 34.3% and 21.9% of events. Altered sensorium and focal deficit were encountered occasionally and represented 3.4% of acute events. Acute renal manifestations, cholelithiasis and priapism were rarely reported, in this cohort. In Kinshasa, the care of patients suffering from sickle cell anemia is characterized by the delayed diagnosis and low detection of organ complications compared to reports of Western countries. This situation is due to resources deficiencies.

Neonatal nephroblastoma has been rarely reported in African neonate. A premature newborn (a 5-day-old male) was transferred with a history of neonatal abdominal mass. Ultrasonography revealed 75×46 mm, well-defined mass with mixed echogenicity replacing the right kidney. The patient underwent right radical nephrectomy and the tumor was confirmed to be a blastemal predominant Wilms’ tumor by the histopathological examination and has an unfavorable prognosis. The child died secondary to multiple organ failure, three days after surgery. Our case report serves to remind us the need to bear in mind the possibility of the diagnosis of neonatal nephroblastoma in neonate with renal mass.

Dix-neuf bonobos d’âges variés en semi-liberté au Sanctuaire de Bonobos de Kinshasa et nourris aux fruits, légumes et canne à sucre dont la quantité totale préparée pour toute la colonie variait entre 73,80 et 127,84 kg par jour. Ces aliments étaient complétés par les céréales, les tiges, les noix de palme, les œufs, le lait en poudre, le yaourt, du sel, du sucre et de l’eau pour combler le déficit par rapport à la quantité exigée par la direction du sanctuaire (90 à 110 kg par jour). L’état général des pensionnaires a été quotidiennement suivi et leurs poids mesurés mensuellement pendant six mois (août 2001 à janvier 2002). L’observation de l’évolution de poids des pensionnaires montre que la colonie a accusé un gain total de poids de 29 kg, soit en moyenne 1,5 kg par individu. Le gain de poids le plus élevé est de 5 kg tandis que le moins élevé enregistré chez 3 individus est de 1 kg. La perte de poids la plus élevée observée est de 3 kg suivie de 1 kg et de 0,5 kg. Le gain pondéral est plus élevé (2,4 kg par individu) chez les jeunes avec une mère de substitution, suivi des grands (1,83 kg). Les jeunes indépendants ont perdu 0,4 kg en moyenne par individu. En effet, ces derniers se disputaient la nourriture avec les grands car ils étaient servis dans les mêmes bacs à aliments alors que ceux qui étaient nourris par les mères adoptives ne connaissaient pas de compétition alimentaire. Les aliments de prédilection sont les fruits et particulièrement les fruits juteux comme l’ananas, la pastèque. Les légumes viennent en deuxième position. Malgré son endémisme, cette espèce peut survivre dans un milieu autre que son habitat naturel à condition de lui fournir une alimentation de qualité et en quantité suffisante. Il importe d’approfondir des recherches sur les besoins nutritifs réels de cet animal et sur les effets de différents aliments et des compléments alimentaires sur sa santé pour donner de meilleures chances à sa survie en captivité.

Background. To determine clinical profile and management of retinoblastoma among children at Kinshasa in Democratic Republic of Congo. Patients and methods. The medical records of patients with a diagnosis of retinoblastoma seen at the University Hospital of Kinshasa from January 1985 till December 2005 were retrospectively reviewed. Demographic profile, clinical data, modes of treatment and outcome were analysed. Results. A total of 49 children, of whom 40 had adequate data on record were identified as retinoblastoma (28 males and 12 females). Nine cases had bilateral disease. The median age at the first symptoms was 9 months (range, 1 month to 6 years) for unilateral retinoblastoma and 18 months (range, 1 month to 3.5 years) for bilateral retinoblastoma. The median age at the first oncology consultation was 2.4 years (range, 6 months to 6 years) for unilateral retinoblastoma and 2.4years (range, 9 months to 4 years) for bilateral disease. Leukokoria was present in 67.5% of subjects. Seventy-five percent abandoned the treatment. The mortality was 92.5%. Conclusion. In Democratic Republic of Congo, retinoblastoma remains a life threatening disease characterized by late referral to a specialized unit and affordability of chemotherapy; all leading to an extension of the disease and high mortality.

Des fruits de l'arbre à pain ont été découpés et séchés sur une claie, avec ou sans leur peau, sous l'action du feu et du soleil. Le séchage a eu lieu soit directement après la récolte, soit un à cinq jours plus tard. Les tranches de fruit sèches ont servi à produire des farines qui ont été entreposées et analysées sur la base de leur teneur en protéines et en matières grasses, le jour de leur préparation puis 2, 4, 6 et 8 semaines après leur entreposage. Les résultats ont permis de constater : une diminution sensible de la teneur en protéines (1,9 à 1,3 % de la matière sèche) et en matières grasses (5,2 à 2,2 %) au cours du stockage, surtout à partir de la 4e semaine; la durée de conservation des fruits a une incidence sur la teneur en protéines des farines, il faudrait donc sécher ceux-ci le plus tôt possible après la récolte; les fruits non épluchés produisent des farines significativement plus riches en protéines que les fruits épluchés, mais la différence est très faible (1,6 et 1,5 %, respectivement)

Purpose: In most low-income countries, the diagnosis of retinoblastoma is delayed, resulting in a severe prognosis. The objectives of this study were to describe the access to diagnosis and care of children diagnosed with retinoblastoma and the challenges in two sub-Saharan African countries: the Republic of Côte d'Ivoire and the Democratic Republic of the Congo. Patients and Methods: A descriptive cross-sectional study was conducted. Data were collected from the medical records of patients admitted during the period of January 1, 2013 to December 31, 2014. Data were entered and analyzed using Epi Info7.1 software and SAS 9.3. Results: One hundred sixteen cases of retinoblastoma were collected, including 60 boys and 56 girls. The median diagnosis age was 3 years for both countries. Ninety-eight patients (84%) had unilateral retinoblastoma. Most of the patients presented with advanced disease (76% had extraocular retinoblastoma). Median time between initial symptoms and diagnosis was 8.5 months (range, 0.4 to 116.7 months). Median time between diagnosis and treatment initiation was 31 days (range, 0 to 751 days). The median cost for the treatment of the disease was estimated at $1,954 per patient. Conclusion: Late diagnosis of retinoblastoma, with extraocular disease, occurs frequently in both African countries. It is associated with delay in initiating treatment, and the cost of the treatment remains unaffordable for most of the families. Support groups for parents of affected children and the support of the Franco-African Pediatric Oncology Group remain important in improving early diagnosis and providing treatment in sub-Saharan African countries. [ABSTRACT FROM AUTHOR]

Background. To determine clinical profile and management of retinoblastoma among children at Kinshasa in Democratic Republic of Congo. Patients and methods. The medical records of patients with a diagnosis of retinoblastoma seen at the University Hospital of Kinshasa from January 1985 till December 2005 were retrospectively reviewed. Demographic profile, clinical data, modes of treatment and outcome were analysed. Results. A total of 49 children, of whom 40 had adequate data on record were identified as retinoblastoma (28 males and 12 females). Nine cases had bilateral disease. The median age at the first symptoms was 9 months (range, 1 month to 6 years) for unilateral retinoblastoma and 18 months (range, 1 month to 3.5 years) for bilateral retinoblastoma. The median age at the first oncology consultation was 2.4 years (range, 6 months to 6 years) for unilateral retinoblastoma and 2.4years (range, 9 months to 4 years) for bilateral disease. Leukokoria was present in 67.5% of subjects. Seventy-five percent abandoned the treatment. The mortality was 92.5%. Conclusion. In Democratic Republic of Congo, retinoblastoma remains a life threatening disease characterized by late referral to a specialized unit and affordability of chemotherapy; all leading to an extension of the disease and high mortality. [ABSTRACT FROM AUTHOR]

Neonatal nephroblastoma has been rarely reported in African neonate. A premature newborn (a 5-day-old male) was transferred with a history of neonatal abdominal mass. Ultrasonography revealed 75×46 mm, welldefined mass with mixed echogenicity replacing the right kidney. The patient underwent right radical nephrectomy and the tumor was confirmed to be a blastemal predominant Wilms' tumor by the histopathological examination and has an unfavorable prognosis. The child died secondary to multiple organ failure, three days after surgery. Our case report serves to remind us the need to bear in mind the possibility of the diagnosis of neonatal nephroblastoma in neonate with renal mass. [ABSTRACT FROM AUTHOR]