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The grey parrot (Psittacus erithacus), once abundant, has become increasingly threatened due to the combined effects of capture for the global pet trade and habitat loss. Although grey parrots are well studied in captivity, effective conservation efforts require a better understanding of their ecological requirements in the wild. The aim of this paper is to quantify grey parrot behaviours across the annual cycle. To do that, we studied groups of grey parrots gathering in a natural forest clearing in the Nkuba Conservation Area, eastern Democratic Republic of the Congo. Using parrot counts and focal sampling, combined with descriptive statistics, we found that an average of 40 grey parrots visited the clearing each day, following a regular pattern in which they first perched in the trees surrounding the clearing, vocalizing loudly, until the group landed in the clearing to feed, drink and interact with each other. Generalized linear models (GLMs) and generalized additive models (GAMs) showed that the time at which parrots arrived, landed at, and left clearings was influenced by the weather, seasonality and the month of the year. We also found that parrots shortened their visits when disturbed by predators or the presence of humans. Although the underlying mechanisms for grey parrot visits to forest clearings remains unclear, the consistency of this behaviour observed elsewhere in Africa and the feeding observed in the clearing in this study suggest that these area support important foraging habitat for the wild grey parrots. Therefore, ensuring the availability of such clearings is paramount to the long‐term survival of the species. We suggest that future efforts to protect grey parrots in their native habitats focus on identifying clearings visited by parrots, monitoring these clearings and allowing parrots to visit them without disturbance or risk of capture. [ABSTRACT FROM AUTHOR]

Background and Aim: The Democratic Republic of Congo (DRC) is facing a humanitarian crisis due to prolonged conflicts, human rights abuses, and gender‐based violence. This perspective article aims to discuss the challenges faced by vulnerable populations in the DRC, including the impact of interventions and broader humanitarian strategies. Methods: A search on Google Scholar was carried out to identify relevant journal articles. Additionally, relevant reports and data on the DR Congo crisis were sourced from the websites of international and humanitarian organizations including the United Nations High Commissioner for Refugees, World Health Organization, United Nations Office for the Coordination of Humanitarian Affairs, and the Norwegian Refugee Council. Results: The crisis has led to 6.1 million displaced individuals and 1 million seeking asylum in neighboring countries. Insecurity and displacement further exacerbate the crisis, exacerbating health issues and malnutrition, particularly among women and children. The deterioration of water, sanitation, and hygiene infrastructure in the region facilitates the spread of infectious diseases. The UN has appealed for $8.3 billion in humanitarian assistance in West and Central Africa, including DRC. However, more attention and efforts are needed to curb the menace of the conflict. Conclusions: Addressing root causes like political volatility, economic disparity, and social unrest is crucial for sustained health protection. Tailoring humanitarian assistance to the context of conflict is essential, prioritizing mental health support and psychosocial services. Improving access to healthcare is crucial. Addressing food insecurity is essential, involving targeted food assistance programs, improving agricultural practices, and establishing income‐generating activities. Sustaining international assistance and investments are needed to address the health needs of the most vulnerable populations. [ABSTRACT FROM AUTHOR]

Mpox (monkeypox) is a neglected tropical disease that has received increased attention since the multi-nation outbreak that began in 2022. The virus is endemic in West and Central Africa, where the Democratic Republic of the Congo (DRC) is the most affected country. Clade I monkeypox virus (MPXV) infection is endemic in the DRC and has an overall case fatality rate of 10.6% among children and adults. A study conducted in Sankuru Province, DRC, from 2007 to 2011 demonstrated that 75% of pregnant women with mpox had miscarriages or stillbirth. Further analysis of a stillborn fetus showed that MPXV could infect both the placenta and fetus, causing congenital infection. No additional cases of Clade I MPXV in pregnant women were reported until a new outbreak occurred in South Kivu Province during 2023 and 2024. Eight pregnant women having Clade I MPXV infection were identified, of whom four had either miscarriages or stillbirth, representing a 50% fetal mortality rate. These reports confirm previous data from the DRC that indicate the capability of Clade I MPXV to affect the fetus, causing congenital infection and fetal loss in a high percentage of cases. In this article, we review both past and new data from the DRC on the effects of Clade I MPXV during pregnancy and discuss the association of mpox with fetal loss. [ABSTRACT FROM AUTHOR]

Civil-military cooperation (CIMIC) has officially emerged as a coordinated strategy between the United Nations peacekeeping missions and humanitarian nongovernmental organizations (NGOs) to enable access to people in need of assistance in complex emergencies. However, this integrated approach raises serious concerns regarding the respect of traditional principles of humanitarian action: humanity, impartiality, neutrality, and independence. While some humanitarian NGOs are opposed to any form of collaboration with the military, others believe this cooperation is very important to enable access and provide aid to civilians in needs. Using the case study of the Democratic Republic of Congo (DRC), this article analyses the impact of the CIMIC integrated approach between the United Nations Peacekeeping and Stabilization Mission in the DRC (MONUSCO) and humanitarian NGOs on the afore-mentioned principles of humanitarian action. It argues that most humanitarian NGOs that are operating in the Eastern DRC are opposed to the CIMIC’s integrated approach as it pushes them to violate the principles of neutrality, independence, and impartiality. Second, CIMIC increases the danger of humanitarian workers to be targeted by illegal armed groups. Third, despite their integrated approach, both MONUSCO and humanitarian actors have not been able to pacify the Eastern DRC, end the humanitarian needs of the population, or improve their effectiveness. [ABSTRACT FROM AUTHOR]

This article explores the conceptualization of the body among former Congolese soldiers living as refugees in Johannesburg. The article draws on extensive fieldwork in Johannesburg, South Africa and employs the concept of deterritorialization and reterritorialization to explain the bodies of those who have decided to join the Congolese Army. The article reveals the complex ways in which the army manipulates soldiers' bodies to generate diverse lines of connection, coalition, and removal (or disconnection). We support that the soldiers' bodies are not necessarily owned by the country, but that soldiers' bodies become owned by military institutions, who employ nationalist rhetoric to justify their existence and actions. The act of joining the army could be considered a way of cutting ties with civilian life and joining a new world in which the individual is socialized into military culture. Through initiation, the soldier's body is reterritorialized; it becomes a national asset. While this study focuses on former Congolese soldiers, it has broader relevance, giving insight into how soldiers perceive their body shifting from individual possession to be reterritorialized as the body of the nation. [ABSTRACT FROM AUTHOR]

Abstract The grey parrot (Psittacus erithacus), once abundant, has become increasingly threatened due to the combined effects of capture for the global pet trade and habitat loss. Although grey parrots are well studied in captivity, effective conservation efforts require a better understanding of their ecological requirements in the wild. The aim of this paper is to quantify grey parrot behaviours across the annual cycle. To do that, we studied groups of grey parrots gathering in a natural forest clearing in the Nkuba Conservation Area, eastern Democratic Republic of the Congo. Using parrot counts and focal sampling, combined with descriptive statistics, we found that an average of 40 grey parrots visited the clearing each day, following a regular pattern in which they first perched in the trees surrounding the clearing, vocalizing loudly, until the group landed in the clearing to feed, drink and interact with each other. Generalized linear models (GLMs) and generalized additive models (GAMs) showed that the time at which parrots arrived, landed at, and left clearings was influenced by the weather, seasonality and the month of the year. We also found that parrots shortened their visits when disturbed by predators or the presence of humans. Although the underlying mechanisms for grey parrot visits to forest clearings remains unclear, the consistency of this behaviour observed elsewhere in Africa and the feeding observed in the clearing in this study suggest that these area support important foraging habitat for the wild grey parrots. Therefore, ensuring the availability of such clearings is paramount to the long‐term survival of the species. We suggest that future efforts to protect grey parrots in their native habitats focus on identifying clearings visited by parrots, monitoring these clearings and allowing parrots to visit them without disturbance or risk of capture.

Abstract Background and Aim The Democratic Republic of Congo (DRC) is facing a humanitarian crisis due to prolonged conflicts, human rights abuses, and gender‐based violence. This perspective article aims to discuss the challenges faced by vulnerable populations in the DRC, including the impact of interventions and broader humanitarian strategies. Methods A search on Google Scholar was carried out to identify relevant journal articles. Additionally, relevant reports and data on the DR Congo crisis were sourced from the websites of international and humanitarian organizations including the United Nations High Commissioner for Refugees, World Health Organization, United Nations Office for the Coordination of Humanitarian Affairs, and the Norwegian Refugee Council. Results The crisis has led to 6.1 million displaced individuals and 1 million seeking asylum in neighboring countries. Insecurity and displacement further exacerbate the crisis, exacerbating health issues and malnutrition, particularly among women and children. The deterioration of water, sanitation, and hygiene infrastructure in the region facilitates the spread of infectious diseases. The UN has appealed for $8.3 billion in humanitarian assistance in West and Central Africa, including DRC. However, more attention and efforts are needed to curb the menace of the conflict. Conclusions Addressing root causes like political volatility, economic disparity, and social unrest is crucial for sustained health protection. Tailoring humanitarian assistance to the context of conflict is essential, prioritizing mental health support and psychosocial services. Improving access to healthcare is crucial. Addressing food insecurity is essential, involving targeted food assistance programs, improving agricultural practices, and establishing income‐generating activities. Sustaining international assistance and investments are needed to address the health needs of the most vulnerable populations.

Abstract Background Little is known about the use of mid-upper arm circumference for age (MUACZ) for diagnosing of severe acute malnutrition (SAM) and its correlation with WHZ (weight-for-height Z-score) in an area endemic for severe acute malnutrition (SAM) and with a high prevalence of kwashiorkor. Our study aims to analyze the concordance between the diagnostic criteria of SAM in a region presenting these characteristics. Methods We analyzed a database of children admitted from 1987 to 2008 for the management of SAM in Eastern Democratic Republic of Congo. Anthropometric indicators (z-score) were calculated and classified into 3 categories according to WHO standards. Cohen’s kappa coefficient (κ) was calculated to assess the concordance between these indicators. Results Out of the 9969 selected children aged 6 to 59 months, 30.2% had nutritional edema, 70.1% had a height-for-age (HAZ) z-score

Abstract Background Aedes albopictus has been reported in several Central African countries, including the Democratic Republic of the Congo (DRC). The establishment of this mosquito species poses a serious threat as a vector of various infectious diseases. Although Ae. albopictus has been reported in the western region of the DRC, information about its distribution is still scarce in the country. The aim of this study was to investigate the current nationwide distribution of the invasive Ae. albopictus, as well as other native Aedes mosquitoes, in the DRC and to identify suitable areas for its future expansion. Methods Two entomological surveys were conducted in 2017–2019 and 2022. Based on the occurrence sites of Ae. albopictus, important environmental variables were identified. Then, geographical areas suitable for Ae. albopictus establishment were determined using the maximum entropy model. The distribution and abundance of Ae. albopictus were also compared with those of the major native Aedes species. Results Aedes albopictus was found in the western, northern, central, and eastern regions of the DRC, but it was not found in the southeastern region. The maximum entropy model predicted that most parts of the DRC are suitable for the establishment of this mosquito. The unsuitable areas encompassed the eastern highlands, known for their low temperatures, and the southeastern highlands, which experience both low temperatures and a long dry season. The native Aedes species found were Aedes aegypti, Aedes simpsoni, Aedes africanus, and Aedes vittatus. Aedes albopictus dominated in the western and northern regions, while Ae. aegypti was more prevalent in other regions. Conclusions Aedes albopictus has been well established in the western and northern regions of the DRC. This mosquito is expanding its distribution while replacing the native Aedes species. Most of the country is suitable for the establishment of this mosquito species, except the highlands of the eastern and the southeastern regions. Graphical Abstract

Maternal nutrition is impacted by personal and environmental factors including dietary intake, knowledge, food availability, and affordability. This cross-sectional analysis aimed to evaluate nutrition-related knowledge, attitudes, practices, and associations with hemoglobin concentration among lactating mothers in the Bukavu region, Democratic Republic of the Congo. In 444 lactating mothers, nutrition-related knowledge and practice were assessed by questionnaires and translated into knowledge and practice scores ranging from 0 to 1, attitudes and drivers of food choice were assessed, the Dietary Diversity Score (DDS) was assessed with 24 h dietary recalls in a potential range from 0 to 10, and hemoglobin (Hb) was measured in mothers and their infants. Anemia prevalence was 28.2% among mothers and 74.3% among infants aged 3–8 months. Nutritional knowledge and practice were limited (the median total knowledge score was 0.39, median DDS was 3.0). While there were slight positive correlations between knowledge and maternal Hb, DDS did not significantly correlate with either knowledge or Hb. Although half of the mothers stated a perception about their own susceptibility to anemia or vitamin A deficiency (56.4%, 47.4%), less than half of those could justify their estimation (40.9%, 44.2%). Taste (68.1%), appearance (42.5%), availability (29.0%), and health effects (25.6%) were important drivers of food choice. In conclusion, interventions on the different influencing factors including nutrition education strategies are needed. [ABSTRACT FROM AUTHOR]

Background: Little is known about the use of mid-upper arm circumference for age (MUACZ) for diagnosing of severe acute malnutrition (SAM) and its correlation with WHZ (weight-for-height Z-score) in an area endemic for severe acute malnutrition (SAM) and with a high prevalence of kwashiorkor. Our study aims to analyze the concordance between the diagnostic criteria of SAM in a region presenting these characteristics. Methods: We analyzed a database of children admitted from 1987 to 2008 for the management of SAM in Eastern Democratic Republic of Congo. Anthropometric indicators (z-score) were calculated and classified into 3 categories according to WHO standards. Cohen's kappa coefficient (κ) was calculated to assess the concordance between these indicators. Results: Out of the 9969 selected children aged 6 to 59 months, 30.2% had nutritional edema, 70.1% had a height-for-age (HAZ) z-score <-2, 11.5% WHZ<-3 z-score, 14.9% had a MUAC < 115 mm and 21.8% had a MUACZ <-3 z-score. With the classic combination WHZ and MUAC, 36% of children with SAM had both criteria at the same time and MUAC alone being the indicator that recruited more children with SAM (77%) compared with 65% with WHZ only. By replacing MUAC with MUACZ, 34% of SAM children fulfilled both criteria, WHZ and MUACZ. MUACZ alone recruited more children with SAM (88%) compared with 46% with WHZ alone. Considering these three indicators together, MUACZ remained the indicator that recruited more children with SAM (85%). WHZ and MUAC showed a moderate agreement [ κ (95% CI) = 0.408(0.392–0.424)], WHZ and MUACZ a weak agreement [ κ (95% CI) = 0.363(0.347–0.379)] and MUAC and MUACZ a good agreement [ κ (95% CI) = 0.604 (0.590–0.618)]. Conclusion: Adjusting MUAC according to age improves its effectiveness in identifying severe acute malnutrition. With low concordance, MUAC and WHZ remain complementary in our context. MUACZ proves to be crucial, especially in the presence of kwashiorkor and chronic malnutrition, becoming a valuable tool for assessing severe acute malnutrition in our context. [ABSTRACT FROM AUTHOR]

Background: Aedes albopictus has been reported in several Central African countries, including the Democratic Republic of the Congo (DRC). The establishment of this mosquito species poses a serious threat as a vector of various infectious diseases. Although Ae. albopictus has been reported in the western region of the DRC, information about its distribution is still scarce in the country. The aim of this study was to investigate the current nationwide distribution of the invasive Ae. albopictus, as well as other native Aedes mosquitoes, in the DRC and to identify suitable areas for its future expansion. Methods: Two entomological surveys were conducted in 2017–2019 and 2022. Based on the occurrence sites of Ae. albopictus, important environmental variables were identified. Then, geographical areas suitable for Ae. albopictus establishment were determined using the maximum entropy model. The distribution and abundance of Ae. albopictus were also compared with those of the major native Aedes species. Results: Aedes albopictus was found in the western, northern, central, and eastern regions of the DRC, but it was not found in the southeastern region. The maximum entropy model predicted that most parts of the DRC are suitable for the establishment of this mosquito. The unsuitable areas encompassed the eastern highlands, known for their low temperatures, and the southeastern highlands, which experience both low temperatures and a long dry season. The native Aedes species found were Aedes aegypti, Aedes simpsoni, Aedes africanus, and Aedes vittatus. Aedes albopictus dominated in the western and northern regions, while Ae. aegypti was more prevalent in other regions. Conclusions: Aedes albopictus has been well established in the western and northern regions of the DRC. This mosquito is expanding its distribution while replacing the native Aedes species. Most of the country is suitable for the establishment of this mosquito species, except the highlands of the eastern and the southeastern regions. [ABSTRACT FROM AUTHOR]

The Democratic Republic of Congo (DRC) has been the subject of several armed conflicts for more than two decades, causing the displacement of millions of Congolese in and outside the country and impacting on their mental health and wellbeing. Mental healthcare interventions are a vital component for the displaced to holistically integrate into their new communities. This policy brief draws from a systematic review of various laws and policies as well as stakeholders' analysis to address the mental health issues of internally displaced persons (IDPs) in the DRC. In addition, we examine data from 32 interviews with various stakeholders at the national level and in 4 provinces of the DRC (Kasai Central, Tanganyika, South Kivu and Ituri). The findings show that while the DRC has committed to progressive policies and conventions the implementation of these policies and conventions, however, remains insufficient. There are also limited local and international stakeholders that provide forms of psychosocial support to IDPs and, effectively address mental health challenges in context. In addition, the provision of such care is limited by the scarcity of specialized and skilled staffs. These findings point to the need to strengthen mental health system governance. This should include scaling up of the integration of mental healthcare at the operational level, the training of community health workers in the screening of mental health issues and the sensitization of the IDPs and the host population to help them change their perception of mental ill-health. [ABSTRACT FROM AUTHOR]

Introduction: cervical cancer is a health concern worldwide. The South Kivu Province in the Eastern DR Congo is facing many cases of this disease but poorly screened and reported. The objective of this was to determine the prevalence of cell abnormalities at cervical cytology in a tertiary teaching hospital in Bukavu and their association with common risk factors of cervical cancer. Methods: a cross-sectional study was conducted on 142 women attending the Provincial Referral Hospital of Bukavu (HPGRB) from February to December 2021. Quantitative variables were described by their median following their asymmetric distributions and the qualitative variables in absolute and relative frequencies. Then the Chi-square test was used for the comparison of proportion. Results: forty-five percent of the participants had between three and five children. Twenty-two (15.5%) of the 142 patients reported to have two or more sexual partners and 17.5% reported the use of hormonal contraception. The prevalence of cell abnormalities at cervical cytology was 17% of which Low-Grade Squamous Intraepithelial Lesion (LSIL) was the most representative (12.9%). There was no statistically significant association between the common cervical risk factors and the occurrence of cell abnormalities. Conclusion: cervical pre-cancerous lesions are frequent in South Kivu province. The Pap smear test remains an early and affordable screening method and constitutes a secondary prevention strategy in women of 18 years and older in a low-income country such as DR Congo where vaccination against HPV is still hypothetic. [ABSTRACT FROM AUTHOR]

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Mpox (monkeypox) is a neglected tropical disease that has received increased attention since the multi-nation outbreak that began in 2022. The virus is endemic in West and Central Africa, where the Democratic Republic of the Congo (DRC) is the most affected country. Clade I monkeypox virus (MPXV) infection is endemic in the DRC and has an overall case fatality rate of 10.6% among children and adults. A study conducted in Sankuru Province, DRC, from 2007 to 2011 demonstrated that 75% of pregnant women with mpox had miscarriages or stillbirth. Further analysis of a stillborn fetus showed that MPXV could infect both the placenta and fetus, causing congenital infection. No additional cases of Clade I MPXV in pregnant women were reported until a new outbreak occurred in South Kivu Province during 2023 and 2024. Eight pregnant women having Clade I MPXV infection were identified, of whom four had either miscarriages or stillbirth, representing a 50% fetal mortality rate. These reports confirm previous data from the DRC that indicate the capability of Clade I MPXV to affect the fetus, causing congenital infection and fetal loss in a high percentage of cases. In this article, we review both past and new data from the DRC on the effects of Clade I MPXV during pregnancy and discuss the association of mpox with fetal loss.

Invasive non-typhoidal Salmonella (iNTS) (serotypes Typhimurium and Enteritidis) are major causes of bloodstream infections in sub-Saharan Africa, but their reservoir is unknown. Aiming to demonstrate human carriers as a reservoir, we assessed an iNTS disease endemic rural community (Kikonka health area, Democratic Republic of the Congo) for intestinal carriage of iNTS. After a census, healthy subjects from randomly selected households provided three successive stool samples for Salmonella culture. We next compared the stool isolates for genetic relatedness with time and health area-matched blood culture isolates obtained from hospitalized patients by multiple locus variable-number tandem repeat analysis (MLVA) and performed whole genome sequencing (WGS) on a subset of stool and blood isolates. Among 2,354 eligible subjects, 2,234 (94.9%) consented and provided at least one stool sample, and 2,219 (94.3%) provided three stool samples. The cumulative proportion of Salmonella carriers after 3 days was 4.4% (n = 98). S. Typhimurium and Enteritidis were found in 26 and 3 carriers, respectively, representing 1.3% (29 out of 2,234) of participants living in 6.0% (26 out of 482) of households. MLVA types of all 26 S. Typhimurium stool isolates matched with the corresponding MLVA types of blood isolates. The MLVA type of one out of three Enteritidis stool isolates matched the single MLVA type of the five Enteritidis blood isolates. WGS analysis of S. Typhimurium (n = 20) and S. Enteritidis (n = 4) isolates revealed Typhimurium multilocus sequence type (ST)313 Lineage 2 and Enteritidis ST11 Central/Eastern African and Outlier clades and confirmed the MLVA clustering. More than three-quarters of Typhimurium isolates showed combined multidrug resistance, ceftriaxone resistance, and fluoroquinolone non-susceptibility. In conclusion, the present study demonstrated iNTS carriage among healthy community members, with stool isolates that were genetically similar to blood culture isolates obtained in patients from the same community. These findings contribute to the evidence of a human reservoir of iNTS. [ABSTRACT FROM AUTHOR]

Sickle Cell Anemia (SCA) is the most common genetic disease worldwide caused by a single mutation in the gene HBB. The disease severity is very variable and depends on many factors. We evaluated the clinical and biological profile of sickle cell anemia children in rural Central Africa. This cross-sectional study was conducted in the Hôpital Saint Luc de Kisantu, located 120 km away from Kinshasa-DR Congo in an area of 35 km around Kisantu with a population of roughly 80 000 individuals. We included SCA patients aged 6 months to 18 years. We collected clinical and hematological data. The SCA scoring system proposed by Adegoke et al. in 2013 was applied to determine the disease severity. We searched for factors associated to the disease severity. This study included 136 patients, 66 males and 70 females (sex-ratio M/F 0.94). The mean severity score was 8.21 ± 5.30 (ranges 0–23). Fifty-nine (43.4%) children had mild disease, 62 (45.6%) moderate and 15 (11%) severe disease. Girls had higher levels of HbF than boys (p = 0.003). An inverse correlation was observed between fetal hemoglobin and the disease severity (p = 0.005, r −0.239, IC95% −6.139; −1.469). Some factors such age influence the occurrence of certain chronic complications such as avascular bone necrosis. In conclusion, the disease severity of SCA depends on multiple factors. In this study, fetal hemoglobin was the main modulator of the disease severity. These data may also serve as a baseline to initiate HU treatment in this setting. [ABSTRACT FROM AUTHOR]

Although previous studies have shown a high prevalence of mental health problems among adult Ebola virus disease survivors, no studies have yet been conducted on mental health problems among children and adolescents in affected regions. Consequently, the current study aimed to examine the prevalence and factors associated with depression and post-traumatic stress disorder (PTSD) among children and adolescent survivors and orphans by utilizing a cross-sectional survey following the 2018–2020 epidemic in Eastern Democratic Republic of the Congo. A total of 146 survivors (mean age = 13.62, standard deviation [SD] = 2.50, 49.32% female), 233 orphans (mean age = 13.18, SD = 2.96, 53.32% female), and 34 orphan-survivor participants (mean age = 13.39, SD = 2.87, 44.12% female) were recruited. Participants completed measures assessing depression and PTSD symptoms, traumatic experiences, and stigma related to Ebola and COVID-19. The prevalence of depression and PTSD symptoms was 87.32% and 44.42%, respectively. Results showed significant differences in depression and PTSD symptoms between orphan-survivors (100% and 97.06%), survivors (90.21% and 75.86%), and orphans (83.48% and 16.52%; χ 2 (2) = 9.02; p =.011 and χ 2 (2) = 168.85; p <.001). Experience of traumatic events, Ebola stigmatization, and COVID-19 stigmatization positively predicted depression and PTSD symptoms. The regression models explained 61%–72% of the variance of depression and PTSD. The results reveal that the Ebola virus disease and its associated grief severely jeopardize the mental health of children and adolescents in affected regions. Despite the relative paucity of resources, intervention programs may be helpful to minimize associated stigma and promote psychological support. [ABSTRACT FROM AUTHOR]

We conducted a population-based survey in 2013 in Kampala, Uganda, to examine violence and mental health outcomes among self-settled male refugees from the Eastern Democratic Republic of Congo (DRC). Male DRC refugees aged 18+ years were sampled through respondent-driven sampling. Key interview domains included demographics, experiences of sexual and nonsexual violence, social support, PTSD, depression and suicide ideation. Data analysis was weighted to generate population-level estimates. We sampled 718 men (mean age: 33 years), most of whom had lived in North or South Kivu. Nonsexual violence, such as beatings (79.4%) and torture (63.8%), was frequent. A quarter (26.2%) had been raped; 49.9% of rape victims had been raped on multiple occasions, and 75.7% of rape victims had been gang raped. We estimated 52.8% had post-traumatic stress disorder (PTSD); 44.4% reported suicidal ideation. Numerous traumas were significantly (p < 0.05) associated with PTSD such as rape (adjusted odds ratio [aOR] = 1.82), war-related injuries (aOR = 2.90) or having been exposed to >15 traumas (compared to ≤10; aOR = 6.89). Traumata are frequent experiences in this self-settled male refugee population and are often accompanied by adverse mental health outcomes. Screening for trauma and adverse mental health outcomes and providing targeted services are paramount to improve these refugees' lives. [ABSTRACT FROM AUTHOR]

The Democratic Republic of Congo (DRC) has been the subject of several armed conflicts for more than two decades, causing the displacement of millions of Congolese in and outside the country and impacting on their mental health and wellbeing. Mental healthcare interventions are a vital component for the displaced to holistically integrate into their new communities. This policy brief draws from a systematic review of various laws and policies as well as stakeholders' analysis to address the mental health issues of internally displaced persons (IDPs) in the DRC. In addition, we examine data from 32 interviews with various stakeholders at the national level and in 4 provinces of the DRC (Kasai Central, Tanganyika, South Kivu and Ituri). The findings show that while the DRC has committed to progressive policies and conventions the implementation of these policies and conventions, however, remains insufficient. There are also limited local and international stakeholders that provide forms of psychosocial support to IDPs and, effectively address mental health challenges in context. In addition, the provision of such care is limited by the scarcity of specialized and skilled staffs. These findings point to the need to strengthen mental health system governance. This should include scaling up of the integration of mental healthcare at the operational level, the training of community health workers in the screening of mental health issues and the sensitization of the IDPs and the host population to help them change their perception of mental ill-health.

Abstract Background Myxoma is the most common cardiac tumor, found in 75–80% of cases in the left atrium. It can grow quietly and therefore reach a large size before being symptomatic. Poor availability of echocardiography also contributes to delayed diagnosis. In Sub-Saharan African countries, myxoma diagnosis can be missed for many patients. Myxoma resection surgery, although technically simple, is not always possible, because of the lack of cardiac surgery development. The aim of this report is to describe the first two consecutive resection cases of huge left-atrial myxoma performed in Kinshasa, Democratic Republic of Congo (DRC) and to discuss the specificities of this surgery in this low-resource context. Case presentation Two patients, 54 and 48 years old, were diagnosed with giant myxoma of the left atrium in the management of progressive dyspnea The first patient's transthoracic echocardiography revealed a pedunculated atrial mass (37 × 48 mm) on the interatrial septum, passing through the mitral valve. For the second patient, the mass (64 × 26 mm) was attached to the roof of the left atrium and protruded into the mitral valve, with significant mitro-tricuspid regurgitation The first patient underwent a simple resection of the myxoma. For the second patient, it was associated to a mitro-tricuspid annuloplasty. The postoperative course was simple for the first patient, but the second patient developed a biventricular failure requiring vasoactive drugs. Both patients were discharged alive from the hospital on postoperative days 10 and 12, respectively. They are regularly followed up and are doing well 2 years after surgery. Discussion and conclusion Surgical resection is the only effective treatment of myxoma. Our first results are encouraging The poor availability of the echocardiography is a challenge in the diagnosis of myxoma. The development of cardiac surgery in DRC and ongoing country-level efforts to address diagnostic challenges for these often silent tumors will allow us to expect more resections to be performed locally and larger series published.

ABSTRACTBackground: Sickle Cell Anemia (SCA) is the most common genetic disease worldwide caused by a single mutation in the gene HBB. The disease severity is very variable and depends on many factors. We evaluated the clinical and biological profile of sickle cell anemia children in rural Central Africa.Methods: This cross-sectional study was conducted in the Hôpital Saint Luc de Kisantu, located 120 km away from Kinshasa-DR Congo in an area of 35 km around Kisantu with a population of roughly 80 000 individuals. We included SCA patients aged 6 months to 18 years. We collected clinical and hematological data. The SCA scoring system proposed by Adegoke et al. in 2013 was applied to determine the disease severity. We searched for factors associated to the disease severity.Results: This study included 136 patients, 66 males and 70 females (sex-ratio M/F 0.94). The mean severity score was 8.21 ± 5.30 (ranges 0–23). Fifty-nine (43.4%) children had mild disease, 62 (45.6%) moderate and 15 (11%) severe disease. Girls had higher levels of HbF than boys (p = 0.003). An inverse correlation was observed between fetal hemoglobin and the disease severity (p = 0.005, r −0.239, IC95% −6.139; −1.469). Some factors such age influence the occurrence of certain chronic complications such as avascular bone necrosis.Conclusion: In conclusion, the disease severity of SCA depends on multiple factors. In this study, fetal hemoglobin was the main modulator of the disease severity. These data may also serve as a baseline to initiate HU treatment in this setting.

Invasive non-typhoidal Salmonella (iNTS) (serotypes Typhimurium and Enteritidis) are major causes of bloodstream infections in sub-Saharan Africa, but their reservoir is unknown. Aiming to demonstrate human carriers as a reservoir, we assessed an iNTS disease endemic rural community (Kikonka health area, Democratic Republic of the Congo) for intestinal carriage of iNTS. After a census, healthy subjects from randomly selected households provided three successive stool samples for Salmonella culture. We next compared the stool isolates for genetic relatedness with time and health area-matched blood culture isolates obtained from hospitalized patients by multiple locus variable-number tandem repeat analysis (MLVA) and performed whole genome sequencing (WGS) on a subset of stool and blood isolates. Among 2,354 eligible subjects, 2,234 (94.9%) consented and provided at least one stool sample, and 2,219 (94.3%) provided three stool samples. The cumulative proportion of Salmonella carriers after 3 days was 4.4% (n = 98). S. Typhimurium and Enteritidis were found in 26 and 3 carriers, respectively, representing 1.3% (29 out of 2,234) of participants living in 6.0% (26 out of 482) of households. MLVA types of all 26 S. Typhimurium stool isolates matched with the corresponding MLVA types of blood isolates. The MLVA type of one out of three Enteritidis stool isolates matched the single MLVA type of the five Enteritidis blood isolates. WGS analysis of S. Typhimurium (n = 20) and S. Enteritidis (n = 4) isolates revealed Typhimurium multilocus sequence type (ST)313 Lineage 2 and Enteritidis ST11 Central/Eastern African and Outlier clades and confirmed the MLVA clustering. More than three-quarters of Typhimurium isolates showed combined multidrug resistance, ceftriaxone resistance, and fluoroquinolone non-susceptibility. In conclusion, the present study demonstrated iNTS carriage among healthy community members, with stool isolates that were genetically similar to blood culture isolates obtained in patients from the same community. These findings contribute to the evidence of a human reservoir of iNTS.

Introduction: infertility is a reproductive health issue in modern society. In developing countries, ultrasonography and hysterosalpingography (HSG) are first-line exams investigating infertility in women. It is a highly reported issue in Africa and is linked to abnormalities diagnosed by medical imagery investigations. Our research aimed to evaluate ultrasonography and HSG usage in female infertility investigation in eastern DR Congo, and to point out the most frequent lesions in infertile women in this area. Methods: it was a cross-sectional research. It included 1024 patients in four equipped hospitals with HSG and ultrasonography, who consulted from January 1st, 2019 up to December 31st, 2021. Data were collected from consultation dossiers and imagery protocols. Results: of 1024 patients, the mean age was 30.85±5.05 years, 41.79 % (n=428) had primary infertility and 57.71% (n=591) had secondary infertility with parity ranges 1.28±1.25, abortion 1.17±1.33. HSG usage rate was 26.85% (n=275) whereas ultrasonography was 66.01%(n=749). The prevalent diagnosed lesions were uterine myomas 10.51 % (n=71), polycystic ovary syndrome (PCOS) 8.28%(n=56), endometrial dysplasia 7.99% (n=54), ovarian cysts 5.03% (n=34) at ultrasonography and tubal obstructions 53.45 %(n=147), hydrosalpinx 4.73% (n=13), cervical impotence 3.27% (n=9), uterine synechias 2.55%(n=7), müllerian abnomalies 2.55%(n=7), uterine retroversion 2.18% (n=6) at HSG. History of upper genital infection was a risk factor aOR= 3.71, 95%CI 1,55-8,88; p <0.001 for tubal obstruction to HSG. Conclusion: regarding the high prevalence of tubal and uterine abnormalities in infertile women of eastern DR Congo, ultrasonography, and HSG should be more performed exams in clinical practice in low-income countries. [ABSTRACT FROM AUTHOR]

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The history of the Democratic Republic of Congo has been one of long, unpeaceful turmoil. Even before the establishment of the state, there has been continuous fighting for decades, displacing and killing millions of inhabitants across this land in Central Africa. Evidence suggests that none of the peacekeeping efforts could make valuable, long-lasting contributions while generations after generations grew up in a hostile environment. In this paper, based on empirical data gathered through research by local organisations (VETO, VACNET), we examine the wide range of deradicalisation and reintegration practices that try to rehabilitate war-affected people through mainly agricultural activities. We are also assessing the effectiveness of these activities and outline the need for further research. Finally, this paper demonstrates that local organisations may have the best means and chances to deradicalise and reintegrate people successfully. [ABSTRACT FROM AUTHOR]

Summary Background One year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of attention has shifted to the emergence and spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs). The aim of the study was to assess the frequency of VOCs in patients followed for COVID-19 at Kinshasa university hospital (KUH) during the 3rd and 4th waves of the pandemic in Kinshasa. Hospital mortality was compared to that of the first two waves. Method The present study included all patients in whom the diagnosis of SARS-CoV-2 infection was confirmed by the polymerase chain reaction (PCR). The laboratory team sequenced a subset of all SARS-CoV-2 positive samples with high viral loads define as Ct

Agriculture, like many occupations, is a gendered activity. In the DR Congo, productive agriculture is generally the attribution of men and food-producing agriculture of women. Seed selection and conservation is subject to the same gendered distribution, whereby women select, sow, harvest, and save seeds for food crops. However, faced with numerous contextual shocks, more and more women farmers are no longer able to save their seeds from one season to the next. Therefore, they turn to external actors to obtain seed, that are generally produced according to Congolese seed regulations. These are based on international standards, inherited from colonisation and modern science. However, the logic of this regulation is productivist, favouring the development of a seed sector driven by the male gender. Moreover, its exogenous dynamics ignore the ancestral knowledge of peasants, and more specifically, of women peasants.

Background: Myxoma is the most common cardiac tumor, found in 75–80% of cases in the left atrium. It can grow quietly and therefore reach a large size before being symptomatic. Poor availability of echocardiography also contributes to delayed diagnosis. In Sub-Saharan African countries, myxoma diagnosis can be missed for many patients. Myxoma resection surgery, although technically simple, is not always possible, because of the lack of cardiac surgery development. The aim of this report is to describe the first two consecutive resection cases of huge left-atrial myxoma performed in Kinshasa, Democratic Republic of Congo (DRC) and to discuss the specificities of this surgery in this low-resource context. Case presentation: Two patients, 54 and 48 years old, were diagnosed with giant myxoma of the left atrium in the management of progressive dyspnea The first patient's transthoracic echocardiography revealed a pedunculated atrial mass (37 × 48 mm) on the interatrial septum, passing through the mitral valve. For the second patient, the mass (64 × 26 mm) was attached to the roof of the left atrium and protruded into the mitral valve, with significant mitro-tricuspid regurgitation The first patient underwent a simple resection of the myxoma. For the second patient, it was associated to a mitro-tricuspid annuloplasty. The postoperative course was simple for the first patient, but the second patient developed a biventricular failure requiring vasoactive drugs. Both patients were discharged alive from the hospital on postoperative days 10 and 12, respectively. They are regularly followed up and are doing well 2 years after surgery. Discussion and conclusion: Surgical resection is the only effective treatment of myxoma. Our first results are encouraging The poor availability of the echocardiography is a challenge in the diagnosis of myxoma. The development of cardiac surgery in DRC and ongoing country-level efforts to address diagnostic challenges for these often silent tumors will allow us to expect more resections to be performed locally and larger series published. [ABSTRACT FROM AUTHOR]

Summary: Background: One year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of attention has shifted to the emergence and spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOCs). The aim of the study was to assess the frequency of VOCs in patients followed for COVID-19 at Kinshasa university hospital (KUH) during the 3rd and 4th waves of the pandemic in Kinshasa. Hospital mortality was compared to that of the first two waves. Method: The present study included all patients in whom the diagnosis of SARS-CoV-2 infection was confirmed by the polymerase chain reaction (PCR). The laboratory team sequenced a subset of all SARS-CoV-2 positive samples with high viral loads define as Ct < 25 to ensure the chances to generate complete genome sequence. RNA extraction was performed using the Viral RNA Mini Kit (Qiagen). Depending on the platform, we used the iVar bioinformatics or artic environments to generate consensus genomes from the raw sequencing output in FASTQ format. Results: During the study period, the original strain of the virus was no longer circulating. The Delta VOC was predominant from June (92%) until November 2021 (3rd wave). The Omicron VOC, which appeared in December 2021, became largely predominant one month later (96%) corresponding the 4th wave. In-hospital mortality associated with COVID-19 fell during the 2nd wave (7% vs. 21% 1st wave), had risen during the 3rd (16%) wave before falling again during the 4th wave (7%) (p < 0.001). Conclusion: The Delta (during the 3rd wave) and Omicron VOCs (during the 4th wave) were very predominant among patients followed for Covid-19 in our hospital. Contrary to data in the general population, hospital mortality associated with severe and critical forms of COVID-19 had increased during the 3rd wave of the pandemic in Kinshasa. [ABSTRACT FROM AUTHOR]

Vitex madiensis Oliv. is a plant widely used in traditional medicine by healers in the Democratic Republic of Congo. The uses of this plant are already known and published but no toxicological investigations have been carried out on this plant to determine its safety. This study, conducted in April 2019, aimed to determine the toxicity profile of the aqueous extract of Vitex madiensis by determining its acute and sub-acute toxicities after oral administration in a male guinea pig model. For the acute toxicity, in adult guinea pigs, single oral administration of the aqueous extract of Vitex madiensis (1; 2; and 3 g/kg body weight) was administered, and general poisoning behaviors such as alopecia, abdominal bloating, weight loss, asthenia, convulsion, etc. was constantly monitored for 14 days. The oral lethal dose 50 was determined with the mortality rate by the Dragstedt and Lang method. In sub-acute toxicity, a daily single oral dose of Vitex madiensis aqueous extract 0.1 g/kg (human dose used in traditional medicine) and 1 g/kg (about the LD 50) was used for 28 days. The LD 50 calculated was 1.4 g/kg with change in mobility behavior, weight loss, alopecia, asthenia, convulsion, and bloating of the abdomen. After 28 days of observation, the aqueous extract of Vitex madiensis induced significant changes in body weights. However, hematological, and biochemical parameters showed a significant decrease in ALT, AST, and creatinine levels suggesting disturbances of haemopoiesis, liver, and kidney functions. Overall, the findings of this study indicate that the aqueous leaf extract of Vitex madiensis has a moderated toxicity for single oral administration and could be dangerous for daily use of doses higher than those used in traditional medicine (0.1 g/kg). This would justify the nontoxic use of this plant under the traditional condition utilizations. [Display omitted] • Many changes in behavior signs of intoxication with high doses of V. madiensis. • Acute and subacute toxicity of the aqueous extract of this plant on Cavia porcellus L. is currently known. • Vitex madiensis is moderately toxic orally at a single dose. • This plant is dangerous in repeated doses in 28 days. • Hematological and biochemical parameters showed a significant decrease in transaminase enzymes. • First toxicity assessment of V. madiensis on Cavia porcellus L. [ABSTRACT FROM AUTHOR]

This article explores the perceptions of COVID-19 among faith communities in north-eastern DR Congo and their intersection with public health responses to disease outbreaks. In a situation of a political and economic insecurity and significant unaddressed health needs, faith communities have a strong trusted public presence and offer resilience in the face of political insecurity, limited state intervention and outbreaks of disease. Semi-structured interviews of members, leaders and medical professionals from seven faith communities in Ituri and North-Kivu were analysed using a thematic framework. The article demonstrates that faith communities and their leaders have a range of opinions on the causes of and responses to COVID-19 that illuminate long term trends in a complex faith-health landscape. It identifies that all faith communities have spiritual responses to disease. Some of those responses cohere with public health messages. Others run counter to them. It argues that understanding the nature, range and variability of these perceptions and their impact on public behaviour is valuable to enable those engaged in public health to work with trusted, resilient communities even where their perceptions of disease are contradictory. [ABSTRACT FROM AUTHOR]

There is limited information on knowledge, perceptions, and management of sickle cell disease (SCD) in Africa in general and in the Democratic Republic of the Congo (DRC) in particular. This study explored knowledge, perceptions, and burden of 26 parents/caregivers of children with SCD in three selected hospitals in Kinshasa, DRC. We conducted a focus group with in-depth interviews with parents/caregivers of children affected with SCD. Four themes were discussed, including knowledge and perceptions, diagnosis and management, society's perceptions, and the psychosocial burden and the quality of life of the family affected by SCD. The majority of participants/caregivers felt that society, in general, had negative perceptions of, attitudes toward, and knowledge about SCD. They reported that children with sickle cell are often marginalized, ignored, and excluded from society or school. They face a number of challenges related to care, management, financial difficulties, and a lack of psychological support. The results suggest the need to promote measures and strategies to improve knowledge and management of SCD in Kinshasa, DRC. [ABSTRACT FROM AUTHOR]

Aim: This research aimed to evaluate health and nutritional practices of mothers during pregnancy and birth outcomes of their newborns in Bukavu, Democratic Republic of the Congo (DRC), comparing semi-urban and rural areas. Background: Health and nutrition during pregnancy are crucial for adequate development of the fetus. Health care plays an important role but is often poor in rural areas of developing countries. Methods: A baseline survey of a nutritional follow-up study was conducted in two semi-urban and one rural hospital in the vicinity of Bukavu, DRC. In total, 471 mother-child pairs were recruited after delivery. Data collection included socio-demographic parameters, nutrition and health measures during pregnancy, and anthropometric parameters. Semi-urban and rural study locations were compared and predictors of birth weight evaluated. Findings: Semi-urban and rural mothers differed significantly in nutrition and health practices during pregnancy, as well as birth outcomes. In the rural area, there was a higher rate of newborns with low birth weight (10.7%) and lower rates of antimalarial medication (80.8%), deworming (24.6%), consumption of nutritional supplements (81.5%), and being informed about nutrition by medical staff (32.8%) during pregnancy as well as practicing family planning (3.1%) than in the semi-urban areas (2.7%, 88.6%, 88.3%; 89.3%, 46.5%, and 17.1%, respectively). Birth weight was positively predicted by increasing maternal MUAC, age, and gestational age and negatively by rural location, being primipara, being a farmer, and female newborn sex. Conclusion: The findings highlight the importance of strengthening antenatal care activities especially in rural areas in order to ameliorate both maternal and infantile health and ensure appropriate development. [ABSTRACT FROM AUTHOR]

Peace research has taken a local turn. Yet, conceptual ambiguities, risks of romanticization, and critiques of co-option of the "local" point to the need to look for novel ways to think about the interactions of actors ranging from the global to the local level. Gearoid Millar proposes a trans-scalar approach to peace based on a "consistency of purpose" and a "parity of esteem" for actors across scales. This article analyzes the concept of trans-scalarity in the peace process in Ituri, a province in the northeastern Democratic Republic of Congo (DRC). Drawing on qualitative data from more than a year of research in the DRC, I argue that while a trans-scalar approach was taken to end violence, it was not applied to transitional justice initiatives. The result was a negative, rather than a positive peace. By showing the high, but still untapped, potential of trans-scalarity, the article makes three contributions. First, it advances the debate on the local turn by adding empirical insights on trans-scalarity and further developing the concept's theoretical foundations. Second, it provides novel empirical insights on the transitional justice process in the DRC. Third, it links scholarship on peacebuilding and transitional justice, which have often remained disconnected. [ABSTRACT FROM AUTHOR]

Human African trypanosomiasis (HAT) is considered a highly promising candidate for elimination within the next decade. This paper argues that the experiential knowledge of frontline health workers will be critical to achieve this goal. Interviews are used to explore the ways in which HAT workers understand, maintain, and adjust their skills amidst global and national challenges. We contrast two cases: South Sudan where HAT expertise is scattered and has been repeatedly rebuilt, and the Democratic Republic of Congo (DRC) where specialised mobile detection teams have pro-actively tested people at risk for almost a century. We describe HAT careers where skills are built through participation in HAT technology trials and screening programmes; in the DRC expertise is also supported through formal rotations in screening teams and HAT referral centres for new health workers. As cases fade, de-skilling is a real threat as awareness of populations and authorities diminishes and previously vertical programmes evolve, re-configuring professional development and career paths and associated opportunities for HAT practice. To avoid repeating the mistakes of the 1960s, when elimination also seemed close at hand, we need to recognise that the 'last mile' of elimination hinges on protecting the fragile expertise of frontline health workers. [ABSTRACT FROM AUTHOR]

This article introduces 'eco-war tourism', a growing niche in which tourists venture into war zones to seek adventure and 'save' nature from its violent surroundings. In Virunga National Park in eastern Democratic Republic of Congo, such tourists can experience the 'threat of mortality' while visiting mountain gorillas, contribute to the survival of the park and supposedly participate in regional peacebuilding. This article considers how the amalgamated commodification of war and gorillas leads to the bunkerization of tourism, the reconfiguration of space into 'safe' and 'dangerous' areas and the militarization of conservation. It links critical security studies and political ecology to theorize how eco-war tourism intensifies green militarization and how militarized conservation itself becomes a spectacularized tourist attraction. Eco-war tourism is informed by, and productive of, various affective geographies, entrenched in colonial durabilities that produce Eurocentric ideas about how and by whom nature should be protected. I call for critical security studies to examine how diverse security interventions – e.g. military, tourism, humanitarianism and conservation – are entangled in and reconfigure inherently political nature–society relations and underscore the futility of approaching 'society' and 'the environment' as separate fields of security. [ABSTRACT FROM AUTHOR]

Postconflict reconstruction programmes often aim to improve state–society relations but fail to spell out the underlying process. We specify a mechanism that links aid programmes through (1) short‐term and (2) medium‐term improvements in basic services and (3) subjective progress to (4) perceptions of the state and spell four conditions (quality, sustainability, magnitude and attribution to the state) that must be met for this process to occur. We use this framework to evaluate a large‐scale reconstruction programme in the Democratic Republic of Congo (DRC). We find that the programme improved basic services in the short term and midterm and positively affected beneficiaries' subjective well‐being. However, we do not find evidence that aid benefits have translated into political trust towards state institutions—on the contrary, project villages display slightly more negative attitudes than control villages. We suggest that this is due to lack of attribution of the improvements to the state that which was included in the selection phase but largely absent in the implementation. This implies that improved services can erode state legitimacy when citizens interpret the provision by nonstate actors as a signal of the state's inability or unwillingness to provide these services. [ABSTRACT FROM AUTHOR]

Policy makers and practitioners usually focus on three durable solutions for IDPs to overcome protracted displacement; return, resettlement and local integration. Based on empirical realities, this paper asks to what extent translocality can be seen as another solution. Drawing on qualitative and quantitative data from the city of Bukavu in eastern DRC, we explore how translocality is shaped in practice and how it helps people to overcome protracted displacement. Translocality of Bukavu's IDPs is mostly oriented towards the community of origin. We argue that this translocality requires mobility or connectivity, or a combination thereof. Mobilisation of resources in the community of origin can then contribute to the livelihoods of urban IDPs, but restraining forces beyond the control of IDPs can make this a risky and costly strategy that is not necessarily sustainable. Although translocality can address the livelihoods challenges related to protracted displacement, it cannot solve all challenges related to displacement. The paper concludes that translocality should – at most – be seen as a semi-durable and partial solution to move out of protractedness rather than as a durable solution to displacement in itself; however, addressing some of the restraining forces could make it a more durable solution. [ABSTRACT FROM AUTHOR]

Rural households depend on forest resources for cash and subsistence needs. Thus, forests represent a valuable natural capital for the rural economy, particularly in developing countries. However, depending on various factors, there are dissimilarities in the rural livelihoods' reliance on forests. Therefore, this study attempted to determine and characterize the level of forest dependence and identify the demographic and socioeconomic factors influencing the households' dependence on forests in the Rubi-Tele Hunting Domain (RTHD)/Democratic Republic of the Congo (DR Congo). Demographic and socioeconomic data of forest dependents and other qualitative information were collected through structured household-level surveys, focus group discussions, and key informant interviews. Descriptive statistical analysis, Kruskal–Wallis Test, χ2 test of independence, and binary logistic regression model were used for data analysis. The findings revealed that the forest dependence index varied from 0.01 to 1 (Mean = 0.46, SD = 0.30). The distribution of forest-dependent households by wealth status (income tercile) and level of forest dependence differs significantly. Logistic regression revealed that household size and non-forest income were significant determinants of forest dependence and had the theoretically expected signs. The household size was in a positive association with forest dependence. Large families tended to depend more on forest resources. On the other hand, the non-forest income was inversely related to forest dependence, implying that forest-dependent households with non-forest income sources were less dependent on forest resources extraction. Other selected variables were not statistically significant while showing positive and negative associations with the reliance on forests. Achieving the balance between forest dependence and conservation requires promoting incentive policies to diversify livelihood opportunities and environmental education. [ABSTRACT FROM AUTHOR]

Introduction: APOL1, GSTM1 risk variants, and sickle cell trait (SCT) are associated with chronic kidney disease (CKD) among African Americans (AAs). Nevertheless, such evidence remains scarce in sub-Saharan Africa (SSA) populations. Methods: In a cross-sectional study, we evaluated the prevalence of these risk variants and their association with estimated glomerular filtration rate (eGFR), albuminuria, and CKD in urban (n = 587) and rural (n = 730) adults from South-Kivu, DR Congo (DRC). Furthermore, we evaluated APOL1 recessive model (high risk [HR] vs. low risk [LR]), SCT carriage, and the active versus inactive GSTM1 genotypes. Results: The frequencies of the APOL1 G1 and G2 alleles were 8.7% and 9.1%, respectively, and 3.2% carried the HR genotype. SCT and GSTM1 null allele frequencies were 3.8% and 51.2%, respectively. APOL1 HR was associated with lower eGFR (P = 0.047, odds ratio [OR] = 4). Individuals with SCT exhibited lower eGFR (P = 0.018), higher albuminuria (P = 0.032), and 2.4× increased risk of CKD (P = 0.031). APOL1 HR and SCT were synergistically associated with lower eGFR (Pinteraction = 0.012). The GSTM1 null allele was not significantly associated with any renal outcomes. Conclusion: Our study highlighted the impact of APOL1 and SCT variants on poorer renal outcomes in the DRC and advocates for further genetic studies in SSA settings.

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 coauthors 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. [ABSTRACT FROM AUTHOR]

• Lakes are key landscapes at the intersection of geography, war and authority. • Lakes should be conceptualised beyond the rebel territory versus state-governed dichotomy. • Lakes in areas of armed conflict are 'rebellious landscapes' • A longue durée approach reveals lakes' influence on political, social and economic orders. • Converting lakes into enclaves neglects their historical socio-political connectivity. Lakes are rarely considered to be political spaces in the literature on the inter-linkages between landscapes, authority, and armed conflict. Scholars mainly focussed on the role of mountains, forests, and mud fields, in war and resistance, and examine how a variety of state(-like) actors try to make these 'unruly' spaces legible. This article discusses the frictions that emerge when the management of Virunga National Park in eastern DR Congo tries to retake control of Lake Edward through infrastructural and military interventions. These interventions not only encounter resistance from multiple rebel groups that hold various fishing villages along the shores of Lake Edward, but also from other state authorities present in the area—'fishing rebels' and 'fishy state officials'. Drawing on a longue durée perspective to understand contemporary contestations allows us to move beyond focussing on practices of illegal fishing in conflict areas and, instead, embed such issues within the broader historically shaped political and social landscapes of power. Park authorities aim to carve the lake into 'enclaves'—to counter subversion and render fishing sustainable—neglecting the ways in which the lake is interconnected. This article argues that we should abandon the dichotomy of landscapes as either producing subversive politics/rebellion or as controlled by 'the state'. Instead of approaching landscapes in conflict areas —in this case lakes— as 'rebel landscapes' they should be approached as 'rebellious landscapes', as they are controlled fluidly amongst different de facto authorities. [ABSTRACT FROM AUTHOR]

The political opposition in Democratic Republic of Congo reamins less studied in studies on the dynamics of democratic transition in this country for two reasons. It is about the omission of this component in the constitutionalist process after independance and the long duration of military government come to power by coup or armed insurrection. Consequently, this article proposes to operate three variables to study congolese political opposition. Institutional determinants (related to the party system, methods of voting systems), the legal expression of the opposition and finaly, the nature and charisma of congolese opposition leaders. Anyway, the congolese political opposition has its origins in an intra-party struggle to evolve into an inter-party oppositon in its fight for the conquest of state power. It remains true that on the three democratic experiences relating to the presidential elections, the congolese political, by forming electoral coalitions, managed to beat the ruling party once in the presidential elections. Nevertheless, the strategies of this opposition remain limited in terms of effectiveness because of the nature of the parties that compose it, political transhumance, the ego between its leaders in a political system combining victory in the presidential and legislative elections to govern without alchemy of cohabition. [ABSTRACT FROM AUTHOR]

Abstract Background The import of wheat flour is the major driver for the high prices and low use of bakery products in non-producing tropical countries such as the Democratic Republic of Congo (DRC). These products’ high prices worsen the risk of malnutrition and food insecurity among rural and resource-poor populations. This study aimed at substituting the imported wheat flour with less expensive local cassava flour fortified with oyster mushroom flour in order to mitigate the nutritional crisis in the region. Methodology Series of experiments were conducted by substituting wheat flour with cassava flour at proportions of 10–25% to find the optimal combination. In addition, oyster mushroom flour (2.5–10%) was added to the composite flour to compensate for nutrient deficiencies of cereals and tuber crops. The overall aim was to identify the optimal wheat–cassava–mushroom combination, improving the nutritional value of breads while keeping their physico-chemical and organoleptic properties. Results Results showed that 0–10% mushroom flour increased bread protein from 19.63 to 22.66%. Besides, 7.5% mushroom flour allowed rising the bread calories from 311.8 to 354.5 kcal, and the dry matter from 77.33 to 87.86%. The wheat substitution for cassava fortified with mushroom flour negatively affected the bread volume, color and taste (p