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The main proteinase (Mpro), or 3CLpro, is a critical enzyme in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lifecycle and is responsible for breaking down and releasing vital functional viral proteins crucial for virus development and transmission. As a catalytically active dimer, its dimerization interface has become an attractive target for antiviral drug development. Recent research has extensively investigated the enzymatic activity of Mpro, focusing on its role in regulating the coronavirus replication complex and its significance in virus maturation and infectivity. Computational investigations have identified four druggable pockets, suggesting potential allosteric sites beyond the substrate-binding region. Empirical validation through site-directed alanine mutagenesis has targeted residues in both the active and allosteric regions and corroborated these predictions. Structural studies of drug target proteins can inform therapeutic approaches, with metadynamics simulations shedding light on the role of H163 in regulating Mpro function and providing insights into its dynamic equilibrium to the wild-type enzyme. Despite the efficacy of vaccines and drugs in mitigating SARS-CoV-2 spread, its ongoing viral evolution, selective pressures, and continued transmission pose challenges, potentially leading to resistant mutations. Phylogenetic analyses have indicated the existence of several resistant variations predating drug introduction to the human population, emphasizing the likelihood of drug spread. Hydrogen/deuterium-exchange mass spectrometry reveals the structural influence of the mutation. At the same time, clinical trials on 3CLPro inhibitors underscore the clinical significance of reduced enzymatic activity and offer avenues for future therapeutic exploration. Understanding the implications of 3CLPro mutations holds promise for shaping forthcoming therapeutic strategies against COVID-19. This review delves into factors influencing mutation rates and identifies areas warranting further investigation, providing a comprehensive overview of Mpro mutations, categorization, and terminology. Moreover, we examine their associations with clinical outcomes, illness severity, unresolved issues, and future research prospects, including their impact on vaccine efficacy and potential therapeutic targeting. more...

Since bucks are raised mainly for meat, there is a need for castration to optimize meat production. In this study, we conducted a comparative evaluation of the serum biochemical profiles of red Sokoto bucks following Burdizzo castration, in situ spermatic cord ligation, and orchidectomy. Sixteen red Sokoto bucks aged 6 months to 1 year old and 11-12 kg body weight were used for this study. The bucks were randomly divided into 4 groups of 4 bucks each as follows; group A (Burdizzo), B (in situ spermatic cord ligation), C (orchidectomy), and D (control). Blood was collected pre-castration, and at immediate, 4, 8, 12, 16, 20, 24, 32, 48, and 72 hours post-castration (HPC) into labeled tubes without anticoagulant, serum was harvested and used for serum biochemical analyses. The outcomes showed non-significant changes in total protein, sodium, chloride, calcium, and potassium levels in all groups of bucks. Glucose levels were significantly increased at immediate PC in groups A, B, and C, followed by a decline from 4 HPC to normal values by 16 HPC (group B) and 20 HPC (group A). The serum creatinine levels increased significantly at immediate PC, peaked at 20 HPC, and declined from 24 HPC. The blood urea nitrogen level increased significantly from immediate PC up to 72 HPC. The activities of superoxide dismutase, glutathione peroxidase, catalase, and malondialdehyde levels increased significantly from 4 HPC, peaked at 16 to 20 HPC, and decreased from 24 to 72 HPC. There were less severe serum biochemical changes by Burdizzo castration and in situ spermatic cord ligation compared to orchidectomy in the red Sokoto bucks. more...

Abstract Objective This study aimed to assess the effect of sildenafil citrate and estradiol valerate as adjuvant therapy during ovarian stimulation cycles with clomiphene citrate in patients with unexplained infertility in Kisangani. Method A double-blind, randomized controlled trial was conducted for two years at two specialized health facilities in Kisangani (University Clinics of Kisangani and “Clinique des Anges Kisangani”). The population included 148 patients, 74 of whom were on clomiphene citrate + sildenafil citrate (CCSC) regimens and 74 of whom were on clomiphene citrate + estradiol valerate (CCEV) regimens for three months. The primary indicator was the conception rate, with secondary outcomes encompassing endometrial thickness, appearance and vascularity, the number of mature follicles and ovulation rate. Results The two groups were comparable in terms of sociodemographic and clinical characteristics. The mean duration of attempting to conceive was 4.39 years versus 4.36 years (P = 0.839), while the mean AFC was 11.51 versus 11.46 (P = 0.831), in the CCSC group versus CCEV group respectively. Secondary infertility was the most frequent diagnosis in each of the two groups. The biochemical pregnancy rate was comparable between the two groups (P = 0.385), while the clinical pregnancy rate was significantly higher in the CCSC group versus CCEV group (P = 0.04). Both perifollicular flow and the ovulation rate were significantly higher in the CCSC group versus the CCEV group (P = 0.006 and P = 0.002 respectively). However, endometrial vascularity/thickness, and the number of Graafian follicles were not significantly different between the two groups. Conclusion As an adjuvant, sildenafil increases the rate of clinical pregnancy more than does estradiol in patients with unexplained infertility undergoing ovarian stimulation with clomiphene citrate. Study registration PACTR 202,310,849,449,401 (Pan African Clinical Trials Registry). more...

Globally, one in five people in post-conflict areas are estimated to be living with a mental health condition. As a key public health issue, these conditions negatively affect individuals, communities, and societies to function after a conflict. Documenting the prevalence of mental health conditions amongst these populations is crucial to prioritise and guide future mental health interventions. This study was the first to use a repeated cross-sectional design and sex-disaggregated analysis, with the aim of estimating the prevalence of depression (PHQ-9) and anxiety (GAD-7) in a post-conflict population of the Kasai Province, Democratic Republic of the Congo. Several domains of Quality of life (WHO-QoL-BREF) were also assessed to gain insight into the relationship between bio-psychosocial stressors and mental health status. Using random cluster sampling, data were collected in two waves from 385 participants, with a one-year interval. The pooled prevalence across both waves was 34.3% for major depression disorder and 26.5% for generalised anxiety disorder. Multivariable linear regression analysis showed that depression and anxiety were both predicted by being female, being of older age, and by experiencing lower physical quality of life, but not by the passing of time. For both mental health outcomes, environmental quality of life served as a significant predictor for women, but not for men. In conclusion, these results suggest that a lack of mental health services and continued exposure to daily stressors are linked to a sustained high prevalence of mental health conditions in our study population. There is a significant need for the development of mental health services in the region. These services should go beyond biomedical interventions and include multi-sectoral approaches that consider the social determinants of (mental) health. more...

This study assessed the safety against overturning of an old entrance structure located at the entrance of Lady of Solitude Cemetery (1850) in Belém do Pará/Brazil. A non-destructive technique using ground penetrating radar (GPR) was used to map the existing foundation and the assessment was made by analyzing the action of load on its centroid and comparing the results of the net allowable capacity of the soil with the maximum pressure exerted at the base of the foundation, also, comparing the moment resistance and the overturning moment in terms of the minimum safety factor required. The GPR results revealed the type of shallow foundation with a depth of 1 m; while the geotechnical results showed that there was no tension in contact with the base. The position of the centroid within the column kern resulted in a safety factor 10 times greater than the minimum recommended value. more...

Background. In Kenya, falls among individuals over 60 years of age are a major concern. Despite physical activity being known to reduce fall risks, existing studies face challenges like high drop-out rates and limited exercise types. The Lebed Method, a dance program originally developed for breast cancer survivors by Sherry Lebed Davis, has shown potential to improve physical and emotional well-being. This study aimed to explore its effectiveness in improving physical stability among the elderly in Kakamega County. Methods. The study involved a community-based randomized control trial with 30 participants aged 60 and older, selected based on low social support scores. They were divided into intervention and control groups, meeting specific inclusion criteria. Baseline functional stability (mobility and balance) was assessed by Timed Up and Go (TUG), Berg Balance Scale (BBS) scores, gait speed time, and de Morton Mobility Index (DEMMI) score. To ensure the reliability of the study, biases such as selection, performance, detection, attrition, and reporting biases were addressed. Changes in physical stability between the groups were analyzed using the Analysis of Covariance, accounting for baseline differences, while within-group changes were evaluated using the dependent sample t-test. The threshold for statistical significance was set at p < 0.05. Results. The findings showed that the intervention group improved significantly in physical stability compared to the control group. Specifically, notable enhancements were observed on TUG times (p < .001, ηp2 = 0.53, d = 3.38), BBS scores (p < .001, ηp2 = 0.64, d = 1.97), gait speed (p < .001, ηp2 = 0.65, d = 1.99) and DEMMI score (p < .001, ηp2 = 0.38, d = 1.94). Conclusions. The intervention significantly improved mobility and balance among participants, demonstrating the effectiveness of the Lebed method for elderly individuals. Future research could explore specific components of dance-based therapy that contribute to functional mobility and balance improvements. more...

Introduction Phenoxymethylpenicillin is commonly presented in various generic forms and rarely as proprietary brands. Given the prevalence of counterfeit products and the increased use of generic drugs in sub-Saharan Africa, ensuring drug quality is critical to meet legal requirements for bioequivalence and interchangeable dispensation. Purpose The purpose of this in vitro study was to meticulously compare the bioequivalence of 250 mg generic Penicillin V tablets with an originator brand marketed in Kisangani, focusing on physicochemical properties and dissolution kinetics based on European Medicines Agency (EMA) standards and USP Pharmacopoeia (USP 43-NF 38, 2013) guidelines. Methods Identification and assay were performed using a UV-visible spectrophotometer, and dissolution kinetics were conducted at pH levels of 1.2, 4.5, and 6.8 with appropriate dissolution equipment. The fit factor method was applied to compare dissolution profiles across these pH levels. Results The findings are significant, revealing that while the generic tablets weighed half as much (340 mg) as the originator tablets (770 mg), both showed acceptable mass uniformity and contained approximately 250 mg of active ingredient. Dissolution profiles were comparable, with difference factors (f1) < 15 and similarity factors (f2) > 50. In acidic media (pH 1.2 and 4.5), full release occurred in under 15 minutes, while in basic intestinal-type medium (pH 6.8), an 80% release rate was observed. Conclusion These results support the interchangeability of the generic and originator Penicillin V products, while potential in vivo variations cannot be ruled out. more...

Introduction The rising consumption of edible vegetable oils underscores the importance of understanding their nutritional value, particularly in terms of fatty acid composition and vitamin E content. Podocarpus usambarensis is a plant that grows in Kahuzi-Biega National Park in the Democratic Republic of the Congo. It produces oils used by the indigenous population for cooking and medicinal purposes. Purpose This study examines the impact of plant age and harvest season on the fatty acid and tocopherol content of Podocarpus usambarensis oil, highlighting significant differences based on these variables and their implications for public health nutrition. Methods Three samples of approximately 500 g of oilseeds were collected from young and old plants in the dry season, and from young plants in both the dry and rainy seasons. After drying, crushing, and powdering the collected seeds, oil was extracted using Soxhlet's procedure. A drop of oil was methylated, and aliquots were injected into a Varian 5890 gas chromatograph for fatty acid and tocopherol analysis. Results The fatty acids found in the oil were monounsaturated, including oleic and palmitoleic acids; polyunsaturated, including eicosadienoic, eicosatetraenoic, linoelaidic, linoleic, and linolenic acids; and saturated, principally behenic, cerotic, palmitic, and stearic acids. Total saturated fatty acids varied between 10 and 13%. Young trees were significantly (p = 0.043) richer in monounsaturated fatty acids than polyunsaturated ones (53.14% vs. 31.46%), while in old trees, there was no significant difference between polyunsaturated and monounsaturated fatty acids (40.68% vs. 40.59%). Conclusion The plant is an essential source of healthier nutrients, i.e., oleic acid, linoleic acid, and tocopherols. Plant age and seasonal climate impact the yields and composition of these nutrients in Podocarpus usambarensis. more...

Le marqueur –ayi dont nous nous proposons d’étudier les motivations sémantiques en cilubà est généralement connu comme un morphème associé à la forme du pluriel de l’impératif ou comme un marqueur de l’allocutif pluriel (MAP). Ce marqueur est également présent dans beaucoup d’autres formes nominales et revêt d’autres sens dont le plus important est celui du suffixe marqueur de l’excès (SME). Aux fins de dissocier ces deux marqueurs et permettre une meilleure compréhension quant à leurs acceptions respectives, nous avons pensé qu’il était indispensable de les étudier en contexte anthroponymique aux fins d’en tirer des conclusions scientifiques qui s’imposent quant au cilubà (L31). more...

BackgroundA better understanding why people living with HIV (PLHIV) become lost to follow-up (LTFU) and determining who is LTFU in a program setting is needed to attain HIV epidemic control.SettingThis retrospective cross-sectional study used an evidence-sampling approach to select health facilities and LTFU patients from a large HIV program supporting 61 health facilities in Kisumu County, Kenya.MethodsEligible PLHIV included adults 18 years and older with at least 1 clinic visit between September 1, 2016, and August 31, 2018, and were LTFU (no clinical contact for ≥90 days after their last expected clinic visit). From March to June 2019, demographic and clinical variables were collected from a sample of LTFU patient files at 12 health facilities. Patient care status and retention outcomes were determined through program tracing.ResultsOf 787 LTFU patients selected and traced, 36% were male, median age was 30.5 years (interquartile range: 24.6-38.0), and 78% had their vital status confirmed with 560 (92%) alive and 52 (8%) deceased. Among 499 (89.0%) with a retention outcome, 233 (46.7%) had stopped care while 266 (53.3%) had self-transferred to another facility. Among those who had stopped care, psychosocial reasons were most common {65.2% [95% confidence interval (CI): 58.9 to 71.1]} followed by structural reasons [29.6% (95% CI: 24.1 to 35.8)] and clinic-based reasons [3.0% (95% CI: 1.4 to 6.2)].ConclusionWe found that more than half of patients LTFU were receiving HIV care elsewhere, leading to a higher overall patient retention rate than routinely reported. Similar strategies could be considered to improve the accuracy of reporting retention in HIV care. more...

Novel "differentiated service delivery" models for HIV treatment that reduce clinic visit frequency, minimize waiting time, and deliver treatment in the community promise retention improvement for HIV treatment in Sub-Saharan Africa. Quantitative assessments of differentiated service delivery (DSD) feature most preferred by patient populations do not widely exist but could inform selection and prioritization of different DSD models. We used a discrete choice experiment (DCE) to elicit patient preferences of HIV treatment services and how they differ across DSD models. We surveyed 18+year-olds, enrolled in HIV care for ≥6 months between February-March, 2019 at four facilities in Kisumu County, Kenya. DCE offered patients a series of comparisons between three treatment models, each varying across seven attributes: ART refill location, quantity of dispensed ART at each refill, medication pick-up hours, type of adherence support, clinical visit frequency, staff attitude, and professional cadre of person providing ART refills. We used hierarchical Bayesian model to estimate attribute importance and relative desirability of care characteristics, latent class analysis (LCA) for groups of preferences and mixed logit model for willingness to trade analysis. Of 242 patients, 128 (53.8%) were females and 150 (62.8%) lived in rural areas. Patients placed greatest importance on ART refill location [19.5% (95% CI 18.4, 10.6) and adherence support [19.5% (95% CI 18.17, 20.3)], followed by staff attitude [16.1% (95% CI 15.1, 17.2)]. In the mixed logit, patients preferred nice attitude of staff (coefficient = 1.60), refill ART health center (Coeff = 1.58) and individual adherence support (Coeff = 1.54), 3 or 6 months for ART refill (Coeff = 0.95 and 0.80, respectively) and pharmacists (instead of lay health workers) providing ART refill (Coeff = 0.64). No differences were observed by gender or urbanicity. LCA revealed two distinct groups (59.5% vs. 40.5%). Participants preferred 3 to 6-month refill interval or clinic visit spacing, which DSD offers stable patients. While DSD has encouraged community ART group options, our results suggest strong preferences for ART refills from health-centers or pharmacists over lay-caregivers or community members. These preferences held across gender&urban/rural subpopulations. more...

BackgroundHuman African trypanosomiasis (HAT) is a neglected tropical disease that usually occurs in rural areas in sub-Saharan Africa. It caused devastating epidemics during the 20th century. Sustained, coordinated efforts by different stakeholders working with national sleeping sickness control programmes (NSSCPs) succeeded in controlling the disease and reducing the number of cases to historically low levels. In 2012, WHO targeted the elimination of the disease as a public health problem by 2020. This goal has been reached and a new ambitious target was stated in the WHO road map for NTDs 2021-2030 and endorsed by the 73rd World Health Assembly: the elimination of gambiense HAT transmission (i.e. reducing the number of reported cases to zero). The interruption of transmission was not considered as an achievable goal for rhodesiense HAT, as it would require vast veterinary interventions rather than actions at the public health level.Methodology/principal findingsData reported to WHO by NSSCPs were harmonized, verified, georeferenced and included in the atlas of HAT. A total of 802 cases were reported in 2021 and 837 in 2022. This is below the target for elimination as a public health problem at the global level (< 2000 HAT cases/year); 94% of the cases were caused by infection with T. b. gambiense. The areas reporting ≥ 1 HAT case/10 000 inhabitants/year in 2018-2022 cover a surface of 73 134 km2, with only 3013 km2 at very high or high risk. This represents a reduction of 90% from the baseline figure for 2000-2004, the target set for the elimination of HAT as a public health problem. For the surveillance of the disease, 4.5 million people were screened for gambiense HAT with serological tests in 2021-2022, 3.6 million through active screening and 0.9 million by passive screening. In 2021 and 2022 the elimination of HAT as a public health problem was validated in Benin, Uganda, Equatorial Guinea and Ghana for gambiense HAT and in Rwanda for rhodesiense HAT. To reach the next goal of elimination of transmission of gambiense HAT, countries have to report zero cases of human infection with T. b. gambiense for a period of at least 5 consecutive years. The criteria and procedures to verify elimination of transmission have been recently published by WHO.Conclusions/significanceHAT elimination as a public health problem has been reached at global level, with seven countries already validated as having reached this goal. This achievement was made possible by the work of NSSCPs, supported by different public and private partners, and coordinated by WHO. The new challenging goal now is to reach zero cases by 2030. To reach this goal is crucial to maintain the engagement and support of donors and stakeholders and to keep the involvement and coordination of all partners. Along with the focus on elimination of transmission of gambiense HAT, it is important not to neglect rhodesiense HAT, which is targeted for elimination as a public health problem in the WHO road map for NTDs 2021-2030. more...

Abstract Background In sub-Saharan Africa, tubal factors are described as the main aetiological factors of infertility. Under these conditions, medically assisted procreation is particularly indicated. However, Assisted Reproductive Technology centres are less available. Thus, infertile couples are quickly oriented towards available alternative conventional treatments. The present study aimed to determine the aetiological factors of infertility, the outcomes of the therapeutic options offered, and the factors associated with the success of conventional treatment among infertile couples seeking tertiary care in Kisangani. Methods A cross-sectional study was conducted at two tertiary health facilities in Kisangani. Infertile couples who provided consent underwent specific examinations necessary for the exploration of infertility and were treated and followed up for a minimum of 6 months. The therapeutic options that were offered were expectant attitude, medical treatment, surgical treatment or transfer to an in vitro fertilization unit. The pregnancy diagnosis was performed by ultrasound. Results A total of 272 infertile couples underwent specific examinations, were treated and were followed up for a minimum of 6 months. Many determinant causes were mostly linked to wives rather than husbands. Overall, only 34 women among 211 who were treated became pregnant during the follow-up period; 61 couples were advised to resort to IVF or adoption, but the couples for whom expectant the attitude was indicated immediately rejected it. The patients who therapeutically succeeded at the end of the treatment were those who were younger than 35 years (OR = 2.27; 95% CI = 1.06–4.87; P = 0.017), had a duration of infertility of less than five years (OR = 6.08; 95% CI = 1.79–20.69; P = 0.001) and had secondary infertility (OR = 6.08; 95% CI = 1.79–20.69; P = 0.001). Conclusion Kisangani faces a major issue in the treatment of infertility. Treatment of patients using conventional methods is limited by the predominance of tubal factors as aetiological determinants of infertility. The low pregnancy rate found in this study provided additional evidence of this. This paper represents a serious plea to national policy-makers to encourage them to pay attention to issues surrounding infertility. more...

IntroductionTo improve retention on HIV treatment in Africa, public health programs are promoting a family of innovations to service delivery-referred to as "differentiated service delivery" (DSD) models-which seek to better meet the needs of both systems and patients by reducing unnecessary encounters, expanding access, and incorporating peers and patients in patient care. Data on the relative desirability of different models to target populations, which is currently sparse, can help guide prioritization of specific models during scale-up.MethodsWe conducted a discrete choice experiment to assess patient preferences for various characteristics of treatment services. Clinically stable people living with HIV were recruited from an HIV clinic in Kisumu, Kenya. We selected seven attributes of DSD models drawn from literature review and previous qualitative work. We created a balanced and orthogonal design to identify main term effects. A total of ten choice tasks were solicited per respondent. We calculated relative utility (RU) for each attribute level, a numerical representation of the strength of patient preference. Data were analyzed using a Hierarchical Bayesian model via Sawtooth Software.ResultsOne hundred and four respondents (37.5% men, 41.1 years mean age) preferred receiving care at a health facility, compared with home-delivery or a community meeting point (RU = 69.3, -16.2, and -53.1, respectively; p << 0.05); receiving those services from clinicians and pharmacists-as opposed to lay health workers or peers (RU = 21.5, 5.9, -24.5; p < 0.05); and preferred an individual support system over a group support system (RU = 15.0 and 4.2; p < 0.05). Likewise, patients strongly preferred longer intervals between both clinical reviews (RU = 40.1 and -50.7 for 6- and 1-month spacing, respectively; p < 0.05) and between ART collections (RU = 33.6 and -49.5 for 6- and1-month spacing, respectively; p < 0.05).ConclusionAlthough health systems find community- and peer-based DSD models attractive, clinically stable patients expressed a preference for facility-based care as long as clinical visits were extended to biannual. These data suggest that multi-month scripting and fast-track models best align with patient preferences, an insight which can help prioritize use of different DSD models in the region. more...

Résumé : Le présent article porte sur la réécriture du mythe de Prométhée dans L’Homme aux pataugas de Jean-Pierre Makouta-Mboukou. En nous appuyons sur l’approche mythocritique théorisée beaucoup plus par Gilbert Durand, nous étudierons la résurgence de ce mythe grec à partir de sa fonction principale, c’est-à-dire le rôle civilisateur et libérateur joué par Prométhée en dérobant le feu des dieux pour le donner aux hommes. Ainsi, il sera question d’analyser les traits de convergences entre ce mythe et le protagoniste du roman de Jean-Pierre Makouta-Mboukou. Il s’agit donc de montrer le lien humaniste et civilisationnel autour duquel gravitent les deux figures littéraires. Mots-clés : Réécriture, mythe, Prométhée, altérité, progrès more...

Un excellent mécanisme de protection des droits garantis, le référé précontractuel en matière des marchés publics, s'est révélé à travers la présente réflexion importante pour la RDC. Abordant les causes qui justifient la saisine du juge des référés, sa procédure ainsi que les effets de sa saisine, il se dégage à suffisance une convergence dans les missions ou attributions dévolues à ces deux juges qui a est celle notamment de pouvoir différer la signature d’un contrat administratif pour cause de la violation des règles de procédure de passation des marchés publics. C’est pourquoi, en droit congolais, et lorsque l’occasion se présentera, il serait mieux pour le juge administratif congolais de s’inspirer du modèle français qui semble poser des balises en matière des référés précontractuels. more...

ABSTRACTBackground Neonatal screening is the first action necessary to identify children with sickle cell disease (SCD) and thus ensure their care. Using rapid tests to give an immediate result to families is a new resilient approach of great interest. These two aspects are essential for establishing an adequate health policy for this disease. This study was undertaken in Kisangani to update the current incidence of neonatal SCD.Methods Heel prick blood samples of 1432 babies born from different racial groups of parents living in Kisangani were collected at birth and screened using a point of care test, i.e. the HemoTypeSCTM.Results The incidence at birth was 2.2% (n = 31; 95% CI: [1.5%−3.1%]) for HbSS homozygosity and 21% (n = 303; 95% CI: [19%−23%]) for HbAS heterozygosity. Compared to a previous study in 2010; the incidence at the birth of the HbSS form has doubled, while that of the heterozygous form HbAS remained almost unchanged. The inter-ethnic incidence of HbSS among the five top-represented ethnic groups was significant ( more...

Objectives Sickle cell disease (SCD) encompasses health complications, primarily affecting the hematologic system and leading to high death rates in childhood. As a rule, the World Health Organisation (WHO) stepwise gold-standard about the strategies for prevention, diagnosis, and treatment of SCD must be multidimensional. This overview aimed to highlight current advances and challenges linked to strategic issues, diagnosis, the prevalence, and treatment of pediatric cases in Sub-Saharan Africa, particularly the Democratic Republic of the Congo. Methods We searched data on Google Scholar, Medline, PubMed, Science Direct, Scopus, and ResearchGate. Results The laboratory diagnosis of SCD has progressed from conventional electrophoresis to rapid point-of-care tests that allows early neonate screening. HemoTypeSCTM is an affordable test for neonatal screening in DRC. The pediatric SCD prevalence in Sub-Saharan Africa lay within 1–7.7% of homozygous(SS) and 15–40% of the heterozygous(AS) forms of SCD, depending on the method used and the ethnic population tested. Various supportive management protocols for comorbidities and complications exist, but they are not standardized in the Region. Conclusion Notwithstanding some progress accomplished, the disease is still challenging in Sub-Saharan Africa due to limited early diagnostic testing and a lack of specific medications. There is a need for harmonizing therapeutic protocols and conducting controlled valid clinical trials. more...

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

Les réseaux sociaux impactent quasi totalement la vie des congolais en général et kinois en particulier, depuis l’avènement du troisième millénaire de la mondialisation et/ou globalisation. Préoccupés par les interférences sociales autour de l’incertitude du quotidien dans tous les aspects politiques, économiques et socio-culturels, notamment la lutte pour la vie et la survie, la quête d’emploi, de promotion et de leadership orientée vers la satisfaction des besoins vitaux d’une manière générale, ces derniers font face d’une part, à des controverses ayant des conséquences parfois négatives à leur réussite, et d’autre part, à la crise d’identité manifeste dans la recherche des intérêts faisant appel à tous les moyens qui s’avèrent utiles pour une grande triomphe. more...

Résumé Dans un régime démocratique, le peuple est considéré comme la source du pouvoir en ce sens qu’il est détenteur de la souveraineté conformément à la constitution1 , qu’il exerce directement ou indirectement par la voie des urnes en élisant ses représentants. Les élections demeurent un mode d’expression ou de désignation par excellence pour un peuple dans le choix d’un nouveau gouvernement.2 Il apparait clairement que l’élection constitue l’essence de la démocratie. Cependant, en Afrique et partout ailleurs, la réalité des urnes fait l’objet des différentes contestations entre les acteurs politiques ; celles-ci peuvent conduire à des troubles post électoraux3mettant ainsi en péril la paix et la sécurité sociale. Les contestations tournent tantôt autour de la fiabilité du processus électoral, tantôt autour de l’acceptation des résultats des élections ou encore sur les irrégularités et les fraudes qui auraient entaché le processus électoral. Les différents acteurs empruntent généralement la voie de droit qui consiste à se référer au juge électoral pour connaitre de la contestation. Il ya lieu de considéré qu’en démocratie, le contentieux électoral apparait comme la technique la mieux indiquée pour assurer autant que possible l’équité et la présentation démocratique. Il est avancé qu’il n’y a pas de véritable élection démocratique et crédible sans contentieux4 . Comme nous pouvons le souligner, le contentieux électoral est un contentieux de sincérité5 qui permet de crédibiliser et légitimer les pouvoirs des gouvernants. En RDC comme ailleurs, l’effectivité démocratique dépend non seulement de son contenu et de son esprit mais aussi, c’est presque une évidence de l’affirmer, du respect que doivent lui porter les électeurs, les candidats mais aussi les juges et les autorités politiques. C’est à ce prix que les élections, comme le soutient jean du bois de Gaudusson, deviennent le temps de la démocratie et du maintien de la paix.6 Lorsqu’ on jette un regard critique sur l’examen minutieux par la cour constitutionnelle congolaise, il se constate qu’au lieu de régler les litiges, la cour constitutionnelle a, généralement, créé ou été à la base de la survenance d’autres contentieux en violations flagrantes de la loi. Mots-clés : protection, droit à l’éligibilité, contentieux électoral, congolais, élections Abstract In a democratic regime, the people are considered the source of power in the sense that they hold sovereignty in accordance with the constitution, which they exercise directly or indirectly through the ballot box by electing their representatives. Elections remain a mode of expression or designation par excellence for a people in the choice of a new government. It is clear that election is the essence of democracy. However, in Africa and everywhere else, the reality of the ballot box is the subject of various disputes between political actors; these can lead to post-electoral unrest, thus jeopardizing peace and social security. The disputes revolve sometimes around the reliability of the electoral process, sometimes around the acceptance of the results of the elections or even on the irregularities and the frauds which would have tainted the electoral process. The various actors generally take the legal route, which consists of referring to the electoral judge to hear about the dispute. It should be considered that in a democracy, electoral disputes appear to be the best technique to ensure fairness and democratic representation as much as possible. It is argued that there is no real democratic and credible election without litigation. As we can underline, electoral litigation is a litigation of sincerity which makes it possible to give credibility and legitimize the powers of those who govern. In the DRC as elsewhere, democratic effectiveness depends not only on its content and its spirit but also, it is almost obvious to affirm it, on the respect that voters, candidates, but also judges and political authorities. It is at this price that elections, as Jean du Bois de Gaudusson argues, become the time for democracy and peacekeeping. When one takes a critical look at the scrutiny by the Congolese constitutional court, it is found that instead of settling disputes, the constitutional court has generally created or been the basis for the occurrence of other disputes. in flagrant violations of the law. more...

L’avènement des référés en droit congolais constitue une avancée notable dans la protection des droits et libertés fondamentaux des citoyens, d’autant plus qu’ils sont des outils qui protège les droits et libertés fondamentaux d’un point de vue juridique que sociologique. Abordant les causes qui justifient la saisine du juge des référés, sa procédure ainsi que les effets de sa saisine, il se dégage à suffisance que quand bien même qu’ils soient précieux à la protection des droits humains par le juge administratif, leur mise en application reste tout de même très difficile pour plusieurs raisons. Notamment par l’inobservance du délai de prononcé en matière d’urgence par le même juge administratif et la difficulté d’exécuter les ordonnances en référé. C’est pourquoi, cette réflexion propose une relecture de la loi organique n°16/027 du 15 octobre 2016 portant organisation, compétence et fonctionnement des juridictions de l’ordre administratif en République démocratique du Congo. more...

[This corrects the article DOI: 10.1371/journal.pone.0200242.].

Félicien Mushagalusa Kasali,1– 3 Justin Ntokamunda Kadima,3 Jonans Tusiimire,2 Amon Ganafa Agaba4 1Pharm-Bio Technology and Traditional Medicine Center, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Pharmacy, Official University of Bukavu, Bukavu, Democratic Republic of the Congo; 4Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, UgandaCorrespondence: Félicien Mushagalusa Kasali, Pharm-Bio Technology and Traditional Medicine Center, Mbarara University of Science and Technology, Mbarara, Uganda, Tel +256 750919712, Email felicienkasali@gmail.comBackground: Physalis peruviana L. (Solanaceae) is a plant widely used in traditional medicine systems to manage various diseases, including diabetes mellitus, which remains a global health problem in developing and developed countries. This study aimed to scientifically evaluate its antidiabetic bioactivity and short-term toxicity in rats.Methods: We prepared various doses (100, 200, 400 mg/kg) of aqueous and methanolic leaf extracts for the antidiabetic study, and a dose of 2000 mg/Kg was prepared for the acute toxicity test. The first group that evaluated the hypoglycemic effect consisted of forty normoglycemic Wistar rats aged 7– 8 months old with a weighted average of 265.8 ± 24.6 g. The second group consisted of intraperitoneal glucose-loaded male animals to evaluate the antihyperglycemic effect. The third group contained two groups of normoglycemic female rats (n = 3), aged 3 and 4 months old (weight average: 187.45 ± 14.82 g), treated for 14 days with aqueous and methanolic extracts (2 g/kg b.w) to assess mortality and toxic effects. Blood samples were taken at 30, 60, 90, and 120 min post-treatment in hypoglycemic and antihyperglycemic evaluations. Glibenclamide (5 mg/kg) was used as a reference drug. The control animals in each group did not receive the extracts.Results: In hypoglycemic rats, 100 mg/kg of aqueous and methanolic extracts significantly lowered the fasting blood glucose level by 13.92% (p < 0.0001) and 21.95% (p < 0.01), respectively, compared to the control group. In glucose tolerance test group, methanolic extracts significantly reduced hyperglycemia by 54.55% (p < 0.0001), 46.50% (p < 0.0001), 39.78% (p < 0.0001) at 400, 200 and 100 mg/kg b.w, respectively, compared to control; aqueous extract 400 mg/kg reduced hyperglycemia by 39.44% (p < 0.05). At the 2000 mg/kg dose, leaf aqueous and methanolic extracts did not show any signs of intoxication and mortality.Conclusion: Crude aqueous and methanolic leaf extracts of P. peruviana ambrosioides appeared safe at 2000 mg/kg and have bioactivity in controlling the blood glucose levels, supporting their use in treating diabetes.Keywords: Physalis peruviana, leaf extracts, antidiabetic bioactivity, toxicity, rats more...

Félicien Mushagalusa Kasali,1– 3 Justin Ntokamunda Kadima,3 Jonans Tusiimire,2 Clement Olusoji Ajayi,1,2 Amon Ganafa Agaba4 1Pharm-Bio Technology and Traditional Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; 2Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Pharmacy, Official University of Bukavu, Bukavu, Democratic Republic of the Congo; 4Department of Pharmacology and Therapeutics, Mbarara University of Science and Technology, Mbarara, UgandaCorrespondence: Félicien Mushagalusa Kasali, Pharm-Bio Technology, and Traditional Medicine, Mbarara University of Science and Technology, Mbarara, Uganda, Tel +256 750919712, Email felicienkasali@gmail.comBackground: Diabetes mellitus is a metabolic disorder that poses a major global health threat. The current diabetes mellitus uses insulin and oral hypoglycemic agents, which have limitations, including adverse effects and secondary failures. Herbal medicine is being evaluated for its role in the pharmacotherapy of diabetes. This study was aimed to assess the anti-diabetic potential and short-term toxicity level of Chenopodium ambrosioides collected from Bukavu in Democratic Republic of Congo.Methods: Leaves of C. ambrosioides were extracted by infusion and maceration with distilled water and 95% methanol, respectively. Hypoglycemic and antihyperglycemic potentials of the aqueous and methanolic were investigated in normoglycemic and intraperitoneal glucose-loaded rats at 100, 200, and 400 mg/kg body weight. An oral acute toxicity test was carried out on healthy female Wistar rats.Results: Acute toxicity test showed the mean lethal dose (LD50) for both aqueous and methanol extracts of C. ambrosioides to be more than 2000 mg/kg. The group treated with glibenclamide (5 mg/kg b.w) and aqueous extract of the plant (200 mg/kg b.w) showed a significant reduction (p< 0.0001 and p< 0.05) of fasting blood glucose by 46.91% and 16.72%, respectively, compared to control and all other treatment groups. In acute conditions, a single oral administration of the aqueous and methanolic extracts lowered fasting blood glucose in rats. Any manifestation and signs of toxicity and mortality have been recorded for 14 days of observation.Conclusion: Leaf aqueous and methanolic extracts of C. ambrosioides appeared safe at 2000 mg/kg. The plant demonstrated some anti-diabetic potential in rats, explaining its use as an anti-diabetic remedy locally.Keywords: Chenopodium ambrosioides, anti-diabetic activity, fasting blood glucose, IGTT, LD50 more...

Many gaps in care exist for provision of antiretroviral therapy (ART) in sub-Saharan Africa. Differentiated HIV care tailors provision of ART for patients based on their level of acuity, providing alternatives for where, by whom, and how often care occurs. We conducted a scoping review to assess novel differentiated care models for ART provision for stable HIV-infected adults in sub-Saharan Africa, and how these models can be used to guide differentiated care implementation in Kenya. A systematic search was conducted using PubMed, Embase, Web of Science, Popline, Cochrane Library, and African Index Medicus between January 2006 and January 2017. Grey literature searches and handsearching were also used. We included articles that quantitatively assessed the health, acceptability, and cost-effectiveness of differentiated HIV care. Two reviewers independently performed article screening, data extraction and determination of inclusion for analysis. We included 40 publications involving over 240,000 participants spanning nine countries in sub-Saharan Africa - 54.4% evaluated clinical outcomes, 23.5% evaluated acceptability outcomes, and 22.1% evaluated cost outcomes. Differentiated care models included: facility fast-track drug refills and appointment spacing, facility or community-based ART groups, community ART distribution points or home-based care, and task-shifting or decentralization of care. Studies suggest that these approaches had similar outcomes in viral load suppression and retention in care and were acceptable alternatives to standard HIV care. No clear results could be inferred for studies investigating task shifting and those reporting cost-effectiveness outcomes. Kenya has started to scale up differentiated care models, but further evaluation, quality improvement and research studies should be performed as different models are rolled out. more...

La loi n°87-010 du 1er août 1987 portant code de la famille telle que modifiée et complétée à ce jour, qui abroge le code civil congolais livre Ier, a consacré la monogamie comme l’unique forme de mariage. Or, dans la vie courante du congolais, il ressort que de nombreux citoyens se livrent à la nouvelle forme de polygynie autrement appelée bureaugamie. Cette situation jette beaucoup de gens dans l’hypocrisie, car en instituant la monogamie, les autorités coloniales pensaient qu’il s’agissait là de la lutte contre l’avilissement de la femme congolaise. Tel ne fut cependant pas le cas à la décolonisation. Au lendemain de l’indépendance en 1960, on assistera au retour de la polygynie sous le terme « bureaugamie ». Ce phénomène perdure jusqu’à ce jour, malgré la loi précitée. La reconnaissance des enfants nés hors mariage par le législateur congolais ne fait que renforcer cette pratique. Aussi nous posons-nous la question : pourquoi le législateur n’a-t-il pas laissé le choix libre à la personne ? Le pouvoir colonial a permis de constater que le législateur n’a pas eu les mains libres dans le choix de la forme du mariage adaptée à la mentalité du congolais ; le législateur n’a pas tenu compte de la dynamique sociale pour repenser la forme du mariage, car au moment où d’un côté il impose la monogamie, de l’autre il tolère la polygynie en imposant l’affiliation des enfants nés hors mariage. Ainsi, cette étude propose la mise sur pied d’une politique législative proche de celle appliquée dans les pays Ouest africains tels que le Sénégal, le Nigéria, le Mali et la Guinée. more...

Physalis peruviana L. is among plant species possessing evident nutritional, nutraceutical, and commercial interests. This review highlights the complexity of the chemical composition supporting the multiple pharmacotherapeutic indications and dietary values of this plant through evidence-based studies from Google Scholar, PubMed/Medline, SciFinder, Science Direct, Scopus, the Wiley online library, and Web of Science. The literature mentions at least 40 compounds isolated from different parts; others are still under investigation. High yields in carotenoids, amino acids, minerals, vitamin C, vitamin E, and essential fatty acids have healthy nutritional benefits. Various phytoconstituents, particularly withanolides, exhibit anti-carcinogenic, anti-inflammatory, and antidiabetic potentials, as well as cardiovascular and liver protective effects. Prospective studies reveal that the leaves would also provide various beneficial bioactive chemicals worth being isolated. However, clinical evidence-based studies are seldom. Therefore, adequate pharmaceutical formulations and more in-depth controlled clinical trials are needed to fill the gap. more...

L’article 591 du Code de la famille dispose que : « Tout enfant congolais a un père et une mère. Nul n’a le droit d’ignorer son enfant, qu’il soit né dans le mariage ou hors mariage ». L’article 593 al 2 renchérit : « Toute discrimination entre congolais basée sur les circonstances dans lesquelles leur filiation a été établie, est interdite ». La lecture déductive de ces dispositions légales nous fait admettre que le législateur congolais met tous les enfants sur un pied d’égalité, quelle que soit leur origine de naissance. Pourtant, l’article 758 al 1 du même Code dispose que : « Les enfants du de cujus nés dans le mariage et ceux nés hors mariage mais affiliés de son vivant ainsi que les enfants adoptifs forment la première catégorie des héritiers de la succession ». Il se dégage de cette disposition légale, quatre groupes d’enfants, à savoir : - les enfants nés dans le mariage ; - les enfants nés hors mariage mais affiliés du vivant du de cujus ; - les enfants adoptés par le de cujus ; - les enfants nés hors mariage mais non affiliés du vivant du de cujus. De la lecture littérale de cette disposition, il ressort que seuls les trois premiers groupes d’enfants sont héritiers de la première catégorie. Partant de la situation ci-haut décrite, peut-on affirmer l’existence de l’égalité entre les enfants nés dans le mariage et les enfants nés hors mariage en matière de succession ? Les enfants nés hors mariage mais non affiliés du vivant du de cujus sont-ils au regard de l’article 758 alinéa 1 exclus de la succession ? Certainement, les articles 614 al. 3, 616 al. 2 et 852 du même code répondent positivement à ces préoccupations. more...

Radiographic and ultrasonographic evaluations of the urinary bladder architecture following autologous composite colo-peritoneal pedicle graft, as alternative tissue for urinary bladder reconstruction, in the surgical repair of experimental urinary bladder defects were carried out in two dogs. Predetermined 2 ´ 4 cm dimension of urinary bladder defect was created on the dorsum of the urinary bladder, and was patched with harvested 3 ´ 5 cm composite colo-peritoneal pedicle flap. All operations were aseptically and humanely conducted. The gross anatomical evaluation of the urinary bladder architecture was performed by ultrasonography and contrast radiography of the repaired urinary bladder. Post-surgical cystosonographic assessments on day 8 showed thickened urinary bladder wall at the point of the graft, which decreased markedly on day 21. Cystographic evaluation revealed gradual transition of the urinary bladder architecture at the point of graft with clear delineation and minimal blurring at week 2 post-operation, which gradually disappeared at weeks 10 and 14. The cystosonographic and cystographic evaluations demonstrated evidence of advanced healing and well-preserved urinary bladder architecture with no evidence of leaks. The imaging modalities are adequately diagnostic to assess urinary bladder repairs following its management with composite colo-peritoneal graft in dogs. more...

Depuis son élection en 2019, le président ukrainien Volodymyr Zelensky travaille pour l’intégration de l’Ukraine à l’Union Européenne ainsi que son adhésion à l’OTAN. Ceci impliquerait l’intervention des pays membres de l’OTAN en faveur de l’Ukraine en cas d’agression militaire. Cependant, la Russie s’oppose à cette perspective étant donné l’impact géopolitique d’une telle décision. Elle craint donc une éventuelle adhésion ukrainienne à l’OTAN, qu’elle voit comme une organisation concurrente menaçant sa sécurité, ainsi que le rapprochement des anciennes républiques soviétiques d’Europe avec l’Union Européenne. Ainsi, pour faire face à la persistance de l’Ukraine, la Russie a depuis le 24 février dernier, lancé une série d’opérations militaires de grande envergure sur le territoire ukrainien. Aux yeux de l’Union Européenne qui a une politique étrangère et de la sécurité commune instituée par le Traité de Maastricht de 1992, l’intervention militaire russe en Ukraine déstabilise profondément l’ordre de sécurité international et européen. En réaction, le Conseil Européen a pris une multitude des sanctions à l’endroit de la Russie, en dépit desquelles la crise s’intensifie provoquant beaucoup de dégâts matériels et des lourdes pertes en vies humaines. C’est pourquoi l’objectif de notre recherche est d’analyser les forces et faiblesses de l’ONU dans le conflit russo-ukrainien. more...

BackgroundSleeping sickness, or human African trypanosomiasis (HAT), is transmitted by tsetse flies in endemic foci in sub-Saharan Africa. Because of international travel and population movements, cases are also occasionally diagnosed in non-endemic countries.Methodology/principal findingsAntitrypanosomal medicines to treat the disease are available gratis through the World Health Organization (WHO) thanks to a public-private partnership, and exclusive distribution of the majority of them enables WHO to gather information on all exported cases. Data collected by WHO are complemented by case reports and scientific publications. During 2011-2020, 49 cases of HAT were diagnosed in 16 non-endemic countries across five continents: 35 cases were caused by Trypanosoma brucei rhodesiense, mainly in tourists visiting wildlife areas in eastern and southern Africa, and 14 cases were due to T. b. gambiense, mainly in African migrants originating from or visiting endemic areas in western and central Africa.Conclusions/significanceHAT diagnosis in non-endemic countries is rare and can be challenging, but alertness and surveillance must be maintained to contribute to WHO's elimination goals. Early detection is particularly important as it considerably improves the prognosis. more...