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The use of the long-lasting insecticide-treated mosquito net (LLIN) is one of the basic interventions recommended by the Global technical strategy for Malaria 2016-2030. Since the start of the LLIN distribution campaigns in 2006 in Democratic Republic of Congo (DRC), it was based on paper tools leading to poor quality data. The first digital campaigns date back to 2014 through "Interchurch medical assistance" (IMA), which used the ODK collect application for recording household count data and LLIN distribution data. In 2020 "Soins de santé primaire en milieu Rurale" (SANRU) developed both household registration and LLIN distribution data recording forms as well as additional modules for supervision, monitoring and training. This article briefly describes the status of the implementation process of this digital-based management of LIIN mass distribution. During the first half of 2020, a roadmap was developed between Sanru and the Global fund to fight Tuberculosis, AIDS and Malaria (GFTAM) on the objectives of digitization, the data to be digitized, and the timelines for implementing the changes. In the last quarter of 2021, an internal Sanru team composed of some members of its technical management, and staff in charge of the digitization of LLIN mass distribution campaign data participated in a document review of the deliverables in comparison with the roadmap and in group discussions. For recording household enumeration data and distribution data, forms configured on smartphones allow data recording and uploading without going through manual calculations and previously necessary transcriptions with management based on paper tools, thus removing sources of errors. Online data delivery and automated production of dashboards allow real-time sharing of information to all stakeholders and shorten data validation times. Feedback to actors in the field is possible thanks to access to information and maps generated on the basis of geolocation data from households. ODK forms for supervision and monitoring have been put in place to ensure that these activities are effectively deployed in the field in accordance with the standards set by geolocating the actors and using the data transmitted online for interactive feedback. The next step is to develop a material flow management module to improve the traceability of inputs. [ABSTRACT FROM AUTHOR]

Background: In 2005, the Democratic Republic of the Congo (DRC) switched to artesunate/amodiaquine as the first-line antimalarial in response to increasing sulfadoxine/pyrimethamine resistance and adopted intermittent preventive treatment using sulfadoxine/pyrimethamine in pregnancy.Objectives: To determine the prevalence of molecular markers of sulfadoxine/pyrimethamine resistance in southwestern DRC 10 years after the new policy was instituted.Methods: From March 2014 to December 2015, blood samples were collected from symptomatic patients presenting to outpatient centres in urban and rural areas. A total of 2030 confirmed Plasmodium falciparum isolates were genotyped at codons associated with sulfadoxine/pyrimethamine resistance.Results: The prevalence of pfdhfr-N51I, C59R and S108N and pfdhps-A437G mutations was consistently high; the prevalence of the pfdhps-K540E mutation was low but increased since its first report in 2008 in the same region, reaching 17.6% by 2015. The pfdhps-A581G mutation increased from ∼4.5% in 2014 to ∼14.0% in 2015 at urban sites while in rural areas it remained low (∼4.0%). The mutations pfdhfr-I164L and pfdhps-A613S were detected for the first time in DRC. Also, 11 (0.8%) isolates revealed the presence of the newly described pfdhps-I431V mutation. Combining pfdhfr and pfdhps alleles, quintuple and sextuple mutations were observed, with the emergence of septuple (IRNI/IAGEGA)- and octuple (IRNI/VAGKGS)-mutant genotypes.Conclusions: Intermittent preventive treatment using sulfadoxine/pyrimethamine during pregnancy remains warranted in southwestern DRC. However, the expansion of pfdhps-K540E mutation and emergence of mutants that cause higher levels of sulfadoxine/pyrimethamine resistance is concerning and may present a challenge for future preventive interventions in the country. [ABSTRACT FROM AUTHOR]

Background: The Democratic Republic of Congo (DRC) is one of the two most leading contributors to the global burden of disease due to malaria. This paper describes the malaria testing and treatment market in the nation's capital province of Kinshasa, including availability of malaria testing and treatment and relative anti-malarial market share for the public and private sector. Methods: A malaria medicine outlet survey was conducted in Kinshasa province in 2013. Stratified multi-staged sampling was used to select areas for the survey. Within sampled areas, all outlets with the potential to sell or distribute anti-malarials in the public and private sector were screened for eligibility. Among outlets with anti-malarials or malaria rapid diagnostic tests (RDT) in stock, a full audit of all available products was conducted. Information collected included product information (e.g. active ingredients, brand name), amount reportedly distributed to patients in the past week, and retail price. Results: In total, 3364 outlets were screened for inclusion across Kinshasa and 1118 outlets were eligible for the study. Among all screened outlets in the private sector only about one in ten (12.1%) were stocking quality-assured Artemisinin-based Combination Therapy (ACT) medicines. Among all screened public sector facilities, 24.5% had both confirmatory testing and quality-assured ACT available, and 20.2% had sulfadoxine-pyrimethamine (SP) available for intermittent preventive therapy during pregnancy (IPTp). The private sector distributed the majority of anti-malarials in Kinshasa (96.7%), typically through drug stores (89.1% of the total anti-malarial market). Non-artemisinin therapies were the most commonly distributed anti-malarial (50.1% of the total market), followed by non quality-assured ACT medicines (38.5%). The median price of an adult quality-assured ACT was $6.59, and more expensive than non qualityassured ACT ($3.71) and SP ($0.44). Confirmatory testing was largely not available in the private sector (1.1%). Conclusions: While the vast majority of anti-malarial medicines distributed to patients in Kinshasa province are sold within the private sector, availability of malaria testing and appropriate treatment for malaria is alarmingly low. There is a critical need to improve access to confirmatory testing and quality-assured ACT in the private sector. Widespread availability and distribution of non quality-assured ACT and non-artemisinin therapies must be addressed to ensure effective malaria case management. [ABSTRACT FROM AUTHOR]

Introduction: The quality of vaccines is critical for good immunization outcomes. It is dependent on the effectiveness of technical and logistics management system put in place. This study aimed to assess the effectiveness of vaccine management and to learn something from this., Methods: We conducted a retrospective study of logistic management of vaccines in the Expanded Programme on Immunization (EPI) antenna in the Kisangani region over the period 2010-2014. A literature review completed by semi-structured interviews of immunization services managers and providers helped to evaluate vaccine management using the WHO GEV model in order to identify the gaps., Results: Provider's demonstrated low level of knowledge of the vaccines that cannot be frozen, of freezing tests and of other vaccine damages. Computerized data management was properly ensured in the antenna. No evaluation criteria reached the goal of 80%. Compliance with the storage temperature was 70% in the antenna; the criterion for vaccine management was 65% and 67% in the health area central office and in the health centre respectively. The maintenance criterion was zero at all levels., Conclusion: Malfunctioning of the logistic system is remarkable at all levels of the health pyramid; this could interfere with the quality and the expected impact of vaccination. Particular attention should be paid to the maintenance of the equipment.

Introduction: No surveillance system or survey data on the congenital rubella syndrome are available in the Democratic Republic of Congo. This article describes the incidence of primary rubella infection between 2010 and 2012 based on the measles case-based surveillance system in Kinshasa., Methods: Suspected cases of measles notified in Kinshasa between 2010 and 2012 were retrospectively analyzed., Results: From January 2010 to December 2012, 1,892 suspected cases of measles were reported, and 1013 serum samples were collected according to the surveillance standard and analyzed in the laboratory. There were more cases of confirmed rubella than measles among the investigated cases. The proportion of confirmed cases of rubella has increased significantly over the last 3 years. The proportion of affected individuals of childbearing age was 15.4%, with a female predominance in this age-group., Conclusion: The Democratic Republic of Congo should consider revising the definition of cases used in the measles surveillance system in order to take into account the incidence of measle, establish sentinel sites for surveillance of CRS and use measles eradication activities and other mass activities to introduce rubella vaccination.

Introduction: HIV testing among TB patients is still low in DRC This study aimed to determine HIV infection prevalence among TB patients with positive microscopy (TPM+) in Kisangani city., Methods: In the period of 15 h August to 31th December 2010, a cross-sectional study was conducted including pulmonary tuberculosis patients with positive microscopy (TPM+) from 15 to 49-years-old received in seven tuberculosis screening and treatment centers (STC). The Chi-square and Fisher's exact test were used to compare proportions and the Wilcoxon test to examine the relationships between quantitative variables with skewed distributions., Results: HIV test has been proposed to 136 TPM+ patients. Among them, 118 (86.76%) agreed to be tested. 24 (20.3%) of them were HIV positive. HIV-positive patients were significantly older (P = 0.02), predominantly female (P < 0.001) unemployed (p = 0.01). There were more cases of TB treatment relapse (p < 0.01) and less knowledge of TB signs (p = 0.01) among HIV-positive patients., Discussion: The Ministry of Health and its partners should extend to all STC provider-initiated HIV counceling and testing, ensure access to antiretroviral treatment for all HIV-positive TB patients and intensify TB screening in all patients living with HIV

The purpose of this study was to identify the determinants of adherence to malaria treatment (co-blistered AS-AQ) among health care providers, medicine sellers and patients in the northeastern region of the Democratic Republic of Congo. A cross-sectional study was carried out on health care providers, medicine sellers and patients in 13 health zones between March and June 2009. Only 69% of the cases of uncomplicated malaria were treated with AS-AQ, including 62.3% of cases treated using the correct dosages. The availability of AS-AQ, the intention to prescribe AS-AQ, longer consultations, providing explanations to patients, working in rural areas, training on the new policy, and the availability of treatment guidelines were found to be significantly associated with treatment adherence among health care providers. The limited availability of AS-AQ, the adverse effects of the treatment, the use of low-quality AS-AQ and the availability of cheap illegal antimalarial drugs were the main factors associated with non-adherence. Among patients, non-adherence was related to the perceived adverse effects of malaria treatment. The results suggest that improving the?accessibility and quality of AS-AQ and the quality of communication with patients, the provision of appropriate training to healthcare providers, the provision of treatment guidelines and appropriate supervision are needed to promote the use of AS-AQ.