Search

BACKGROUND: Malnutrition is identified as a risk-factor for insufficient polioseroconversion in the context of a vaccine-derived polio virus (VDPV) outbreak prone region. To assess the prevalence of malnutrition and its link to poliovirus insufficient immunity, a cross-sectional household survey was conducted in the regions of Haut- Lomami and Tanganyika, DRC. METHODS: In March 2018, we included 968 healthy children aged 6 to 59 months from eight out of 27 districts. Selection of study locations within these districts was done using a stratified random sampling method, where villages were chosen based on habitat characteristics identified from satellite images. Consent was obtained verbally in the preferred language of the participant (French or Swahili) by interviewers who received specific training for this task. Furthermore, participants contributed a dried blood spot sample, collected via finger prick. To assess malnutrition, we measured height and weight, applying WHO criteria to determine rates of underweight, wasting, and stunting. The assessment of immunity to poliovirus types 1, 2, and 3 through the detection of neutralizing antibodies was carried out at the CDC in Atlanta, USA. RESULTS: Of the study population, we found 24.7% underweight, 54.8% stunted, and 15.4% wasted. With IC95%, underweight (OR=1.50; [1.11-2.03]), and the non-administration of vitamin A (OR=1.96; [1.52-2.54]) were significantly associated with seronegativity to polioserotype 1. Underweight (OR=1.64; [1.20-2.24]) and the non-administration of vitamin A (OR=1.55; [1.20-2.01]) were significantly associated with seronegativity to polioserotype 2. Underweight (OR=1.50; [1.11-2.03]), and the non-administration of vitamin A (OR=1.80. [1.38-2.35]) were significantly associated with seronegativity to polioserotype 3. Underweight (OR=1.68; IC95% [1.10-2.57]) and the non-administration of vitamin A (OR=1.82; IC95% [1.30-2.55]) were significantly associated with seronegativity to all polioserotypes. CONCLUSION: This study reveals a significant association between underweight and polioseronegativity in children. In order to reduce vaccine failures in high-risk areas, an integrated approach by vaccination and nutrition programs should be adopted.

Seven samples were selected from various facies of geological formations intersected by the drill holes for petrographic analysis, supplemented by diffractometry. The goal was to identify the mineralogical composition of Banded Iron Formations (BIFs), the associated parageneses, and elements deleterious to the metallurgical processing of iron ore. Field tests, based on geophysical maps, were conducted to identify high-prospectivity sites characterized by low magnetic susceptibility and hematite richness, followed by sampling and drilling to confirm mineralization. Selected samples from characteristic facies in contact with iron ores underwent petrographic analysis using optical and scanning electron microscopy, supported by diffractometric analyses to ensure accurate mineralogical identification. The study revealed the presence of hematitic BIF, predominantly composed of weakly aggregated euhedral and subhedral martite grains, with evidence of some leaching. Magnetite, identified as the protore mineral, has been oxidized by fluid influence into martite (hematite), with a low presence of secondary supergene minerals. Variscite, kaolinite, and gibbsite were the main secondary minerals identified in both petrographic and diffractometric analyses, and are considered sources of phosphorus, aluminum, and silica—elements recognized as harmful in the metallurgical processing of iron and its alloys. These secondary minerals were precipitated within interstitial cavities leached between martite and hematite aggregates, forming a botryoidal texture. The BIFs of the Zatua Hills are primarily composed of hematitic iron ores associated with goethite, microplaty hematite, and secondary supergene minerals, likely formed through fluid circulation along fracture zones, shearing, and folding. Geochemical studies are recommended to complete the analysis, aiming to determine the content of these iron oxides, secondary minerals, and the degree of hydration through loss on ignition.

Guillaume N Mwamba,1,2 Michel Kabamba Nzaji,1,2 Nicole A Hoff,3 Patrick K Mukadi,4 Kamy Kaminye Musene,5 Sue K Gerber,6 Megan Halbrook,3 Cyrus Sinai,3 Trevon Fuller,3 Oscar Luboya Numbi,7 Emile Okitolonda Wemakoy,8 Jean Jacques Muyembe Tamfum,4 Dalau Nkamba Mukadi,8 Mala Ali Mapatano,8,9,* Anne W Rimoin,3,* Paul-Samson Lusamba Dikassa8,* 1Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of the Congo; 2Expanded Program on Immunization, Ministry of Health, Kinshasa, Democratic Republic of the Congo; 3Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; 4National Institute of Biomedical Research (INRB), Ministry of Health, Kinshasa, Democratic Republic of the Congo; 5UCLA-DRC Health Research and Training Program, UCLA-DRC, Kinshasa, Democratic Republic of the Congo; 6Polio Eradication program, The Bill and Melinda Gates Foundation, Seattle, WA, 98109, USA; 7Faculty of Medicine, University of Lubumbashi, Lubumbashi, 1825, Democratic Republic of the Congo; 8Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; 9Department of Nutrition, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo*These authors contributed equally to this workCorrespondence: Nicole A Hoff, Field Director for UCLA-DRC Research Program and Researcher at UCLA Fielding School of Public Health, 5345 Av De la Démocratie (Ex Av. Des huileries), Kinshasa, Democratic Republic of the Congo, Tel +1 (240) 409-0578, Email nhoff84@ucla.edu Guillaume N Mwamba, Expanded Program on Immunization, 32 Av De la Justice, Kinshasa-Gombe, Democratic Republic of the Congo, Tel +243817975023, Email guillaumengoiemwamba@gmail.comBackground: Malnutrition is identified as a risk-factor for insufficient polioseroconversion in the context of a vaccine-derived polio virus (VDPV) outbreak prone region. To assess the prevalence of malnutrition and its link to poliovirus insufficient immunity, a cross-sectional household survey was conducted in the regions of Haut- Lomami and Tanganyika, DRC.Methods: In March 2018, we included 968 healthy children aged 6 to 59 months from eight out of 27 districts. Selection of study locations within these districts was done using a stratified random sampling method, where villages were chosen based on habitat characteristics identified from satellite images. Consent was obtained verbally in the preferred language of the participant (French or Swahili) by interviewers who received specific training for this task. Furthermore, participants contributed a dried blood spot sample, collected via finger prick. To assess malnutrition, we measured height and weight, applying WHO criteria to determine rates of underweight, wasting, and stunting. The assessment of immunity to poliovirus types 1, 2, and 3 through the detection of neutralizing antibodies was carried out at the CDC in Atlanta, USA.Results: Of the study population, we found 24.7% underweight, 54.8% stunted, and 15.4% wasted. With IC95%, underweight (OR=1.50; [1.11– 2.03]), and the non-administration of vitamin A (OR=1.96; [1.52– 2.54]) were significantly associated with seronegativity to polioserotype 1. Underweight (OR=1.64; [1.20– 2.24]) and the non-administration of vitamin A (OR=1.55; [1.20– 2.01]) were significantly associated with seronegativity to polioserotype 2. Underweight (OR=1.50; [1.11– 2.03]), and the non-administration of vitamin A (OR=1.80. [1.38– 2.35]) were significantly associated with seronegativity to polioserotype 3. Underweight (OR=1.68; IC95% [1.10– 2.57]) and the non-administration of vitamin A (OR=1.82; IC95% [1.30– 2.55]) were significantly associated with seronegativity to all polioserotypes.Conclusion: This study reveals a significant association between underweight and polioseronegativity in children. In order to reduce vaccine failures in high-risk areas, an integrated approach by vaccination and nutrition programs should be adopted.Keywords: children, underweight, polioserotype, malnutrition, seronegativity, DRC

BACKGROUND: Malnutrition is identified as a risk factor for insufficient polio seroconversion in the context of a vaccine-derived poliovirus (VDPV) outbreak-prone region. In the Democratic Republic of Congo (DRC), underweight decreased from 31% (in 2001) to 26% (in 2018). Since 2004, VDPV serotype 2 outbreaks (cVDPV2) have been documented and were geographically limited around the Haut-Lomami and Tanganyika Provinces. METHODS: To develop and validate a predictive model for poliomyelitis vaccine response in malnourished infants, a cross-sectional household study was carried out in the Haut-Lomami and Tanganyika provinces. Healthy children aged 6 to 59 months (n=968) were enrolled from eight health zones (HZ) out of 27, in March 2018. We performed a bivariate and multivariate logistics analysis. Final models were selected using a stepwise Wald method, and variables were selected based on the criterion p < 0.05. The association between nutritional variables, explaining polio seronegativity for the three serotypes, was assessed using the receiver operating characteristic curve (ROC curve). RESULTS: Factors significantly associated with seronegativity to the three polio serotypes were underweight, non-administration of vitamin A, and the age group of 12 to 59 months. The sensitivity was 10.5%, and its specificity was 96.4% while the positive predictive values (PPV) and negative (PNV) were 62.7% and 65.3%, respectively. We found a convergence of the curves of the initial sample and two split samples. Based on the comparison of the overlapping confidence intervals of the ROC curve, we concluded that our prediction model is valid. CONCLUSION: This study proposed the first tool which variables are easy to collect by any health worker in charge of vaccination or in charge of nutrition. It will bring on top, the collaboration between the Immunization and the Nutritional programs in DRC integration policy, and its replicability in other low- and middle-income countries with endemic poliovirus.

Guillaume Ngoie Mwamba,1,2 Michel Kabamba,1,2 Nicole A Hoff,3 Patrick K Mukadi,4 Kamy Kaminye Musene,5 Sue K Gerber,6 Megan Halbrook,3 Cyrus Sinai,3 Trevon Fuller,3 Arie Voorman,6 Paul Makan Mawaw,7 Oscar Luboya Numbi,7 Emile Okitolonda Wemakoy,8 Patricia N Mechael,9 Jean Jacques Muyembe Tamfum,4 Mala Ali Mapatano,10,&ast; Anne W Rimoin,3,&ast; Paul-Samson Lusamba Dikassa8,&ast; 1Department of Public Health, University of Kamina, Kamina, Haut-Lomami, Democratic Republic of the Congo; 2Expanded Programme on Immunization, Ministry of Health, Kinshasa, Democratic Republic of the Congo; 3Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; 4National Institute of Biomedical Research (INRB), Ministry of Health, Kinshasa, Democratic Republic of the Congo; 5Health Research and Training Program, UCLA-DRC, Kinshasa, Democratic Republic of the Congo; 6Polio eradication program, The Bill and Melinda Gates Foundation, Seattle, WA, 98109, USA; 7Faculty of Medicine, University of Lubumbashi, Lubumbashi, Haut-Katanga, 1825, Democratic Republic of the Congo; 8Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; 9Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA; 10Department of Nutrition, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo&ast;These authors contributed equally to this workCorrespondence: Michel Kabamba, Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Haut-Lomami, 279, Democratic Republic of the Congo, Tel +243978467432, Email michelnzaji@yahoo.frBackground: Malnutrition is identified as a risk factor for insufficient polio seroconversion in the context of a vaccine-derived poliovirus (VDPV) outbreak-prone region. In the Democratic Republic of Congo (DRC), underweight decreased from 31% (in 2001) to 26% (in 2018). Since 2004, VDPV serotype 2 outbreaks (cVDPV2) have been documented and were geographically limited around the Haut-Lomami and Tanganyika Provinces.Methods: To develop and validate a predictive model for poliomyelitis vaccine response in malnourished infants, a cross-sectional household study was carried out in the Haut-Lomami and Tanganyika provinces. Healthy children aged 6 to 59 months (n=968) were enrolled from eight health zones (HZ) out of 27, in March 2018. We performed a bivariate and multivariate logistics analysis. Final models were selected using a stepwise Wald method, and variables were selected based on the criterion p < 0.05. The association between nutritional variables, explaining polio seronegativity for the three serotypes, was assessed using the receiver operating characteristic curve (ROC curve).Results: Factors significantly associated with seronegativity to the three polio serotypes were underweight, non-administration of vitamin A, and the age group of 12 to 59 months. The sensitivity was 10.5%, and its specificity was 96.4% while the positive predictive values (PPV) and negative (PNV) were 62.7% and 65.3%, respectively. We found a convergence of the curves of the initial sample and two split samples. Based on the comparison of the overlapping confidence intervals of the ROC curve, we concluded that our prediction model is valid.Conclusion: This study proposed the first tool which variables are easy to collect by any health worker in charge of vaccination or in charge of nutrition. It will bring on top, the collaboration between the Immunization and the Nutritional programs in DRC integration policy, and its replicability in other low- and middle-income countries with endemic poliovirus.Keywords: prediction model, validation, child health, child nutrition, underweight, serotypes, polio serotype, seronegativity, poliomyelitis-neutralizing antibodies, malnutrition, DRC

Antiretroviral treatment (ART) has revolutionized the management of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), enabling long-term viral load (VL) suppression in patients. Despite the proven effectiveness of ART, a significant proportion of patients with HIV receiving ART fail to achieve viral load suppression (VLS). This study aimed to identify factors associated with low VLS in the Tanganyika province. An unmatched case–control study was conducted from January 2022 to June 2023, including 22 care facilities with viral load data. Data were collected from patient records. For each reviewed record, the patient was invited for an interview upon providing informed consent. Data were analyzed using SPSS version 27. In a multivariable binary logistic regression model, variables with a p-value < 0.05 and a 95% confidence interval for the adjusted odds ratio were considered significantly associated with unsuppressed VL. A total of 462 individuals, including 156 cases and 306 controls, were included in the study. The mean age (standard deviation) of participants was 42.12 (±11.6) years. The following covariates were significantly associated with unsuppressed VL: poor HIV status disclosure to a confidant [adjusted OR = 2.10, 95% CI (1.33–3.31), p = 0.001], poor ART adherence [adjusted OR = 2.01, 95% CI (1.25–3.23), p = 0.004], ART interruption [adjusted OR = 3.43, 95% CI (2.00–5.88), p < 0.001], no participation in support groups [adjusted OR = 2.16, 95% CI (1.25–3.71), p = 0.005], baseline WHO clinical stage 3 and 4 [adjusted OR = 2.24, 95% CI (1.32–3.79), p = 0.003], opportunistic infections (OIs) [adjusted OR = 2.30, 95% CI (1.27–4.16), p = 0.006], and non-communicable chronic diseases (NCDs) [adjusted OR = 2.30, 95% CI (1.10–4.79), p = 0.026]. Given the clear association between several factors and unsuppressed VL, prevention should involve the implementation of innovative strategies targeting at-risk patient groups. Strengthening the monitoring of these factors among active patients at each appointment is recommended to achieve this goal.

Copyright of Cahiers d'Études Africaines is the property of Editions EHESS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Migration, xenophobia, barriers and rights to education have emerged as a significant issue in recent South African history. While there is a growing body of work on migrants and refugees within South Africa, little is known of the histories and contexts from which migrants come and how these have shaped their educational trajectories. Using in-depth interviews with seven female migrants from the Democratic Republic of Congo (DRC) in Johannesburg, South Africa, and a complex notion of context, the article provides a comparative, relational 'assemblage' of the political economies framing educational experiences in the DRC and South Africa. Two main themes are explored: violence and school fees. Differences in the nature of fee-extraction and privatisation across the two societies are highlighted. The article further argues that NGOs and individual schools' initiatives in South Africa mitigate dominant trends to some extent.

The article is devoted to the study of political identity in the Democratic Republic of Congo. The author pays particular attention to the modern interpretation of the concept of ‘Congolité’ – Congolese identity, which is in many ways identical to the idea of national citizenship. The concept of ‘Congolité’ itself is considered in the article as a set of legal norms, as an instrument of electoral struggle and as a symbolic construct. The concept has acquired a new meaning in the context of the 2021 draft law, and its return to domestic politics is significant for understanding the mood of Congolese society. The author also tries to identify the main lines of the identity debate and concludes that one of its constants is the problem of the political-legal status of the Rwandafon minority (Banyarwanda / Banyamulenge), and another is regional-linguistic fragmentation, which is reinforced by economic-demographic specificity. Both of these factors have a significant impact on internal voting patterns. The discourse of autochthonous ‘purity’ is seen as exacerbating this fragmentation and as generating conflict in Congo’s relations with states in the region, particularly Rwanda.

Abstract Introduction The coronavirus (COVID 19) pandemic is one of the most terrifying disasters of the twenty-first century. The non-pharmaceutical interventions (NPIs) implemented to control the spread of the disease had numerous positive consequences. However, there were also unintended consequences—positively or negatively related to the nature of the interventions, the target, the level and duration of implementation. This article describes the unintended economic, Psychosocial and environmental consequences of NPIs in four African countries. Methods We conducted a mixed-methods study in the Democratic Republic of Congo (DRC), Nigeria, Senegal and Uganda. A comprehensive conceptual framework, supported by a clear theory of change was adopted to encompass both systemic and non-systemic interventions. The data collection approaches included: (i) review of literature; (ii) analysis of secondary data for selected indicators; and (ii) key informant interviews with policy makers, civil society, local leaders, and law enforcement staff. The results were synthesized around thematic areas. Results Over the first six to nine months of the pandemic, NPIs especially lockdowns, travel restrictions, curfews, school closures, and prohibition of mass gathering resulted into both positive and negative unintended consequences cutting across economic, psychological, and environmental platforms. DRC, Nigeria, and Uganda observed reduced crime rates and road traffic accidents, while Uganda also reported reduced air pollution. In addition, hygiene practices have improved through health promotion measures that have been promoted for the response to the pandemic. All countries experienced economic slowdown, job losses heavily impacting women and poor households, increased sexual and gender-based violence, teenage pregnancies, and early marriages, increased poor mental health conditions, increased waste generation with poor disposal, among others. Conclusion Despite achieving pandemic control, the stringent NPIs had several negative and few positive unintended consequences. Governments need to balance the negative and positive consequences of NPIs by anticipating and instituting measures that will support and protect vulnerable groups especially the poor, the elderly, women, and children. Noticeable efforts, including measures to avoid forced into marriage, increasing inequities, economic support to urban poor; those living with disabilities, migrant workers, and refugees, had been conducted to mitigate the negative effects of the NIPs.