Papers by murielle longokolo
Antibiotics
Background: The AWaRe tool was set up by the World Health Organization (WHO) to promote the ratio... more Background: The AWaRe tool was set up by the World Health Organization (WHO) to promote the rational use of antimicrobials. Indeed, this tool classifies antibiotics into four groups: access, watch, reserve and not-recommended antibiotics. In The Democratic Republic of Congo, data on antibiotic dispensing (prescribing) by health professionals according to the AWaRe classification are scarce. In this research work, we aimed to explore antibiotic dispensing pattern from health professionals according to the WHO AWaRe classification to strengthen the national antimicrobial resistance plan. Methods: For this purpose, a survey was conducted from July to December 2022 in the district of Tshangu in Kinshasa. From randomly selected drugstores, drug-sellers were interviewed and randomly selected customers attending those drugstores were included in the study for medical prescriptions collection. The prescribed antibiotics were classified into the access, watch, reserve and not-recommended ant...
Revue Malienne d'Infectiologie et de Microbiologie, 2020
ObjectifCette étude avait pour objectif de décrire le profil clinique et biologique des personnes... more ObjectifCette étude avait pour objectif de décrire le profil clinique et biologique des personnes vivant avec le VIH (PVVIH).MéthodesIl s'est agi d'une étude rétrospective menée aux Cliniques universitaires de Kinshasa (CUK) du 1 Janvier 2008 au 31 Décembre 2014 portant sur le profil clinique et biochimique. Les données ont été analysées par SPSS 22. Les statistiques appropriées ont été appliquées au cours de l'analyse des données. Les principes d'Helsinki ont été respectés.RésultatsAu total, 270 patients étaient inclus à l'étude. L'âge moyenne (écart-type) était de 45,7±11,1 ans (Extrêmes : 22 et 65 ans) et le sex-ratio (M/F) de 0,58. Quarante pour cent des patients étaient au stade 4 de l'OMS. La diarrhée (88,9 %), les vomissements (87 %) et la toux étaient les plaintes les plus rencontrées. Au stade 4 de l'OMS, la toux (80,3 %), l'amaigrissement (87 %) et les céphalées (24,4 %) étaient plus fréquemment rencontrées (p<0,05) et la tuberculose ...
International Journal of Clinical Virology, 2021
Background: The survival of people living with HIV (PLWHIVs) is increased and Health systems will... more Background: The survival of people living with HIV (PLWHIVs) is increased and Health systems will have to deal with the early-aging-associated medical conditions. Objective: The objective of this study is to compare the clinical and biological profiles of PLWHIVs aged 50 and over and those aged less than 50 years. Material and methods: This study conducted at Kinshasa University Teaching Hospital (KUTH) covers 6 years. The clinical and biological characteristics of PLWHIVs aged 50 and over were compared with those under 50. Statistical analysis used the means ± SD, the calculation of frequencies, Student’s t-test and Chi-square. Results: PLWHIVs aged 50 or over represented 35.1%. Their average age was 58.0 ± 4.8 years. Women predominate among those under 50 and men among those 50 and over. Married people were more numerous (54% among those under 50). There were more unemployed (50% of PLHIV under 50). Patients 50 years and older were significantly classified as WHO stage 4 with a hi...
OALib, 2021
Background and Aim: Cerebral toxoplasmosis is a very common opportunistic infection in people liv... more Background and Aim: Cerebral toxoplasmosis is a very common opportunistic infection in people living with HIV but the data on this pathology in the DRC are fragmentary. This study aims to assess the extent of cerebral toxoplasmosis and its associated factors in hospitals in the city of Kinshasa. Methods: A cross-sectional study of data was collected from 263 PLHIV in 3 medical hospital facilities in the city of Kinshasa during the period from 01/01/2008 to 12/31/2013. Data on the socio-demographic, clinical, paraclinical and evolutionary profiles were collected using a questionnaire. A predictive model using logistic regression identified factors associated with cerebral toxoplasmosis at a threshold of p < 0.05. Results: The frequency of cerebral toxoplasmosis in PLHIV was 19.4%. The absence of cotrimoxazole prophylaxis (aOR 6.9 95% CI [2.7-17.5]), ART less than 6 months (aOR8.1 95% CI [3.2-21.0], the rate CD4 < 200 cells/mm 3 (aOR 3.6 95% CI [1.018-12.8]) were independent predictors of cerebral toxoplasmosis. Conclusion: This study found a high prevalence of cerebral toxoplasmosis, similar to other studies. Early management of PLWHA is recommended to reduce this frequency.
International Journal of Clinical Microbiology and Biochemical Technology, 2020
Background and aim: Metabolic abnormalities are common in HIV/AIDS. Increasingly, lipid ratios ar... more Background and aim: Metabolic abnormalities are common in HIV/AIDS. Increasingly, lipid ratios are used as screening tools for dyslipidaemia in these medical conditions. The aim of this study was to assess the ability of 4 lipid ratios to predict cardiovascular risks. Methods: This is a cross-sectional and analytical study included 105 HIV+ patients followed in Kinshasa University Teaching Hospital (KUTH). Four indices [Atherogenic Index of Plasma (AIP), Castelli Risk Index (CRI) I and II, Atherogenic coefficient (AC)] were compared. Statistical analyzis consisted of measuring frequencies and means, Student’s t-tests, ANOVA and Ficher’s exact test, and the calculation of the Kappa value. Results: Lipid ratios predicted respectively the risk in 62% (AIP), 28.6% (CRI-I) and 23.8% (CRI-II). CRI-I and II were elevated, especially in women. The AIP appeared to be a better predictor than CRI-I and II to assess dyslipidaemia in general and the high-risk frequency. The cholesterol detected ...
International Journal of Clinical Virology, 2020
Introduction: HIV infection leads to metabolic disorders. The objective of this work was to study... more Introduction: HIV infection leads to metabolic disorders. The objective of this work was to study the lipid profile of HIV + patients followed at the University Teaching Hospital of Kinshasa (UTHK). Methods: This study analyzes the lipid profile of HIV + patients, aged at least 18 years, followed at the UTHK from January 1, 2008 to December 31, 2014. The medians of different types of lipids, the frequency of lipid disorders, the general clinical characteristics of patients and factors associated with dyslipidaemia were studied. Haemoglobin (Hb), White Blood Cells (WBC), Leukocyte Formula (LF), Blood Sugar, Urea, Creatinine, Transaminases, Uric Acid, CD4s+ count were analyzed. Results: The lipid balance was performed in 38.8% of patients; 38.1% of them had dyslipidaemia. Total hypercholesterolaemia (28.6%), elevated LDL-C (19%), hypertriglyceridemia (23.8%) and HDL hypocholesterolaemia (42.9%) were observed. The medians of TG (128 mg / dL), HDL-C (51 mg/dL) and LDL-C (78 mg/dL) were ...
Virology Journal
Summary Background One year after the coronavirus disease 2019 (COVID-19) pandemic, the focus of ... more 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...
Background One year after the COVID-19 pandemic, the focus of attention has shifted to the emerge... more Background One year after the COVID-19 pandemic, the focus of attention has shifted to the emergence and spread of 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 was conducted from June 2021 to January 2022 and 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 ...
The Pan African medical journal, 2022
PLOS ONE
Aim Mortality rates of coronavirus-2019 (COVID-19) disease continue to increase worldwide and in ... more Aim Mortality rates of coronavirus-2019 (COVID-19) disease continue to increase worldwide and in Africa. In this study, we aimed to summarize the available results on the association between sociodemographic, clinical, biological, and comorbidity factors and the risk of mortality due to COVID-19 in sub-Saharan Africa. Methods We followed the PRISMA checklist (S1 Checklist). We searched PubMed, Google Scholar, and European PMC between January 1, 2020, and September 23, 2021. We included observational studies with Subjects had to be laboratory-confirmed COVID-19 patients; had to report risk factors or predictors of mortality in COVID-19 patients, Studies had to be published in English, include multivariate analysis, and be conducted in the sub-Saharan region. Exclusion criteria included case reports, review articles, commentaries, errata, protocols, abstracts, reports, letters to the editor, and repeat studies. The methodological quality of the studies included in this meta-analysis w...
Infection and Drug Resistance
In Coronavirus disease 2019 (COVID-19), some patients have low oxygen saturation without any dysp... more In Coronavirus disease 2019 (COVID-19), some patients have low oxygen saturation without any dyspnea. This has been termed "happy hypoxia." No worldwide prevalence survey of this phenomenon has been conducted. This review aimed to summarize information on the prevalence, risk factors, and outcomes of patients with happy hypoxia to improve their management. Methods: We conducted a systematic search of electronic databases for all studies published up to April 30, 2022. We included high-quality studies using the Newcastle-Ottawa Scale (NOS) tool for qualitative assessment of searches. The prevalence of happy hypoxia, as well as the mortality rate of patients with happy hypoxia, were estimated by pooled analysis and heterogeneity by I 2. Results: Of the 25,086 COVID-19 patients from the 7 studies, the prevalence of happy hypoxia ranged from 4.8 to 65%. The pooled prevalence was 6%. Happy hypoxia was associated with age > 65 years, male sex, body mass index (BMI)> 25 kg/m2, smoking, chronic obstructive pulmonary disease, diabetes mellitus, high respiratory rate, and high d-dimer. Mortality ranged from 01 to 45.4%. The pooled mortality was 2%. In 2 studies, patients with dyspnea were admitted to intensive care more often than those with happy hypoxia. One study reported that the length of stay in intensive care did not differ between patients with dyspnea and those with happy hypoxia at admission. One study reported the need for extracorporeal membrane oxygenation (ECMO) in patients with happy hypoxia. Conclusion: The pooled prevalence and mortality of patients with happy hypoxia were not very high. Happy hypoxia was associated with advanced age and comorbidities. Some patients were admitted to the intensive care unit, although fewer than dyspneic patients. Its early detection and management should improve the prognosis.
The Democratic Republic of Congo (DRC) declared the first case of Coronavirus infection disease (... more The Democratic Republic of Congo (DRC) declared the first case of Coronavirus infection disease (COVID-19) on March 10, 2020. Ever since then, assessment in terms of management and care outcomes for COVID-19 patients has not yet been formally established. Since, the number of patients has been increasing; however, there has been no formal guideline for COVID-19 patient management. This paper provides an overview of the experience of the overall management of COVID-19 at the Kinshasa University Hospital (KUH), between March and the end of April 2020. Clinical data of 49 patients from surronding municipalities, including 61% of males, are presented in this report. Patients were young (median age 34 years). At admission, 20.4% of patients were at advanced stage and 6.1% at severe stage, and almost all of them have been using self-medication prior to admission at the hospital. The lethality rate was 10.2%. In almost all the cases (8 cases out of 10), death occurred within the first 24 h...
Context and objectives. The extent of COVID-19 impact on overall in-hospital mortality is controv... more Context and objectives. The extent of COVID-19 impact on overall in-hospital mortality is controversial. The objectives of the study were to compare the number of deaths in the first semesters of 2018, 2019 and 2020; determine the proportion of COVID-19 cases and identify the factors associated with COVID-19 among the deaths recorded at the morgue of the Kinshasa University Hospital (KUH). Methods. We collected death certificates registered at the KUH morgue. The diagnosis of COVID-19 was confirmed using RT-PCR in all suspected subjects (from March 2020), including those who have arrived dead. Pearson’s khi-square, Student’s t-test, and logistic regression were used as statistical tests. Results. The number of deaths recorded in the first semester of 2019 (868 cases) was higher than in 2020 (768 cases) and 2018 (744 cases). In 2020, 45 deaths related to COVID-19 (6.0%) were reported. The risk of COVID-19 depended on the period (month of June 2020, OR: 5.69; p = 0.002), sex...
The world is going through a serious health crisis due to the COVID 19 pandemic. Although little ... more The world is going through a serious health crisis due to the COVID 19 pandemic. Although little is known about COVID-19, we have observed an increased interhuman transmission of etiological agent SARS-Cov-2 and we assume that each new cases of COVID-19 get at least two or three news persons infected. Therefore, the test for detection of the infection should be much implemented as an efficient strategy to fight against the COVID 19 pandemic. The COVID-19 diagnostic tests are an essential tool for assessing the pandemic. This review paper will discuss the advantages and limitations of the diagnosis tests for COVID 19. There are 2 categories of tests: those that directly detect the virus or its component, and those that search for the antibodies generated by the virus infection. The real time Reverse transcriptase Polymerase chain reaction (test rt-RT-PCR) remains the gold standard for the diagnosis of COVID-19. Its sensitivity on the nasopharynx swab seems high, though fals...
Annales Africaines de Medecine
Context and objective: Like all epidemics, the COVID-19 pandemic occurs in several highly diverse... more Context and objective: Like all epidemics, the COVID-19 pandemic occurs in several highly diverse waves. The objective of the present study was to compare the demographic and clinical characteristics and mortality of patients between the first and second waves of COVID-19. Methods: This was a historical follow-up study conducted at the Kinshasa University Hospital (KUH) between March 2020 and January 2021. We used the χ² test to compare proportions. Survival was described by the Kaplan Meier method. Cox regression was used to identify independent predictors of mortality. Results: A total of 411 COVID-19 patients were enrolled. Compared to wave 1 patients, wave 2 patients were significantly older (52.4 ±17.5 vs. 58.1 ±15.7; p=0.026). The death rate of patients in the first wave was higher than in the second wave (p=0.009). Survival was more reduced in the first wave compared with the second wave. Predictors of mortality present in both the first and second waves were respiratory...
PLOS Global Public Health, 2022
The retention of patients in care is a key pillar of the continuum of HIV care. It has been sugge... more The retention of patients in care is a key pillar of the continuum of HIV care. It has been suggested that the implementation of a “treat-all” strategy may favor attrition (death or lost to follow-up, as opposed to retention), specifically in the subgroup of asymptomatic people living with HIV (PLWH) with high CD4 counts. Attrition in HIV care could mitigate the success of universal antiretroviral therapy (ART) in resource-limited settings. We performed a retrospective study of PLWH at least 15 years old initiating ART in 85 HIV care centers in Kinshasa, Democratic Republic of Congo (DRC), between 2010 and 2019, with the objective of measuring attrition and to define factors associated with it. Sociodemographic and clinical characteristics recorded at ART initiation included sex, age, weight, height, WHO HIV stage, pregnancy, baseline CD4 cell count, start date of ART, and baseline and last ART regimen. Attrition was defined as death or loss to follow-up (LTFU). LTFU was defined as ...
The Journal of Clinical Hypertension
The Pan African Medical Journal, 2020
Introduction l´objectif de cette étude était d´identifier les déterminants de non-observance des ... more Introduction l´objectif de cette étude était d´identifier les déterminants de non-observance des patients vivant avec le VIH (PVVIH) au TAR (traitement antirétroviral) à Kinshasa. Méthodes dans une étude transversale conduite à Kinshasa du 1e rmai au 31 août 2015 chez des PVVIH âgées d´au moins 18 ans et sous traitement antirétroviral depuis au moins 3 mois. Un échantillon probabiliste de 400 patients a été pris en compte. Le CASE Adherence Index (méthode subjective) et le renouvellement d´ordonnance (méthode objective) ont évalué l´observance. Les déterminants de la non-observance ont été recherchés par régression logistique multiple. Résultats les 400 PVVIH avaient un âge médian de 43 ans (18-75). La fréquence de non-observance globale était de 25,5%. La fréquence de la non-observance objective était plus élevée que celle de la non-observance subjective (29% vs 21%, p = 0,01). Le paiement de la consultation (ORaj: 1,70; IC95%: 1,02-2,81; p = 0,042), les effets indésirables (ORaj: ...
Cardiovascular Journal of Africa, 2015
Summary Introduction The metabolic syndrome (MetS) is common in human immune deficiency virus (HI... more Summary Introduction The metabolic syndrome (MetS) is common in human immune deficiency virus (HIV)-infected individuals receiving highly active antiretroviral therapy (HAART). Immune deficiencies caused by HIV give rise to numerous opportunistic gastrointestinal pathogens such as Helicobacter pylori, the commonest cause of chronic gastritis. The study sought to determine the relationship between H pylori infection and the MetS among HIV-infected clinic attendees. Methods This cross-sectional study was carried out in a specialised heart clinic in Kinshasa, DR Congo. Between January 2004 and December 2008, 116 HIV-infected patients (61 with MetS and 55 without MetS) who underwent upper gastrointestinal endoscopy for dyspeptic symptoms were included in the study following an informed consent. Univariate associations were determined by odds ratios (OR), while multivariate logistic regression analysis was used to identify factors associated with the MetS. Results H pylori infection (OR ...
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Papers by murielle longokolo