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Maternal Knowledge of Tuberculosis and Bacillus Calmette Guerin Vaccination in Pediatric Health Services in Kinshasa

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Journal of Tuberculosis Research 2017年第1期5卷 30-43页

作者： Loukia Aketi Joseph Shiku Diayisu Zacharie Kashongwe Grace Nkabikueni patrick kayembe kalambay Jean-Marie kayembe Cardio-Pulmonary and Infectious Diseases Unit Department of Pediatrics University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Pneumology Service Department of Internal Medicine University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Epidemiology and Biostatistics Public Health School University of Kinshasa Kinshasa Democratic Republic of Congo

Introduction: To participate effectively in the fight against tuberculosis (TB), mothers need to have a good knowledge of TB and its prevention. The objective of this study was to evaluate the knowledge of mothers about TB and Bacillus Calmette Guérin (BCG). Methods: This was a cross-sectional survey performed from September to December 2015 in 4 health care facilities of Kinshasa. It concerned mothers of children who received BCG vaccine. The frequencies and chi-square of Pearson were used to report results. Results: A total of 380 couples of the children and their mothers were recruited. The median age of children was 16 months (ranges: 6 days to 59 months);224 (58.9%) of them received BCG during the period recommended;62 (16.3%) experienced a side effect. There was a significant association (p = 0.00) between sides effects and the delayed vaccination. The average age of the mothers was 29.3 ± 6.4 years;352 (92.6%) had heard about TB;28 (7.4%) never heard about it;168 (44.2%) knew that TB is a contagious disease;only 111 (29.2%) knew the mode of transmission;87 (22.9%) did not know any signs of TB, and 54 (14.2%) knew about prevention with the BCG vaccine. Factors significantly associated with the mothers’ lack of knowledge were a low level of education (p = 0.01), young age (p = 0.02), and place of residence (p = 0.04). Conclusion: There is an urgent need to improve the education of the population, particularly those who lives in poor conditions and who are uneducated.

关键词： Maternal Knowledge Tuberculosis BCG Children

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How to Develop a Realist Evaluation to Evaluate the Effectiveness of Integrated Management of Childhood Illness Strategy in Community Care Sites in the Democratic Republic of Congo

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Open Journal of Epidemiology 2019年第3期9卷 243-258页

作者： John Mukulukulu Etshumba Dosithée Ngo Bebe patrick kayembe kalambay Fulbert Kwilu Nappa Kinshasa School of Public Health Management Department University of Kinshasa Kinshasa Democratic Republic of the Congo (DRC) Kinshasa School of Public Health Chief of Management Department University of Kinshasa Kinshasa DRC Kinshasa School of Public Health Chief of Epidemiology and Biostatistics Departement University of Kinshasa Kinshasa DRC

Background: In sub-Saharan Africa, the DRC ranks among countries with high infant mortality. To solve this problem, the Health Ministry has set up a programme: the use of integrated management childhood illness (IMCI) in community care sites (CCSs) managed by non-health professional persons known as community health workers (CHW). This approach has not yet been integrated into the health pyramid. This is why we chose the Realist Evaluation Approach to evaluate the effectiveness of this programme on Universal Access to care for children under 5 years of age in the DRC. Methods/design: To conduct this exploratory study which is essentially a descriptive case study, we applied the principles of a realist evaluation by context—mechanisms—effects explained in the conceptual framework. The preliminary theory of the programme was elaborated by data collection through a literature review coupled with semi-structured interviews with key informants who were managers of the government programme and technical and financial partners of the programme. Results: IMCI has been evaluated and shown its positive contribution in the reduction of global children mortality. In the DRC, summaries of data collection through a literature review coupled with semi-structured interviews showed the same result. However, under criticism, based on the data collected during this exploratory study, it is promisingly apparent that this programme will achieve the objectives assigned to it through the preliminary theory of the programme. Conclusion: The literature review corroborated the effectiveness of the IMCI programme. The application of this programme in CCS with non-health professionals who are Community Health Workers has been shown to be effective in the DRC. Based on this reality, it was possible to define the basis for a realist evaluation of the effectiveness of the programme in CCS.

关键词： IMCI in Community Care Sites Democratic Republic of the Congo Realist Evaluation

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Trends in Tuberculosis Epidemiology among Children in the Democratic Republic of Congo

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Journal of Tuberculosis Research 2016年第4期4卷 235-248页

作者： Aketi Loukia Shiku Diayisu Joseph Kashongwe Zacharie Lay Gertrude Kibadi Kapay kayembe kalambay patrick Department of Pediatrics University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Department of Internal Medicine University Hospital of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Program Kinshasa Democratic Republic of Congo Department of Surgery University Hospital of Kinshasa Kinshasa Democratic Republic of Congo National Program of Buruli Ulcer Surveillance Kinshasa Democratic Republic of Congo Epidemiology and Biostatistics Department Public Health School University of Kinshasa Kinshasa Democratic Republic of Congo

Setting: The epidemiology of tuberculosis (TB) among children in the Democratic Republic of Congo (DRC) is not well known. Objective: This study aimed to describe the trends in TB epidemiology among children in the DRC and to compare these trends in children and adults. Design: Data from the National TB program, the WHO Global TB Report, and a demographic survey of health in the DRC were retrospectively analyzed. The study period was from 1995 to 2014. The notification rate, absolute incidence and incidence rate of TB per 100,000 population were reported. Results: In 2014, 12,785 (12.6% of adult cases) TB cases were reported in children and 101,303 in adults. Among children, 3438 (26.89%) had PTB+;2828 (22.11%) had PTB–;and 6519 (50.98%) had extrapulmonary TB (EPTB). Children under 5 years had a lower reported prevalence of TB (184 cases). The incidence rate per 100,000 population was 10 in children and 181 in adults. The TB incidence decreased between 2010 (11.47) and 2014 (10.46). The proportion of children in overall cases of PTB+ was 4% to 5% in all districts. Conclusion: Caring for childhood TB remains a challenge in the DRC. Improved diagnostic procedures and effective training of providers who care for childhood TB are needed.

关键词： Childhood Tuberculosis Epidemiology Africa

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