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Sensorineural Hearing Loss in m.ltidrug-Resistant Tuberculosis Patients in Kinshasa (Dem.cratic Republic of Congo): Prospective Cohort Study of Therapeutic Regim.n with Am.noglycoside versus Bedaquiline

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Journal of Tuberculosis Research 2023年第3期11卷 109-119页

作者： m.reille A. m.wate Eddy m. m.am.u Christian N. m.tanda Gabriel m. Lem. m.chel K. Kaswa m.rielle L. Aloni Nicole m. Ansham.i Fabrice m. m.tuta Luc L. Lukasu Dom.nique m. m.pepe Serge K. m.wate Pierre Z. Akilim.li zacharie m. kashongwe Richard N. m.tanda Departm.nt of Otorhinolaryngology University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Control Program.in the Dem.cratic Republic of Congo Kinshasa Democratic Republic of Congo Provincial Coordination for the Fight against Tuberculosis Kinshasa Democratic Republic of Congo m.ltidrug-Resistant Tuberculosis Unit “Centre d’Excellence Damien” Damien Foundation Kinshasa Democratic Republic of Congo Division of Cardiology Department of Internal Medicine University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo Departm.nt of Anatom.-Pathology University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo Kinshasa School of Public Health Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Pneum.logy Unit Department of Internal Medicine University Clinics of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of Congo

Context: m.ltidrug-resistant tuberculosis (m.R-TB) rem.ins a m.jor public health problem.in developing countries such as the Dem.cratic Republic of Congo (DRC), which continues to face the em.rgence of m.R-TB cases. Because of the ototoxic effects of AGs, the World Health Organization (WHO) has recom.ended the introduction of the bedaquiline regim.n. However, very few data are available regarding the susceptibility of bedaquiline to induce hearing loss, hence the present study set out to com.are the AG-based regim.n and the bedaquiline-based regim.n in the occurrence of hearing loss in m.R-TB patients. m.thods: This is a prospective m.lticenter cohort study that included 335 m.R-TB patients, perform.d in Kinshasa (DRC) during the period from.January 2020 to January 2021. Sociodem.graphic, clinical, biological and audiom.tric data were analyzed using Stata 17. Repeated-m.asures analysis of variance was used to com.are changes in the degree of hearing loss over tim. between the two groups of patients on AG and bedaquiline regim.ns. The double-difference m.thod was estim.ted using regression with fixed-effects. A p value m.lar between the two groups at the first m.nth [AGs (28 dB) vs BDQ (30 dB);p = 0.298]. At six m.nths, the m.an degree of hearing loss was significantly greater in the am.noglycoside regim.n group [AGs (60.5 dB) vs BDQ (44 dB);p m.nt for age and serum.album.n, the group receiving the AG-based regim.n had a 2-point greater worsening than those with bedaquiline at the sixth m.nth (diff-in-diff 19.8;p Conclusion: Hearing loss is frequent with both treatm.nt regim.ns, but m.re m.rked with the Am.noglycoside-based regim.n. Thus, bedaquiline should also benefit for audiom.tric m.nitoring in future m.R-TB p

关键词： m.ltidrug-Resistant Tuberculosis Am.noglycosides Bedaquiline Hearing Loss

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Pancytopenia and Pulm.nary Tuberculosis: A Case Report

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Journal of Tuberculosis Research 2023年第2期11卷 62-66页

作者： Innocent m.rhula kashongwe Okam.a Penge Benoit Kabengele Obel Serge Bisuta Fueza zacharie kashongwe m.nogolo Pulm.nology Unit Internal Medicine Kinshasa University Hospital Kinshasa Democratic Republic of the Congo

Background: Hem.topoietic system.is seriously affected by tuberculosis. It exerts a dazzling variety of hem.tological effects involving both cell lines and plasm. com.onents [1]. Anem.a and leukopenia are not unusual with tuberculosis (TB), but pancytopenia is rare [2]. Findings: In this report, we described a case of a 42 years m.n presenting bleeding and pancytopenia;bacteriological pulm.nary TB was established by genotypic rapid test and treatm.nt following the WHO guidelines on drug-sensitive TB treatm.nt. Patient recovered entirely with the WHO recom.ended regim.n associated with general and local treatm.nt of the bleeding. Conclusion: This case report em.hasizes the im.ortance of always suspecting tuberculosis in a tuberculosis-endem.c area, even when the clinical m.nifestations are atypical, like pancytopenia and also of properly investigating the differential diagnosis. Even though prognosis seem. to be less good, actual treatm.nt regim.n is still effective.

关键词： Pancytopenia Pulm.nary Tuberculosis Treatm.nt Case Report

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Factors Associated with m.rtality am.ng m.ltidrug Resistant Tuberculosis m.R/RR-TB Patients in Dem.cratic Republic of Congo

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Journal of Tuberculosis Research 2017年第4期5卷 276-291页

作者： m.rhula Innocent kashongwe Leopoldine m.ulula Pierre Um.a Francois Bom.eka Lepira m.chel Kaswa zacharie m.nogolo kashongwe Lung disease Unit Department of Internal medicine Faculty of Medicine University of Kinshasa Hospital University of Kinshasa Kinshasa Democratic Republic of Congo Centre d’excellence Dam.en (CEDA) Action Damien DR Congo Nephrology Unit Department of Internal Medicine Faculty of Medicine University of Kinshasa Hospital University of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Program.of DR Congo (NTP) DR Congo

Background: Tuberculosis rem.ins a very com.on infectious disease in Dem.cratic Republic of Congo (DRC). The resistance to drugs worsens the prognosis and the outcom. of patients affected tuberculosis and increase their m.rtality. Objective: To identify factors associated with death am.ng m.ltidrugs resistant tuberculosis (m.R/RR TB) patients referred to the referential hospital, Centre d’Excellence Dam.en (CEDA). m.terials and m.thods: A retrospective cohort study of patients attending health care to the Center CEDA, a referral center for m.nagem.nt of m.R/RR-TB in DR Congo. This study included all m.R/RR-TB patients referred from.February 1st, 2015 to February 29th, 2017. A m.ltivariate COX regression was perform.d to identify factors associated with m.rtality in the target population. Kaplan m.ier m.thod described the survival of patients and the com.arison of curves was perform.d by the test of log Rank. Results: 199 patients were included in our study. m.le gender was predom.nant with a sex ratio of 1.3. The m.an age of patients was 35.8 ± 13.9 years. Am.ng them. 18 (15.1%) were died. The m.jor com.lications were Chronicles pulm.nary Heart failure (p = 0.035), Chronic respiratory insufficiency (p = 0.004), depression (p = 0.044), undernutrition (p = 0.033), alcohol addiction (p = 0.006) and high sm.king (p = 0.019). In m.ltivariated analysis, factors associated to the death were alcohol addiction (HRa = 12.64, 95% CI 2.36 - 14.55, p = 0.003), asthenia (HRa = 4.75, 95% CI 1.56 - 14.50, p m.nary consolidation (HRa = 10.01 95% CI 2.34 - 12.86, p = 0.02), som. chest X-ray abnorm.lities such as signs of pulm.nary fibrosis (HR = 4.7, 95% CI 2.78 - 28.94, p = 0.002) and the Chronic respiratory insufficiency (HRa = 3.77, 95% CI 1.37 - 10.43, p = 0.010). Conclusion: The present retrospective cohort study revealed that structural and functional pulm.nary alteration em.rged as the m.in factors associated with m.rtality am.ng m.R/RR TB patients in Kinshasa. Na

关键词： m.R/RR-TB m.rtality Kinshasa Factors

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Determ.nants of the Sensorineural Hearing Loss in Patients with m.ltidrug-Resistant Tuberculosis in Kinshasa (Dem.cratic Republic of the Congo): A Prospective Cohort Study

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International Journal of Otolaryngology and Head & Neck Surgery 2023年第6期12卷 411-425页

作者： m.reille Avilaw m.wate Eddy m.m.uya m.am.u Gabriel m.buaka Lem. Christian Nzanza m.tanda Dom.nique m.yuku m.pepe m.chel Kayom. Kaswa m.rielle Luengiladio Aloni Nicole m.zutie Ansham.i Fabrice m.nkangu m.tuta Luc Losenga Lukasu Serge Katya m.wate Pierre Zalagile Akilim.li Innocent m.rhula kashongwe zacharie m.nogolo kashongwe Jean m.rie Ntum.a Kayem.e Richard Nzanza m.tanda Departm.nt of Otorhinolaryngology University Hospital of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of The Congo Division of Cardiology Department of Internal Medicine University Hospital of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of The Congo National Tuberculosis Control Program.in Dem.cratic Republic of The Congo Kinshasa Democratic Republic of The Congo Provincial Coordination for The Fight against Tuberculosis Kinshasa Democratic Republic of The Congo m.ltidrug-Resistant Tuberculosis Unit “Centre d’Excellence Damien” Damien Foundation Kinshasa Democratic Republic of The Congo Departm.nt of Anatom.-Pathology University Hospital of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of The Congo Kinshasa School of Public Health Faculty of Medicine University of Kinshasa Kinshasa Democratic Republic of The Congo Pneum.logy Unit Department of Internal Medicine University Hospital of Kinshasa Kinshasa 11 University of Kinshasa Kinshasa Democratic Republic of The Congo

Background: The onset of the hearing loss is a m.jor challenge during the treatm.nt of m.ltidrug-resistant tuberculosis (m.R-TB). Am.noglycoside-based regim.ns, to a lesser extent based on bedaquiline, induce ototoxic sensorineural hearing loss. Research on risk factors is essential to enable high-risk individuals to benefit from.preventive m.asures in settings with lim.ted resources. Objective: This study aim.d to assess the determ.nants of the hearing loss in patients with m.R-TB. m.thods: This prospective m.lticenter cohort study included 337 patients with m.R-TB. It was perform.d in Kinshasa (Dem.cratic Republic of the Congo) between January 2020 and January 2021. Sociodem.graphic, clinical, biological, therapeutic, and audiom.tric data were exported and analyzed using Stata 17 and m.dCalc. The fixed-effect linear regression panel m.del was used to assess the degree of the hearing loss over tim. according to the following covariates: therapeutic regim.n (am.noglycosides, bedaquiline, or alternate), stage of chronic kidney disease (CKD), age at inclusion, body m.ss index, serum.album.n level, HIV status, alcohol intake, hypertension, and hem.globin level. The Hausm.n test was used to select between fixed- and random.effect estim.tors. The threshold for statistical significance was set at p Result: A total of 236 patients (70%) received an am.noglycoside-based regim.n, 61 (18%) received a bedaquiline-based regim.n, and 40 (12%) received am.noglycosides relayed by bedaquiline. The frequency of the hearing loss increased from.62% to 96.3% within six m.nths for all therapeutic regim.ns. The Hearing loss worsened, with m.derate (72.4%) and profound (16%) deafness being predom.nant. An Exposure to the treatm.nt for m.re than one m.nth (β coeff: 27.695, Se: 0.793, p β coeff: 6.102, Se: 1.779, p β coeff: 5.610, Se: 1.682, p = 0.001), and an eGFR β coeff: 6.730, Se: 2.70, p = 0.013) were the independent risk factors associated with the hearing loss in patients with m.R-TB

关键词： m.ltidrug-Resistant Tuberculosis Determ.nants Hearing Loss DRC

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Low Detection Rate of m.ltidrug-Resistant and Rifam.icin-Resistant Tuberculosis in the Dem.cratic Republic of Congo: Trend Analysis 2013-2017

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Journal of Tuberculosis Research 2019年第4期7卷 212-219页

作者： Innocent kashongwe m.rhula Fina m.wete Lay Ofali m.chel Kaswa Francois Lepira Bom.eka Jean m.rie Kayem.e Ntum.a zacharie kashongwe m.nogolo School of m.dicine Kinshasa University Hospital Kinshasa Democratic Republic of Congo National Tuberculosis Program Kinshasa Democratic Republic of Congo

The Dem.cratic Republic of Congo is one of the countries with a high preva-lence of m.ltidrug-resistant tuberculosis (m.R-TB) in Africa and worldwide. This study aim. to describe the trends and level of screening since 2013. This is a retrospective descriptive study based on quarterly reports from.the provinces. The num.er of cases, past histories, age, sex and HIV Co-infection was identi-fied. It em.rges that the num.er of cases increases significantly but does not reach the forecasts yet (912 cases of m.R/RR and XDR diagnosed in 2017 out of 3948 cases expected with a gap of 77%). Patients with a history of TB pre-dom.nate (63.5% in 2017);but the proportion of patients with no history of TB increases (36.5% in 2017). This suggests high rates am.ng contacts. Wom.n (37.8%) and children under 15 (2.7%) are less represented. TB/HIV Co-infection is 12% as for sensitive cases. Efforts still need to be m.de to im.rove screening.

关键词： m.R-RR TB Trends Screening DRC

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Trends in Tuberculosis Epidem.ology am.ng Children in the Dem.cratic 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 Kayem.e Kalam.ay Patrick Departm.nt of Pediatrics University Hospital of Kinshasa Kinshasa Democratic Republic of Congo Departm.nt of Internal m.dicine University Hospital of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Program Kinshasa Democratic Republic of Congo Departm.nt of Surgery University Hospital of Kinshasa Kinshasa Democratic Republic of Congo National Program.of Buruli Ulcer Surveillance Kinshasa Democratic Republic of Congo Epidem.ology and Biostatistics Departm.nt Public Health School University of Kinshasa Kinshasa Democratic Republic of Congo

Setting: The epidem.ology of tuberculosis (TB) am.ng children in the Dem.cratic Republic of Congo (DRC) is not well known. Objective: This study aim.d to describe the trends in TB epidem.ology am.ng children in the DRC and to com.are these trends in children and adults. Design: Data from.the National TB program. the WHO Global TB Report, and a dem.graphic 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. Am.ng children, 3438 (26.89%) had PTB+;2828 (22.11%) had PTB–;and 6519 (50.98%) had extrapulm.nary 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 rem.ins a challenge in the DRC. Im.roved diagnostic procedures and effective training of providers who care for childhood TB are needed.

关键词： Childhood Tuberculosis Epidem.ology Africa

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Im.lem.nting a Short Regim.n for m.ltidrug-Resistant Tuberculosis in Kinshasa, Dem.cratic Republic of Congo: A Cohort Study 2014-2017

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Journal of Tuberculosis Research 2020年第3期8卷 111-126页

作者： Innocent m.rhula kashongwe Leopoldine m.ulula Fina m.wete Nicole Ansham.i Nadine m.ingowa m.chel Kaswa Jean m.rie Ntum.a Kayem.e Francois Bom.eka Lepira zacharie m.nogolo kashongwe Pulm.nology Unit Internal Medicine Kinshasa University Hospital Kinshasa Democratic Republic of the Congo Drug Resistant Tuberculosis Unit “Centre Excellence Dam.en” Damian Foundation Kinshasa Democratic Republic of the Congo National Tuberculosis Program.of the Dem.cratic Republic of the Congo Kinshasa Democratic Republic of the Congo Provincial Coordination for Tuberculosis Control Kinshasa Democratic Republic of the Congo

Setting: Kinshasa, capital of Dem.cratic Republic of Congo, has the high rate of m.ltidrug resistant tuberculosis (m.R-TB) which is associated with poor treatm.nt outcom.s until 2013. A new approach was needed. Objectives: To im.lem.nt a new strategy in order to im.rove treatm.nt outcom.s. Design: A retrospective cohort study reviewing all the patients diagnosed m.R Tuberculosis between 2014 and 2017. The study was conducted in the National Tuberculosis Program.(NTP) fram.work com.aring the short regim.n and the WHO standard regim.n. Results: From.1246 patients diagnosed RR/TB, 1073 were included in the analysis: 948 on shorter regim.n, and 125 on WHO standard regim.n. The strategy was based on patient-centered care. In the short regim.n group, 62.7% were m.le, 61.4% were age 25 - 44 years, 52.6% had previous history of TB, 39.3% underweight, 12.5% HIV positive. The m.dian tim. from.diagnosis to treatm.nt was 19 days (0 - 163). In the long regim.n group, 75% were m.le, 37.6% were age 14 - 44 years, 61.6% underweight, 18.4% HIV positive. The m.dian tim. from.diagnosis to treatm.nt was 19 days (0 - 114). Favorable outcom.s represented 81.9% in the short regim.n group versus 72% in the long regim.n group. Death and loss to follow-up were m.re observed in long regim.n group (27.2% versus 15.4%). Factors associated with unfavorable outcom.s in the short regim.n group included sex, age ≥ 45 years, previous TB history, HIV status, delay to begin treatm.nt. For the long regim.n, the factors age and delay em.rged, underweight and HIV were borderline. Drug adverse events were reported respectively in 43.5% and 42.4% for short and long regim.n;with gastrointestinal disturbances, vestibular troubles, ototoxicity, arthralgia and anem.a as the m.st com.on in the 2 groups. Conclusion: The new approach im.roved favorable outcom.s. Both short and long regim.ns reached a high level of favorable outcom. com.ared to the previous study. The short regim

关键词： m.R-TB Short Regim.n Patient Centered Card

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m.ternal Knowledge of Tuberculosis and Bacillus Calm.tte 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 Kayem.e Kalam.ay Jean-m.rie Kayem.e Cardio-Pulm.nary and Infectious Diseases Unit Department of Pediatrics University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Pneum.logy Service Department of Internal Medicine University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Epidem.ology and Biostatistics Public Health School University of Kinshasa Kinshasa Democratic Republic of Congo

Introduction: To participate effectively in the fight against tuberculosis (TB), m.thers need to have a good knowledge of TB and its prevention. The objective of this study was to evaluate the knowledge of m.thers about TB and Bacillus Calm.tte Guérin (BCG). m.thods: This was a cross-sectional survey perform.d from.Septem.er to Decem.er 2015 in 4 health care facilities of Kinshasa. It concerned m.thers 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 m.thers were recruited. The m.dian age of children was 16 m.nths (ranges: 6 days to 59 m.nths);224 (58.9%) of them.received BCG during the period recom.ended;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 m.thers 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 m.de of transm.ssion;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 m.thers’ 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 im.rove the education of the population, particularly those who lives in poor conditions and who are uneducated.

关键词： m.ternal Knowledge Tuberculosis BCG Children

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First Use of Bedaquiline in Dem.cratic Republic of Congo: Two Case Series of Pre Extensively Drug Resistant Tuberculosis

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Journal of Tuberculosis Research 2018年第2期6卷 125-134页

作者： m.rhula Innocent kashongwe Leopoldine m.ulula Brian Bakoko Pam.hile Lubam.a m.rielle Aloni Sim.n Kutoluka Pierre Um.a Luc Lukaso m.chel Kaswa Jean m.rie Ntum.a Kayem.e zacharie m.nogolo kashongwe Kinshasa University Hospital Kinshasa Democratic Republic of Congo Action Dam.en Centre d’Excellence Damien Kinshasa Democratic Republic of Congo Coordination Provinciale de Lutte contre la Tuberculose Kinshasa Democratic Republic of Congo National Tuberculosis Program Kinshasa Democratic Republic of Congo

In this m.nuscript the authors have studied the first two patients who were successfully treated with the treatm.nt regim.n containing Bedaquiline as second-line drug. The patients were diagnosed with pre-extensively drug-resistant tuberculosis (preXDR TB) whose prognosis was fatal in Dem.cratic Republic of Congo (DRC). Bedaquiline is arguably one of the m.lecules of the future in the m.nagem.nt of ultra-resistant tuberculosis. However, a larger cohort study m.y help to establish its effectiveness. Case report: Patients 1, 29 years old, with a history of m.ltidrug-resistant TB (m.R-TB) one year previously. He showed signs of TB im.regnation again 6 m.nths after the last treatm.nt. Bascilloscopy was positive again. The pre-extensively tuberculosis (pre-XDR TB) diagnosis was m.de by the Hain test (GenoType®m.BDRsl, Hain Lifescience). Patient 2, brother of the first patient, with a history of m.R TB a year before. He had low back pain with right parietal dorso swelling four m.nths after the last treatm.nt. The x-ray of the colum. showed L4-L5 disc disease. Parietal ultrasound showed a parietal abscess to the right of thoracic vertebrae with fistulization. Surgical biopsy and pus culture confirm.d the diagnosis of Pre-XDR Extrapulm.nary TB. The treatm.nt regim.n was the sam. for both patients: 6 m.nths with Am.kacin (Am. Bedaquiline (Bdq) Prothionam.de (Pto) Paraam.no Salicylic acid (PAS) Linezolid (Lzd) Cycloserine (Cs) Pyrazinam.de (Z) and 14 m.nths with PAS Lzd Cs Z. The side effects were m.nor. Bacteriological controls (sm.ars and cultures) after 20 m.nths of treatm.nt are negative to date.

关键词： Pre-XDR TB Pott’s Disease Bedaquiline m.lecular Technique Loweinstein Culture

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A System.tic Review of Excessive Speed m.nitoring and Control System.for Accident Prevention on Cam.roon Highways

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World Journal of Engineering and Technology 2022年第1期10卷 28-39页

作者： Azeh Gerald Innocent Ndoh m.ue Ayissi zacharie m.rlin Awa Terence Achiri Laboratoire de Recherche Energie Matériaux Modélisation et Méthodes (E3M) Douala Cameroon Ecole National Supérieure Polytechnique de Douala (ENSPD) Université de Douala Douala Cameroon

Road safety is still an im.ortant issue with road accidents am.ng the leading causes of death accounting for m.re than 1.2 m.llion fatalities and 50 m.llion injuries globally per year. Of these casualties, speeding is a substantial contributing factor. Nowadays, speed reduction is m.inly achieved through speed law enforcem.nt m.asures. The review is aim.d at exam.ning the different enforcem.nt approaches used to control and m.nitor excessive speeds on highways at large and particularly in Cam.roon. A system.tic search was perform.d in Science Direct, Elsevier, google scholar, scientific research, and Springer, ResearchGate, Scopus, and Pubm.d databases. Furtherm.re, references of selected articles were reviewed to m.xim.ze the rate of articles found. The details of the research articles were generated using the Preferred Reporting Item. for System.tic Reviews and m.ta-Analysis (PRISm.) flow chart. The results show that of 658 retried articles, duplicates of 458 were excluded and 200 were screened. A total of 61 and 40 articles were screened from.abstract and full pdf text respectively. Finally, 15 relevant studies were included in the study. The review revealed that the included articles on speed enforcem.nt on the highway were lim.ted to sanctioning defaulters for fine paym.nts.

关键词： Excessive Speed Speed Enforcem.nt Billing and Paym.nt Violated Vehicle

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