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Anemia and Hematologic Characteristics in Newly Diagnosed Pulmonary Tuberculosis Patients at Diagnosis in Kinshasa

Journal of Tuberculosis Research 2017年第4期5卷 243-257页

作者： Christophe Mbombo Mulenga jean-marie ntumba kayembe Benoit Obel Kabengele Alain Bakebe Division of Pulmonology University Hospitals of the University of Kinshasa Faculty of Medicine University of Kinshasa Kinshasa DR Congo

Context: The burden of TB in Africa tends to be exacerbated by the socio-economic situation and the high prevalence of intercurrent infections such as HIV, malaria and non-specific bacterial infections. These factors often result in anemia, making patients at high risk for anemia. Objective: We aimed to gain insights into the characteristics of anemia, hematologic variations and socio-economic status in untreated pulmonary TB patients (PTB) in Kinshasa, the Democratic Republic of Congo. Methods: We conducted a cross-sectional analysis of 200 smear-positive pulmonary TB patients (PTB) recruited at the initiation of TB treatment. Complete Blood Count, Iron profile, BMI, CRP and albuminemia were assessed. Data were analyzed using Student t or Mann Whitney tests as appropriate, and logistic regression was performed to assess the strength of associations. Results: Anemia was a regular finding in (69%). This anemia was mostly moderate (92.2%) and with iron deficiency pattern (48%). Hypoalbuminemia was observed in half of the subjects and appears to be correlated with the severity of anemia. Surprisingly, the severity of inflammation, as reflected by the CRP, was inversely correlated with the anemia. In the multivariate analysis, alcohol intake (OR: 2.38;IC 95%: 1.05 - 5.38), hypoalbuminemia (OR: 1.98;IC 95%: 1.02 - 3.82) and CRP rate were significantly associated with the presence of anemia among pulmonary tuberculosis at the diagnostic. Conclusion: This study demonstrates the heavy burden of the iron responsive anemia and risky life conditions in newly diagnosed TB patients, and underscores the potential usefulness of iron supplementation in the Congolese context.

关键词： Tuberculosis Pulmonary Tuberculosis Anemia Characteristics Blood Cell Count Disorders TB Patients Kinshasa

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Effects of Judo Strength-Velocity Training during Precompetition on Cardiorespiratory Responses in Congolese Judoists Aged 15 - 17 Years Old

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Journal of Biosciences and Medicines 2016年第10期4卷 50-64页

作者： jean Georges André Moulongo Alphonse Massamba jean marie kayembe ntumba François Lepira Bompeka Félix Lotoko Lisule Bernard Packa-Tchissambou Laboratory for Exercise Physiology and Biomechanics Higher Institute of Physical Education and Sports (ISEPS) University Marien NGOUABI Brazzaville Congo Direction of Research Documentation and the Files National Institute of Youth and Sports (INJS) Brazzaville Congo Laboratory of Biomaterials Health and Simulation of the Processes Higher School of Technology of the Cataracts Brazzaville Congo Faculty of Medicine University of Kinshasa Kinshasa Congo Department of Physical Education National Teaching University Kinshasa Congo

Objective: To evaluate the effects of “strength-velocity” training on the evolution of some cardiorespiratory parameters in postpubertal judoists of the Congolese national elite. Methods: The survey, exploratory, experimental and longitudinal, was about 14 boys, belonging to seven categories of weight of the International Federation of Judo. These judoists, at the level belonged to stages 3, 4 and 5 of the classification to Tanner, of pubertal maturation. Their median age was 16 years (range: 15 - 17 years). All topics have been submitted to “strength-velocity” training, focused around exercises bound to the development of the power and automatisms, from plyometric and isometric training. Three assessments have been realized in the beginning, to mid-training (3 months) and at the end of the program (6 months). The measured values were cardiorespiratory parameters. Results: The heart rate to the doorstep was decreased significantly (p = 0.048), so VO2 max (p = 0.046), FVC (p = 0.0244) and ratio VEMS/FVC (p = 0.046) as function of pubertal stage. In contrast, increase was not significant for VEMS (p = 0.205) and absolute VO2 to doorstep (p = 0.097). No significant effect of pubertal state on respiratory frequency was found. On the other hand, strength-velocity training improved cardiorespiratory data. To the recovery of the “strength-velocity test”, the decrease of the VO2 took place more quickly that the one of the VE, the VCO2 and the HR, variations linked to the category of topic weight. Conclusion: Among high level Congolese postpubertal judoists, the cardiorespiratory modifications induce faculty to the realization of a good performance and pursue objectives of health. However, it is necessary to be heedful as for situations to put in place in sittings at the time of such of “strength-velocity” training.

关键词： Judo Postpuberty Strength-Velocity Training Cardiorespiratory Modifications

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Multidrug-Resistant Tuberculosis in the Democratic Republic of Congo: Analysis of Continuous Surveillance Data from 2007 to 2016

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Journal of Tuberculosis Research 2019年第1期7卷 25-44页

作者： Serge Bisuta-Fueza jean marie kayembe-ntumba marie-Jose Kabedi-Bajani Pascale Mulomba Sabwe Hippolyte Situakibanza-Nani Tuma jean-Pierre Simelo Ernest Sumaili-Kiswaya John Ditekemena-Dinanga Patrick kayembe-Kalambayi Pneumology Unit University Hospital of Kinshasa University of Kinshasa Kinshasa Democratic Republic of Congo Department of Microbiology Medical Biology Department University of Kinshasa Kinshasa Democratic Republic of Congo National Tuberculosis Program Ministry of Public Health Kinshasa Democratic Republic of Congo Infectious Diseases Unit Department of Internal Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Physiology Unit Department of Internal Medicine University of Kinshasa Kinshasa Democratic Republic of Congo Department of Community Health Kinshasa School of Public Health University of Kinshasa Kinshasa Democratic Republic of Congo Department of Epidemiology & Biostatistics Kinshasa School of Public Health University of Kinshasa Kinshasa Democratic Republic of Congo

Background: For countries with limited resources such as the Democratic Republic of the Congo (DRC), the diagnosis of Multidrug-resistant tuberculosis (MDR-TB) is still insufficient. The MDR-TB identification is done primarily among at-risk groups. The knowledge of the true extent of the MDR-TB remains a major challenge. This study tries to determine the proportion of MDR-TB in each group of presumptive MDR-TB patients and to identify some associated factors. Methods: This is an analysis of the DRC surveillance between 2007 and 2016. The proportions were expressed in Percentage. The logistic regression permits to identify the associated factors with the RR-/MDR-TB with adjusted Odds-ratio and 95% CI. Significance defined as p ≤ 0.05. Results: Overall, 83% (5407/6512) of the MDR-TB presumptive cases had each a TB test. 86.5% (4676/5407) had each a culture and drug sensitive testing (DST) on solid medium, and 24.3% (1312/5407) had performed an Xpert MTB/RIF test. The proportion of those with at least one first-line drug resistance was 59.3% [95% CI 57.2 - 61.4] among which 50.1%, [95% CI 47.9 - 52.3] for the isoniazid, 45.6% [95% CI 43.4 - 47.8] for the rifampicin, 49.9% [95% CI 47.8 - 52.1] for ethambutol and 35.8% [95% CI 33.7 - 37.9] for streptomycin. The confirmation of MDR-TB was 42.8% [95% CI 38.4 - 47.8]. Combining both tests, the proportion of RR-/MDR-TB was 49.6% [95% CI 47.9 - 51.4] for all presumptives. This proportion was 60.0% for failures, 40.7% for relapses and 34.7% for defaulters. Associated factors with the diagnosis of MDR-TB were: aged less than 35 years;prior treatment failure;defaulters;the delay between the collection of sputum and the test completion. Conclusion: The proportion of RR-/MDR-TB among the presumptives has been higher than those estimated generally. The National tuberculosis programme (NTP) should improve patient follow-up to reduce TB treatment failures and defaulting. Moreover, while increasing the use of molecular tests, they sho

关键词： Multidrug-Resistant Tuberculosis Resistance to Rifampicin Factors Associated DR Congo

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Low Detection Rate of Multidrug-Resistant and Rifampicin-Resistant Tuberculosis in the Democratic 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 Murhula Fina Mawete Lay Ofali Michel Kaswa Francois Lepira Bompeka jean marie kayembe ntumba Zacharie Kashongwe Munogolo School of Medicine Kinshasa University Hospital Kinshasa Democratic Republic of Congo National Tuberculosis Program Kinshasa Democratic Republic of Congo

The Democratic Republic of Congo is one of the countries with a high preva-lence of multidrug-resistant tuberculosis (MDR-TB) in Africa and worldwide. This study aims to describe the trends and level of screening since 2013. This is a retrospective descriptive study based on quarterly reports from the provinces. The number of cases, past histories, age, sex and HIV Co-infection was identi-fied. It emerges that the number of cases increases significantly but does not reach the forecasts yet (912 cases of MDR/RR and XDR diagnosed in 2017 out of 3948 cases expected with a gap of 77%). Patients with a history of TB pre-dominate (63.5% in 2017);but the proportion of patients with no history of TB increases (36.5% in 2017). This suggests high rates among contacts. Women (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 made to improve screening.

关键词： MDR-RR TB Trends Screening DRC

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Implementing a Short Regimen for Multidrug-Resistant Tuberculosis in Kinshasa, Democratic 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 Murhula Kashongwe Leopoldine Mbulula Fina Mawete Nicole Anshambi Nadine Maingowa Michel Kaswa jean marie ntumba kayembe Francois Bompeka Lepira Zacharie Munogolo Kashongwe Pulmonology Unit Internal Medicine Kinshasa University Hospital Kinshasa Democratic Republic of the Congo Drug Resistant Tuberculosis Unit “Centre Excellence Damien” Damian Foundation Kinshasa Democratic Republic of the Congo National Tuberculosis Program of the Democratic 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 Democratic Republic of Congo, has the high rate of multidrug resistant tuberculosis (MDR-TB) which is associated with poor treatment outcomes until 2013. A new approach was needed. Objectives: To implement a new strategy in order to improve treatment outcomes. Design: A retrospective cohort study reviewing all the patients diagnosed MDR Tuberculosis between 2014 and 2017. The study was conducted in the National Tuberculosis Program (NTP) framework comparing the short regimen and the WHO standard regimen. Results: From 1246 patients diagnosed RR/TB, 1073 were included in the analysis: 948 on shorter regimen, and 125 on WHO standard regimen. The strategy was based on patient-centered care. In the short regimen group, 62.7% were male, 61.4% were age 25 - 44 years, 52.6% had previous history of TB, 39.3% underweight, 12.5% HIV positive. The median time from diagnosis to treatment was 19 days (0 - 163). In the long regimen group, 75% were male, 37.6% were age 14 - 44 years, 61.6% underweight, 18.4% HIV positive. The median time from diagnosis to treatment was 19 days (0 - 114). Favorable outcomes represented 81.9% in the short regimen group versus 72% in the long regimen group. Death and loss to follow-up were more observed in long regimen group (27.2% versus 15.4%). Factors associated with unfavorable outcomes in the short regimen group included sex, age ≥ 45 years, previous TB history, HIV status, delay to begin treatment. For the long regimen, the factors age and delay emerged, underweight and HIV were borderline. Drug adverse events were reported respectively in 43.5% and 42.4% for short and long regimen;with gastrointestinal disturbances, vestibular troubles, ototoxicity, arthralgia and anemia as the most common in the 2 groups. Conclusion: The new approach improved favorable outcomes. Both short and long regimens reached a high level of favorable outcome compared to the previous study. The short regim

关键词： MDR-TB Short Regimen Patient Centered Card

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First Use of Bedaquiline in Democratic 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： Murhula Innocent Kashongwe Leopoldine Mbulula Brian Bakoko Pamphile Lubamba Murielle Aloni Simon Kutoluka Pierre Umba Luc Lukaso Michel Kaswa jean marie ntumba kayembe Zacharie Munogolo Kashongwe Kinshasa University Hospital Kinshasa Democratic Republic of Congo Action Damien 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 manuscript the authors have studied the first two patients who were successfully treated with the treatment regimen containing Bedaquiline as second-line drug. The patients were diagnosed with pre-extensively drug-resistant tuberculosis (preXDR TB) whose prognosis was fatal in Democratic Republic of Congo (DRC). Bedaquiline is arguably one of the molecules of the future in the management of ultra-resistant tuberculosis. However, a larger cohort study may help to establish its effectiveness. Case report: Patients 1, 29 years old, with a history of multidrug-resistant TB (MDR-TB) one year previously. He showed signs of TB impregnation again 6 months after the last treatment. Bascilloscopy was positive again. The pre-extensively tuberculosis (pre-XDR TB) diagnosis was made by the Hain test (GenoType®MTBDRsl, Hain Lifescience). Patient 2, brother of the first patient, with a history of MDR TB a year before. He had low back pain with right parietal dorso swelling four months after the last treatment. The x-ray of the column showed L4-L5 disc disease. Parietal ultrasound showed a parietal abscess to the right of thoracic vertebrae with fistulization. Surgical biopsy and pus culture confirmed the diagnosis of Pre-XDR Extrapulmonary TB. The treatment regimen was the same for both patients: 6 months with Amikacin (Am) Bedaquiline (Bdq) Prothionamide (Pto) Paraamino Salicylic acid (PAS) Linezolid (Lzd) Cycloserine (Cs) Pyrazinamide (Z) and 14 months with PAS Lzd Cs Z. The side effects were minor. Bacteriological controls (smears and cultures) after 20 months of treatment are negative to date.

关键词： Pre-XDR TB Pott’s Disease Bedaquiline Molecular Technique Loweinstein Culture

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Relationship between Inter Canine Width and Inter Alar Width, Inter Commissural Width, and Inter Canthal Distance: A Pilot Study

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Open Journal of Stomatology 2024年第6期14卷 279-290页

作者： Grevisse Bindele Ndombolo Augustin Mantshumba Milolo Fidele Nyimi Bushabu Em Kalala Kazadi Pierrot Kumpanya ntumba jean marie kayembe Bukama Elias Lubadi Tshilumba jean Paul Sekele Isouradi Department of Prosthodontics Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo National Center of Research in Dental Sciences Kinshasa Democratic Republic of the Congo Department of Oral and Maxillofacial Surgery Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo Department of Periodontology Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo Department of Operative Dentistry Teaching Hospital of Kinshasa University Kinshasa Democratic Republic of the Congo

The aim of this study was to determine the relationship between inter canine width (ICW) and inter alar width (IAW), inter commissural width (ICoW), and inter canthal distance (ICaD) in Bantu population. Materials and Methods: It was a pilot study included all participants who were aged at least 18 years, without a history of orthodontics treatment from Prosthodontics Department, Faculty of Dental Medicine, University of Kinshasa. The Ethics committee of the National Center of Research for Dental Sciences in DR Congo approved the study protocol (CNRSB 1504.218). The participants medical records were obtained from the interview and dental examination. Nature of the study was explained with participant information sheet, and an informed consent of all participants was obtained. The inclusion criteria were no missing maxillary and mandibular teeth, no diastema, and no anterior restorations, 18 years old before enrollment in the study. The exclusion criteria were inability to meet the above requirements, pregnancy, and refusal to participate in the study. The inter-canine width (ICW), inter alar width (IAW), inter canthal distance (ICaD) and inter-commissural width (ICoW) of each participant were measured with a digital Vernier caliper (Mitutoyo, UK Ltd.,) (0.01 mm) three times and the average value was recorded. The inter canthal distance (ICaD) was measured without applying pressure by bringing the recording parts of the caliper just in contact with the medial angle. The inter alar width (IAW) was marked with a fine marked pencil on the widest outer surface of the alae of the nose on either side or width. Those two points were measured without applying pressure by bringing the recording parts of the caliper just in contact with the outer surface. The participant was told to stop breathing shortly to avoid any change in shape of the nose. The inter-commissural width (ICoW) was determined by measuring the maxillary lip vermilion from commissure to commissure without the

关键词： Relationship Inter-Canine Width Inter Alar Width Inter Canthal Distance Inter Commissural Width

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Determinants of the Sensorineural Hearing Loss in Patients with Multidrug-Resistant Tuberculosis in Kinshasa (Democratic 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： Mireille Avilaw Mpwate Eddy Mampuya Mbambu Gabriel Mabuaka Lema Christian Nzanza Matanda Dominique Mayuku Mupepe Michel Kayomo Kaswa Murielle Luengiladio Aloni Nicole Muzutie Anshambi Fabrice Mankangu Matuta Luc Losenga Lukasu Serge Katya Mpwate Pierre Zalagile Akilimali Innocent Murhula Kashongwe Zacharie Munogolo Kashongwe jean marie ntumba kayembe Richard Nzanza Matanda Department 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 Democratic Republic of The Congo Kinshasa Democratic Republic of The Congo Provincial Coordination for The Fight against Tuberculosis Kinshasa Democratic Republic of The Congo Multidrug-Resistant Tuberculosis Unit “Centre d’Excellence Damien” Damien Foundation Kinshasa Democratic Republic of The Congo Department of Anatomy-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 Pneumology 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 major challenge during the treatment of multidrug-resistant tuberculosis (MDR-TB). Aminoglycoside-based regimens, 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 measures in settings with limited resources. Objective: This study aimed to assess the determinants of the hearing loss in patients with MDR-TB. Methods: This prospective multicenter cohort study included 337 patients with MDR-TB. It was performed in Kinshasa (Democratic Republic of the Congo) between January 2020 and January 2021. Sociodemographic, clinical, biological, therapeutic, and audiometric data were exported and analyzed using Stata 17 and MedCalc. The fixed-effect linear regression panel model was used to assess the degree of the hearing loss over time according to the following covariates: therapeutic regimen (aminoglycosides, bedaquiline, or alternate), stage of chronic kidney disease (CKD), age at inclusion, body mass index, serum albumin level, HIV status, alcohol intake, hypertension, and hemoglobin level. The Hausman test was used to select between fixed- and random-effect estimators. The threshold for statistical significance was set at p Result: A total of 236 patients (70%) received an aminoglycoside-based regimen, 61 (18%) received a bedaquiline-based regimen, and 40 (12%) received aminoglycosides relayed by bedaquiline. The frequency of the hearing loss increased from 62% to 96.3% within six months for all therapeutic regimens. The Hearing loss worsened, with moderate (72.4%) and profound (16%) deafness being predominant. An Exposure to the treatment for more than one month (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 MDR-TB

关键词： Multidrug-Resistant Tuberculosis Determinants Hearing Loss DRC

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Relationship between Inter Canine Width and Inter Alar Width, Inter Commissural Width,and Inter Canthal Distance: A Pilot Study

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Open Journal of Stomatology（口腔学期刊） 2024年第6期 279页

作者： Grevisse Bindele Ndombolo Augustin Mantshumba Milolo Fidele Nyimi Bushabu Em Kalala Kazadi Pierrot Kumpanya ntumba jean marie kayembe Bukama Elias Lubadi Tshilumba jean Paul Sekele Isouradi

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Determinants of the Sensorineural Hearing Loss in Patients with Multidrug-Resistant Tuberculosis in Kinshasa (Democratic Republic of the Congo): A Prospective Cohort Study

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International Journal of Otolaryngology and Head & Neck Surgery（耳鼻喉） 2023年第6期

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