Democratic Republic Of Congo Research Articles

Monkeypox Clade Ib virus introduction into Burundi: first findings, July to mid-August 2024.

We describe cases with monkeypox virus (MPXV) Clade Ib in Burundi from their first detection in July until 20 August 2024. Testing 442 people with vesicular lesions confirmed 170 cases (98 male; 72 female), 82 (48%) being < 15 years old. Differential diagnosis of the first 30 individuals testing MPXV negative revealed chickenpox in 20. Cases occurred in 26 of 49 Burundi health districts, but mostly in Bujumbura Nord (88/170; 67%). Case-derived MPXV genetic sequences from Burundi and South-Kivu (Democratic Republic of the Congo), clustered together in phylogenetic analysis.

Seroprevalence of Arboviruses in Travelers in Morocco: Focus on Dengue and Zika

Dengue and Zika viruses belong to the arbovirus family and are emerging infectious diseases transmitted by Aedes mosquitoes, prevalent in tropical and subtropical regions. Their proliferation is facilitated by factors such as adaptability, climate change, and globalization. Despite surveillance efforts by the World Health Organization (WHO), global monitoring remains limited. This study aimed to ascertain the seroprevalence of these diseases among travelers returning from endemic regions. A prospective, cross-sectional study was conducted on 2023 targeted travelers in the Democratic Republic of Congo and the Central African Republic. Participants were selected based on specific criteria over a six-month period. Blood samples were assessed in our laboratory using the VirClia® automated chemiluminescence immunoassay to detect Dengue and Zika IgG and IgM antibodies. The analysis involved interpretation of the results using a specific formula. The study included a young, asymptomatic cohort, averaging 30.8 years of age. Travelers were categorized according to age, sex, and country of residence. Dengue virus seroprevalence was 18.6%, predominantly IgG. The prevalence of ZIKV infection was 12.9%. The seroprevalence of these arboviruses varies according to sociodemographic factors. Epidemiological studies play a crucial role in assessing the prevalence of vector-borne diseases and informing public health strategies to mitigate their global impact.

Cross-sectional study exploring the prevalence and clinical manifestations of acute diarrhea among under-five children in primary care hospital in democratic republic of the congo

Background: Acute diarrhea (AD), which is defined as frequent passing of liquid stools compared to normal, is a serious and worrying problem and remains a concern for health care systems because of its high mortality cause in children under 5 years old. Our study aimed to present the prevalence and to describe the clinical manifestation of AD among under-five children. Methods: From June 2022 to May 2023, we conducted a retrospective, descriptive and cross-sectional study including all patients aged 0 to 5 years hospitalized for AD. Results: Out of 512 patients, only 197 (38.5%) children with AD were selected for our study. The average age is 25.5 months, and the sex ratio is 1.11. Some families (75.1%) have clean latrines, and 21.8% use water from the river. Inaccessibility to clean water and intolerance or food poisoning were the causes of acute diarrhea in children. Major signs and symptoms are fever, dehydration and vomiting. Weight loss and malnutrition are the major complications of AD in children. The treatment of AD is provided by oral rehydration solutions and antibiotics. Conclusion: The study highlights the significant prevalence of acute diarrhea among under-five children underscores the importance of preventive measures and government intervention, such as the introduction of rotavirus vaccination. However, conclusions regarding prevalence rates should be interpreted with caution due to the lack of detailed population data.

Activity-based contracting for optimization of the mass distribution of insecticide-treated nets in the Democratic Republic of Congo: pilot implementation in Kwilu province

BackgroundPromoting the use of insecticide-treated mosquito nets (ITNs) is one of the main strategies for reducing malaria-related morbidity. An innovative activity-based contracting (ABC) approach has been implemented in Kwilu Province, Democratic Republic of Congo to optimize ITN mass distribution campaigns, with payments based on contractually defined programmatic outcomes for key campaign activities following independent verification of results.MethodsThis internal evaluation was carried out using a mixed methods approach combining qualitative and quantitative document and content analysis from a series of three workshops: validation workshops for campaign results at provincial level for the 2021 and 2022 campaigns; internal evaluation workshop for the Kwilu campaign as part of the ABC approach organized by “Santé pour tous en milieu rural” (SANRU) with its sub-contractors; and national campaign evaluation workshop organized by the National Malaria Control Program.ResultsThe pilot campaign with the ABC approach in Kwilu has demonstrated better results than campaigns conducted using the standard, non-ABC, approach: better household coverage (99.9% vs. 97.3%) and improved compliance with ITN allocation to households based on the household size (98. 9% vs. 84.7%); lower loss of ITNs (0.3% vs. 0.5%) with immediate penalties for lost ITNs in the province under the ABC approach; shorter campaign lead times (14 vs. 28 weeks from the start of training to the launch of distribution). This last point is crucial, as it is likely to generate efficiencies and contribute to ensuring timely ITN replacement campaigns.ConclusionThe challenges encountered and the lessons learned in the implementation of the pilot ABC approach in Kwilu could guide future distribution campaigns in the DRC and other African countries that would like to engage in distribution campaigns based on performance-based incentive contracts.

Four new Afrotropical Hypotrabala from moist broadleaf forests&amp;nbsp;and the first description of the female of H. obscura&amp;nbsp;(Lepidoptera, Lasiocampidae, Lasiocampinae, Selenepherini)

Four new species in the genus Hypotrabala Holland, 1893 are described: 1) Hypotrabala leopoldi sp. n. from the Democratic Republic of the Congo (DRC); 2) Hypotrabala benjamini sp. n. from DRC; 3) Hypotrabala carlottae sp. n. from Côte d’Ivoire and Ghana; and 4) Hypotrabala bettinae sp. n. from Nigeria. They are somewhat reminiscent of the dark colored Hypotrabala obscura Takano &amp; László, 2024 known from the type series of four males originating from Gabon. The female of H. obscura and its genitalia are described for the first time; the species is recorded for the first time for Cameroon. Adults of both sexes, their genitalia, and map with collecting localities are illustrated.

ESSAI DE TRAITEMENT BIOLOGIQUE DES HUILES LUBRIFIANTES USAGÉES RÉCUPÉRÉES DANS DES GARAGES DE KINSHASA À L’AIDE DES URINES HUMAINES ET KAOLIN EN RÉPUBLIQUE DÉMOCRATIQUE DU CONGO

In the various car garages of Kinshasa (in the Democratic Republic of Congo), the lack of consideration of environmental standards is the basis of the voluntary and/or accidental discharges of used oils directly into the environment without any prior treatment. These used hydrocarbons are pollutants that can cause major environmental problems due to their toxicity. The aim of this study is to treat used lubricating oils from car garages biologically in order to reduce their toxic potential. To this end, an aerobic biological treatment system was set up by mixing 4L of used oils with IL of urine, 2Kg of active Kaolin and 20L of water. The reduction in the toxicity of hydrocarbons was assessed through acute toxicity tests on the species Gambusia Affinis and microbiological analyses before and after biological treatment of these oils. The results obtained on the toxicity before treatment of these oils revealed that the LC50 was around ±3 ml/g of used oils to say that the pollutant is very toxic. After biological treatment, the LC50 rise to around ±66.7 ml/g for the treated oils, which represents a significant reduction in toxicity and ranks these treated oils in the order of less toxic effluents. The microbiological analyses of the used oils before their treatment did not show any bacteria; on the other hand, the analyses after treatment made it possible to highlight the presence of bacterial colonies whose identification revealed the following bacteria: Citrobacter, Enterobacter, Klebsiella and Pseudomonas, which are mostly lipolytic. This study thus allowed to treat used oils thanks to microorganisms and the intrinsic properties of urine and Kaolin.

Current exposure to environmental pollutants in the general adult population of Kinshasa, Democratic Republic of Congo (DRC): A cross-sectional study

BackgroundEnvironmental pollution is a serious public health problem because of its adverse effects on both human health and biodiversity. In Western countries, many human biomonitoring (HBM) studies are conducted to assess population exposure to pollutants. In contrast, the number of HBM studies in Africa is very low. ObjectiveTo measure contamination by arsenic, lead, 4,4′-dichlorodiphenyldichloroethylene (4,4′-DDE) and polychlorobiphenyls (PCBs) in the adult population of Kinshasa and to identify the susceptible population. MethodsIn the present work, we measured the contamination by arsenic in urine and lead in blood and by 4,4′-DDE and polychlorobiphenyls (PCBs) in serum in samples collected from 151 volunteers recruited in Kinshasa, the capital of the Democratic Republic of Congo (DRC). ResultsThe PCBs 180, -153 and −138 were detected in most samples with median concentrations of 0.04, 0.05 and 0.04 ng/ml, respectively. The median concentration of 4,4′-DDE was 0.83 ng/ml and 12.7% of our population showed contamination above the threshold of 3.675 ng/ml, which is associated with a significantly higher risk of cancer. Arsenic concentrations were also high (median: 48.1 μg/L in urine). Finally, exposure to lead is problematic: the median blood concentration was 54.9 μg/L, which is above the thresholds proposed by the WHO and the US CDC (50 μg/L and 35 μg/L respectively) to initiate clinical intervention, and 12.6% of the population had a lead level above 100 μg/L, which is associated with several health outcomes. ConclusionsOur results highlight the need for further HBM studies in Africa and should encourage the authorities of the DRC to implement laws and regulations to reduce pollution and population exposure.

CRP, PCT, and D-dimer as Biomarkers for Disease Severity in COVID-19 Patients: A Retrospective Study in Kinshasa, Democratic Republic of Congo

Introduction: The COVID-19 pandemic has had a significant impact on global health, resulting in more than 6 million reported deaths worldwide as of April 2023. This study aimed to investigate the potential of C-reactive protein (CRP), procalcitonin (PCT), and D-dimer as biomarkers for assessing disease severity in COVID-19 patients in Kinshasa, Democratic Republic of Congo Methods:A retrospective examination was conducted involving 339 COVID-19 patients admitted to Kinshasa hospitals between January 2021 and March 2022. CRP, PCT, and D-dimer levels were measured in all patients and compared between those with severe and non-severe illnesses. Results: Our findings revealed significantly higher CRP, PCT, and D-dimer levels in severe cases compared to non-severe cases. Specifically, the median CRP level was 120.6 mg/L in severe cases, 47.3 mg/L in mild cases, and 13.5 mg/L in moderate cases. The median PCT levels were 0.26 ng/mL in severe cases, 0.08 ng/ mL in mild cases, and 0.07 ng/L in moderate cases. Additionally, the median D-dimer level was 1836.9 µg/L in severe cases and 597.6 µg/L in mild cases, with a value of 481.1 µg/L in moderate cases. System learning techniques were also employed to predict disease severity based on these biomarkers, achieving high accuracy. Conclusion: Our findings suggest that CRP, PCT, and D-dimer serve as valuable biomarkers for identifying severe COVID-19 cases in Kinshasa. Furthermore, the application of machine learning methods can yield accurate predictions of disease severity based on these biomarkers. These biomarkers hold the potential to assist clinicians in informed decision-making regarding patient management and contribute to improved clinical outcomes for COVID-19 patients.

Measurement and Validation of Market Power in China’s Log Import Trade—Empirical Analysis Based on PTM Model and AIDS Model

China is the world’s largest importer of logs, possessing the scale to exert significant influence in the international market. This paper uses a fixed-effect variable coefficient Pricing-to-Market panel model to measure China’s market power in log import trade. It also utilizes the Almost Ideal Demand System model from an elasticity perspective to explore the market behavior characteristics of various source countries in China’s log import trade, thereby validating the mechanism of market power. The results indicate that: ① China’s main trading partners can be categorized into four groups according to their market power in the log import trade. Specifically, China holds superlative market power in log imports from Indonesia, Malaysia, and Myanmar; holds strong market power in log imports from Russia, the Democratic Republic of the Congo, and Mozambique; holds weak market power in log imports from Papua New Guinea, Equatorial Guinea, France, Germany, Australia, and New Zealand; and holds no market power in Japan, Cameroon, and the United States. ② As China’s expenditure on log imports increases, there is a tendency to purchase high-quality precious wood and a greater concern for the legality of market transactions. Consequently, China is anticipated to augment its imports from source countries with no or weak market power. ③ The simple price elasticity of log imports from each source country is negative. Source countries with stronger market power tend to increase prices to achieve higher total revenue, while those with weaker market power are more inclined to lower prices to achieve the same. ④ Log products from various source countries are complementary in the Chinese market, indicating that China’s substantial demand for logs relies on the simultaneous supply from multiple countries and diverse wood types. Based on the existence or absence of market power in China’s log import trade, this paper provides targeted insights into enhancing international market power and reducing trade losses.

Ethnomedical knowledge of plants used in alternative medicine to treat hemorrhoidal diseases in Lubumbashi, Haut-Katanga province, Southern Democratic Republic of Congo

BackgroundA variety of medicinal plants are used in traditional medicine in Lubumbashi for the management of hemorrhoidal diseases. However, no investigation has been conducted to gather the knowledge required for this type of management in the region. The present study was conducted to inventory the plants used in Lubumbashi to treat hemorrhoidal diseases and to relate their ethnomedical characteristics.MethodsThis study was conducted between March 2022 and February 2023 by interviews using semi-structured questionnaire with households (n = 1520), herbalists (n = 25), and traditional healers: THs (n = 59).ResultsThe 1,604 respondents (sex ratio M/F = 0.9; mean age: 56 ± 3 years; experience: 12 ± 3 years) provided information on 100 taxa, 84 of which are used against internal hemorrhoids, Phyllanthus amarus being the most cited (Citation Index, CI: 0.76). Most of them are trees (38%) or shrubs (32%), belonging to 90 genera and 45 families dominated by the Fabaceae (10%) and Asteraceae (9%). They are indicated in 76 other pathologies, dominated by gastrointestinal disorders (GID), wounds and sexually transmitted infections (CI > 0.57). From these 100 taxa, 117 anti-hemorrhoidal formulations were derived, 11 of which combined more than one plant. In all these recipes, the leaf is the most commonly used part (> 60%) and the liniment (> 45%) is the most popular form of application. For the first time, this study reports 14 taxa as plants used in the treatment of hemorrhoids. Among these taxa, Ficus stuhlmannii, Ficus laurifolia, and Ocimum centraliafricanum are listed as medicinal plants for the first time. Khaya nyasica, and Syzygium cordatum, each with 11 uses, have the highest traditional medicinal value.ConclusionThe findings of this study indicate that a significant number of medicinal plants are used in traditional medicine in Lubumbashi for the treatment of hemorrhoidal diseases. Some of these plants are endemic to the biodiversity area, while others are shared with other cultures and regions. A series of pharmacological studies is currently underway with the objective of validating the anti-hemorrhoidal properties of these plants and in order to identify phytochemical compounds responsible of this activity.Graphical

Community perspectives of Ebola Viral Disease in high-risk transmission border regions of Tanzania: a qualitative inquiry

BackgroundTanzania faces ever-rising concerns due to the recurrence of the Ebola Virus Disease (EVD) in neighbouring Democratic Republic of Congo (DRC) and Uganda. This necessitates a better understanding of the community perspectives in high-risk regions for effective risk communication and preparedness.MethodsThis rapid ethnographic assessment study used explorative qualitative methods to collect data. People from diverse backgrounds participated in 59 in-depth interviews, 57 Key Informant interviews, and 35 focus group discussions. Data was analysed using a thematic analysis approach.FindingThe study revealed existence of awareness of EVD and its symptoms, with radio and television being the main sources of information. However, there were varied perceptions of EVD’s cause and transmission, some attributed it to bats, monkeys, and wild animal meat, while others associated it with high fever, a dirty environment, changing dietary patterns, and the COVID-19 virus. Physical contact with an infected person’s body fluids and eating meat from infected animals were perceived as EVD transmission routes. Women, school children, boda-boda (motorcycle) riders, and fishermen were considered the most susceptible to EVD infections due to their daily activities. Preventive measures included avoiding physical contact, touching fluids, and refraining from eating wild animal meat. Prompt reporting of suspected cases to health facilities was deemed crucial for earlier outbreak identification and containment.ConclusionThe high-risk regions of Tanzania had a high level of awareness and perceived susceptibility to EVD, coupled with varying degrees of misperception about the etiology and its transmission. To improve community perspectives and preparedness in the case of an outbreak, there is a need for ongoing risk communication and participation in EVD prevention and responses.

Therapeutic agents for the treatment of human mpox.

The aim of this study was to summarize the current knowledge of therapeutic options for mpox (formerly known as monkeypox) in the context of recent outbreaks and the ongoing evolution of the virus. Multiple therapeutic agents, including tecovirimat, cidofovir, brincidofovir, and vaccinia immune globulin, have been used during the multicountry outbreak of mpox caused by Clade 2b monkeypox virus that began in 2022. Tecovirimat has been most extensively used, based on efficacy against mpox lethal challenge in animal models, and human safety data. Real-world observational evidence has further supported safety with minimal adverse events in large cohorts and mixed reports of reductions in time to lesion resolution. Several prospective randomized controlled trials using tecovirimat are underway with headline results from a study in the Democratic Republic of the Congo showing no difference in lesion resolution compared to placebo. Other studies including in outpatient settings are underway in Europe and the Americas. Cidofovir and brincidofovir, limited by adverse event profiles, have been less extensively studied. Vaccinia immune globulin has been used predominantly in salvage therapy for severe mpox, with no large observational series available. The 2022 multicountry outbreak of mpox marked a public health emergency. Agents approved for smallpox management were widely used for mpox, supported by animal and in-vitro evidence, and human safety data. The large number of human cases has allowed retrospective observational study of these agents and facilitated recruitment in prospective trials. The ongoing evolution of the virus may pose challenges for therapeutic interventions, necessitating rigorous randomized controlled trials to guide clinical use.

Participation in artisanal diamond mining and food security: A case study of Kasai Oriental in DR Congo

Abstract The high prevalence of food insecurity and malnutrition in Kasai Oriental, Democratic Republic of the Congo, prompted an investigation into the complex relationship between household livelihood activities and food security. Despite many rural households relying on subsistence farming, this alone may not ensure improved food security in Kasai Oriental. Consequently, non-farm sectors like artisanal mining offer a potential solution to address food insecurity among rural households. The aim of this study is to explore the association between engagement in artisanal diamond mining, food insecurity, and children’s nutritional status in Kasai Oriental. The research utilizes household cross-sectional data collected between November and December 2022. Fixed effects and Instrumental variable models were employed to address household heterogeneity and potential endogeneity related to participation in artisanal diamond activities. The regression results reveal a significant relationship between participation in artisanal diamond mining and food security. This implies that participation increases households’ cash, enabling them to access sufficient food and potentially mitigating the risk of falling into food insecurity. However, involvement in artisanal mining has not shown a significant association with children’s malnutrition. These findings call for further research on “hidden hunger.” Policies aiming to encourage and formalize artisanal diamond mining should integrate specific extension services and inform rural households about hidden hunger.

Perception et Conservation des Archives à la Direction « Etudes et Planification » du Ministère de la Santé, Hygiène et Prévention, République Démocratique du Congo

The administrative services of the Ministry of Health are not immune to the multifaceted crises affecting the Congolese public administration. As administration is both the foundation and backbone of public management in a country, the Democratic Republic of the Congo is a nation where archival science, in all its nobility, plays a vital role in good governance. If administrations continue to thrive at the beginning of the 20th century, it is due to the importance of archival documents, which every modern and organized nation strives to preserve well, as an essential tool of national memory. Archives are data with an indefinite lifespan and cannot be materials that disappear. The observation within the General Secretariat of Health is that archives are thrown haphazardly into dark rooms where they are exposed to the elements and various kinds of rodents. Under these conditions, the disappearance of historical data is inevitable, which could constitute a significant loss, especially as some documents exist in a single copy and, once destroyed, they cannot be reconstructed.

A review of Mpox: Biological characteristics, epidemiology, clinical features, diagnosis, treatment, and prevention strategies

AbstractThe outbreak of monkeypox virus (MPXV) was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO), and the zoonotic disease caused by viral infection was renamed as “Mpox” on November 28, 2022. Currently, there is no approved vaccine or specific antiviral treatment for Mpox, and a main preventive strategy against MPXV infection remains the smallpox vaccine. Although there was an emergency use authorization (EUA) of Brincidofovir and Tecovirimat for the clinical treatment of clade II Mpox, while Tecovirimat failed to reduce the duration of Mpox lesions among patients infected with clade I Mpox in the Democratic Republic of the Congo (DRC). Therefore, it is still an urgent need to develop an effective medication. This review aims to enhance the understanding of Mpox and contribute to its prevention and treatment strategies, it provides a systemic introduction of the biological and epidemiological characteristics of MPXV, the clinical feature and diagnosis of Mpox, as well as treatment and prevention strategies, which will improve the comprehension about MPXV and offer potential strategies for clinical treatment.

Relationship between Prices and Quality of Essential Medicines from Different Manufacturers Collected in Cameroon, the Democratic Republic of the Congo, and Nigeria.

Achieving universal access to affordable medicines and at the same time ensuring the quality of medicines presents a challenge, especially in low- and middle-income countries. Here, the relationship between medicine prices and medicine quality was investigated in three African countries. From different types of health facilities and medicine vendors, 711 samples of 18 different essential medicines were purchased and analyzed for quality (assay and dissolution) according to the United States Pharmacopeia. Without exception, all originator brand medicines and all SRA generics (generic medicines manufactured in countries with stringent regulatory authorities [SRAs]) complied with pharmacopeial specifications. In contrast, 21.1% of the non-SRA generics (manufactured in countries without SRAs) were substandard. The median prices of originator brands and SRA generics were three times and two times higher than those of non-SRA generics, respectively. Within the non-SRA generics, no positive correlation was observed between medicine quality and medicine price. Medicines manufactured in India, China, or African countries showed similar quality and similar prices. Only a single WHO-prequalified medicine sample was found among the 711 samples. Non-SRA generic medicines produced by manufacturers for which WHO had published Public Inspection Reports showed a significantly lower rate of substandard medicines (7.3%) and, at the same time, significantly lower prices (by 33%) than other non-SRA generics. Falsified medicines (total 2.0%) were found among all categories of medicines and had prices similar to those of non-SRA generics. Our findings indicate that adequate quality assurance does not necessarily imply an increase in medicine prices.

Low level of awareness and prevention of hepatitis B among Congolese healthcare workers: urgent need for policy implementation.

The Democratic Republic of Congo (DRC) is a country with many public health challenges, including those related to the prevention and management of viral hepatitis B. Healthcare workers, who are at the frontline of patient care, are particularly at risk of contracting and spreading this virus, especially given its high prevalence in the general population. This paper examines the level of awareness and preventive measures among Congolese healthcare workers. Overall, the data show that health workers are under-immunized and lack formal training in hepatitis B prevention and management. In addition to limited awareness, health facilities are insufficiently involved in the implementation of standardized infection control protocols, the provision of personal protective equipment and routine hepatitis B vaccination programmes. There also appears to be a lack of clear and effective national policies outlining the main axes of infection control targets by 2030. This calls for urgent policy implementation focusing on mandatory vaccination, training, resource availability, adherence to infection control practices and comprehensive post-exposure management.

Prevalence and risk of occurrence of visible birth defects in mining areas in South Kivu: A hospital-based cross-sectional study.

Possible contamination related to mining activities might contribute with other risk factors in increasing the burden of birth defects (BDs) in many developing countries including the Democratic Republic of Congo. The subsequent prevalence is frequently underestimated. Implementation of focused public health interventions is hindered by the paucity of comprehensive data. We assessed the potential impact of mining on the prevalence and occurrence of visible BDs in neonates in South Kivu (SK). A hospital-based cross-sectional study was conducted among 65,474 newborns registered in 7 hospitals in SK from 2016-2021. Hospitals were categorized based on mining activities in their respective catchment areas. Living in a mining zone was the exposure, whereas the outcome was visible BDs. Prevalence was estimated per 100,000 live births, and risk of occurrence with odds ratio (OR) and their 95% confidence interval. 261 neonates with visible BDs were recorded accounting for a prevalence of 399 cases per 100,000 live births. The prevalence ranges between 217 and 1365 cases per 100,000 live births. An increased risk was found in mining zones(OR=2.07; 95%CI=1.59-2.68), Mubumbano(OR=1.72, 95%CI=1.22-2.43), and Mwenga(OR=3.89, 95%CI=2.73-5.54), whereas a reduced risk was reported in non-mining zones(OR=0.48, 95%CI=0.37-0.62) in Katana (OR=0.49, 95%CI=0.33-0.73). Musculoskeletal(28.74%) and central nervous systems(19.92%) were the most common BDs. A significant difference in prevalence for BDs involving the face, GI system and abdominal wall, musculoskeletal, central nervous and genitourinary systems between mining and non-mining zones was found(p<0.001). There is an excessive risk for visible BDs in areas with hazardous mining activities in SK region.​​ More complex studies are needed to define the possible causal relationship. Moreover, findings generated herein should be corroborated by other research design, periodically monitored by public health authorities, and used to inform initiatives promoting enhanced environmental health, access to pediatric surgical care, and public health campaigns aimed at decreasing risk of BDs.

High frequency of artemisinin partial resistance mutations in the Great Lakes region revealed through rapid pooled deep sequencing.

In Africa, the first Plasmodium falciparum artemisinin partial resistance mutation, was Kelch13 (K13) 561H - detected and validated at appreciable frequency in Rwanda in 2014. Surveillance to better define the extent of the emergence in Rwanda and neighboring countries is critical. We used novel liquid blood drop preservation combined with pooled sequencing to provide cost-effective rapid assessment of resistance mutation frequencies at multiple collection sites across Rwanda and neighboring regions in Uganda, Tanzania, and the Democratic Republic of the Congo (DRC). Malaria-positive samples (n=5,465) from 39 health facilities collected between May 2022 and March 2023 were sequenced in 199 pools. In Rwanda, K13 561H and 675V were detected in 90% and 65% of sites with an average frequency of 19.0% (0-54.5%) and 5.0% (0-35.5%), respectively. In Tanzania, 561H had high frequency in multiple sites. 561H appeared at 1.6% in Uganda. 561H was absent from the DRC, although 675V was seen at low frequency. Concerningly candidate mutations were observed: 441L, 449A, and 469F co-occurred with validated mutations suggesting they are arising under the same pressures. Other markers for decreased susceptibility to artemether-lumefantrine are common: P. falciparum multidrug resistance protein 1 N86 at 98.0% (63.3-100%) and 184F at 47.0% (0-94.3%) and P. falciparum chloroquine resistance transporter 76T at 14.7% (0-58.6%). Additionally, sulfadoxine-pyrimethamine-associated mutations show high frequencies. K13 mutations are rapidly expanding in the region further endangering control efforts with the potential of engendering partner drug resistance.

Trajectories of personal agency by gender and pubertal development among adolescents in Kinshasa: Longitudinal evidence from the GlobalEarly Adolescent Study

BackgroundEmpowerment research has largely focused on adult women with little focus on younger adolescents. Additionally, despite recognition that empowerment is a process, few studies have longitudinally explored its development. MethodsWe used secondary data from four waves of the Global Early Adolescent Study to explore trajectories in the development of three domains of agency (i.e. the internal processes composing empowerment) - Freedom of Movement, Voice, and Decision-Making - for 1188 boys and 1153 girls in Kinshasa, Democratic Republic of Congo. Respondents were age 10–14 at enrollment and followed through age 14–18. We created scales for each domain and conducted gender- and age-stratified latent growth curve modeling with random effects, comparing age 10–14 to age 15–18, accounting for clustering within individuals over waves. We examined the role of puberty within each domain in the analysis of age 10–14. ResultsScores across all domains increased with age for boys and girls, with the exception of Voice amongst boys 10–14. Rates of change varied by age group and gender; for boys, scores increased at a faster rate for older boys relative to younger boys for Freedom of Movement (ß(10-14): 3.98 versus ß(15-18): 6.12) and Voice (ß(10-14): .50 versus ß(15-18): 2.54). Relative to younger girls, scores amongst older girls increased at a faster rate for Freedom of Movement (ß(10-14): 1.76 versus ß(15-18): 3.72) and a slower rate for Decision-Making (ß(10-14): 6.41 versus ß(15-18): 2.80). Puberty was associated with significant increases in scores across all domains for both genders, with the exception of Decision-Making for girls. InterpretationYoung people develop/acquire different forms of agency at different stages of adolescence and development is not uniform across forms. Gender inequalities in agency amplify at puberty, signaling the need to intervene at or before this critical stage of development.