North Kivu Research Articles

Assessment of Risk Factors Associated with Malaria Infection Among Adult Populations in Selected Internally Displaced Camps in Goma, North Kivu Province, Dr. Congo

Malaria remains a significant public health concern in many parts of the world, particularly in Africa. The Democratic Republic of the Congo (DRC) is one of the countries most heavily affected by malaria, with millions of cases reported annually. In the Eastern region of the DRC, ongoing conflict has resulted in large numbers of people living in precarious conditions within IDP camps, where the risk of malaria transmission is heightened due to unsuitable housing conditions, lack of bed net, overcrowded and unsanitary conditions with limited access to essential healthcare services. This study aims to assess the risk factors associated with malaria infection among adult populations in the Kashaka and Shabindu IDP camps in Goma, North Kivu Province. The study employed a cross-sectional design using a mixed-method approach. Data were collected from 371 households through interviews and medical record reviews. Chi-square tests were performed for bivariate analysis, and then logistic regression to evaluate the impact of multiple variables simultaneously. All participants pointed to mosquitoes as the causal agent. Around 97.8% confirmed that fever is the main symptom followed by chills (75.2%), headache (54.5%), and sweating (10.2%). Bed net was identified as a preventive measure at (100%), mosquito repellents (71.7%), and Indoor residual spraying (68;2%). Approximately 43.9% of households had at least one case of malaria with an increasing incidence in April (26.7%) and October (35.9%). The most significant factors affecting the spread of malaria were gender (OR: 1.73; p-value < 0.001), lack of bed net (OR: 5.231; p-value < 0.001), outdoor activities at night (OR: 0.661; p-value = 0.0364), and being close to sanitation facilities (OR: 2.458; p-value = 0.0013). These underscore the critical need for targeted malaria prevention measures, including increased bed net availability and usage, enhanced sanitation infrastructure, and heightened awareness about the dangers of outdoor nighttime activities.

Screening for Eye Disease in Ebola Virus Disease Survivors: Program Implementation During an Active Outbreak in the North Kivu and Ituri Provinces, Democratic Republic of the Congo.

First identified in the Democratic Republic of the Congo (DRC, formerly Zaire) in 1976, Ebola virus disease (EVD) outbreaks have afflicted thousands of Congolese over the past several decades. The nation's largest outbreak of EVD in 2018-2020 was complicated by security challenges as well as large case numbers across an expansive geographic region. These factors provided challenges for logistical considerations as well as clinical coverage. In conjunction with the EVD survivor care program spearheaded by the Ministry of Health in DRC, the DRC Intitut National de Recherche Biomédicale, (DRC Institut National de Recherche Biomedicale, DRC National Institute of Biomedical Research) and others, we launched a multidimensional effort to provide ophthalmic care to EVD survivors. During the engagement period, 237 EVD survivors were screened, 56% of which were women. The 237 EVD survivors constituted ∼75% of the total EVD survivors who were discharged at the time of the intervention. The mean time from EVD symptom onset to evaluation was 4.6 months ± 1.8 SD (range: 24d to 8.5mo). Ninety-seven (41%) of EVD survivors screened reported ocular symptoms during or after acute illness, such as itchy eyes (49%), eye pain (25%), and tears (24%). Ophthalmic findings, including retinal scarring, active uveitis, dry eye disease, cataracts, and glaucoma, were also identified. The need for continued monitoring and longitudinal care for EVD survivors is evident from the expanding body of literature pertaining to post-acute sequelae, including ophthalmic manifestations. Initiatives for such care should be conducted across and in conjunction with multidisciplinary stakeholders for contextualization and effectiveness.

First imported Cases of MPXV Clade Ib in Goma, Democratic Republic of the Congo: Implications for Global Surveillance and Transmission Dynamics.

The ongoing national mpox outbreak in the Democratic Republic of the Congo has resulted in more >30,000 suspected cases in the country from January 2023 to August 2024. While these historic case totals have been driven by primarily by zoonosis, the emergence of Clade Ib monkeypox virus (MPXV), which is connected to more sustained human-to-human transmission, has been associated with increasing public health impacts in eastern DRC. First identified in South Kivu province, Clade Ib MPXV has been identified in multiple non-endemic East African countries for the first time. In DRC, there have been concerns over broader Clade Ib expansion in the country that could further complicate containment and mitigation responses. Here, we report the first introductions of Clade Ib into North Kivu province, including within internal displacement camps, with suspected close contact transmission that includes non-intimate contacts and children. These findings demonstrate that mpox case investigations and community messaging campaigns should include considerations for non-sexual contact-mediated transmission of Clade Ib that includes children <15 years.

PERLINDUNGAN HAK ANAK DALAM KONFLIK BERSENJATA DI KONGO BERDASARKAN CONVENTION ON THE RIGHTS OF THE CHILD 1989

The armed conflict, particularly in the Eastern Congo regions of North Kivu, South Kivu and Ituri, has led to many violations of children's rights. 14.9 million children have been most severely affected by this conflict. There are violations in terms of recruitment, use, detention, abduction, physical and sexual violence, attacks on schools and health facilities. The formulation of the problem of this article is what forms of violations of children's rights in the armed conflict that occurred in Congo based on the UNCRC 1989 and how efforts should be made by Congo in protecting children's rights based on the UNCRC 1989. This article uses normative research methods, descriptive-analytical in nature, drawing conclusions with deductive methods. The results of the research are the form of violations of children's rights committed by Congo, namely the right to survival, the right to protection, the right to growth and development and violating the principle of non-discrimination, the principle of state responsibility, the principle of the right to life and development to the fullest. The conclusion is that Congo should take the best measures to protect children's rights, especially in armed conflict, such as legislative, administrative, social and educational efforts to protect children's rights

Maternal mortality in Eastern Democratic Republic of Congo: a 10-year multi-zonal institutional death review

BackgroundMaternal mortality (MM) remains a real scourge that hits hardest in the poorest regions of the world, particularly those affected by conflict. However, despite this worrying reality, few studies have been conducted about MM ratio in the Democratic Republic of Congo (DRC). The study aimed to describe the trends as well as the epidemiological profile and causes of reported institutional maternal deaths between 2013 and 2022 in Eastern DRC.MethodsA retrospective descriptive study was conducted between March 2023 and August 2023 in eight Health Zones (HZ), five in South Kivu Province (Mwana, Minova, Miti-Murhesa, Kamituga and Idjwi) and three in North Kivu Province (Kirotshe, Karisimbi and Kayna) in the eastern region of the DRC. Our study covers 242 health facilities: 168 health centers (HC), 16 referral health centers (RHCs),50 referral hospitals (RH) and 8 general referral hospitals (GRHs). Data from registers and medical records of maternal deaths recorded in these zones from 2013–2022 were extracted along with information on the number of deliveries and live births. Sociodemographic, clinical parameters, blood and ultrasound tests and suspected causes of death between provinces were assessed.ResultsIn total, we obtained 177 files on deceased women. Of these, 143 (80.8%) were retained for the present study, including 75 in the 3 HZs of North Kivu and 68 in the 5 HZs of South Kivu. From 2013 to 2022, study sites experienced two significant drops in maternal mortality ratio (MMR) (in 2015 and 2018), and a spike in 2016–2017. Nonetheless, the combined MMR (across study sites) started and ended the 10-year study period at approximately the same level (53 and 57 deaths per 100,000 live births in 2013 and 2022 respectively). Overall, 62,6% of the deaths were reported from secondary hospital. Most deaths were of married women in their thirties (93.5%). Almost half (47.8%) had not completed four antenatal consultations. The main direct causes of death were, in decreasing order of frequency: post-partum haemorrhage (55.2%), uterine rupture (14.0), hypertensive disorders (8.4%), abortion (7.7%) puerperal infections (2.8%) and placental abruption (0.7%). When comparing among provinces, reported abortion-related maternal mortality (14.1% vs 0%) was more frequent in North Kivu than in South Kivu.ConclusionThis study imperatively highlights the need for targeted interventions to reduce maternal mortality. By emphasizing the crucial importance of antenatal consultations, intrapartum/immediate post-partum care and quality of care, significant progress can be made in guaranteeing maternal health and reducing many avoidable deaths.

The Challenges of Conflict Transformation, Peacebuilding and Education Towards Intractable Conflicts: The Youth Involvement in North-Kivu Province, Democratic Republic of Congo

Peacebuilding and transformation are essential in creating a peaceful environment, in responding to conflicts and in promoting good relationships for social harmony. This paper establishes the challenges to transformation and peacebuilding in dealing with conflicts and violence among young people as it explores the strategies for conflict transformation and peacebuilding in North Kivu province. It looks at how these tools can help the youths and the communities to break away from violence and work towards peace. The study is based on the systems theory in general and confict transformation in particular how to train young generations to get out of conflicts and violence in order to preapre a bright future. Thus, the paper triangulates the systems theory, transformation, peacebuilding and the intergroup contact. From the participatory action research design, the paper provides resources in the struggle against intractable conflicts and subsequent violence for peacemaking. The paper establishes ubuntu as a starting point for conflict transformation, peacebuilding and in restoring peace and peaceful cohabitation among the youth in Eastern Democratic Republic of Congo.

Understanding the Compound Risk Context of Goma City Through the Pressure and Release Model

Goma, the capital of the North Kivu Province in the Democratic Republic of Congo, is a transborder and conflict-affected city that is also chronically vulnerable to volcanic eruptions. Using the extended version of the Pressure and Release model, this study examines Goma’s progressive vulnerability over the course of three volcanic disasters—the eruptions of Mount Nyiragongo in 1977, 2002, and 2021. We find that the rich natural resources and weak governance are the root causes of Goma’s chronic vulnerability to volcanic eruptions. In the first phase (1977–2002), an influx of ethnic groups seeking land as well as conflicts between them and natives over the land and natural resources can be regarded as dynamic pressure, generating unsafe conditions. In the second phase (2002–2021), the conflict added a global dimension, with the influx of global businesses and humanitarian organizations increasing the population pressure. It caused a gentrification process, in which the urban poor were pushed out to the marginal area of the city, which resulted in significant damage from the 2021 eruption. We find that globalization produces two opposing forces in the increased vulnerability; it accelerated economic prosperity in the region, on the one hand, but also caused a rapid population increase and increased progression, on the other.

“They raped me and killed my husband”: Women survivors of sexual violence’s experience in South and North Kivu, Democratic Republic of Congo.

“They raped me and killed my husband”: Women survivors of sexual violence’s experience in South and North Kivu, Democratic Republic of Congo.

An agricultural field, a dangerous place for women: survivors of sexual violence’s experience ineastern democratic republic of Congo

ABSTRACT This study investigates Congolese girls’ and women’s experience in the eastern Democratic Republic of Congo concerning the rape they face during field activities. A qualitative approach was employed to collect data from 40 single young women and married women aged 18–45 years old. Four focus group discussions and 28 individual interviews were conducted among women survivors of sexual violence from the South and North Kivu provinces. Findings indicate that the agricultural fields in remote areas represent a sexually hostile work environment where militias or attackers gang-rape women and girls. According to the participants, they occasionally avoid going to the fields due to pain, fear, and illness resulting from rape. It is believed that the enemy is using such brutal rape as a tactic to instil fear in the community and families in order to force them to starve. Greater efforts are needed from the government to ensure the protection of traumatized population, girls and women living in rural areas.

Perinatal mortality and its predictors in Beni City, Democratic Republic of Congo: a cross-sectional study

BackgroundGlobally, perinatal mortality rates have decreased considerably in the last 30 years. However, in sub-Saharan African countries perinatal mortality remains a public health burden. Therefore, this study aimed to determine the Perinatal Mortality Rate and the factors associated with perinatal mortality in Beni City, Northeastern Democratic Republic of Congo.MethodsA hospital-based retrospective cross-sectional study was conducted among 1394 deliveries that were documented in Beni General Referral Hospital from 2 January to May 31, 2022. The study was done in the conflict-ridden Beni city of the North Kivu Province. Analysis was done using Open Epi and SPSS version 22. Binary and Multivariate logistic regression analyses were performed. Odds ratio with 95% confidence interval was used to measure strength of association.ResultsFindings indicate that 60.7% of 1394 participants were below the age of 21 years, and 95.1% (1325) Beni residents. The Perinatal Mortality Rate was 42.3 per 1000 live births. Majority (51) of the postpartum women who experienced perinatal mortality didn`t have a history of perinatal mortality as compared to their counterparts. Multivariable analysis revealed that birth weight (AoR = 0.082, 95% CI 0.014–0.449, p < 0.05) and Apgar score in the 10th minute (AoR = 0.082, 95% CI 0.000- 0.043, p < 0.05) were significantly associated with Perinatal mortality.ConclusionThe high perinatal mortality rate in Beni General Referral Hospital, approximately four in every 100 births remains a disturbing public health concern of which is attributable to low birth weight and Apgar score. This study may help policy-makers and healthcare providers to design preventive interventions.

Integration of Information Communication Technology, Strategic Leadership and Academic Performance in Universities in North Kivu, Democratic Republic of Congo

Information communication technology has become an integral part of the management of higher educational institutions worldwide. There is no aspect of our lives that technology has not penetrated and brought lasting impact. This study delves into the intricate dynamics of how ICT influences management and learning processes in higher learning institutions. It sought to critically examine the impact of the integration of information communication technology in the strategic management of institutions of higher learning, specifically focusing on North Kivu, Democratic Republic of Congo. It aims to critically assess the integration of ICT and its impact on financial management, human resource management, and the overall enhancement of faculty and employee effectiveness in Congolese higher learning institutions. The study was conducted within selected institutions of higher learning in North Kivu in Congo. The study engaged a sample size of 124 staff from select universities who participated in this study. The study was guided by the positivist research philosophy, and it employed a cross-sectional descriptive design. This study utilized purposive sampling technique to get the sample size. Data collection was done through questionnaires. Data analysis entailed using descriptive statistics and inferential statistics. Descriptive statistics used mean and standard deviation which served as key metrics. The F- test was used to make statistical inferences. Analysis of qualitative data was done using the use of content analysis. The study established that ICT usage, ICT accessibility, and ICT integration both have significant influence on academic performance. Furthermore, the study determined that strategic leadership played a mediating role in the relationship between ICT integration and academic performance. It is, therefore, advisable for managers of these institutions to invest in ICT so that they can improve performance and increase service delivery to all the stakeholders.

Obstetric vesico-uterine fistula in nine reference hospitals in the Democratic Republic of the Congo: epidemiological, clinical, and therapeutic aspects

IntroductionWith global cesarean section rates rising, there’s concern about increase in obstetric vesico-uterine fistula (OVUF). Very little is known about this anatomoclinical entity of obstetric fistula in Africa in general and in DRC in particular. Our purpose was to describe the epidemiological, clinical, and therapeutic aspects of OVUF in the Democratic Republic of the Congo (DRC).MethodsThis was a descriptive cross-sectional study. Data were collected from patients who presented with OVUF across seven provinces of the DRC (North Kivu, Haut-Uélé, Kasai Central, Kwilu, Maniema, Nord-Ubangi and Sankuru) from January 2017 to December 2022. Study variables were epidemiological, clinical, and therapeutic features.ResultsOf 1,267 patients presenting with obstetric fistulas, 355 (28.0%) had OVUF. The mean age was 32.9 ± 11.6 years, 80.6% of patients (286/355) lived in rural areas, and the majority had a low level of education (40% no formal education, 30.1% primary school, 28.7% secondary school). In total, 64.8% of patients were primiparous (230/355) and in all (100%) cases, OVUF was caused iatrogenically during cesarean delivery. Majority (76.3%) of patients laboured for one day or less (mean duration 1.0 ± 0.5 days) before giving birth, and the fetus died in 58.3% of cases. In 35.8% of cases, the fistula had lasted more than 10 years (mean age 10.1 ± 10.0 years) before repair. A proportion of 88.2% (n = 313) of OVUF was isolated while 11.3% (n = 40) was associated with a uretero-vaginal fistula. In 82.8% (n = 294) of cases the OVUF was single. The average fistula size was 2.4 ± 1.0 cm (range: 0.5 and 5.5 cm) and 274 (77.2%) fistulas measured between 1.5 and 3 cm, with 14.9% (n = 53) of them larger than 3 cm. Fibrosis was present in 65.1% of cases, cervical involvement was absent in 97.7% and post-operative complications were absent in 94.4%. In all cases, the OVUF was surgically repaired abdominally with a success rate of 97.5% (346/355).ConclusionThe proportion of OVUF is relatively high in the DRC. Most affected patients were young, under-educated, primiparous women living in rural areas. Cesarean section was the sole identified cause of OVUF which was isolated, single, without fibrosis, in majority of cases. Abdominal repair of OVUF was very effective, with good results in almost all cases. Teaching young doctors working mainly in remote areas how to perform safe cesarean section is needed to reduce incidence of OVUF in DRC.

Provincial Intra-Action Review of the COVID-19 Vaccination Programme: Opportunities to Improve Vaccine Response in North Kivu, Democratic Republic of Congo.

Low levels of COVID-19 vaccination coverage in many countries prompted the use of rapid assessments to characterize barriers to vaccination and identify corrective measures. The World Health Organization recommended the use of intra-action reviews (IARs) to identify best practices, gaps, and lessons learned to make real-time improvements to the COVID-19 vaccination response. The Democratic Republic of the Congo (DRC) implemented a national IAR in July 2021 that was poorly attended by the provincial health level, where vaccination activities are planned and implemented. To bridge this gap, we proposed sub-national IARs focused on COVID-19 vaccine program implementation at the provincial level. Using the WHO methodology, we organized a four-day provincial IAR workshop and invited national, provincial and health zone Ministry of Health (MoH) representatives and private and non-governmental organizations involved in the provincial COVID-19 vaccination response. Participants were divided into six groups based on their expertise, affiliation, and role within the health system to assess and identify lessons learned, challenges and the solutions within each of the six technical areas: (1) coordination, planning and monitoring; (2) service delivery; (3) risk communication and community engagement; (4) adverse effects following immunization (AEFI); (5) logistics; (6) and data management, monitoring and evaluation. The first provincial COVID-19 IAR was conducted in Goma, North Kivu, from January 19-22, 2022. A total of 56 participants came from provincial and health zone offices, and non-governmental organizations. Through work group discussions, they identified best practices, challenges, and lessons learned, and made recommendations to improve implementation of vaccination activities and reach coverage targets. Activities were proposed to operationalize recommendations and address challenges to improve the provincial response. This provincial IAR was a useful tool for reviewing progress and areas of improvement, while evaluating aspects of the COVID-19 vaccine rollout. It provided a means to share information with vaccination partners on areas of intervention, tailored to the local context.

Prioritization of maternal and newborn health policies and their implementation in the eastern conflict affected areas of the Democratic Republic of Congo: a political economy analysis.

Maternal and neonatal mortality remains a major concern in the Democratic Republic of Congo (DRC), and the country's protracted crisis context exacerbates the problem. This political economy analysis examines the maternal and newborn health (MNH) prioritization in the DRC, focussing specifically on the conflict-affected regions of North and South Kivu. The aim is to understand the factors that facilitate or hinder the prioritization of MNH policy development and implementation by the Congolese government and other key actors at national level and in the provinces of North and South Kivu. Using a health policy triangle framework, data collection consisted of in-depth interviews with key actors at different levels of the health system, combined with a desk review. Qualitative data were analysed using inductive and then deductive approaches, exploring the content, process, actor dynamics, contextual factors and gender-related factors influencing MNH policy development and implementation. The study highlighted the challenges of prioritizing policies in the face of competing health and security emergencies, limited resources and governance issues. The universal health coverage policy seems to offer hope for improving access to MNH services. Results also revealed the importance of international partnerships and global financial mechanisms in the development of MNH strategies. They reveal huge gender disparities in the MNH sector at all levels, and the need to consider cultural factors that can positively or negatively impact the success of MNH policies in crisis zones. MNH is a high priority in DRC, yet implementation faces hurdles due to financial constraints, political influences, conflicts and gender disparities. Addressing these challenges requires tailored community-based strategies, political engagement, support for health personnel and empowerment of women in crisis areas for better MNH outcomes.

Role of Media in Promoting Peace and Conflict Resolution in North Kivu, Democratic Republic of Congo

Role of Media in Promoting Peace and Conflict Resolution in North Kivu, Democratic Republic of Congo

COVID-19 epidemiology, health services utilisation and health care seeking behaviour during the first year of the COVID-19 pandemic in Mweso health zone, Democratic Republic of Congo.

Although the evidence about coronavirus disease 2019 (COVID-19) has increased exponentially since the beginning of the pandemic, less is known about the direct and indirect effects of the pandemic in humanitarian settings. In the Democratic Republic of the Congo (DRC), most studies occurred in Kinshasa and other cities. Limited research was conducted in remote conflict-affected settings. We investigated the COVID-19 epidemiology, health service utilisation, and health care-seeking behaviour during the first year of the pandemic (March 2020-March 2021) in the Mweso health zone, North Kivu, DRC. This mixed-methods study includes a descriptive epidemiological analysis of reported COVID-19 cases data extracted from the provincial line list, interrupted time series analysis of health service utilisation using routine health service data, qualitative perceptions of health care workers about how health services were affected, and community members' health care seeking behaviour from a representative household survey and focus group discussions. The COVID-19 epidemiology in North Kivu aligns with evidence reported globally, yet case fatality rates were high due to underreporting. Testing capacity was limited and initially mainly available in the province's capital. Health service utilisation showed different patterns - child measles vaccinations experienced a decrease at the beginning of the pandemic, while outpatient consultations, malaria, and pneumonia showed an increase over time. Such increases might have been driven by insecurity and population displacements rather than COVID-19. Community members continued seeking care during the first months of the COVID-19 pandemic and visited the same health facilities as before COVID-19. Financial constraints, not COVID-19, were the main barrier reported to accessing health care. The first year of the COVID-19 pandemic in the Mweso health zone was characterised by low testing capacity and an underestimation of reported COVID-19 infections. The increase in health care utilisation should be further explored to understand the role of factors unrelated to COVID-19, such as insecurity, population displacement, and poverty, which remain major challenges to successfully providing health services and improving the population's health. Measles vaccination coverage dropped, which exacerbated the ongoing measles outbreak. Improved decentralised testing capacity will be crucial for future epidemics and enhanced efforts to maintain child vaccination coverage.

Care-seeking patterns and timely access to care among survivors of sexual violence in North Kivu, the Democratic Republic of the Congo: a retrospective file-based study

ABSTRACT Background Sexual violence is widespread in war-torn North Kivu province in the Democratic Republic of the Congo (DRC). Timely access to care is crucial for the healing and wellbeing of survivors of sexual violence, but is problematic due to a variety of barriers. Through a better understanding of care-seeking behaviours and factors influencing timely access to care, programmes can be adapted to overcome some of the barriers faced by survivors of sexual violence. Objective The aim of this study was to describe demographics, care-seeking patterns and factors influencing timely care-seeking by survivors of sexual violence. Methods Retrospective file-based data analysis of sexual violence survivors accessing care within two Médecins Sans Frontières (MSF) programmes supporting the Ministry of Health, in North Kivu, DRC, 2014–2018. Results Most survivors (66%) sought care at specialised sexual violence clinics and a majority of the survivors were self-referred (51%). Most survivors seeking care (70%) did so within 3 days. Male survivors accessing care were significantly more likely to seek care within 3 days compared to females. All age groups under 50 years old were more likely to seek care within 3 days compared to those aged 50 years and older. Being referred by the community, a family member, mobile clinic or authorities was significantly associated with less probability of seeking care within 3 days compared to being self-referred. Conclusion Access to timely health care for survivors of sexual violence in North Kivu, DRC, is challenging and varies between different groups of survivors. Providers responding to survivors of sexual violence need to adapt models of care and awareness raising strategies to ensure that programmes are developed to enable timely access to care for all survivors. More research is needed to further understand the barriers and enablers to access timely care for different groups of survivors.

Assessment of the integrated disease surveillance and response system implementation in health zones at risk for viral hemorrhagic fever outbreaks in North Kivu, Democratic Republic of the Congo, following a major Ebola outbreak, 2021

BackgroundThe Democratic Republic of the Congo (DRC) experienced its largest Ebola Virus Disease Outbreak in 2018–2020. As a result of the outbreak, significant funding and international support were provided to Eastern DRC to improve disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy has been used in the DRC as a framework to strengthen public health surveillance, and full implementation could be critical as the DRC continues to face threats of various epidemic-prone diseases. In 2021, the DRC initiated an IDSR assessment in North Kivu province to assess the capabilities of the public health system to detect and respond to new public health threats.MethodsThe study utilized a mixed-methods design consisting of quantitative and qualitative methods. Quantitative assessment of the performance in IDSR core functions was conducted at multiple levels of the tiered health system through a standardized questionnaire and analysis of health data. Qualitative data were also collected through observations, focus groups and open-ended questions. Data were collected at the North Kivu provincial public health office, five health zones, 66 healthcare facilities, and from community health workers in 15 health areas.ResultsThirty-six percent of health facilities had no case definition documents and 53% had no blank case reporting forms, limiting identification and reporting. Data completeness and timeliness among health facilities were 53% and 75% overall but varied widely by health zone. While these indicators seemingly improved at the health zone level at 100% and 97% respectively, the health facility data feeding into the reporting structure were inconsistent. The use of electronic Integrated Disease Surveillance and Response is not widely implemented. Rapid response teams were generally available, but functionality was low with lack of guidance documents and long response times.ConclusionSupport is needed at the lower levels of the public health system and to address specific zones with low performance. Limitations in materials, resources for communication and transportation, and workforce training continue to be challenges. This assessment highlights the need to move from outbreak-focused support and funding to building systems that can improve the long-term functionality of the routine disease surveillance system.

Prognostic value of chest computed tomography in adult inpatients with coronavirus disease 2019 pneumonia in Goma, in the Democratic Republic of the Congo

Objectives: Chest computed tomography (CT) plays a crucial role in evaluating patients with coronavirus disease 2019 (COVID-19) pneumonia. This study aimed to assess the association between initial chest CT findings and mortality in adult inpatients with COVID-19 in the city of Goma, North Kivu province, the Democratic Republic of the Congo. Materials and Methods: This was a multicenter retrospective study of patients hospitalized in Goma with COVID-19 pneumonia who underwent chest CT from January 1, 2021, to December 31, 2022. For each patient included, two experienced radiologists independently reviewed the initial chest CT. A multivariate logistic regression was performed to identify chest CT findings associated with mortality at the 5% significance level. Results: Of 76 patients included in the study, 26 (34.2%) died. The degree of lung parenchymal involvement &gt;25% (adjusted odds ratio [aOR] = 16.27 [3.30–80.16]) and the presence of consolidations (aOR = 3.33 [1.00–11.47]) were predictive of mortality with an area under the receiver operating characteristic curve of 0.8392. Sensitivity was 73.08%, specificity was 82%, positive predictive value was 67.86%, and negative predictive value was 85.42%. Conclusion: Lung involvement &gt;25% and consolidations on chest CT appear to predict death in adult inpatients with COVID-19 pneumonia.

Psychometric Validation of the Domestic Violence Questionnaire in Swahili Among Congolese Female Survivors of Domestic Violence

The Domestic Violence Questionnaire (DVQ) is a measure that captures physical, sexual, economic, and psychological violence perpetrated against women. A team of local academicians and intervention experts evaluated several tools for domestic and gender-based violence, concluding that the DVQ fitted best in the context of evaluating the Living Peace intervention in conflict-affected eastern DRC. The purpose of this validation study was to: (1) validate the factor structure of the Swahili version of the DVQ, (2) to evaluate its convergent and divergent validity, and (3) to examine its internal consistency reliability. The factor structure was evaluated using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) while concurrent validity and internal consistency reliability were evaluated using Pearson correlation and Cronbach’s alpha coefficients, respectively. The study participants were women, partners of men that participated in the Living Peace program, a community-based intervention program that works on promoting positive masculinity among men that are perceived to be violent by their community. Data were obtained from two independent purposive samples of 704 participants for EFA and 878 participants for CFA, selected from 60 villages in North and South Kivu, DRC. The results indicated that five and three-factor structures could be meaningfully interpreted in EFA, each with 66% explained variance. For comparative purposes, CFA was conducted on the two newly created factor models and the original factor model. All models reach good fit indexes, with the three-factor model demonstrating the best fit. Its standardized factor loadings ranged from 0.57 to 0.91. The internal consistency was α = .90 for the total scale and ranged from α = .75 to .926 per dimension. Finally, scores of DVQ were negatively correlated with mental well-being ( r = −0.23, p &lt; .001), and positively with depression ( r = .435, p &lt; .001), as hypothesized. The Swahili version of DVQ has excellent psychometric properties and can be applied to evaluate the physical, sexual, economic and psychological violence in victims of domestic violence in humanitarian crisis settings.