Kinshasa General Hospital

Background: The DRC faces the paradox of high mortality and low incidence of breast cancer due to late consultations and delayed treatment; however, it lacks studies detailing the different delays of breast cancer management. We initiated this study to assess these delays and identify the associated factors. Methods: This was a cross-sectional study conducted on 201 records of women followed for breast cancer at the University Clinics of Kinshasa (UCK) from January 2020 to December 2024. Population characteristics and delays were described using descriptive statistics, logistic regression was used to identify factors associated with delays. Results: The mean age was 48±12 years. 90.8% of patients were diagnosed at advanced stages, 67% received chemotherapy as first treatment. The median patient delay was 365 days, the median diagnostic delay was 26 days, the median treatment delay was 39 days, the median health system delay was 67 days, the median total delay was 398 days. Single women had a higher risk of consultation delay (aOR=2.48; p=0.02), diagnostic delay (aOR=1.79 p=0.01) and treatment delay (aOR=3.67; p=0.04). Women who followed alternative pathways had a higher risk of delay in consultation (aOR=9; p=0.01), diagnosis (aOR=3.27; p=0.02), and treatment (aOR=3.27; p=0.01). Consulting for symptoms other than breast lump was associated with a higher risk of treatment delay (aOR=3.44; p=0.02). Conclusions: Efforts must be made to address the causes of delayed consultations and to improve the patient care pathway.

BackgroundHypertensive disorders of pregnancy (HDP) are the leading cause of maternal mortality in sub-Saharan Africa (SSA), accounting for 70% of the global maternal death burden. Despite international guidelines, the management of these conditions, particularly preeclampsia, is hindered by significant structural, clinical, and sociocultural challenges in low-income countries. This narrative review critically analyzes the challenges in the prevention, diagnosis, and management of HDP in resource-constrained settings in SSA, and identifies contextually appropriate solutions to improve maternal outcomes.MethodsA literature search of studies published between 2014 and 2024 was conducted using the PubMed, Scopus, Google Scholar, and African Journal Online databases. This review synthesizes evidence from qualitative, quantitative, and mixed-method studies and systematic reviews focusing on the epidemiological, organizational, and community dimensions of care for hypertensive disorders across SSA countries. Studies were selected on the basis of their relevance to HDP care challenges and innovations in SSA. The Scale for the Assessment of Narrative Review Articles (SANRA) guided the rigor and reporting of this review, with six core criteria systematically applied: justification of article selection, comprehensive literature search, quality assessment, evidence synthesis, transparent reporting, and methodological transparency.ResultsKey challenges identified included fragmented health systems, poor adherence to clinical protocols, shortages of essential medicines and equipment, inadequate healthcare worker training, delayed care-seeking due to low health literacy and cultural beliefs, and insufficient epidemiological data. Promising strategies include strengthening antenatal care and screening, maternal education, task-sharing with community health workers, providing targeted training for healthcare workers, implementing simplified protocols, utilizing task sharing with community health workers, and enhancing interdisciplinary coordination.ConclusionReducing maternal mortality due to HDP in SSA requires an integrated approach that combines strengthening health systems, community engagement, targeted training, and context-adapted guidelines. Sustained investment in local research, data sharing, and policy reform is essential for achieving sustainable improvements in maternal health care.

This study assessed the morphometric diversity, genetic relationships, and histological profiles of Nile tilapia populations in Mwenga territory, South Kivu, an area affected by mining activities. A total of 144 specimens were collected from four subareas (Mwenga Centre, Kamituga, Kibe, and Kitutu) and analyzed at the Molecular Biology Laboratory of the Université Evangélique en Afrique. Analysis of 22 morphometric traits showed statistically significant variations (p < 0.05) among subareas, except for eye diameter, snout length, third anal spine length, longest anal ray, and post-orbital length, which did not exhibit significant differences. The heaviest fish were found in Kamituga (168.57 g), while the longest were in Kitutu (16.13 cm). Principal component analysis revealed three distinct clusters based on morphometric traits. Genetic analysis of 22 specimens using CO1 gene sequencing indicated moderate differentiation among subpopulations (Fst = 0.13) and low pairwise genetic distances, suggesting weak genetic divergence. Histopathological examination of selected tissues (flesh, liver, gills, fins, and heart) showed that flesh was the most affected tissue (35.62 %), with Kamituga exhibiting the highest hemosiderin deposits in muscle and liver, indicating potential heavy-metal contamination. These findings provide a valuable baseline for future genetic improvement and conservation strategies in the region.

Le cancer de la prostate constitue l’un des principaux problèmes de santé publique chez l’homme à l’échelle mondiale. Le diagnostic précoce et précis demeure un défi majeur, en particulier pour la détection des lésions de faible volume et des récidives précoces. L’imagerie par tomographie par émission de positons (TEP) utilisant des radiopharmaceutiques ciblant l’antigène de membrane spécifique de la prostate (PSMA) a considérablement amélioré la prise en charge diagnostique. Dans cette étude, une approche de modélisation moléculaire in silico a été employée afin d’analyser et de comparer les interactions entre deux radiopharmaceutiques marqués au fluor-18, le Piflufolastat F-18 et le Flotufolastat F-18, et plusieurs cibles biologiques impliquées dans le cancer de la prostate, notamment le récepteur des androgènes (AR), HIF-1α, HER2 et le PSMA. Le docking moléculaire a permis d’évaluer les affinités de liaison et d’identifier les interactions stabilisantes au niveau atomique. Les résultats montrent que les deux radiopharmaceutiques présentent une forte affinité pour le PSMA, avec des énergies de liaison particulièrement favorables, confirmant leur pertinence en imagerie diagnostique. Par ailleurs, le Piflufolastat F-18 est un ligand multi-cible, ce qui peut limiter sa sélectivité, tandis que le Flotufolastat F-18 est très sélectif. Cette étude met en évidence l’intérêt de la modélisation moléculaire comme outil complémentaire pour la compréhension des interactions ligand-récepteur et pour l’optimisation future des radiotraceurs PSMA-ciblés.

Pressure injuries remain a significant and largely preventable cause of morbidity among hospitalized patients. Accurate and complete risk assessment using validated tools such as the Braden Scale is fundamental to effective prevention; however, documentation practices are often inconsistent, particularly in resource-limited settings. To evaluate the completeness of Braden Scale documentation in the Internal Medicine Department at Dongola Specialized Hospital and to assess the impact of a targeted quality-improvement intervention through a closed-loop clinical audit. A prospective closed-loop clinical audit was conducted over two cycles, each reviewing 51 patient records. Baseline documentation practices (Cycle 1) were assessed against predefined standards derived from international pressure-injury prevention guidelines. Following a structured two-month intervention comprising staff education, reinforcement of documentation expectations, and introduction of a standardized Braden documentation form, a second audit cycle (Cycle 2) was performed using identical criteria. Documentation completeness was analyzed using descriptive statistics, and differences between cycles were assessed using chi-square tests. At baseline, none of the Braden subscale scores, total scores, risk levels, or preventive actions were documented. Following the intervention, documentation of all six Braden subscales improved to near-universal completion (96.4-100%). Documentation of total Braden score, risk level, and preventive actions increased to 89.1%, 83.6%, and 89.1%, respectively (all p < 0.001). Significant improvements were also observed in consultant identification and bed number documentation. Conversely, completion rates for certain demographic fields, particularly hospital number and admission date, declined in Cycle 2. This audit demonstrates that targeted education and standardized documentation tools can lead to substantial and statistically significant improvements in Braden Scale documentation. While clinical risk assessment practices improved markedly, persistent gaps in administrative documentation highlight the need for sustained monitoring and system-level reinforcement. Closed-loop clinical audits represent an effective strategy for strengthening pressure-injury risk assessment practices in hospital settings.

Although fine particulate matter (PM2.5) is a well-established environmental risk factor for cardiorespiratory diseases, evidence from sub-Saharan Africa remains limited. This study presents the first assessment of the Air Quality Index (AQI) in Kinshasa from 2018 to 2020, evaluating the associated cardiorespiratory health risks across all age groups. Methods: Hospital admissions for respiratory and cardiovascular (HARC) diseases were analyzed in relation to short-term exposure to PM2.5 concentrations. Health data were obtained from the Institute for Health Metrics and Evaluation (IHME), while PM2.5 concentrations were measured using Purple Air PA-II-SD sensors from March 2018 to August 2020. The AQI and qualitative risk categories were determined using the U.S. AQI model, and relative risks (RRs) for HARC diseases were estimated using AirQ + software. In situ monitoring of PM2.5 recorded high daily mean concentrations, exceeding the World Health Organization (WHO) guideline value (15 µg/m³). Results: The AQI analysis revealed no days classified as “good”, with most days falling within the “moderate” to “unhealthy. In 2018, “very unhealthy” levels were recorded for 1% of the days. A linear trend was observed for the RRs with clear seasonal components. The highest risk occurred in the dry season (June–July), with elevated hospital admissions for respiratory diseases (RR: 1.258; 95% confidence interval (CI): 1.000–1.616) and cardiovascular diseases (RR: 1.117; 95% CI: 1.021–1.222). Conclusions: These findings highlight the persistently poor air quality in Kinshasa and demonstrate the significant health risks associated with PM2.5. They underscore the urgent need for effective public health interventions and air quality management policies, particularly during the dry season, when these risks are greatest.

Neurocysticercosis (NCC), caused by the larval stage of Taenia solium, is a leading preventable cause of epilepsy in children, particularly in Sub-Saharan Africa (SSA), where inadequate sanitation practices and limited veterinary control strategies persist. A missing link in the One Health response to NCC has been the absence of communication between neurospecialists and the other partners in control strategies. This narrative review explores how integrating neurological expertise into One Health strategies can enhance the prevention and control of NCC-associated epilepsy in children across the region. We reviewed literature from PubMed/MEDLINE, Scopus, Google Scholar, Embase, Web of Science, Global Health, CINAHL, PsycINFO, and the African Index Medicus, including peer-reviewed articles and organizational reports published between 2013 and March 2025. Out of 1,509 records screened, 28 studies met the inclusion criteria, focusing on neuroparasitosis-associated epilepsy in children across SSA. These included research on disease burden and care challenges (n = 10), pathogenesis (n = 8), One Health control strategies (n = 4), and implementation barriers and solutions (n = 6). NCC remains a major contributor to pediatric epilepsy and associated disability in SSA. A One Health approach informed by direct input from neuro-specialists and better recording of infectious causes of epilepsy can assist teams to implement key strategies, including community education, improved sanitation, food safety measures, pig vaccination, and mass drug administration. Strengthening intersectoral collaboration and healthcare access is critical to reducing NCC burden and improving neurological outcomes for affected children.