1.  Peer Reviewed Title: A visual dosing aid for first-line pediatric antiretroviral treatment in resource-poor settings. Author: Callens SF; Westreich D; Kitetele F; Lusiama J; Shabani N; Belhorn T; Colebunders R; Behets F; Van Rie A Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):135-7. Abstract: The visual dosing aid (VDA) was developed to facilitate dosing calculations in response to children's; growth and weight during antiretroviral treatment. The theoretical accuracy of the VDA was assessed using anthropometric data from 55 children receiving care in the USA and 324 children in the Democratic Republic of the Congo. The VDA dose was similar to the WHO recommended dose. A potentially significant relative dosing difference of >or=20% occurred in <3% of children for NVP, AZT and d4T, but was observed in 20% for 3TC, overdosing being more frequent. The VDA compared well with generic pediatric fixed dose combination tablets. Results did not differ between sites. The VDA enables accurate dosing of pediatric ART in distinct populations and could facilitate roll-out of pediatric ART in resource-poor settings. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | CHILDREN | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | TREATMENT | ADMINISTRATION AND DOSAGE | BODY WEIGHT | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | HIV Infections | Viral Diseases | Diseases | Drugs | Physiology | Biology Document Number: 331199 |
| 2. Peer Reviewed Title: HIV infection among internally displaced women and women residing in river populations along the Congo River, Democratic Repubic of Congo. Author: Kim AA; Malele F; Kaiser R; Mama N; Kinkela T Source: AIDS and Behavior. 2009 Mar 25;:7 p. Abstract: The author's conducted a reproductive health assessment among women aged 15-49 years residing in an internally displaced persons (IDP) camp and surrounding river populations in the Democratic Republic of Congo. After providing informed consent, participants were administered a behavioral questionnaire on demographics, sexual risk, reproductive health behavior, and a history of gender based violence. Participants provided a blood specimen for HIV and syphilis testing and were referred to HIV counseling and testing services established for this study to learn their HIV status. HIV prevalence was significantly higher among women in the IDP population compared to women in the river population. Sexually transmitted infection symptoms in the past 12 months and a history of sexual violence during the conflict were associated with HIV infection the river and IDP population, respectively. Targeted prevention, care, and treatment services are urgently needed for the IDP population and surrounding host communities during displacement and resettlement. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | PREVALENCE | WOMEN | INTERNALLY DISPLACED PERSONS | WAR | HIV TRANSMISSION | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Demographic Factors | Population | Settlement and Resettlement | Migration | Population Dynamics | Political Factors | Sociocultural Factors | Viral Diseases | Diseases | Reproductive Tract Infections | Infections Document Number: 341519 |
| 3. Title: Impact of maternal malaria and under-nutrition on intrauterine growth restriction: a prospective ultrasound study in Democratic Republic of Congo. Author: Landis SH; Lokomba V; Ananth CV; Atibu J; Ryder RW; Hartmann KE; Thorp JM; Tshefu A; Meshnick SR Source: Epidemiology and Infection. 2009 Feb;137(2):294-304. Abstract: Maternal malaria and under-nutrition are established risk factors for small-for-gestational-age (SGA) births; however, whether malaria is associated with intrauterine growth restriction (IUGR) is unknown. We investigated IUGR risk among 177 HIV-negative pregnant women enrolled in a longitudinal ultrasound study conducted in Democratic Republic of Congo from May 2005 to May 2006. Malaria infection, maternal anthropometrics, and ultrasound estimated fetal weight were measured monthly. All positive malaria cases were treated and intermittent presumptive therapy (IPTp) provided. Log-binomial regression models for IUGR were fitted using generalized estimating equations to account for statistical clustering of repeat IUGR measurements. Twenty-nine percent of fetuses experienced an episode of IUGR with the majority occurring in the third trimester. The risk of IUGR associated with malaria was greatest after three or more cumulative infections (RR 3.3, 95% CI 1.3-8.2) and was two- to eight-fold higher among women with evidence of under-nutrition. Receiving antimalarial treatment in the previous month (for IPTp or treatment) was significantly protective against IUGR (RR 0.5, 95% CI 0.3-0.7). The interaction observed between malaria and under-nutrition suggests that antenatal programmes in malaria endemic areas should incorporate nutritional screening and supplementation in addition to IPTp. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | PROSPECTIVE STUDIES | INTRAUTERINE GROWTH RETARDATION | ULTRASONICS | MALARIA | MATERNAL NUTRITION | RISK FACTORS | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Congenital Abnormalities | Neonatal Diseases and Abnormalities | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Parasitic Diseases | Nutrition | Biology Document Number: 330491 |
| 4. Peer Reviewed Title: The role of religion in HIV-positive women's disclosure experiences and coping strategies in Kinshasa, Democratic Republic of Congo. Author: Maman S; Cathcart R; Burkhardt G; Omba S; Behets F Source: Social Science and Medicine. 2009 Mar;68(5):965-70. Abstract: Literature from the U.S. has documented the importance of spirituality on the psychological health of people living with HIV/AIDS; however there is little published data on the ways in which people living with HIV/AIDS in Africa turn to religion for support. We conducted 40 in-depth interviews with HIV-positive women who were pregnant or had recently given birth in Kinshasa, Democratic Republic of Congo to inform the development of a comprehensive family-centered HIV treatment and care program. Women described how they relied upon their faith and turned to church leaders when they were diagnosed with HIV and prepared to share their diagnosis with others. The women used prayer to overcome the initial shock, sadness and anger of learning their HIV diagnosis. They turned to their church leaders to help them prepare for disclosing their diagnosis to others, including their partners. Church leaders were also important targets for disclosure by some women. Women's faith played an important role in their long-term coping strategies. Conceptualizing their infection as a path chosen by God, and believing that God has the power to cure their infection comforted women and provided them with hope. In settings like the Democratic Republic of the Congo, where there is a strong foundation of faith, we need to recognize how individuals draw upon their different health belief systems in order to develop and implement coherent and effective prevention, treatment and care strategies. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | KAP SURVEYS | PERSONS LIVING WITH HIV/AIDS | URBAN POPULATION | PREGNANT WOMEN | INFLUENTIALS | POSTPARTUM WOMEN | WOMEN IN DEVELOPMENT | PARTNER COMMUNICATION | HIV INFECTIONS | PSYCHOLOGICAL FACTORS | RELIGIOUS ASPECTS | LEADERSHIP | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Knowledge Sources | Communication | Puerperium | Reproduction | Economic Development | Economic Factors | Interpersonal Relations | Behavior | Religion | Sociocultural Factors | Organization and Administration Document Number: 341170 |
| 5. Peer Reviewed Title: Local differences in human immunodeficiency virus prevalence: a comparison of social venue patrons, antenatal patients, and sexually transmitted infection patients in eastern kinshasa. Author: Mwandagalirwa K; Jackson EF; McClamroch K; Bollinger R; Ryder RW; Weir SS Source: Sexually Transmitted Diseases. 2009 Jul;36(7):406-12. Abstract: BACKGROUND: This study compares the sexual behavior and HIV prevalence of men and women at social venues where people meet new sexual partners in Eastern Kinshasa with that of sexually transmitted infection (STI) treatment and antenatal clinic (ANC) patients in the same area. METHODS: ANC patients, STI clinic patients, and social venue patrons were interviewed, asked to provide a blood sample on-site, and provided with information about obtaining test results. Every patron at identified social venues in the study area was invited to participate. RESULTS: One thousand one hundred sixteen pregnant women; 66 male and 229 female STI clinic patients; and 952 male and 247 female patrons of social venues were interviewed and tested for HIV. HIV prevalence differed by group: ANC patients (4%); female venue patrons (12%); female STI patients (16%); male venue patrons (2%); and male STI patients (23%). HIV prevalence among sex workers at social venues (29%) was higher than HIV prevalence among other female patrons with new or multiple partnerships in the past four weeks (19%) and higher than HIV prevalence among female patrons denying sex work (6%). However, the absolute number of infected women was higher among women reporting recent new or multiple partnerships than among the smaller group of sex workers (23 vs. 18). Two-thirds of the infected female STI patients (24/36) reported no more than one and no new sexual partner in the past year. CONCLUSION: Improving prevention programs in Kinshasa is essential. Prevention efforts should not neglect women at social venues who do not self-identify as sex workers but who have high rates of new sexual partnership formation. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | MULTIPLE PARTNERS | HIV INFECTIONS | PREVALENCE | ANTENATAL CARE | SEXUALLY TRANSMITTED DISEASES | CLINICS | VOLUNTARY COUNSELING AND TESTING | INTERVIEWS | CONDOM USE | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Sexual Partners | Sex Behavior | Behavior | Viral Diseases | Diseases | Measurement | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Health Facilities | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Data Collection | Risk Reduction Behavior Document Number: 342831 |
| 6. Title: High prevalence of undiagnosed chronic kidney disease among at-risk population in Kinshasa, the Democratic Republic of Congo. Author: Sumaili EK; Cohen EP; Zinga CV; Krzesinski JM; Pakasa NM; Nseka NM Source: BMC Nephrology. 2009;10:18. Abstract: BACKGROUND: There is limited knowledge of Chronic Kidney Disease (CKD) among high risk populations, especially in the developing countries. We report our study of testing for CKD in at-risk subjects. METHODS: In a cross-sectional study, 527 people from primary and secondary health care areas in the city of Kinshasa were studied from a random sample of at-risk out-patients with hypertension, diabetes, obesity, or HIV+. We measured blood pressure (BP), blood glucose level, proteinuria, body mass index, and estimated glomerular filtration rate (eGFR by MDRD equation) using calibrated creatinine levels based on one random measurement. The associations between health characteristics, indicators of kidney damage (proteinuria) and kidney function (<60 ml/min/1.73 m2) were also examined. RESULTS: The prevalence of CKD in this study was 36%, but only 12% were aware of their condition. 4% of patients had stage 1 CKD, 6% stage 2, 18% stage 3, 2% stage 4, and 6% had stage 5. 24 hour quantitative proteinuria (>300 mg/day) was found in 19%. In those with the at-risk conditions, the % of CKD was: 44% in patients with hypertension, 39% in those with diabetes; 16% in the obese and 12% in those who were HIV+. 82% of those with a history of diabetes had elevated serum glucose levels at screening (>or= 126 mg/dl). Only 6% of individuals with hypertension having CKD had reduced BP to lower than 130/80 mmHg. In multivariate analysis, diabetes, proteinuria and hypertension were the strongest determinants of CKD 3+. CONCLUSION: It appears that one out of three people in this at-risk population has undiagnosed CKD and poorly controlled CKD risk factors. This growing problem poses clear challenges to this developing country. Therefore, CKD should be addressed through the development of multidisciplinary teams and improved communication between traditional health care givers and nephrology services. Attention to CKD risk factors must become a priority. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | POPULATION AT RISK | RENAL EFFECTS | PREVALENCE | EXAMINATIONS AND DIAGNOSES | RISK FACTORS | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Research Methodology | Urogenital Effects | Urogenital System | Physiology | Biology | Measurement | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342965 |
| 7. Title: Reproductive health-care provision in emergencies: preventing needless suffering. Author: van Min M Source: Forced Migration Review. 2009 Apr;(32):68-69. Abstract: This article discusses the need for comprehensive reproductive health services in all situations to prevent unnecessary deaths. It opens with a gripping story of a woman in birth reaching a hospital too late and not equipped with the proper supplies. It argues that not enough emphasis is placed on RH supplies and services and talks about solutions to overcome these challenges. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | EQUIPMENT AND SUPPLIES | REPRODUCTIVE HEALTH | CLINICAL DISTRIBUTION | EMERGENCY SERVICES | MATERNAL HEALTH | LOGISTICS | PREVENTION AND CONTROL | DELIVERY OF HEALTH CARE | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Medical Procedures | Medicine | Health Services | Health | Distributional Activities | Program Activities | Programs | Organization and Administration | Management | Diseases Document Number: 340195 |
8.  Title: Achieving the MDGs: the contribution of family planning. Democratic Republic of Congo. Author: Futures Group International. Health Policy Initiative Source: Washington, D.C., Futures Group International, Health Policy Initiative, [2008]. [2] p. Abstract: The Millennium Development Goals (MDGs) -- a set of eight important, timebound goals ranging from reducing poverty by half to providing universal primary education -- represent a blueprint for global development agreed to by member states of the United Nations and international development institutions. However, achieving them will be a major challenge for the Democratic Republic of Congo and many other developing countries that are not "on track" to meet the goals by the target date of 2015. As stated by former United Nations Secretary-General Kofi Annan, it will take time and commitment to mobilize the necessary resources, train the required personnel, and establish the needed infrastructure to meet the MDGs. In the Democratic Republic of Congo and other African countries, one major factor contributing to the challenge is the continued rapid growth of the population. The number of people in need of health, education, economic, and other services is large and increasing, which, in turn, means that the amount of resources, personnel, and infrastructure required to meet the MDGs is also increasing. In light of this fact, development efforts in support of the MDGs should not overlook the importance and benefits of slowing population growth. This brief looks at how one strategy -- meeting the need for family planning -- can reduce population growth and make achieving the MDGs more affordable in the Democratic Republic of Congo, in addition to directly contributing to the goals of reducing child mortality and improving maternal health. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | SUMMARY REPORT | GOALS | FAMILY PLANNING | CHILD MORTALITY | MATERNAL HEALTH | POVERTY | NEEDS | DISEASE PREVENTION | EDUCATION | PREVENTION AND CONTROL | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Planning | Organization and Administration | Mortality | Population Dynamics | Demographic Factors | Population | Health | Socioeconomic Factors | Economic Factors | Diseases Document Number: 331538 |
| 9. Title: AWARENESS Project. Democratic Republic of Congo country report, 2003-2007. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Jan. [17] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: In 2003, the USAID Mission and the National Reproductive Health Program (PNSR) invited IRH to introduce the SDM in the Democratic Republic of Congo (DRC). The strategy focused on training providers and integrating the SDM into existing clinic, community, and pharmacy services in Kinshasa, Lubumbashi, and Bukavu, and the rural area of Katako Kombe. By 2004, 14 organizations were able to offer the SDM. CycleBeads are included in the national list of essential medicines and the five-year contraceptive security plan. The SDM is part of in-service family planning training curricula. The PNSR is developing national norms and protocols and intends to include the SDM. IRH also worked with the MOH to incorporate the SDM into national policies and logistics and reporting systems. However, the lack of overall government norms and functioning distribution and reporting systems is an obstacle requiring more comprehensive attention than the AWARENESS Project could offer. The program leveraged significant resources, as most partners paid for their own training programs and CycleBeads. The Congolese program participated in a study to determine the impact of the social marketing campaign, a general evaluation of SDM integration in the DRC. Major findings from the simulated client study showed that 89% of clinic providers gave spontaneous information on the SDM as opposed to only 38% of pharmacists; confidentiality was observed in over 70% of both clinics and pharmacies; 96% of providers in clinics told clients that CycleBeads represent a woman?s cycle while only 35% of pharmacists did so; and 7% of clinic providers attempted to convince clients to use other methods of family planning as opposed to 23% of pharmacists. The success of recent initiatives in DRC to introduce the TDM through services of an faith-based organization (FBO) suggest that this method may also be an appropriate addition to family planning services. (excerpt) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | CONTRACEPTIVE METHOD ACCEPTABILITY | INTEGRATED PROGRAMS | FAMILY PLANNING TRAINING | FAMILY PLANNING PROGRAMS | GOVERNMENT PROGRAMS | SOCIAL MARKETING | CLINICAL DISTRIBUTION | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Family Planning | Family Planning, Behavioral Methods | Contraceptive Usage | Contraception | Programs | Organization and Administration | Training Programs | Education | Marketing | Economic Factors | Distributional Activities | Program Activities Document Number: 327619 |
| 10. Title: Evaluation of the acceptability of the Standard Days Method in the Democratic Republic of Congo: executive summary. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Feb. 4 p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: Georgetown University's Institute for Reproductive Health (IRH) and its partners introduced the Standard Days Method® (SDM) in the Democratic Republic of Congo (DRC) in 2004, beginning with health centers and pharmacies in the province of Kinshasa. IRH's partners included the National Reproductive Health Program, Action Santé Familiale/Population Services International, Catholic Relief Services, and Conduite de la Fécondité. In 2006, IRH contracted a local research organization, Bureau d'Etudes Médicales (BEM) to conduct a qualitative and quantitative study to determine the degree of SDM integration into family planning services. The study explored issues related to choice and use of the SDM, intra-couple communication, sources of SDM information, client satisfaction, service provider and community animator attitudes and experiences, and suggestions for improving informational campaigns and services. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | TECHNICAL REPORT | FERTILITY AWARENESS | FAMILY PLANNING, BEHAVIORAL METHODS | HEALTH FACILITIES | PHARMACIES | FOCUS GROUPS | PARTNER COMMUNICATION | CONTRACEPTIVE METHOD ACCEPTABILITY | NATURAL FAMILY PLANNING | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Family Planning, Behavioral Methods | Family Planning | Delivery of Health Care | Health | Data Collection | Research Methodology | Interpersonal Relations | Behavior | Contraceptive Usage | Contraception Document Number: 327615 |
| 11. Title: Introducing the TwoDay method to experienced national family planning providers in Africa. Author: Georgetown University. Institute for Reproductive Health. AWARENESS Project Source: Washington, D.C., Georgetown University, Institute for Reproductive Health, 2008 Mar. [12] p. (USAID Cooperative Agreement No. HRN-A-00-97-00011-00) Abstract: The TwoDay Method® (TDM) is a fertility awareness-based method of family planning, developed by the Institute for Reproductive Health (IRH) at Georgetown University. This natural method relies on noticing the presence or absence of cervical secretions to determine whether or not a woman is fertile each day. An efficacy trial found that the TDM was more than 96% effective with correct use and more than 86% effective with typical use. These effectiveness rates are similar to those of a number of other user-dependent methods1. IRH piloted the TDM with two faith-based organizations (FBOs): Action Familiale Rwandaise (AFR) in Rwanda and Conduite de la Fécondité (CF) in the Democratic Republic of Congo (DRC) in August and September 2007 respectively. In Rwanda, IRH's Country Representative and the Director of AFR trained 18 female instructors working for AFR on the TDM from May 7 to 8, 2007. In the DRC, the Country Representative and the CF Director trained 14 instructors from June 25 to 26, 2007. A one-day refresher training was held approximately one month after the initial training in Rwanda and three months after the initial training in the DRC to assess how well the instructors were able to use the method, answer questions, and reinforce concepts as necessary. Focus groups discussions (FGDs) were conducted the same day as the refresher trainings. At the time, most providers had started using the method themselves and a few had begun offering it to clients. The instructors participating in the focus groups demonstrated knowledge of the TDM and a theoretical ability to offer it; however, many of the participants had not yet had the opportunity to offer the method to clients. Instructors who used the method (about half) found the method to be simple. Some believed that the TDM is easier for clients than the Billings Ovulation Method because women are more likely to notice the presence or absence of secretions rather than to be able to distinguish qualities of secretions. They also felt that the accompanying materials, such as the client card, helped simplify the method. They did not report any potential problems for integrating the TDM into their current programs. However, some providers disliked the fact that post-partum women must wait at least three menstrual cycles before beginning to use the TDM. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RWANDA | TECHNICAL REPORT | FOCUS GROUPS | FERTILITY AWARENESS | NATURAL FAMILY PLANNING | FAMILY PLANNING PERSONNEL | FAMILY PLANNING TRAINING | CONTRACEPTIVE METHOD ACCEPTABILITY | KNOWLEDGE | ATTITUDES | RECOMMENDATIONS | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Research Methodology | Family Planning | Family Planning, Behavioral Methods | Family Planning Programs | Training Programs | Education | Contraceptive Usage | Contraception | Sociocultural Factors | Psychological Factors | Behavior Document Number: 327646 |
| 12. Peer Reviewed Title: Tobacco use and secondhand smoke exposure during pregnancy: an investigative survey of women in 9 developing nations. Author: Bloch M; Althabe F; Onyamboko M; Kaseba-Sata C; Castilla EE Source: American Journal of Public Health. 2008 Oct;98(10):1833-1840. Abstract: The author's examined pregnant women's use of cigarettes and other tobacco products and the exposure of pregnant women and their young children to secondhand smoke (SHS) in 9 nations in Latin America, Asia, and Africa. Face-to-face surveys were administered to 7961 pregnant women (more than 700 per site) between October 2004 and September 2005. At all Latin American sites, pregnant women commonly reported that they had ever tried cigarette smoking (range: 78.3% [Uruguay] to 35.0% [Guatemala]). The highest levels of current smoking were found in Uruguay (18.3%), Argentina (10.3%), and Brazil (6.1%). Experimentation with smokeless tobacco occurred in the Democratic Republic of the Congo and India; one third of all respondents in Orissa, India, were current smokeless tobacco users. SHS exposure was common: between 91.6% (Pakistan) and 17.1% (Democratic Republic of the Congo) of pregnant women reported that smoking was permitted in their home. Pregnant women's tobacco use and SHS exposure are current or emerging problems in several low- and middle-income nations, jeopardizing ongoing efforts to improve maternal and child health. Language: English Keywords: DEVELOPING COUNTRIES | INDIA | DEMOCRATIC REPUBLIC OF THE CONGO | PAKISTAN | RESEARCH REPORT | TOBACCO USE | PREGNANCY | CHILD HEALTH | QUESTIONNAIRES | DEMOGRAPHIC FACTORS | Asia, Southern | Asia | Africa, Central | Africa, Sub Saharan | Africa | Behavior | Reproduction | Health | Population Document Number: 328358 |
| 13. Title: Promotion and protection of all human rights, civil, political, economic, social and cultural, including the right to development. Report of the Special Rapporteur on violence against women, its causes and consequences, Yakin Erturk. Addendum: Mission to the Democratic Republic of the Congo. Advance edited version. Author: Erturk Y Source: [Geneva, Switzerland], United Nations, Office of the High Commissioner for Human Rights [OHCHR], Human Rights Council, 2008 Feb 28. 26 p. (A/HRC/7/6/Add.4) Human Rights Council, Seventh Session, Agenda item 3. Abstract: Sexual violence has been a defining feature of the Democratic Republic of the Congo's recent armed conflicts. Women, in areas of armed conflict, still suffer sexual violence committed by the Forces armees de la Republique democratique du Congo (FARDC), the Police nationale congolaise (PNC), armed groups and, increasingly, civilians. The situation is particularly dramatic in South Kivu, where non-State armed groups, including foreign militia, commit sexual atrocities that aim at the complete physical and psychological destruction of women with implications for the entire society. Given the multitude of actors involved in the conflict and the continuation of these crimes, the international community, in cooperation with the Congolese authorities, has a responsibility to take all necessary measures to ensure that women in South Kivu are protected. Sexual violence extends beyond eastern Congo. In Equateur Province, PNC and FARDC have carried out systematic reprisals against the civilian population, including mass rape. Soldiers and police who commit these acts amounting to crimes against humanity are rarely held accountable by the commanding officers. Some of the perpetrators have been given commanding positions in the State security forces, which further aggravates the situation. (excerpt) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | ADMINISTRATIVE DISTRICTS | PROGRESS REPORT | RECOMMENDATIONS | EVALUATION | WOMEN IN DEVELOPMENT | WOMEN'S RIGHTS | WOMEN'S STATUS | DOMESTIC VIOLENCE | RAPE | WAR | SOCIAL POLICY | SOCIAL PROTECTION | INSTITUTION BUILDING | PREVENTION AND CONTROL | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Geographic Factors | Population | Economic Development | Economic Factors | Human Rights | Political Factors | Sociocultural Factors | Socioeconomic Factors | Crime | Social Problems | Policy | Program Sustainability | Programs | Organization and Administration | Diseases Document Number: 326335 |
| 14. Peer Reviewed Title: Correlates of ever had sex and of recent sex among teenagers and young unmarried adults in the Democratic Republic of Congo. Author: Kayembe KP; Mapatano MA; Busangu FA; Nyandwe KJ; Mashinda KD Source: AIDS and Behavior. 2008 Jul;12(4):585-593. Abstract: The future of the HIV/AIDS epidemic in the Democratic Republic of Congo will depend on the behavior that teenagers and young adults are likely to adopt. Documenting teenagers and young adults behavior can help design effective interventions. The premarital sexual activity of 13,091 teenagers and young adults aged 15-24 years was examined. Logistic regression models were used to identify the correlates of ever had sex and recent sex. Ever had sex and recent sex were associated with older individuals, males, school dropouts, those addicted to alcohol and drug use, those living alone or with friends, those involved in an income generating activity, those with low capacity to resist sex, those with low socioeconomic status and those living in permissive milieu. Controlling access to alcohol and drugs, teaching teenagers skills to resist sex, getting schools involved in teaching values of abstinence and delayed sex, could impact the age at first sex and trigger the adoption of lower risk behavior. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | CORRELATION STUDIES | YOUTH | ADOLESCENTS | SEX BEHAVIOR | FIRST INTERCOURSE | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | DROPOUTS | POVERTY | HIV PREVENTION | CONDOM USE | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Statistical Studies | Studies | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Programs | Organization and Administration | Socioeconomic Factors | Economic Factors | HIV Infections | Viral Diseases | Diseases | Risk Reduction Behavior Document Number: 327537 |
| 15. Peer Reviewed Title: Determinants of consistent condom use among female commercial sex workers in the Democratic Republic of Congo: Implications for interventions. Author: Kayembe PK; Mapatano MA; Busangu AF; Nyandwe JK; Musema GM Source: Sexually Transmitted Infections. 2008 Jun;84(3):202-206. Abstract: The objective was to identify correlates of consistent condom use among commercial sex workers (CSW) over a four-week period. A total of 2638 CSW selected in all the provincial capital cities in the Democratic Republic of Congo using the time location sampling technique were interviewed to collect information on sociodemographic data, sexual history and behaviour, consumption of intoxicants (alcohol and drugs), knowledge of condoms, their accessibility and the pattern of their use over a four-week period, and exposure to HIV/AIDS prevention services. 40% (95% CI 38.1 to 41.8) of the CSW have used condoms consistently and this pattern differed according to the category of sexual partners (61.4% in the case of paying partners and 38.2% in the case of nonpaying partners). Consistent condom use was associated with age, those aged 20-44 years were more likely to be consistent users (OR 1.34, 95% CI 1.06 to 1.69), having cited it as a prevention means for HIV (OR 2.88, 95% CI 2.09 to 3.96), less time incommercial sex work, higher number of clients (OR 3.83, 95% CI 2.95 to 4.96), exposure to voluntary counselling and testing (VCT; OR 2.02, 95% CI 1.70 to 2.42), and access to condoms (OR 1.51, 95% CI 1.25 to 1.82). The risk perception bias associated with non-paying partners, time as a commercial sex worker and age should be taken into account when planning interventions targeting CSW. Access to condoms and VCT should be improved because they are likely to impact on behaviour. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | INTERVIEWS | SAMPLING STUDIES | SEX WORKERS | WOMEN | SEX BEHAVIOR | ALCOHOL USE AND ABUSE | DRUG USE AND ABUSE | CONDOM USE | KNOWLEDGE | PROGRAM ACTIVITIES | HIV PREVENTION | INTERVENTIONS | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Studies | Behavior | Demographic Factors | Population | Risk Reduction Behavior | Sociocultural Factors | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Program Evaluation Document Number: 327256 |
| 16. Title: Knowledge of HIV, sexual behavior and correlates of risky sex among street children in Kinshasa, Democratic Republic of Congo. Author: Kayembe PK; Mapatano MA; Fatuma AB; Nyandwe JK; Mayala GM; Kokolomami JI; Kibungu JP Source: East African Journal of Public Health. 2008 Dec;5(3):186-92. Abstract: CONTEXT: Homeless children are at risk of getting many diseases, including sexually transmitted infections (STI). The number of street children is on the rise in the Democratic Republic of Congo (DRC), while very little is known about their health problems. OBJECTIVES: To determine knowledge of HIV (transmission and prevention means), sexual activity, exposure to HIV-prevention services, and to identify correlates of risky sexual behaviour (not having used a condom at first or last sexual encounter and/or having multiple sexual partners over a 12-month period) among street children in Kinshasa. RESULTS: At the time of the survey, most participants (85.8%, 95% CI = 83.5-88.1) were sexually experienced and 55.8% had their first sexual intercourse when they were already living on the streets. The median age at first sexual activity was 14.3 years for males and 13.5 years for females. Compared to males (median number of sexual partners = 1), females tended to be more involved with multiple sexual partners (median = 12). Condoms were used less at the fist sexual encounter (20.2%; 95% CI = 17.3-23.1) and the pattern of condom use depended on the type of sexual partners (61.1% at last sexual encounter with a paid/paying partner and 23.1% at last sexual encounter with a non-paid/non-paying partner). In males, sleeping in a NGO-provided night shelter (OR = 0.47; 95% CI = 0.27-0.79), and having had the first sexual intercourse while living on the streets (OR = 0.55; 95% CI = 0.35-0.88) were protective of risky sexual behaviour, while a history of drug use (OR = 3.00; 95% CI = 1.46-6.18), and being aged 20 to 24 years (OR = 1.59; 95% 1.00-2.55) increased the likelihood of displaying risky sexual behaviour. In females, not knowing where to get a condom (OR = 0.04; 95% CI = 0.005-0.29), having started sexual activity when living on the streets (OR = 0.10; 95% CI = 0.01-0.73) and not having an income-generating activity (OR = 0.09; 95% CI = 0.01-0.44) were protective of risky sexual behaviour. CONCLUSION: Street children need to be regarded as a high-risk group for acquiring HIV. The potential benefit of providing homeless youth with night-shelters should be explored more since this could be an opportunity to integrate risk-reduction programmes that take into account all problematic behaviors such as risky sexual behaviour and drug use. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | KAP SURVEYS | STREET KIDS | MULTIPLE PARTNERS | SEX BEHAVIOR | RISK BEHAVIOR | HIV TRANSMISSION | KNOWLEDGE | CONDOM USE | SEX FACTORS | AGE FACTORS | FIRST INTERCOURSE | DRUG USE AND ABUSE | HOUSING | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Homeless Persons | Residence Characteristics | Population Distribution | Geographic Factors | Population | Sexual Partners | Behavior | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Risk Reduction Behavior | Population Characteristics | Demographic Factors Document Number: 331263 |
| 17. Title: Low prevalence of HIV and other selected sexually transmitted infections in 2004 in pregnant women from Kinshasa, the Democratic Republic of the Congo. Author: Kinoshita-Moleka R; Smith JS; Atibu J; Tshefu A; Hemingway-Foday J Source: Epidemiology and Infection. 2008 Sep;136(9):1290-6. Abstract: This study examined the prevalence of HIV and other sexually transmitted infections (STIs) in pregnant women in Kinshasa, the Democratic Republic of the Congo (DRC). Between April and July 2004, antenatal attendees at two of the largest maternity clinics in Kinshasa were tested to identify HIV status, syphilis, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). HIV seroprevalence was 1.9% in 2082 women. With PCR techniques, CT and NG infections were also uncommon in the first 529 women (1.7% and 0.4%, respectively). No active syphilis infection case was identified by Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin test (RPR). A woman's risk of HIV infection was significantly associated with her reporting a male partner having had other female sexual partners (OR 2.7, 95% CI 1.2-6.2). The continuing low seroprevalence of HIV in pregnant women from Kinshasa was confirmed. Understanding factors associated with this phenomenon could help prevent a future HIV epidemic in low HIV transmission areas in Africa. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | PREVALENCE | PREGNANT WOMEN | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | TRANSMISSION | ANTENATAL CARE | SYPHILIS | CHLAMYDIA | HIV TRANSMISSION | HIV TESTING | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine Document Number: 328391 |
| 18. Peer Reviewed Title: Fistula and traumatic genital injury from sexual violence in a conflict setting in Eastern Congo: Case studies. Author: Longombe AO; Claude KM; Ruminjo J Source: Reproductive Health Matters. 2008 May;16(31):132-141. Abstract: The Eastern region of the Democratic Republic of Congo (DRC) is currently undergoing a brutal war. Armed groups from the DRC and neighbouring countries are committing atrocities and systematically using sexual violence as a weapon of war to humiliate, intimidate and dominate women, girls, their men and communities. Armed combatants take advantage with impunity, knowing they will not be held to account or pursued by police or judicial authorities. A particularly inhumane public health problem has emerged: traumatic gynaecological fistula and genital injury from brutal sexual violence and gang-rape, along with enormous psychosocial and emotional burdens. Many of the women who survive find themselves pregnant or infected with STIs/HIV with no access to treatment. This report was compiled at the Doctors on Call for Service/Heal Africa Hospital in Goma, Eastern Congo, from the cases of 4,715 women and girls who suffered sexual violence between April 2003 and June 2006, of whom 702 had genital fistula. It presents the personal experiences of seven survivors whose injuries were severe and long-term, with life-changing effects. The paper recommends a coordinated effort amongst key stakeholders to secure peace and stability, an increase in humanitarian assistance and the rebuilding of the infrastructure, human and physical resources, and medical, educational and judicial systems. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | CASE STUDIES | WOMEN | ADOLESCENTS, FEMALE | CHILD, FEMALE | FISTULA | GENITAL EFFECTS, FEMALE | VIOLENCE AGAINST WOMEN | RAPE | PSYCHOSOCIAL FACTORS | WAR | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Child | Diseases | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Domestic Violence | Crime | Social Problems | Sociocultural Factors | Behavior | Political Factors Document Number: 327197 |
| 19. Title: [Pulmonary tuberculosis in infants in Brazzaville, Congo. A review of 117 cases] Tuberculose pulmonaire du nourrisson a Brazzaville (congo). A propos de 117 cas. Author: Mabiala-Babela JR; M'Pemba Loufoua AB; Mouko A; Senga P Source: Medecine Tropicale. 2008 Apr;68(2):167-72. Abstract: Little information is available on pulmonary tuberculosis in infants in sub-Saharan Africa. This retrospective study was conducted in infants ranging in age from 1 to 23 months admitted to the Paediatric Departments of the University Hospital Centre in Brazzaville, Congo for pulmonary tuberculosis between January 1, 1999 and July 1, 2004. Tuberculosis was diagnosed on the basis of epidemiological, clinical, radiological, and follow-up data. All children over 12 months old underwent HIV testing. In case of positive test results, children between the ages of 12 and 18 months were retested after the age of 18 months. Of a total of 803 children admitted for tuberculosis during the study period, 117 (14.6%) were under the age of 24 months (53% males). Mean age was 17.5 months. The BCG test was mentioned in 75.2% of cases. Determination of the contagion in 50.4% of cases indicated that transmission was intrafamilial in 69.3% of cases. The mean delay for hospitalization was 2.6 months (range, 21 days to 16 months). Eighty-one patients (69.2%) presented severe malnutrition. Intrathoracic forms accounted for most cases with bronchopneumopathy (72.6%) and mediastinal adenopathy (40.2%). The incidence of bronchopneumonopathy and isolated forms was significantly higher in children over one year old than in children under one year old: 78.3% versus 21.7 % (p<0.01) and 62.8% versus 37.2% (p<0.001) respectively. A total of 35 children (43.8%) over the age of 12 months presented HIV infection. In comparison with HIV-negative children, HIV-positive children were more likely to present malnutrition and presented a statistically higher incidence of mediastinal adenopathy and multifocal forms. All associated extrathoracic lesions (21.4% of cases) occurred in HIV-positive children. Outcome was favourable in all HIV-negative children while 7 HIV-positive children (20%) died during treatment. Pulmonary tuberculosis in infants in Brazzaville is characterized by frequent association with HIV infection and prognosis is more severe in case of HIV co-infection. Language: French Keywords: AFRICA, SUB SAHARAN | DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | CHILDREN | TUBERCULOSIS | PULMONARY EFFECTS | HIV TESTING | MALNUTRITION | HIV INFECTIONS | SIGNS AND SYMPTOMS | TREATMENT | Africa | Developing Countries | Africa, Central | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nutrition Disorders | Viral Diseases Document Number: 328914 |
| 20. Title: Immunisation-related knowledge, attitudes and practices of mothers in Kinshasa, Democratic Republic of the Congo. Author: Mapatano MA; Kayembe K; Piripiri L; Nyandwe K Source: South African Family Practice. 2008 Mar-Apr;50(2) Abstract: In the Democratic Republic of Congo, it was reported in 1995 that the routine coverage for BCG was as low as 47%, and that it was 27% for DPT3, 28% for OPV3 and 39% for measles vaccine. The trend also was declining unevenly. This study aimed to determine the reasons for such low coverage, examining the socio-demographic characteristics of mothers and health system factors such as health services barriers. It further sought to assess the knowledge, attitudes and practices of mothers associated with routine immunisation. In 1999, a cross-sectional household survey applied a systematic sampling technique in a sample of eight out of the 22 health zones that then served the population of Kinshasa. These were dichotomised into low- and high-coverage health zones, based on BCG immunisation coverage. Mothers of children aged from zero to four years were the respondents to a standardised questionnaire. A total of 1 613 children aged zero to four years participated in the study. Awareness of immunisation and its importance in protecting a child against diseases was universal, although most mothers could not tell exactly against which diseases. Mothers had positive attitudes towards immunisation (98%). Coverage based on the immunisation card, however, was as low as 37%, indicating a discrepancy between the high level of knowledge and positive attitudes, with the observed low immunisation coverage. The father's education and the mother's experience of an EPI-targeted disease in the family emerged as significant predictors of complete immunisation of the child. The father's involvement and the mother's ability to cite signs of severity of EPI diseases were associated with the child's vaccination status in the high-coverage health zone. The mother's vaccine-related knowledge was a predictor of immunisation status only in the low-coverage zone. Different factors determine the complete vaccination status, depending on whether the child lives in a zone with low or high routine EPI coverage. For example, the father's involvement is associated with the child's vaccination status in the high-coverage zone, but not in the low-coverage zone. Programmes and policy makers should take these factors into account when designing strategies to increase immunisation coverage. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | KAP SURVEYS | MOTHERS | IMMUNIZATION | PREVALENCE | CHILD HEALTH SERVICES | PROGRAM ACCESSIBILITY | SOCIOECONOMIC FACTORS | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Primary Health Care | Health Services | Delivery of Health Care | Health | Measurement | Maternal-Child Health Services | Program Evaluation | Programs | Organization and Administration | Economic Factors Document Number: 327279 |
| 21. Peer Reviewed Title: Baseline assessment of collaborative tuberculosis/HIV activities in Kinshasa, the Democratic Republic of Congo. Author: Martinot A; Van Rie A; Mulangu S; Mbulula M; Jarrett N Source: Tropical Doctor. 2008 Jul;38(3):137-141. Abstract: Ninety-two clinics were surveyed in 2005 as part of a baseline assessment of HIV activities in Tuberculosis (TB) clinics in Kinshasa, Democratic Republic of Congo. Some HIV activities were implemented in 58% of TB clinics. The majority of health had > or = 1 health care worker (HCW) trained in either HIV counseling or testing (71%). Fifty-three clinics offered counseling and testing to TB patients; twenty-two (42%) routinely offered HIV CT to all patients, while others used selective criteria. While most offered on-site counseling (92%) and testing (77%), not all 53 clinics had a HCW trained in counseling and only 31 had access to a counseling room. Cotrimoxazole prophylaxis was offered in 51% of clinics; antiretroviral treatment in 17%. Shortcomings in human resources, infrastructure and quality of services were revealed. Strengthening those clinics already implementing HIV activities could be prioritized to achieve the goals set forward by the Global Plan to Stop TB. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | BASELINE SURVEYS | INTEGRATED PROGRAMS | HIV | TUBERCULOSIS | VOLUNTARY COUNSELING AND TESTING | COUNSELING | PREVENTION AND CONTROL | DELIVERY OF HEALTH CARE | NATIONAL HEALTH SERVICES | PROGRAM EVALUATION | PROGRAM ACTIVITIES | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Infections | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Health | Clinic Activities Document Number: 328305 |
| 22. Title: [Prevalence of HIV infection among pregnant women. A study in rural Africa] Prevalence de l'infection par le VIH chez les femmes enceintes. Etude en milieu Author: Mathe MK; Rigo J; Sontag D; Gerard C Source: Revue D'epidemiologie Et De Sante Publique. 2008 Dec;56(6):407-13. Abstract: BACKGROUND: The goal of the study is to assess the prevalence and risk factors of HIV in pregnant women in the North-East rural area of the Democratic Republic of Congo. METHODS: We undertook an exploratory study on women attending the antenatal care during the study period (from December 2002 to December 2004) in the referral General hospital of the health catchments' area of Oicha (DRC). Women with gestational age equal or above 36 weeks were included in the study. After a first test using rapid test Abbott Determine locally, a second crossing check was performed in the referral HIV laboratory in Liege (Belgium). RESULTS: Among 5016 participants tested, 94 were positive (prevalence of 1.9% [CI95% 1.5-2.5]). Following factors predict a risk of being positive among participants: the statute of displacement (OR: 5.77; IC95%: 3.59-9.29); widowhood and divorces (OR: 4.47; IC95%: 1.47-13.60); mobility related to the profession of the husband (OR: 4.00; IC95%: 2.36-6,75); living the countryside (OR: 1.67; IC95%: 1.06-2.62; p: 0.0258). Language: French Keywords: AFRICA | DEMOCRATIC REPUBLIC OF THE CONGO | PREVALENCE | PREGNANT WOMEN | RURAL POPULATION | PERSONS LIVING WITH HIV/AIDS | RISK FACTORS | ANTENATAL CARE | HIV TESTING | MARITAL STATUS | Developing Countries | Africa, Central | Africa, Sub Saharan | Measurement | Research Methodology | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Biology | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Nuptiality Document Number: 330261 |
| 23. Title: [Sexual violence in the Democratic Republic of Congo: impact on public health?] Les violences sexuelles en Republique Democratique du Congo: quelles consequences Author: Omba Kalonda JC Source: Medecine Tropicale. 2008 Dec;68(6):576-8. Abstract: The Democratic Republic of Congo (DRC) has been through two recent wars (1996-1998). In addition to a death toll estimated at over four million, more than 50000 persons were subjected to sexual violence particularly in Eastern regions. Rape was used as a weapon of war by men in uniform and fighters from countries with a high prevalence of HIV/AIDS. Experts have estimated the prevalence of HIV/AIDS to be up to 60% among soldiers and fighters in the region. Sexual violence against women has impacted public health by spreading sexually transmissible diseases including HIV/AIDS, causing unwanted pregnancies, leading to the gynaecological complications of rape-related injuries, and inflicting psychological trauma on the victims. Officials in the DRC must set up appropriate structures to cope with the medical, psychosocial and legal effects of sexual violence. Language: French Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | PREVALENCE | MILITARY PERSONNEL | MEN | WAR | VIOLENCE | DEATH RATE | HIV INFECTIONS | AIDS | RAPE | SEXUAL ABUSE | PREGNANCY, UNWANTED | PUBLIC HEALTH | IMPACT | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Measurement | Research Methodology | Government | Political Factors | Sociocultural Factors | Demographic Factors | Population | Behavior | Mortality | Population Dynamics | Viral Diseases | Diseases | Crime | Social Problems | Reproductive Behavior | Fertility | Health | Communication Document Number: 342676 |
| 24. Peer Reviewed Title: Sexual violence-related fistulas in the Democratic Republic of Congo. Author: Onsrud M; Sjoveian S; Luhiriri R; Mukwege D Source: International Journal of Gynecology and Obstetrics. 2008 Sep 22;:[5] p. Abstract: Objective: To determine the magnitude of traumatic gynecologic fistulas caused by sexual violence in the Democratic Republic of Congo. Methods: A retrospective analysis of hospital records from 604 consecutive patients who received treatment for gynecologic fistulas at Panzi Hospital between November 2005 and November 2007. Results: Of the 604 patients, 24 (4%) reported that their fistulas had been caused by sexual violence; of these, 5 (0.8%) had developed fistulas as a direct result of forced penetration with foreign objects and/or gang rapes. Of the remaining patients, 6 had a fistula before they were raped, 9 developed iatrogenic fistulas following inappropriate instrumentation to manage rape-induced spontaneous abortion or stillbirth, or after abdominal hysterectomy, and 4 developed fistulas after prolonged and obstructed labor. Conclusion: Traumatic fistulas are rare compared to obstetric fistulas. Fistulas indirectly related to sexual violence are likely to be more common than those directly related. All fistulas resulting from sexual violence, whether direct or indirect, should be considered traumatic and special care should be given to these women. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | RETROSPECTIVE STUDIES | EXAMINATIONS AND DIAGNOSES | RECORDS | SEXUAL ABUSE | SEX BEHAVIOR | VIOLENCE | VIOLENCE AGAINST WOMEN | RAPE | FISTULA | ABORTION, SPONTANEOUS | HYSTERECTOMY | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Information Processing | Information | Crime | Social Problems | Sociocultural Factors | Behavior | Domestic Violence | Diseases | Pregnancy Complications | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment Document Number: 328492 |
| 25. Peer Reviewed Title: Bed net ownership, use and perceptions among women seeking antenatal care in Kinshasa, Democratic Republic of the Congo (DRC): opportunities for improved maternal and child health. Author: Pettifor A; Taylor E; Nku D; Duvall S; Tabala M Source: BMC Public Health. 2008;8:331. Abstract: BACKGROUND: To describe malaria knowledge, attitudes toward malaria and bed net use, levels of ownership and use of bed nets, and factors associated with ownership and use among pregnant women attending their first antenatal care (ANC) visit in Kinshasa, DRC. METHODS: Women attending their first ANC visit at one maternity in Kinshasa were recruited to take part in a study where they were given free insecticide treated bed nets (ITNs) and then followed up at delivery and 6 months post delivery to assess ITN use. This study describes the baseline levels of bed net ownership and use, attitudes towards net use and factors associated with net use RESULTS: Among 351 women interviewed at baseline, 115 (33%) already owned a bed net and 86 (25%) reported to have slept under the net the previous night. Cost was reported as the reason for not owning a net by 48% of the 236 women who did not own one. In multivariable analyses, women who had secondary school or higher education were 3.4 times more likely to own a net (95% CI 1.6-7.3) and 2.8 times more likely to have used a net (95% CI 1.3-6.0) compared to women with less education CONCLUSION: Distribution of ITNs in antenatal clinics in this setting is needed and feasible. The potential for ITN use by this target population is high. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | KAP SURVEYS | MULTIVARIATE ANALYSIS | WOMEN IN DEVELOPMENT | CHILDREN | PREGNANT WOMEN | BED NETS | ANTENATAL CARE | PERCEPTION | CHILD HEALTH | MATERNAL HEALTH | ATTITUDES | OWNERSHIP | PESTICIDES | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Data Analysis | Economic Development | Economic Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Parasite Control | Public Health | Health | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Psychological Factors | Behavior | Socioeconomic Factors | Ingredients and Chemicals Document Number: 329018 |
| 26. Title: Ethics of mandatory premarital HIV testing in Africa: the case of Goma, Democratic Republic of Congo. Author: Rennie S; Mupenda B Source: Developing World Bioethics. 2008 Aug;8(2):126-37. Abstract: Despite decades of prevention efforts, millions of persons worldwide continue to become infected by the human immunodeficiency virus (HIV) every year. This urgent problem of global epidemic control has recently lead to significant changes in HIV testing policies. Provider-initiated approaches to HIV testing have been embraced by the Centers for Disease Control and Prevention and the World Health Organization, such as those that routinely inform persons that they will be tested for HIV unless they explicitly refuse ('opt out'). While these policies appear to increase uptake of testing, they raise a number of ethical concerns that have been debated in journals and at international AIDS conferences. However, one special form of 'provider-initiated' testing is being practiced and promoted in various parts of the world, and has advocates within international health agencies, but has received little attention in the bioethical literature: mandatory premarital HIV testing. This article analyses some of the key ethical issues related to mandatory premarital HIV testing in resource-poor settings with generalized HIV epidemics. We will first briefly mention some mandatory HIV premarital testing proposals, policies and practices worldwide, and offer a number of conceptual and factual distinctions to help distinguish different types of mandatory testing policies. Using premarital testing in Goma (Democratic Republic of Congo) as a point of departure, we will use influential public health ethics principles to evaluate different forms of mandatory testing. We conclude by making concrete recommendations concerning the place of mandatory premarital testing in the struggle against HIV/AIDS. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | CRITIQUE | RECOMMENDATIONS | CROSS-CULTURAL COMPARISONS | POLICYMAKERS | PERSONS LIVING WITH HIV/AIDS | ETHICS | HIV TESTING | MARRIAGE | HEALTH POLICY | SOCIAL POLICY | PUBLIC HEALTH | VOLUNTARY COUNSELING AND TESTING | CHRISTIANITY | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Comparative Studies | Studies | Research Methodology | Administrative Personnel | Organization and Administration | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Nuptiality | Demographic Factors | Population | Policy | Political Factors | Religion Document Number: 330328 |
| 27. Peer Reviewed Title: Coinfection with HIV-1 and simian foamy virus in West Central Africans. Author: Switzer WM; Garcia AD; Yang C; Wright A; Kalish ML Source: Journal of Infectious Diseases. 2008 May 15;197(10):1389-1393. Abstract: Frequent infection with zoonotic simian foamy virus (SFV) has been reported among HIV-negative primate hunters in rural Cameroon. Plasma samples obtained from urban commercial sex workers (CSWs; n = 139), patients with sexually transmitted diseases (n = 41), and blood donors (n = 179) in the Democratic Republic of Congo [formerly known as Zaire] and Cameroon were tested for SFV and HIV-1 infection. One CSW and one blood donor were found to be seropositive for both SFV and HIV-1, thereby documenting what are, to our knowledge, the first reported cases of dual SFV and HIV infection. The findings of the present study suggest opportunities for bloodborne and sexual transmission of SFV and highlight the importance of defining the clinical consequences of dual infections. (author's) Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | BLOOD DONORS | SEXUALLY TRANSMITTED DISEASES | VIRAL DISEASES | BLOOD | TRANSMISSION | HIV INFECTIONS | LABORATORY PROCEDURES | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Reproductive Tract Infections | Infections | Diseases | Hemic System | Physiology | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 326473 |
| 28. Title: Sexual violence in the Democratic Republic of the Congo [letter] Author: Taback N; Painter R; King B Source: JAMA. Journal of the American Medical Association. 2008 Aug 13;300(6):653-654. Abstract: Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | KAP SURVEYS | THEORETICAL MODELS | POLICE | WOMEN IN DEVELOPMENT | CHILD, FEMALE | VIOLENCE AGAINST WOMEN | RAPE | WAR | CHILD ABUSE | SEXUAL ABUSE | PREVALENCE | FAMILY RELATIONSHIPS | PREVENTION AND CONTROL | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Corrections Officers | Government | Political Factors | Sociocultural Factors | Economic Development | Economic Factors | Child | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Domestic Violence | Crime | Social Problems | Measurement | Family Characteristics | Family and Household | Diseases Document Number: 308318 |
| 29. Peer Reviewed Title: Impact of the HIV / AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Democratic Republic of the Congo. Author: Van Rie A; Mupuala A; Dow A Source: Pediatrics. 2008 Jul;122(1):e123-e128. Abstract: OBJECTIVES. Pediatric HIV infection is a growing problem in most regions of the world. Data on the effects of HIV on the neurodevelopment of children in resource-poor settings are scarce but necessary to guide interventions. The purpose of this study was to compare the neurodevelopment of preschool-aged HIV-infected, HIV-affected (HIV-uninfected AIDS orphans and HIV-uninfected children whose mother had symptomatic AIDS), and healthy control children in Kinshasa, Democratic Republic of Congo. METHODS. Thirty-five HIV-infected, 35 HIV-affected, and 90 control children aged 18 to 72 months were assessed by using the Bayley Scales of Infant Development II, Peabody Developmental Motor Scales, Snijders-Oomen Nonverbal Intelligence Test, and Rossetti Infant-Toddler Language Scale, as appropriate for age. RESULTS. Overall, 60% of HIV-infected children had severe delay in cognitive function, 29% had severe delay in motor skills, 85% had delays in language expression, and 77% had delays in language comprehension, all significantly higher rates as compared with control children. Young HIV-infected children (aged 18-29 months) performed worse, with 91% and 82% demonstrating severe mental and motor delay, respectively, compared with 46% and 4% in older HIV-infected children (aged 30-72 months). HIV-affected children had significantly more motor and language expression delay than control children. CONCLUSIONS. The impact of the HIV pandemic on children's neurodevelopment extends beyond the direct effect of the HIV virus on the central nervous system. AIDS orphans and HIV-negative children whose mothers had AIDS demonstrated significant delays in their neurodevelopment, although to a lesser degree and in fewer developmental domains than HIV-infected children. Young HIV-infected children were the most severely afflicted group, indicating the need for early interventions. Older children performed better as a result of a "survival effect," with only those children with less aggressive disease surviving. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | CONTROL GROUPS | COMPARATIVE STUDIES | INFANT | PERSONS LIVING WITH HIV/AIDS | CHILD DEVELOPMENT | NEUROLOGIC EFFECTS | HIV INFECTIONS | AIDS | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Biology | Physiology Document Number: 327918 |
| 30. Peer Reviewed Title: The process of HIV status disclosure to HIV-positive youth in Kinshasa, Democratic Republic of the Congo. Author: Vaz L; Corneli A; Dulyx J; Rennie S; Omba S; Kitetele F; Behets F Source: AIDS Care. 2008 Aug;20(7):842-52. Abstract: As access to HIV/AIDS treatment increases in sub-Saharan Africa, greater attention is being paid to HIV-infected youth. Little is known about how HIV-positive youth are informed of their HIV infection. As part of a larger formative study informing a treatment program in Kinshasa, Democratic Republic of the Congo, semi-structured interviews were conducted with 19 youth (10-21 years) who had previously been told their HIV status and 21 caregivers who had disclosed the youth's HIV status to the youth. Questions explored youth's and caregivers' experiences of and immediate reactions to disclosure. Youth's median age at disclosure was 15 years old, with a range of 10-18 years based on caregiver reports (n=21) and from 10-19 years based on youth reports (n=18). The most common reasons spontaneously given for disclosing were the child's adherence to their treatment regimen (5/16), the need of the child to protect her/himself or stay healthy (5/16), the child's increasing age (4/16) and so that the child would know why they are suffering (3/16). Most youth (16/19) were surprised to learn of their diagnosis; 50% (8/16) wondered about the infection's origins. A large majority felt that it is better for them to know their HIV status (88%; 15/17). HIV care and treatment programs must be prepared to address the psychosocial needs of youth and their caregivers during the disclosure process. Language: English Keywords: DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | QUALITATIVE RESEARCH | YOUTH | CONTACTING CLIENTS | HIV INFECTIONS | AIDS | HIV TESTING | TREATMENT | Africa, Central | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Age Factors | Population Characteristics | Demographic Factors | Population | Clients | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | |