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P. Nkoli Mandoko V. Sinou D. Moke Mbongi D. Ngoyi Mumba G. Kahunu Mesia J. Losimba Likwela S. Bi Shamamba Karhemere L. Muepu Tshilolo J.-J. Tamfum Muyembe D. Parzy 《Médecine et maladies infectieuses》2018,48(4):269-277
Objective
Artemisinin-based combination therapies have been available since 2005 in the Democratic Republic of the Congo to treat malaria and to overcome the challenge of anti-malarial drug resistance as well as to improve access to effective treatments. The private sector is the primary distribution source for anti-malarial drugs and thus, has a key position among the supply chain actors for a rational and proper use of anti-malarial drugs. We aimed to assess access to nationally recommended anti-malarial drugs in private sector pharmacies of the capital-city of Kinshasa.Method
We performed a cross-sectional survey of 404 pharmacies.Results
Anti-malarial drugs were stocked in all surveyed pharmacies. Non-artemisinin-based anti-malarial therapies such as quinine or sulfadoxine-pyrimethamine, were the most frequently stocked drugs (93.8% of pharmacies). Artemisinin-based combination therapies were stocked in 88% of pharmacies. Artemether-lumefantrine combinations were the most frequently dispensed drugs (93% of pharmacies), but less than 3% were quality-assured products. Other non-officially recommended artemisinin-based therapies including oral monotherapies were widely available.Conclusion
Artemisinin-based combination therapies were widely available in the private pharmacies of Kinshasa. However, the private sector does not guarantee the use of nationally recommended anti-malarial drugs nor does it give priority to quality-assured anti-malarial drugs. These practices contribute to the risk of emergence and spread of resistance to anti-malarial drugs and to increasing treatment costs. 相似文献2.
Mary G. Reynolds Ginny L. Emerson Elisabeth Pukuta Stomy Karhemere Jean J. Muyembe Alain Bikindou Andrea M. McCollum Cynthia Moses Kimberly Wilkins Hui Zhao Inger K. Damon Kevin L. Karem Yu Li Darin S. Carroll Jean V. Mombouli 《The American journal of tropical medicine and hygiene》2013,88(5):982-985
Monkeypox is an acute viral infection with a clinical course resembling smallpox. It is endemic in northern and central Democratic Republic of the Congo (DRC), but it is reported only sporadically in neighboring Republic of the Congo (ROC). In October 2009, interethnic violence in northwestern DRC precipitated the movement of refugees across the Ubangi River into ROC. The influx of refugees into ROC heightened concerns about monkeypox in the area, because of the possibility that the virus could be imported, or that incidence could increase caused by food insecurity and over reliance on bush meat. As part of a broad-based campaign to improve health standards in refugee settlement areas, the United Nations International Children''s Emergency Fund (UNICEF) sponsored a program of intensive community education that included modules on monkeypox recognition and prevention. In the 6 months immediately following the outreach, 10 suspected cases of monkeypox were reported to health authorities. Laboratory testing confirmed monkeypox virus infection in two individuals, one of whom was part of a cluster of four suspected cases identified retrospectively. Anecdotes collected at the time of case reporting suggest that the outreach campaign contributed to detection of suspected cases of monkeypox. 相似文献
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B Goussard D Zabe J M Meudec B Karhemere J J Salaun 《Bulletin de la Societe de pathologie exotique (1990)》1989,82(4):447-450
880 suspect sera were analysed for HIV2 antibodies (ELISA, Western Blot) during the 2nd and 3rd trimester of 1988. Results show that Kinshasa is not yet an endemic zone for this virus. The authors recommend the use of a mixed test for diagnostics. 相似文献
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Leisha Diane Nolen Lynda Osadebe Jacques Katomba Jacques Likofata Daniel Mukadi Benjamin Monroe Jeffrey Doty Christine Marie Hughes Joelle Kabamba Jean Malekani Pierre Lokwa Bomponda Jules Inonga Lokota Marcel Pie Balilo Toutou Likafi Robert Shongo Lushima Benoit Kebela Ilunga Frida Nkawa Elisabeth Pukuta Stomy Karhemere Jean-Jacques Muyembe Tamfum Beatrice Nguete Emile Okitolonda Wemakoy Andrea M. McCollum Mary G. Reynolds 《Emerging infectious diseases》2016,22(6):1014-1021
A 600-fold increase in monkeypox cases occurred in the Bokungu Health Zone of the Democratic Republic of the Congo during the second half of 2013; this increase prompted an outbreak investigation. A total of 104 possible cases were reported from this health zone; among 60 suspected cases that were tested, 50 (48.1%) cases were confirmed by laboratory testing, and 10 (9.6%) tested negative for monkeypox virus (MPXV) infection. The household attack rate (i.e., rate of persons living with an infected person that develop symptoms of MPXV infection) was 50%. Nine families showed >1 transmission event, and >6 transmission events occurred within this health zone. Mean incubation period was 8 days (range 4–14 days). The high attack rate and transmission observed in this study reinforce the importance of surveillance and rapid identification of monkeypox cases. Community education and training are needed to prevent transmission of MPXV infection during outbreaks. 相似文献
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Andrea M. McCollum Yoshinori Nakazawa Guy Mutombo Ndongala Elisabeth Pukuta Stomy Karhemere Robert Shongo Lushima Benoit Kebela Ilunga Joelle Kabamba Kimberly Wilkins Jinxin Gao Yu Li Ginny Emerson Inger K. Damon Darin S. Carroll Mary G. Reynolds Jean Malekani Jean-Jacques Muyembe Tamfum 《The American journal of tropical medicine and hygiene》2015,93(4):718-721
Monkeypox (MPX) is a zoonotic Orthopoxvirus infection endemic in central and western Africa. Human MPX cases occur in the central and northern regions of the Democratic Republic of the Congo (DRC), and this is the first report of confirmed MPX cases in the forested areas of North and South Kivu Provinces, with a detailed epidemiological investigation for one case. The location of each case is within areas predicted to be suitable for MPX virus transmission based on an ecological niche model. Phylogenetic analysis places these viruses in the Congo Basin clade. 相似文献
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Büscher P Bin Shamamba SK Ngoyi DM Pyana P Baelmans R Magnus E Van Overmeir C 《Tropical medicine & international health : TM & IH》2005,10(9):850-855
Human African Trypanosomiasis is caused by Trypanosoma brucei gambiense and T. b. rhodesiense. Historically, a treatment relapse rate of about 5% is observed in patients treated with melarsoprol, an arsenical derivative used for treatment of both gambiense and rhodesiense second stage sleeping sickness. More recently, relapse rates up to 30% are noted in gambiense sleeping sickness foci in Angola, Sudan and Uganda. Therefore, WHO established a Network on Treatment Failure and Drug Resistance in Sleeping Sickness. One of its objectives is to improve isolation of T. b. gambiense from relapsing cases for research on drug resistance mechanisms. Trypanosoma b. gambiense isolation techniques suffer from low success rates and long periods needed to adapt the parasite to its new host. Usually, rodents are inoculated with patient's blood or cerebrospinal fluid and sub-passaged until the strain becomes sufficiently adapted to yield high parasitaemia within few days after inoculation. Until now, the best recipient for T. b. gambiense is Mastomys natalensis, with a success rate of about 50%. In this study, Grammomys surdaster (former Thamnomys surdaster) was investigated as a potential recipient for isolation of T. b. gambiense. Comparative experimental infections of Swiss mice, Wistar rats and G. surdaster thicket rats with T. b. gambiense clearly show that this trypanosome grows faster in G. surdaster. Inoculation of the same rodent species with patient's blood and cerebrospinal fluid in Kinshasa (R.D. Congo) confirms the observation that the thicket rats are more susceptible to T. b. gambiense infection than typical laboratory rodents. 相似文献
8.
Improved detection of Trypanosoma brucei by lysis of red blood cells, concentration and LED fluorescence microscopy 总被引:1,自引:0,他引:1
Biéler S Matovu E Mitashi P Ssewannyana E Bi Shamamba SK Bessell PR Ndung'u JM 《Acta tropica》2012,121(2):135-140
Confirmatory diagnosis of African trypanosomiasis relies on demonstration of parasites in body fluids by bright field microscopy. The parasitaemia in infected patients and animals is usually low, and concentration methods are used to try and increase the chances of seeing parasites. Recently, fluorescence microscopes using light-emitting diodes (LED) have been developed. Since they emit strong light, their use does not require a dark room, making field application a possibility. We have combined LED fluorescence microscopy with lysis of red blood cells (RBC) to improve the sensitivity and speed of detecting trypanosomes. In studies conducted at four centers in Uganda and the Democratic Republic of the Congo, parasitaemic blood was serially diluted and the RBCs lysed using commercial buffer. Samples were then concentrated by centrifugation, and different volumes of the sediment used to make thin and thick smears. Next, these were stained with acridine orange or Giemsa, and examined using an LED microscope under fluorescence or bright light, respectively. Detection of parasites was significantly improved by RBC lysis and concentration, regardless of the staining and microscopy method used. Further improvements were made when smears were prepared using larger volumes of sediment. The best results were obtained with thin smears prepared using 20 μl of sediment and stained with acridine orange. The time taken to see the first parasite was dramatically reduced when smears were examined by LED fluorescence microscopy, compared to bright light. LED fluorescence microscopy was found to be easier and requiring less visual effort than bright field microscopy. These studies demonstrate the potential for incremental improvement in detection of Trypanosoma brucei by combining LED fluorescence microscopy with RBC lysis and concentration. The lysis and concentration method may also be useful in sample preparation for other diagnostic tests for trypanosomiasis. 相似文献
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Jessica Leung Andrea M. McCollum Kay Radford Christine Hughes Adriana S. Lopez Sarah Anne J. Guagliardo Beatrice Nguete Toutou Likafi Joelle Kabamba Jean Malekani Robert Shongo Lushima Elisabeth Pukuta Stomy Karhemere Jean Jacques Muyembe Tamfum Mary G. Reynolds Emile Wemakoy Okitolonda D. Scott Schmid Mona Marin 《Tropical medicine & international health : TM & IH》2019,24(7):839-848
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