41 research outputs found
Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community
No full textTelomere length (TL) is a marker of ageing and mitochondrial DNA (mtDNA) is an early marker of inflammation caused by oxidative stress. We determined TL and mtDNA content among active pulmonary tuberculosis (PTB) patients to assess if these cellular biomarkers differed between artisanal miners and non-miners, and to assess if they were predictive of treatment outcome. We conducted a prospective cohort study from August 2018 to May 2019 involving newly diagnosed PTB patients at three outpatient TB clinics in a rural Democratic Republic of Congo. We measured relative TL and mtDNA content in peripheral blood leukocytes (at inclusion) via qPCR and assessed their association with PTB treatment outcome. We included 129 patients (85 miners and 44 non-miners) with PTB (median age 40 years; range 5–71 years, 22% HIV-coinfected). For each increase in year and HIV-coinfection, TL shortened by − 0.85% (− 0.19 to − 0.52) (p ≤ 0.0001) and − 14% (− 28.22 to − 1.79) (p = 0.02) respectively. Independent of these covariates, patients with longer TL were more likely to have successful TB treatment [adjusted hazard ratio; 95% CI 1.27 for a doubling of leucocyte telomere length at baseline; 1.05–1.44] than patients with a shorter TL. Blood mtDNA content was not predictive for PTB outcome. For a given chronological age, PTB patients with longer telomeres at time of diagnosis were more likely to have successful PTB treatment outcome.sponsorship: P.D.M.C. K was fellow of the Fonds Marc Vervenne of the KU Leuven (Belgium) and he is supported by the US National Institutes of Health (NIH)-Fogarty Postdoctoral Fellowship: Grant no. 1D43TW010937-01A1. D.S.M is a FWO postdoc, with funding number: FWO Grant 12X9620N. Fieldwork has been supported by the KU Leuven Alumni Association and the University of Antwerp-USOS via the CEGEMI of the Catholic University of Bukavu. The costs of measuring Telomere length and mtDNA were covered by a grant of the European Research Council (ENVIRONAGE). The funders had no role in the study design, data collection, analysis, interpretation, or writing of the report. The corresponding author had full access to all the study data and had final responsibility for the decision to submit for publication. (US National Institutes of Health (NIH)-Fogarty Postdoctoral Fellowship|1D43TW010937-01A1, FWO|12X9620N, European Research Council (ENVIRONAGE), John E. Fogarty International Center for Advanced Study in the Health Sciences|D43TW010937, John E. Fogarty International Center for Advanced Study in the Health Sciences|R25TW011217, National Center for Advancing Translational Sciences|UL1TR001863)status: Publishe
Transplacental transfer of cobalt: Evidence from a study of mothers and their neonates in the African Copperbelt
No full textBackground: Transfer of the trace metal cobalt (Co) from mother to foetus has not been documented in pop-ulations with high environmental exposure to Co, as is the case in the African Copperbelt mining region. We analysed data obtained from 246 mother-infant pairs included (at delivery) in a previously published case -control study on birth defects, done in Lubumbashi (Democratic Republic of Congo) between March 1, 2013, and Feb 28, 2015.Methods: Co was measured by Inductively Coupled Plasma Mass Spectrometry in maternal blood, maternal urine, umbilical cord blood and placental tissue, as available.Results: The Co concentrations [geometric mean (GM) with interquartile range (IQR)] in maternal blood (GM 1.77 mu g/L, IQR 1.07-2.93) and urine (GM 7.42 mu g/g creatinine, IQR 4.41-11.0) were highly correlated (Spearman r = 0.71, n = 166; p < 0.001) and considerably higher than reference values determined for general populations elsewhere in the world. The concentrations of Co in umbilical cord blood (GM 2.41 mu g/L) were higher (Wilcoxon test, p < 0.001) than in maternal blood (GM 1.37 mu g/L), with a correlation between both values (Spearman r = 0.34; n = 127, p < 0.001). Co concentrations in placental tissue (geometric mean 0.02 mu g/g wet weight) correlated with concentrations in maternal blood (Spearman r = 0.50, n = 86, p < 0.001) and in neonatal blood (Spearman r = 0.23, n = 83, p = 0.039).Conclusion: This first study of maternal and neonatal Co concentrations in the African Copperbelt provides strong evidence of a high transfer of Co from mother to foetus.This article is part of the PhD work of Tony Kayembe-Kitenge, who benefitted from travel and training grants from the VLIR-UOS (Vlaamse Interuniversitaire Raad - Universitaire Ontwikkelingssamenwerking),
and from ARES (Acad´emie de Recherche et de l′Enseignement Sup´erieur), Belgium
Agnathia otocephaly: A case from the Katanga Copperbelt
No full textBackground Agnathia otocephaly is a rare craniofacial malformation complex characterised by absent/hypoplastic mandible, abnormally positioned ears meeting at level of neck. Besides mutations in two genes,PRRX1andOTX2, a teratogenic cause has been suggested. A higher risk of congenital malformations has been associated with paternal work in mining in the Democratic Republic of the Congo's part of the Copperbelt. Case We studied a female neonate with a clinical diagnosis of agnathia otocephaly, stillborn in Lubumbashi in 2019. The child's father had been working as an artisanal mineworker at the time of conception. Results Genetic analysis did not reveal a causal mutation. The concentrations of cobalt, arsenic cadmium, and uranium in cord blood of the infant were much higher than those of normal neonates from a previous study. Conclusion In the absence of identified genetic causes, we hypothesize this case of agnathia otocephaly was related to an exogenous cause, possibly the father's mining-related job
Les ambiguïtés d'une expérience privée : réflexions libres sur le musée en Afrique
No full textAbstract
The Ambiguties of a Private Experience: Free-ranging thoughts on Museums in Africa. — In Africa, museums are in the throes of a crisis as a consequence of policies and paradigms. Crisis keeps it from becoming "native"' in order to better serve its first consumers. This analysis of the experiences inside and outside museums that Africans (friends, art merchants, curators, collectors) have had in several African and Western cities sheds light on the contradictions running through museums and their practices and through the perception of local and national consumers. Questions are raised about national policies in matters of culture and about the cooperation between museums in the North and in Africa on the basis of an itinerant exhibition, in which the author took part, that traveled between the Museum of Civilization in Quebec and museums in French-speaking western Africa.Résumé
En Afrique, le musée traverse une crise profonde, conséquence des politiques et des paradigmes qui l'ont imposé sur le continent. Cette crise théorique l'empêche de « s'autochtoniser » pour mieux servir ses premiers consommateurs. Cette contribution est une réflexion libre qui porte sur une somme d'expériences intra- et extra-« muséales » d'Africains (proches, amis, vendeurs d'ceuvres d'art, conservateurs, collectionneurs...) rencontrés dans plusieurs villes d'Afrique et d'Occident. L'analyse de ces diverses expériences vécues et rapportées à l'auteur permet de mettre en évidence les contradictions qui traversent et qui nourrissent d'une part le musée et ses pratiques actuelles, d'autre part la perception qu'en a le consommateur local et national. Cette contribution s'interroge également sur les politiques culturelles nationales. Elle questionne la collaboration « muséale » entre le Nord et l'Afrique en prenant pour exemple une exposition itinérante entre le musée de la Civilisation du Québec et les musées d'Afrique de l'Ouest francophone, expérience à laquelle l'auteur a contribué.Biaya Tshikala Kayembe. Les ambiguïtés d'une expérience privée : réflexions libres sur le musée en Afrique. In: Cahiers d'études africaines, vol. 39, n°155-156, 1999. Prélever, exhiber. La mise en musées. pp. 747-765
Preeclampsia and blood lead (and other metals) in Lubumbashi, DR Congo.
No full textAmong parturient women in Lubumbashi, blood lead concentrations [geometric means (25th-75th percentiles)] were higher among 40 women with preeclampsia [6.66 µg/dL (5.16-79.4)] than among 39 control women matched for age and gestation duration [5.08 µg/dL (4.27-6.30)]. Blood lead exceeded 5 µg/dL in 33 (83%) preeclamptic women and 17 (44%) control women [odds ratio 6.1 (95%CI 2.1-17.1)]. In another study, we found high levels of lead in surface dust collected in front of homes in Lubumbashi (36/127 samples exceeding 120 µg lead/g dust). Our findings support the conclusions of a systematic review that increased blood lead level increases the likelihood of preeclampsia. Moreover, our study indicates that, as in other urban areas in Africa, exposure to lead is unacceptably high among pregnant women in Lubumbashi. Preventive measures are needed to protect mothers and children from the serious adverse effects of lead exposure
An assessment of civil society peace building efforts in the Democratic Republic of Congo
No full textDuring the Rwandan genocide, from April to July 1994, more than two million Rwandans, including Hutu extremists who feared retribution, fled to neighbouring countries. The majority of people who took refuge in the Democratic Republic of the Congo (DRC, known until May 1997 as Zaire) were located in North and South Kivu provinces. Tensions grew between DRC and Rwanda governments due to the use of refugee camps in North Kivu as rear bases by Hutu extremists to attack, destabilise and regain control of power in Rwanda (Leeuwen, 2008: 400). In 1996, a group of four political parties [the Council of Resistance for Democracy, the Revolutionary Movement for the Liberation of Congo, the Democratic Alliance of the People and the Party of the Peoples' Revolution] founded the Alliance of Democratic Forces for the Liberation of Congo (AFDL) to pursue regime change in DRC [First Congo war]. Mobutu’s 32 years of bad governance had transformed DRC into one of the poorest countries in the world despite its abundant wealth in natural resources. A deadly conflict erupted in 1998 [Second Congo war], in which several armed rebel groups supported by neighbouring countries sought to overthrow the regime of President Kabila. In 1999, a cease-fire agreement was signed in Lusaka, Zambia which paved the way for the deployment of UN peacekeeping troops. An inter-Congolese dialogue was convened in 2002 in South Africa. As a result of the dialogue, the war ended [sporadic conflicts continued] and a new transitional government of national unity was formed in June 2003. President Joseph Kabila, who was declared winner of the 2006 presidential elections, promised to restore peace and security in the Kivu provinces. But, after more than 10 years, the root causes of the conflict have not been resolved in South Kivu. The province still faces violence perpetrated by armed rebel groups, human insecurity, human rights violations and economic decline; all these issues have compromised the relative peace that local people have had for a couple of years. The treatise identifies, through a literature and documentary analysis, some local and external Civil Society Organisations (CSOs) which have been advocating, supporting and recommending post-conflict reconstruction and development (PCRD) in South Kivu. The concept of Peacebuilding has been one of the core objectives of dozens of actors in South Kivu. The aim of this treatise is to assess local CSOs’ efforts in building peace in South Kivu. The author has evaluated their capacities in resolving the root causes of conflicts, building capacity of communities through training, delivering humanitarian assistance to vulnerable people, and working towards a sustainable and lasting stability in the province. This treatise’s objectives are aimed at assessing the works and challenges of local non-states actors and stakeholders in peace consolidation. The author has also outlined the programmes implemented by local actors to address the root causes of conflicts; has made recommendations to promote peace and has concluded that a durable stability can be achievable with the support of all peace stakeholders in Eastern DRC
Cobalt and Thyroid Function. Case-Control Study of Patients with Goiters in Katanga, DR Congo
No full textEvaluating service provision for midwifery education: a case study
No full textAbstract
In keeping with the ethos of the Higher Education Funding Council for England (HEFCE), related Key Information Sets (KIS) and National Student Survey (HEFCE 2012), the local university’s five year strategic plan 2011-15 (Strategic Plan 2011) includes at its heart investing in the student experience with a curriculum that is flexible and responsive to changes both within and outside the university, and offering a ‘high quality university experience’ through innovative methods of learning. As part of a varied array of teaching, learning and assessment facilities, the university boasts of skills lab services which increasingly provide a unique opportunity for student midwives to practice clinical skills in a safe environment which ultimately prepares them to be fit for practice at the point of registration (Nursing and Midwifery Council (NMC) 2009). However, there has not been a formal evaluation of this service to date.
Purpose
This study set out to evaluate the current service provided for pre-registration midwifery students in the university skills lab in order to establish current standard, provide a benchmark for future development, and contribute to the students’ learning experience.
Methodology
Using a case study approach, a representative convenient sample of users of the service was studied. Participants included 7 third year and 3 first year students from the pre-registration midwifery programme based on one of the two university campus sites, and 2 midwifery lecturers plus 2 skills lab support staff working across both campuses. All participants were asked about their experience of using the skills labs. Interviews were transcribed verbatim and analysed using a thematic approach and NVivo software. Student focus groups and staff one-to-one interviews were carried out, as well as observation of activity in the skills lab. Relevant document analysis was also undertaken.
Findings
The main themes emerging from analysis of the data include the following: both staff and students felt that there was more theory than practice in the teaching and learning activities in the skills lab; that the management of time and communication around the assessment process in the skills lab could be improved; that the quality and authenticity of equipment and facilities could be improved; that capacity issues, consisting of an interaction between student numbers, time and space management in the lab, had a negative impact on the learning experience; and that better communication amongst users overall could further improve the service.
Implications
Whilst some of the findings support the literature, there appears to be some new information particularly related to student perceptions of the theory - practice ratio of sessions, and capacity issues impacting on learning. The author makes several recommendations for educational institutions providing a skills lab service including the following: Educational institutions should
• explore innovative teaching strategies such as the blended approach which would allow more time for students to spend on hands-on practice in the lab,
• explore strategies to enhance the authenticity of the equipment to improve the students’ learning experience in the lab,
• develop better communication systems and appropriate management of timetables, coupled with clear guidelines for staff-student ratios in order to address capacity issues; clear communication around assessment that takes into account individual students’ unique needs must also be ensured.
Limitations
The author recognises that this study was primarily based on the experience of students from one out of two university campuses admitting pre-registration midwifery students. This was due to time constraints related to the timetable for the Master’s study. It would therefore be useful to consider further research that encompasses the experience of students from both campus sites as well as addressing possible issues surrounding parity of experience across sites
