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PubMed2000

Dietary cyanide from insufficiently processed cassava and growth retardation in children in the Democratic Republic of Congo (formerly Zaire).

Dietary cyanide exposure from cyanogenic glucosides in insufficiently processed cassava has been advanced as a contributing factor in child growth retardation. Whether cyanide exposure aggravates children's growth retardation was studied by comparing two populations of children from the northern and the southern zones of the Bandundu region, Democratic Republic of Congo (former Zaire), using dietary interviews, anthropometry and urine analyses. Both populations consumed cassava as their staple diet, but whereas in the north the cassava was well processed, in the south it was inadequately processed. The mean urinary thiocyanate was much higher in the south, whereas mean urinary sulphate excretion was equally low in the two areas. However, the mean urinary SCN/SO4 molar ratio was higher in the south (0.20), indicating that 10-20% of sulphur amino-acids were used for cyanide detoxication. No significant differences were found between the two populations in weight-for-height and weight-for-age indices but the height-for-age index was significantly lower in children from the south, indicating more severe growth retardation in children exposed to dietary cyanide. Because of the preferential use of sulphur amino-acids for cyanide detoxification in the human body, dietary cyanide exposure from cassava may be a factor aggravating growth retardation in Bandundu.

Anthropometry↗
PubMedDate not supplied

Antitrypsin and Gc polymorphisms in some populations of Congo: an unusual, highly frequent mutant, PIS, in Bateke and Babenga.

Four population samples from Congo (Beti and Bateke from Cuvette area, Bateke and Babenga from 'Pool' area) were typed for the electrophoretic mutants of protease inhibitor (PI) and group-specific component (Gc), as part of a general survey on the genetic structure of these ethnic groups. An unusual PI mutant (tentatively called PIS*) had a singularly high frequency in the Bateke and the Babenga. Data shown here will help in ascertaining whether genetic differentiation could exist in Congolese populations.

Black People↗
PubMed2006

Unprotected intercourse for extra money among commercial sex workers in Kinshasa, Democratic Republic of Congo.

This study assessed the extent and correlates of the practice of engaging in unprotected intercourse for extra money among commercial sex workers (CSWs) in Kinshasa, Democratic Republic of the Congo. We conducted a cross-sectional survey using a structured, interviewer-administered questionnaire among a convenience sample of 136 CSWs. More than one-quarter of CSWs (26.5%) engaged in unprotected intercourse for extra money. These CSWs charged about 3.5 times more for unprotected intercourse than for protected intercourse. Multivariate logistic regression showed that CSWs who engaged in unprotected intercourse for extra money were significantly more likely to live or work in non-downtown (lower socioeconomic) areas of Kinshasa (odds ratio [OR] = 3.07), to have at least one child less than six years of age (OR = 2.95), and to know other CSWs who engaged in the same practice (OR = 9.38). We hypothesize that desperate socioeconomic conditions combined with peer/social norms drive the practice of engaging in unprotected intercourse for extra money. Additional circumstances under which Kinshasa CSWs engaged in unprotected intercourse included intercourse with clients who tore their condoms to increase sexual pleasure (58.8% of CSWs), episodes of condom failure (56.8% of CSWs), and unprotected intercourse with regular noncommercial partners (only 5.3% of CSWs with noncommercial partners always used condoms with these partners).

Adolescent↗
PubMed2006

Care burden and self-reported health status of informal women caregivers of HIV/AIDS patients in Kinshasa, Democratic Republic of Congo.

We conducted a cross-sectional study on women who were caregivers of HIV/AIDS-affected spouses in Bumbu in Kinshasa, Democratic Republic of Congo. The sample consisted of 80 women randomly selected from a client visitation list of the home-based care program for AIDS patients. A semi-structured questionnaire was applied. A self-reported health status was calculated with five items from the questionnaire. The self-reported health status score of participants indicated poor health. The study highlights the great burden on caregivers in sub-Saharan Africa.

Adolescent↗
PubMedDate not supplied

Community preparedness for HIV vaccine trials in the Democratic Republic of Congo.

This paper reports on an assessment of community preparedness for HIV vaccine trials in the Democratic Republic of Congo. Formative research was conducted in the capital city of Kinshasa during the period October 2003 to March 2004 to answer questions pertinent to planning trials of a preventive HIV vaccine and to identify related issues. Twenty-seven in-depth interviews and two focus groups were held with potential trial participants and community leaders. Data was collected on the subjects of vaccines, HIV/AIDS and sexual behaviour, and an HIV vaccine. The study also sought to identify factors that motivate a person to volunteer for a vaccine trial or which are disincentives to participation, along with preparedness of the larger community for trials. Personal concerns for health and for the impact of the epidemic on families and country were common motivations for participation. The danger of an experimental vaccine and the stigma of a positive HIV antibody test as the result of vaccination are major concerns and disincentives. The health, educational, and local non-governmental sectors are identified as having important roles to play in assuring preparedness for trials, although significant challenges exist to achieving community preparedness.

AIDS Vaccines↗
PubMed2003

The efficacy of oral ribavirin in the treatment of crimean-congo hemorrhagic fever in Iran.

We compared the mortality rate among patients suspected of having Crimean-Congo hemorrhagic fever (CCHF) who received treatment with oral ribavirin and those who did not. Ninety-seven (69.8%) of 139 treated patients suspected of having CCHF survived, and 61 (88.9%) of 69 treated patients with confirmed CCHF survived. The efficacy of oral ribavirin was 80% among patients with confirmed CCHF and 34% among patients suspected of having CCHF. Considering the limitations of observational studies, we conclude that oral ribavirin is an effective treatment for the hemorrhagic form of CCHF.

Administration, Oral↗
PubMed2004

Crimean-Congo hemorrhagic fever: prevention and control limitations in a resource-poor country.

In autumn 2000, an outbreak of Crimean-Congo hemorrhagic fever (CCHF) occurred in Pakistan and involved nosocomial cases due to human-to-human transmission at a tertiary care hospital in Karachi. During a hospital-based investigation, 6 serologically confirmed cases (i.e., patients seropositive for CCHF antigen or anti-CCHF immunoglobulin M antibodies by means of a capture enzyme-linked immunosorbent assay [ELISA]) and 3 clinically confirmed cases (i.e., patients with negative ELISA for CCHF but with relevant epidemiologic exposures and compatible clinical disease) of CCHF were identified. The outbreak originated in rural Balochistan, a region of known CCHF endemicity where miniepidemics regularly occur, and subsequently spread to the urban centers of Quetta and Karachi. This outbreak demonstrated the capacities and weaknesses associated with a developing country's response to hemorrhagic fever epidemics. We describe aspects of disease prevention, control challenges, and political obstacles posed by illness associated with what we refer to as the "Asian Ebola virus."

Adolescent↗
PubMed2004

New insights into chimpanzees, tools, and termites from the Congo Basin.

The tool-using behaviors of wild chimpanzees comprise the most impressive assemblages and flexible repertoires of nonhuman material culture. We expand knowledge of the breadth and complexity of tool use in this species by providing the first descriptions of the form and function of two distinct tool sets used by chimpanzees in preying upon termites within the forests of the Goualougo Triangle, Republic of Congo. Further, we report the first application of remote video monitoring technology to record wild chimpanzee tool-using behavior. Based on tool assemblages recovered at termite nests, we hypothesized that chimpanzees were regularly visiting two forms of termite nests and using specific tools to extract termite prey depending on the structure of the nest. Six months of continuous remote video monitoring at six termite nests confirmed that chimpanzees use a tool set to puncture and fish at subterranean termite nests and another tool set to perforate and fish at epigeal (aboveground) nests. Our findings of strict adherence to tool forms at different nest types, tool material selectivity, repeated visits to nests with reusable wood tool assemblages, and differences in material culture between communities have broad implications for our understanding of the ecological and cultural factors that shape hominoid tool use.

Animals↗
PubMed2006

Detection of Ebola virus in oral fluid specimens during outbreaks of Ebola virus hemorrhagic fever in the Republic of Congo.

BACKGROUND: Patients who have refused to provide blood samples has meant that there have been significant delays in confirming outbreaks of Ebola virus hemorrhagic fever (EVHF). During the 2 EVHF outbreaks in the Republic of Congo in 2003, we assessed the use of oral fluid specimens versus serum samples for laboratory confirmation of cases of EVHF. METHODS: Serum and oral fluid specimens were obtained from 24 patients with suspected Ebola and 10 healthy control subjects. Specimens were analyzed for immunoglobulin G antibodies by enzyme-linked immunosorbent assay (ELISA) and for Ebola virus by antigen detection ELISA and reverse-transcriptase polymerase chain reaction (RT-PCR). Oral fluid specimens were collected with a commercially available collection device. RESULTS: We failed to detect antibodies against Ebola in the oral fluid specimens obtained from patients whose serum samples were seropositive. All patients with positive serum RT-PCR results also had positive results for their oral fluid specimens. CONCLUSIONS: This study demonstrates the usefulness of oral fluid samples for the investigation of Ebola outbreaks, but further development in antibodies and antigen detection in oral fluid specimens is needed before these samples are used for filovirus surveillance activities in Africa.

Adult↗
PubMed1999

A search for Ebola virus in animals in the Democratic Republic of the Congo and Cameroon: ecologic, virologic, and serologic surveys, 1979-1980. Ebola Virus Study Teams.

More than 30 years after the first outbreak of Marburg virus disease in Germany and Yugoslavia and 20 years after Ebola hemorrhagic fever first occurred in central Africa, the natural history of filoviruses remains unknown. In 1979 and 1980, animals in the Democratic Republic of the Congo and Cameroon were collected during the dry season near the site of the 1976 Ebola hemorrhagic fever epidemic. The study objectives were to identify local animals and search for evidence of Ebola virus in their tissues. A total of 1664 animals representing 117 species was collected, including >400 bats and 500 rodents. Vero and CV-1 cells and IFA and RIA were used for virus and antibody detection, respectively. No evidence of Ebola virus infection was found. This study was limited in time and animal collections and excluded insects and plants. Long-term, prospective, multidisciplinary comparative studies will yield more information than will repeat short forays on the ecology of filoviruses.

Animals↗
PubMed1999

Ebola hemorrhagic fever, Kikwit, Democratic Republic of the Congo, 1995: risk factors for patients without a reported exposure.

In 1995, 316 people became ill with Ebola hemorrhagic fever (EHF) in Kikwit, Democratic Republic of the Congo. The exposure source was not reported for 55 patients (17%) at the start of this investigation, and it remained unknown for 12 patients after extensive epidemiologic evaluation. Both admission to a hospital and visiting a person with fever and bleeding were risk factors associated with infection. Nineteen patients appeared to have been exposed while visiting someone with suspected EHF, although they did not provide care. Fourteen of the 19 reported touching the patient with suspected EHF; 5 reported that they had no physical contact. Although close contact while caring for an infected person was probably the major route of transmission in this and previous EHF outbreaks, the virus may have been transmitted by touch, droplet, airborne particle, or fomite; thus, expansion of the use of barrier techniques to include casual contacts might prevent or mitigate future epidemics.

Adult↗
PubMed1999

Ebola hemorrhagic fever: lessons from Kikwit, Democratic Republic of the Congo.

The outbreak of Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo, clearly signaled an end to the days when physicians and researchers could work in relative obscurity on problems of international importance, and it provided many lessons to the international public health and scientific communities. In particular, the outbreak signaled a need for stronger infectious disease surveillance and control worldwide, for improved international preparedness to provide support when similar outbreaks occur, and for accommodating the needs of the press in providing valid information. A need for more broad-based international health regulations and electronic information systems within the World Health Organization also became evident, as did the realization that there are new and more diverse partners able to rapidly respond to international outbreaks. Finally, a need for continued and coordinated Ebola research was identified, especially as concerns development of simple and valid diagnostic tests, better patient management procedures, and identification of the natural reservoir.

Democratic Republic of the Congo↗
PubMed1999

Late ophthalmologic manifestations in survivors of the 1995 Ebola virus epidemic in Kikwit, Democratic Republic of the Congo.

Three (15%) of 20 survivors of the 1995 Ebola outbreak in the Democratic Republic of the Congo enrolled in a follow-up study and 1 other survivor developed ocular manifestations after being asymptomatic for 1 month. Patients complained of ocular pain, photophobia, hyperlacrimation, and loss of visual acuity. Ocular examination revealed uveitis in all 4 patients. All patients improved with a topical treatment of 1% atropine and steroids.

Adult↗
PubMed1999

Persistence and genetic stability of Ebola virus during the outbreak in Kikwit, Democratic Republic of the Congo, 1995.

Ebola virus persistence was examined in body fluids from 12 convalescent patients by virus isolation and reverse transcription-polymerase chain reaction (RT-PCR) during the 1995 Ebola hemorrhagic fever outbreak in Kikwit, Democratic Republic of the Congo. Virus RNA could be detected for up to 33 days in vaginal, rectal, and conjunctival swabs of 1 patient and up to 101 days in the seminal fluid of 4 patients. Infectious virus was detected in 1 seminal fluid sample obtained 82 days after disease onset. Sequence analysis of an RT-PCR fragment of the most variable region of the glycoprotein gene amplified from 9 patients revealed no nucleotide changes. The patient samples were selected so that they would include some from a suspected line of transmission with at least three human-to-human passages, some from 5 survivors and 4 deceased patients, and 2 from patients who provided multiple samples through convalescence. There was no evidence of different virus variants cocirculating during the outbreak or of genetic variation accumulating during human-to-human passage or during prolonged persistence in individual patients.

Adolescent↗
PubMed1999

Ebola between outbreaks: intensified Ebola hemorrhagic fever surveillance in the Democratic Republic of the Congo, 1981-1985.

Surveillance for Ebola hemorrhagic fever was conducted in the Democratic Republic of the Congo from 1981 to 1985 to estimate the incidence of human infection. Persons who met the criteria of one of three different case definitions were clinically evaluated, and blood was obtained for antibody confirmation by IFA. Contacts of each case and 4 age- and sex-matched controls were also clinically examined and tested for immunofluorescent antibody. Twenty-one cases of Ebola infection (persons with an antibody titer of > or = 1:64, or lower if they fit the clinical case definition) were identified, with a maximum 1-year incidence of 9 and a case fatality rate of 43%. Cases occurred throughout the year, but most (48%) occurred early in the rainy season. Fifteen percent of contacts had antibody titers > or =1:64 to Ebola virus, compared with 1% of controls (P < .0001). Results suggest that Ebola virus periodically emerges from nature to infect humans, that person-to-person transmission is relatively limited, and that amplification to large epidemics is unusual.

Adolescent↗
PubMed1999

Epidemiologic and clinical aspects of the Ebola virus epidemic in Mosango, Democratic Republic of the Congo, 1995.

Twenty-three Ebola hemorrhagic fever (EHF) cases (15 males, 8 females) were identified in Mosango, Democratic Republic of the Congo; 18 (78%) of them died. Eight of the patients came from Kikwit General Hospital and were hospitalized at Mosango General Hospital, 10 acquired their infection at the Mosango hospital and were treated there, and 5 acquired their infection through contact with a hospitalized patient but were never hospitalized themselves. For most of the EHF cases, it was clear that they had been in contact with blood or body fluids of another EHF patient. The Ebola outbreak in Mosango remained relatively small, probably because hygienic conditions in this hospital were relatively good at the time of the outbreak and because as soon as the epidemic was recognized, barrier nursing techniques were used.

Adult↗
PubMed1999

Search for the Ebola virus reservoir in Kikwit, Democratic Republic of the Congo: reflections on a vertebrate collection.

A 3-month ecologic investigation was done to identify the reservoir of Ebola virus following the 1995 outbreak in Kikwit, Democratic Republic of the Congo. Efforts focused on the fields where the putative primary case had worked but included other habitats near Kikwit. Samples were collected from 3066 vertebrates and tested for the presence of antibodies to Ebola (subtype Zaire) virus: All tests were negative, and attempts to isolate Ebola virus were unsuccessful. The investigation was hampered by a lack of information beyond the daily activities of the primary case, a lack of information on Ebola virus ecology, which precluded the detailed study of select groups of animals, and sample-size limitations for rare species. The epidemiology of Ebola hemorrhagic fever suggests that humans have only intermittent contact with the virus, which complicates selection of target species. Further study of the epidemiology of human outbreaks to further define the environmental contact of primary cases would be of great value.

Animals↗
PubMed1999

Isolated case of Ebola hemorrhagic fever with mucormycosis complications, Kinshasa, Democratic Republic of the Congo.

A patient with undiagnosed Ebola (EBO) hemorrhagic fever (EHF) was transferred from Kikwit to a private clinic in Kinshasa, Democratic Republic of the Congo. A diagnosis of EHF was suspected on clinical grounds and was confirmed by detection of EBO virus-specific IgM and IgG in serum of the patient. During the course of the disease, although she had no known predisposing factors, the patient developed a periorbital mucormycosis abscess on eyelid tissue that was biopsied during surgical drainage; the abscess was histologically confirmed. Presence of EBO antigen was also detected by specific immunohistochemistry on the biopsied tissue. The patient survived the EBO infection but had severe sequelae associated with the mucormycosis. Standard barrier-nursing precautions were taken upon admission and upgraded when EHF was suspected; there was no secondary transmission of the disease.

Adult↗