Dynamics in the Prevalence of Insulin Resistance between 2005 and 2023 in Type 2 Diabetics in South Kivu in the East of the Democratic Republic of Congo: Cross-Sectional Studies

Aim: Sub-Saharan Africa is undergoing an epidemiological transition responsible for a change in the metabolic profile in favour of insulin resistance. The aim of this study was to assess the dynamics of the prevalence of insulin resistance and associated risk factors in diabetic patients in the Democratic Republic of Congo between 2005 and 2023. Method: We measured fasting blood glucose and insulin levels and looked for metabolic syndrome parameters (2009 criteria) in type 2 diabetes patients in 2005-2008 (n = 176) and in 2018-2023 (n = 303). The HOMA model was used to measure insulin sensitivity and islet β-cell secretory function. Results: Between 2005 and 2013, the trend was towards an increase in the prevalence of insulin resistance (from 13.1% to 50.8%;p Conclusion: This present study shows an increase in insulin resistance in Congolese urban areas and a persistence of atypical diabetes mellitus in Congolese rural areas, confirming the particularity of the pathophysiology of the disease in African areas currently influenced by the epidemiological transition. Further studies using an appropriate methodology are required.

Vitamin D, Parathyroid Hormone, Insulin Sensitivity and Islet β-Cell Secretory Function in Diabetic Patients from South Kivu in the Democratic Republic of Congo: Cross-Sectional Study

Background: The role of vitamin D and parathyroid hormone in the metabolic profile of type 2 diabetes mellitus in sub-Saharan Africa has not been adequately assessed. The aim of this study was to determine the prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin sensitivity and β-cell secretory function among Congolese type 2 diabetics. Methodology: Fasting glycaemia, fasting insulin, 25OH D3 and human parathyroid hormone (hPTH) were measured in one hundred and eighty-four type 2 diabetic patients followed as outpatients in South Kivu. Levels of 25OH D3 65 pg/ml defined low vitamin D and elevated parathyroid hormone levels, respectively. The HOMA model was used to measure insulin sensitivity and β-cell secretory function. Results: Medians (IQR) were 25.3 (20.4 - 32.4) ng/ml for 25OH D3 and 53.7 (38.4 - 115.7) pg/ml for hPTH. 58.7% of diabetics had insulin resistance, 126 (68.5%) had low vitamin D and 80 (43.5%) had hyperparathyroidism. In multivariate analysis, hPTH (partial r = −0.28;p = 0.0002) and 25OH D3 (partial r = 0.16;p = 0.03) showed an independent association with insulin sensitivity after adjustment for body mass index and waist circumference. Finally, hPTH (partial r = 0.27;p = 0.0002) was the sole determinant of β-cell secretory function. Conclusions: This study confirms the high prevalence of low vitamin D level and secondary hyperparathyroidism and their association with insulin resistance and impaired islet β-cell secretory function among Congolese with type 2 diabetes mellitus. Vitamin D and calcium supplementation should be envisaged for cases of deficiency in this region.

Epidemiological and Cytopathological Profile of Dysplastic Lesions of the Cervix in South-Kivu/Dr Congo

Background: Cervical cancer is one of the most common cancers in women in the world. The recrudescence of dysplastic lesions is increasing, especially in developing countries, because of the absence of screening. The objective of this work is to determine the prevalence of dysplastic lesions of the cervix in women who are sexually active in South Kivu province. Methods: It was a cross-sectional, descriptive and analytical study of 625 women who came for gynecological consultation, all of whom had cervical-uterine Pap smears, during the period from January 1st, 2017 to December 31st, 2018 at Panzi General Referral Hospital (South Kivu, DR Congo). Data analysis was done using Epi Info software version 7. Results: The median age of the respondents was 34 years, 47.0% of them were married, and 59.0% had a low socio-economic level. The majority had first sexual intercourse between the ages of 15 and 20 (67.5%), a number of former sexual partners estimated at 1 - 5 (87.8%), did not use tobacco (97.4%) and did not use contraception (78.1%). Pap smear was normal in 82.88% of cases, inflammatory in 2.4% of cases and with cytologic abnormalities in 14.72% of cases. Rates of dysplastic lesions were significantly higher among women aged ≥35 years (p = 0.0245), brides (p = 0.0183) and nulliparas (p = 0.0042). Multivariate analysis revealed the adjusted OR (95% CI) statistically insignificant (p < 0.05) for the age group, marital status and parity respondents. Conclusion: Cervical cancer remains a real scourge in the world, especially in sub-Saharan Africa, where the diagnosis is often made when the pathology is at its stage almost incurable. Early detection of dysplastic lesions by Pap smear is therefore imperative in the eradication of this pathology.

Sediment Transport and Its Impacts on Lake Kivu, Gihira Water Treatment Plant and Various Hydropower Plants along Sebeya River in Rwanda

Complex processes of sediment transport in a river impact on overall aquatic system and result in the productivity decrease of socio-economic development projects taking the river as a source of water. The present study was designed to estimate Sebeya river sediment load and assess its impacts on Lake Kivu, Gihira water treatment plant and various hydropower plants constructed in Sebeya catchment located in Western Province of Rwanda. Water samples were hand-collected from five different sampling points along Sebeya river during rainy and dry seasons. Laboratory analysis for turbidity, total suspended solids, sieve analysis for bed load materials and NPK content of water samples were conducted. The results revealed that the average turbidity was found to be high during rainy season compared to dry season. The same trend was found in total suspended solids concentrations. At all 5 sampling sites and during rainy season compared to dry season, the average mass flowrates of bed load materials were 7.84 and 2.96 kg/hr respectively. Sieve analysis results showed that all bed load sediments were mainly composed of high proportions of fine sand of more than 70% which adversely causes damages on hydropower turbines and the effect of high soil erosion rates on Gihira water treatment plant was traduced by high turbidity of raw water and excessive costs of reagents. At Sebeya outlet, nutrients load and high turbidity reduce significantly the aesthetic quality of Lake Kivu, having a harmful impact on recreation and tourism, aquatic life and affect the livelihoods of people living in the vicinity. Researchers recommend two options of reducing the amount of sediment load in Sebeya river: either to prevent soil erosion or to trap eroded sediment at the upstream of the hydropower and the water treatment plants. Assessing the sediment load fluctuations in Sebeya river is useful for water managers and planners to adjust operations accordingly at water treatment and hydropower plants.

Spatio-Temporal Variation of Atmospheric Nutrient Deposition in Different Land Uses/Covers around Lake Kivu

Atmospheric deposition of nutrients, particularly nitrogen and phosphorus has the capacity to significantly affect the productivity and biogeochemistry of aquatic ecosystems. The objective of this study was to assess the impact of land use/cover types on the atmospheric deposition of nutrients around Lake Kivu. Dry and wet atmospheric deposition samples were collected from four different land use/cover types (forest, wetland, agricultural and urbanized area) at four stations (Goma, Lwiro, Bukavu and Iko) around the Lake Kivu basin. The highest annual loading of dry total phosphorus (TP) was recorded at a station located in an urban area at Goma (4.4 ± 3.9 μmol/m2/yr) and the highest dry deposition of total nitrogen (TN) was recorded at Iko (84.5 ± 41.2 μmol/m2/yr). High wet TP and TN were at Bukavu (0.7 ± 1.1 μmol/m2/yr) and Iko (21.7 ± 34.7 μmol/m2/yr) respectively. High dry TP loads were recorded in the forest area of Goma and the highest dry TN at Lwiro. High wet TP loads were record in agriculture at Goma and high values of wet TN in agriculture at Iko. Phosphorus and nitrogen deposition rates around Lake Kivu were similar to those reported for other African lakes. The highest rate of TP was recorded mainly in the forest area for dry deposition while high TN was recorded in all types of land use/cover in the basin. This study found out that forest traps high concentration of nutrient than other land uses/covers.

Screening for Human Immunodeficiency Virus, Hepatitis B, High Blood Pressure, and Diabetes Mellitus in the General Population of South Kivu<br/>—Results of World AIDS Day 2016

Background: It has been well-established that a program to fight HIV can accomplish the same results with noncommunicable diseases (NCDs). Such a strategy has not yet been the subject of a trial in the Democratic Republic of the Congo (DRC). The aim of this study was to test the feasibility of HIV concurrent and respectively other chronic infectious and NCDs in the general population of South Kivu. Methods: Between 1 December 2016 and 15 January 2017, HIV, hepatitis B, high blood pressure (HBP) and diabetes mellitus (DM) were tested in the general adult population ≥ 15 years, respectively, in the towns of Bukavu and Uvira, and the rural areas Nyangezi and Walungu, on World AIDS Day 2016. Previous screening of these diseases has been sought, but the association between them was modeled in a multiple logistic regression. Results: Among the three thousand eight hundred and sixty-three (3863) adult subjects > 15 years (52.1% of men) tested voluntarily, the previous screening and prevalence were 33.8% and 1.2% respectively for HIV, 1.3% and 8.3% for hepatitis B, 18.2% and 25.1% for HBP and 9.5% and 4.8% for DM. The acceptance rate for current screening was significantly higher (p Conclusion: This study did more HIV testing than screens for other diseases. Finally, these problems can be managed (at a reasonable cost) with a view similar to the objectives of the World Health Organization (WHO).

Local Perception on the Exploitation, the Current State and Taboos Related to Pangolins (Pholidota, Mammalia) by the Communities Living in the Tayna Nature Reserve and Its Surroundings (RNT) North Kivu DRC

Pangolins are currently considered the most endangered mammal species due to their high rank in local and international traffic. This species is protected in DRC and worldwide, unfortunately it is threatened by numerous human actions. The objective of this study is to identify the different reasons for which these animals are exploited, to provide information to determine from the opinions of the respondents the current state of the population from 2015 to today and to identify their hunting techniques by the local populations. We carried out surveys in the households of hunters, farmers and people practicing other professions in 12 villages, located within the RNT and surroundings areas. Two interview techniques were used: the individual interview and the participatory diagnostic technique. 175 people were interviewed individually. Nearly 97% of our respondents are motivated to consume pangolin as bush meat obtaining by hunting. The main reason for eating pangolin meat is 44% preference and 33% habit. The zone does not know the foreign solicitation of the exploitation of pangolins and its derivatives. The opinions of the population regarding the current state of pangolin in the Tayna Nature Reserve indicate that from 2015 to the present day the common pangolin “Manis tricuspis” has been abundant. Hunters use different hunting techniques, dominated by pickup for the Manis tricuspis, digging burrow, fire at the entrance of the burrow for Manis gigantea and the shotgun for the Manis tetradactyla.

Major Ions in Atmospheric Deposition in Lake Kivu Basin

This study investigated the major ion composition and sources in wet and dry deposition samples collected over 15 months (December 2017 to February 2019) at four stations representing four different land use/cover types on the western side of Lake Kivu basin in D.R. Congo. The samples were collected every 13 days for dry deposition and two to three times per month for wet deposition. Samples were analyzed for major ionic components (Cl-, NO-3, SO2-4, Na+, K+, NH+4, Ca2+, CO2-3, HCO-3 and Mg2+). Electrical conductivity and pH were analyzed immediately in the field while major ion measurements were in the laboratory. Results showed the pH of both the dry and the wet depositions were higher than what would have been expected based on equilibration with atmospheric CO2 (pH > 5.6) at all four sites, with conductivity less than 50 μS/cm. The neutralization process in dry and wet atmospheric deposition is due to Ca2+, NH+4, HCO-3 and CO2-3. The anion: cation ratio in dry deposition was close to 1 for Iko and Bukavu, and it was greater than 1.0 (1.1 - 1.2) for Lwiro and Goma in wet deposition. The dominant anions in wet deposition were SO2-4 and NO-3, found around the rural area near cement factory and the urban area near active volcanoes, respectively. The most abundant cation was Na+ followed by K+. The enrichment factors and correlation analysis suggest that the main sources of Ca2+, Na+ and Mg2+ were disintegration of soil processes, aeolian suspension of soil and volcanic ash, biomass burning and the cement/lime factory around the Lake Kivu basin.

Multidrug-Resistant Tuberculosis Disease in North-Kivu Province, Democratic Republic of Congo

Introduction: The emergency of Mycobacterium tuberculosis resistant to the first line drug reduced access possibility to second line drugs for appropriate treatment and required for urgent action especially in le Democratic Republic of Congo (DRC), which counts among the highest tuberculosis (TB) burden countries in Africa. Objective: To present prevalence and describe multidrug-resistant tuberculosis cases in North-Kivu Province identified by using Genexpert technology. Methods: We conducted an observational prospective study on multidrug-resistant tuberculosis (MDR-TB) cases in North-Kivu Province, DRC from 2017 to 2018. All cases of MDR-TB identified by Genexpert MTB/ RIB were included in this series. Result: Of 15,544 tuberculosis cases registered during the study period, 19 cases of MDR-TB were identified. 57.9% was male, 89.5% was retreatment cases and 5.3% was coinfection HIV/TB cases. Conclusion: This new molecular technology diagnostic facilitates multidrug-resistance tuberculosis detection and improves the reporting of data lack.

Multiple Cassava Viruses’ Co-Infections and Resurgence of Pests Are Leading to Severe Symptoms and Yield Losses on Cassava in the South-Kivu Region, Democratic Republic of Congo

A survey was completed during the last five years (2014-2018) to update and assess changes in the cassava pests and diseases occurrence as well as to understand how these changes occur regarding the recent new viruses spread under a climate change context in the South-Kivu region, Democratic Republic of Congo. The eight territories of South-Kivu were surveyed during the rainy seasons from 2015 until 2017 except for Uvira and Fizi where data were recorded in 2018 regarding the prevalence of unstable agro ecological factors which may influence pest and diseases dynamic in these two territories. During the data collection, pests and disease incidence and severity were recorded as well as the sampling of cassava leaves for molecular viruses’ detection. The recorded data showed that Cassava mosaic disease (CMD) remains the most encountered disease (75% - 80%) and its vector (the whitefly Bemisia tabaci) the most important pest (10 - 18 adult whiteflies per leaf). The major changes were recorded for Cassava brown streak disease, recently reported in the region, for which a significant increase was recorded, with not reports before 2012 to 70% - 80% incidence in 2018 in the Ruzizi plain area (Uvira and Fizi). Molecular detection revealed a coexistence of both two viruses, the cassava brown streak virus (CBSV) and Ugandan cassava brown streak virus (UCBSV) in single and mixed infections. Co-infections cassava mosaic and cassava brown streak diseases were frequently recorded resulting in severe expression leaves’ symptoms and tuber yields’ losses. Common pests and diseases considered as minor have drastically become serious threat to cassava production by increasing both their incidence and severity values. The cassava bacterial blight (20%), cassava green mite (20% - 70%), cassava mealy bugs and cassava grasshoppers were recorded as a great challenge in relation with an occurrence of long dry season resulting in four consecutive dry months without rain. The high occurrence of CBSD on new CMD-resistant varieties has enforced farmers to recover local CMD-susceptible varieties which revealed a relative CBSD-tolerance and moderate yield losses. This need for virus control is really challenging cassava crop in a region where the diseases pressure is high and people consume cassava and its products seven days a week. Research gaps identified in the study are the need for breeding new varieties with tolerance/resistance to both CMD and CBSD viruses as well as the extensive use of rapid multiplex diagnostic tools to ensure early diagnostic and availability of good quality planting material at farmers’ level.

Towards a Volumetric Variation of Lake Kivu Gases by the Nyamulagira and Nyiragongo Volcanoes

After the volcanic eruption of January 17th, 2002, Goma Volcano Observatory (OVG) initiated carbon dioxide (CO2) monitoring in the fractures south of the Nyiragongo volcano and at the northern edge of Lake Kivu. During the period from March 17th, 2017 to June 10th, 2020, twice a week, a GA 5000 gasometer was used for CO2 in the fractures as well as in the mazukus, respectively, as part of a project funded by the Kingdom of the Netherlands through the Lake Kivu Monitoring Program (LKMP) in Rwanda. The level of volcanic activity was determined by the volume of gas emitted by the volcano and measured by a DOAS and the seismicity measured by a network of 15 seismometers managed by the OVG. The results show that the concentration of CO2 in the active fractures from recent Nyiragongo eruptions varies with volcanic activity and the occurrence of a large earthquake in the East African Rift;but in the mazukus there is almost no relationship between CO2 content and volcanic activity. The study also shows that the influence of carbon dioxide in mazukus on the carbon dioxide into the Lake Kivu waters remains a major research question. The purpose of this study is to establish the relationship between the existing Carbon Dioxide (mazukus) in the Northern watershed and that of the deep waters of Lake Kivu.

The Place of Human Papillomavirus Test in the Screening of Intraepithelial Lesions of Cervix in South-Kivu Province, DR Congo

Introduction: Human papillomavirus (HPV) infection remains the most common cause of cervical intraepithelial neoplasia. The objective of this study is to evaluate the sensitivity and predictive value of the HPV test associated with the cervico-uterine smear in the screening of cervical intraepithelial neoplasia in our environment. Methodology: This is a descriptive cross-sectional study of 625 women who consulted in the department of gynecology for cervical cancer screening, of whom 300 received an HPV test;during the period from January the 1st to December 31st, 2018 at Panzi general reference hospital (South-Kivu, DRC). Data analysis was done using Epi Info version 7 software. Results: For all respondents (n = 625), the cervico-uterine smear was normal in 82.88%, inflammatory in 2.4% of cases and with cellular atypia in 14.72%. The HPV test was positive in 87 respondents against 213 negatives cases, i.e. a prevalence of HPV of 29% [95% CI: 23.9% - 34.5%]. Among women with precancerous lesions, 27.6% had HPV infection;among those with normal smears, 29.3% of them had HPV infection;however, this difference was not statistically significant. Patients with dysplastic lesions, 31.3% had genotypes with very high carcinogenic potential;and for those with a normal Pap smear, 45.1% had genotypes with very high carcinogenic potential;however, this difference was also not statistically significant. Conclusion: The human papillomavirus test remains a very important indication cation in the detection of cervical intraepithelial neoplasia, its sensitivity remaining clearly superior to that of cytology, especially for high grade lesions.

Decision-Making Information System for Academic Careers in Congolese Universities: From Analysis to Design of a Data Warehouse

Universities collect and generate a considerable amount of data on students throughout their academic career. Currently in South Kivu, most universities have an information system in the form of a database made up of several disparate files. This makes it difficult to use this data efficiently and profitably. The aim of this study is to develop this transactional database-based information system into a data warehouse-oriented system. This tool will be able to collect, organize and archive data on the student’s career path, year after year, and transform it for analysis purposes. In the age of Big Data, a number of artificial intelligence techniques have been developed, making it possible to extract useful information from large databases. This extracted information is of paramount importance in decision-making. By way of example, the information extracted by these techniques can be used to predict which stream a student should choose when applying to university. In order to develop our contribution, we analyzed the IT information systems used in the various universities and applied the bottom-up method to design our data warehouse model. We used the relational model to design the data warehouse.