Profile of Multidrug Resistant Bacteria in Bukavu Hospitals and Antimicrobial Susceptibility to Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis and Staphylococcus aureus

Objective: To evaluate the spread of Multidrug-Resistant (MDR) bacterial infections in Bukavu hospitals and test antimicrobial susceptibility patterns of some isolates to usual marketed antibiotics. Methods: The prevalence of MDR strains was determined by using general antimicrobial susceptibility data collected from 3 hospital laboratories. The susceptibility of some isolates to usual antibiotics was processed by agar diffusion method with standard E. coli ATCC8739 and standard antibiotics discs as controls. The tested antibiotics were ampicillin, ceftriaxone, gentamicin, chloramphenicol and ciprofloxacin. Results: At the 3 hospitals, 758 tests were realized in urine, pus, stool, FCV, blood, LCR, split and FU specimens;46 strains were unidentified and 712 strains were identified. Of 712 identified strains, 223 (31.4%) were MDR or XDR strains including Escherichia coli, Klebsiella pneumoniae, Enterobacter, Proteus mirabilis, Salmonella enterica, Pseudomonas aeruginosa, Citrobacter freundii, Morganella morganii, Enterococcus faecalis and E. faecium, Neisseria gonorrohoae, Staphylococcus aureus, coagulase-negative, staphylococci, Streptococcus pneumoniae and Streptococcus pyogenes. Of the infected patients, 36 (21.5%) children were under 16 years and 188 (78.5%) adults were predominately women (58.5%). The susceptibility test showed that all strains but S. aureus were resistant to ampicillin and amoxicillin and ciprofloxacin. Gentamicin, ceftriaxone, and chloramphenicol remain partially active (27% - 80%) against P. mirabilis, E. coli and P. aeruginosa. The resistance is more likely related to strain mutation than to pharmaceutical quality of the antibiotics prescribed. Conclusion: Both data from hospital laboratories and in vitro post-testing findings confirmed the ongoing elevated prevalence of MDR strains in Bukavu. The causes of antibiotic misuse and socio-economic determinants of the phenomenon of resistance should be scrutinized in order to take adequate strategies in the prospective of establishing an effective control system against this threat to overall health. The results of this work on MDR profiles have various implications for the management of infectious diseases. It provides indicators for the surveillance of antimicrobial resistance, practical guidelines for antibiotic susceptibility testing in biomedical laboratories, and guidance for antibiotic therapy.

Mummified Ovarian Pregnancy at the General Reference Hospital of Panzi in Bukavu/DRC: A Case Report

This is a 39-year-old female patient, commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who consulted for desire of maternity after 15 years of infertility. The physical examination showed an abdomen of normal volume, soft and tender in the right iliac fossa. On vaginal touch, the uterus was of normal volume in an anteverted anteflexed position, regular surface with palpation at the right adnexa of a firm mass about 5 cm in diameter, irregular and tender. Free douglas. A diagnosis of infertility of 15 years was retained. Infertility workup showed a normal uterus. Right ovary normal volume, left ovary normal volume. Hysterosalpingography with and without opacification showed signs suggestive of bilateral hydrosalpinx predominating on the right. There was no obvious uterine anomaly. The blood biology did not show anything particular. An exploratory laparoscopy revealed multiple epiplo-tubero-intestinal adhesions. The right trumpet was dilated and adherent to an adnexal mass. A large adhesiolysis allowed the release of the right tube, thus opening the possibility to explore the adnexal mass. The opening of the mass allowed to individualize bony structures corresponding to the forearm with the calcified hand, and other less distinct structures. The latter finding led to the diagnosis of calcified ovarian pregnancy.

Assessment of Acute Poisoning Cases in Emergency Department of the Provincial General Reference Hospital in Bukavu, DR-Congo

Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.

Assessment of Knowledge, Attitude and Practice of the General Population of Bukavu in the Democratic Republic of Congo on Blood Donation and Blood Transfusion

Objective: To assess the knowledge, attitudes and practices regarding blood donation in the general population. Methods: A cross-sectional study was conducted and enrolled 416 people between 18 and 65 years old at random, living in three health zones in the city of Bukavu in eastern DRC. These subjects responded to a questionnaire on knowledge, attitudes and practices regarding blood donation. Results: Our sample consisted of 61.5% men, 70.9% of people from one level of education at the secondary level and 60% unemployed. According to the surveyed subjects blood was considered as a fuel of the body in 44.6% and as a source of life in 44.1%. Sixty-one percent of the population did not know the practice of blood donation;this knowledge differed significantly (p < 0.0001) according to the level of education. 67.1% of people knew that the blood had negative effects and 27.4% did not know where the blood bags were stored. Channels of knowledge about blood donation practices were associations of blood donors (30.9%), awareness campaigns (18.2%), school (17.3%) and media (15.5%), churches (10%), and friends (8.1%). Approximately 85% of subjects who knew blood donation agreed with blood donation and blood transfusion but only 54.9% had donated blood in their lifetime, with a proportion of loyalty to blood donation (31.8%). In the population 59.4% were willing to donate blood. Motivation to donate blood most common (66%) was volunteerism while 19.1% were willing to donate blood for a family member and 12.6% willing to donate blood against money. The reasons for refusal to donate blood identified were fear of contracting diseases especially HIV, lack of information, religious beliefs, the sale of the collected blood by medical staff, and fear of test result for HIV. Conclusion: Factors of refusal to donate blood were identified. Efforts and new strategies tailored to these factors must be developed and implemented to increase blood donation.

SURVEY OF PLANTS USED IN TRADITIONAL MEDICINE AGAINST MALARIA IN BUKAVU AND UVIRA/DR CONGO

Malaria,for its high prevalence and morbidity,is one of the major tropical parasitic diseases,particularly in DR Congo.Its therapy not only uses modem antimalarials,for which many Resistance problems are encountered,but also medicinal plants which are promising sources for new and effective antimalarials.This study was conducted

Rapid Urbanization and Environment Management in Nkafu Municipality, Eastern DR Congo

Rapid and uncontrolled urbanization as well as urban land management are major constraints to land planning in the Democratic Republic of Congo. A household data collection and analysis was carried out in 283 random households in the Nkafu municipality, eastern DR Congo, to assess the local community’s perception of rapid urbanization and its impact on land policy and management of the built landscape. Data of socio-demographics characteristics, rapid urbanization, and environment management data were collected and analyzed using XLStat version 2019. In addition, the study area location map, land use and cover change maps were generated using ArcMap 10.8. Results indicate that landowners are dominant and, build simple houses with unsustainable building materials (i.e. wooden plank) obtained locally. In addition, land management is not appreciated by local communities, due to anarchic construction due to lack of financial resources generating thus an increasing amount of urban waste, which is poorly managed. The study suggests, urban roads renew, building in conformity with urban planning and building regulations, potable water supply and health services availability to improve the study area. Geographic Information Systems (GIS) use, would provide spatial information on land planning in the study area.