Getting pregnant after infertility management is a more challenging situation in some under equipped sub-Saharan setting. To highlight the determinants of conception without Assisted Reproductive technology (ART) in a...Getting pregnant after infertility management is a more challenging situation in some under equipped sub-Saharan setting. To highlight the determinants of conception without Assisted Reproductive technology (ART) in a low-income area. The current study concerned 2958 patients who sought care for infertility in the University Clinic of Kinshasa et the Centre Medical Edith, from January 2003 to December 2013. For them, any technique of ART was used. Age of patients ranged from 18 to 49 with average of 33.2 ± 5.6 years old. After treatment, 249 (9%) patients conceived (clinical pregnancy). Most of the patients who conceived were less than 36 years, without history of illegal abortions et who suffered from genital infections. The treatments closely associated with conception were antibiotics (73%), hydrotubation (12%) ovulation inductors (11%) and gynecologic surgery (4%). In that setting, ART is a must. Very few infertility problems, apart from infection and its consequences, can get solution.展开更多
Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the ...Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the main pathogen. In our setting, some studies failed to establish the link between tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’ average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more specific (93.3%;CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to invasive investigation, like laparoscopy.展开更多
Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post...Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post abortum or postpartum origin is the most frequent. Worldwide we are witnessing the transition of pathologies: from infectious to non-communicable ones. Objective: To analyze the evolution of infertile couples’ profiles over time to improve management in the future. Setting: University clinic of Kinshasa and a private clinic, the Edith Medical Center. Design: A cross-sectional analytical study. Patients: A total of 4456 patients who sought care for infertility from January 1999 to December 2014 were enrolled. Main Outcome: The evolution of socio-demographic, clinical and paraclinical parameters of infertile couples over time. Results: The average age of female patients was 33.1 ± 5.7 years and it increased by 36 days every year and the male partner by 29 days per year. The average number of cigarette rods consumed decreased by 5% per year. The average intercourse frequency per week decreased by 2% every year. A fifth of patients (21.8%) were obese. And the average BMI increased by 0.04 kg/m2 per year. Tubal occlusion was the main lesion found in hysterosalpingogram and diagnostic laparoscopy. Conclusion: Patients were more and more aged and gaining weight. A part from infection which is the main cause of infertility this day;in the future, infertility care providers will be facing non-communicable diseases, namely obesity.展开更多
The sub-Saharan African region is increasingly becoming urbanized with the creation of an urban ecology that is conducive to the emergence of vector-borne diseases,such as Aedes-borne viral infections.Aedesborne viral...The sub-Saharan African region is increasingly becoming urbanized with the creation of an urban ecology that is conducive to the emergence of vector-borne diseases,such as Aedes-borne viral infections.Aedesborne viral infections pose a threat to urban health in sub-Saharan Africa.The major menacing arbovirus diseases in sub-Saharan Africa include dengue,yellow fever,chikungunya,and Zika,since they have shown(re)emergence in the last decades.In this review,we analyzed the risk factors for the resurgence of these arboviral diseases as well as their epidemiology and burden by studying the literature.The results suggested that the risk of emergence of Aedes-borne viral infections was related to the urbanicity and competence of Aedes,the genetics of these viruses,environmental factors,and the socio-economic conditions of the sub-Saharan population in urban areas.Better public health awareness and appropriate epidemiological and vector surveillance are essential.展开更多
Dynamic complexity is often a characteristic of public health issues;to visualize these problems as a system rather than isolated elements,system dynamics modeling may be an appropriate tool.The dynamic complexity of ...Dynamic complexity is often a characteristic of public health issues;to visualize these problems as a system rather than isolated elements,system dynamics modeling may be an appropriate tool.The dynamic complexity of risk factors for lymphatic filariasis(LF)as an urban vector-borne disease has been addressed using system dynamics methodology.Some causal loop diagrams(CLDs)were designed to display the network of interactions of risk factors for urban transmission of LF and a potential set of public health interventions.A stock and flow diagram was also designed to capture the transmission dynamics as an accumulation and flow system,and a simulation model was built and executed.The system dynamics(SD)methodology is suitable for addressing the dynamic complexity of risk factors for LF in urban settings and is well-suited for public health interventions.展开更多
文摘Getting pregnant after infertility management is a more challenging situation in some under equipped sub-Saharan setting. To highlight the determinants of conception without Assisted Reproductive technology (ART) in a low-income area. The current study concerned 2958 patients who sought care for infertility in the University Clinic of Kinshasa et the Centre Medical Edith, from January 2003 to December 2013. For them, any technique of ART was used. Age of patients ranged from 18 to 49 with average of 33.2 ± 5.6 years old. After treatment, 249 (9%) patients conceived (clinical pregnancy). Most of the patients who conceived were less than 36 years, without history of illegal abortions et who suffered from genital infections. The treatments closely associated with conception were antibiotics (73%), hydrotubation (12%) ovulation inductors (11%) and gynecologic surgery (4%). In that setting, ART is a must. Very few infertility problems, apart from infection and its consequences, can get solution.
文摘Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the main pathogen. In our setting, some studies failed to establish the link between tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’ average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more specific (93.3%;CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to invasive investigation, like laparoscopy.
文摘Background: Infertility is a dramatic situation for a couple, especially in the Sub-Saharan area, known as extremely pro-natalist. Until this day infertility of tubal origin due to infection sexually transmitted, post abortum or postpartum origin is the most frequent. Worldwide we are witnessing the transition of pathologies: from infectious to non-communicable ones. Objective: To analyze the evolution of infertile couples’ profiles over time to improve management in the future. Setting: University clinic of Kinshasa and a private clinic, the Edith Medical Center. Design: A cross-sectional analytical study. Patients: A total of 4456 patients who sought care for infertility from January 1999 to December 2014 were enrolled. Main Outcome: The evolution of socio-demographic, clinical and paraclinical parameters of infertile couples over time. Results: The average age of female patients was 33.1 ± 5.7 years and it increased by 36 days every year and the male partner by 29 days per year. The average number of cigarette rods consumed decreased by 5% per year. The average intercourse frequency per week decreased by 2% every year. A fifth of patients (21.8%) were obese. And the average BMI increased by 0.04 kg/m2 per year. Tubal occlusion was the main lesion found in hysterosalpingogram and diagnostic laparoscopy. Conclusion: Patients were more and more aged and gaining weight. A part from infection which is the main cause of infertility this day;in the future, infertility care providers will be facing non-communicable diseases, namely obesity.
文摘The sub-Saharan African region is increasingly becoming urbanized with the creation of an urban ecology that is conducive to the emergence of vector-borne diseases,such as Aedes-borne viral infections.Aedesborne viral infections pose a threat to urban health in sub-Saharan Africa.The major menacing arbovirus diseases in sub-Saharan Africa include dengue,yellow fever,chikungunya,and Zika,since they have shown(re)emergence in the last decades.In this review,we analyzed the risk factors for the resurgence of these arboviral diseases as well as their epidemiology and burden by studying the literature.The results suggested that the risk of emergence of Aedes-borne viral infections was related to the urbanicity and competence of Aedes,the genetics of these viruses,environmental factors,and the socio-economic conditions of the sub-Saharan population in urban areas.Better public health awareness and appropriate epidemiological and vector surveillance are essential.
文摘Dynamic complexity is often a characteristic of public health issues;to visualize these problems as a system rather than isolated elements,system dynamics modeling may be an appropriate tool.The dynamic complexity of risk factors for lymphatic filariasis(LF)as an urban vector-borne disease has been addressed using system dynamics methodology.Some causal loop diagrams(CLDs)were designed to display the network of interactions of risk factors for urban transmission of LF and a potential set of public health interventions.A stock and flow diagram was also designed to capture the transmission dynamics as an accumulation and flow system,and a simulation model was built and executed.The system dynamics(SD)methodology is suitable for addressing the dynamic complexity of risk factors for LF in urban settings and is well-suited for public health interventions.
