Risk Factors of Bacterial Resistance to Antibiotics in Internal Medicine and Hemodialysis Nephrology Services at the Edith Lucie Bongo Ondimba General Hospital

Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at the Edith Lucie BONGO ONDIMBA general hospital (HGELBO). Patients, material and method: This was an analytical cross-sectional study conducted from January 1 to August 31, 2019 at the HGELBO. It concerned all patients admitted to the HGELBO with positive bacteriological samples. After a study of the sensitivity to isolated species, the patients were divided into two (02) groups: those MRB positive (+) and not MRB or negative (-). Epi Info software version 3.5.1 was used for the calculation of the rates and the comparison of the variables. The adjusted odds ratio (ORa) with a 95% confidence interval was used to measure the specific effect of each risk factor such as chronic kidney disease and diabetes, in order to rule out confounding factors. Multivariate analysis by binomial logistic regression was used. Results: There were 375 bacteriological samples from 258 patients, among them 247 patients with 235 positive samples or 63%. The eleven (11) are healthy patients. The median age was 33 with extremes ranging from 16 to 90. The female sex was predominant with a sex ratio of 0.6. The majority of MRB+ cases were found in internal medicine and nephrology with 12 cases (38.7%) and hemodialysis with 4 cases (12.9%). Urinary samples were in the majority with 74.5%. Escherichia coli was predominant in 30.3%. After studying the sensitivity to antibiotics of the 247 species included, 113 were MRB+ and 134 BMR- i.e. a frequency of 45.7%. Methicilin-resistant Staphylococcus aureus (MRSA) was predominant (51.3%). Multivariate logistic regression analysis showed that the main risk factor was antibiotic use (0Ra: 3.2 [1.9 - 5.4];p-value < 0.01). Chronic renal failure and diabetes were not risk factors for carriage. The other risk factors identified were: hospitalization of more than 7 days (prolonged), S. aureus infection and male sex. Conclusion: Probabilistic antibiotic therapy leads to the selection of BMRs. Long hospital stays, male sex, and MRSA are risk factors or determinants of antibiotic resistance, but not chronic kidney disease.

Knowledge and Practices of Pregnant Women on Malaria Prevention in Brazzaville

Introduction: Since the deployment of preventive measures against malaria in pregnant women in Congo, the coverage rates in Intermittent Preventive Treatment for malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) and Long Lasting Insecticidal Nets (LLINs) remain low compared to the objectives set by WHO. This study aimed to analyze the knowledge and practices of pregnant women in the prevention of malaria in Brazzaville. Population and Method: This is an analytical cross-sectional study, conducted from September 15th to October 30th, 2021. The sample consisted of pregnant women who performed at least three antenatal care consultations one month apart each;obtained from a two-stage random sample. Data were collected from a self-administered questionnaire and analyzed with Epi-Info version 7.2.6 software. The odds-ratios and their 95% confidence intervals were calculated to assess the associations between the variables. Results: A total of 331 pregnant women were selected. The mean age was 27 years (22;31). Most women were single (82.8%), multiparous (63.4%) and 74.9% had secondary level education. The level of knowledge was insufficient in 53.8% of respondents;nearly 64.7% had good preventive practices. Pregnant women with no education are 8 times more likely to have insufficient knowledge of malaria prevention (OR = 8.33 [2.02 - 34.17];p = 0.0036). Also, those whose gestational age is between 22 - 27 weeks are 2.54 times more likely to have insufficient knowledge than those with gestational age of 36 weeks and above (OR = 2.54 [1.33 - 4.46], p = 0.0071). Conclusion: It is important to strengthen the awareness in order to bring pregnant women to improve their knowledge of malaria prevention and change their behavior.

Prevalence of Hepatitis C Virus Infection and Risk Factors among Pregnant Women in Pointe Noire, Republic of Congo

Background: Hepatitis C virus (HCV) is a public health problem and is highly endemic in Sub-Saharan Africa. This study was carried out to determine the prevalence and potential risk factors of hepatitis C virus in pregnant women. Methods: This was a cross-sectional study involving pregnant women who attended at seven antenatal clinics in Pointe Noire, from June to November 2018. Structured questionnaires were used to obtain participants data. Samples were screened for HCV infection by using 4th ELISA methods and data analysis was done by Epi-info version 7.0 statistical software. Results: A total of 150 pregnant women were included, out of which 11 (7.3%) were positive for HCV. The high proportion of HCV was found in age group 25 - 34 years (45.4%), educated (81.1%), professional (36.4%) and 54.6% were in second trimester gestational stage. Moreover, 54.6% of HCV positive patients had scarification and 45.5% had a history of surgery. There was not a statistically significant association between demographics characteristics, risks factors and HCV seropositivity (p > 0.05). Conclusion: This study showed a high prevalence of HCV infection and confirmed that this infection is a public health problem in pregnant women in Pointe Noire.

Burnout among Caregivers in Four Maternities in Brazzaville

Introduction: The professional exhaustion syndrome, also referred to as burnout, combines deep fatigue, disinvestment in professional activity, a feeling of failure and incompetence at work resulting from the chronic constraints suffered by the worker. The purpose of this work is to assess its prevalence among caregivers of the maternity wards in the district hospitals of Brazzaville. Methodology: This is a descriptive cross-sectional study carried out in four maternities of respectively Bacongo, Makélékélé, Mfilou and Talangai hospitals in Brazzaville between February 1st and February 28th, 2021. Socio-demographic and professional characteristics were collected from a sample of midwives and nurses. The level of exhaustion was evaluated using the “Maslach Burnout Inventory” scale defined as “high” when the 3 dimensions are reached, “moderate” when only 2 are reached, and low for any other result. Results: Among the 143 caregivers investigated (62.9%) of respondents declared being in burnout. According to the dimensions of the Maslach Burnout Inventory scale, 53.1% are caregivers are in high emotional exhaustion;53.1% have a high level of depersonalization and 75.5% have a low level of personal accomplishment. Workload (OR = 13.69;[4.28 - 61.27];p Conclusion: In our study, all dimensions of burnout were high. It is therefore a real phenomenon among caregivers in the four maternities of the district hospitals of Brazzaville. The associated factors can be avoided through prevention.