We aimed to determine hepatitis B virus (HBV) prevalence and risk factors for health care workers (HCWs) to contract HBV infection in a referral hospital in the Democratic Republic of Congo. From October 2015 to August 2016, we recruited 97 HCWs (55 males and 42 females, aged 41.2 ± 10 yr) from Kisantu St. Luke's Hospital, a Congolese referral hospital located in the province of Kongo Central. Serum samples were assayed for HBV markers using ELISA. A questionnaire was used to record the HCWs' demographics, medical histories, and risk factors. The overall prevalence of exposure to HBV infection [HBsAg+, and/or hepatitis B core antibody (anti-HBc)+] was 56.7% (55/97). HBsAg positivity was found in 18.6% (18/97) of the HCWs whereas 29.9% (29/97) were anti-HBc positive. Approximately 8.2% (8/97) of the HCWs tested positive for both HBsAg and anti-HBc. Being a physician [odds ratio (OR)=2.8 (95% CI: 1.34-12.23)], a laboratory technician [OR=3.35 (95% CI: 1.35-5.21)], and having multiple sex partners [OR=3.05 (95% CI: 1.13-9.09)] were found to be factors associated with HBV infection. Exposure to HBV is common among HCWs at Kisantu St. Luke's Hospital. Isolated HBsAg was also prevalent among them. There is a high risk that HBV could be spread to others. Therefore, there is an urgent need for HBV screening, treatment, and vaccination policies.
To evaluate the clinical accuracy of rapid diagnostic tests for the detection of Ebola virus.We searched MEDLINE®, Embase® and Web of Science for articles published between 1976 and October 2021 reporting on clinical studies assessing the performance of Ebola virus rapid diagnostic tests compared with reverse transcription polymerase chain reaction (RT-PCR). We assessed study quality using the QUADAS-2 criteria. To estimate the pooled sensitivity and specificity of these rapid diagnostic tests, we used a bivariate random-effects meta-analysis.Our search identified 113 unique studies, of which nine met the inclusion criteria. The studies were conducted in the Democratic Republic of the Congo, Guinea, Liberia and Sierra Leone and they evaluated 12 rapid diagnostic tests. We included eight studies in the meta-analysis. The pooled sensitivity and specificity of the rapid tests were 86% (95% confidence interval, CI: 80-91) and 95% (95% CI: 91-97), respectively. However, pooled sensitivity decreased to 83% (95% CI: 77-88) after removing outliers. Pooled sensitivity increased to 90% (95% CI: 82-94) when analysis was restricted to studies using the RT-PCR from altona Diagnostics as gold standard. Pooled sensitivity increased to 99% (95% CI: 67-100) when the analysis was restricted to studies using whole or capillary blood specimens.The included rapid diagnostic tests did not detect all the Ebola virus disease cases. While the sensitivity and specificity of these tests are moderate, they are still valuable tools, especially useful for triage and detecting Ebola virus in remote areas.Évaluer la précision clinique des tests de diagnostic rapide pour dépister le virus Ebola.Nous avons exploré les bases de données MEDLINE®, Embase® et Web of Science à la recherche d'articles, publiés entre 1976 et octobre 2021, qui évoquaient des études cliniques mesurant les performances des tests de diagnostic rapide du virus Ebola comparés à une réaction en chaîne par polymérase après transcription inverse (RT-PCR). Nous avons déterminé la qualité de ces études à l'aide des critères QUADAS-2. Enfin, pour estimer la sensibilité et la spécificité regroupées de ces tests de diagnostic rapide, nous avons eu recours à une méta-analyse bivariée à effets aléatoires.Nos recherches nous ont permis d'identifier 113 études uniques, dont neuf correspondaient aux critères d'inclusion. Ces études avaient été menées en Guinée, au Libéria, en République démocratique du Congo et en Sierra Leone, et portaient sur douze tests de diagnostic rapide. Nous avons inclus huit études dans notre méta-analyse. La sensibilité et la spécificité combinées des tests rapides s'élevaient respectivement à 86% (intervalle de confiance de 95%, IC: 80–91) et 95% (IC de 95%: 91–97). Néanmoins, la sensibilité combinée baissait à 83% (IC de 95%: 77–88) après retrait des valeurs aberrantes. Lorsque l'analyse se limitait aux études utilisant la RT-PCR d'altona Diagnostics en guise de référence, la sensibilité combinée augmentait jusqu'à 90% (IC de 95%: 82–94). Elle atteignait même 99% (IC de 95%: 67–100) quand l'analyse se limitait aux études basées sur des échantillons de sang total ou capillaire.Les tests de diagnostic rapide pris en compte ne détectaient pas tous les cas de maladie à virus Ebola. Néanmoins, en dépit d'une sensibilité et d'une spécificité modérées, ils demeurent de précieux outils, en particulier pour le triage et le dépistage du virus Ebola dans les zones reculées.Evaluar la precisión clínica de las pruebas diagnósticas rápidas para la detección del virus del Ébola.Se realizaron búsquedas en MEDLINE®, Embase® y Web of Science de artículos publicados entre 1976 y octubre de 2021 que informaran sobre estudios clínicos en los que se evaluara el rendimiento de las pruebas diagnósticas rápidas para detectar el virus del Ébola en comparación con la reacción en cadena de la polimerasa con retrotranscripción (RT-PCR). Se evaluó la calidad de los estudios mediante los criterios QUADAS-2. Para estimar la sensibilidad y la especificidad combinadas de estas pruebas diagnósticas rápidas, se utilizó un metanálisis bivariante de efectos aleatorios.La búsqueda identificó 113 estudios singulares, de los que nueve cumplían los criterios de inclusión. Los estudios se realizaron en la República Democrática del Congo, Guinea, Liberia y Sierra Leona y evaluaron doce pruebas diagnósticas rápidas. Se incluyeron ocho estudios en el metanálisis. La sensibilidad y la especificidad agrupadas de las pruebas rápidas fueron del 86 % (intervalo de confianza del 95 %, IC: 80-91) y del 95 % (IC del 95 %: 91-97), respectivamente. Sin embargo, la sensibilidad agrupada disminuyó al 83 % (IC del 95 %: 77-88) tras eliminar los valores atípicos. La sensibilidad agrupada aumentó al 90 % (IC del 95 %: 82-94) cuando el análisis se restringió a los estudios que utilizaban la RT-PCR de altona Diagnostics como criterio de referencia. La sensibilidad agrupada aumentó al 99 % (IC del 95 %: 67-100) cuando el análisis se restringió a los estudios que utilizaban muestras de sangre total o capilar.Las pruebas diagnósticas rápidas incluidas no detectaron todos los casos de enfermedad por el virus del Ébola. Aunque la sensibilidad y la especificidad de estas pruebas son moderadas, siguen siendo herramientas valiosas, sobre todo útiles para el triaje y la detección del virus del Ébola en zonas remotas.تقييم الدقة السريرية لاختبارات التشخيص السريع للكشف عن فيروس الإيبولا.قمنا بالبحث في MEDLINE® و Embase® و Web of Science عن المقالات المنشورة بين 1976 وأكتوبر/تشرين أول 2021 التي تشير إلى الدراسات السريرية، التي تقيّم أداء اختبارات التشخيص السريع لفيروس الإيبولا، بالمقارنة مع النسخ العكسي لتفاعل البوليميراز المتسلسل ( RT–PCR ). قمنا بتقييم جودة الدراسة باستخدام معايير QUADAS-2 . لتقدير الحساسية والخصوصية المجمعة لهذه الاختبارات التشخيصية السريعة، قمنا باستخدام التحليل التلوي للتأثيرات العشوائية المزدوجة.حدد بحثنا 113 دراسة فريدة، تسعة منها حققت معايير الاشتمال. تم إجراء الدراسات في جمهورية الكونغو الديمقراطية وغينيا وليبيريا وسيراليون، وقامت بتقييم اثني عشر اختبارًا تشخيصيًا سريعًا. قمنا بتضمين ثماني دراسات في التحليل التلوي. كانت الحساسية والخصوصية المجمعة للاختبارات السريعة 86% (بفاصل ثقة مقداره 95%: 80 إلى 91) و95% (بفاصل ثقة مقداره 95%: 91 إلى 97)، على الترتيب. ومع ذلك، انخفضت الحساسية المجمعة إلى 83% (بفاصل ثقة مقداره 95%: 77 إلى 88) بعد إزالة القيم المتطرفة. انخفضت الحساسية المجمعة إلى 90% (بفاصل ثقة مقداره 95%: 82 إلى 94) عندما اقتصر التحليل على الدراسات التي تستخدم RT-PCR من altona Diagnostics باعتبارها معيار ذهبي. انخفضت الحساسية المجمعة إلى 99% (بفاصل ثقة مقداره 95%: 67 إلى 100) عندما اقتصر التحليل على الدراسات التي تستخدم عينات دم كاملة أو شعيرية.لم تكتشف الاختبارات التشخيصية السريعة المُضمّنة جميع حالات الإصابة بمرض فيروس الإيبولا. في حين أن حساسية وخصوصية هذه الاختبارات معتدلة، إلا أنها لا تزال أدوات ذات قيمة كبيرة، ومفيدة بشكل خاص لفرز واكتشاف فيروس الإيبولا في المناطق النائية.评估埃博拉病毒快速诊断检测法的临床准确性。.我们搜索了 MEDLINE®、Embase® 和 Web of Science 上于 1976 年至 2021 年 10 月期间发表的文章，这些文章报道了埃博拉病毒快速诊断检测与实时逆转录聚合酶链反应 (RT–PCR) 相比的效果评估。我们采用 QUADAS-2 标准评估了研究的质量，并且采用双变量随机效应元分析来评估这些快速诊断检测的综合敏感性和特异性。.我们搜索了 113 项研究，其中有九项符合纳入标准。这些研究是在刚果民主共和国、几内亚、利比里亚和塞拉利昂开展的，研究评估了十二种快速诊断检测方法。我们在元分析中纳入了八项研究。快速检测的综合敏感性和特异性分别为 86%（95% 置信区间，CI: 80–91）和 95% (95% CI: 91–97)。但是，在去除离群值之后，综合敏感性降至 83% (95% CI: 77–88)。当分析限定于将采用来自 altona Diagnostics 公司的 RT–PCR 检测作为黄金标准的研究时，综合敏感性增至 90% (95% CI: 82–94)。当分析限定于采用全血标本或末梢采血标本的研究时，综合敏感性增至 99% (95% CI: 67–100)。.纳入的快速诊断检测并未检测出所有埃博拉病毒病例。尽管这些检测在敏感性和特异性方面表现一般，但仍然是有价值的工具，尤其适用于偏远地区的埃博拉病毒分诊和检测。.Оценить клиническую точность экспресс-тестов для диагностики вируса Эбола.Авторы провели поиск в базах данных MEDLINE®, Embase® и Web of Science статей, опубликованных в период с 1976 г. по октябрь 2021 г., в которых сообщалось о клинических исследованиях, оценивающих эффективность экспресс-тестов для диагностики вируса Эбола по сравнению с полимеразной цепной реакцией с обратной транскрипцией (ОТ-ПЦР). Авторы оценивали качество исследования с использованием критериев QUADAS-2. Для оценки совокупной чувствительности и специфичности диагностических экспресс-тестов авторы использовали двумерный метаанализ случайных эффектов.Поиск выявил 113 уникальных исследований, девять из которых соответствовали критериям включения. Исследования проводились в Гвинее, Демократической Республике Конго, Либерии и Сьерра-Леоне, в которых оценивались двенадцать диагностических экспресс-тестов. Авторы включили восемь исследований в метаанализ. Совокупная чувствительность и специфичность экспресс-тестов составила 86% (95%-й ДИ: 80–91) и 95% (95%-й ДИ: 91–97) соответственно. Однако совокупная чувствительность снизилась до 83% (95%-й ДИ: 77–88) после удаления выбросов. Совокупная чувствительность увеличилась до 90% (95%-й ДИ: 82–94), когда анализ был ограничен исследованиями с использованием ОТ-ПЦР от altona Diagnostics в качестве главного стандарта. Совокупная чувствительность увеличилась до 99% (95%-й ДИ: 67–100), когда анализ был ограничен исследованиями с использованием образцов цельной или капиллярной крови.Включенные диагностические экспресс-тесты не выявили всех случаев болезни, вызванной вирусом Эбола. Хотя чувствительность и специфичность этих тестов умеренные, они по-прежнему являются ценными инструментами, особенно полезными для сортировки больных и диагностики вируса Эбола в удаленных районах.
Summary: Malaria is one of the most prevalent and deadliest illnesses in the Sub-Saharan Africa. Despite recent gains made towards its control or elimination in past decades, many African countries still have endemic malaria transmission. Therefore, the search for novel disease control strategies and approaches are in progress. This study aimed to evaluate household malaria burden in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory water, sanitation and hygiene (WASH) action. Methods: Mixed method study was conducted in two semi-rural towns, Mbanza-Ngungu (WASH action site) and Kasangulu (control site), involving 625 households (3,712 individuals). Baseline and post-intervention surveys were conducted; an action research consisting of six-month prospective study was carried out which comprised two interventions: (1) community participatory WASH action and (2) anti-malaria education campaign. The latter was implemented in both study sites. In addition, rapid diagnostic test (RDT) for malaria was performed in respondents. Findings: Prevalence of positive malaria RDT among respondents decreased (38% vs. 20%) at WASH-action site, whereas it increased at the control site but not significantly. Of 96% of respondents who reported at least one malaria event occurring in the previous six-month period, only 66.5% of them received malaria care at a health setting. At household level, long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%), followed by mosquito repellent (15%), indoor residual spraying (IRS) (2%), LLIN-IRS combination (2%); however, 24% of households did not use any measures. Mean household malaria incidence decreased in WASH action site; 2.3±2.2 cases vs. 1.2±0.7 cases, whereas no significant change was noted in control site. Moreover, malaria incidence rate was highest (60.9%) among households living in proximity to grassy and stagnant water spots. Proximity to high risk area (grassy/stagnant water spots) for malaria (ORa=5.13; 95%CI: 2-29-8.07; p<0.001), poor WASH (ORa=4.10; 95%CI: 2.11-7.08; p<0.001), and low household income (ORa=2.37; 95%CI: 1.05-3.12; p<0.05) were determinants of household malaria. Interpretation: Findings suggest the necessity to scale up the fight against malaria by integrating efficient indoor and outdoor preventive measures, including WASH intervention in residential environment, and improve malaria care accessibility.Funding Statement: This work was supported in part by JSPS KAKENHI Grant Number JP 17H04675.Declaration of Interests: The authors have no conflict of interest related to this study.Ethics Approval Statement: Prior to implementing this research, informed consent from was obtained from each household head, and ethical approval was also obtained from the School of Public Health of the University of Lubumbashi and the Faculty of Medicine of William Booth University in DRC. All medical procedures performed in this study were in accordance with the Helsinki declaration regarding the use of human subjects in research.
Shigella remains one of the most common causes of diarrhoea in South Asia. Current estimates of the prevalence of Shigella are critical for guiding control measures. We estimated the prevalence of Shigella species and serogroups in South Asia.We performed a systematic review using PubMed, EMBASE, Google Scholar and Web of Science for peer-reviewed studies published between 2000 and 19 June 2022. We also manually searched the reference lists of the reviewed studies to identify additional studies. We included studies that detected the presence of Shigella in stool by culture or polymerase chain reaction (PCR). Studies associated with outbreaks were excluded. Two investigators independently reviewed the studies, extracted the data and performed quality assessment. A random-effects meta-analysis was performed to determine the pooled prevalence of Shigella.Our search yielded 5707 studies, of which 91 studies from five South Asian countries were included in the systematic review, 79 in the meta-analysis of Shigella prevalence and 63 in the meta-analysis of Shigella serogroups prevalence. The pooled prevalence of Shigella was 7% [95% confidence interval (CI): 6-7%], with heterogeneity (I2 = 98.7; P < 0.01). The prevalence of Shigella was higher in children aged <5 years (10%; 95% CI: 8-11%), in rural areas (12%; 95% CI: 10-14%) and in studies using PCR (15%; 95% CI: 11-19%). Shigella flexneri (58%) was the most abundant serogroup, followed by Shigella sonnei (19%), Shigella boydii (10%) and Shigella dysenteriae (9%). Shigella flexneri 2a was the most frequently isolated serotype (36%), followed by serotype 3a (12%), serotype 6 (12%) and serotype 1b (6%). The prevalence of non-typeable Shigella was 10.0%.Although the prevalence of Shigella in South Asia remains generally high, it varies by age group and geographical area, with data lacking in some countries. Effective Shigella vaccines would be advantageous for both endemic communities and travellers.
Over the past few decades, the Japanese Ministry of the Environment has been biomonitoring dioxins in the general Japanese population and, in response to public concerns, has taken measures to reduce dioxin exposure. The objectives of this study were to assess the current dioxin dietary intake and corresponding body burden in the Japanese and compare Japanese dioxin data from 2011 to 2016 and 2002–2010 surveys. We also examined the relationship between blood dioxins and health parameters/clinical biomarkers. From 2011 to 2016, cross-sectional dioxin surveys were conducted on 490 Japanese (242 males and 248 females, aged 49.9 ± 7.6 years) from 15 Japanese prefectures. Blood (n = 490) and food samples (n = 90) were measured for 29 dioxin congeners including polychlorinated dibenzo-para-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and coplanar polychlorinated biphenyls (Co-PCBs) using gas chromatography coupled with high-resolution mass spectrometry. Using the 2006 World Health Organization toxic equivalence factors, the toxic equivalents (TEQs) were calculated. Clinical biomarkers and anthropometric parameters were also measured and information on lifestyle behaviours collected. Data imputations were applied to account for blood dioxins below the detection limit. The median (95% confidence interval or CI) blood levels and dioxin dietary intake was respectively 9.4 (8.8–9.9) pg TEQ/g lipid and 0.3 (0.2–0.4) pg TEQ/kg body weight/day. The median blood dioxin level in the 2011–2016 survey was found to have decreased by 41.3% compared to the 2002–2010 surveys. Participants who were older were found to be more likely to have higher dioxin levels. Blood dioxins were also significantly associated with body mass index, triglycerides, docosahexaenoic acid, eicosapentaenoic acid, and dihomo-gamma-linoleic acid levels in blood. Furthermore, associations between blood dioxin and dietary dioxin intake were evident in the unadjusted models. However, after adjusting for confounders, blood dioxins were not found to be associated with dietary dioxin intake. Blood dioxin levels declined over the past decade. This study showed that the measures and actions undertaken in Japan have possibly contributed to these reductions in the body burden of dioxins in the Japanese population.
Abstract Strain KK2020170 T , a Gram-stain negative, yellow colony-forming bacterium, was isolated from surface seawater sampled in Kojima Bay, Okayama, Japan. Phylogenetic analysis based on the 16S rRNA gene revealed that strain KK2020170 T belongs to the genus Flavobacterium , with Flavobacterium haoranii LQY-7 T (98.1% similarity) being its closest relative, followed by Flavobacterium sediminis MEBiC07310 T (96.9%) and Flavobacterium urocaniciphilum YIT 12746 T (96.0%). Whole-genome shotgun sequencing showed that strain KK2020170 T , when paralleled with F. haoranii LQY-7 T , had 81.3% average nucleotide identity, and 24.6% in silico DNA–DNA hybridization values, respectively. The DNA G + C content of strain KK2020170 T was 31.1 mol%. The most abundant fatty acids (> 10%) of strain KK2020170 T were iso-C15: 0, iso-C17: 0 3-OH and iso-C15: 1 G. The dominant respiratory quinone of the strain was menaquinone MK-6. Based on the phylogenetic and phenotypic analysis results, we propose that strain KK2020170 T represents a novel species, for which the name Flavobacterium okayamense sp. nov. has been proposed. The type strain is KK2020170 T (= ATCC TSD-280 T = NBRC 115344 T ).
Cholera cases have increased globally across the Eastern Mediterranean, Africa, Southeast Asia, and parts of Europe since early 2024. This study aims to identify cholera hotspots and understand the spatial distribution of cholera in Kolkata and surrounding regions, a key cholera reservoir. Additionally, we examine sociodemographic factors and aspects related to water, sanitation, and hygiene (WASH).
Environmental and occupational exposure to high dust levels are known to be associated with lung function impairment. We assessed the ambient air quality in the working environment and the respiratory health of female stone quarry workers in Lubumbashi, Democratic Republic of Congo (DRC) in a context of severe economic, security, and health crises.This was a case-control study conducted in three stone quarry sites. Participants were 256 dust-exposed female stone quarry workers matched to 256 unexposed female office workers and market tax collectors (N = 512). They each answered a structured respiratory health questionnaire and underwent physical examination and a lung function test with the use of a spirometer and peak flow meter. Quality of ambient air in the working environment was assessed by means of a BRAMC air quality monitor (BR-AIR-329).Results showed that exposed women did not use any personal protective equipment (PPE); in quarry sites, abnormally high levels of PM2.5 (205 ± 13.2 μg/m3 vs. 31.3 ± 10.3 μg/m3 in control sites; p < 0.001) and volatile organic compounds (VOC, 2.2 ± 0.2 μg/m3 vs. 0.5 ± 0.3 μg/m3, respectively; p < 0.01) were found. Furthermore, respiratory complaints were more common among exposed women (32.4% vs. 3.5% in controls; p < 0.01), who had abnormal chest auscultation and reduced lung capacity than controls (mean PEFR: 344.8 ± 2.26 and 405 ± 67.7 L/s, respectively; p < 0.001 Conclusion. Findings from this study show that in the midst of severe crises in the DRC, women stone quarry workers are exposed to abnormally high levels of respiratory hazards, which contribute to impaired lung function. There is a need to regulate quarry work and improve the working conditions in quarry sites in the DRC.
Abstract Background Malaria is one of the most prevalent and deadliest illnesses in sub Saharan Africa (SSA). Despite recent gains made towards its control or elimination in past decades, many African countries still have endemic malaria transmission. Thus, the search for disease control strategies is indispensable. This study aimed to assess malaria burden at household level in Kongo central province, Democratic Republic of Congo (DRC), and the impact of community participatory water, sanitation and hygiene (WASH) action. Methods Mixed method research was conducted in two semi-rural towns, Mbanza-Ngungu (WASH action site) and Kasangulu (WASH control site) between July 2017 to March 2018, involving 625 households (3,712 individuals). Baseline and post-intervention malaria surveys were conducted in 2017 and 2018, respectively, using the World Bank/WHO Malaria Indicator Questionnaire. In addition, an action research consisting of a six-month (September 2017 - February 2018) prospective study was carried out which comprised two interventions: (1) a community participatory WASH action aiming at eliminating mosquito breeding sites in the residential environment and a (2) community anti-malaria education campaign. The latter was implemented at both study sites. In addition, baseline and post-intervention rapid diagnostic test (RDT) for malaria was performed among respondents. Furthermore, a six-month prospective hospital-based epidemiological study was simultaneously conducted using records of patients admitted at health settings located at both study sites. Results Prevalence of positive malaria RDT among respondents decreased significantly at WASH-action site (38% vs. 20%; p < 0.05), but no significant change was observed at the WASH control site. There were 96% of respondents (heads of households) who reported at least one malaria event occurring in the previous six-month period, only 66.5% of them received malaria care at a health setting. At household level, long-lasting insecticide-treated net (LLIN) was the most commonly used preventive measure (55%), followed by mosquito repellent (15%), indoor residual spraying (IRS) (2%), LLIN-IRS combination (2%); however, 24% of households did not use any measures. Mean household malaria incidence decreased at the WASH action site; 2.3 ± 2.2 cases vs. 1.2 ± 0.7 cases (p < 0.05), whereas no significant change was noted in control site. Moreover, malaria incidence rate was highest (60.9%) among households living in proximity to grassy and/or stagnant water spots. Low household monthly income (ORa = 2.37; 95%CI: 1.05–3.12; p < 0.05), Proximity to high risk area (grassy/stagnant water spots) for malaria (ORa = 5.13; 95%CI: 2-29-8.07; p < 0.001), poor general WASH status in residential area (ORa = 4.10; 95%CI: 2.11–7.08; p < 0.001) were determinants of household malaria. Furthermore, data collected from referral health settings showed high malaria frequency, 67.4% (1,108/1,645) occurring during the first semester of 2017, including 772 (70%) of pediatric malaria cases and 336 (30%) of cases from Internal medicine departments. Conclusion Findings from this research suggest the necessity for DRC government to scale up the fight against malaria by integrating efficient indoor and outdoor preventive measures, including WASH intervention in residential environment, and improve malaria care accessibility to reduce malaria burden. This would be a step towards achieving universal health coverage (UHC) in the Congo.
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