Primary healthcare training in the Democratic Republic of the Congo

Family medicine is a relatively new discipline in the Democratic of the Congo. It was developed under South­South and Churches Collaboration with the aim of responding in a cost-efficient manner to the crisis of health practitioners in mostly Christian and protestant hospitals based in rural areas in the Democratic Republic of the Congo.

Frequency and determinants of ocular trauma in the Kimpese Rural Health Zone, Kongo Central, Democratic Republic of Congo

Context and objective. Ocular trauma is very common and its etiological factors vary by region and age group. This study aims to describe the magnitude and determinants of ocular trauma complications in rural areas. Methods. We conducted a retrospective study of patients admitted for ocular trauma at Kimpese Hospital between January 2014 and December 2016. Univariate logistic regression was used to assess the determinants of ocular trauma complications. The statistical significance level is p˂ 0.05. Results. A total of 223 patients were included. The majority of participants were men (69.5%), over 18 years of age (70%), with poor visual acuity (57.8%) and bilateral ocular involvement (51.1%). Plant objects (44.8%) and metal objects (15.2%) were the most common traumatic agents. After treatment, an improvement in visual acuity was observed in 64.3% of patients with previously poor visual acuity (p < 0.001). The delay of care > 7 days [aOR: 2.286 (95% CI: 1.302-4.012), p=0.004] and the poor visual acuity on admission [aOR: 5.906 (95% CI: 3.231-10.796), p< 0.0001] emerged as determinants of the onset of complications. Conclusion. Awareness-raising efforts for early consultation after ocular trauma and integration of eye care at the primary level should be promoted for efficiency in care

Active management of third stage of labour, post­partum haemorrhage and maternal death rate in the Vanga Health Zone, Province of Bandundu, Democratic Republic of the Congo

Background: Post-partum haemorrhage (PPH) is the single largest cause of maternal death worldwide and a particular burden for developing countries. In Africa, about 33.9 % of maternal deaths are due to PPH. In the Democratic Republic of the Congo (DRC), the prevalence of PPH is unknown. PPH can be prevented with active management of the third stage of labour (AMTSL). Objectives: To describe the practice of AMTSL in Vanga Health Zone and to calculate the incidence of PPH in Vanga Health Zone. Method: An intervention study with post-test-only design was conducted among health maternity wards using a data collection sheet to obtain information. All pregnant women attending Vanga Health maternity wards constituted the study population. Frequencies were determined for variables of interest. Results: From April 2007 to March 2008, 6339 deliveries took place at Vanga Health maternity wards, representing 71% of the institutional delivery rate. The number of deliveries realised with the practice of (AMTSL) were 5562; 366 cases of PPH were reported, making an incidence of 5.77%. Three cases of maternal deaths ­ two of which were related to PPH ­ were reported during the study period, which means there was a decline of 70% compared with the previous two years. Conclusion: The prevalence of PPH has been estimated to be 5.77%; PPH represents the cause of 67% of all maternal deaths. The extension of AMTSL practice, combined with the assurance of better supplies of oxytocin to enhance drug management, is strongly advised/suggested. As a number of births still take place outside the health maternity wards, the introduction of oral misoprostol could be considered a part of AMTSL for use by patients being treated by traditional midwives