Type 2 diabetes mellitus among the elderly in Goma, Democratic Republic of the Congo: prevalence, clinical features and complications

Background and aim: Diabetes is one of the leading non-communicable diseases in the world; diabetes is common in the elderly. The aim of this study is to assess the prevalence, clinical features and complications of type 2 diabetes mellitus among the elderly in the Hôpital Provincial du Nord Kivu in Goma. Subjects and Methods: A cross sectional study was based on data collected among the elderly from 2013 to 2015 in the Department of Internal Medicine. Overall, 418 elders were included. Results: The prevalence of type 2 diabetes mellitus was 8.6% (95% CI: 6.3 to 11.7). Overall, 54% of the elderly were males while 46% were females. Among males, 6.6% were diagnosed with diabetes whereas 11.0% were among females (p less than 0.001). All elderly diabetic subjects (n = 36) were taking anti diabetic drugs such as insulin or oral medications (sulfonylurea and or biguanide). Among those, 15 (41.7%) were on insulin and 21 (58.3%) on oral anti diabetic. Mean fasting glucose was higher among elderly individuals taking oral medications compared with their counterparts on insulin (104.4 versus 157.3 mg/dl, p less than 0.001). The asthenia (86.1%), the polyuria (13.9%), the coma (11.1%) and the polydipsia (5.6%) were the principal symptoms on admission. The infectious, metabolic, micro vascular and macrovascular complications were diagnosed in this study. Conclusion: Our study provides evidence on the high prevalence of type 2 diabetes mellitus among elderly individuals. Moreover, the study found many factors associated with type 2 diabetes mellitus among the elderly and the difficulty of diagnosing diabetes in the elderly. Hence, there is need to enhance the existing prevention programmes with emphasis on social determinants of diabetes, which need to be clarified by broad epidemiological studies at the population level. Keywords: Diabetes; Type 2; Elderly; Goma; Democratic Republic of the Congo

Profil clinique et étiologique de l'infertilité féminine à Goma

Objectif : Une etude visant a degager le profil epidemiologique; clinique et etiologique de l'infertilite chez la femme a ete menee a Goma/RDC et ses environs; de janvier 2006 a decembre 2008.Methodologie : il s'agit d'une etude cas-temoins comparant les femmes consultant pour infertilite et les femmes fertiles (gestantes); au regard des parametres sociodemographiques; medicaux; sexuels; gynecoobstetricaux; chirurgicaux; et cliniques. Les patientes infertiles ont beneficie; en plus de l'examen gynecologique approfondi; d'une exploration systematique par l'HSG; les dosages hormonaux; l'echographie endovaginale et pelvienne. Le chi carre de Pearson ou le test de rapport de vraisemblance; et le test t de Student ont ete mis a profit pour l'analyse statistique des donnees.); de loin le plus preponderant; etait suivi par des troubles ovulatoires (41;0); les facteurs uterin et cervicovaginal etaient relativement moins frequents. L'etiologie etait multifactorielle dans 38;1 des cas. La preponderance du facteur tuboovarien suggere une grande implication des infections genitales dans la survenue de l'infertilite feminine a Goma. Resultats : 105 femmes infertiles et 108 gestantes ont ete examinees en series continues. Les patientes fertiles sont significativement plus jeunes que les patients infertiles (p=0;001). Bien que l'age au debut de l'activite sexuelle ne soit pas different entre les patientes et les gestantes (p=0;67); les patientes infertiles etaient caracterisees par une plus grande mobilite conjugale (p=0;015) et sexuelle (p=0;001); une plus grande frequence des antecedents d'infections genitales (p=0;00) et des interventions chirurgicales pelviennes; et par des symptomes suggestifs des sequelles d'infections genitales. Les facteurs etiologiques suivants ont ete identifies : le facteur tubopelvien (67;6

Health care seeking and financial behaviours of the elderly during wartime in Goma, Democratic Republic of Congo

Background: Health and social services utilisation is seen to be more closely related to age than to other socio-demographic characteristics. Many health problems are known to increase with age and this demographic trend may lead to an increase in the absolute number of health conditions in this population. However, questions are still emerging as to how the elderly seek care in response to their needs in the context of a war-torn region. Objectives: The aim of this study was to determine the behaviour of the elderly in seeking care during a time of conflict. Method: A descriptive cross-sectional study was carried out in the health district Goma, in the Democratic Republic of the Congo (DRC), using a multistage sampling of 500 senior citizens. Eight trained field-workers were deployed in the field where they administered a structured questionnaire. Results: The public health sector was well known and preferred by 186 participants (37.2%), but only used by 16 (3.2%) participants. Financial support received by the elderly came from their own relatives and fellow believers in 33.5% and 20.2% of cases, respectively. Almost 71% of monetary support is the result of begging and unknown sources ­ there is no government involvement whatsoever. Much of the external support that the elderly receive involves support in the form of food. Disease expenses remain a main concern of the elderly themselves. Conclusion: Government support for the elderly in the DRC is non-existent. There is an overuse of private sector and traditional medicine, despite the preference indicated for the public health sector. As a recommendation, a general increase in income-related activities could contribute to alleviating the health state of the elderly in a war situation. Further studies might explore in future the contribution of those results on the health of elders