Inconclusive results with HIV serodiagnosis algorithms, and HIV-1 and HIV-2 co-infection in North-eastern Democratic Republic of Congo

Background:Inconclusive serodiagnosis of HIV infection is particularly frequent in Central Africa. The aims of this study were to: (i) determine the rate of inconclusive results with the two-test algorithm that the WHO proposed in 1997 (WHO II) versus the three-test algorithm (revised in 2012 and consolidated in 2015 by WHO) for HIV testing, and (ii) determine the prevalence of HIV-1 and HIV-2 co-infection in the north-eastern region of the Democratic Republic of the Congo (DRC).Methods:A multicentre cross-sectional study was performed between March and June 2016 in Kisangani and Bunia, the capital cities of Tshopo and Ituri provinces respectively. Alere Determine HIV-1/2 (Alere Medical Co. Ltd., Japan), Uni-GoldTM HIV (Trinity Biotech Manufacturing Ltd., Ireland) and recomLine HIV-1 and HIV-2 IgG (Biosynex, France) were the first, second and third tests in the serial algorithm.Results : The rate of inconclusive results was 1.1% (95% CI: 0.4 to 3.1) with the two-test algorithm and 0.4% (95% CI: 0.1 to 2.1) with the three-test algorithm (p less than 0.001). The prevalence of HIV-1 and HIV-2 co-infection among HIV positive sera was 16.7% (95% CI: 4.7 to 44.8).Conclusion:The three-test algorithm HIV testing strategy significantly reduces the rate of inconclusive results. In addition, the prevalence of HIV-1 and HIV-2 co-infection is higher in a context where HIV-2 infection is poorly documented. Large-scale research is essential to clarify these results

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