Assessing the management of healthcare waste for disease prevention and environment protection at selected hospitals in Kinshasa, Democratic Republic of Congo.

Incineration is the most used healthcare waste (HCW) disposal method. Disease outbreaks due to Ebola virus and SARS-CoV2 require attention to HCW management to avoid pathogens spread and spillover. This study describes HCW management prior to incineration and hospital incinerators performance by analysing bottom ashes from hospitals in Kinshasa, Democratic Republic of Congo. We used semi-structured interviews to capture information on pre-incineration waste management and analysed the chemical composition of 27 samples of incinerator bottom ashes using the energy dispersive X-ray fluorescence. Neither sorting nor waste management measures were applied at hospitals surveyed. Incinerator operators were poorly equipped and their knowledge was limited. The bottom ash concentrations of cadmium, chromium, nickel and lead ranged between 0.61-10.44, 40.15-737.01, 9.11-97.55 and 16.37-240.03 mg kg-1, respectively. Compared to Chinese incinerator performance, the concentrations of some elements were found to be lower than those from China. This discrepancy may be explained by the difference in the composition of HCW. The authors conclude that health care waste in Kinshasa hospitals is poorly managed, higher concentrations of heavy metals are found in incinerator bottom ashes and the incinerators quality is poor. They recommend the strict application of infection prevention control measures, the training of incinerator operators and the use of high-performance incinerators.

Feasibility of iFISH patterns in hematologic malignancies among Congolese patients at Kinshasa University clinics

Objective:To analyze the feasibility of detecting Ph1 in leukemia patients in the Kinshasa University Clinics in the Democratic Republic of Congo,at KU Leuven,Belgium.Methods:Bone marrow and peripheral blood samples with chronic myeloid leukemia,acute myeloid leukemia or acute leukocytes leukemia were obtained from 32 patients in Kinshasa University clinics in the Democratic Republic of Congo and transferred to KU Leuven in Belgium for iFISH feasibility.Ph1 was detected by using a remote analysis of interphase fluorescence in situ hybridization (iFISH).Results:Out of the 32 patients involved in this study,65.6％ (n =21) of the cases were successfully tested,of which 52.4％ (n =11) were iFISH positives for the variant t(9;22)(presence of Ph1) in chronic myeloid leukemia samples and 47.6％ (n =10) negatives in all subtypes of hematological malignancies.However,there was a female predominance in chronic myeloid leukemia samples Phi-positives by iFISH,whereas no sexual influence was observed on acute subtypes of leukemia.Conclusions:iFISH analysis is feasible on samples obtained from remote sites in the Democratic Republic of Congo.However,the optimization of the sample storage is necessary to further improve iFISH's performance.