Effectiveness of wetlands as reservoirs for integrated water resource management in the Ruzizi plain based on water evaluation and planning (WEAP) approach for a climate-resilient future in eastern D.R. Congo.

It is widely predicted that climate change's adverse effects will intensify in the future, and along with inadequate agricultural practices, settlement development, and other anthropic activities, could contribute to rapid wetland degradation and thus exert significant negative effects on local communities. This study sought to develop an approach based on the Integrated Water Resource Management (IWRM) in the Ruzizi Plain, eastern Democratic Republic of Congo (DRC), where adverse effects of the climate change are increasingly recurrent. Initially, we analyzed the trends of climate data for the last three decades (1990-2022). Subsequently, the Water Evaluation and Planning (WEAP) approach was employed on two contrasting watersheds to estimate current and future water demands in the region and how local wetlands could serve as reservoirs to meeting water demands. Results indicate that the Ruzizi Plain is facing escalating water challenges owing to climate change, rapid population growth, and evolving land-use patterns. These factors are expected to affect water quality and quantity, and thus, increase pressure on wetland ecosystems. The analysis of past data shows recurrence of dry years (SPI ≤ - 1.5), reduced daily low-intensity rainfall (Pmm < 10 mm), and a significant increase in extreme rainfall events (Pmm ≥ 25 mm). The WEAP outcomes revealed significant variations in future water availability, demand, and potential stressors across watersheds. Cropland and livestock are the main water consumers in rural wetlands, while households, cropland (at a lesser extent), and other urban uses exert significant water demands on wetlands located in urban environments. Of three test scenarios, the one presenting wetlands as water reservoirs seemed promising than those considered optimal (based on policies regulating water use) and rational (stationary inputs but with a decrease in daily allocation). These findings highlight the impact of climate change in the Ruzizi plain, emphasizing the urgency of implementing adaptive measures. This study advocates for the necessity of the IWRM approach to enhance water resilience, fostering sustainable development and wetland preservation under changing climate.

Crop calendar optimization for climate change adaptation in yam farming in South-Kivu, eastern D.R. Congo.

The traditional crop calendar for yam (Dioscorea spp.) in South-Kivu, eastern Democratic Republic of Congo (DRC), is becoming increasingly inadequate given the significant climatic variability observed over the last three decades. This study aimed at: (i) assessing trends in weather data across time and space to ascertain climate change, and (ii) optimizing the yam crop calendar for various South-Kivu agro-ecological zones (AEZs) to adapt to the changing climate. The 1990-2022 weather data series were downloaded from the NASA-MERRA platform, bias correction was carried out using local weather stations' records, and analyses were performed using RClimDex 1.9. Local knowledge and CROPWAT 8.0 were used to define planting dates for yam in different AEZs. Results showed the existence of four AEZs in the South-Kivu province, with contrasting altitudes, temperatures, and rainfall patterns. Climate change is real in all these South-Kivu's AEZs, resulting either in rainfall deficits in some areas, or extreme rainfall events in others, with significant temperature increases across all AEZs. Suitable yam planting dates varied with AEZs, September 15th and 20th were recommended for the AEZ 2 while October 15th was optimal for AEZ 1, AEZ 3, and AEZ 4. However, none of the planting date scenarios could meet the yam water requirements in AEZ1, AEZ3, and AEZ4, since the effective rainfall (Pmm) was always inferior to the plant water demand (ETc), meaning that soil water conservation practices are needed for optimum plant growth and yield in these AEZs. This study does not recommend planting yam during the short rainy season owing to prolonged droughts coinciding with critical growth phases of yam, unless supplemental irrigation is envisaged. This study provided insights on the nature of climate change across the past three decades and suggested a yam crop calendar that suits the changing climate of eastern DRC.

Predictors of Mortality in Adults with Acute Kidney Injury Requiring Dialysis: A Cohort Analysis.

Introduction: Acute kidney injury (AKI) requiring renal replacement therapy is accompanied by considerable mortality. This present study evaluated predictors of mortality at initiation of hemodialysis (HD) in AKI patients in Goma (in the Democratic Republic of the Congo (DRC)). Methods: A single-centre cohort survey evaluated the clinical profile and survival rates of AKI patients admitted to HD in the only HD centre in Goma, North Kivu province (DRC). Data were collected from patients who underwent HD for AKI. Patient demographics, comorbidities, clinical presentation, laboratory tests, and mortality were reviewed and analyzed. The survival study used the Kaplan-Meier curve. Predictors of mortality were evaluated using Cox regression. Results: Of the 131 eligible patients, the mean age was 43.69 ± 16.56 years (range: 18-90 years). Men represented 54.96% of the cohort. The overall HD mortality rate was 25.19% (n = 33). In multivariate analysis, independent predictors of mortality in AKI stage 3 patients admitted to HD were as follows: age ≥ 60 years (adjusted hazard ratio (AHR) = 15.89; 95% CI: 3.98-63.40; p < 0.0001), traditional herbal medicine intake (AHR = 5.10; 95% CI: 2.10-12.38; p < 0.0001), HIV infection (AHR = 5.55; 95% CI: 1.48-20.73; p=0.011), anemia (AHR = 9.57; 95% CI: 2.08-43.87; p=0.004), hyperkalemia (AHR = 6.23; 95% CI: 1.26-30.72; p=0.025), respiratory distress (AHR = 4.66; 95% CI: 2.07-10.50; p < 0.0001), and coma (AHR = 11.39; 95% CI: 3.51-36.89; p < 0.0001). Conclusion: Initiation of hemodialysis with AKI has improved survival in patients with different complications.

Prevalence and Factors Associated with Acute Kidney Injury in Sub-Saharan African Adults: A Review of the Current Literature.

Acute kidney injury (AKI) is a complex condition that can occur in both community and hospital settings and has many aetiologies. These aetiologies may be infectious, toxic, surgical, or related to the different management methods. Although it is a major public health problem worldwide, it must be emphasised that both its incidence and mortality rate appear to be very high in sub-Saharan African (SSA) countries compared to developed countries. The profile of AKI is very different from that of more developed countries. There are no reliable statistics on the incidence of AKI in SSA. Infections (malaria, HIV, diarrhoeal, and other diseases), nephrotoxins, and obstetric and surgical complications are the main aetiologies in Africa. The management of AKI is costly and associated with high rates of prolonged hospitalisation and in-hospital mortality.

Prevalence, Location, and Determinants of Valvular Calcifications in Congolese Patients on Chronic Hemodialysis: A Multicenter Cross-Sectional Study.

Valvular calcifications (VCs) are one of the major cardiovascular complications in patients on chronic hemodialysis (HD) due to its prevalence and predictive morbidity and mortality. The current study assessed the prevalence, location, and risk factors of VC among chronic HD Congolese patients in Kinshasa. This observational study involved three HD centers in Kinshasa between March and August 2016. Consecutive consenting adults on maintenance HD for at least six months were recruited. VCs were defined as a luminous echo on one or more cusps of the aortic or mitral valve. Risk factors of VC were determined by multivariate analysis. Sixty patients (mean age: 52.5 ± 15.9 years) were enrolled. The mean serum calcium and phosphorus were7.9 ± 1.3 mg/dL and 5.7 ± 1.7 mg/dL, respectively. VCs were encountered in 38% of the whole group in aortic and mitral valvular location in 64% and 23%, respectively. Hypertension, age >60 years, tobacco use, and hyperphosphatemia were independently associated with VC. Despite a young age of patients, VCs were a common finding and associated with both traditional and chronic kidney disease-specific risk factors.