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1.
New Microbes New Infect ; 3: 21-3, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25755887

RESUMO

We describe the first case of bacteraemia caused by Chromobacterium violaceum in the Democratic Republic of the Congo. This diagnosis was made in an apparently healthy adult who was admitted to a rural hospital of the province of Bandundu with severe community-acquired sepsis. The patient developed multi-organ failure and died; to our knowledge, this is the first reported fatal case in an adult in Africa.

2.
Trop Med Int Health ; 17(9): 1127-32, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22809002

RESUMO

OBJECTIVE: To enable the human African trypanosomiasis (HAT) control program of the Democratic Republic of the Congo to generate data on treatment outcomes, an electronic database was developed. The database was piloted in two provinces, Bandundu and Kasai Oriental. In this study, we analysed routine data from the two provinces for the period 2006-2008. METHODS: Data were extracted from case declaration cards and monthly reports available at national and provincial HAT coordination units and entered into the database. RESULTS: Data were retrieved for 15 086 of 15 741 cases reported in the two provinces for the period (96%). Compliance with post-treatment follow-up was very poor in both provinces; only 25% had undergone at least one post-treatment follow-up examination, <1% had undergone the required four follow-up examinations. Relapse rates among those presenting for follow-up were high in Kasai (18%) but low in Bandundu (0.3%). CONCLUSIONS: High relapse rates in Kasai and poor compliance with post-treatment follow-up in both provinces are important problems that the HAT control program urgently needs to address. Moreover, in analogy to tuberculosis control programs, HAT control programs need to adopt a recording and reporting routine that includes reporting on treatment outcomes.


Assuntos
Cooperação do Paciente/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Tripanossomicidas/uso terapêutico , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/tratamento farmacológico , Adolescente , Adulto , Fatores Etários , Congo , Feminino , Humanos , Masculino , Recidiva , Estudos Retrospectivos , Fatores Sexuais , Fatores Socioeconômicos , Resultado do Tratamento , Tripanossomíase Africana/prevenção & controle , Adulto Jovem
3.
Trop Med Int Health ; 16(7): 869-74, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21447063

RESUMO

OBJECTIVE: About half of the patients with Human African trypanosomiasis (HAT) reported in the Democratic Republic of the Congo (DRC) are currently detected by fixed health facilities and not by mobile teams. Given the recent policy to integrate HAT control into general health services, we studied health seeking behaviour in these spontaneously presenting patients. METHODS: We took a random sample from all patients diagnosed with a first-time HAT episode through passive case finding between 1 October 2008 and 30 September 2009 in the two most endemic provinces of the DRC. Patients were approached at their homes for a structured interview. We documented patient delay (i.e. time between onset of symptoms and contacting a health centre) and health system delay (i.e. time between first contact and correct diagnosis of HAT). RESULTS: Median patient delay was 4 months (IQR 1-10 months, n = 66); median health system delay was 3 months (IQR 0.5-11 months). Those first presenting to public health centres had a median systems delay of 7 months (IQR 2-14 months, n = 23). On median, patients were diagnosed upon the forth visit to a health facility (IQR 3rd-7th visit). CONCLUSIONS: Substantial patient as well as health system delays are incurred in HAT cases detected passively. Public health centres are performing poorly in the diagnostic work-up for HAT, mainly because HAT is a relatively rare disease with few and non-specific early symptoms. Integration of HAT diagnosis and treatment into general health services requires strong technical support and well-organized supervision and referral mechanisms.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/tratamento farmacológico , Adolescente , Adulto , Criança , Pré-Escolar , Diagnóstico Tardio , República Democrática do Congo/epidemiologia , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Saúde Pública , Inquéritos e Questionários , Fatores de Tempo , Tripanossomicidas/uso terapêutico , Tripanossomíase Africana/epidemiologia
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