Objective:To determine the seroprevalence of toxoplasmosis in pregnant women,as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo.Methods:Thirty maternities in Kinshasa we...Objective:To determine the seroprevalence of toxoplasmosis in pregnant women,as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo.Methods:Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate.They were interviewed with a structured questionnaire about known risk factors(age,meat consumption,contact with soil,and presence of cat)and a venous blood sample was taken.Sera were analysed for total immunoglobulins(Ig)by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay.IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity.Results:A total of 781 women were included.Median age was 28 years old(IQR:8.S).And 627women(80.3%;95%CI:77.5-83.1)were found to be positive to total Ig and 17 out of 387(4.4%;95%CI:2.3-6.4)were positive to IgM.IgC avidity was low for 2(11.8%)women,intermediate for 2(11.8%)and high for 13 women(76.4%).There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed.Conclusion:In Kinshasa,toxoplasmosis endemicity is highly prevalent.One woman out of twenty five had a recent toxoplasmosis infection and 20%were not protected against primoinfection,indicating a need for measures to prevent and control toxoplasmosis during pregnancy.展开更多
Background: Confirmatory diagnosis of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) is based on demonstration of parasites by microscopy. However, the sensitivity of routine microscopy methods is ve...Background: Confirmatory diagnosis of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) is based on demonstration of parasites by microscopy. However, the sensitivity of routine microscopy methods is very low, and many cases are missed and left untreated. A clinical study was conducted in the Democratic Republic of the Congo to evaluate the accuracy of improved microscopy methods in diagnosis of HAT. These included examination by fluorescence microscopy (FM) of acridine orange (AO) stained smears of whole blood and smears made following a new procedure for concentrating trypanosomes by selective lysis of red blood cells (RBC). Methodology/Principal Findings: Venous blood was collected from 213 HAT cases, 101 HAT suspects and 95 controls and used to determine the accuracy of four microscopy methods: bright field microscopy of Giemsa-stained thick blood smears, FM of AO-stained thick blood smears, FM of AO-stained thick blood smears prepared after RBC lysis and concentration, and FM of AO-stained thin blood smears prepared after RBC lysis and concentration. The sensitivity of FM using thick blood smears stained with AO was 3 times higher than bright field microscopy using Giemsa-stained thick blood smears [19.7% (95% CI: 14.9% - 25.6%) versus 6.1% (95% CI: 3.6% - 10.2%)]. When the RBC lysis and concentration procedure was included, sensitivity of the test was further enhanced to 23.0% (95% CI: 17.9% - 29.1%) with thick blood smears and 34.3% (95% CI: 28.2% - 40.9%) with thin blood smears. Specificity of all four microscopy methods was 100% (95% CI: 96.1% - 100.0%). However, the miniature anion exchange chromatography technique (mAECT) and capillary tube centrifugation (CTC) method remained more sensitive. Conclusions: These new methods have practical advantages, including shorter staining time, ease of demonstration of parasites, and the possibility of archiving slides. They could, therefore, be alternative methods to improve case detection where concentration procedures such as mAECT or CTC are not performed.展开更多
Objective: To improve knowledge and practice of health staff as well as the availability of material resources for diagnosis and management of schistosomiasis in two endemic provinces of DRC(Kinshasa and Bas-Congo).Me...Objective: To improve knowledge and practice of health staff as well as the availability of material resources for diagnosis and management of schistosomiasis in two endemic provinces of DRC(Kinshasa and Bas-Congo).Methods: Structured interviews were performed using questionnaires with staff from 35 healthcare facilities in 9 health zones(HZ) of Kinshasa and 2 HZ in Bas-Congo.Results: Schistosomiasis was reported to be present in all the included HZ.Health staff knew the most important symptoms of schistosomiasis, but advanced symptoms were more accurately reported in Bas-Congo.Knowledge of symptoms related to schistosomiasis such as anemia(P = 0.0 115) and pollakiuria(P = 0.0 260) was statistically different in both two provinces.Kato-Katz technique and urine filtration were unavailable in both provinces.Parasitological diagnosis was mostly performed using the direct smear method.PZQ was available in 70% of the health facilities, all situated in Bas-Congo.Diagnosis and treatment mostly relied on symptoms and cost more in urban area than in rural.Conclusions: Though knowledge on schistosomiasis among health staff appears sufficient, substantial efforts still must be made to improve the availability of diagnostic tools and treatment in the health facilities in DRC.展开更多
基金Supported by the VLIR UOS Project(Grant N.VLIR:42/FA02000/13/5806),University of Antwerp and University of Kinshasa
文摘Objective:To determine the seroprevalence of toxoplasmosis in pregnant women,as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo.Methods:Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate.They were interviewed with a structured questionnaire about known risk factors(age,meat consumption,contact with soil,and presence of cat)and a venous blood sample was taken.Sera were analysed for total immunoglobulins(Ig)by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay.IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity.Results:A total of 781 women were included.Median age was 28 years old(IQR:8.S).And 627women(80.3%;95%CI:77.5-83.1)were found to be positive to total Ig and 17 out of 387(4.4%;95%CI:2.3-6.4)were positive to IgM.IgC avidity was low for 2(11.8%)women,intermediate for 2(11.8%)and high for 13 women(76.4%).There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed.Conclusion:In Kinshasa,toxoplasmosis endemicity is highly prevalent.One woman out of twenty five had a recent toxoplasmosis infection and 20%were not protected against primoinfection,indicating a need for measures to prevent and control toxoplasmosis during pregnancy.
文摘Background: Confirmatory diagnosis of Trypanosoma brucei gambiense human African trypanosomiasis (HAT) is based on demonstration of parasites by microscopy. However, the sensitivity of routine microscopy methods is very low, and many cases are missed and left untreated. A clinical study was conducted in the Democratic Republic of the Congo to evaluate the accuracy of improved microscopy methods in diagnosis of HAT. These included examination by fluorescence microscopy (FM) of acridine orange (AO) stained smears of whole blood and smears made following a new procedure for concentrating trypanosomes by selective lysis of red blood cells (RBC). Methodology/Principal Findings: Venous blood was collected from 213 HAT cases, 101 HAT suspects and 95 controls and used to determine the accuracy of four microscopy methods: bright field microscopy of Giemsa-stained thick blood smears, FM of AO-stained thick blood smears, FM of AO-stained thick blood smears prepared after RBC lysis and concentration, and FM of AO-stained thin blood smears prepared after RBC lysis and concentration. The sensitivity of FM using thick blood smears stained with AO was 3 times higher than bright field microscopy using Giemsa-stained thick blood smears [19.7% (95% CI: 14.9% - 25.6%) versus 6.1% (95% CI: 3.6% - 10.2%)]. When the RBC lysis and concentration procedure was included, sensitivity of the test was further enhanced to 23.0% (95% CI: 17.9% - 29.1%) with thick blood smears and 34.3% (95% CI: 28.2% - 40.9%) with thin blood smears. Specificity of all four microscopy methods was 100% (95% CI: 96.1% - 100.0%). However, the miniature anion exchange chromatography technique (mAECT) and capillary tube centrifugation (CTC) method remained more sensitive. Conclusions: These new methods have practical advantages, including shorter staining time, ease of demonstration of parasites, and the possibility of archiving slides. They could, therefore, be alternative methods to improve case detection where concentration procedures such as mAECT or CTC are not performed.
基金supported by the World Health Organization(WHO/TDR),project ID A61119
文摘Objective: To improve knowledge and practice of health staff as well as the availability of material resources for diagnosis and management of schistosomiasis in two endemic provinces of DRC(Kinshasa and Bas-Congo).Methods: Structured interviews were performed using questionnaires with staff from 35 healthcare facilities in 9 health zones(HZ) of Kinshasa and 2 HZ in Bas-Congo.Results: Schistosomiasis was reported to be present in all the included HZ.Health staff knew the most important symptoms of schistosomiasis, but advanced symptoms were more accurately reported in Bas-Congo.Knowledge of symptoms related to schistosomiasis such as anemia(P = 0.0 115) and pollakiuria(P = 0.0 260) was statistically different in both two provinces.Kato-Katz technique and urine filtration were unavailable in both provinces.Parasitological diagnosis was mostly performed using the direct smear method.PZQ was available in 70% of the health facilities, all situated in Bas-Congo.Diagnosis and treatment mostly relied on symptoms and cost more in urban area than in rural.Conclusions: Though knowledge on schistosomiasis among health staff appears sufficient, substantial efforts still must be made to improve the availability of diagnostic tools and treatment in the health facilities in DRC.
