Roland Muyisa

BACKGROUND AND AIMS: Diabetes mellitus poses a significant public health challenge in Sub-Saharan Africa (SSA), exacerbated by healthcare limitations, socioeconomic disparities and sociocultural factors affecting disease management. Medication adherence is critical for glycaemic control but remains suboptimal in this region. This review synthesises evidence on adherence to antidiabetic medications in SSA, identifies key determinants and suggests strategies to improve adherence. METHODS: A systematic review was conducted following PRISMA 2020 guidelines by searching PubMed, Scopus, Web of Science and African Journals Online for studies published between January 2015 and May 2025. Studies involving diabetic patients in SSA and assessing medication adherence were included. Data were extracted using a standardized form, and methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS: Twenty-six studies with over 6500 participants from 10 SSA countries were included. Adherence rates varied from 13.9% to 84.5%, with most settings reporting moderate to low adherence. Key determinants of non-adherence included socioeconomic barriers, therapy-related factors, health system limitations, and sociocultural influences. CONCLUSION: Effective interventions need to be culturally sensitive and address these multidimensional barriers. Future research should focus on longitudinal and interventional designs.

• Depression affects over half of the diabetic population in the sample. • Older age, low education, low income, alcohol/tobacco use, early diabetes duration, acute complications, and hypertension are major risk factors. • Marriage, higher education, employment, and mid-duration diabetes (5–9 years) confer protective effects. • Clinical interventions should focus on high-risk patients (older, low-income, hypertensive, and alcohol users) for early depression screening and counseling. Depression among patients with diabetes is a major public health problem, but it is not well described in our region. The objective of this survey was to determine the prevalence and identify predictive factors of depression in individuals with diabetes in our region. It was a cross-sectional and analytic study of patients under regular medical consultations at Matanda Hospital. Data collection involved a structured questionnaire covering socio-demographic parameters, clinical characteristics, depression assessment using the PHQ-9, and glycemic control through HbA1c levels. Among 294 diabetic patients, 170 (57.8%) exhibited depressive symptoms. Major risk factors for depression included age ≥45 years, illiteracy, unemployment, low income (<30 USD/month), alcohol use, tobacco use, diabetes duration <5 years, hygiene measures-only therapy, acute complications, and hypertension. Protective factors included age 30–44 years, marriage, university education, employment, diabetes duration 5–9 years, and combined hygiene measures plus oral antidiabetic therapy. Depression was significantly associated with poor glycemic control (HbA1c >6.5%; p=0.0043). There is a high prevalence of depression among patients with diabetes in our region. The implementation of routine screening for depression is necessary to improve the quality of life of patients with diabetes.

Introduction: Hypertension represents a significant public health issue and stands as one of the most prevalent chronic diseases worldwide, affecting both developed and developing nations.Notably, data regarding hypertension in the Democratic Republic of the Congo (DRC) remains scarce.This study sought to evaluate the effects of adherence to antihypertensive medication on the quality of life among hypertensive patients.Method: This study focused on hypertensive patients aged 18 and older in Katwa, Butembo, and Musienene from July 1 to November 1, 2024, involving 211 patients selected by convenience sampling.Inclusion required at least six months of treatment.Health-Related Quality of Life (HRQoL) was measured using the SF-36 scale, and medication adherence was assessed with the MMAS-8.Data were analyzed through descriptive statistics and linear regression to examine the relationship between adherence and quality of life.Results: The findings indicated a non-adherence rate of 56.40% among participants.Furthermore, the mean scores across various dimensions of quality of life were observed to be relatively low, particularly in the domain of general health, which registered a score of 36.11%,indicative of poor quality of life.A significant correlation was identified between high levels of adherence to medication and improvement in specific domains of quality of life, including physical function, social function, physical limitation, and mental health.Conclusion: Hypertensive patients had low treatment adherence, correlating with poor qualityof-life scores, while high adherence was linked to better quality-of-life improvements.

Necrotizing fasciitis (NF) is a severe infection, rare in pediatrics, often challenging to diagnose. An 18-month-old girl presented with fever and swelling after a minor cut. Over six days, her condition worsened, leading to the diagnosis of NF. Surgical debridement revealed extensive necrosis. After intensive care with sugar dressings and broad-spectrum antibiotics, her wound improved significantly. She was discharged after 21 days, emphasizing the importance of hygiene and timely medical care.

BACKGROUND: Early-onset neonatal infections (EONIs) are those infections diagnosed in newborns aged lesser than 72 h and constitute a public health problem in both industrialized and developing countries. The objective of this study was to determine the incidence and identify the risk factors of EONIs in the health facilities of the Katwa Health Zone. METHODS: This was longitudinal and descriptive study of the incidence of hospital-based EONIs from January 1, 2020 to December 31, 2022, in four health facilities of the Katwa Health Zone: Matanda, Wahamahika, and Sainte Famille Hospitals, and the Katwa General Referral Hospital. All newborns aged lesser than 72 h, found in the maternity ward and/or the neonatology department and whose sheets contained the study parameters, were included. EONIs were suspected by clinical symptoms (e.g., fever) and confirmed by laboratory exams (WBC, culture). The following variables were analyzed: Newborn risk factors (gestational age, sex, weight, history) and mother (mother's age, origin, marital status, occupation). The statistical analysis was performed by Epi-INFO version 7. RESULTS: The incidence of intra-hospital EONIs was 3.54%. The risk factors related to the newborn are: gestational age inferior to 37 weeks (OR = 2.84; EFs = 64.79%), weight inferior to 2000 g (OR = 4.99; EFs = 79.96%), history of a premature rupture of membranes (OR: 9.53; EFs = 89.91%), maternal fever (OR = 6, 82; Fes = 85.34%), lower than 4 prenatal consultations (OR = 2.28, EF = 56.14%), APGAR score bellow to 8 (OR = 3.14; EF = 68.13%) and meconial amniotic fluid (OR = 2.74; EFs = 63.50%). Mother's age under 18 was associated with 55.56% (OR = 2.25; EFs = 55.56). CONCLUSION: Refocused antenatal consultations would be of great importance to limit the risks of maternal-fetal infection, a public health challenge.

Breast cancer (BC) is a significant health challenge in Africa, characterized by high incidence, morbidity, and mortality rates. This systematic review aims to identify factors delaying BC diagnosis and treatment, evaluate management outcomes, and highlight the contributing pathways. The study thoroughly searched electronic databases for articles on breast cancer in Africa, focusing on publications in English or French from the past decade. Independent reviewers screened the articles, extracting relevant data according to PRISMA guidelines. Barriers to early detection and management in Africa include poor symptom recognition, limited awareness, financial constraints, fear of diagnosis, and reliance on traditional medicine. Poor outcomes are often linked to advanced disease stages and larger tumor sizes, along with factors like the luminal B subtype and HIV status. Strategies to improve outcomes should focus on raising awareness, enhancing knowledge of hormonal tumor status, and implementing expedited referral pathways for women with concerning symptoms. Urgent measures for early detection and management are essential to address the breast cancer burden in Africa and improve patient outcomes.

INTRODUCTION AND IMPORTANCE: Acute urinary retention (AUR) is uncommon in pediatric and adolescent populations, particularly among females. To highlight the presentation of AUR as a symptom of hematocolpos due to an imperforate hymen in a 15-year-old girl. CASE PRESENTATION: A 15-year-old girl presented with AUR and lower abdominal pain, which led to the diagnosis of hematocolpos. CLINICAL DISCUSSION: This case underscores clinicians' need to consider gynecological conditions in adolescent females with urinary retention. Early diagnosis and prompt surgical intervention are crucial to prevent complications, such as hydronephrosis and renal damage. CONCLUSION: Clinicians should have a heightened awareness of this rare but significant cause of AUR, particularly in patients with a history of primary amenorrhea and cyclic abdominal pain.

Mellitus diabetes is an endocrine trouble characterized by chronic high glycemia caused by a relative or absolute insulin deficiency. It is a public health problem because of its frequency associated with high morbi-mortality. The objective of this research was to determine the frequency of mellitus diabetes in under 15-year-old patients in Butembo Town. it was a cross-sectional descriptive study realized at the University Clinics of Graben from January 1st, 2017 to December 31st, 2021. Between 2017 and 2021, 3,681 children and adolescents were hospitalized at the University Clinics of the Graben Pediatrics Department. Out of them, 49 were diagnosed with mellitus diabetes, which indicates a prevalence of 1.331%. The majority of patients were males, with high frequencies observed between the ages of 2 to 12 years. Common complaints included coma, polyurea-polydipsia, vision troubles, fever, weight loss, and growth retardation. Complications in infants and adolescents with diabetes included retinopathies, neuropathies, coma, infection, and ketoacidosis. The patients were admitted with extreme glycemia, with many suffering from hypoglycemia. Forty-three out of the 49 patients received insulin, and five of them died. Mellitus diabetes in young remains a health problem in Butembo. Effective healthcare must include medical professionals, the population, and the state.

Introduction: Sickle cell disease is an inherited disease of autosomal transmission, clinically recessive and biologically co-dominant, characterized by the presence in red blood cells of an abnormal hemoglobin called hemoglobin S. This study aimed to determine the epidemiological and clinical aspects of sickle cell disease in patients aged 0 to 15 years in the city of Butembo, eastern DR Congo. Methods: It was a descriptive cross-sectional study that spanned a period of 3 years from January 1, 2017 to December 31, 2019. Our sample was extensive. Our population consisted of all patients aged 0 – 15 years hospitalized in the pediatric department of the structure concerned by the study. The data was processed and analyzed by the Epi Info version 7 computer software. Results: The frequency of sickle cell disease found during the years 2017, 2018, and 2019 was 2.01% with a slight male predominance, sexratio of 1.453. The age group between 6 and 10 years was the most found. The study proves that patients presented themselves much more with as a reason for consultation: joint pain followed by mucocutaneous pallor in the proportions of 21.71% and 15.36%, respectively. The hemoglobin level associated with the Emmel test and the blood type and rhesus associated with hemoglobin and white blood cell count were the most commonly requested tests in sickle cell patients in the proportions of 43.03% and 14.63%. Folic acid, hydraa combined with folic acid were more prescribed than other drugs in the proportions of 17.39% and 16.84%. 95% of sickle cell disease followed in hospital were discharged improved, 1.65% were discharged dead, 2.71% remained in the status quo, and 0.54% escaped. Conclusion: Sickle cell disease is common in our community. Despite its frequency and its seriousness, it remains unknown to the public, and this ignorance gives rise to false information and a veil of silence, handicapping its care.

Introduction : les menstruations sont un phénomène physiologique mais souvent entourées de silence, des mythes et des tabous et peuvent faire l’objet de stigmatisation des jeunes filles dans les pays à faible revenu. L’objectif de ce travail est d’évaluer les niveau de connaissance, attitude et pratiques des jeunes filles de 8 à 25 ans en matière de la gestion de l’hygiène menstruelle en ville de Butembo afin d’identifier les opportunités et les contraintes pour la mise en œuvre d’une intervention axée sur la promotion de l’hygiène menstruelle en ville de Butembo. Matériel et méthode : Il s’agit d’une enquête descriptive transversale et transversale dans les institutions scolaires de Butembo, 594 jeunes filles ont participé à l’étude. Résultats et discussion : 13,8% des jeunes filles affirment ne pas savoir de quoi les menstruations s’agissent ou qu’il s’agirait d’un phénomène pathologique. 84,20% sont informées sur les règles avant leur ménarche. Les premières informations sur les menstruations sont données principalement dans un contexte familial et rarement à l’école. 58,20% ont leur ménarche sans savoir pas de quoi il s’agit ; et réagissent par la peur ou se cachent. A chaque cycle, 68,70% de filles ayant déjà eu leur ménarche affirment être gênées ou inquiètes à la période de menstruation. 70,54% des filles ont des interdictions pendant la période de menstruation. 57,7% n’utilisent plus le même type de matériel qu’à leur ménarche à cause du coût du matériel. 6,76% de filles ne se lavent pas les mains après changement du matériel de protection lors des menstruations. Apres usage du matériel de protection lors de la période des menstruations, 39,9% le jettent dans les toilettes, 27,0% l’enterrent, 18,4% le jettent à la poubelle ménagère et 14,7% le brulent. Lorsque le matériel de protection est souillé à l’école ou au lieu de service, 44,1% de filles le ramènent à la maison pour s’en débarrasser, 33,3% s’en débarrassent dans les toilettes. 27,10% des filles affirment faire un changement de leurs activités en période des menstruations ; 12,9% de filles pensent que les menstruations ont un impact sur leur personnalité. Conclusion : le niveau de connaissance des mesures d’hygiène menstruelle est encore faible dans notre milieu. Des mesures pour l’améliorer permettrait de hausser le niveau de santé de la reproduction chez les jeunes filles.

Introduction : les menstruations sont un phénomène physiologique mais souvent entourées de silence, des mythes et des tabous et peuvent faire l’objet de stigmatisation des jeunes filles dans les pays à faible revenu. L’objectif de ce travail est d’évaluer les niveau de connaissance, attitude et pratiques des jeunes filles de 8 à 25 ans en matière de la gestion de l’hygiène menstruelle en ville de Butembo afin d’identifier les opportunités et les contraintes pour la mise en œuvre d’une intervention axée sur la promotion de l’hygiène menstruelle en ville de Butembo. Matériel et méthode : Il s’agit d’une enquête descriptive transversale et transversale dans les institutions scolaires de Butembo, 594 jeunes filles ont participé à l’étude. Résultats et discussion : 13,8% des jeunes filles affirment ne pas savoir de quoi les menstruations s’agissent ou qu’il s’agirait d’un phénomène pathologique. 84,20% sont informées sur les règles avant leur ménarche. Les premières informations sur les menstruations sont données principalement dans un contexte familial et rarement à l’école. 58,20% ont leur ménarche sans savoir pas de quoi il s’agit ; et réagissent par la peur ou se cachent. A chaque cycle, 68,70% de filles ayant déjà eu leur ménarche affirment être gênées ou inquiètes à la période de menstruation. 70,54% des filles ont des interdictions pendant la période de menstruation. 57,7% n’utilisent plus le même type de matériel qu’à leur ménarche à cause du coût du matériel. 6,76% de filles ne se lavent pas les mains après changement du matériel de protection lors des menstruations. Apres usage du matériel de protection lors de la période des menstruations, 39,9% le jettent dans les toilettes, 27,0% l’enterrent, 18,4% le jettent à la poubelle ménagère et 14,7% le brulent. Lorsque le matériel de protection est souillé à l’école ou au lieu de service, 44,1% de filles le ramènent à la maison pour s’en débarrasser, 33,3% s’en débarrassent dans les toilettes. 27,10% des filles affirment faire un changement de leurs activités en période des menstruations ; 12,9% de filles pensent que les menstruations ont un impact sur leur personnalité. Conclusion : le niveau de connaissance des mesures d’hygiène menstruelle est encore faible dans notre milieu. Des mesures pour l’améliorer permettrait de hausser le niveau de santé de la reproduction chez les jeunes filles.