The present External Quality Assessment (EQA) assessed microscopy of blood parasites among diagnostic laboratories in the Democratic Republic of the Congo. The EQA addressed 445 participants in 10/11 provinces (October 2013–April 2014). Participants were sent a panel of five slides and asked to return a routinely stained slide which was assessed for quality of preparation and staining. Response rate was 89.9% (400/445). For slide 1 (no parasites), 30.6% participants reported malaria, mostly Plasmodium falciparum. Only 11.0% participants reported slide 2 (Plasmodium malariae) correctly, 71.0% reported “malaria” or “Plasmodium falciparum” (considered acceptable). Slide 3 contained Plasmodium falciparum (109/μl) and Trypanosoma brucei brucei trypomastigotes: they were each reported by 32.5% and 16.5% participants respectively, 6.0% reported both. Slide 4 (Trypanosoma) was recognised by 44.9% participants. Slide 5 (Plasmodium ovale) was correctly reported by 6.2% participants, another 68.8% replied “malaria” or “Plasmodium falciparum” (considered acceptable). Only 13.6% of routine slides returned were correctly prepared and stained. The proportion of correct/acceptable scores for at least 4/5 slides was higher among EQA-experienced participants compared to first time participants (40.9% versus 22.4%, p = 0.001) and higher among those being trained < 2 years ago compared to those who were not (42.9% versus 26.3%, p = 0.01). Among diagnostic laboratories in Democratic Republic of the Congo, performance of blood parasite microscopy including non-falciparum species and Trypanosoma was poor. Recent training and previous EQA participation were associated with a better performance.
This study showed high prevalence of respiratory complaints in Congolese informal coltan miners, suggesting the necessity to implement efficient occupational safety measures and regulate this informal mining business.
Hepatitis B and D viruses are responsible for about 2 million deaths annually worldwide. In co-infection with hepatitis B (HBV) and D (VHD) viruses, the prognosis for hepatitis B is exacerbated by HDV. This study aimed at estimating the seroprevalence of hepatitis D among blood donors at Cliniques Universitaires and Hôpital Jason Sendwe in Lubumbashi. Screening for HBsAg was performed using rapid diagnostic tests and then confirmed by the Liaison XL test which was also used for screening for anti-HDV antibodies. Of 200 blood donors who tested positive for HBsAg, only four (2%) tested positive for anti-HDV antibodies. This study has the merit of highlighting, for the first time, HBV-HDV co-infection in Lubumbashi. Hepatitis D should be screened for in all HBsAg carriers with severe or chronic hepatitis in order to allow early management of these patients and thus avoid aggravation of liver disease. The limitations of this study are the lack of data on the course of liver disease, the genotype of HBV and HDV, the viral load of HDV and any current treatments.
Les virus des hépatites B et D sont responsables d’environ 2 millions de décès annuellement dans le monde. Lors de la coïnfection par les virus de l’hépatite B (VHB) et D (VHD), le pronostic de l’hépatite B est aggravé par le VHD. Cette étude voudrait estimer la séroprévalence de l’hépatite D chez les donneurs de sang des Cliniques Universitaires et Hôpital Jason Sendwe de Lubumbashi. Le dépistage de l’AgHBs a été réalisé au moyen des tests de diagnostic rapide puis confirmé par test de Liaison XL qui a été également utilisé pour le dépistage d’anticorps anti-VHD. Sur 200 donneurs de sang testés positifs pour l’AgHBs, seuls quatre (2%) se sont révélés positifs en anticorps anti-VHD. Cette étude a le mérite d’avoir mis en évidence, pour la première fois, la co-infection VHB-VHD à Lubumbashi. L’hépatite D devrait être recherchée chez tous porteurs d’AgHBs présentant une hépatite sévère ou chronique afin de permettre une prise en charge précoce de ces patients et éviter ainsi l’aggravation de la maladie hépatique. Le manque des données sur l’évolution de la maladie hépatique, le génotype de VHB et VHD, la charge virale de VHD et les traitements éventuels en cours constituent les limites de cette étude.
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