Background Anecdotal reports from DRC suggest that long-lasting insecticidal nets (LLIN) distributed through mass campaigns in DRC may not last the expected average three years. To provide the National Malaria Control Programme with evidence on physical and insecticidal durability of nets distributed during the 2016 mass campaign, two brands of LLIN, DawaPlus® 2.0 and DuraNet©, were monitored in neighbouring and similar health zones in Sud Ubangi and Mongala Provinces. Methods This was a prospective cohort study of representative samples of households from two health zones recruited at baseline, 2 months after the mass campaign. All campaign nets in these households were labelled, and followed up over a period of 31 months. Primary outcome was the “proportion of nets surviving in serviceable condition” based on attrition and integrity measures and the median survival in years. The outcome for insecticidal durability was determined by bio-assay from subsamples of campaign nets. Results A total of 754 campaign nets (109% of target) from 240 households were included in the study. Definite outcomes could be determined for 67% of the cohort nets in Sud Ubangi and 74% in Mongala. After 31 months all-cause attrition was 57% in Sud Ubangi and 76% in Mongala (p = 0.005) and attrition due to wear and tear was 26% in Sud Ubangi and 48% in Mongala (p = 0.0009). Survival in serviceable condition at the last survey was 37% in Sud Ubangi and 17% in Mongala (p = 0.003). Estimated median survival was 1.6 years for the DawaPlus® 2.0 in Mongala (95% CI 1.3–1.9) and 2.2 years for the DuraNet in Sud Ubangi (95% CI 2.0–2.4). Multivariable Cox proportionate hazard models suggest that the difference between sites was mainly attributable to the LLIN brand. Insecticidal effectiveness was optimal for DuraNet©, but significantly dropped after 24 months for DawaPlus® 2.0. Conclusions In the environment of northwest DRC the polyethylene LLIN DuraNet© performed significantly better than the polyester LLIN DawaPlus® 2.0, but both were below a three-year median survival. Improvement of net care behaviours should be able to improve physical durability.

Objective To investigate the availability of and access to opioid analgesics at hospital level in the Democratic Republic of Congo. Methods Exploratory mixed‐method study combining a descriptive survey of the availability of opioid analgesics at hospital pharmacies with a qualitative survey that explored the experiences and perceptions of healthcare workers, managers, patients and caregivers, by means of a short questionnaire and of semi‐structured interviews. The study was conducted in a convenience sample of 12 hospitals, located in five different provinces, in 2021. Results The quality and completeness of stock data for opioid analgesics were generally poor. Stock‐outs were frequent. Only five hospital pharmacies had records on prescriptions of opioids in 2020. In‐patients and caregivers indicated they generally must purchase opioids out‐of‐pocket, sometimes far from the place of residence. Doctors and nurses confirmed that prescribed opioids are often unavailable at the hospital pharmacy. Furthermore, they suggested an important need of training in pain management with opioids, and of effective regulation to ensure opioid availability. Pharmacists and managers recognised important weaknesses in the processes of needs quantification, stock management, planning and supply. Conclusions Our exploratory study suggests the need of a complex set of coordinated actions to be undertaken by all relevant actors in DRC to correct the poor practices in opioids' management and to improve opioids' availability, affordability and adequate use. This will require a change of mindset to overcome the neglect of the health needs of persons with acute and chronic pain.

Background/Aim: The management of pregnant women is a significant public health concern. This study aims to demonstrate the benefits of prenatal gymnastics and psychological support on pain, walking, anxiety, and self-esteem during pregnancy. Methods: A quasi-experimental study was conducted over eight months, from September 2020 to April 2021, with 38 pregnant women participating. They underwent 16 sessions of prenatal gymnastics and psychological support once a week, lasting 45 min at low to moderate intensity. Pain, six-minute walk, anxiety, and self-esteem were measured using the visual analog scale (VAS), the six-minute walk test, the Hospital Anxiety and Depression Scale (HAD Scale), and the Rosenberg scale, respectively. The parametric Student's t-test and chi-square were used to compare quantitative and qualitative variables before and after the program, with P<0.05 considered statistically significant. Results: The study found that the distance traveled (377.45 m vs. 393 m; P=0.001) and VO2max (15.1 ml/kg/m2 vs. 18.5 ml/kg/m2; P=0.001) increased at the end of the program. However, pain (6 vs. 1.16; P=0.001) and walking speed (2.2 m/s vs. 1.9 m/s; P=0.001) decreased. The program also improved self-esteem (low: 55.3% before vs. 0% after; P=0.001, medium: 44.7% before vs. 13.2% after; P=0.001, strong: 0% before vs. 86.8% after; P=0.001) and anxiety (Uncertain anxiety: 31.6% before vs. 97.4% after; P=0.001, Questionable anxiety: 50% before vs. 2.6% after, Certain anxiety: 18.4% before vs. 0% after; P=0.001). Conclusion: Regular prenatal gymnastics and psychological support positively affect oxygen consumption, pain, anxiety, and self-esteem among pregnant women. This program should be provided continuously to minimize pregnancy-related complications.