Democratic Republic of the Congo (DRC). 5 In Kinshasa, a study conducted in 2000 estimated the prevalence of diabetes to 7% in adults. 6 In Kisantu, a semi-urban area in the DRC, the prevalence of diabetes mellitus was estimated at 4.8% in 2007. 7 In Bukavu, Katchunga et al. reported a prevalence rate of 7.3% in 2012. 8 Background: The prevalence of diabetes mellitus is increasing dramatically in developing countries, where diabetic patients usually present with poor glycaemic control, leading to complications and worsening the prognosis. Aim:The aim of this study was to determine the extent of poor glycaemic control and its determinants in diabetic patients. Setting:The study was conducted in a rural area of the province of Kwilu, Democratic Republic of the Congo.Methods: This research comprised a cross-sectional study involving 300 Type 1 and 2 diabetic patients attending Vanga Evangelical Hospital in the Democratic Republic of the Congo from January 2018 to March 2018. Patients' sociodemographic, clinical and biological characteristics, accessibility to the health structure and treatment were described. The determinants of poor glycaemic control were identified using multivariate logistic regression at the p < 0.05 level of statistical significance. Results:The mean age of participants was 46.9 ± 16.3 years, 68.4% were men, and 62.3% had Type 2 diabetes mellitus. Poor glycaemic control was present in 78% of patients. The independent determinants of poor glycaemic control were tobacco use (adjusted odds ratio [aOR]: 2.01 [1.77-5.20], p = 0.015), the presence of comorbidities (aOR: 2.86 [1.95-6.65], p = 0.007), the presence of a factor contributing to hyperglycaemia (aOR: 2.74 [1.83-3.67], p = 0.014), missing scheduled appointments (aOR: 2.59 [1.94-7.13], p = 0.006) and non-adherence to treatment (aOR: 4.09 [1.35-6.39], p = 0.008). Conclusion:This study shows that more than three-quarters of diabetics undergoing treatment are not controlled, with mainly patient-related factors as the main explanatory factors for this poor glycaemic control. Therefore, the establishment of a therapeutic education programme and wider integration of diabetes care services, mainly at the primary level of the healthcare pyramid, should contribute to improved diabetes treatment.

Good practice on modifiable cardiovascular risk factors is based on good knowledge and a positive attitude. The study aims to assess cardiovascular risk and knowledge, attitudes and practices of hypertensive patients in Kinshasa on modifiable cardiovascular risk factors as well as their associated determinants. We conducted a cross-sectional study with 345 hypertensive patients followed at Monkole Hospital and at Saint-Joseph Hospital in the city of Kinshasa in the Democratic Republic of the Congo from September 2017 to February 2018. The participants were submitted to the WHO-Steps survey. Cardiovascular risk was assessed by the number of deleterious risk factors present in patients. Descriptive and inferential analyzes were performed. The statistical significance threshold was set at p<0.05. The average age of the participants was 62.1±11.2 years with a gender ratio of 1.1 in favor of women. In total, 61%, 56% and 60% of our respondents had, respectively, a low level of knowledge, a bad attitude and an insufficient practice on modifiable cardiovascular risk factors. Good knowledge was statistically significantly linked to education, the medical profession as a source of information, and employment. Only age ≥ 60 years was significantly associated with the right attitude in our patients while good practice was linked to the level of education. The majority of participants (80.3%) had a high cardiovascular risk. Poor knowledge (p: 0.032) and insufficient overall practice (p<0.001) were significantly associated with high cardiovascular risk. The present study showed that hypertension was associated with a high Cardiovascular risk underpinned by a low level of knowledge, a bad attitude and insufficient practice on modifiable cardiovascular risk factors. Therefore, education programs and strategies to positively influence attitudes and practices are essential to reduce the impact of cardiovascular disease and its risk factors in our environment.