HIV / AIDS Epidemic in the Democratic Republic of the Congo: Current Level of Key Indicators and Projection by 2030

Kokolomami, Jack Hyyombo Tambwe

doi:10.11648/j.cajph.20180403.16

Cited by 4 publications

(4 citation statements)

References 24 publications

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“…Our study reported a high HIV prevalence of 23.7% among MSM in Kinshasa compared to the prevalence of 1.0% estimated in the general population (Kokolomami and Kayembe, 2018). The HIV epidemic in the Western and Central Africa sub-region presents distinct dynamics compared to the rest of sub-Saharan Africa.…”

Section: Discussioncontrasting

confidence: 53%

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HIV Prevalence and Related Risk Behaviors among Men Who Have Sex with Men in Kinshasa, the Democratic Republic of the Congo

Inungu

Ndeke

Jahanfar

et al. 2019

EUROPEAN J ENV PUBLI

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The purpose of this study was to determine the prevalence of HIV and syphilis and examine the HIV-related behaviors among men who have sex with other men (MSM) in Kinshasa, Congo. A modified snowball sampling was used to recruit the participants. The results showed that among the 401 men studied, 23.7% and 11.2% were infected with HIV and syphilis, respectively. HIV risk behaviors were rampant in this population. In the last 6 months preceding the survey, 83.3% of MSM reported receptive anal sex (RAS) with an average of 7 sexual partners. As high as 37.7% of MSM did not use condoms during the last RAS. About 65.9% (n = 249) reported drinking alcohol before sex. Logistic regression model indicated that being diagnosed with syphilis and not using lubricant were associated with positive HIV test. High-risk behaviors coupled with high prevalence of HIV among MSM underscore the need for the National HIV Control program to design new interventions to prevent HIV transmission from the MSM community into the general population.

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Section: Discussioncontrasting

confidence: 53%

“…The study showed a prevalence of HIV as high as 23.7% among MSM in Kinshasa. This rate is 24 times higher than the prevalence of 1.0% reported in the general population (Kokolomami and Kayembe, 2018). In addition, MSM in Kinshasa were engaged in a wide variety of high-risk behaviors.…”

Section: Discussionmentioning

confidence: 65%

HIV Prevalence and Related Risk Behaviors among Men Who Have Sex with Men in Kinshasa, the Democratic Republic of the Congo

Inungu

Ndeke

Jahanfar

et al. 2019

EUROPEAN J ENV PUBLI

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“…This is consistent with the disproportionate levels of violent conflict in SSA since 2010 [4, 5]. Examples of regions in SSA with a dual burden of HIV and conflict in 2018 include South Sudan, which had a national adult prevalence of 2.5% in 2018 [2] though higher estimates (3.1–6.8%) in conflict affected southern states [6], the Cabo Delgado province of northern Mozambique which was subject to attacks by Islamic extremists in 2018 and had a HIV prevalence of 12.6% in the same year [2], and Maniema province of the eastern Democratic Republic of Congo, which saw clashes between government forces and rebel groups in 2018, had an estimated HIV prevalence of 3.4% compared with a national average of 1.0% [7].…”

Section: Introductionmentioning

confidence: 99%

What drives mortality among HIV patients in a conflict setting? A prospective cohort study in the Central African Republic

Crellen

Ssonko

Piening³

et al. 2019

Confl Health

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BackgroundProvision of antiretroviral therapy (ART) during conflict settings is rarely attempted and little is known about the expected patterns of mortality. The Central African Republic (CAR) continues to have a low coverage of ART despite an estimated 110,000 people living with HIV and 5000 AIDS-related deaths in 2018. We present results from a cohort in Zemio, Haut-Mboumou prefecture. This region had the highest prevalence of HIV nationally (14.8% in a 2010 survey), and was subject to repeated attacks by armed groups on civilians during the observed period.MethodsConflict from armed groups can impact cohort mortality rates i) directly if HIV patients are victims of armed conflict, or ii) indirectly if population displacement or fear of movement reduces access to ART. Using monthly counts of civilian deaths, injuries and abductions, we estimated the impact of the conflict on patient mortality. We also determined patient-level risk factors for mortality and how the risk of mortality varies with time spent in the cohort. Model-fitting was performed in a Bayesian framework, using logistic regression with terms accounting for temporal autocorrelation.ResultsPatients were recruited and observed in the HIV treatment program from October 2011 to May 2017. Overall 1631 patients were enrolled and 1628 were included in the analysis giving 48,430 person-months at risk and 145 deaths. The crude mortality rate after 12 months was 0.92 (95% CI 0.90, 0.93). Our model showed that patient mortality did not increase during periods of heightened conflict; the odds ratios (OR) 95% credible interval (CrI) for i) civilian fatalities and injuries, and ii) civilian abductions on patient mortality both spanned unity. The risk of mortality for individual patients was highest in the second month after entering the cohort, and declined seven-fold over the first 12 months. Male sex was associated with a higher mortality (odds ratio 1.70 [95% CrI 1.20, 2.33]) along with the severity of opportunistic infections (OIs) at baseline (OR 2.52; 95% CrI 2.01, 3.23 for stage 2 OIs compared with stage 1).ConclusionsOur results show that chronic conflict did not appear to adversely affect rates of mortality in this cohort, and that mortality was driven predominantly by patient-specific risk factors. The risk of mortality and recovery of CD4 T-cell counts observed in this conflict setting are comparable to those in stable resource poor settings, suggesting that conflict should not be a barrier in access to ART.

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“…In 2013, the HIV prevalence in the general population of the Democratic Republic of Congo (DRC) was 1.2% [1]. In accordance with the World Health Organization guidelines formalized in 2003, sentinel surveillance (SS) of HIV infection among pregnant women attending antenatal clinics PMTCT Program Data for HIV Surveillance, According to the WHO Criteria Assessment Results (ANC), through an anonymous and unlinked testing (AUT), can be used to estimate the magnitude of such an epidemic, and the tendency of its key indicators [2,3].…”

Section: Introductionmentioning

confidence: 99%

DRC Is Not Ready for Transition from Anonymous Unlinked Sero-surveillance to Using PMTCT Program Data for HIV Surveillance, According to the WHO Criteria Assessment Results

Kokolomami¹

2018

CAJPH

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Since 2003, the Democratic Republic of Congo (DRC) has carried on HIV surveillance through Anonymous Unlinked Testing in Sentinel Surveillance sites (AUT-SS) amongst pregnant women attending Antenatal Clinics (ANC).However, this expensive process raises ethical limitations. In 2013, the World Health Organization (WHO) recommended countries to evaluate the possibility of transitioning from the AUT-SS to surveillance based on data from the routine diagnosis of HIV in Prevention of Mother-To-Child Transmission (PMTCT) programs. The authors carried out this evaluation for DRC. An evaluation of four of the five criteria proposed by the WHO was conducted by following the defined procedure, and comparing with the determined benchmarks, to assess whether DRC can undergo the transition. Data for this assessment were collected in 2013 and 2015 during sentinel surveillance activities. AUT-SS data of 26,301 pregnant women were collected from 60 sentinel sites, while data from PMTCT routine testing were available for 12,291 women. The overall rate of agreement between routine PMTCT and AUT-SS test results (Cohen's Kappa coefficient of agreement) was 0.7% (95% CI: 0.65 -0.76%), the proportion of positive agreement (PPA) was 65.7% (95% CI: 59.8%-71.1%), and the proportion of negative agreement (PNA) was 99.5% (95% CI: 99.4%-99.7%). The level of non-consent bias in the routine screening test was 4.8%, with a ratio of difference in prevalence of 1 to 10. Eighty-three per cent of sentinel surveillance sites also offered PMTCT service, which was discontinued for 34% of them. DRC must still strengthen the robustness of routine HIV testing, the overall rate of access to this test, its permanence/regularity, and the quality of the data collected in routine, before claiming to use the data from the PMTCT program for purposes of HIV surveillance, in lieu of the ANC AUT-SS.

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HIV / AIDS Epidemic in the Democratic Republic of the Congo: Current Level of Key Indicators and Projection by 2030

Cited by 4 publications

References 24 publications

HIV Prevalence and Related Risk Behaviors among Men Who Have Sex with Men in Kinshasa, the Democratic Republic of the Congo

HIV Prevalence and Related Risk Behaviors among Men Who Have Sex with Men in Kinshasa, the Democratic Republic of the Congo

What drives mortality among HIV patients in a conflict setting? A prospective cohort study in the Central African Republic

DRC Is Not Ready for Transition from Anonymous Unlinked Sero-surveillance to Using PMTCT Program Data for HIV Surveillance, According to the WHO Criteria Assessment Results

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