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ObjectivesTo study the prevalence and risk markers of diabetes mellitus and intermediate hyperglycaemia (IH) in Kisantu, a semirural town in Bas-Congo province, The Democratic Republic of Congo.DesignA cross-sectional population-based survey.SettingsA modified WHO STEPwise strategy was used. Capillary glycaemia was measured for fasting plasma glucose and 2-h-postload glucose. Both WHO/IDF (International Diabetes Federation) 2006 and American Diabetes Association (ADA) 2003 diagnostic criteria for diabetes and IH were used.Participants1898 subjects aged ⩾ 20 years.ResultsResponse rate was 93.7%. Complete data were available for 1759 subjects (86.9%). Crude and standardised (for Doll and UN population) prevalence of diabetes were 4.8% and 4.0–4.2%. Crude IH prevalence was 5.8% (WHO/IDF) and 14.2% (ADA). Independent risk markers for diabetes (p<0.01) were male (OR 2.5), age 50–69 years (OR 2.6), family history (OR 3.5), waist (OR 4.1) and alcohol consumption (OR 0.36). In receiver operating characteristic (ROC) analysis, prediction of diabetes was slightly better by waist than body mass index (BMI). IH defined according to WHO/IDF was associated with BMI (OR 2.6, p<0.001). IH defined according to ADA was associated (p<0.05) with waist (OR 1.4), education level (OR 1.6), BMI (OR 2.4) and physical activity (OR 0.7).ConclusionsCurrent prevalence of diabetes in DR Congo exceeds IDF projections for 2030. The lower glucose threshold used by ADA almost triples impaired fasting glucose prevalence compared to WHO/IDF criteria. The high proportion of disorders of glycaemia made up by IH suggests the early stages of a diabetes epidemic.

BackgroundThe problem of access to medical information, particularly in low-income countries, has been under discussion for many years. Although a number of developments have occurred in the last decade (e.g., the open access (OA) movement and the website Sci-Hub), everyone agrees that these difficulties still persist very widely, mainly due to the fact that paywalls still limit access to approximately 75% of scholarly documents. In this study, we compare the accessibility of recent full text articles in the field of ophthalmology in 27 established institutions located worldwide.MethodsA total of 200 references from articles were retrieved using the PubMed database. Each article was individually checked for OA. Full texts of non-OA (i.e., “paywalled articles”) were examined to determine whether they were available using institutional and Hinari access in each institution studied, using “alternative ways” (i.e., PubMed Central, ResearchGate, Google Scholar, and Online Reprint Request), and using the website Sci-Hub.ResultsThe number of full texts of “paywalled articles” available using institutional and Hinari access showed strong heterogeneity, scattered between 0% full texts to 94.8% (mean = 46.8%; SD = 31.5; median = 51.3%). We found that complementary use of “alternative ways” and Sci-Hub leads to 95.5% of full text “paywalled articles,” and also divides by 14 the average extra costs needed to obtain all full texts on publishers’ websites using pay-per-view.ConclusionsThe scant number of available full text “paywalled articles” in most institutions studied encourages researchers in the field of ophthalmology to use Sci-Hub to search for scientific information. The scientific community and decision-makers must unite and strengthen their efforts to find solutions to improve access to scientific literature worldwide and avoid an implosion of the scientific publishing model. This study is not an endorsement for using Sci-Hub. The authors, their institutions, and publishers accept no responsibility on behalf of readers.

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Purpose: To determine frequency of headache and associated eye conditions in patients from D R Congo. Methods: A case‐control study was performed between April and September 2004 and inluded patients seen at an ophthalmologic clinic in the city of Kinshasa. Cases were all consecutive new patients with headache detected during the study period. Controls were all other patients seen in the same ophthalmologic clinic. Data were collected from 476 patients by medical examination and interview. Ocular examination included measurement of visual acuity, refraction, slit lamp examination and fundoscopy. Other examinations were performed when needed. Results: There were 102 patients with headache (cases) and 374 patients without headache (controls), giving a frequency of patients with headache of 22%. Mean age was 39 years±14 for cases and 41 years±19 for controls (P=0.32). There were more female compared to male in cases (71%) than controls (55%)(P<0.0001). Eye conditions were found in 91 (89%) cases and 357 (95%) controls (P=0.018). Cases were more likely to have asthenopia than controls (15% vs 6%, P=0.006). There was no differences between cases and controls in the distribution of ametropia (20% vs 16%, P=0.39), presbyopia (30% vs 21%, P=0.07), pterygium (5% vs 4%, P=0.69). There were no significant differences between cases and controls in the distribution of hypertension, sinusitis and diabetes. The commonest locations of headache in cases were diffuse, the frontal, temporal areas. Conclusions: Ocular examination could be necessary in patients with headaches.