The last five years, Lubumbashi records the emergence centers of dialysis. We achieved this study to evaluate the risk factors of death for the renal insufficient patients and the economic accessibility to this peak therapy. A cross sectional study based on a random sample of 53 patients has been completed in 2012. The data is analyzed using the SPSS 19.0 software. A significance level of p < 0.05 and Confidence interval fixed to 95%. The Fischer exact test and the odds ratio have been used. The participation rate was 65.4%. The mean age was 49.49 ± 13.30 years old and 60.4% were aged > 50 years old. The sex ratio 0.3 women by men was noted. 83% of patients was private versus other category (p<0.05). 66% are renal insufficient chronic patients versus 34% of recent renal insufficient patients. 90% of patients were diabetic hypertensive. The patients’ monthly income declared was US$ 205 for 52.8% of patients, US $ 525 for 34% patients and US $ 750 for 13.2% of patients versus US $ 1, 270 monthly mean care cost. The deaths are associated statistically with an interruption of the treatment (χ2=9.30, p=0.0022, OR= 8.5) and with the irregularity of treatment (χ2=8.65, p=0.0032, OR=6). Africa in comparison with countries of other continents, to invest in advanced medical equipment is a salutary measure, but the majority of patients are not able to pay the costs of health care. Our results shown that, the dialysis became an ultimate recourse for the renal insufficient patients at Lubumbashi city but the economic accessibility remains a major obstacle. Consequently, it's important to subsidize the health care of these patients.

There is an urgent need for accurate information on the rules of the road for drivers and road users to reduce the mortality and morbidity due to road accidents.

ObjectivesThe continuum of maternal care along antenatal (ANC), intrapartum and postnatal care (PNC) is fundamental for protecting women’s and newborns’ health. The COVID-19 pandemic interrupted the provision and use of these essential services globally. This study examines maternal healthcare utilisation along the continuum during the COVID-19 pandemic in the Democratic Republic of the Congo (DRC).DesignThis is a cross-sectional study using data collected on a survey of 599 households in Lubumbashi, DRC, using stratified random sampling.ParticipantsWe included 604 women (15–49 years) who were pregnant between March 2020 and May 2021.Outcome measuresA structured interview involved questions on sociodemographic characteristics, attitudes regarding COVID-19 and maternal service use and cost. Complete continuum of care was defined as receiving ANC 4+ consultations, skilled birth attendance and at least one PNC check for both mother and newborn. Data were analysed in SPSS using descriptive statistics and multivariable logistic regression.ResultsOne-third (36%) of women who gave birth during the COVID-19 pandemic completed the continuum of maternal healthcare. Factors significantly associated with completing the continuum included higher education (aOR=2.6; p<0.001) and positive attitude towards the COVID-19 vaccination (aOR=1.9; p=0.04). Reasons for not seeking maternal care included lack of money and avoiding COVID-19 vaccination.ConclusionDuring the COVID-19 pandemic, maternal healthcare seeking behaviours were shaped by vaccine hesitancy and care unaffordability in Lubumbashi. Addressing the high cost of maternal healthcare and vaccine hesitancy appear essential to improve access to maternal healthcare.

IntroductionLes patients hospitalisés en Afrique intertropicale sont exposés à un risque des infections nosocomiales. La rareté des données publiées sur le sujet limite l’analyse descriptive de la situation. L’objectif de ce travail était de déterminer l’incidence, les germes en cause et les facteurs de risque des infections nosocomiales urinaires et des sites opératoires à la maternité de l’HGR Katuba de Lubumbashi en République Démocratique du Congo(DRC).MéthodesNous avons réalisé une étude descriptive longitudinale de la période allant du 1er octobre 2014 au 1er Janvier 2015. Notre population d’étude était constituée de 207 femmes ayant séjourné dans cette maternité. La collecte de données était réalisée d’une manière exhaustive.RésultatsL’incidence de ces infections nosocomiales était de 15,5%. Les parturientes ayant passé plus de trois jours à l'hôpital avaient trois fois plus de risque de développer une infection nosocomiale (p = 0,003) tandis que celles qui ont eu un accouchement avec complication avaient quatre fois plus de risque de contracter une infection nosocomiale (p = 0,000). Escherichia coli était l'agent causal le plus isole (38,1%), suivi de Citrobacter freundii (23,8%), Acinobacter baumannii (18, 2%), Staphylococcus aureus (18,2%), Enterococcus feacalis (14,3%) et Pseudomonas aeruginosa (9,1%). L'ampicilline était l'antibiotique le plus prescrit auquel tous les microbes isoles ont été résistants.ConclusionIl faut améliorer des conditions d’hygiène hospitalière; mais aussi une étude ultérieure pour étudier la ressemblance entre les souches des germes de l’environnement et celles trouvés dans les liquides biologiques.

IntroductionThis article analyses the composition of healthcare costs for HIV/AIDS infected patients in a country with limited resources and attempts to identify the factors that influence these costs. The aims are to calculate medical care costs, analysing how they vary depending on patients’ income, and to evaluate the factors explaining healthcare consumption.MethodsThis is a prospective cohort study focusing on patients who were admitted to hospital for a short stay between January 2010 and June 2011, before their integration into a specialised program. The patients were selected randomly. Free consent was obtained from all participants. Data were analysed using the SPSS 19.0 software. The significance threshold was set at 5% and the CI (Confidence Interval) at 95%. We used Kruskal-Wallis tests, Fisher's exact test and multiple linear regression.ResultsWe monitored 209 patients. Their average age was 36.37 years (SD: 8.72). The sex ratio was 0.58 and the women patients were generally younger than the male ones (p=0.011). The overall cost of healthcare amounted to $US 41,922. The cost of Antiretroviral Therapy represented 21.6% ($US 9,045). The price of para-clinical examinations represented 46% ($US 19,136) of the overall cost. The patient's average monthly income was $US 157.40 whereas the average direct cost per patient was$US 201.45. Both monthly income (t=4.385; p=0.0000) and education level (t=3.703 p=0.0003) were statistically significant predictive factors for healthcare consumption. The medical care costs for patients with opportunistic infections were nine times higher than those for patients who presented none. The presence of opportunistic infections increased healthcare consumption by approximately 31$ US (CI 95%: 15-46.9).ConclusionThe average direct cost for patients on each short-term stay was higher than the average monthly income. To be able to access the necessary services, the patients need additional resources, which are derived from various sources. Monthly income and the level of education were both statistically significant predictors for healthcare consumption. The analysis allows us to extend the study by using different analytical accounting approaches such as by case and by pathology.