IntroductionAdherence of 95% or more to antiretroviral therapy is generally considered necessary for optimal virologic suppression in patients living with HIV/AIDS (PLWHA). In the African context of access followed by low viral load, understand the determinants of poor adherence is essential to improve compliance, optimise virologic suppression and reduce morbidity and mortality.MethodA transversal analytical study referred to was conducted on patients aged at least 18 years on antiretroviral treatment for at least three months. We randomly selected patients and 9 support structures for PLWHA from 63 following more than 100 patients in Kinshasa, from May 2015 to August 2015. The Case Adherence Index (subjective method) and renewal of order (method objective) were used as indicators of compliance. Khi-2 and Student tests were used for comparisons. The determinants of nonadherence were sought in multivariate logistic regression analysis.ResultsOn a global active file of 5724 patients, 400 were included. The median age was 43 years and the sex ratio in favour of the three women. The overall incidence of non compliance was 25%. The prevalence of non-objective compliance was higher than that of non-subjective compliance (29% vs 21%, p=0.01). In multivariate analysis, the payment of the consultation [adjusted OR 1.70 95% CI (1.020 to 2.813), p=0.042], side effects [adjusted OR 2.23 95% CI (1.32 to 3.74), p=0.002] and lack of perception that the missed dose can aggravate the disease [adjusted OR 4.15, 95% CI (1.03 to 16.67), p=0.045] have emerged as determinants of the overall non-adherence.ConclusionThe results are in accordance with what has already been shown. The discrepancy observed between the two methods highlights the importance of access to biological methods. The identified risk factors will through regular evaluation, better identify PLWHA at greater risk of non-compliance and to offer enhanced compliance support.
Background and objective: Strokes represent a significant cause of morbidity and mortality throughout the world. But data relating to this in sub-Saharan Africa is scarce. The objective of this study is to identify traumatic pathologies with CT scan in patients followed in hospitals in Kinshasa, Democratic Republic of Congo.
Methods: descriptive cross-sectional study of data from the medical records of patients having performed a cerebral CT scan covering a period of 24 months at the University Clinics of Kinshasa and at the Biamba Marie Mutombo Hospital. The study parameters are of three kinds, those relating to socio-demographic data (age, sex, date of the CT scan); those relating to the clinical data and the indications for the examination and the CT data.
Results: Among the 717 cases of stroke diagnosed by CT scan, 529 were of the ischemic type while 188 were of the hemorrhagic type (Figure 1). The ischemic stroke / hemorrhagic stroke ratio was 3/1. The demographic transition was very characteristic for all strokes increasing with advancing age 18.4% in the age 0-19 years, 14% in the age group 20-49 years, 27.8%, and 56.6% in age ≥ 60 years. Comparisons of the proportions of ischemic and hemorrhagic strokes by sex and age groups. There was no statistically significant difference in the sex of patients between the types of stroke (P> 0.05) when there was a statistically significant difference in the proportions of hemorrhagic and ischemic strokes between age groups. There was therefore an exponential type curve of the proportions of ischemic-type strokes according to age advancement: the highest frequency at age ≥ 60 years.
Conclusion: strokes are frequent in Kinshasa; they are characterized by a high frequency of ischemic stroke and increase with age.
Key words: Stroke, CT scan, Epidemiological transition hospitals in Kinshasa.
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