Background
Loiasis (Loa loa filariasis) is considered a benign disease and is currently not included in the WHO’s list of Neglected Tropical Diseases, despite mounting evidence suggesting significant disease burden in endemic areas. We conducted a retrospective cohort study to assess the mortality associated with L. loa microfilaremia in southwestern Republic of Congo.
Methods
The cohort included 3329 individuals from 53 villages screened for loiasis in 2004. We compared mortality rates in 2021 for individuals initially diagnosed as with or without L. loa microfilariae 17 years earlier. Data were analysed at the community level to calculate crude mortality rates. Survival models were used to estimate the effect of L. loa microfilaremia on mortality in the population.
Results
At baseline, prevalence of microfilaremia was 16.2%. During 17.62 years of cohort follow-up, 751 deaths were recorded, representing a crude mortality rate of 15.36 (95% Confidence interval [CI], 14.28-16.50) per 1000 person-years. Median survival time were 58.5 years (95% CI, 49.7-67.3) and 39.2 (95% CI, 32.6-45.8), for amicrofilaremic and microfilaremic indiviudals, respectively.
Conclusion
A significant reduction in life expectancy was associated with L. loa microfilaremia, confirming previous observations from Cameroon. This adds to the evidence that loiasis is not a benign disease and deserves to be included in the WHO’s list of Neglected Tropical Diseases.
Patient satisfaction is considered an indicator of quality of care. This study aimed to assess the degree of clients' satisfaction with family planning (FP) services in government health centers in Congo. A cross-sectional study was conducted. A total of 635 clients nested in 27 health facilities were included in the analysis. Satisfaction was defined as "having a good perception of provider technical skills, being satisfied with the service organization and having a general positive appreciation of FP services. Statistical analyses were performed using SPSS v15. Among 635 clients, 57% perceived lack of technical competence in providers, 88% perceived good organization in FP services and 77% declared having general positive appreciation of FP services. Global level of client satisfaction was 42%. In conclusion client satisfaction with FP service was low and strengthening health workers technical competence is crucial. But, as the quality is multidimensional, other aspects especially significant funding investment and quality-assurance interventions must be taken into account. (Afr J Reprod Health 2017; 21[3]:70-75).Keywords: family planning, services, user satisfaction, Congo
RésuméLa satisfaction des patients est considérée comme un indicateur de qualité des soins. Cette étude visait à évaluer le degré de satisfaction des clients avec les services de planification familiale (PF) dans les centres de santé gouvernementaux au Congo. Une étude transversale a été réalisée. Au total, 635 clients nichés dans 27 établissements de santé ont été inclus dans l'analyse. La satisfaction a été définie comme « avoir une bonne perception des compétences techniques du fournisseur, être satisfait de l'organisation des services et avoir une appréciation positive générale des services PF. Les analyses statistiques ont été effectuées à l'aide de SPSS v15. Parmi les 635 clients, 57% ont perçu un manque de compétence technique chez les fournisseurs, 88% ont perçu une bonne organisation dans les services de PF et 77% ont déclaré avoir une appréciation positive générale des services de PF. Le niveau global de satisfaction des clients était de 42%. En conclusion, la satisfaction de la clientèle devant le service de PF était faible et le renforcement des compétences techniques des travailleurs de la santé est crucial. Puisque la qualité est multidimensionnelle, d'autres aspects, en particulier des investissements de financement importants et des interventions d'assurance de la qualité, doivent être pris en compte. (Afr J Reprod Health 2017; 21[3]: 70-75).
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