Orapuh Journal

Identification of predictive biological markers of maternal-fetal complications in patients with severe preeclampsia

Dophie Beya Tshibuela — 2025-08-28

Introduction

Preeclampsia (PE) is a serious pregnancy complication associated with significant risks for both mothers and fetuses. Identifying biological markers that predict adverse outcomes is essential for improving clinical management and outcomes in severe preeclampsia.

Purpose

This study aimed to identify blood and urine biological markers that are strongly associated with maternal-fetal complications among women with severe preeclampsia.

Methods

A total of 204 pregnant women hospitalized for severe preeclampsia were included. Demographic, clinical, and laboratory data were collected. Univariate and multivariate logistic regression analyses were performed to determine biological predictors of maternal-fetal complications.

Results

The mean age of participants was 28 ± 6.7 years, with 53.8% being primiparous. A history of preeclampsia was present in 19.2% of patients, and 63.5% had chronic hypertension. The median gestational age at diagnosis was 32 weeks (range: 28–36 weeks). Overall, 53.8% of patients experienced complications, most commonly retroplacental hematoma (14.4%), eclampsia (11.5%), and acute renal failure (10.6%). Biological markers significantly associated with maternal-fetal complications were uric acid > 6 mg/dl (p = 0.006), AST > 40 IU/L (p = 0.017), creatinine ≥ 1.3 mg/dl (p = 0.037), proteinuria ≥ 3 g/24h (p = 0.023), and ACR ≥ 30 (p = 0.023). After multivariate adjustment, three markers remained independently associated with complications: uric acid > 6 mg/dl (ORa: 2.26; 95% CI: 1.05–4.87), AST > 40 IU/L (ORa: 2.43; 95% CI: 1.02–5.76), and ACR ≥ 30 (ORa: 2.95; 95% CI: 1.21–7.19).

Conclusion

Preeclampsia remains a complex condition requiring vigilant monitoring. Elevated uric acid, AST, and ACR were identified as independent predictors of maternal-fetal complications and may serve as valuable markers for risk stratification. These findings support the integration of biomarker assessment into management strategies, while future research should evaluate additional markers and personalized protocols to improve maternal and perinatal outcomes.

A review of nurse educators’ knowledge and perceptions of climate change and its implications for nursing care

Tshegofatso P. Mogotlane — 2025-08-29

Introduction

Climate change is rapidly becoming a global challenge, posing increased risks to human health. The United Nations has set a target to take urgent action to combat climate change and to strengthen educational institutions by incorporating climate change education into their curricula by 2030. This initiative is supported by the Intergovernmental Panel on Climate Change. Although nurses are at the forefront of managing health impacts related to climate change, little is known about the extent to which climate change is incorporated into their training on environmental education.

Purpose

This review aimed to explore the knowledge and perceptions of nurse educators regarding climate change and its implications for nursing care.

Methods

A systematic search strategy was applied to identify articles focusing on nurse educators' understanding of climate change and its effects on nursing care. Databases searched included ProQuest Central, PubMed, ClinicalKey, EBSCOhost, Scopus, Web of Science, Sage Journals, and Google Scholar. The search yielded 431 articles published between 2014 and 2024. Of these, 14 articles met the inclusion criteria and were analysed using content analysis.

Results

The review of 14 studies revealed that 87% of nurse educators acknowledged climate change as a global concern, but only 42% reported confidence in teaching its health impacts. Five major themes emerged: (1) acknowledgment of climate change as a global phenomenon, (2) scientific knowledge and understanding of climate change education, (3) integration of content into curricula, (4) perceptions of climate change and its impact on health among nurse educators, and (5) barriers to incorporating climate change education into nursing curricula. Nurse educators’ global health experience and interest enhanced their perception of the relevance of climate change to nursing education.

Conclusion

Climate change poses significant challenges in terms of resource availability, curriculum integration, and educator readiness. There is an urgent need for competency building, curriculum reform, and resource development to prepare nurses for climate-related health challenges. Interdisciplinary collaborations, standardized guidelines, and frameworks that support the integration of climate change content into nursing education are recommended.

Prevalence of HIV status disclosure among young adolescents on antiretroviral therapy in Johannesburg, South Africa

Tafadzwa Mhakakora — 2025-08-30

Introduction

Disclosure of HIV status is crucial for effective management and support among adolescents on antiretroviral therapy (ART).

Purpose

This study aimed to assess the prevalence of HIV status disclosure and its associations with various factors among adolescents aged 10–14 years on ART.

Methods

This quantitative, descriptive study analysed secondary data from 281 adolescents aged 10–14 years on ART across thirteen public clinics. Participants were selected using convenience sampling. Key variables included disclosure status, gender, age, ART duration, attendance at support groups, clinic adherence, and viral load. Data were analysed using IBM SPSS (version 25), employing chi-square tests and t-tests, with a significance level set at p < .05.

Results

The findings revealed that only 26.3% of participants had fully disclosed their HIV status. Full disclosure was significantly associated with clinic adherence (p = .002) and support group attendance (p < .05). However, no significant correlation was found between disclosure and viral load suppression (p = .886).

Conclusion

The low prevalence of full HIV status disclosure underscores the urgent need for targeted interventions to enhance disclosure practices. Strengthening caregiver training and aligning health policies with the psychosocial development of adolescents are critical steps to improve health outcomes and provide effective support for this vulnerable population.

Kidney biopsies in Kinshasa: Epidemiology and histopathology

Rive LUKUAKU Buanza — 2025-09-02

Introduction

Renal biopsy (Renal Puncture Biopsy, RPB) is essential for the diagnosis and prognosis of kidney disease. However, it is rarely performed in African countries, particularly in French-speaking regions, despite its importance for assessing disease progression and guiding treatment.

Purpose

To determine the epidemiological and histopathological profiles of kidney biopsies in Kinshasa from 2020 to 2022.

Methods

This retrospective cross-sectional study was conducted across various laboratories in Kinshasa and covered the period from January 2020 to December 2022.

Results

Among the 1,642 biopsies performed between 2020 and 2022 at Kinshasa University Clinic (KUC), Nganda Center (NC), and the National Institute for Biomedical Research (NIBR), only 51 were renal biopsies, representing 2% (n = 51). The most represented age group was 38–47 years (35%). Men accounted for 67.7% of cases. Nephrotic syndrome was the most common clinical indication (39.2%). Segmental and focal hyalinosis predominated histologically, accounting for 45.1% of cases.

Conclusions

Although infrequent in our setting, renal biopsies remain indispensable when kidney disease is suspected. They constitute a critical tool in the nosological, diagnostic, and therapeutic approach to nephrology for the effective management of kidney disease.

Factors associated with the use of curative healthcare services in Bunia Health Zone facilities, Ituri Province, Democratic Republic of the Congo

C. F. Kpane — 2025-09-10

Introduction

Access to quality curative care remains a challenge in many low-resource settings. The World Health Organization (WHO) identifies healthcare utilization as a key determinant of public health outcomes.

Purpose
This study aimed to identify household and organizational factors associated with the use of curative healthcare services in the Bunia Health Zone, Democratic Republic of Congo (DRC).

Methods
A cross-sectional study was conducted in January–February 2023 using a multi-stage cluster sampling technique. Data from 824 households were collected via structured questionnaires. Logistic regression analyses were performed to identify factors associated with facility choice.

Results
Among households reporting illness in the last 30 days, 68.7% used non-subsidized private facilities. Significant factors influencing this choice included satisfaction with care (OR = 5.50, p = 0.001), good reception (OR = 5.41, p = 0.012), availability of medicine (OR = 3.26, p = 0.006), affordable cost (OR = 4.89, p = 0.010), and smaller household size (OR = 3.52, p = 0.008).

Conclusion
To enhance the utilization of subsidized services, health system interventions should prioritise improving patient satisfaction, affordability, waiting times, and drug availability.