Orapuh Journal

Evaluation of the impacts of trace metals on market gardening consumers: The case of Kimwenza-Gare

Plamedi IYELI LOBOTA, Andre KANJINGA NGOYI , Thierry TANGOU TABOU — Tue, 07 Apr 2026 17:50:55 +0200

Introduction

The reliance of agriculture on mineral fertilizers and pesticides has raised concern for decades. In Kinshasa, market gardening contributes substantially to feeding the local population.

Purpose

This study assesses the impacts of trace metals accumulated in leafy vegetables cultivated in Kimwenza-Gare (Mont-Ngafula Commune), with a particular focus on potential risks to consumer health.

Methods

A survey of market gardeners was conducted to identify the most frequently sold vegetables throughout the year and to document the agricultural inputs used for soil fertilization and pest control. Six vegetable samples and three soil samples were analyzed for ionic composition using an energy-dispersive X-ray fluorescence spectrometer (ED-XRF). Statistical analyses included Student’s t-test, as well as Spearman and Pearson correlation coefficients, performed using RStudio (version 4.3). Results were compared with World Health Organization (WHO) standards.

Results

Trace elements were detected in all vegetable samples at a 95% confidence interval. Chromium (Cr) concentrations exceeded the WHO guideline value (2.3 mg/kg dry weight) in all Amaranthus viridis samples from the Lukaya sector, reaching a maximum concentration of 9.46 ± 1.26 mg/kg. Lead (Pb) concentrations also exceeded the guideline value (0.30 mg/kg) in this vegetable, with the highest level recorded in the same sector (0.67 ± 0.01 mg/kg). Cadmium (Cd) was detected but remained below the detection limit. Overall, vegetables accumulated heavy metals present in the soil, particularly Amaranthus viridis in the Lukaya sector (ρ = 1).

Conclusion

Although the overall concentrations of trace metals were relatively low, consumers remain exposed to potential risks of chronic poisoning. Preventive measures, including awareness campaigns targeting market gardeners, should be implemented.

The Substandard and falsified medicines in the Democratic Republic of the Congo: Situational analysis and future perspectives

Tue, 07 Apr 2026 22:45:07 +0200

Introduction

The circulation of counterfeit medicines in the Democratic Republic of the Congo (DRC) and elsewhere is driven by several factors, including regulatory weaknesses, inadequate inspections, and porous borders. This issue is frequently highlighted in case reports and scientific publications, demonstrating the link between regulatory capacity—particularly the maturity level of the National Regulatory Authority (NRA)—and the prevalence of substandard and falsified medicines.

Purpose

To assess the extent of counterfeit medicines in the DRC and propose future perspectives.

Methods

Publications related to counterfeit medicines were collected from databases such as ScienceDirect, PubMed, Google, Google Scholar, ACOREP, the World Health Organization (WHO), websites of major organizations, case reports, and alerts. Searches were conducted using the keywords “falsified,” “substandard,” “counterfeit,” and “alert” (in both English and French). References were managed using Zotero software and analyzed through a structured literature review flowchart. Inclusion criteria comprised articles published between 2010 and 2025, including case reports, alerts, and study summaries focusing on the prevention, detection, and response to counterfeit medicines for human use in the DRC or other low- and middle-income countries.

Results

Of the 238 articles and documents identified, 62 met the inclusion criteria. The average prevalence of counterfeit medicines in Africa was estimated at 18.7% (range: 12.9%–24.5%), with 34.6% classified as unregistered. In the DRC, the consolidated average prevalence rates were 22.4% for counterfeit medicines, 22.2% for substandard medicines, and 35% for unregistered medicines.

Conclusion

The Congolese Pharmaceutical Regulatory Authority (ACOREP) has not yet achieved WHO maturity level 3 (ML3) in accordance with good regulatory practices. The Congolese government is therefore encouraged to strengthen its commitment to establishing a robust and deterrent national regulatory system (NRA) to combat the circulation of counterfeit medicines, particularly given the high proportion (approximately 35%) of unregistered products

Post-cesarean rehabilitation practices without an ERAS protocol in two hospitals in Kinshasa: A prospective descriptive study

Wed, 22 Apr 2026 15:47:16 +0200

Introduction

Post-cesarean rehabilitation aims to promote functional recovery after surgery. In low-resource settings, these practices often remain conservative, particularly in the absence of formal Enhanced Recovery After Surgery (ERAS) protocols.

Purpose

To describe post-cesarean rehabilitation practices in two hospitals in Kinshasa without an ERAS protocol, in order to provide baseline data for future strategies aimed at improving postoperative care.

Methods

This prospective descriptive study was conducted from December 2024 to February 2025 at the Kinshasa University Clinics and Ngaliema Clinic. Women aged ≥ 18 years, classified as American Society of Anesthesiologists (ASA) physical status II, and who underwent cesarean delivery were included. Patients with perioperative or postoperative complications likely to prolong hospitalization were excluded. A consecutive exhaustive sampling strategy was used throughout the study period. Data were collected through direct observation and structured interviews using a standardized data collection form. Statistical analysis was descriptive.

Results

A total of 204 patients were included in the analysis. The mean age was 29.9 ± 5.8 years, and 62.3% of cesarean deliveries were performed as emergencies. Spinal anesthesia was used in 98.5% of patients, with limited use of intrathecal morphine. Prevention of postoperative nausea and vomiting using dexamethasone was performed in 5.4% of cases. Mean times to postoperative recovery milestones were 11.7 ± 5.3 hours for first oral fluid intake, 40.5 ± 12.8 hours for the first meal, 25.1 ± 10.6 hours for urinary catheter removal, 62.9 ± 28.5 hours for intravenous catheter removal, and 21.4 ± 9.0 hours for first mobilization. At 24 hours postoperatively, 78.9% of patients reported moderate to severe pain (numerical rating scale [NRS] > 3). Indicators of mother–infant bonding, such as infant carrying, were infrequent. The mean length of hospital stay was 5.1 ± 0.7 days.

Conclusion

These findings indicate underutilization of several ERAS components, particularly early feeding, early mobilization, and optimized multimodal analgesia. This highlights opportunities for the progressive implementation of ERAS strategies adapted to the local context.

Facility managers’ views on contraceptive data management in primary healthcare facilities in the Tshwane District, South Africa

Sophy Mogatlogedi Moloko, Ntlogeleng Mabina Mogale — Thu, 30 Apr 2026 09:26:05 +0200

Introduction

Contraceptive data are critical for determining the proportion of women of childbearing age who are protected from unintended pregnancies. These data must be of high quality to assess the performance of, and guide improvements in, family planning programmes.

Purpose

This study explored facility managers’ views on the management of contraceptive data in the Tshwane District, South Africa.

Methods

The study was conducted in 11 primary healthcare facilities in the Tshwane District, South Africa, using a qualitative exploratory design. The sample consisted of 11 purposively selected facility managers. Data were collected through semi-structured interviews using an interview guide developed by the researchers. Data were analysed using thematic analysis.

Results

Three themes were generated. Theme 1 showed that facility managers provided leadership in contraceptive data management by ensuring availability of resources and capacitating healthcare providers. Managers supervised and monitored data collection processes to strengthen data quality assurance. Theme 2 reflected mixed perceptions of supportive supervision from health information officers, with some managers reporting satisfaction while others reported gaps in consistency and responsiveness. Theme 3 showed that most managers considered contraceptive data to be of acceptable quality and accuracy, largely due to verification practices at facility level. The data were mainly used for monitoring family planning programme performance and for contraceptive supply management.

Conclusion

The study demonstrates that facility managers play an active role in strengthening contraceptive data quality through leadership, supervision, and verification. However, their efforts are constrained by behavioural challenges among healthcare providers and inconsistent organisational support from district structures. Improving data quality requires strengthened collaboration between facility managers, health information officers, and district management, supported by structured supervision, continuous training, and adequate staffing for data management.

Epidemiological patterns of poisoning worldwide: A comparative narrative review of high-income and low-income countries

Fri, 01 May 2026 12:05:35 +0200

Poisoning remains a major global public health concern and a significant cause of morbidity and mortality worldwide. This narrative review synthesizes current evidence on poisoning patterns across countries, with emphasis on epidemiological characteristics including affected populations, causal agents, routes of exposure, and circumstances of poisoning. Particular attention is given to differences between high-income and low-income settings. Relevant literature was identified through online searches and bibliographic screening of databases including PubMed, Medline, JSTOR, EBSCOhost, Publons, and Google Scholar. Evidence was extracted from original studies, systematic reviews, narrative reviews, and institutional reports. Findings suggest that poisoning epidemiology differs substantially by national income level. In high-income countries, medications—particularly paracetamol—are the leading agents of poisoning, with children aged 0–5 years representing the most affected group. Most cases occur unintentionally, mainly through accidental ingestion. In contrast, in low-income countries, pesticides are the predominant toxic agents, and young adults are the most affected population. Poisoning in these settings is frequently intentional, commonly associated with suicide and interpersonal conflict. Despite limitations related to data scarcity in low-income countries, consistent patterns highlight important epidemiological disparities. Strengthening poison control centers, improving toxicovigilance, and implementing regulatory policies targeting pesticide access are strongly recommended in resource-limited settings.

Assessment of human health risks associated with trace metal exposure through the consumption of Amaranthus viridis and Manihot esculenta grown in the Kimwenza gare area of Mont-Ngafula (Kinshasa, DRC)

Fri, 01 May 2026 18:28:20 +0200

Introduction

Human populations are exposed to trace metal contamination through foodstuffs, particularly leafy vegetables.

Purpose

This study assessed the human health risks associated with consumption of vegetables grown in the Kimwenza gare agroecosystem. It focused on the vegetables most commonly consumed by populations relying on this production area.

Methods

Surveys were conducted among residents living near the agroecosystem to identify the vegetables most frequently prepared and to collect data on consumption habits. Two vegetable species were selected for chemical analysis using an energy-dispersive X-ray fluorescence spectrometer (ED- XRF). The daily exposure dose and hazard quotient were calculated for cadmium (Cd) and lead (Pb). Pearson correlation analysis was performed using RStudio (version 4.5.1).

Results

Trace metal concentrations were determined with a 95% confidence interval. Lead concentrations were low, whereas cadmium concentrations exceeded the WHO/FAO permissible limit in five samples (0.129 ± 0.012, 0.164 ± 0.123, 0.133 ± 0.012, 0.291 ± 0.026, and 0.420 ± 0.028 mg/kg, compared with the limit of 0.10 mg/kg). Statistical analysis indicated that both vegetables accumulated trace metals proportionally (r = 0.967 to r = 0.995). Hazard quotient values calculated from the daily exposure dose were > 1 for cadmium, indicating a potential risk of non-carcinogenic health effects among consumers, with children being the most vulnerable group.

Conclusion

Consumption of vegetables grown in the Kimwenza gare agroecosystem may expose consumers to health risks, as indicated by hazard quotient values. Raising awareness among market gardeners and implementing periodic monitoring of trace metal concentrations could help reduce this risk.

Semantic analysis of healthcare workers’ perceptions of neonatal mortality in Tshopo Province, Democratic Republic of the Congo

Fri, 01 May 2026 20:28:13 +0200

Introduction

Neonatal mortality remains a major public health concern in the Democratic Republic of the Congo, particularly in Tshopo Province. While quantitative evidence is widely available, few studies have explored how healthcare workers interpret neonatal death within its sociocultural context.

Purpose

This study aimed to explore healthcare workers’ perceptions of neonatal mortality in Tshopo Province using semantic analysis.

Methods

A qualitative descriptive study was conducted in June 2025 among 25 healthcare workers (doctors, nurses, midwives, community health workers, and matrons) from four health zones in Tshopo Province (Lubunga, Yahisule, Makiso-Kisangani, and Yakusu). Data were collected through semi-structured interviews conducted in French, Lingala, and Swahili. Audio recordings were transcribed and analyzed manually using a semantic analysis approach grounded in social construction theory, based on a predefined coding framework.

Results

Participants perceived neonatal mortality as a major and persistent community problem. Cultural interpretations were prominent, with neonatal deaths frequently explained as God’s will or attributed to witchcraft and misfortune. Respondents also identified health system and socioeconomic factors, including inadequate antenatal follow-up, poor quality of care, limited financial resources, delayed care-seeking, and insufficient parental awareness. Proposed strategies emphasized improving access to maternal and neonatal care, strengthening community education and awareness, enhancing staff training, and ensuring institutional support through better equipment provision, drug availability, and government involvement.

Conclusion

Healthcare workers’ perceptions of neonatal mortality in Tshopo Province reflect an interaction between sociocultural beliefs and structural barriers to care. Reducing neonatal mortality requires integrated interventions combining culturally sensitive health education, improved healthcare quality, strengthened antenatal follow-up, and stronger institutional commitment

The phenotypic profile of blood donors and recipients at the University Clinics of Kinshasa and the National Blood Transfusion Center of Kinshasa from November 2024 to July 2025

Thu, 07 May 2026 21:57:16 +0200

Introduction

Blood transfusion is essential in the Democratic Republic of the Congo (DRC); however, comprehensive epidemiological data remain limited beyond the basic ABO and RhD systems. This study addresses this gap by providing data on extended Rhesus and Kell phenotyping.

Purpose

To determine the phenotypic distribution of ABO, Rhesus (D, C, c, E, e), and Kell blood group systems among blood donors and recipients at the University Clinics of Kinshasa and the National Blood Transfusion Center.

Methods

A descriptive cross-sectional study was conducted from November 2024 to July 2025. ABO blood group antigens were identified using both forward (cell) and reverse (serum) typing. Extended Rhesus and Kell antigens were determined using the direct serological method.

Results

A total of 240 samples from 214 subjects were analyzed (163 donors and 51 recipients). The mean age was 30.47 ± 15.08 years. The frequencies of blood groups O, A, B, and AB were 50.0%, 26.2%, 18.2%, and 5.6%, respectively. The RH1 (D) antigen was present in 95.3% of subjects. Extended phenotyping showed a high prevalence of RH4 (c) (99.5%) and RH5 (e) (96.7%) antigens. Haplotype analysis revealed a predominance of the R0 (Dce) complex (67.3%). All subjects were Kell-negative (100% KEL:-1). No statistically significant difference was observed in blood group distribution between donors and recipients (p > .05).

Conclusion

This study confirms the predominance of blood group O and the R0 haplotype in the Kinshasa population. However, the presence of C and E antigens in nearly one-quarter of participants, combined with universal Kell negativity, highlights a significant risk of alloimmunization in polytransfused patients. Implementing extended phenotyping is therefore essential to improve transfusion safety and clinical outcomes in the DRC.

Evaluation of trace metal element contamination in kaolin and health risks associated with geophagy: A case study of Kimbanseke Commune, Democratic Republic of the Congo

Thu, 07 May 2026 00:00:00 +0200

Introduction

In Kinshasa, kaolin consumption is a deeply rooted cultural practice, particularly among women. However, it represents a major exposure pathway for chemical contaminants, while the toxicological risks associated with trace metal elements (TMEs) remain poorly documented.

Purpose

This study evaluated health hazards associated with kaolin consumption. The overall objective was to assess health exposure risks among women in Kimbanseke to TMEs (lead, cadmium, and arsenic) resulting from geophagy. Specifically, the study aimed to (a) identify consumers and assess their level of exposure; (b) measure total concentrations of Pb, Cd, and As; (c) determine their in vitro bioaccessible fractions (gastric and intestinal phases) to calculate the Average Daily Dose (ADD), Hazard Quotient (HQ), and Hazard Index (HI); and (d) propose a decision-making tool.

Methods

A cross-sectional survey was conducted among 100 respondents in Kimbanseke. Physicochemical characterization was performed using X-ray fluorescence (XRF) to determine total metal concentrations. In vitro digestion simulation was conducted using a bioaccessibility model mimicking the gastric phase (pH 1.5) and intestinal phase (pH 7.0).

Results

XRF analyses revealed alarming total concentrations at Site 1 (Pb: 32.7 mg/kg; Cd: 11.1 mg/kg; As: 4.1 mg/kg) and Site 2 (Pb: 22.0 mg/kg; Cd: 1.8 mg/kg). These concentrations exceeded permissible limits set by WHO/FAO, notably the 2.0 mg/kg safety threshold for lead (Food and Agriculture Organization of the United Nations & World Health Organization, 2011) and 0.1 mg/kg for cadmium and arsenic. Bioaccessibility tests showed substantial release in the intestinal digestate (Pb: 0.90 mg/L; Cd: 0.16 mg/L; As: 0.13 mg/L). Risk assessment based on a daily consumption of 115 g over 15 years indicated potential health concern. However, inconsistencies were identified between reported bioaccessibility values and hazard indices, requiring recalculation for final risk classification.

Conclusion

Kaolin consumed in Kimbanseke contains TMEs above international guideline limits. The intestinal solubilization of metals indicates potential absorption and systemic toxicity. Public health intervention is required to regulate kaolin exploitation and raise awareness among consumers.

Securing the ofloxacin–ornidazole combination in the Democratic Republic of the Congo

Fri, 08 May 2026 21:02:46 +0200

Introduction

Pharmaceutical stability in tropical regions is a critical public health concern, as extreme heat and humidity can compromise drug integrity before the expiry date.

Purpose

This cross-sectional analytical study, incorporating experimental stability testing, aimed to evaluate the effects of architectural microclimates and hygrothermal conditions on the stability of the ofloxacin–ornidazole combination in the Democratic Republic of the Congo (DRC).

Methods

Observational field sampling (N = 30), combined with laboratory stability testing, was conducted in Kinshasa, Kisangani, and Bukavu. Laboratory stability was assessed using a validated spectrophotometric method.

Results

Drug content levels in Kinshasa pharmacies, characterized by uninsulated iron roofs, showed statistically significant underdosing (87.27% ± 1.45; p < .001; 95% CI [85.8, 88.7]) compared with the 98.40% ± 0.55 observed in temperate Bukavu (p < .001).

Conclusion

Building architecture and physical integrity (e.g., tablet crushing) are major determinants of drug quality in Climatic Zone IVb. The observed underdosing may compromise therapeutic efficacy and represents a recognized risk factor for accelerating antimicrobial resistance, as supported by global climatic models.