Schistosomiasis is a poverty-related parasitic infection, leading to chronic ill-health. For more than a century, schistosomiasis has been known to be endemic in certain provinces of the Democratic Republic of Congo (DRC). However, a clear overview on the status of the disease within the country is currently lacking, which is seriously hampering control. Here, we review the available information on schistosomiasis in DRC of the past 60 years. Findings and data gaps are discussed in the perspective of upcoming control activities. An electronic literature search via PubMed complemented by manual search of non-peer-reviewed articles was conducted up to January 2015. The search concerned all relevant records related to schistosomiasis in the DRC from January 1955 onwards. A total of 155 records were found, of which 30 met the inclusion criteria. Results were summarized by geographical region, mapped, and compared with those reported sixty years ago. The available data reported schistosomiasis in some areas located in 10 of the 11 provinces of DRC. Three species of Schistosoma were found: S. mansoni, S. haematobium and S. intercalatum. The prevalence of schistosomiasis varied greatly between regions and between villages, with high values of up to 95 % observed in some communities. The overall trend over 60 years points to the spread of schistosomiasis to formerly non-endemic areas. The prevalence of schistosomiasis has increased in rural endemic areas and decreased in urban/peri-urban endemic areas of Kinshasa. Hepatosplenomegaly, urinary tract lesions and anaemia were commonly reported in schistosomiasis endemic areas but not always associated with infection status. The present review confirms that schistosomiasis is still endemic in DRC. However, available data are scattered across time and space and studies lack methodological uniformity, hampering a reliable estimation of the current status of schistosomiasis in DRC. There is a clear need for updated prevalence data and well-designed studies on the epidemiology and transmission of schistosomiasis in DRC. This will aid the national control program to adequately design and implement strategies for sustainable and comprehensive control of schistosomiasis throughout the country.

School-aged children suffer the most from schistosomiasis infection in sub Saharan Africa due to poverty and limited sanitary conditions. Mapping of disease burden is recommended and there is a need of updating prevalence data which is as old as 20 years in the Democratic Republic of Congo. An epidemiological and parasitological study was carried out in 2011 in the health zone of Kasansa. Six health areas (HA) were included in the study. In each health area, one primary school was selected. School-aged children were screened for S. mansoni infection using parallel Kato-Katz and direct microscopy techniques. A total of 335 school-aged children were screened. The average prevalence was 82.7% and ranged between 59.5–94.9%. Four of the six HAs had a prevalence level over 91%. Of all infected children, about half 112 (43.2%) had light parasite density. These results demonstrate that Schistosoma mansoni infection is a bigger problem than anticipated and there is an urgent need to implement effective control measures. Schistosomiasis (SCH) is a parasitic infection and one gets infected when bathing or in contact with contaminated fresh water bodies like rivers. It has been shown that people living in poor sanitary conditions and especially school-aged children suffer the most from this infection. Mapping is needed in order to control or prevent the disease. However, in the Democratic Republic of the Congo (DRC), surveillance of schistosomiasis is lacking. Previous data on distribution of schistosomiasis may have lost relevance since the disease was last mapped 20 years ago. This study was carried out in 2011 in the health zone of Kasansa, DRC. Six primary schools were visited and stool samples were collected from children attending the 3rd class. The stool samples were analyzed for S. mansoni infection. Up to 335 children were recruited and 82.7% were infected. Moreover, in 4 health areas over 91% of the children were infected. Of all infected children, almost half, 112 (43.2%) had light parasite density. These results demonstrate that Schistosoma mansoni infection is a bigger problem than anticipated and there is an urgent need to put effective control measures.

Introduction: Schistosomiasis (SCH) is an important public health problem in developing countries and school-aged children are the most affected. This study explored health and nutritional status and their correlation with SCH in children attending primary school (3rd to 6th class) living in the area of Kasansa in the Democratic Republic of Congo. Methods: Across-sectional household survey was carried out in Kasansa health area in February 2011. Children whose parents reported to attend primary school (3rd to 6th class) were included. Socio-demographic characteristics, information on morbidity history and risk factor were collected using a semi-structured questionnaire. S. mansoni and malaria infection were assessed using the Kato-katz technique and rapid diagnostic test, respectively. Haemoglobin concentration was also performed using a portable HemoControl device. Bivariate and multiple logistic regressions were used to assess risk factors for S. mansoni. Results: A total of 197 school aged children participated in the study with a median age of 12 years and 53.8% of them were boys. The overall health status of the children was poor with very high prevalences of S. mansoni infection (89.3%), malaria infection (65.1%), anaemia (61.4%) and stunting (61.0%). Regular contact with river water was the most important risk factor (OR: 11.7; p<0.001) related to SCH infection. A low haemoglobin concentration was significantly associated with a SCH infection (OR: 12.3; p=0.003) and egg load was associated with stunting (OR: 12.4; p=0.04). Children from farmers were more at risk for low school performance (OR: 5.3; p=0.03). Conclusion: High prevalence of Schistosoma mansoni and malaria infection was observed in the study population living in Kasansa area. Moreover, they presented a high burden of anaemia, chronic malnutrition and low school performance. An integrated disease control and management of these diseases and their consequences, endorsed by surveillance, is needed.

INTRODUCTION: La qualité des soins est essentielle pour sauver des vies humaines de différentes ma-ladies. Cependant, un diagnostic inapproprié ne peut en aucun cas aboutir à une prise en charge correcte des patients ainsi qu´à des soins de qualité. Nous avons effectué une analyse descriptive transversale dans trois laboratoires des hôpitaux généraux en République démocratique du Congo. METHODES: une équipe d´experts nationaux dans le domaine des laboratoires avait conduit l´enquête au niveau de trois laboratoires cliniques des hôpitaux généraux de la République Démocratique du Congo. Des observations, visites et entretiens structurés à l´aide d´un questionnaire ont été utilisées pour évaluer la performance de ces labora-toires cliniques. Nous avons également utilisé un guide d´évaluation développée au niveau national pour l´évaluation des laboratoires. RESULTATS: les laboratoires cliniques des hôpitaux généraux visités ont présenté de nombreux déficits notamment en ce qui concerne les infrastructures, la formation de base et continue des personnels, les équipements, la supervision et le contrôle de qualité. Le plateau technique de ces laboratoires n´était pas adapté pour répondre aux besoins de la population en ce qui concerne les maladies fréquemment rencontrées dans ces zones. Nous avons également noté que, ces laboratoires sont peu ou presque pas accompagnés et qu´il n´y avait aucune équipe de coordination dédiée à la supervision et évaluation des laboratoires au niveau de l´hôpital, voire même au niveau de la zone de santé. En plus, les techniciens de ses différents laboratoires n´ont pas été supervisés pendant de nombreuses années. CONCLUSION: les laboratoires cliniques doivent être améliorés pour permettre un diagnostic adéquat de différentes maladies. Cette amélioration doit s´appuyer sur les maladies locales. Au sein du système, il est important de consacrer plus d´attention aux laboratoires cliniques. Un plaidoyer pour cette composante négligée du système de santé est nécessaire, car cette situation pourrait être la même dans de nombreux pays en voie de développement.

To adequately plan mass drug administration campaigns, the Democratic Republic of the Congo (DRC) needs further support for the mapping and monitoring of schistosomiasis (SCH) and soil-transmitted helminths (STH). We conducted a community-based survey in the health districts of Mosango and Yasa Bonga of the Kwilu province, DRC. A stratified two-stage cluster random sampling method was used to include participants into three different strata: Preschool-aged children (PSAC), school-aged children (SAC), and adults who were further subdivided into women of reproductive age (WRA) and other adults. In total, surveyors visited 30 villages, and 1 206 individuals participated in the study. Stool samples were collected to perform duplicate Kato-Katz smears for the detection of SCH and STH infection. Hookworm was the most prevalent infection in both districts, 34.1% (95%CI: 32.0–38.4), followed by A. lumbricoides (2.7%; 95%CI: 1.3–2.9) and T. trichiura (1.9%; 95%CI: 1.1–2.7). We did not find any SCH infection. The prevalence of each STH infection was similar across all risk groups, and the majority of the infected individuals was carrying light intensity infection. Compared to SAC, other adults were equally infected with hookworm. The prevalence of STH infection in SAC guides the MDA implementation because schoolchildren are most at risk and easily accessible program targets if school attendance is high. The current treatment strategy targets PSAC, SAC and WRA. However, this study shows that adults in general could also benefit from deworming. Therefore, community-wide preventive chemotherapy would be the most appropriate choice to control the hookworm burden rapidly. Helminths are a group of intestinal worms that cause abdominal discomfort, diarrhea, and anemia due to blood loss in the stool. Regular mass drug administration (MDA) is one strategy to fight these worm infections. The appropriate MDA treatment scheme is chosen based on a population survey estimating the burden of infection. This survey is usually done in schoolchildren because they suffer the most from these infections and they are easy to reach through school infrastructures. However, one particular worm, the hookworm, is also highly present and clinically relevant in adults. We conducted a community-based survey in two districts of the Kwilu Province of the DRC. We found that hookworm was the predominant infection in the area and that adults were as often infected as the schoolchildren. Therefore, to effectively reduce hookworm infection, we advise extending treatment schemes to the entire community.

The epidemiological risk factors associated with mpox acquisition and severity in the Democratic Republic of the Congo (DRC) are changing. We assessed perceived mpox risk, and behavioral, clinical and sexual histories among key populations at risk of acquisition through sexual contact. Here, we describe a sampling strategy to enroll participants considered to be at increased risk for mpox infection - men who have sex with men (MSM) and sex workers (SW) - in three urban centers in the DRC. Through the combined approach of time-location sampling with peer educators and respondent-driven sampling, a mixed cohort of 2826 individuals including self-identified MSM (n = 850), SW (n = 815), both MSM and SW (n = 118) and non-MSM, non-SW individuals (n = 1043) were enrolled in Kinshasa, Kinshasa province, Kenge, Kwango province, and Goma, North Kivu province, from March-August 2024. Of these, over 90% were reached through peer educators. The odds of sampling SW individuals were higher at bars/clubs than traditional health facilities. Conversely, the odds of enrolling MSM were highest at selected health facilities. Modifications to the sampling approach were introduced in Kenge and Goma, but these did not affect the enrollment of MSM or SW participants. Ultimately, the selection of, and collaboration with, well-integrated peer educators was the most important facet of this sampling strategy. As the definitions of at-risk populations continue to change for mpox, we demonstrate a functional approach to quickly surveying otherwise hard-to-reach groups for both public health surveillance activities and response.