Introduction: The Democratic Republic of Congo (DRC) does not have national prevalence data for arterial hypertension (HTN) or diabetes (type I and II combined) to aid evidence-based decision-making, despite the assumption of epidemiological transition in low- and middle-income countries. The aim of this study was to estimate a proxy of prevalence for HTN and diabetes. Methodology: This study used routine monthly reported data pertaining to HTN and diabetes from the District Health Information Software 2 (DHIS2), spanning 2019–2023. Data underwent quality assessment and adjustments using standardization before analysis. Equity analyses were carried out at the national and sub-national levels. Epidemiological curves and maps were produced to analyze trends in the prevalence of HTN and diabetes among adults aged 18 and over. Permission to use the data was obtained from the regulatory authority. Results: Over five years, incidence of HTN increased from 13.23% (CI 95%: 13.22–13.24) to 15.23% (CI 95%: 15.22–15.24) (+15.1% relative increase), and diabetes rose from 2.73% (CI 95%: 2.72–2.74) to 3.345% (CI 95%: 3.34–3.35) (+16.3% relative increase), with provincial variations observed. Conclusions: In the DRC, hypertension and diabetes are advancing rapidly. Primary and preventative healthcare services and public health interventions must prioritize these diseases.

This study examines the community integration and One Health strategies employed to combat Ebola virus disease in the Democratic Republic of Congo from 2007 to 2022. We synthesized 12 outbreak reports, conducted qualitative interviews with 36 managers, organized three focus groups, and adapted an analytical framework (MATCH) to evaluate three essential dimensions: the integration of the One Health approach, community involvement, and bottom-up approaches. This study evidences progressive improvement in all domains. The first outbreaks (2007–2009) were marked by moderate community engagement and a One Health approach that was largely limited to the human health sector, deemed suboptimal. The 10th outbreak represented an era of transformation, when the Incident Management System (IMS) was adopted to better manage the response to the virus. The latest outbreaks (13th to 15th) demonstrate an “optimal” implementation of the “One Health” approach through effective collaboration between those in charge of ensuring human, animal, and environmental health and that of the community. This study demonstrates that success is largely dependent on bottom-up initiatives in which local populations, their leaders (both traditional and religious), community liaisons, and specific groups (women and youth) are involved in the design and implementation of such measures. The inclusion of anthropologists and psychologists in addressing the psychosocial dimensions—fear, stigma, and distress—has been critical in ensuring the success of these initiatives and the degree to which the public trusts and accepts them. However, many issues still need to be addressed, including poor coordination among sectoral ministries and the partial implementation of IMS at the grassroots level. In summary, the authors of this study propose that these integrated and participatory models are sustainable and imperative to building the resilience of the Congolese health system to future outbreaks.

The 2025 Ebola outbreak that ravaged the Bulape Health District (HD) in Kasai, Democratic Republic of Congo (DRC), was tackled using the incident management system (IMS) model. The Bulape HD is located in the Mweka territory, which has experienced two Ebola epidemics: one in 2007 and another in 2008. The IMS comprises seven strategies recommended for an effective response to an Ebola outbreak: (i) thorough investigation, (ii) strengthening infection prevention and control measures in the community, (iii) ensuring that medical care is provided by experienced professionals, (iv) strengthening risk communication and community engagement (RCCE), (v) ring vaccination, (vi) operational research, and (vii) anchoring interventions in the existing health system. We share our experience implementing these seven strategies and compare them with those utilized during three previous Ebola outbreaks. This paper describes our achievements, the resulting benefits, and the factors that facilitated the implementation of the aforementioned strategies. A literature review and interviews were conducted. The atlas.ti 22 software was used for data analysis. Implementing these seven strategies contributed to an effective response, largely due to the experience and expertise of those involved but also thanks to the support of technical and financial partners (TFPs) and the engagement of the local community. Challenges such as geographical accessibility, the fragile health system, the community’s strong attachment to traditional practices, and negative reactions to healthcare—which was widely discredited, with many of those involved expressing a lack of faith in its effectiveness—were major obstacles. To overcome these challenges, an integrated approach was utilized, combining a rapid comprehensive response with deep and respectful community engagement. The support and alignment of TFPs were invaluable during this process. The RCCE pillar proved key to successful IMS implementation. Our experiences will be useful during the next Ebola outbreak in the DRC; additionally, they may also help to inform the response to similar outbreaks in other countries.

Introduction: The mortality rates associated with cardiovascular disease (CVD) and diabetes exhibit disparities by region, with Central Africa ranking fourth globally in terms of mortality rate. The Democratic Republic of Congo (DRC) does not possess mortality data pertaining to these specific underlying causes of death. This study aimed to determine the death rate attributable to CVD and diabetes in two cities in the DRC. Methodology: The data on CVD and diabetes utilized in this study were obtained from a pilot project and were registered in the National Health Information System (NHIS). Data quality was initially evaluated using an automated Digital Open Rule Integrated Selection (DORIS), followed by an assessment conducted manually by three assessors. Descriptive and comparative analyses were carried out to determine the proportion of mortality related to CVD and diabetes. Results: CVD accounted for 20.4% (95%CI: 17.7–23.4%) of deaths in the two cities (Kinshasa and Matadi), whereas diabetes accounted for 5.4% (95%CI: 3.9–7.2%). After adjusting for age and city, the proportional mortality from CVD and diabetes was higher for women than men and increased with age. This study recorded 4.4% of deaths among men and 7.0% among women as the proportional mortality from diabetes. Conclusions: Non-communicable diseases (NCDs) continue to be a major cause of death, and CVD and diabetes are among the leading causes of early mortality in adults in urban areas. The proportional mortality related to CVD and diabetes appears to be higher in women than in men. Special emphasis should be placed on women, particularly during adulthood, to ensure the prompt detection of diabetes and cardiovascular conditions.

Introduction: Sub-Saharan Africa in general, and the Democratic Republic of the Congo (DRC) in particular, is undergoing an epidemiological transition characterized by a more rapid increase in the number of non-communicable diseases (NCDs). However, the level of readiness of the DRC’s healthcare facilities (HFs) to manage these diseases is unknown. Thus, our study aimed to assess these HFs’ level of readiness to manage cardiovascular disease (CVD) and diabetes. Methodology: This cross-sectional study involved 1412 HFs in the DRC, selected by stratified random sampling. They are representative of the country’s 26 provinces. The World Health Organization (WHO) Service Availability and Readiness Survey (SARA) was used. The “readiness” outcome was a composite measure of the capacity of HFs to manage CVD and diabetes. The readiness indicator comprised four domains, and a score of ≥70% indicated “readiness” to manage CVD and diabetes. Informed consent was obtained from the stakeholders, and the ethics committee held a positive opinion. Statistical analyses were performed using STATA 17 software. Results: The average readiness scores of the DRC’s HFs to manage CVD and diabetes are less than 50%, being 38.3% (37.3–39.3) and 39.8% (38.7–40.9), respectively. These scores were less than 40% for CVD and diabetes in rural HFs. They were less than 30% for CVD and diabetes in primary-level HF. No province possesses over 50% of health facilities equipped to address cardiovascular illnesses, and only four provinces (Haut Uele, Kinshasa, Nord Kivu, and Sud Kivu) possess over 50% of health facilities equipped to address diabetes. The provinces with health facilities exhibiting the least preparedness in managing cardiovascular illnesses and diabetes are Nord Ubangi and Sankuru. Only 0.07% (0.01–0.5) of HFs obtained a score ≥ 70% for CVD management, and 5.9% (4.8–7.3) obtained this score for diabetes management. Conclusions: Significant deficiencies must be rectified to enhance service delivery in the management of cardiovascular disease (CVD) and diabetes. Most primary-level and rural facilities demonstrated inadequate preparedness for CVD and diabetes screening and management, exhibiting low readiness scores and limited-service availability in the assessed domains. While secondary-level services are relatively accessible, critical gaps persist that must be addressed to improve readiness for CVD and diabetes care. Healthcare facilities should possess the capacity to deliver recommended services across various tiers, ensuring both service readiness and availability.

Dans le contexte de la transition épidémiologique en zones tropicales, la République Démocratique du Congo (RDC) ne disposait pas de donnée scientifique à jour sur l’épidémiologie des maladies cardiovasculaires (MCV) et des maladies métaboliques dont le diabète afin d’aider la prise de décision. Ainsi, cette thèse avait pour objectif de décrire l’épidémiologie des MCV et de diabète en RDC. Spécifiquement d’étudier la progression de l’hypertension artérielle (HTA) et du diabète sur cinq années, d’estimer la part de la mortalité liée aux MCV et au diabète, et d’évaluer le niveau de préparation des Etablissements des Soins de Santé (ESS) à gérer ces maladies. Les données des enquêtes et de routine ont été utilisées à cette fin, en appliquant des outils et méthodes standardisés : l’approche de l’analyse des données de routine mise en place par l’Université John Hopkins, l’approche de la certification médicale des causes de décès mise en place par l’Organisation Mondiale de la Santé (OMS), et l’approche de l’enquête Service Availability and Readiness Assessment établie également par l’OMS. Il a été trouvé que l’HTA et le diabète ont progressé rapidement sur cinq ans (15,1% et 16,3%) et que les MCV et le diabète représentaient une charge importante de mortalité (20,4% et 5,4%). A contrario à ce double fardeau, il a été constaté que les ESS n’étaient pas prêts à gérer les MCV et le diabète. Les MCV et métabolique étant un fardeau épidémiologique en RDC, les actions de santé publique devraient être intégrées, en considérant au même niveau la lutte contre les Maladies Transmissibles et les Maladies Non Transmissibles, et le système de santé devrait être renforcé.