As mortality remains high for patients with Ebola virus disease (EVD) despite new treatment options, the ability to level up the provided supportive care and to predict the risk of death is of major importance. This analysis of the EVISTA cohort aims to describe advanced supportive care provided to EVD patients in the Democratic Republic of the Congo (DRC) and to develop a simple risk score for predicting in-hospital death, called PREDS. In this prospective cohort (NCT04815175), patients were recruited during the 10^th EVD outbreak in the DRC across three Ebola Treatment Centers (ETCs). Demographic, clinical, biological, virological and treatment data were collected. We evaluated factors known to affect the risk of in-hospital death and applied univariate and multivariate Cox proportional-hazards analyses to derive the risk score in a training dataset. We validated the score in an internal-validation dataset, applying C-statistics as a measure of discrimination. Between August 1^st 2018 and December 31^th 2019, 711 patients were enrolled in the study. Regarding supportive care, patients received vasopressive drug (n = 111), blood transfusion (n = 101), oxygen therapy (n = 250) and cardio-pulmonary ultrasound (n = 15). Overall, 323 (45%) patients died before day 28. Six independent prognostic factors were identified (ALT, creatinine, modified NEWS2 score, viral load, age and symptom duration). The final score range from 0 to 13 points, with a good concordance (C = 86.24%) and calibration with the Hosmer-Lemeshow test (p = 0.12). The implementation of advanced supportive care is possible for EVD patients in emergency settings. PREDS is a simple, accurate tool that could help in orienting early advanced care for at-risk patients after external validation. This study was funded by ALIMA.

Polio-associated paralysis is one of the diseases under national surveillance in the Democratic Republic of the Congo (DRC). Although it has become relatively rare due to control measures, non-polio paralysis cases are still reported and constitute a real problem, especially for etiological diagnosis, which is necessary for better management and response. From September 2022 to April 2023, we investigated acute flaccid paralysis (AFP) cases in Kinshasa following an alert from the Provincial Division of Health. All suspected cases and their close contacts were investigated and sampled. Among the 57 sampled patients, 21 (36.8%) were suspects, and 36 (63.2%) were contacts. We performed several etiological tests available in the laboratory, targeting viruses, including Poliovirus, Influenza virus, SARS-CoV-2, Enterovirus, and arboviruses. No virus material was detected, but the serological test (ELISA) detected antibodies against Chikungunya Virus, i.e., 47.4% (27/57) for IgM and 22.8% (13/57) for IgG. Among suspected cases, we detected 33.3% (7/21) with anti-Chikungunya IgM and 14.3% (3/21) of anti-Chikungunya IgG. These results highlight the importance of enhancing the epidemiological surveillance of Chikungunya.

Background: Poliomyelitis is a vaccine-preventable disease, with oral poliomyelitis vaccines (OPVs) and injectable poliomyelitis vaccines. In the Democratic Republic of the Congo (DRC), circulating vaccine-derived polioviruses (VDPVs) persist due to intrinsic and extrinsic factors, including the quality of the cold chain, which may make the vaccines less effective. This study’s objective was to evaluate the cold chain’s quality of OPVs and its effect on the vaccine’s viability and potency at different levels in health systems in Kinshasa. Methods: A cross-sectional study was conducted in Kinshasa, collecting OPVs at different levels of the health pyramid. Vaccine viability was assessed by cell culture using a modified World Health Organization (WHO) protocol, and the viral titer was determined using the Karber formula. The vaccine titer was classified as “very good”, “good”, or “poor” according to the WHO standard’s viral titer. Results: A total of 53 vaccines were collected and analyzed, compressing 38 bivalent oral poliomyelitis (bOPV) vaccines and 15 novel oral poliomyelitis vaccines, type 2 (nOPV2). The viral titer ranged from log10^5.8 to log 10^7.3 and from log10^5.4 to log10^8.9 for the nOPV2 and the bOPV, respectively. Of these 53 vaccine samples, 10% of the bOPVs showed viral titers below the recommended WHO threshold (>10⁶ CCID₅₀/dose), 100% of the nOPV2 had viral titers within the WHO standards (>10⁵ CCID₅₀/dose), and a significant decline in the viral titer was observed for both types of vaccines (nOPV2 and bOPV) as the distribution progressed along the level of the health pyramid. Conclusions: This study demonstrated that the viral titer of OPV declined from central to peripheral areas in routine and campaign strategies in Kinshasa.