Sickle cell anemia (SCA) is considered a major risk factor for renal complications. The main goal of this study was to determine the frequency of macroalbuminuria and microalbuminuria in Congolese children <18 years of age suffering from Sickle cell anemia and to identify associated factors. The cross-sectional study was completed in 150 hemoglobin-SS children (77 boys and 73 girls). Microalbuminuria was defined by a urine albumin:creatinine ratio of 30–299 mg/g. The mean age of this group was 8.8 ± 4.3 years (range 2–18). Microalbuminuria was found in 27 children (18%). In multivariate logistic regression, only age emerged as a determinant of microalbuminuria odds ratio 1.11 (95% confidence interval 1.00–1.22); P = 0.042]. In our series, only age was a major determinant of the occurrence of microalbuminuria. These results confirm the need for early screening of microalbuminuria in Congolese children suffering from Sickle cell anemia in a context where access to renal and bone marrow transplant is nonexistent.

Cette étude descriptive transversale, réalisée aux Cliniques Universitaires de Kinshasa (CUK), avait pour objectif de déterminer la prévalence de l’automédication chez les malades reçus aux CUK et identifier les molécules consommées en automédication. Au total, 391 patients âgés de 14 à 92 ans admis au service d’urgences de médecine interne des CUK entre le 15/01/2011 et le 15/02/2011 ont été inclus et interrogés. Deux cent trente-trois patients sur 391 se sont automédiqués entre le début des symptômes et la consultation aux CUK, soit une prévalence d’automédication de 59,6 %. Le nombre de médicaments consommés en automédication a varié de 1 à 7. Parmi ces 233 patients, 224 (96,1 %) ont consommé des produits pharmaceutiques seuls, 4 (1,7 %) des médicaments traditionnels africains seuls, 1 (0,4 %) des médicaments de la médecine chinoise seuls, et 4 (1,7 %) ont combiné des produits pharmaceutiques et des médicaments traditionnels africains. Les produits pharmaceutiques les plus utilisés étaient les analgésiques et antipyrétiques (44,3 %), les anti-inflammatoires non stéroïdiens (AINS) (26,3 %), les antipaludiques (20,6 %) et les antibiotiques (12,3 %). Le paracétamol était l’analgésique et antipyrétique le plus consommé (89,1 %). Parmi les AINS, le diclofénac (65 %) a prédominé. Les combinaisons thérapeutiques à base d’artémisinine (40,4 %) étaient les antipaludiques les plus utilisés. Les antibiotiques les plus cités étaient les β-lactamines (amoxicilline et ampicilline) (42,9 %). Cette étude montre que l’automédication est un choix thérapeutique de la majorité des patients avant leur recours aux CUK. Elle concerne surtout des produits d’origine pharmaceutique, couramment prescrits, dont l’utilisation inadéquate pourrait entraîner un risque sanitaire individuel et/ou communautaire.

Decreased residual urine volume (RUV) is associated with higher mortality in hemodialysis (HD). However, few studies have examined RUV in patients on HD in Sub-Saharan Africa. The aim of this study was to identify predictors of RUV among incident hemodialysis patients in Kinshasa. This historical cohort study enrolled 250 patients with ESRD undergoing hemodialysis between January 2007 and July 2013 in two hemodialysis centers in Kinshasa. RUV were collected over 24 h at the initiation of HD and 6 and 12 months later during the interdialytic period. We compared the baseline characteristics of the patients according to their initial RUV (≤ 500 ml/day vs > 500 ml/day) using Student’s t, Mann-Whitney U and Chi2 tests. Linear mixed-effects models were used to search for predictors of decreased RUV by adding potentially predictive baseline covariates of the evolution of RUV to the effect of time: age, sex, diabetes mellitus, hypertension, diastolic blood pressure, diuretics, angiotensin conversion enzyme inhibitors (ACEI), angiotensin receptor blockers, hypovolemia, chronic tubulointerstitial nephropathy, left ventricular hypertrophy and initial hemodialysis characteristic. A value of p < 0.05 was considered the threshold of statistical significance. The majority of hemodialysis patients were male (68.8%, sex ratio 2.2), with a mean age of 52.5 ± 12.3 years. The population’s RUV decreased with time, but with a slight deceleration. The mean RUV values were 680 ± 537 ml/day, 558 ± 442 ml/day and 499 ± 475 ml/day, respectively, at the initiation of HD and at 6 and 12 months later. The use of ACEI at the initiation of HD (beta coefficient 219.5, p < 0.001) and the presence of chronic tubulointerstitial nephropathy (beta coefficient 291.8, p = 0.007) were significantly associated with RUV preservation over time. In contrast, the presence of left ventricular hypertrophy at the initiation of HD was significantly associated with decreased RUV over time (beta coefficient − 133.9, p = 0.029). Among incident hemodialysis patients, the use of ACEI, the presence of chronic tubulointerstitial nephropathy and reduced left ventricular hypertrophy are associated with greater RUV preservation in the first year of dialysis.

Objectives: This study aimed to summarize validity estimates of International Classification of Diseases (ICD) codes in identifying opioid overdose (OOD) among patient data from emergency rooms, emergency medical services, inpatient, outpatient, administrative, medical claims, and mortality, and estimate the sensitivity and specificity of the algorithms in the absence of a perfect reference standard. Methods: We systematically reviewed studies published before December 8, 2023, and identified with Medline and Embase. Studies reporting sufficient details to recreate a 2 × 2 table comparing the ICD algorithms to a reference standard in diagnosing OOD-related events were included. We used Bayesian latent class models (BLCM) to estimate the posterior sensitivity and specificity distributions of five ICD-10 algorithms and of the imperfect coroner’s report review (CRR) in detecting prescription opioid–related deaths (POD) using one included study. Results: Of a total of 1990 studies reviewed, three were included. The reported sensitivity estimates of ICD algorithms for OOD were low (range from 25.0% to 56.8%) for ICD-9 in diagnosing non-fatal OOD-related events and moderate (72% to 89%) for ICD-10 in diagnosing POD. The last included study used ICD-9 for non-fatal and fatal and ICD-10 for fatal OOD-related events and showed high sensitivity (i.e. above 97%). The specificity estimates of ICD algorithms were good to excellent in the three included studies. The misclassification-adjusted ICD-10 algorithm sensitivity estimates for POD from BLCM were consistently higher than reported sensitivity estimates that assumed CRR was perfect. Conclusion: Evidence on the performance of ICD algorithms in detecting OOD events is scarce, and the absence of bias correction for imperfect tests leads to an underestimation of the sensitivity of ICD code estimates.