Abstract
Introduction
Urolithiasis represents a growing public health concern in sub-Saharan Africa. In low-resource settings such as the Democratic Republic of the Congo (DRC), access to advanced imaging modalities—particularly non-contrast computed tomography (CT)—remains severely restricted. Consequently, ultrasonography and plain abdominal radiography (KUB) serve as primary diagnostic modalities despite inherent sensitivity limitations for small and distal ureteral calculi. Local data describing the frequency and radiological characteristics of urolithiasis remain scarce in northeastern DRC.
Purpose
This study aimed to determine the frequency of imaging-confirmed urolithiasis and evaluate its sociodemographic, clinical, and radiological characteristics at the Cinquantenaire Hospital of Kisangani.
Methods
A retrospective descriptive study was conducted among 303 consecutive patients presenting with suspected urolithiasis who underwent ultrasonography and/or KUB at the Cinquantenaire Hospital of Kisangani between January 2020 and December 2024. An exhaustive sampling method was utilized. Categorical variables were summarized as frequencies and percentages, and continuous variables were expressed as means and standard deviations (M ± SD). Bivariate associations were evaluated using Pearson’s chi-square test or Fisher’s exact test. Odds ratios (ORs) with 95% confidence intervals (CIs) were computed, with statistical significance set at p < 0.05.
Results
Imaging-confirmed urolithiasis was identified in 159 of 303 evaluated patients, yielding a frequency of 52.5% (95% CI [46.9, 58.1]). The mean age was 41.9 ± 15.3 years, with a major representation among individuals aged 30–49 years (55.1%). Renal colic was the primary presenting symptom (89.1%). Nephrolithiasis accounted for the predominant anatomical localization (93.1%), and the majority of calculi measured ≤10 mm (84.3%). Multiple stones were more common than solitary stones (56.6% vs. 43.4%). Hydronephrosis was detected in 8.2% of confirmed cases. In bivariate analysis, age (p = 0.047), a personal history of urolithiasis (OR = 3.4, 95% CI [1.02, 4.39], p = 0.030), urinary tract infection (OR = 2.5, 95% CI [1.15, 5.50], p = 0.012), and diabetes mellitus (OR = 0.2, 95% CI [0.04, 0.81], p = 0.015) demonstrated statistically significant associations with urolithiasis status.
Conclusion
The frequency of imaging-confirmed urolithiasis was high among symptomatic patients evaluated in Kisangani. Ultrasonography remains indispensable as a first-line diagnostic modality in resource-constrained environments. Standardized ultrasound protocols, clinician training, and optimized clinical decision pathways are required to improve early detection and management.
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