Keywords
syndrome
poisoning
sociodemographic characteristics, clinical profile
Democratic Republic of Congo
How to Cite
Abstract
Introduction
In eastern Democratic Republic of Congo, particularly in Bunia, a phenomenon locally referred to as karuho is widely reported and interpreted as intentional poisoning or a culturally defined illness. Due to the absence of standardized biomedical diagnostic criteria, many cases are managed in traditional or tradimodern treatment centers.
Purpose
This study aimed to describe the sociodemographic and clinical profile of karuho-positive patients using a syndromic approach.
Methods
A descriptive cross-sectional study was conducted from May 5, 2024, to January 2, 2025, among 345 consecutive patients diagnosed as karuho-positive in four tradimodern treatment centers in Bunia, DRC. Data on sociodemographic characteristics, medical history, vital signs, and clinical manifestations were collected using a structured questionnaire and clinical examination. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20 and presented as frequencies and percentages. A comparative syndromic analysis was performed against selected infectious and chronic diseases.
Results
A total of 345 participants were included, with a male predominance (58.8%). The most affected age group was 30–44 years (37.1%), followed by those aged ≥60 years (33.3%). Most participants had secondary (39.7%) or university education (33.1%). Nearly half were married (49.9%), and 27.5% were unemployed. The most frequent clinical manifestations were asthenia (67.2%), headache (62.9%), epigastric pain (57.4%), chest pain (50.1%), and fever (47.0%). Gastrointestinal symptoms included nausea (38.0%), vomiting (25.8%), diarrhea (15.1%), constipation (18.0%), and abdominal pain (16.2%). Neurological manifestations included agitation (12.5%), confusion (12.2%), somnolence (13.0%), and coma (0.9%). Medical history was dominated by reported liver disease (79.1%), followed by exertional dyspnea (31.3%), peripheral neuropathy (15.1%), hypertension (12.8%), and pneumonia (10.7%). Elevated blood pressure (>140 mmHg) was observed in 78.3% of participants. Other findings included tachycardia (16.5%), bradycardia (4.1%), oxygen desaturation (4.6%), and fever (2.6%). Pulmonary rales (10.4%), jaundice (3.5%), dry skin (3.5%), and peripheral edema (2.9%) were the most common physical findings. Comparative analysis showed strong clinical overlap between karuho symptoms and those of malaria, typhoid fever, tuberculosis, HIV infection, Helicobacter pylori infection, and selected cancers.
Conclusion
Karuho presents as a non-specific multisystem syndrome with prominent gastrointestinal, respiratory, neurological, and general systemic manifestations. Its clinical profile closely overlaps with common infectious and chronic diseases in tropical settings, suggesting that many cases may represent misinterpreted or undiagnosed medical conditions rather than a distinct pathological entity. Further laboratory studies are needed to determine its true nature.
References
Abbas, M., Sharif, F. A., Osman, S. M., Osman, A. M., El Sanousi, S. M., Magzoub, M., & Ibrahim, M. E. (2018). Prevalence and associated symptoms of Helicobacter pylori infection among schoolchildren in Kassala State, East of Sudan. Interdisciplinary Perspectives on Infectious Diseases, 2018, 4325752. https://doi.org/10.1155/2018/4325752
Bria, Y. P., Yeh, C.-H., & Bedingfield, S. (2021). Significant symptoms and nonsymptom-related factors for malaria diagnosis in endemic regions of Indonesia. International Journal of Infectious Diseases, 103, 194–200. https://doi.org/10.1016/j.ijid.2020.11.177
Bush, L. M., Vazquez, M., & Tesini, B. (2024). Typhoid fever. In Merck Manual Professional Version. https://www.msdmanuals.com
Charan, J., & Biswas, T. (2013). How to calculate sample size for different study designs in medical research? Indian Journal of Psychological Medicine, 35(2), 121–126. https://doi.org/10.4103/0253-7176.116232
Kaboru, B. B. (2013). Geographical, health systems’ and sociocultural patterns of TB/HIV co-infected patients’ health-seeking behavior in a conflict-affected setting: The case of Eastern Democratic Republic of Congo. Journal of Community Medicine & Health Education, 4(1). https://doi.org/10.4172/2161-0711.1000263
Kyolo, S. K., Bbosa, G. S., Odda, J., Lubega, A. M., & Edmond, N. N. (2018). Toxicity profile of karuho poison on the brain of Wistar albino rats. Neuroscience and Medicine, 9(2), 63–80. https://doi.org/10.4236/nm.2018.92008
Kyolo, S. K., Odda, J., Lubega, A., & Bbosa, G. S. (2019). Blood chemistry and major body organ induced-toxicity by locally-made traditional OMGKRP karuho poison in Wistar albino rats. Neuroscience and Medicine, 10(3), 272–291. https://doi.org/10.4236/nm.2019.103021
Lackman, M. J., & Wilkinson, A. N. (2024). Colon cancer in primary care. Canadian Family Physician, 70(1), e14–e19. https://doi.org/10.46747/cfp.7001e14
Letizia, A. G., Eller, L. A., Bryant, C., Dawson, P., Nitayaphan, S., Kosgei, J., Kibuuka, H., Maganga, L., Kroon, E., Sriplienchan, S., Michael, N. L., O’Connell, R. J., Kim, J. H., & Robb, M. L. (2022). Clinical signs and symptoms associated with acute HIV infection from an intensely monitored cohort on two continents. Medicine, 101(5), e28686. https://doi.org/10.1097/MD.0000000000028686
Longo-Mbenza, B., Apalata, T., Longokolo, M., Mbula Mambimbi, M., Mokondjimobe, E., Gombet, T., Ellenga, B., Buassa-bu-Tsumbu, B., Milongo Dipa, G., Lukoki Luila, E., & Nge Okwe, A. (2015). Association of Helicobacter pylori infection with the metabolic syndrome among HIV-infected Black Africans receiving highly active antiretroviral therapy. Cardiovascular Journal of Africa, 26(2), 52–56. https://doi.org/10.5830/CVJA-2015-012
Luneghe, M. (2019, May 28). DRC: A town searching for remedy against hostility turning into poisoning. Global Press Journal. https://globalpressjournal.com
Mbeva, J.-B. K., Prudence, M. N., Musubao, E. T., Nzanzu, M., Namegabe, N., Kimanuka, C., Lambert, H., & Porignon, D. (2021). Therapeutic itineraries of patients in urban African settings: The case of Goma City, eastern Democratic Republic of the Congo. International Journal of Innovation and Scientific Research, 53(1), 85–97. http://www.ijisr.issr-journals.org/
Micoulaud-Franchi, J.-A., Amad, A., Geoffroy, P. A., Fovet, T., & Quiles, C. (2016). The concept of syndrome as a didactic tool in biomedical education. Pédagogie Médicale, 17(4), 269–272. https://doi.org/10.1051/pmed/2017009
Mwabi, A. N., Ntakarutimana, V., & Bisimwa, G. B. (2020). Poisoning investigations in the city of Bukavu and the effects of antidotes administered by traditional healers. International Journal of Innovative Science and Research Technology, 5(2), 216–222. http://www.ijisrt.com/
Nassenstein, N. (2019). The linguistic taboo of poisoning in Kivu Swahili. https://www.academia.edu/39209581
Nawa Mwengu, L., Kitambala, L., Malonga Kaj, F., Kahumba Byanga, B., & Kakoma Sakatolo, K. (2021). Cartography and characteristics of traditional practitioners and phytotherapy in Lubumbashi, Democratic Republic of the Congo. International Journal of Sciences and Scientific Studies, 1(4), 23–24.
Ndelo-di-Phanzu, J., Mputu Malolo, L., Ndelo Matondo, P., Nuapia, Y., & Mbendi Nsukini, S. (2018). Helicobacter pylori digestive and extra-digestive pathologies collected in the Democratic Republic of the Congo. Journal of Pharmaceutical Sciences & Emerging Drugs, 6(1), Article 1000124. https://doi.org/10.4172/2380-9477.1000124
Nemi, K. D., Djalogue, L., Djagadou, K. A., Tchamdja, T., Tsevi, Y. M., & Balaka, A. (2019). Modes of diabetes diagnosis at Sylvanus Olympio University Hospital. Pan African Medical Journal, 34, Article 99. https://doi.org/10.11604/pamj.2019.34.99.20012
Nsapu, E. (2014). Traditional healer in DRC treats suspected poisoning victims regardless of tribe. Global Press Journal. https://globalpressjournal.com/africa/democratic-republic-of-congo/traditional-healer-in-drc-treats-suspected-poisoning-victims-regardless-of-tribe/
Tan, M., Otake, Y., Tamming, T., Akuredusenge, V., Uwinama, B., & Hagenimana, F. (2021). Local experience of using traditional medicine in northern Rwanda: A qualitative study. BMC Complementary Medicine and Therapies, 21, Article 210. https://doi.org/10.1186/s12906-021-03380-5
Tékpa, G., Fikouma, V., Téngothi, R. M. M., Longo, J. de D., Woyengba, A. P. A., & Koffi, B. (2019). Epidemiological and clinical aspects of tuberculosis in hospital settings in Bangui. Pan African Medical Journal, 33, Article 31. https://doi.org/10.11604/pamj.2019.33.31.13442
World Health Organization. (n.d.). Typhoid fever. https://www.who.int/news-room/fact-sheets/detail/typhoid
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