Orapuh Journal

Heavy metal removal from hospital effluents at the University Clinics of Kinshasa using a UASB reactor: A comparative analysis under optimised and non-optimised operational conditions

Sun, 25 Jan 2026 13:58:06 +0200

Introduction

Hospital effluents often contain heavy metals that pose significant environmental and public health risks, particularly in settings with limited access to advanced wastewater treatment technologies. Upflow Anaerobic Sludge Blanket (UASB) reactors represent a low-cost alternative; however, pilot-scale data on heavy metal removal remain scarce.

Purpose

This study evaluated the performance of a pilot-scale UASB reactor for heavy metal removal under optimised and non-optimised operational conditions and identified key factors influencing treatment efficiency.

Methods

A Plackett–Burman experimental design was used to screen critical operational parameters. The UASB reactor was operated for 12 weeks using real hospital effluent collected from the University Clinics of Kinshasa, with 36 samples analysed per monitoring point. The optimised reactor (P14) incorporated natural additives, including clay, eggshells, maize, and lime. Heavy metal concentrations were determined using atomic absorption spectrophotometry (AAS), with quality assurance and quality control procedures, calibration standards, and analytical blanks applied throughout.

Results

Under optimised conditions, substantial reductions were observed in chemical oxygen demand (COD; 620 → 150 mg/L) and heavy metal concentrations: iron (1.20 → 0.45 mg/L), copper (0.85 → 0.30 mg/L), and zinc (0.60 → 0.22 mg/L), corresponding to removal efficiencies of approximately 60–70%. Nickel and manganese concentrations also decreased but remained above World Health Organization guideline limits. Reactor performance remained stable throughout the 12-week operational period.

Conclusion

Pilot-scale UASB reactors supplemented with natural additives can significantly enhance heavy metal removal from hospital effluents. Further research is required to assess long-term operational stability, heavy metal fate, sludge management, and scalability prior to full-scale implementation.

Evaluation of access to water, hygiene and sanitation (WASH) in the Lushagala displaced persons camp, Goma, Democratic Republic of the Congo: Compliance with SPHERE standards

Sun, 01 Feb 2026 00:00:00 +0200

Introduction

Access to safe drinking water, hygiene, and sanitation (WASH) is a fundamental human right and a critical public health determinant, particularly in humanitarian emergency settings.

Purpose

This study aimed to assess access to WASH services in the Lushagala displaced persons camp in Goma, Democratic Republic of the Congo (DRC), and to compare the findings with the SPHERE minimum standards in order to identify gaps and inform improvement interventions.

Methods

A descriptive cross-sectional study was conducted from 1 to 31 July 2024 among 446 households selected using a systematic two-stage probability sampling method. Data were collected using KoboCollect and analysed with Stata version 15.0. The study received ethical approval (Approval No. ESP/CE/200/2024) and was conducted after obtaining verbal informed consent from participants.

Results

Average water consumption was 5.9 litres per person per day. Sixty-two per cent of households spent more than 30 minutes collecting water (95% CI: 57.5%–66.5%). The sanitation coverage ratio was 63 people per latrine. Only 6.3% of sanitation facilities (95% CI: 4.0%–8.6%) had a functional handwashing station, and 82% of latrines were poorly maintained (95% CI: 78.4%–85.6%). In addition, 87.7% of households (95% CI: 84.6%–90.8%) reported the presence of solid waste in their household surroundings.

Conclusion

The study reveals critical gaps in access to WASH services in the Lushagala displaced persons camp when compared with SPHERE minimum standards. These findings highlight the urgent need to increase water supply to at least 15 litres per person per day and to address sanitation deficits through the construction of approximately 2,900 additional latrines, thereby reducing the current ratio of 63 people per latrine to the recommended standard of 20 people per latrine. These results provide essential evidence to guide the actions of authorities and humanitarian actors.

Verification of an analytical method and in vitro comparative study of the dissolution kinetics of generic amoxicillin 500 mg capsules manufactured by the local pharmaceutical industry in the Democratic Republic of the Congo

Thu, 05 Feb 2026 14:32:07 +0200

Introduction

Strengthening the local pharmaceutical industry in the Democratic Republic of the Congo to produce affordable, effective, and high-quality medicines contributes to improved health outcomes and economic development. The government grants a monopoly to local manufacturers for the production of certain generic medicines, such as amoxicillin. These products are required to meet established quality, safety, and efficacy standards to adequately address population health needs.

Purpose

The objective of this study was to evaluate the interchangeability of different brands of amoxicillin produced by local manufacturers in the Democratic Republic of the Congo with a reference (innovator) product through comparative in vitro dissolution testing.

Methods

Two generic products manufactured by local pharmaceutical companies and one innovator product were evaluated. For each product, one batch was randomly purchased from authorised wholesalers. Analyses were conducted using high-performance liquid chromatography in accordance with the United States Pharmacopeia–National Formulary (USP–NF, 2024). Twelve dosage units were analysed to establish dissolution profiles. Comparative dissolution testing was performed at different pH conditions (1.2, 4.5, and 6.8) using a paddle-type dissolution apparatus. Quantification was carried out by UV spectrophotometry, and dissolution profiles were compared using the difference factor (f₁) and similarity factor (f₂). Acceptable ranges were 0–15 for f₁ and 50–100 for f₂.

Results

All samples complied with the USP–NF 2024 specifications. However, dissolution recovery rates differed across sampling points. The fit factor analysis demonstrated interchangeability with the reference product only at pH 1.2, while no similarity was observed at pH 4.5 and 6.8.

Conclusion

The findings indicate potential concerns regarding the efficacy and interchangeability of locally manufactured generic amoxicillin products compared with the innovator product. Manufacturers should re-evaluate their formulations, considering all factors influencing dissolution performance. In addition, regulatory authorities should strengthen post-marketing surveillance to ensure the quality of pharmaceutical products.

Evaluation of the effectiveness of Spirulina platensis for the nutritional rehabilitation of malnourished children aged 6–59 months: The case of the Mont-Ngafula II health zone

Fri, 13 Feb 2026 00:00:00 +0200

Introduction

Childhood malnutrition remains a major public health challenge, particularly in resource-limited settings such as the Democratic Republic of the Congo (DRC). Effective, affordable, and sustainable nutritional interventions are urgently needed to improve the recovery of malnourished children. Spirulina platensis, a microalga with high nutritional density, represents a promising option; however, evidence from controlled trials in this context remains limited.

Purpose

To evaluate the nutritional effectiveness of Spirulina platensis supplementation on the nutritional status and biological parameters of malnourished children aged 6–59 months in the Mont-Ngafula II health zone in Kinshasa.

Methods

A single-blind randomised controlled trial was conducted among 100 malnourished children allocated to two groups over a 120-day period. One group received maize porridge enriched with spirulina (4 g every other day), while the control group received non-enriched maize porridge. Anthropometric indicators (mid-upper arm circumference, weight, and height) and biological parameters (haemoglobin, serum iron, albumin, total proteins, urea, and creatinine) were assessed before and after the intervention. Multivariate logistic regression was used to identify independent determinants of nutritional recovery.

Results

At the end of follow-up, 32% of children achieved complete nutritional recovery. The prevalence of severe acute malnutrition decreased from 71% to 47%. A highly significant improvement in mid-upper arm circumference was observed in the spirulina group (p < .001), along with significant increases in serum iron, albumin, and total protein levels. Spirulina consumption was strongly associated with nutritional recovery (OR = 357.2, 95% CI [5.24, 24,344.7], p = .006), with excellent model performance (AUC = 0.98).

Conclusion

Supervised supplementation with Spirulina platensis, integrated into a staple food, significantly improves both nutritional and biological status in malnourished children. This strategy appears well suited to resource-limited settings and merits thoughtful integration into child malnutrition management programmes, pending confirmation through larger-scale and longer-term studies.

Periodontal status of hypertensive patients in hospital settings in Kinshasa

Fri, 27 Feb 2026 22:30:20 +0200

Introduction

Periodontal disease may contribute to the development or aggravation of high blood pressure (HBP). Conversely, hypertension increases susceptibility to periodontal deterioration. Despite the high prevalence of hypertension in the Congolese population, no periodontal profile of Congolese adults with hypertension has yet been established.

Purpose

This study aimed to describe the periodontal status of hypertensive patients receiving care in hospitals in Kinshasa and to identify associated factors.

Methods

A cross-sectional study was conducted from November 2023 to May 2024 in two medical institutions in Kinshasa. Patients aged ≥18 years with diagnosed hypertension who provided informed consent were included. Patients with prior periodontal treatment, leukaemia, pregnancy, or diabetes were excluded. A single trained and calibrated examiner collected demographic, clinical, and periodontal data. Statistical analyses were performed using IBM SPSS Statistics version 20.0. The chi-square test and multinomial regression analysis were applied to determine factors associated with periodontal status. Statistical significance was set at p < .05.

Results

A total of 227 hypertensive patients with a mean age of 57.9 ± 11.5 years participated in the study. Periodontal disease was present in 93.8% of participants. Age was identified as an independent predictor of severe periodontitis (OR = 17.86; 95% CI [3.58–89.07]). Duration of hypertension independently predicted both moderate and severe periodontitis. Patients with hypertension lasting at least four years showed an increased risk of moderate periodontitis (OR = 8.02; 95% CI [1.37–47.06]) and severe periodontitis (OR = 10.05; 95% CI [1.75–57.65]). Gingivitis was not significantly associated with periodontal disease severity.

Conclusion

Hypertensive patients demonstrated a high prevalence of periodontal disease. These findings support the integration of oral health assessment, particularly periodontal screening, into routine hypertension management.

Radiologic patterns of distant organ metastasis in advanced breast cancer patients: A report of 114 computed tomography cases in private and public medical practice in Kinshasa

Thu, 05 Mar 2026 18:57:46 +0200

Introduction

Distant metastases from breast cancer represent a major determinant of prognosis and therapeutic decision-making. Computed tomography (CT) plays a central role in staging advanced disease, particularly in resource-limited settings where local epidemiological data remain scarce.

Purpose

To describe the radiological patterns of distant metastases detected on CT scans in patients with advanced breast cancer in Kinshasa.

Methods

A retrospective descriptive study was conducted over a five-year period (January 2020–January 2025) across four medical imaging centres in Kinshasa. Thoracoabdominopelvic CT scan reports from 114 patients diagnosed with stage IIIB and IV breast cancer were analysed. Metastases were identified according to predefined radiological criteria, and data were analysed using descriptive statistics.

Results

The mean age of patients was 52.9 years (range: 19–96 years). Thoracic metastases were observed in 98 patients (85.9%), abdominopelvic metastases in 67 patients (58.3%), and bone metastases in 40 patients (35.0%). The lungs were the most frequently affected site (75 cases), followed by the liver (46 cases). Bone metastases predominantly involved the spine (32 cases) and were mainly osteolytic in nature. Lymph node involvement was identified in 26 patients, primarily within the thoracic region. Multisite metastases were present in 74 patients (64.9%).

Conclusion

Advanced breast cancer in Kinshasa is characterised by a high prevalence of metastases, frequently multisystemic, with predominant involvement of the lungs and liver. CT imaging remains an essential tool for disease staging and treatment guidance in this setting.

Strategies to enhance nurse educator–student interaction in the higher education classroom environment: A Limpopo Province study

Rirhandzu Friddah Mathevula, Letta Mathebula — Thu, 19 Mar 2026 16:24:25 +0200

Introduction

The effectiveness of nurse education largely depends on meaningful engagement between nurse educators and student nurses in the classroom environment. Positive classroom interaction supports active learning, improves knowledge acquisition, and promotes the development of critical thinking abilities essential for professional nursing practice.

Purpose

The study aimed to explore strategies to enhance interaction between nurse educators and novice student nurses within the higher education classroom environment in Limpopo Province.

Methods

A qualitative descriptive design was employed. Three nurse educators were selected using purposive sampling, and data were collected through in-depth, face-to-face semi-structured interviews. A sample of 25 student nurses was selected using stratified random sampling and participated in focus group discussions. The group consisted of 10 males and 15 females. Data analysis was guided by Tesch’s method, a systematic eight-step qualitative data analysis process commonly used in nursing research to identify themes from textual interview data.

Results

The findings revealed three key factors influencing educator–student classroom interaction: the classroom environment, teaching methods, and educator attitudes. Students reported that overcrowded classrooms hindered concentration, questioning, and meaningful interaction. They preferred active and participatory approaches—such as case studies, group discussions, and problem-based learning—over traditional lectures. Educator approachability, respect, and the creation of a safe learning space were considered critical. One student noted that being listened to made them feel valued and encouraged positive interaction. Using Peplau’s Theory, the study identified building trust and safety, promoting collaborative knowledge exchange, and fostering independence and reflection as key strategies for enhancing educator–student classroom interaction.

Conclusion

A key recommendation is that nursing programmes should limit class sizes in foundational courses to a maximum of 40 students and implement structured training for educators in interactive, student-centred teaching approaches to improve classroom interaction and overall learning quality.

Factors influencing the quality of induction of labour at a district hospital in Tshwane: A qualitative study

Rirhandzu Friddah Mathevula, Gofaone Precious Mosesane-Kuduntwane — Fri, 27 Mar 2026 18:18:15 +0200

Introduction

Induction of labour is a widely used obstetric intervention performed when continuation of pregnancy poses risks to maternal or fetal health. In South Africa’s public healthcare sector, induction rates remain high. Outcomes are closely linked to the quality of care, which is influenced by clinical practices, health system factors, and resource constraints. Associated risks include failed induction, uterine hyperstimulation, and emergency caesarean delivery.

Purpose

This study aimed to explore factors influencing the quality of induction of labour practices among midwives at a district hospital in Tshwane, South Africa.

Method

A qualitative exploratory descriptive design was employed. The study was conducted at a busy district hospital in the Tshwane District, Gauteng Province. Purposive sampling was used to recruit 16 female midwives qualified in basic and advanced midwifery, aged 27–64 years, each with at least two years of experience and direct involvement in labour induction. Data were collected between July and August 2023 through in-depth semi-structured interviews. Interviews were audio-recorded with participants’ consent and transcribed verbatim. Data were analysed using the thematic analysis approach described by Braun and Clarke.

Results

Analysis revealed one overarching theme, systemic barriers compromising induction quality, comprising three subthemes derived from participant responses. Five participants reported (1) overbooking and heavy caseloads leading to rushed procedures; seven participants highlighted (2) increasing induction volumes alongside fixed staffing levels; and seven participants identified (3) inadequate institutional support, including limited access to guidelines, insufficient training, and lack of multidisciplinary support. These factors collectively undermine clinical decision-making, adherence to protocols, and overall quality of care, while also contributing to midwife burnout and adverse maternal–fetal outcomes.

Conclusion

The findings highlight systemic challenges at a district hospital in Tshwane that compromise the quality of labour induction. These results underscore the need for urgent interventions, including strengthened institutional support, implementation of a scheduling cap of three inductions per day, staffing reviews, and the establishment of quarterly induction of labour (IOL) review mechanisms.

Factors associated with urinary lithiasis detected by ultrasound and radiography at the Cinquantenaire Hospital of Kisangani

Fri, 27 Mar 2026 19:32:15 +0200

Introduction

Urinary lithiasis is an increasingly significant public health concern in sub-Saharan Africa. However, in the Democratic Republic of the Congo (DRC), epidemiological data and factors associated with this condition remain limited.

Purpose

This study aimed to analyze factors associated with urinary lithiasis among patients examined in Kisangani.

Methods

A cross-sectional analytical study was conducted involving 303 patients who underwent ultrasound and/or radiography for suspected urinary lithiasis at the Cinquantenaire Hospital of Kisangani between 2020 and 2024. Qualitative variables were expressed as proportions, while age was presented as mean ± standard deviation. Bivariate analysis was performed to identify significant associations using Pearson’s chi-square test or Fisher’s exact test at a 5% significance level. Crude odds ratios (ORs) with 95% confidence intervals (CIs) and Wald p-values were calculated.

Results

The mean age of the patients was 41.9 ± 15.3 years, with a predominance of individuals aged 30 to 49 years. Bivariate analysis revealed a statistically significant association between urinary lithiasis and a personal history of lithiasis (crude OR = 3.43, p = .030), as well as the presence of a urinary tract infection (crude OR = 2.45, p = .012).

Conclusion

Young adulthood, a history of kidney stones, and urinary tract infection appear to be significantly associated factors. These findings highlight the need to strengthen targeted ultrasound screening and to integrate the management of risk factors into local public health strategies.

Prevalence and associated factors of dyslipidemia among the population infected with Helicobacter pylori in Bunia town, Province of Ituri, Democratic Republic of the Congo

Mon, 30 Mar 2026 18:36:22 +0200

Introduction

Beyond gastric disease, Helicobacter pylori infection has been implicated in metabolic disturbances, including dyslipidemia; however, evidence from eastern Democratic Republic of the Congo remains limited.

Purpose

This study aimed to determine the prevalence and associated factors of dyslipidemia among individuals infected with H. pylori in Bunia, Ituri Province.

Methods

This cross-sectional study was conducted at the Evangelical Medical Centre Clinic (CME-Bunia) among 384 adult patients diagnosed with H. pylori infection from January to June 2025. For diagnosis, 0.5 g of stool was diluted in solvent and analyzed using a test strip. For lipid profiling, 5 mL of fasting venous blood was collected, and serum was analyzed for high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), and triglycerides. A structured questionnaire was used to collect sociodemographic, medical, and lifestyle-related data. Data were analyzed using STATA version 15.2. Logistic regression was used for bivariate and multivariate analyses.

Results

The prevalence of dyslipidemia was 54.17%. The most frequent lipid abnormalities were combined elevated LDL-C and triglycerides (20.57%), followed by combined low HDL-C and elevated triglycerides (20.05%). Alcohol consumption of more than two glasses per day was associated with a tenfold increased risk of LDL-C disorder after adjustment for other variables (AOR = 9.96, 95% CI [4.56, 21.75], p < .001). Factors significantly associated with HDL-C disorder included age 31–40 years (AOR = 2.72, 95% CI [1.31, 5.64], p = .007), hypertension (AOR = 2.49, 95% CI [1.48, 4.19], p = .001), overweight (AOR = 1.80, 95% CI [1.11, 2.91], p = .008), and obesity (AOR = 2.30, 95% CI [1.24, 4.25], p < .001). Hypertension was associated with triglyceride disorder (AOR = 0.56, 95% CI [0.33, 0.93], p = .026). Smoking was significantly associated with total cholesterol disorder (AOR = 1.86, 95% CI [1.01, 3.42], p = .046).

Conclusion

Routine lipid profile testing should be introduced for patients diagnosed with H. pylori infection through systematic screening. Community health education should be strengthened to inform both the population and healthcare professionals about potential complications, given the high prevalence of H. pylori infection.