Jean-Pierre Fina | University of Limpopo (original) (raw)

Papers by Jean-Pierre Fina

Health Promotion International, Sep 30, 2023

Advances in Infectious Diseases

African Health Sciences

Background: Conflict in the DRC led to a poor health care. HIV/AIDS in children remains one of th... more Background: Conflict in the DRC led to a poor health care. HIV/AIDS in children remains one of the leading causes of pediatric morbidity and mortality.Methods: This cross-sectional study used a sample size of 238 files and aimed to determine the epidemiological profile of childrenliving with HIV at Heal Hospital in 2015.Results: The age ranged from zero to fifteen, with a mean of 6.1 (±3.9) years. Records of PMTCT were noted in 12%. The mean birth weight was 3(±0.8) kg, most cases (88 percent) had normal vaginal delivery. Many of them (71 percent) were living with at least one parent. The majority of the children (92 percent) were from Goma, and 75 percent were diagnosed at WHO Stage 3. At least one episode of hospital admission was reported in 71 percent. Respiratory tract infections were the most common disease, and they were also the leading cause of death. Based on the CD4, which was the most cost-effective method ofmonitoring, there was an improvement in immunity at the last vi...

Background Despite advances in the therapeutic management of type 2 diabetes, glycaemic control r... more Background Despite advances in the therapeutic management of type 2 diabetes, glycaemic control remains suboptimal in sub-Saharan Africa, including in the Democratic Republic of the Congo (DRC). Defining interventions to improve glycaemic control requires a clear knowledge of local factors related to poor glycaemic control including the views and perspectives of key stakeholders such as healthcare providers and patients. Qualitative studies exploring these are lacking in the DRC. The aim of this study was to explore the perspectives of patients with type 2 diabetes and healthcare providers on ways to improve glycaemic control in the DRC. Methods This qualitative study utilized in-depth interviews conducted on 26 purposefully sampled participants − 10 patients with type 2 diabetes and 16 healthcare providers in Kinshasa, Democratic Republic of the Congo. The study used phenomenology approach, and inductive, constructionist, and thematic analysis. Themes were organized and integrated ...

Background Glycaemic control is a significant problem in diabetes care in sub-Saharan Africa. In ... more Background Glycaemic control is a significant problem in diabetes care in sub-Saharan Africa. In the Democratic Republic of the Congo, factors associated with glycaemic control are not fully known as previous studies rarely explored patients’ perspectives and lived experiences. This study describes the lived experiences and perspectives of patients with type 2 diabetes regarding glycaemic control in Kinshasa, Democratic Republic of the Congo. Methods This study was a qualitative study conducted in 7 health centres in 7 health districts (out of 24) in Kinshasa. Purposively selected patients with type 2 were invited to participate in in-depth interviews to explore their lived experience on diabetes treatment and glycaemic control. All interviews were audio recorded, transcribed verbatim and translated into English by a language expert. Data coding and thematic analysis were performed using the MAXQDA 2022. Results Twenty-three participants were included in the study. Six themes emerge...

The Lancet Global Health

Background Fexinidazole has been reported as an effective oral monotherapy against non-severe gam... more Background Fexinidazole has been reported as an effective oral monotherapy against non-severe gambiense human African trypanosomiasis in a recent trial in adults. We aimed to assess the safety and efficacy of fexinidazole in children across all disease stages of gambiense human African trypanosomiasis. Methods We did a multicentre, single-arm, open-label, phase 2-3 trial at eight district hospitals in the Democratic Republic of the Congo. We recruited children with a Karnofsky score of more than 50, those aged 6 years to younger than 15 years, weighing 20 kg or more, and with confirmed gambiense human African trypanosomiasis (any stage). Children weighing 20 kg or more and less than 35 kg received oral fexinidazole of 1200 mg (two × 600 mg tablets) once per day for 4 days (days 1-4) followed by 600 mg (one × 600 mg tablet) once per day for 6 days (days 5-10). Children weighing 35 kg or more received oral fexinidazole of 1800 mg (three × 600 mg tablets) once per day for 4 days (days 1-4), followed by 1200 mg (two × 600 mg tablets) once per day for 6 days (days 5-10). The primary endpoint was fexinidazole treatment success rate 12 months after end of treatment. A rate greater than 80% was deemed acceptable and a target value of 92% was aimed for. Safety was assessed through routine monitoring. This study is completed and registered with ClinicalTrials.gov, number NCT02184689. Findings Between May 3, 2014, and Nov 22, 2016, we screened a total of 130 paediatric patients, of whom 125 (96%) received at least one dose of fexinidazole. All 125 patients (69 [55%] patients with stage 1, 19 [15%] with early stage 2, and 37 [30%] with late stage 2 gambiense human African trypanosomiasis) completed the 10-day treatment. Treatment success rate at 12 months was 97•6% (95% CI 93•1-99•5; 122 of 125 patients). The primary endpoint was met and the targeted value of 92% was exceeded. Treatment success at 12 months was elevated across all disease stages: 98•6% (95% CI 92•2-99•9; 68 of 69 patients) in stage 1, 94•7% (74•0-99•9; 18 of 19 patients) in early stage 2, and 97•3% (85•8-99•9; 36 of 37 patients) in late stage 2 gambiense human African trypanosomiasis. No new safety issues were observed beyond those found in adult trials. Overall, 116 (93%) of 125 patients reported 586 treatment-emergent adverse events, mainly mild or moderate. The most frequently reported treatment-emergent adverse events of interest during hospital admission were vomiting (86 [69%] of 125) and headache (41 [33%]). Seven (6%) of 125 patients had severe malaria, which was often accompanied by anaemia that was unrelated to fexinidazole. One patient died following dyspnoea and injury due to traumatic aggression 172 days after end of treatment, which was considered unrelated to fexinidazole or gambiense human African trypanosomiasis. Interpretation Oral fexinidazole is a safe and effective first-line treatment option across all gambiense human African trypanosomiasis disease stages in paediatric patients.

PLOS ONE

In Kinshasa, Democratic Republic of the Congo (DRC), between 68–86% of patients with type 2 diabe... more In Kinshasa, Democratic Republic of the Congo (DRC), between 68–86% of patients with type 2 diabetes present with poor glycaemic control leading to increased risk of complications and high cost of care. Identifying the factors driving glycaemic control is essential for better management. There is lack of data on factors associated with poor glycaemic control and targeted interventions in the DRC. This study aims to determine the factors associated with type 2 diabetes control and develop an appropriate intervention package in Kinshasa. The study will comprise of three sub-studies as follows: the first sub-study being a concurrent parallel mixed-methods cross-sectional study to determine factors driving poor glycaemic control among patients in Kinshasa. A total of 614 patients will be invited to participate in a cross-sectional study and respond to standardized questionnaires. A minimum of 20 purposively selected patients will participate in the qualitative study that will involve in...

Diabetology & Metabolic Syndrome

Background There is an increased burden of diabetes globally including in sub-Saharan Africa. The... more Background There is an increased burden of diabetes globally including in sub-Saharan Africa. The literature shows that glycaemic control among type 2 diabetes patients is poor in most countries in sub-Saharan Africa. Understanding the factors influencing glycaemic control in this region is therefore important to develop interventions to optimize glycaemic control. We carried out a systematic review to determine the prevalence and factors associated with glycaemic control in sub-Saharan Africa to inform the development of a glycaemic control framework in the Democratic Republic of the Congo. Methods We searched five databases (African Index Medicus, Africa-Wide Information, Global Health, PubMed, and Web of Science) using the following search terms: type-2 diabetes, glycaemic control, and sub-Saharan Africa. Only peer-reviewed articles from January 2012 to May 2022 were eligible for this review. Two reviewers, independently, selected articles, assessed their methodological quality u...

Context and objective. Ocular trauma is very common and its etiological factors vary by region an... more Context and objective. Ocular trauma is very common and its etiological factors vary by region and age group. This study aims to describe the magnitude and determinants of ocular trauma complications in rural areas. Methods. We conducted a retrospective study of patients admitted for ocular trauma at Kimpese Hospital between January 2014 and December 2016. Univariate logistic regression was used to assess the determinants of ocular trauma complications. The statistical significance level is p˂ 0.05. Results. A total of 223 patients were included. The majority of participants were men (69.5%), over 18 years of age (70%), with poor visual acuity (57.8%) and bilateral ocular involvement (51.1%). Plant objects (44.8%) and metal objects (15.2%) were the most common traumatic agents. After treatment, an improvement in visual acuity was observed in 64.3% of patients with previously poor visual acuity (p < 0.001). The delay of care > 7 days [aOR: 2.286 (95% CI: 1...

Combined rate of cure and probable cure at 12 months.</p

Secondary efficacy variables at months 3, 6, 12, 18, and 24 (per-protocol dataset).</p

CONSORT flowchart for pafuramidine phase 2 studies.</p

Combined rate of cure and probable cure at 24 months.</p

Treatment-emergent adverse events experienced by ≥5% of patients in either treatment gro... more Treatment-emergent adverse events experienced by ≥5% of patients in either treatment group (treatment period).</p

Clinical response definitions.</p

Baseline demographics.</p

African Journal of Primary Health Care & Family Medicine, 2014

Background: Contraception is often necessary in order to plan for children and without it there i... more Background: Contraception is often necessary in order to plan for children and without it there is a risk of unplanned pregnancies. In the Democratic Republic of Congo, this often results in abortions by untrained persons with resultant morbidity and mortality. Aim: To investigate the factors that influence contraceptive use amongst women of childbearing age in the Vanga health zone. Methods: Cross-sectional survey using interviewer-administered questionnaires. Results: Of the 384 women recruited, a majority (46.1%) were in the 31–40 year age group;52% had reached primary school and 88% did not have formal employment. One hundredand forty of the participants reported current use of contraception, with 60% of them using modern methods of contraception; 36.1% of them had begun using contraception before the age of 20; and the most common methods were oral contraceptive pills and injection, each accounting for 22.9%. There was variation in the duration of contraceptive use and the main...

BMC Public Health, 2018

Background: Type 2 diabetes mellitus (T2DM) and hypertension (HT) are major noncommunicable healt... more Background: Type 2 diabetes mellitus (T2DM) and hypertension (HT) are major noncommunicable health problems in both developing and developed countries, including Thailand. Each year, a large amount of money is budgeted for treatment and care. Hill tribe people are a marginalized population in Thailand, and members of its elderly population are vulnerable to health problems due to language barriers, lifestyles, and daily dietary intake. Methods: An analytic cross-sectional study was conducted to estimate the prevalence of T2DM and HT and to assess the factors associated with T2DM and HT. The study populations were hill tribe elderly adults aged ≥ 60 years living in Chiang Rai Province, Thailand. A simple random method was used to select the targeted hill tribe villages and participants into the study. A validated questionnaire, physical examination form, and 5-mL blood specimen were used as research instruments. Fasting plasma glucose and blood pressure were examined and used as outcome measurements. Chi-square tests and logistic regression were used for detecting the associations between variables at the significance level alpha=0.05. Results: In total, 793 participants participated in the study; 49.6% were male, and 51.7% were aged 60-69 years. A total of 71.5% were Buddhist, 93.8% were uneducated, 62.9% were unemployed, and 89 % earned an income of < 5,000 baht/month. The overall prevalence of T2DM and HT was 16.8% and 45.5%, respectively. Approximately 9.0% individuals had comorbidity of T2DM and HT. Members of the Lahu, Yao, Karen, and Lisu tribes had a greater odds of developing T2DM than did those of the Akha tribe. Being overweight, having a parental history of T2DM, and having high cholesterol were associated with T2DM development. In contrast, those who engaged in highly physical activities and exercise had lower odds of developing T2DM than did those who did not. Regarding HT, being female, having a high dietary salt intake, being overweight, and having a parental history of HT were associated with HT development among the hill tribe elderly populations. Conclusions: The prevalence of T2DH and HT among the hill tribe elderly populations is higher than that among the general Thai population. Public health interventions should focus on encouraging physical activity and reducing personal weight, dietary salt intake, and greasy food consumption among the hill tribe elderly.

Pan African Medical Journal, 2021

PLoS Neglected Tropical Diseases, Feb 16, 2016

Background Sleeping sickness (human African trypanosomiasis [HAT]) is a neglected tropical diseas... more Background Sleeping sickness (human African trypanosomiasis [HAT]) is a neglected tropical disease with limited treatment options that currently require parenteral administration. In previous studies, orally administered pafuramidine was well tolerated in healthy patients (for up to 21 days) and stage 1 HAT patients (for up to 10 days), and demonstrated efficacy comparable to pentamidine.