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Ectopic pregnancy occurs when a fertilized ovum implants outside the uterine cavity, most commonly in the fallopian tube. While rare, ectopic pregnancies can also occur in atypical locations such as the ovary, cervix, abdominal cavity, or broad ligament, often posing significant diagnostic and therapeutic challenges. We report a highly unusual case of ectopic pregnancy implanted in the left labium majus, a site not previously documented in the literature. A 20‐year‐old woman presented with abdominal pain, vulvar swelling, and amenorrhea of approximately 4 months. Initial imaging and clinical evaluation did not reveal the ectopic implantation. Diagnosis was made intraoperatively during marsupialization of the vulvar swelling, which revealed a macerated fetus within the left labium majus. This case highlights the importance of maintaining a high index of suspicion for rare ectopic pregnancy sites in patients presenting with unexplained vulvar symptoms and a positive pregnancy test—particularly when imaging is inconclusive. It underscores the critical role of prompt surgical exploration in preventing life‐threatening complications and contributes to expanding the clinical spectrum of ectopic pregnancy presentations.

Background In southern Democratic Republic of the Congo, malaria transmission is stable with seasonal fluctuations. Different measurements can be used to monitor disease burden and estimate the performance of control programmes. Repeated school-based malaria prevalence surveys (SMPS) were conducted from 2007 to 2014 to generate up-to-date surveillance data and evaluate the impact of an integrated vector control programme. Methods Biannual SMPS used a stratified, randomized and proportional sampling method. Schools were randomly selected from the entire pool of facilities within each Health Area (HA). Subsequently, school-children from 6 to 12 years of age were randomly selected in a proportional manner. Initial point-of-care malaria diagnosis was made using a rapid detection test. A matching stained blood film was later examined by expert microscopy and used in the final analysis. Data was stratified and analysed based on age, survey time and location. Results The baseline SMPS (pre-control in 2007) prevalence was approximately 77%. From 2009 to 2014, 11,628 school-children were randomly screened. The mean age was 8.7 years with a near equal sex ratio. After exclusion, analysis of 10,493 students showed an overall malaria prevalence ratio of 1.92 in rural compared to urbanized areas. The distribution of Plasmodium falciparum malaria was significantly different between rural and urban HAs and between end of wet season and end of dry season surveys. The combined prevalence of single P. falciparum , Plasmodium malariae and Plasmodium ovale infections were 29.9, 1.8 and 0.3% of those examined, respectively. Only 1.8% were mixed Plasmodium species infections. From all microscopically detected infections (3545 of 10,493 samples examined), P. falciparum represented 88.5%, followed by P. malariae (5.4%) and P. ovale (0.8%). Cases with multiple species represented 5.3% of patent infections. Malaria prevalence was independent of age and gender. Control programme performance contributed to a significant decrease in mean P. falciparum infection density in urban compared to rural locations. Some rural areas remained highly refractory to control measures (insecticide-treated bed nets, periodic indoor residual spraying). Conclusion The SMPS is a useful longitudinal measurement for estimating population malaria prevalence and demonstrating disease burden and impact of control interventions. SMPS can identify refractory areas of transmission and thus prioritize control strategies accordingly.

Background Previous studies have reported the association between maternal vitamin D deficiency and preeclampsia. However, the efficacy of vitamin D supplementation in reducing the occurrence of preeclampsia remains unclear. The objective of this study was to evaluate the effect of cholecalciferol supplementation on the incidence of preeclampsia in primigravid women and its related maternal and foetal outcomes. Methods A single-blinded clinical trial was conducted in fourteen antenatal care health facilities in the North (Goma, Mwesso, Nyiragongo) and South Kivu (Bukavu-Panzi) provinces of the Democratic Republic of Congo from March 1, 2020, to June 30, 2021. A total of 1300 primigravid women not exceeding 16 weeks of gestation were randomised with a 1:1 ratio to either the supplemented (A) or control (B) group. Each pregnant woman (A) presenting for antenatal care received a single monthly dose of cholecalciferol (60,000 IU) orally for 6 months. The control group received no vitamin D supplementation or placebo. Serum 25(OH)D was measured at recruitment and at 34 weeks of gestation. Outcomes were assessed monthly until delivery. Results The median maternal age was 21 years (14–40), while the median gestational age was 15 weeks (5.4–29.0). A significant reduction in the risk of preeclampsia [RR = 0.36 (0.19–0.69); p  = 0.001] and preterm delivery [RR = 0.5 (0.32–0.78); p  = 0.002] was observed in the intervention group. An RR of 0.43 [(0.27–0.67); p  < 0.001] was found for low birth weight. The RR for caesarean section was 0.63 [(0.52–0.75); p  < 0.001]. The APGAR score at the 5th minute ( p  = 0.021) and the size of the newborn were significantly higher in the supplemented group ( p  = 0.005). Conclusion A single monthly dose (60,000 IU) of vitamin D supplementation, started in earlypregnancy, significantly reduced the incidence of preeclampsia and its maternal and foetal complications. Trial registration ISRCTN Register with ISRCTN46539495 on 17 November 2020.

Introduction Hypertension (HT) is a major global public health challenge, responsible for more than 10 million deaths annually. In sub-Saharan Africa (SSA), its prevalence is high and rising, driven by rapid urbanisation, nutritional transition, and increasing sedentary behaviour, while screening and control rates remain suboptimal. This systematic review and meta-analysis aimed to estimate the prevalence of HT among adults in SSA and identify its key associated factors. Methods The protocol was registered in PROSPERO (CRD420251021429) and conducted in accordance with PRISMA 2020. We included cross-sectional studies published between January 2010 and November 2025, involving adults (≥ 18 years) and defining HT according to JNC7. Searches were conducted across seven databases and grey literature. Methodological quality was assessed using Joanna Briggs Institute tools (threshold ≥ 50%). A random-effects meta-analysis was performed using Stata 16. Results Of 11,895 records screened, 52 studies were included. The pooled prevalence of HT was 27.09% (95% CI: 24.22%–29.96%; I² = 99.5%). Regional estimates ranged from 22.43% in Southern Africa to 32.75% in Central Africa. Major factors associated with HT included age > 50 years, which conferred nearly a fivefold increased risk (OR = 4.93; 95% CI: 3.61–6.72), male sex (OR = 1.80; 95% CI: 1.14–2.84), diabetes mellitus (OR = 4.01; 95% CI: 2.88–5.58), abdominal obesity (OR = 2.86; 95% CI: 2.33–3.52), overweight/obesity (OR = 2.72; 95% CI: 2.26–3.28), alcohol consumption (OR = 1.97; 95% CI: 1.57–2.46), smoking (OR = 1.69; 95% CI: 1.44–1.97), physical inactivity (OR = 1.60; 95% CI: 1.36–1.89), low fruit and vegetable intake (OR = 1.42; 95% CI: 1.16–1.75), urban residence (OR = 1.21; 95% CI: 1.08–1.35), and a family history of HT (OR = 2.37; 95% CI: 1.66–3.38). Occupational status was not significantly associated with HT (OR = 1.21; 95% CI: 0.76–1.93). Conclusion More than one in four adults in SSA is hypertensive, with substantial regional disparities. Most identified determinants are modifiable, underscoring the urgent need for strengthened primary prevention through healthier lifestyles, community-based screening, and integrated management of metabolic disorders. Context-specific strategies are essential to curb this silent epidemic and reduce the cardiovascular burden across the region.

Maternal anthropometric parameters as risk factors for cesarean section have always been a matter of interest and concern for obstetricians. Some of these parameters have been shown to be predictors of dystocia. This study aims at showing the relationship between cesarean section indications and anthropometric parameters sizes in Rwandan nulliparae for the purpose of comparison and appropriate recommendations. A cross-sectional and analytical study was made on data collected from 32 operated patients among 152 nulliparae with singleton pregnancy at term and vertex presentation. Concerned anthropometric parameters were height, weight and six pelvic distances. Fisher exact and Student's tests were used to compare observed proportions and mean values, respectively. Findings were as follows: 1) the overall cesarean section rate was 21.05%; 2) acute fetal distress (31.3 %), generally contracted pelvis (28.1 %), and engagement failure (25%) were the most frequent indications of cesarean section; 3) all patients ≤ 145 cm tall were operated on for general pelvis contraction whose proportion was significantly higher in them than in the others (p < 0.01); 4) more than half of pelvis contraction cases were observed in patients weighing ≤ 50 kg, but the difference with other weight categories was not significant; 5) considered external pelvic diameters but the Biiliac Diameter displayed average measurements smaller in clinically contracted pelvis than in other CS indications. External pelvimetry associated with specific other anthropometric parameters could be helpful in the screening of generally contracted pelves, and consequently pregnancies at high risk of cephalopelvic disproportion in nulliparous women, particularly in developing countries with limited resources. Further investigations are requested to deal with this topic in depth.

Malaria is still a major public health concern in the Democratic Republic of Congo. Its morbidity and mortality challenge the actual strategies of the fight agains malaria. This study was aimed to describe the epidemiology, the clinical caracteristics and the risk factors of death associated to severe malaria in the pediatric population under 5 years at Sendwe Hospital of Lubumbashi. This analytical retrospective study was conducted in Lubumbashi, in the province of Haut-Katanga. All patients under 5 years hospitalized for severe malaria were registered from January 2014 to December 2016. Among the 3,092 patients hospitalised during our study period, 452 (14.6%) were admitted for severe malaria. The average age was 27.04 months, the male sex was the most affected (53.54% with the sex-ratio 1.15). The most frequent forms of gravity noticed were cerebral malaria (48.23%) and severe anemia (46.90%). Death was noted in the evolution in 28.32%. Repeated convulsion (OR = 2.27; 95% CI: 1.47-3.48), coma (OR = 3.55; 95% CI: 2.19-5.74) and severe acute malnutrition (OR = 3.32; 95% CI: 1.56-7.06) were asscociated with a high risk of death. This research shows that severe malaria is still an important cause of morbidity and mortality among young children in Lubumbashi. Neurologic and anemic forms are the most frequent. The predictive signs of death are: repeated convulsions, coma and severe acute malnutrition.

Universal Health Coverage (UHC) has been a global concern for a long time and even more nowadays. While a number of publications are almost unanimous that Rwanda is not far from UHC, very few have focused on its financial sustainability and on its extreme external financial dependency. The objectives of this study are: (i) To assess Rwanda UHC based mainly on Community-Based Health Insurance (CBHI) from 2000 to 2012; (ii) to inform policy makers about observed gaps for a better way forward. A retrospective (2000-2012) SWOT analysis was applied to six metrics as key indicators of UHC achievement related to WHO definition, i.e. (i) health insurance and access to care, (ii) equity, (iii) package of services, (iv) rights-based approach, (v) quality of health care, (vi) financial-risk protection, and (vii) CBHI self-financing capacity (SFC) was added by the authors. The first metric with 96,15% of overall health insurance coverage and 1.07 visit per capita per year versus 1 visit recommended by WHO, the second with 24,8% indigent people subsidized versus 24,1% living in extreme poverty, the third, the fourth, and the fifth metrics excellently performing, the sixth with 10.80% versus ≤40% as limit acceptable of catastrophic health spending level and lastly the CBHI SFC i.e. proper cost recovery estimated at 82.55% in 2011/2012, Rwanda UHC achievements are objectively convincing. Rwanda UHC is not a dream but a reality if we consider all convincing results issued of the seven metrics.

The burden of non-communicable diseases (NCDs) is increasing rapidly in low- and middle-income countries, with the largest portion occurring in Africa. Results from earlier baseline measures on obesity, diabetes and hypertension (ODH) in the Tenke Fungurume Mining (TFM) workforce in 2010 showed high proportions of overweight, pre-diabetic and pre-hypertensive individuals, predicting an upward trend in the burden of ODH over time. The 2010-2015 longitudinal trends on ODH and related risk factors among the TFM workforce is presented herein, and projects the consequent burden of these diseases on the workforce by 2025 if an effective prevention program is not implemented. A longitudinal, retrospective cohort study with 3-time intervals was conducted using occupational health records collected on all employees and contractors who had a pre-employment or follow up medical checkups covering the period between January 2010 and December 2015. Repeated paired t tests measured changes in mean values of quantitative risk factors, while a chi-square test assessed changes in prevalence and categorical risk factors over time. A linear projection model was used to predict the consequent morbidity of ODH for the subsequent 10 years up to 2025. Between 2010 and 2015, prevalence increased from 4.5% to 11.1% for obesity, 11.9% to 15.6% for diabetes, and 18.2% to 26.5% for hypertension. By 2025, provided no prevention program is implemented, prevalence is predicted to reach 25%, 24% and 42% respectively for obesity, diabetes and hypertension. Without implementation of a comprehensive NCD prevention plan, the burden of ODH and other NCDs is predicted to increase dramatically in the TFM workforce. Alone or combined, NCDs have the potential to dramatically increase operational costs while decreasing productivity over time.

The burden of non-communicable diseases (NCDs) is increasing in low and middle-income countries (LMIC). According to the World Health Organization (WHO) the largest increase occurs in Africa. Obesity, diabetes mellitus and hypertension (ODH) are major risk factors for cardiovascular diseases, causing nearly 18 million deaths worldwide. Various risks associated with mining as an occupational activity are implicated in NCDs' occurrence. This study describes the baseline prevalence of ODH and associated risk factors in the workforce of Tenke Fungurume Mining (TFM), in southern Democratic Republic of Congo. A cross-sectional study was conducted on a sample of 2,749 employees' and contractor's occupational health examination files for 2010. Socio-demographic, occupational, medical, anthropometric and behavioral characteristics were collected and assessed. Disease status regards ODH was based on WHO criteria. A multivariate logistic regression model was used. Overall prevalence of ODH was 4.5%, 11.7%, and 18.2% respectively. Proportions of pre-ODH individuals were 19.7%, 16.5%, and 47.8% respectively. Prevalence of ODH increased with age, professional grade, nature of work, gender and reported alcohol use. Smoking 10 or more cigarettes per day increased risk of diabetes and hypertension, while decreasing obesity. Rates of ODH and associated risk factors are higher in the TFM workforce, than in the general DRC population. This is likely reflective of other mining sites in the country and region. It is evident that ODH are associated with various socio-demographic, occupational, anthropometric, biomedical and behavioral risk factors. A NCD prevention program and close monitoring of disease and risk factors trends are needed in this population.

PurposeIn Democratic Republic of the Congo (DRC), informal coltan mining has been expanding amidst increased insecurity due to armed conflicts. We investigated the impact of occupational dust-exposure on the respiratory health of Congolese coltan miners.MethodsIn total, 441 Congolese workers participated in this study, including 199 informal coltan miners and 242 office workers (controls). Information on respiratory complaints was collected using two standardized questionnaires. Physical examination (vital signs, auscultation) and lung function test (Peak Flow meter) were performed. In addition, workplace airborne PM2.5 and volatile organic compounds (VOC) concentrations were measured.ResultsHigher airborne PM2.5 (range 180–210 µg/m3) and VOC (range 1.4–2.3 µg/m3) levels were detected at coltan mining work stations as compared with control sites (19–44 and 0.5–0.8 µg/m3, respectively). All respiratory complaints and disorders were more prevalent in informal coltan miners than in controls. Additionally, a markedly lower mean PEFR was observed in coltan miners than in controls (347.93 ± 6.88 vs. 493.23 ± 67.38 L/min, respectively). Moreover, positive associations between informal coltan mining and almost all respiratory complaints were observed, except wheezing at effort and night cough. On the other hand, an inverse association was observed between lung function (PEFR) and PM2.5 exposure, between PEFR and VOC exposure, and also between PEFR and current smoking.ConclusionsThis study showed high prevalence of respiratory complaints in Congolese informal coltan miners, suggesting the necessity to implement efficient occupational safety measures and regulate this informal mining business.