Didier Malamba-Lez

Background: Hypertension is increasingly recognised among young adults, but its estimated prevalence varies substantially according to the diagnostic criteria used. This study assessed the prevalence and factors associated with hypertension among medical students in Lubumbashi, Democratic Republic of the Congo (DRC), using the 2025 American College of Cardiology/American Heart Association (ACC/AHA) criteria, and compared the findings with the JNC 7 classification. Methods: We conducted a cross‐sectional study among students aged ≥ 18 years at the Faculty of Medicine, University of Lubumbashi, from July to August 2023. Blood pressure and anthropometric measurements were obtained using standardised procedures, and sociodemographic, behavioural and family‐history data were collected using a structured questionnaire. Hypertension was defined according to the 2025 ACC/AHA criteria and, for sensitivity analysis, according to JNC 7. Factors associated with hypertension were assessed using logistic regression, with adjusted odds ratios (aORs) and 95% confidence intervals (CIs). The agreement between the two classifications was assessed using Cohen’s κ and McNemar’s test. Results: Among 3505 medical students, 1171 (33.4%) were classified as hypertensive according to the 2025 ACC/AHA criteria. In multivariable analysis, hypertension was independently associated with a family history of hypertension (aOR 1.31, 95% CI 1.09–1.59), higher BMI (aOR 1.02 per kg/m ² , 95% CI 1.00–1.04), alcohol consumption (aOR 1.32, 95% CI 1.09–1.62) and physical inactivity (aOR 1.22, 95% CI 1.02–1.46). Using JNC 7, only 168 students (4.8%) were classified as hypertensive. In the sensitivity analysis, older age, higher academic level and a family history of hypertension were associated with JNC 7‐defined hypertension. The agreement between the two classifications was 71.4% ( κ = 0.18, p < 0.001), while McNemar’s test indicated a significant difference in paired classifications ( χ ² = 1003.0, p < 0.001). Conclusion: Hypertension was highly prevalent among medical students when classified according to the 2025 ACC/AHA criteria, although the prevalence was substantially lower using JNC 7. The limited agreement between the two classifications highlights the considerable impact of diagnostic thresholds on the estimated burden of hypertension among young adults. Early identification of modifiable and familial factors may support targeted cardiovascular risk prevention in university populations.

Blood and/or urine levels of 27 heavy metals were determined by ICPMS in 41 patients with dilated cardiomyopathy (DCM) and 29 presumably healthy subjects from the Katanga Copperbelt (KC), in the Democratic Republic of Congo (DRC). After adjusting for age, gender, education level, and renal function, DCM probability was almost maximal for blood concentrations above 0.75 and 150 µg/dL for arsenic and copper, respectively. Urinary concentrations above 1 for chromium, 20 for copper, 600 for zinc, 30 for selenium, 2 for cadmium, 0.2 for antimony, 0.5 for thallium, and 0.05 for uranium, all in μg/g of creatinine, were also associated with increased DCM probability. Concurrent and multiple exposures to heavy metals, well beyond permissible levels, are associated with increased probability for DCM. Study findings warrant screening for metal toxicity in case of DCM and prompt public health measures to reduce exposures in the KC, DRC.

Blood and/or urine levels of 27 heavy metals were determined by ICPMS in 41 patients with dilated cardiomyopathy (DCM) and 29 presumably healthy subjects from the Katanga Copperbelt (KC), in the Democratic Republic of Congo (DRC). After adjusting for age, gender, education level, and renal function, DCM probability was almost maximal for blood concentrations above 0.75 and 150 µg/dl for arsenic and copper, respectively. Urinary concentrations above 1 for chromium, 20 for copper, 600 for zinc, 30 for selenium, 2 for cadmium, 0.2 for antimony, 0.5 for thallium and 0.05 for uranium, all in μg/g of creatinine, were also associated with increased DCM probability. Concurrent and multiple exposures to heavy metals, well beyond permissible levels, are associated with increased probability for DCM. Study findings warrant screening for metal toxicity in case of DCM and prompt public health measures to reduce exposures in the KC, DRC.

Epilepsy is the most common of serious neurological disorders, yet despite considerable efforts, good access to medication, appropriate social and societal acceptance and acceptable quality of life (QoL) are difficult to achieve especially in developing countries. It is estimated that over 500,000 people suffer from epilepsy in the DRC. There is no report, in our knowledge on the epilepsy in Lubumbashi. A descriptive study was undertaken in individuals with a clinical diagnosis of epilepsy who presented at the CNPJG outpatient clinic in Lubumbashi over a 12 months period. A 64-item questionnaire was used to collect information from the patients. Case records were reviewed and relevant demographic, social, professional, medical history, medical condition data were extracted. Among 3,540 patients who presented to a neuropsychiatric clinic run by the Fracarita charity over a 1-year period, 423 (11.9%) were identified as having epilepsy, and 179 were subsequently included in the survey after they (or their parent/guardian) provided informed consent and completed an EEG investigation. Data were collected using a standardized, 64-item questionnaire. Epilepsy had negative impact on the lives of individuals with the condition; 40.8% had either no education or had completed primary education only, 38.0% were unemployed and the majority (64.6%; n = 113) were unmarried or divorced. Family history of epilepsy (first or second degree) was present in 23.5% of cases. Other reported factors that could potentially precipitate epilepsy included obstetric and perinatal factors (15.1%) and central nervous system infections during infancy (8.4%). Consumption of alcohol or recreational drugs accounted for 10.6%. The treatment gap was above 67% and the delay between first seizure and first consultation was 15 months. When asked to describe their condition, or its cause, 55.3% of participants (or their families) considered epilepsy to be of spiritual/ religious origin, while 25.1% had almost no insight and could not provide any description. This first epidemiological study shows a high prevalence of epilepsy among patients presenting to the clinic in Lubumbashi, DRC, and reveals a significant treatment gap.