Edmond Ntabe Namegabe

Bio: Edmond Ntabe Namegabe is an academic researcher. The author has contributed to research in topics: Sexual violence & Public health. The author has an hindex of 3, co-authored 6 publications receiving 22 citations.

TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo

Abstract: Background: HIV/AIDS and Tuberculosis (TB) are major contributors to the burden of disease in sub-Saharan Africa. The two diseases have been described as a harmful synergy as they are biologically and epidemiologically linked. Control of TB/HIV co-infection is an integral and most challenging part of both national TB and national HIV control programmes, especially in contexts of instability where health systems are suffering from political and social strife. This study aimed at assessing the provision of HIV/TB co-infection services in health facilities in the conflict-ridden region of Goma in Democratic Republic of Congo. Methods: A cross-sectional survey of health facilities that provide either HIV or TB services or both was carried out. A semi-structured questionnaire was used to collect the data which was analysed using descriptive statistics. Results: Eighty facilities were identified, of which 64 facilities were publicly owned. TB care was more available than HIV care (in 61% vs. 9% of facilities). Twenty-three facilities (29%) offered services to co-infected patients. TB/HIV co-infection rates among patients were unknown in 82% of the facilities. Only 19 facilities (24%) reported some coordination with and support from concerned diseases’ control programmes. HIV and TB services are largely fragmented, indicating imbalances and poor coordination by disease control programmes. Conclusion: HIV and TB control appear not to be the focus of health interventions in this crisis affected region, despite the high risks of TB and HIV infection in the setting. Comprehensive public health response to this setting calls for reforms that promote joint TB/HIV co-infection control, including improved leadership by the HIV programmes that accuse weaknesses in this conflict-ridden region.

Knowledge and attitudes towards sexual violence in conflict-affected rural communities in the Walikale District, DR Congo : implications for rural health services

Abstract: Sexual violence has become endemic in the Democratic Republic of Congo (DRC), but the perspectives of rural communities of the scourge remain poorly researched. This study aims to describe the atti ...

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

Abstract: Background: The Democratic Republic of Congo (DRC) is one of the high burden TB countries. The country has been affected by a political conflict for more than 15 years now. HIV prevalence has been increasing in the country too. Detection and care of TB/HIV co-infected cases is a major problem in the country. Aim: This study aimed at describing patterns of health seeking behaviors among patients with TB/HIV regarding their choice of health facilities for integrated TB/HIV care in the Goma and surrounding health districts.Methods: The methods used included a cross-sectional descriptive survey with TB/HIV co-infected patients and qualitative interviews of health workers.Results: The study found that geographical residence did not play a major role in choice of facility for care by patients infected with TB and HIV. Many patients shun facilities which are close and seek care relatively far away. Instead of geographical proximity, availability of drugs and welcoming attitudes determined the choice of integrated care facilities. Also, fear for discrimination and stigmatization in the community result into patients in this area concealing their infection; rather, they claim being victim of empoisoning.Conclusion: Sustained decentralization of integrated TB/HIV services through better programs’ coordination and community involvement to address misconceptions about TB and HIV and stigmatization are essential to promote uptake of TB/HIV services and retain patients in treatment.

Health Workers' Assessment of the Frequency of and Caring for Urinary and Fecal Incontinence among Female Victims of Sexual Violence in the Eastern Congo: An Exploratory Study

Abstract: Background: Throughout the long war that the Democratic Republic of Congo (DRC) has endured, women and children have been depicted as the primary victims of widespread sexual violence. In some settings women have been raped in entire villages, with devastating physical and psychological consequences, which include sexually transmitted infections such as HIV, trauma and fistulas, as well as social isolation and involuntary pregnancies. The aim of this study was to assess the prevalent perceptions of health professionals on the magnitude of urine and/or fecal incontinence among assaulted women, caused by sexual violence, as well as the opinions regarding the type of care provided to affected women. Methods: The study was part of a larger pilot study that had a cross-sectional design and a descriptive approach, which explored health professionals’ views regarding their own levels of competence at responding to the health needs of victims of sexual violence, in the form of a semi-structured questionnaire. Results: 104 health workers responded to the questionnaire. Nurses reported seeing raped women more frequently on a day-to-day basis (69.2%), in comparison to medical doctors and social workers (11.5%). Urinary incontinence was common according to 79% of health workers, who estimated that up to 15% of the women affected experienced huge amounts of urine leakage. Only 30% of the care seekers underwent in depth investigations, but the majority of the victims were not offered any further examination or appropriate treatments. Conclusion: Urinary and fecal incontinence due to urogenital or colorectal fistulas among women exposed to sexual violence is a common in the specified setting, but lack of systematic investigation and appropriate treatment means that the quality of life of the victims may be negatively affected. An improvement in the ability of health workers to manage these complex diagnoses is urgently needed, as well as adequately equipping health services in the affected settings.

“Qualified but not competent enough”: Health workers’ assessment of their competence in relation to caring for sexually abused women in Eastern Democratic Republic of Congo

Abstract: The aim of this study was to assess health professionals’ opinions of their competence levels in responding to health needs of victims of sexual violence. This study used a cross-sectional design with a descriptive approach. A total of 104 physicians, nurses and social workers participated in the study. The data was collected using a questionnaire consisting of open and close-ended questions. Overall, 75% of the respondents were university graduates, but only a quarter of them felt they have adequate competence to care for these women; 36% had difficulties with general health assessment of assaulted women. The results indicated that nurses are critical professionals in caring for victims of sexual violence, that they see these women more than any other professional category. However, they are more likely than other categories to report being incompetent. Access to continued education was difficult, and more so for clinically-oriented health professionals than for others social professionals. Human resources capacity strengthening and particularly that of nurses will be the key investment in addressing assaulted women’s health needs in this region. Clinical researchers are called to identify rapid methods to reinforce nurses’ capacity and role in such a context with deprived health systems.

‘Sexurity’ and its effects in eastern Democratic Republic of Congo

Abstract: Newly recognised as a threat to global peace and security, sexual violence in conflict is now a fixed item on international security agendas. This marks significant progress for women, gender equality and the integrity of peace programmes. Our aim here, however, is to reflect upon the risks that inhere in this accomplishment. Through the concept of ‘sexurity’, a tripartite amalgam of the securitisation of sexual violence, the sexualisation of security, and the language of crisis, we outline the adverse effects of tethering sexual violence to security. This article concerns itself with the material and symbolic effects of ‘sexurity’ for eastern Democratic Republic of Congo (DRC). It first outlines ‘sexurity’ and the context of its emergence before, drawing on fieldwork in eastern DRC, the second part underlines the effects of ‘sexurity’ for the country.

Undoing Research on Sexual Violence in Eastern Democratic Republic of Congo

Abstract: In the last decade, the Democratic Republic of the Congo (DRC) figures on the international radar as a place of horrific sexual violence and ‘vile barbarity’. Drawing on ethnographic research in eastern DRC, this paper argues these framings have a contaminating effect on the researcher and the way knowledge is produced and mediated. What does it mean to do research on violence in the ‘rape capital of the world’? This paper addresses three significant ‘fields of power’ that emerge when conducting research in a violent setting as a politically and geographically situated researcher. First, the paper argues that a colonial imaginary, which produces racial and sexual hierarchies, informs contemporary representations on sexual violence. Second, it critically examines current knowledge on sexual violence in eastern DRC that, primarily drawing on victims’ testimonies, may reinforce harmful framings. Third, the paper shows how I shaped my research in relation to ‘toxic’ discourses on sexual violence. In doing so, this article reflects on what it means to ‘undo’ research from a ‘violent’ space by disrupting received knowledge on sexual violence and critically exploring the researcher’s responsibility in representing violence as experienced by others and his/her complicity in perpetuating harmful framings.

The epidemiological aspects of tuberculosis in Hamadan Province during 2005-11

Abstract: Background Epidemiological information on tuberculosis (TB) is required to plan control and prevention strategies and to inform service delivery systems. The aim of present study was to determine the epidemiological status of TB in Hamadan Province covering a seven-year period. Methods In this cross-sectional study all registered TB patients suffering from any form of smear-positive, smear-negative or extra pulmonary from 2005 to 2011 were assessed. Age-adjusted incidence trend was studied. The Cochran-Armitage (C-A) test was used for testing the trends over time. Results The mean age of TB patients was 57.0 (±21.1), 49.9% were males, 52.8% were aged 61 years or older and 39.7% were rural residents. Previous history of jailed was present in 13 (2.2%) patients and 12 (2.0%) were HIV positive. From all TB patients, 60.8% were smear-positive, 87.6% were new cases, and 87.3% of smear-positive patients were cured cases. Also, 23.6% patients had history of hospitalization for TB. More than half (55.4%) of TB patients were reported by public health system. Age-adjusted incidence rates of all TB cases during 2005–11 was 3.4, 3.2, 3.6, 4.7, 3.3, 4.4 and 7.3 in 100,000 respectively (C-A trend test, P< 0.001). Conclusion Although, the incidence rate of TB in Hamadan Province is lower than country’s average, increasing trend of TB incidence is not concordant with its decreasing trend in Iran. An epidemiological study is required to evaluate risk factors associated with TB to identify ways to decrease the prevalence of TB.

Environmental health practice in a South African metropolitan municipality: professional, ethical and legal responsibilities and challenges

Abstract: A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the requirements for the degree of Doctor of Philosophy, Johannesburg, 2017

Impact of Violent Rapes Among Women in Eastern Democratic Republic of Congo

Abstract: Impact of Violent Rapes Among Women in Eastern Democratic Republic of Congo by Benoit Munganga Mirindi MPH, Tulane University, 2005 MPA, University of Maine at Orono, 2000 BA, University of Maine at Orono, 1998 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Doctor of Philosophy Epidemiology