Onchocerciasis is an independent risk factor for renal damage in high endemicity : a case-control study from the Democratic Republic of Congo

Résumé

In order to determine the frequency and determinant of the CKD in an onchocercal hyper-endemic area, this work was conducted in the health zone of Kalunguta. This is a case-control study of 443 subjects, or 111 cases of onchocerciasis and 332 controls, in January 2015 and February 2016. The mean age of the patients is 45 years (range 18 years and 85 years old) 39±8.9 years, with a sex ratio women/man of 2.1. Proteinuria was more common in onchocerciasis carriers than controls (29.7% Versus 10.5%) and higher creatinine levels in cases than controls (p =0.032). the strength of association observed in univariate analysis persisted for the status of onchocerciasis and parasite density as major major determinants of proteinuria (p<0.005) and compared with non-carriers of onchocerciasis, onchocerciasis carriers increased the risk of CKD by 3 (OR = 2.8, 95% CI: 1.46-6.19, p = 0.007). The age ≥65 years multiplied this risk by 5 (OR = 5.2, 95% CI: 2.1-12.99, p = 0.000). The personal antecedent of HBP increased this risk by 4 (OR = 4.1, 95% CI: 1.57-10.65, p = 0.004). Personal diabetes mellitus antecedent multiplied this risk by 7 (OR = 6.9, 95% CI: 1.69-70.19, p = 0.009).

In view of these results, the search for renal involvement in a hyperendemic zone of onchocerciasis must be systematic and the prescription of the molecules must take into account the presence or absence of the CKD.