1 aUnit of Toxicology and Environment, Faculty of Medicine, Department of Public Health Departments of bPediatrics cSurgery, University Hospital of Lubumbashi dCentre for Human Genetics, Faculty of Medicine, University of Lubumbashi eDepartment of Internal Medicine, Service National/Medical Division of the Presidency of the Democratic Republic of the Congo fDepartment of Internal Medicine, University of Kolwezi, Kolwezi, Democratic Republic of the Congo gCentre for Environment and Health, Department of Public Health and Primary Care, KU Leuven hCentre for Human Genetics, University Hospital, KU Leuven, Leuven, Belgium.