Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo

Abstract

Several years of war have created a humanitarian crisis in the Democratic Republic of Congo (DRC) with extensive disruption of civil society, the economy and provision of basic services including health care. These challenges are faced against a background of heavy disease burden, especially of HIV/ AIDS, tuberculosis, diarrhoea, acute respiratory infection, and malaria. Health policy and planning in the DRC are constrained by a lack of reliable and accessible population data.Thus there is currently a need for primary research to guide programme and policy development for reconstruction and to measure attainment of the Millennium Development Goals (MDGs).This study uses the 2001 Multiple Indicators Cluster Survey to disentangle children's health inequalities by mapping the impact of geographical distribution of childhood morbidity stemming from diarrhoea, acute respiratory infection, and fever. We account for important risk factors and nonlinear effects using a Bayesian geo-additive regression model based on Markov Chain Monte Carlo techniques.We observe a low prevalence of childhood diarrhoea, acute respiratory infection and fever in the western provinces (Kinshasa, Bas-Congo and Bandundu), and a relatively higher prevalence in the south-eastern provinces (Sud-Kivu and Katanga). However, each disease has a distinct geographical pattern of variation. Among covariate factors, child age had a significant association with disease prevalence. The risk of the three ailments increased in the first 8-10 months after birth, with a gradual improvement thereafter. The effects of socioeconomic factors vary according to the disease.Accounting for the effects of the geographical location, our analysis was able to explain a significant share of the pronounced residual geographical effects. Using large scale household survey data, we have produced for the first time spatial residual maps in the DRC and in so doing we have undertaken a comprehensive analysis of geographical variation at province level of childhood diarrhoea, acute respiratory infection, and fever prevalence. Understanding these complex relationships through disease prevalence maps can facilitate design of targeted intervention programs for reconstruction and achievement of the MDGs.

Sociocultural Determinants of Anticipated Vaccine Acceptance for Acute Watery Diarrhea in Early Childhood in Katanga Province, Democratic Republic of Congo

“…The study sites are located in Katanga Province approximately 200 km east of Lubumbashi in a riverine and lakeland area with a high prevalence of childhood diarrhea and endemic cholera. 37,38 Two sites eligible for both rotavirus and cholera vaccine introduction were selected, one (Kasenga) being more urban than the other (Nkolé). Kasenga is a rural town situated on the riverside of the Luapula River, which forms the border with Zambia, and has eight quartiers with a total population of 27,000 persons, mainly ciBemba-speaking inhabitants living in an area of 10 km 2 .…”

“…30,33,36 This study investigates anticipated vaccine acceptance to prevent acute diarrhea in children in two sites of Katanga Province, Democratic Republic of Congo, where diarrhea incidence is among the highest in the country and cholera is endemic. 37 The study sought to describe local illness perceptions, establish the local priority for vaccines, and clarify the role of socioeconomic *Address correspondence to Sonja Merten, Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, Basel 4002, Switzerland. E-mail: sonja.merten@unibas.ch and sex differentials.…”

Antimicrobial resistance of bacteria isolated from patients with bloodstream infections at a tertiary care hospital in the Democratic Republic of the Congo

“…[8] In fact, the DRC has a crude mortality rate well above the average for sub-Saharan countries [9] and the highest under-5 mortality rate in Africa, [10] with malaria, pneumonia and diarrhoea the leading causes of death. [11,12] In South Kivu Province, most healthcare facilities lack the capacity to identify causative agents of infectious diseases reliably, including invasive bacterial infections such as BSIs. BSI and malaria are practically indistinguishable on clinical examination, [13] and available World Health Organization (WHO) guidelines for managing childhood illnesses fail to identify up to half of the cases of BSI.…”

Community vulnerability and symptoms of acute respiratory infection among preschool age children in the Democratic Republic of Congo, Malawi and Nigeria: evidence from Demographic and Health Surveys

“…Third, the assessment of other important factors of ARI symptoms is limited by the use of existing data in the DHS, such as country-specific environmental factors. For instance, mining discharges in the south-eastern provinces of DRC were left with polluted air in these neighbourhoods; as a result, a high prevalence of ARI in children was observed 18. Fourth, my analysis is based on sets of simple multilevel logit models with random intercept and fixed coefficients only.…”