Diarrhea in Children in Pediatric Hospitals in the Democratic Republic of Congo : Epidemio-Clinical, Therapeutic and Evolutionary Profile

Abstract

Diarrhea remains a significant cause of pediatric morbidity and mortality in resource-limited countries, particularly in the Democratic Republic of Congo. This study aimed to describe the epidemiological, clinical, therapeutic, and evolutionary profile of diarrhea cases observed in children in Congolese hospitals.

Through a multicenter and descriptive analysis, the records of children admitted to 5 pediatric services across the DRC between 2019 and 2021 were collected.

The results reveal a hospital prevalence of 16.8%. The sex ratio is 1.2. The average age is 3.5 years with 70.3% of children under 5 years. There are two peaks of admissions; from December to January and March to May. Only 52.4% of cases were consulted within the first 48 hours of the onset of diarrhea. Fever, physical asthenia and vomiting are the main complaints associated with diarrhea in 63%, 34% and 26% of cases respectively. Stools were watery in 91.6% of cases. Malaria, sepsis and urinary tract infection are the most frequently mentioned associated hypotheses with respective frequencies of 68%, 18% and 14%. Severe anemia was mentioned in 33% of children with diarrhea. The main treatment was parenteral rehydration in 55%, oral rehydration in 41% and zinc supplementation in 27.5%. Transfusion was performed in 37.6% of children with diarrhea. Other therapies applied were antibiotic therapy in 80%, antimalarial treatment in 64% and antipyretic treatment in 61.5%. The average length of stay was 4 days ± 3. Mortality among children with diarrhea was 5%.

The extent of diarrhea among children in Congolese hospitals remains evident. The observations of this study reveal the need to improve the practices of healthcare workers in the hospital management of diarrhea in children.