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Demographic and Clinical Factors Affecting Pediatric Survival in South Kivu, the Democratic Republic of the Congo

Tshibambe Nathanael TshimbombuDartmouth Geisel School of Medicine, Hanover, New Hampshire;

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Mapendo N. FefeDepartment of Medicine, University of Kaziba, South-Kivu;

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Minkyung ShinUniversity of Regina, Regina, Saskatchewan, Canada;

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John H. KanterSection of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire;

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Sarah C. CrockettDepartment of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire;

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Bahizire R. RichardDepartment of Public Health, Higher Institute Medical Techniques, Nyangezi, Democratic Republic of the Congo;

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Jean-Jacques Muyembe TamfumNational Institute of Biomedical Research and Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo

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ABSTRACT.

Promoting children’s health is challenging in underresourced regions, with worse outcomes in areas of sociopolitical instabilities. This encapsulates the difficulties faced by the Panzi General Referral Hospital (PGRH) in South Kivu, the Democratic Republic of the Congo. In this retrospective, cross-sectional study of 456 children ≤ 18 years who presented to the pediatric emergency department of PGRH between December 2018 and May 2019, we present demographic and clinical predictors that affect pediatric survival. We note that referrals from external clinics (odds ratio [OR], 0.37; 95% CI, 0.18–0.75), poor maternal education (OR, 0.21; 95% CI, 0.07–0.67), diagnoses of meningitis (OR, 0.37; 95% CI, 0.18–0.75) or malnutrition (OR, 0.21; 95% CI, 0.07–0.67) are risk factors hindering pediatric survival. Paternal unemployment or longer durations of hospital stay, on the other hand, are protective toward survival. These predictors confirm the importance of accessibility and availability of medical resources and knowledge as levers to establish an effective, robust network of pediatric care delivery capable of withstanding South Kivu’s unresolved political tumult.

Author Notes

Address correspondence to Tshibambe Nathanael Tshimbombu, Dartmouth Geisel School of Medicine, 1 Rope Ferry Rd., Hanover, NH 03755. E-mail: tnt.med@dartmouth.edu

These authors contributed equally to this work.

Authors’ addresses: Tshibambe Nathanael Tshimbombu, Dartmouth Geisel School of Medicine, Hanover, NH, E-mail: tnt.med@dartmouth.edu. Mapendo N. Fefe, Department of Medicine, University of Kaziba, South-Kivu, E-mail: mapendofefe@gmail.com. Minkyung Shin, University of Regina, Regina, Saskatchewan, Canada, E-mail: msy762@uregina.ca. John H. Kanter, Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, E-mail: john.h.kanter@hitchcock.org. Sarah C. Crockett, Department of Emergency Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, E-mail: sarah.c.crockett@hitchcock.org. Bahizire R. Richard, Department of Public Health, Higher Institute Medical Techniques, Nyangezi, Democratic Republic of the Congo, E-mail: brrichard79@gmail.com. Jean-Jacques Muyembe Tamfum, National Institute of Biomedical Research and Department of Medical Microbiology and Virology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo, E-mail: pjjmuyembet@gmail.com.

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