Epidemiology and clinical characteristics of acute malnutrition among under-5 children attending a rural hospital in the Democratic Republic of Congo: a cross-sectional study.

Background: Malnutrition, a public health problem in a low-income country such as the Democratic Republic of Congo (DR Congo), is a major killer among children under 5 who are most at risk of acute malnutrition. This study aims to describe the epidemiological and clinical characteristics of acute malnutrition in children under 5 years old. Methods: The authors conducted a retrospective and descriptive cross-sectional study on children under 5 with acute malnutrition from April 2022 to April 2023. A total of 287 malnourished children were consulted, hospitalized in a rural hospital, and registered for participation in this study. Results: Two hundred eighty-seven (25%) children were victims of acute malnutrition. The age group between 13 and 24 months is the most affected by acute malnutrition with 30%. The male-to-female(M/F) sex ratio was 1.17. Kwashiorkor is the most common form of acute malnutrition with 171 (59.6%) cases. Abdominal bloating, weight loss as well as diarrhea and vomiting were the more frequent clinical signs. Shock is the most complication of acute malnutrition. Therapeutic milk (Food 75 and Food 100) was the most effective in management. Twenty-nine (10.1%) other children died from acute malnutrition and 258 (89.9%) children progressed to full recovery. Conclusion: Acute malnutrition in children remains a public health problem worldwide and particularly in low-income countries such as DR Congo. It is associated with multiple physiological vulnerabilities and has many short- and long-term complications in children who have suffered from it.

National burden of Ebola virus disease in Democratic Republic of the Congo: the urgency to act.

Ebola virus disease (EVD) has long been a major public health concern for Democratic Republic of the Congo (DR Congo). First identified in DR Congo in 1976, the country has witnessed more than 25 outbreaks of this deadly disease, which has a case fatality rate of nearly 90% and manifesting with symptoms such as diarrhoea, vomiting, stomachache and haemorrhagic fever. African fruit bats have been speculated to be the reservoir of this virus. DR Congo is currently facing another EVD outbreak simultaneously with other communicable diseases, rendering it vulnerable to a shortage of medical and paramedical staff along with distrust among remote communities towards local authorities due to armed conflict and political instability. Moreover, lack of ring vaccinations and inefficient surveillance of suspected individuals are some other significant hurdles in disease control. Despite the availability of rVSV-ZEBOV/Erbevo vaccine and many antibody-based vaccines, challenges including politicization, low access to remote communities, and illiteracy have limited their effectiveness. Recently, the Congolese govt. has put in efforts such as building local capacities at the health zone level, outbreak control intervention, community engagement and social mobilization to counter the rising EVD cases. Four successive Strategic Response Plans have been implemented to increase resource mobilization by DR Congo and her partners. The Spread of zoonotics such as EVD can be confronted by implementing the One Health approach, which involves medical staff, veterinarians and public health officials.