Profile of Anemia in Children Aged 0 to 59 Months Treated at Kabondo Reference General Hospital of Kisangani City, R. D. Congo

Profile of Anemia in Children Aged 0 to 59 Months Treated at Kabondo Reference General Hospital of Kisangani City, R. D. Congo Joseph – Désiré OLEKO WA OLEKO*, Antoinette O. HAKONYANGE, José TSHIBANDA, Dorothée D. TSHILANDA, Salomon A. BATINA, Dynamo R. KASONGO, Briston E. MONGITA, Aimé M. LUKUSA and Puis T. MPIANA Institute Superior of the Medical Techniques of Tshumbe P.O. BOX. 64 Tshumbe, DR Congo Faculty of Sciences, University of Kinshasa, P.O. BOX. 190 Kinshasa XI, DR Congo Faculty of Medicine and Pharmacy, University of Kisangani, P.O. BOX. 2912 Kisangani, DR Congo Institute Superior of the Medical Techniques of Kibombo P.O. BX. 117 Kibombo, DR Congo Institute Superior of the Medical Techniques of Buta P.O. BOX. 315 Buta, DR Congo 6 Faculty of Public Health, University CEPROMAD, P.O. BOX. 321 Kisangani, DR Congo *Corresponding author: OLEKO WA OLEKO. , Ph: +243 81 56 26 506, Email: j_d_Oleko@yahoo.fr Received: September 12, 2018, Accepted: October 25, 2018, Published: October 25, 2018. ABSTRACT: Severe anemia is a major risk factor for infant mortality and is a public health problem in our country, DR Congo. Most cases require urgent medical care with blood transfusions and a very high hospital bed occupancy rate. This cross-sectional study aims to determine the profile of anemia in children from 0 to 59 months in care at the Kabondo Reference General Hospital during 2017. Our study is transversal descriptive, based on the register of consultations of the pediatric department of the reference general hospital of Kabondo in the year 2017, and 3,641 cases were selected, and based on selection criteria, 486 cases were retained. At the end of our investigations, the following results were obtained: the anemias represent a significant morbid load with a hospital prevalence of 13.3%, in children from 0 to 11 months (38.9%) predominantly female (57.5%). The dominant clinical signs were: fever (40.3%) and digestive disorders (26.1%). 94.1% of cases were cured against 3.9% of deaths. These results demonstrate the use in case management by: 95.9% antianemic agents and 70.3% antibiotic therapy. This study brings to the database more information on the anemic profile of children aged 0 to 59 months treated at the Kabondo Reference General Hospital and gives the relevance of certain drugs in case management. Keyword: Anemia, public health problem DR Congo, infant mortality, INTRODUCTION According to the World Health Organization (WHO), anemia is the most common public health problem in the world, affecting all ages [1-3]. Two billion people around the world are affected by this disease, especially developing countries whose prevalence is of the order of 60% in pregnant women, 50% in children under 4 and 45% in school-aged children [4, 5, 6]. Severe anemia is a medical emergency that usually requires blood transfusion and; the hospitalization rate is relatively higher in sub-Saharan Africa [7]. The transfusion rate was 12.1% in 2016 at the Kinshasa Reference General Hospital and 9% at the Kabondo Reference General Hospital [8]. The management of anemia due to malaria is very important in Africa where mortality is very high among children [9]. As anemia problems are not adequately addressed in the child survival program, it was difficult to achieve the Millennium Development Goal (MDG). Because of multiple reasons related to infections, enzymatic deficiency (G6PD) and micronutrients, through intestinal parasites [10]. The situation is aggravated by the context of HIV infection. In fact, HIV contributes 45% of the deaths of children with severe anemia. According to several studies, malaria is among the main causes of anemia in areas of high endemicity. Severe anemia is one of the 15 criteria for severity of malaria formulated by WHO. With or without fever, children with moderate or severe anemia are among those with high parasitaemia, compared to children without plasmodia [11]. In the Democratic Republic of Congo, the decrease in the number of malaria cases was parallel to the decline in the rate of severe anemia. It accounted for 17% of hospitalizations in patients treated for malaria during 2015. Severe anemia is the result of poor management of simple cases of malaria. According to WHO, the risk of developing signs of untreated malaria severity ranges from 30 to 80%. The physiopathological mechanism is the destruction of erythrocytes or the dyserythropoiesis associated with certain etiological factors [12]. Promoting the national health policy of iron supplementation and malaria control could reduce the incidence of severe anemia and its deaths. In addition, improving access to quality health care remains essential. The objective of our study is to determine the profile of anemia in children from 0 to 59 months in care at the Kabondo Reference General Hospital during 2017.