Direct cost of management and clinical profile of severe malaria in Paediatric Hospital of Mbujimayi; Congo DR

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Abstract Background: Leading cause of morbidity and mortality of the Congolese child, malaria especially severe is so much a source of economic losses, both direct (related to curative treatment or prevention) and indirect (due to absenteeism or the decrease of productivity), non-negligible for Mbujimayi’s population whose majority lives below the poverty line.Methods: This prospective study related to the direct cost of in-hospital hold in charge of severe malaria among children of 6 to 59 months, as well as the factors influencing it, was undertaken from July 01, 2012 to June 30, 2013 in the Provincial Hospital Dipumba. Consultation, laboratory tests, medication and hospitalization were the components of the direct cost. EPI Info and SPSS software were used to analyse data. Results: Severe malaria accounted for 70.9% of admissions (534 of 753). The subject was generally male (55.1%), under 3 years of age (28.6±17.5 months), having received no correct anti-malarial treatment before admission (81.5%), brought urgently in serious condition (95.5%), subjected to a low rate of laboratory tests (4.8±1.6) and treated mainly with quinine infusion (93.25%). Recovery amounted to 79.2% against 7.3% of deaths most often early. The majority of affected households (81.5%) were very poor as earning less than $ 30/month. The mean direct cost of the hold in charge of a severe malaria episode rose to US $ 38.6±11.2 (range US $ 8.5-79.94) of which 74% were bound to medication, 11% to consultation, 8% to hospitalization and 7% to laboratory tests. Age, quality of treatment before admission, severity at admission, severe anaemia and disease outcome were the factors influencing this direct cost.Conclusion: Malaria is a costly disease in relation to the standard of living of our population and severe malaria is the main reason for hospitalization among children aged 6 to 59 months. It is necessary to reinforce management capabilities of cases correctly and early so much at home that in hospital and to streamline medical prescriptions in order to reduce costs led by malaria.

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