title: [Children hospitalized with severe malaria in Kinshasa (Democratic Republic of the Congo): Household characteristics and factors associated with mortality].
abstract: BACKGROUND
  Malaria is a major health problem in tropical Africa. In DRC, little is known about the characteristics of households of children with severe malaria or the factors associated with its lethality, especially relative to hospital status.
  
  
  METHODS
  This study of 9 hospitals of the city-province of Kinshasa studied 1350 children younger than 15 years and hospitalized for severe malaria from January to November 2011.
  
  
  RESULTS
  More than three quarters of children admitted to public (state) and church hospitals were from poor households and with uneducated mothers (P < 0.001). The case-fatality rate (5.9% of all children) differed according to hospital status: 5.3% in state hospitals, 8.4% in private hospitals, and 4.0% in the faith-based hospitals (P < 0.001). The risk of death was significantly associated with circulatory collapse (odds ratio, OR = 10.3), number of associated syndromes >2 (OR = 3.5), z-score of weight-for-age ≤-2 (OR = 3.5), delay in seeking medical care (OR = 4.9), body temperature ≥40°C (OR = 2.9), respiratory distress (OR = 1.9) and home rental (versus ownership) a tenant (OR = 2.8), and anorexia was a protective factor (odds ratio = 0.5).
  
  
  CONCLUSIONS
  Severe cases of malaria are rife in poor households and periurban residential areas. Orienting prevention, control, and care- according to the vulnerability of affected households and providing early treatment are imperative if we are to reduce mortality from malaria.
authors.affiliation: Université libre de Bruxelles, campus Érasme, CP598, 808 route de Lennik, 1070 Bruxelles, Belgique, Institut supérieur des techniques médicales de Kinshasa.
authors.forename: F
authors.initials: F
authors.lastname: Ilunga-Ilunga
authors.affiliation: École de santé publique, Centre de recherche en épidémiologie, biostatistiques et recherche clinique, Université libre de Bruxelles, Belgique.
authors.forename: A
authors.initials: A
authors.lastname: Levêque
authors.affiliation: École de santé publique, Centre de recherche en épidémiologie, biostatistiques et recherche clinique, Université libre de Bruxelles, Belgique.
authors.forename: P
authors.initials: P
authors.lastname: Donnen
authors.affiliation: École de santé publique, Centre de recherche en épidémiologie, biostatistiques et recherche clinique, Université libre de Bruxelles, Belgique.
authors.forename: M
authors.initials: M
authors.lastname: Dramaix
mesh_terms: D000293:Adolescent; D000328:Adult; D001831:Body Temperature; D002648:Child; D002675:Child, Preschool; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D016304:Hospitals, Private; D016519:Hospitals, Religious; D006783:Hospitals, State; D006801:Humans; D007223:Infant; D000067010:Literacy / Q000706:statistics & numerical data; D008288:Malaria / Q000453:epidemiology*; D008297:Male; D011203:Poverty / Q000706:statistics & numerical data; D012131:Respiratory Insufficiency / Q000401:mortality; D012720:Severity of Illness Index; D061665:Time-to-Treatment
keywords: Democratic Republic of the Congo; Kinshasa; children; lethality; severe malaria