Abstract
BackgroundChronic illnesses are a major public health problem in low-income countries. In the Democratic Republic of the Congo (DRC), few data are available, especially in palliative care. In this context, the present study aimed at describing the patterns of diseases in Kinshasa hospitals as well as risk factors associated with patients’ evolving status and length of hospital stay.MethodsA prospective study was conducted in ten hospitals of Kinshasa, over a 1-year period. A total of 2699 patients with a chronic condition (non-communicable diseases (NCD) and/or AIDS) were consecutively enrolled in the study between January and December, 2013.ResultsOut of 2699 patients studied, 36.9% were suffering from cardiovascular diseases, 29.7% from comorbidity and 17.5% from AIDS. 27.5% of patients died while hospitalized, and 67.4% were lost to follow-up. The risk factors independently associated with death in hospitals were AIDS (adjusted OR = 2.2) and age over 65 years old (adjusted OR = 1.7).Peri-urban and rural areas were significantly associated with a mean adjusted hospital stay longer than 3 days. The length of stay (LOS) was shorter for women and patients living in urban areas. Patients survived for a median of 10 days (range 7–20 days).ConclusionsThis study reveals the high proportion of patients suffering from advanced chronic diseases, including cardiovascular diseases, AIDS and comorbidity. It demonstrates the need for palliative care (PC) in medical practices in Kinshasa, the capital of the Democratic Republic of the Congo.
Highlights
Chronic illnesses are a major public health problem in low-income countries
Ten hospitals were selected on the basis of the following criteria: (i) accommodation capacity, (ii) capacity of healthcare provided to patients with an advanced chronic condition and (iii) accessibility to services
Evolution of patients showed that 27.5% of them deceased during the study while 67.4% were lost to follow-up
Summary
Chronic illnesses are a major public health problem in low-income countries. In the Democratic Republic of the Congo (DRC), few data are available, especially in palliative care. According to the World Health Organization (WHO) global estimates, around 54.6 million deaths occurred globally in 2011; 66% of these deaths were due to noncommunicable diseases (NCD); 25% were due to communicable, maternal, perinatal and nutritional causes; and 9% were due to injuries. Among these diseases, NCD were the major one requiring PC services in addition to other chronic conditions such as AIDS and drug-resistant tuberculosis [3]. PC is for cancer patients but is extended to people with AIDS, severe kidney disease or renal failure (RF), heart failure, progressive neurological diseases, end-stage lung disease and other life-limiting
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