Democratic Republic of Congo: ‘Dead Certainty’ in North Kivu

2020 ◽  
Vol 57 (11) ◽  
pp. 1314-1319
Author(s):  
Luc Malemo Kalisya ◽  
Jacques Fadhili Bake ◽  
Bake Elisee ◽  
Kavira Nyavandu ◽  
Robert Perry ◽  
...  

Background: There is a high prevalence of orofacial clefts in low- and middle-income countries with significant unmet need, despite having 50% of the population younger than 18 years in countries such as the Democratic Republic of Congo (DRC). The purpose of this article is to report on the experience of general surgeons with orofacial clefts at a single institution. Methods: This is a retrospective study of patients treated for cleft lip/palate in the province of North Kivu, DRC between 2008 and 2017. Results: A total of 1112 procedures (122/year) were performed. All procedures were performed by general surgeons following training by an international nongovernmental aid organization. A total of 59.2% of patients were male and the median age was 3.4 years (interquartile range: 0.7-13 years). Average distance from surgical center to patient location was 242.6 km (range: 2-1375 km) with outreach performed for distances >200 kms. A majority (82.1%) of patients received general anesthesia (GA) with significant differences in use of GA, age, weight, and length of stay by major orofacial cleft category. Of the 1112 patients, 86.1% were reported to have cleft lip alone, 10.5% had cleft lip and palate, and 3.4% cleft palate alone. Despite this, only 5.3% of patients underwent surgical repair of cleft palate. Conclusions: Multiple factors including malnutrition, risk of bleeding, procedural complexity, and cosmetic results may contribute to the distribution of procedures performed where most cleft palates are not treated. Based on previously published estimates, unmet needs and social burden of cleft lip and palate are high in the DRC.


2017 ◽  
Vol 9 (10) ◽  
pp. 292-305 ◽  
Author(s):  
Charles Sivirihauma ◽  
Walter Ocimati ◽  
Kambale Valimuzigha ◽  
Deborah Karamura ◽  
Joseph Adheka ◽  
...  

2013 ◽  
Vol 76 (1) ◽  
Author(s):  
Benoît Smets ◽  
Nicolas d’Oreye ◽  
François Kervyn ◽  
Matthieu Kervyn ◽  
Fabien Albino ◽  
...  

2017 ◽  
Vol 25 (51) ◽  
pp. 140-150 ◽  
Author(s):  
Michelle Hynes ◽  
Kate Meehan ◽  
Janet Meyers ◽  
Leon Mashukano Maneno ◽  
Erin Hulland

2019 ◽  
Vol 148 (3) ◽  
pp. 405-406 ◽  
Author(s):  
Anna Scolese ◽  
Danielle Roth ◽  
Meghan O'Connor ◽  
Jean De Dieu Hategekimana ◽  
Kathryn L. Falb

2019 ◽  
Vol 26 (7) ◽  
Author(s):  
Ashleigh R Tuite ◽  
Alexander G Watts ◽  
Kamran Khan ◽  
Isaac I Bogoch

Abstract Background The 2018–2019 Ebola virus disease (EVD) outbreak in North Kivu and Ituri provinces, Democratic Republic of Congo (DRC), continues to spread. The recent discovery of cases in Uganda and in Goma, a major city in the eastern DRC, raises concern for potential EVD transmission in distant locales via commercial air travel. Methods We examined air travel patterns from the affected region with itinerary-level data from the International Air Transport Association for the year 2018 between July and October, inclusive. We focused on three scenarios: (i) travel from Beni airport, (ii) travel from Beni, Goma and Bunia airports and (iii) travel from Beni, Goma and Bunia, and Kigali airports. We evaluated country-level Infectious Disease Vulnerability Index (IDVI) scores for traveller destinations. Results There were 2255 commercial air passengers departing from Beni Airport during the specified time frame, all with domestic destinations, and 55% of which were to Goma. A total of 29 777 passengers travelled from Beni, Bunia and Goma airports during this time frame, with most travel (94.6%) departing from Goma Airport. A total of 72.4% of passengers’ final destination from these three airports were within the DRC, primarily to Kinshasa. There were 166 281 outbound passengers from Beni, Bunia, Goma and Kigali airports with the majority (82.1%) of passengers departing from Kigali. The most frequent destinations from these airports were Nairobi, Kinshasa and Entebbe. Eight of the 10 destinations with greatest passenger volumes are to countries with IDVI scores less than 0.4. Conclusion There is little commercial airline connectivity from the current EVD-affected area; however, larger cities in DRC and throughout East Africa should be aware of the low potential for EVD importation through this route. Most countries at greatest risk for EVD importation have limited capacity to manage these cases.


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