Review Article
Volume 2 Issue 1
Okitandjate Dimandja Antoine*, Coppieters Yves, Aruna A Aaron and Chenge M Faustin
December 29, 2022
Abstract
Context. In the Democratic Republic of Congo (DRC), the epidemiological profile is dominated by infectious diseases including cholera. It evolves in endemic and epidemic form depending on the province. Despite multisectoral and multidisciplinary interventions organized in the field, the number of deaths remains high, as some contributing factors remain unknown while interventions need to be directed towards these factors.
Objective. Develop and analyse the conceptual model of the factors underlying cholera deaths in the community and in cholera treatment centres (CTCs).
Methodology. A retrospective cross-sectional study, from 2000 to 2013, of descriptive and exploratory type was used. It used the Directorate of Disease Control (DLM) database of 500,670 cases and 11,560 deaths. Finally, the qualitative and prospective method was carried out from 16 September to 16 December 2016, multicentric and covering five cities: Kinshasa, Lubumbashi, Kisangani, Mbandaka and Kalemie. Focus group techniques with 50 community leaders, an in-depth semi-structured interview with 50 patients, 15 health experts and 25 cholera patients. And a structured face-to-face interview with 15 health workers assigned to the CTC was organized. The percentage (%) of respondents' responses was calculated. Content analysis and triangulation of information was performed. Some qualitative survey data was collected by telephone, for obvious reasons.
Results. Four main groups of factors: (i) Organization of services (training of providers, availability of inputs, principles of separation of treatment rooms, lack of working hours, poor management of inputs, lack of systematic follow-up and evaluation of patients, poor clinical evaluation of patients), (ii) Individual factors (physiological state, pathological state and immunological status), (iii) Cholera profile (endemic area, epidemic and virulence of Vibrio cholerae). (iv) Socio-community and anthropological factors (perception and representation of cholera on the one hand, and treatment on the other). These factors can be influenced by complex interrelations without linearity.
Conclusion. Our study, to the importance of developing a conceptual model of the factors of death due to cholera. Understanding the factors that influence and interact with death is the straight line on which efforts must be focused to effectively and significantly reduce mortality from this disease. This conceptual model was designed to develop and analyze more than 96% of these factors, with the exception of those related to the biology of Vibrio cholera, including virulence genes. An ongoing prospective analytical study will determine virulence gene characteristics and antibiotic susceptibility profiles of Vibrio cholerae O1 in clinical and environmental isolates in Lubumbashi, Democratic Republic of Congo.
Conclusion. Our study showed the importance of developing a new conceptual model of cholera death factors. Understanding the factors that influence and interact on death is the straight line on which efforts must be focused to effectively and significantly reduce mortality from this disease. In our view, actors targeting these factors would ipsofacto reduce cholera deaths in the Democratic Republic of Congo.
Keywords: Deaths; cholera; conceptual mode; DRC