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Introduction: Malaria remains a real problem of public health. Its hospital care generates important expenditures for affected households. The present study aimed to estimate direct and indirect costs of severe child malaria in reference hospitals in Kinshasa. Methodology: This prospective study included 1,350 children under 15 years of age suffering from severe malaria. The study was performed between 1 January and 30 November, 2011. Data were collected in nine reference hospitals. The studied parameters were direct pre-hospital costs, direct hospital costs, and indirect costs. Costs were assessed from the household point of view. Results: Median costs associated with the disease ranged from 114 USD in confessional hospitals to 173 USD in state hospitals and 308 USD in private hospitals. Direct pre-hospital median costs ranged between 3 and 11 USD. Direct hospital costs reached 72 USD in confessional hospitals, 139 USD in state hospitals, and 254 USD in private hospitals. Indirect costs ranged from 22 USD in state hospitals to 30 USD in confessional hospitals and 46 USD in private hospitals, regardless of the status of the accompanying parent or guardian. Factors explaining the variability of costs were the neurological form of malaria, indirect recourse to hospital, socioeconomic level, type of prescribing person, child's status upon leaving the hospital, and child's transfusion status. Conclusions: The care of severe child malaria appeared to be expensive in private and state hospitals. A state subsidy of health care and regulation of the private sector would contribute to the reduction of malaria's financial impact. [ABSTRACT FROM AUTHOR]

Introduction: The African Programme for Onchocerciasis Control (APOC), the main objective of which was the Community-Directed Treatment with Ivermectin (CDTI), was closed by the end of 2015. The purpose of this study was to describe untreated villages in DRC and to assess the factors associated with the absence of CDTI in endemic villages, between 2001 and 2014. Methodology: This retrospective study was descriptive. Several annual technical reports of the National Onchocerciasis Task Force (NOTF) and national technical reports of CDTI projects were analysed; 21 projects implemented to control the disease were considered, representing the coverage of 42,778 endemic villages. Data were collected over a 3 month-period, between October and December 2016. Results: Only 15,700 endemic villages were not treated through an annual CDT with Mectizan, i.e. 36.7%. The population at risk totalled 29,712,381 individuals and 7,681,995 of them were not treated, i.e. 25.9%. Eight projects recorded high proportions of untreated villages, i.e. 7,100 endemic entities (16.6%). Factors independently associated with non-treatment were the fear of serious side effects (adjusted OR: 10.6; 95% CI: 4.5-27.7), supply impaired by insecurity (adjusted OR: 15.9; 95% CI: 6.7-41.4) and geographical inaccessibility (adjusted OR: 19; 95% CI: 6.9-63.9). Conclusion: After 15 CDTI-cycles in DRC, the mean geographical coverage and therapeutic coverage rates reached 63.3% and 74.1%, respectively. The 2025 target of onchocerciasis eradication, as advocated by APOC, will not be reached. Untreated areas are partly responsible for such results. Many weaknesses persist in the National Program for Onchocerciasis Control (NPOC) and new strategies of disease control should be investigated. [ABSTRACT FROM AUTHOR]

Introduction: The African Programme for Onchocerciasis Control (APOC), the main objective of which was the Community-Directed Treatment with Ivermectin (CDTI), was closed by the end of 2015. The purpose of this study was to describe untreated villages in DRC and to assess the factors associated with the absence of CDTI in endemic villages, between 2001 and 2014., Methodology: This retrospective study was descriptive. Several annual technical reports of the National Onchocerciasis Task Force (NOTF) and national technical reports of CDTI projects were analysed; 21 projects implemented to control the disease were considered, representing the coverage of 42,778 endemic villages. Data were collected over a 3 month-period, between October and December 2016., Results: Only 15,700 endemic villages were not treated through an annual CDT with Mectizan, i.e. 36.7%. The population at risk totalled 29,712,381 individuals and 7,681,995 of them were not treated, i.e. 25.9%. Eight projects recorded high proportions of untreated villages, i.e. 7,100 endemic entities (16.6%). Factors independently associated with non-treatment were the fear of serious side effects (adjusted OR: 10.6; 95% CI: 4.5-27.7), supply impaired by insecurity (adjusted OR: 15.9; 95% CI: 6.7-41.4) and geographical inaccessibility (adjusted OR: 19; 95% CI: 6.9-63.9)., Conclusion: After 15 CDTI-cycles in DRC, the mean geographical coverage and therapeutic coverage rates reached 63.3% and 74.1%, respectively. The 2025 target of onchocerciasis eradication, as advocated by APOC, will not be reached. Untreated areas are partly responsible for such results. Many weaknesses persist in the National Program for Onchocerciasis Control (NPOC) and new strategies of disease control should be investigated., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2018 jean-claude makenga bof, Fortunat Ntumba Tshitoka, Dieudonné Mpunga Mukendi, Paul Mansiangi Mankadi, Félicien Ilunga - Ilunga, Yves Coppieters’t Wallant.)