Firearm injuries among children due to the Kivu conflict from 2017 to 2020: A hospital-based retrospective descriptive cohort study

Introduction: Firearm-related injuries are deadly but avoidable. The case of Kivu, a region in the Eastern Democratic Republic of Congo (DRC), is alarming. Decades of unresolved regional conflicts birthed armed groups that have massacred inhabitants and injured several children. This regional instability has also created barriers to seeking and obtaining timely care, decreasing the survival rate. This region\u27s lack of data on paediatric fatal and nonfatal firearm injuries (F&NFFIs) needs studying. Thus, we aim to determine the prevalence and evaluate the outcomes of paediatric F&NFFIs in Kivu. Methods: We included all F&NFFI paediatric patients (≤18 years), admitted at our institution between 2017 and 2020. We extracted data from patient records. Next, we assessed the relationship between determinants of paediatric outcomes using the Chi-square test and the student\u27s t-test. Confounders were identified using cox regression. Results: This study included 101 paediatric patients, mostly male (63.4%), with an average age of 15.9 years residing 164.4 km on average from the hospital. On average, they were admitted 2.9 days post-injury, with the most affected anatomical regions being lower limbs (53.5%) and upper limbs (18.8%). The mean length of stay was 52.9 days, and the mortality rate was 4.0%. Also, injury complications increased the mean length of stay and mortality rate. In addition, mortality was correlated with circulatory failure and anaemia. Discussion: Paediatric F&NFFIs in Eastern DRC is a preventable tragedy. Mortality is increased by injury complications and correlates with some biological factors. Prevention strategies should be developed to protect children and appropriate measures should be established to improve rates of prehospital care and early hospital presentation to lower mortality and improve paediatric outcomes

Les urgences chirurgicales néonatales à l’hôpital provincial général de référence de Bukavu en République Démocratique du Congo

Introduction: L’objectif de cette étude était de déterminer la prévalence des urgences chirurgicales en néonatologie et en déterminer les facteurs épidémiologiques. Méthodes: Il s’agissait d’une étude de cohorte historique de 30 cas sur 3 ans allant de janvier 2010 en Décembre 2013, réalisé dans le département de chirurgie de l’Hôpital Provincial Général de Référence de Bukavu. Résultats: Les urgences chirurgicales néonatales représentent 1,31% pathologies chirurgicales en général. L’âge de consultation le plus fréquemment rencontré est de moins de 8 jours. La prédominance masculine a été notée avec un sex-ratio 3/2. Les pathologies les plus fréquemment rencontrées sont les urgences du tube digestif à 43,3 % suivies de celles neurologiques à 40%. 80 % des nouveau-nés ont bénéficié d’une intervention chirurgicale. Le taux de mortalité a été évalué à 43,3 %. Conclusion: Les pathologies chirurgicales néonatales existent dans notre milieu. Que les cliniciens soient attentifs et arrivent premièrement à poser le diagnostic avant la naissance et deuxièmement à bien prendre en charge dans le but de sauver la vie de ces enfants.Pan African Medical Journal 2016; 2

Predictors of acute stress disorder in victims of violence in Eastern Democratic Republic of the Congo

Background: The Democratic Republic of the Congo underwent more than 25 years of war resulting in millions of deaths and in survivants struggling with trauma related disorders. The factors contributing to acute stress disorder following a traumatic event remain little understood. Emotion regulation might play a role in the development of acute stress disorder among victims of war-related violence. Objectives: We assessed the association between acute stress disorder expression and cognitive strategies of emotion regulation among injured victims of violence in the Eastern Democratic Republic of the Congo. Methods: This cross-sectional study included 120 patients (77% males, mean age 30 ± 11 years) with traumatic wounds admitted at the Bukavu General Hospital. We assessed acute stress disorder through the Stanford Acute Reaction Stress Questionnaire and emotion regulation strategies through the Cognitive emotional regulation questionnaire. Results: Using Pearson Chi2 and Student t-test we found that compared with patients without acute stress disorder (N = 56), patients with acute stress disorder (N = 64) were more likely to be victims of armed robbery (p = .02), of a bullet (p = .04), of having wounds with fracture (p = .03) or neurological damage (p = .05). In multivariate logistic regression, wounds with neurological damage [OR = 2.23 (1.03-6.05)] and maladaptive emotion regulation, namely self-blame [OR = 1.71 (1.01-3.21)] and rumination [OR = 1.97 (1.04-4.13)], were significant predictors of acute stress disorder. Conclusion: Acute stress disorder was prevalent in the aftermath of violence induced injuries and might be associated with emotion regulation strategies such as self-blame and rumination. HIGHLIGHTS Acute stress disorder is strongly associated with maladaptive emotion regulation strategies such as self-blame and rumination. Interventions targeting emotion regulation may reduce acute stress reactions in the aftermath of violence induced injuries