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AbstractIntroductionSevere child malaria is a deadly disease in numerous tropical and subtropical areas. Its management requires expensive means, resulting in a great strain on the economy of households. In the Democratic Republic of Congo (DRC), households must directly pay for the management costs, as social security is almost inexistent. MethodThe chapter is based on epidemiological and clinical, as well as on medical and economic analyses, carried out in reference Hospitals of Kinshasa in 2011; 1,350 children hospitalised because of severe malaria allowed collecting needed data. Main resultsMore than half children hospitalised for severe malaria were coming from areas where malaria transmission is either elevated or moderate. The lethality rate (5.9%, considering all children) differed according to the type of hospital: 5.3% in state hospitals, 8.4% in private hospitals and 4.0% in confessional hospitals. For what therapeutic behaviours adopted by households were concerned, 31.5% of households directly resorted to a health centre or to the hospital (modern structures). The first option most often selected was self-medication (61.5%). The cost analysis highlighted that the median total costs of malarial disease management reached 114.00 USD in confessional hospitals, 173.00 USD in State hospitals and 308.00 USD in private hospitals.Regarding the analysis of catastrophic health expenditures, their incidence reached 81.1% when the threshold was fixed at 40% of the capacity to pay, and 46.4% if the same threshold was fixed at 10% of total expenditures. For what funding sources are concerned, only 46.0% of households declared having the required financial means at their disposal, in terms of household budget.Conclusion Most households suffered financial difficulties to pay healthcare expenditures resulting from the child disease. Such situation led most households to sell a good or to contract debt in order to settle the care bill.

infectious diseases

Malaria Lethality in Children under 5 Years of Age and Study of Risk Factors in MbujiMayi Paediatric Environment, a Neglected Deadly Epidemic in the Democratic of Republic of Congo