BARRIERS AND FACTORS ASSOCIATED WITH ANESTHESIA-RELATEDINCIDENTS AND POSTOPERATIVE MORBIDITY IN PEDIATRIC SURGERY INRURAL AREAS OF THE DEMOCRATIC REPUBLIC OF THE CONGO: AMULTICENTER ANALYTICAL CROSS-SECTIONAL STUDY OF 964 CHILDREN,2017–2020
Poteau Kambale Katsuva
University of Douala, Cameroon
- Identifiant
- ASPIRE-pp-2026-005
- Déposé le
- 13 February 2026
- Discipline
- Faculty of Medicine and Pharmaceutical Sciences
Prépublications non évaluées par les pairs. Elles ne constituent pas une publication scientifique formelle.
Background: Pediatric anesthesia involves specific physiological, pharmacological, and
organizational challenges that increase perioperative risk, particularly in resource-limited
healthcare settings. This study assessed the frequency of anesthesia-related incidents and
postoperative morbidity and identified associated factors among children undergoing general
surgery in rural Democratic Republic of the Congo (DRC).
Methods: We conducted a multicenter analytical cross-sectional study from January 2017 to
May 2020 in 48 rural health facilities across nine provinces of the DRC. The study included
964 children aged 0–18 years undergoing surgery under general anesthesia and all 48
healthcare providers responsible for their anesthetic care. Children were selected by simple
random sampling, while providers were included exhaustively. Binary logistic regression was
performed using OpenEpi 3.2.
Results: The incidence of intraoperative anesthesia-related incidents was 27.8% (95% CI:
25.0–30.7), while postoperative morbidity was 15.2% (95% CI: 13.0–17.6). Overall
perioperative mortality was 0.83%. None of the facilities had a formal pediatric anesthesia
protocol, and 94.7% had inadequate technical capacity. Infection (aOR 2.8; 95% CI: 1.8–4.4),
poor nutritional status (aOR 1.9; 95% CI: 1.2–3.0), emergency surgery (aOR 3.4; 95% CI:
2.1–5.5), and less than five years of provider experience (aOR 4.6; 95% CI: 2.7–7.9) were
independently associated with anesthesia-related incidents.
Conclusion: Pediatric anesthesia practice in rural DRC is characterized by substantial
perioperative morbidity, reflecting cumulative deficiencies in provider qualifications,
availability of essential resources, and organization of care. Developing an adapted pediatric
anesthesia protocol should be considered a public health priority.
Keywords: pediatric anesthesia; anesthesia-related incidents; postoperative morbidity; rural
settings; Democratic Republic of the Congo.
Citer ce travail
Poteau Kambale Katsuva. BARRIERS AND FACTORS ASSOCIATED WITH ANESTHESIA-RELATEDINCIDENTS AND POSTOPERATIVE MORBIDITY IN PEDIATRIC SURGERY INRURAL AREAS OF THE DEMOCRATIC REPUBLIC OF THE CONGO: AMULTICENTER ANALYTICAL CROSS-SECTIONAL STUDY OF 964 CHILDREN,2017–2020. University of Douala, Cameroon; 2026. Prépublication ASPIRE ASPIRE-pp-2026-005. https://aspire-science.org/memoires/barriers-and-factors-associated-with-anesthesia-relatedincidents-and-postoperative-morbidity-in-pediatric-surgery-inrural-areas-of-the-democratic-republic-of-the-congo-amulticenter-analytical-cross-s/