[Nighttime attendance at the Pediatric Emergency Room of the University Hospital Centre in Brazzaville, Congo].

The University Hospital Center is the only hospital in Brazzaville, Congo with a pediatric emergency room. The purpose of this prospective study carried out from January 1 to December 31, 2006 was to evaluate nighttime emergency room attendance by comparing children (excluding newborns) admitted between 7 p.m. and 7 a.m. (group 1) to those admitted between 8 a.m. and 2 p.m. (group 2). A total of 5796 emergency room admissions were recorded including 2648 children (45.7%) between 7 p.m. and 7 a.m. and 2209 (38.1%) between 8 a.m. and 2 p.m. The delay for admission was comparable for the two groups. The death rate at the time of admission was significantly higher in group 1 than group 2: 84.6 % vs. 15.4 % (p<0.01). The main reasons for seeking emergency room care in group 1 were fever (84.6%), digestive problems (44.2%), cough (35.7%), and convulsions (13.9%). The rate of hospitalization was the same in the two groups: 56.7% in group 1 versus 52.8% in group 2. The most common reasons for hospitalization were acute gastroenteritis (24.7%), bronchopulmonary infection (18.9%), malaria (17.3%), severe septicemia (9.3%) and ORL infection (8.1%). Risk factors for hospitalization included age under 2 years, arrival before midnight, and malnutrition. The death rate within 24 hours after hospitalization was 23% in group 1 and 11.5% in group 2 (p<10-4). The death rate was higher in children admitted before midnight. Nighttime attendance as well as hospitalization and death rates remain high at the pediatric emergency room of the University Hospital Center in Brazzaville. The most frequent reason for attendance was fever. Improving outcomes will require providing better information to parents (reducing admission delay) and upgrading hospital resources in terms of patient assessment and medical intervention (health care personnel and facilities).