Identifying resource needs for sepsis care and guideline implementation in the Democratic Republic of the Congo: a cluster survey of 66 hospitals in four eastern provinces.

The ongoing conflict in the Eastern Republic of the Congo (DRC) has claimed up to 5.4 million lives by 2008. Whereas few deaths were directly due to violence, most victims died from medical conditions such as infectious diseases. This survey investigates the availability of resources required to provide adequate sepsis care in Eastern DRC. The study was conducted as a self-reported, questionnaire-based survey in four Eastern provinces of the DRC. Questionnaires were sent to a cluster of 80 urban-based hospitals in the North Kivu, South Kivu, Maniema and Orientale provinces. The questionnaire contained 74 questions on the availability of resources required to adequately treat sepsis patients as suggested by the latest Surviving Sepsis Campaign (SSC) guidelines. Sixty-six questionnaires were returned (82.5%) and analyzed. Crystalloid solutions and intravenous fluid giving sets were the only resources constantly available in all hospitals. None of the respondents reported to have constant access to piperacillin, carbapenems, fresh frozen plasma, platelets, dobutamine, activated protein C, echocardiography or equipment to measure lactate levels, invasive blood pressure, central venous pressure, cardiac output, pulmonary artery pressure or endtidal carbon dioxide. No respondent stated that a mechanical ventilator, syringe pump, fluid infuser, peritoneal dialysis or haemodialysis/hemofiltration machine was constantly available at his/her hospital. Resources required for consistent implementation of the SSC guidelines were not available in any hospital. care and implement the SSC guidelines in a cluster of hospitals in the Eastern DRC.