Community Zinc Treatment: Innovation in DR Congo

1
Community Zinc Treatment Innovation in DR Congo
Flavien Mulumba, Miriam Silva, Joseph Ndakala,
Emmanuel dHarcourt
4. Results
1. Objectives

• Reduce morbidity and mortality from diarrhea in
  Kabare Health Zone
• Determine the best strategy for zinc treatment in
  DRC
• Prepare for scale-up of zinc treatment in DRC

Coverage
ORS

• ORS use increased from 26 to 33.

• 460 children treated with 401 cases (87.2)
  treated in the community and 173(38)
  werechildren lt1year.

2. Setting

• Zinc coverage 0 (Nov.-04) to 29 (July-05).

• Kabare Health Zone
• is located in Eastern DRC
• has 19 health areas (HA) with 140,270
  inhabitants.
• This pilot program started in Cibingu HA since
  November 2004
• Cibingu population7,000 including the target of
  1,400 children under 5.
• Child Survival program
• For a 5-year duration
• 5 key domains of intervention Malaria, Diarrhea,
  ARI, Malnutrition and Immunization
• Activities are conducted by the International
  Rescue Commitee - IRC and the Ministry of Health.

Inappropriate antibiotics
Compliance

• Zinc community treatment reduced inappropriate
  use of antibiotics.

• Compliance is very good (73)
• Site of administration did not have any impact on
  compliance

CHW Performance
3. Methods

• 28 trained distributors (1/250 people or 1/40
  households) according to the diarrhea treatment
  protocol.
• Zinc tablets of 20mg x 10 days (1/2 tablet - 10mg
  for children under 6 months) Free of charge
• 2 Coverage 2 compliance surveys
• Monthly quality monitoring

• The overall of cases treated by each distributor
  per month is 1.8
• 100 of compliance was reached in the community
  nutrition clinics where integrated activities are
  held.

5. Lessons Learned

• Zinc community treatment is possible in DRC
• Compliance is good
• Does not guarantee very high coverage
• Reduces antibiotic use
• Mothers satisfied with service