Reasons for consultations and afflicted body systems in rural areas of The Republic of the Congo: A cross-sectional study

In the Republic of the Congo, rural areas are characterized by vulnerable populations and endemic infectious diseases, while health facilities have limited technical capabilities. Our objective was to study the distribution of reasons for consultation and afflicted body systems in rural health facilities. We conducted a cross-sectional study in Bouenza, Lékoumou, and Sangha departments. Individuals attending General Medicine outpatient services of selected health facilities were included in the study between September 2020 and January 2021. Reasons for consultation and afflicted body systems were standardized using the second edition of the International Classification of Primary Care (ICPC-2). The overall results were subsequently stratified by department, sex, and age. Most participants were females (53.2%) and the most attended health facilities for consultation were health care centers (55.9%). The most common reason for consultation was fever (25.7%), followed by headache (8.9%), with the most common combination of reasons for consultation being 'fever-cough-nasal congestion' (4.5%). In Bouenza specifically, asthenia (3.0%) and headache (11.6%) were the most common reasons for consultation, whereas skin rash (4.6%) and foot injuries (2.0%) were the most frequent in Lekoumou and cough (8.1%) and chills (6.6%) the most frequent reasons for consultation in Sangha. Although neglected tropical diseases (NTDs) are considered to be common diseases in rural areas of the Republic of the Congo, reasons for consultation related to NTDs were uncommon in this study. According to the ICPC-2 classification, "fever or chills" (taken as non-specific manifestations, thus separate from body systems) and the digestive system were the most afflicted body systems, as observed in 29.7% and 21.2% of cases, respectively. The main reason for consultation was fever, and "fever or chills" was found to be the most frequent afflicted body system, followed by the digestive system. Further studies are required to complete the history of diseases, the medical diagnoses, and collect information during rainy seasons due to the seasonal nature of several diseases.