Understanding the medical challenges for the diagnosis and treatment of bilateral pitting oedema in children

A qualitative study

Bibliographic Data

ID19593232
AuthorsGiulia Scarpa (0000-0002-4810-4293, University of Leeds, corresponding author), Joseph Sagara (0009-0004-0285-1412, Médecins Sans Frontières, corresponding author), Christopher Mambula (0009-0001-2960-4786, Médecins Sans Frontières, corresponding author), Marie-Hortense Koudika (Médecins Sans Frontières, corresponding author), Fabrizio Loddo (0009-0006-8751-446X, Save the Children, corresponding author), Emelie Yonally-Phillips (Médecins Sans Frontières, corresponding author), Manal Shamseldin (0000-0001-9270-3931, Médecins Sans Frontières, corresponding author), M Tiv (0000-0002-5694-6175, Médecins Sans Frontières, corresponding author), Emily Lynch (0000-0002-6811-1351, Médecins Sans Frontières, corresponding author), Nana Nimbu (0009-0005-5442-2852, Médecins Sans Frontières, corresponding author), Aimé Lulebo Mampasi (0000-0002-4526-5243, University of Kinshasa, corresponding author), Nono Mvuama Mazangama (0000-0003-2046-5836, University of Kinshasa, corresponding author), Akory Ag Iknane (0000-0001-6832-7921, corresponding author), Jihane Ben Farhat (0000-0002-6362-1264, Médecins Sans Frontières, corresponding author)
EditorsGerard Bryan Gonzales Gerard Bryan Gonzales
Year2025
Volume5
Issue3
Pagese0004125
Publication date2025-03-18
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0004125
PMID40100821
OpenAlexW4408567494
LanguageEN
References cited31

Severely malnourished patients can present with bilateral pitting oedema, which is a common sign of Kwashiorkor. However, bilateral pitting oedema can also be an expression of other pathologies. In Mali and DRC, the number of children presenting with bilateral pitting oedema at MSF (Médecins Sans Frontiers/Doctors Without Borders) hospitals are up to 30% (Mali) and 49% (DRC) higher than in other countries, however, the reasons underlying this trend are unknown. Through this qualitative study, we aimed to explore the perspectives and lived experiences of health professionals on the diagnosis and management of children with bilateral pitting oedema. Using a participatory approach, we conducted 21 in-depth interviews, and 2 focus groups with health professionals at MSF health facilities who had worked in the settings of Koutiala (Mali) and Rutshuru (DRC) for at least 6 months. The understanding of the bilateral pitting oedema phenomenon is complex. Health workers described clinical obstacles to reducing mortality, including: i) difficulties making the diagnosis due to a lack of specialized staff and insufficient resources, ii) challenges treating complications that may arise due to the complexity of the diseases associated with bilateral pitting oedema, and iii) lack of scientific evidence in the literature explaining the physiopathology of bilateral pitting oedema. Study participants shared several key recommendations for reducing mortality among children presenting with bilateral pitting oedema, including prevention of bilateral pitting oedema at the community level, standardization of the diagnostic process, strengthening of medical training, and better collaboration both within the medical teams and between teams and the children’s families

Emergency and Acute Care Studies · Medicine · Pneumonia and Respiratory Infections · Ultrasound in Clinical Applications · Pediatrics

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