Multicenter Epidemiological Review of Appendicular Pathology in the Democratic Republic of Congo: a 10-Year Retrospective Study

Abstract

Age and sex distribution could not be assessed due to lack of available data in hospital registers. Objectives: To assess the epidemiology of appendicular pathology in the Democratic Republic of Congo (DRC) and evaluate the rate of histopathological confirmation of intraoperative diagnoses. Design: Multicenter retrospective descriptive study. Setting: 22 referral hospitals across several provinces of the DRC. Participants: A total of 8,849 patients clinically diagnosed with appendicitis between 2013 and 2023, out of 147,306 surgical interventions. Results: The overall frequency of appendicitis was 6%, reaching up to 50% in Bolenge (Grand Equateur). Only 5% of intraoperative diagnoses of appendicitis were confirmed by histopathological examination. Conclusions: Appendicitis remains one of the most frequent surgical diagnoses in the DRC. However, the lack of systematic histopathological confirmation raises concerns regarding diagnostic accuracy. Routine submission of appendectomy specimens for histopathological examination is strongly recommended. Strengths and Limitations of this Study: • Multicenter study including data from 22 hospitals over a 10-year period. • Provides novel insights into appendicular pathology in the DRC. • Limited by incomplete access to pathology services and missing data in some hospitals.