15-Year-old with neglected recto-vestibular fistula in western Uganda: a case report

Oyania, Felix; Kotagal, Meera; Situma, Martin

doi:10.1186/s13256-021-02717-5

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…Papers focused on different issues, including challenges faced by patients in accessing surgical care e.g. [ 25 , 35 , 37 ] (including due to COVID-19, [ 57 ]); and performing surgery for complex anomalies [ 37 , 38 ]; the quality of peri- and/or post-operative surgical care (e.g., [ 32 , 33 ]); outcome/survival after surgery (e.g., [ 19 , 89 , 120 ]); and developing cost-effective, local surgical management tools (e.g. management silos for gastroschisis [ 58 ]).…”

Section: Resultsmentioning

confidence: 99%

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

Leke,

Malherbe,

Kalk

et al. 2023

PLOS Glob Public Health

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The aim of this scoping review was to determine the scope, objectives and methodology of contemporary published research on congenital anomalies (CAs) in sub-Saharan Africa (SSA), to inform activities of the newly established sub-Saharan African Congenital Anomaly Network (sSCAN). MEDLINE was searched for CA-related articles published between January 2016 and June 2021. Articles were classified into four main areas (public health burden, surveillance, prevention, care) and their objectives and methodologies summarized. Of the 532 articles identified, 255 were included. The articles originated from 22 of the 49 SSA countries, with four countries contributing 60% of the articles: Nigeria (22.0%), Ethiopia (14.1%), Uganda (11.7%) and South Africa (11.7%). Only 5.5% of studies involved multiple countries within the region. Most articles included CA as their primary focus (85%), investigated a single CA (88%), focused on CA burden (56.9%) and care (54.1%), with less coverage of surveillance (3.5%) and prevention (13.3%). The most common study designs were case studies/case series (26.6%), followed by cross-sectional surveys (17.6%), retrospective record reviews (17.3%), and cohort studies (17.2%). Studies were mainly derived from single hospitals (60.4%), with only 9% being population-based studies. Most data were obtained from retrospective review of clinical records (56.1%) or via caregiver interviews (34.9%). Few papers included stillbirths (7.5%), prenatally diagnosed CAs (3.5%) or terminations of pregnancy for CA (2.4%).This first-of-a-kind-scoping review on CA in SSA demonstrated an increasing level of awareness and recognition among researchers in SSA of the contribution of CAs to under-5 mortality and morbidity in the region. The review also highlighted the need to address diagnosis, prevention, surveillance and care to meet Sustainable Development Goals 3.2 and 3.8. The SSA sub-region faces unique challenges, including fragmentation of efforts that we hope to surmount through sSCAN via a multidisciplinary and multi-stakeholder approach.

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Section: Resultsmentioning

confidence: 99%

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

Leke,

Malherbe,

Kalk

et al. 2023

PLOS Glob Public Health

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“…More than two-thirds of cases are high ARMs, and most receive delayed surgical repair, at a median age of 11 months (4)(5)(6). This delay is attributable to limited pediatric surgical expertise, poor community awareness (7), and lack of systematic follow-up after preliminary colostomy (8). Some patients even undergo de nitive surgical correction as adolescents (7,9).…”

Section: Introductionmentioning

confidence: 99%

“…This delay is attributable to limited pediatric surgical expertise, poor community awareness (7), and lack of systematic follow-up after preliminary colostomy (8). Some patients even undergo de nitive surgical correction as adolescents (7,9).…”

Section: Introductionmentioning

confidence: 99%

Quality of Life of Children After Completion of Surgical Treatment for Anorectal Malformation: A Single-Centre Cross-Sectional Study in South-Western Uganda

Mucunguzi,

Oyania,

Egesa

et al. 2023

Preprint

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Background Anorectal malformations (ARMs) range from minor abnormalities such as imperforate anus to complex forms such as cloaca, and are often associated with other anomalies and residual functional stooling problems. The present study aimed to evaluate the quality of life (QoL) of children after surgical treatment for ARMs at Mbarara Regional Referral Hospital (MRRH) in South-Western Uganda. Methods In this cross-sectional study, we enrolled children who had completed surgical treatment for ARMs between 2014 to 2021 at MRRH. A 23-item PedsQL 4.0 inventory was used to evaluate health-related QoL in children using a multidimensional parent proxy reporting for children aged 3 months to 7 years and child self-reporting for children aged 8 to 17 years. Regression analysis was used to determine the association between sociodemographic and clinical variables and QoL. Crude and adjusted coefficients and their corresponding 95% confidence intervals (CI) were calculated. The significance level was set to a p-value < 0.05. Results A total of 88 participants (F:M ratio = 1.15:1) aged 3 months to 18 years with a median age of 4.5 (IQR 3–7) years were enrolled. The median age at diagnosis of ARM and preliminary diverting colostomy was 3 days (range: 2 to 30 days) and 3 days (range: 2 to 60 days) respectively. Rectovestibular fistulas, 47 (53.4%) were the most prevalent subtype of ARMs, and 5.7% of children had associated anomalies. Over one-third of the participants (38.6%) had definitive surgery after 3 years of age, and PSARP was the most common procedure. The average PedsQL score was 94 out of a maximum score of 100. The mean physical functioning score was 96.7 in males and 98.9 in females. The overall mean emotional functioning score was 91 ± 2. The mean social functioning score was 92 ± 3.0. The mean school functioning score was 95.7 in males and 98.5 in females. Associated anomalies and reoperation significantly predicted poor QoL. Increasing years after completion of surgery was significantly associated with good QoL scores. Conclusion The overall QoL of the participants was good. Associated anomalies and reoperation were associated with poor QoL, while years after completion of definitive surgery was associated with good QoL. There is need for increased awareness and utilization of QoL assessments as an outcome measure after definitive surgery for ARM.

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Hirschsprung disease: a cost analysis study of the direct, indirect costs and financial coping strategies for the surgical management in Western Uganda

Binde,

Oyania,

Ullrich

et al. 2024

Pediatr Surg Int

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Background: Surgical management of Hirschsprung disease (HD) in low-and middle-income countries is typically a staged procedure, necessitating multiple hospitalizations and clinic visits increasing family nancial burden. Currently there is limited information on the costs borne by caretakers of children with Hirschsprung disease seeking surgical intervention. This study seeks to measure the costs and economic burden of surgical treatment for Hirschsprung Disease in western Uganda.Methods: A cross-sectional study using cost analysis was conducted among caretakers of patients who completed surgical treatment of HD between January 2017 to December 2021 at two hospitals in western Uganda. The average direct and indirect costs incurred by caretakers presenting at a public and private hospital were computed.Results: A total of 69 patients (M: F = 7:1) were enrolled in the study. The median age at diagnosis was 60.5 (IQR 3 -151.25) days for children and 2-staged pull through procedure was the common surgery performed. The mean overall cost for treatment was US $960 (SD = $720), with the majority of costs coming from direct medical costs. Nearly half (48%) of participants resorted to distress nancing to nance their child's surgical care. The overwhelming majority of patients (n = 64, 93%) incurred catastrophic expenditure from the total costs of surgery for HD, and 97% of participants fell below the international poverty line at the time treatment was completed.Conclusion:Despite the availability of 'free care' from government hospital and non-pro t services, this study found that surgical management of Hirschsprung disease imposed substantial cost burden on families with Hirschsprung disease patients.

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15-Year-old with neglected recto-vestibular fistula in western Uganda: a case report

Cited by 4 publications

References 13 publications

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review

Quality of Life of Children After Completion of Surgical Treatment for Anorectal Malformation: A Single-Centre Cross-Sectional Study in South-Western Uganda

Hirschsprung disease: a cost analysis study of the direct, indirect costs and financial coping strategies for the surgical management in Western Uganda

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