Epidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda

Cheung, Maija; Kakembo, Nasser; Rizgar, Nensi; Grabski, David F.; Ullrich, Sarah; Muzira, Arlene; Kisa, Phyllis; Sekabira, John; Ozgediz, Doruk

doi:10.1007/s00383-019-04520-2

Cited by 21 publications

(24 citation statements)

References 33 publications

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“…Most of epidemiological studies published in recent years on the subject were conducted in third level hospitals, depicting, as expected, a different incidence of disease groups. For example, in a study conducted in a third-level center in Uganda, congenital anomalies were the first diagnostic group, followed by trauma, infections and tumors (20). These data are surely precious, but we need to consider that in LMICs only a very little part of the population has access to third-level hospitals due to the costs and to the distances that people need to cover before reaching more advanced care.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi

et al. 2021

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Background: Little is known about the surgical conditions affecting the pediatric population in low-income countries. In this article we describe the epidemiology of pediatric surgical diseases observed in Mutoyi hospital, a first-level hospital in Burundi.Methods and Findings: We retrospectively reviewed the records of all children (0–14 years) admitted to the Surgery ward from January 2017 to December 2017. We also reviewed the records of all the patients admitted to the Neonatology ward in 2017 and among them we selected the ones in which a surgical diagnosis was present. Five hundred twenty-eight children were admitted to the surgical ward during the study period. The most common conditions requiring hospitalization were abscesses (29.09%), fractures (13.59%), osteomyelitis (9.76%), burns (5.40%) and head injuries (4.36%). The average length of stay was 16 days. Fifty-six newborns were admitted to the Neonatology ward for a surgical condition; 29% of them had an abscess.Conclusions: Conditions requiring surgical care are frequent in Burundian children and have a completely different spectrum from the western ones. This is due on one side to an under-diagnosis of certain conditions caused by the lack of diagnostic tools and on the other to the living conditions of the population. This difference should lead to intervention plans tailored on the actual necessities of the country and not on the western ones.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi

et al. 2021

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“…Our result is comparable to the scenario of other LMICs. In a study in Uganda, mortality was 15% among 2,090 children who were admitted with surgical conditions over a period of four years [7]. According to UNICEF child mortality report (2019), children living in sub-Saharan Africa were 16 times more likely to die before the age of five in comparison to children in HICs [8].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, there has not been substantial decline in deaths in under-5 children over the years from surgical conditions in the LMICs in comparison to deaths from infectious diseases [9]. It was reported that surgical conditions represented about 6-12% of all paediatric admissions in sub-Saharan Africa, and about 87% of the surgical needs in children in LMICs remains unmet [7].…”

Section: Discussionmentioning

confidence: 99%

“…According to UNICEF child mortality report (2019), neonatal deaths accounted for 47 per cent of all under-five deaths and it has been predicted that 26 million new-borns would die between 2019 and 2030, and 80 per cent of these deaths would occur in Southern Asia and sub-Saharan Africa [8]. Studies showed that the outcome of neonatal surgical conditions in these regions is also dismal [3,7,10,[14][15][16]. This clearly denotes that some babies born in the LMICs are very unfortunate, and had they been born in any developed world, a large portion of them could have led a normal life.…”

Section: Discussionmentioning

confidence: 99%

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Mortality from Surgical Conditions in Children: An Insight from a Tertiary-Level Government Hospital in Bangladesh

Chowdhury

Kabir²,

Farooq

et al. 2020

AJPR

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Aims: While the developed world has significantly reduced mortality from surgical conditions in children, there is lack of adequate data on the outcome of children’s surgical conditions in the developing world. This study aims at assessing the spectrum of mortalities from children’s surgical conditions in a low-middle income country (LMIC). Methods: Mortality data were collected for a period of 12 years (2008 to 2019) among 0 to12-year old children to analyse the diseases which had higher mortality trends, age -group specific mortality trends and categorize those according to body system. Results: Among a total of 30,301 admitted children, 1228 (4.05%) patients died. Among them 53.01% were neonates, 20.28% were infants and 26.71% were children. Male to female ratio was 1.95:1. Mortality from neonatal surgical conditions was 24.21%. Infant mortality rate was 5.65% and child mortality rate was 1.41%. Neonatal surgical admission and mortality had a higher yearly trend. Anorectal malformation (ARM) was the most common cause of death (12.05%), followed by intestinal obstruction (11.40%) and gastroschisis (8.63%). Tracheo-oesophageal fistula/ oesophageal atresia (TOF/OA) had the highest mortality rate (83.33%), followed by gastroschisis (80.92%) and intestinal atresia (42.535) among the respective admissions. Other important causes of mortality were jejuno-ileal atresia (5.37%), trauma (5.05%), Hirschsprung disease (4.64%), intestinal perforation (4.48%), omphalocele (4.15%), burn (4.07%) and posterior urethral valves (PUV), 3.58%. Conclusion: Overall mortality rate was much higher than developed countries and lower than some African countries. Neonatal mortality rate was very high and among them TOF/OA and gastroschisis had extremely high mortality rates.

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“…After the meeting, a prospective clinical pediatric surgical database developed at Mulago National Referral Hospital was implemented at both sites in 2016 to measure the case volume as well as clinical outcomes. 25 This investigation uses these 2 databases to describe the impact on pediatric surgical access in Uganda from these 2 rural regional referral hospitals with general surgery teams. We hypothesize that general surgeons can deliver safe, regional care to children as well as have a meaningful impact on the overall burden of pediatric surgical disease in the country.…”

Section: Introductionmentioning

confidence: 99%

Access to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals

Grabski

Ajiko

Kayima

et al. 2021

Surgery

Self Cite

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Conclusion: This investigation demonstrates that lifesaving pediatric procedures are safely performed by general surgeons in Uganda. General surgeons who perform pediatric surgery significantly increase surgical access to rural regions of the country and add a large economic benefit to Ugandan society. Overall, the results of the study support increasing pediatric surgical capacity in rural areas of low-and middle-income countries through support and training of general surgeons and anesthesia providers.

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Epidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda

Cited by 21 publications

References 33 publications

Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi

Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi

Mortality from Surgical Conditions in Children: An Insight from a Tertiary-Level Government Hospital in Bangladesh

Access to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals

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