Gastroschisis in Uganda: Opportunities for improved survival

Wesonga, Anne; Fitzgerald, Tamara N.; Kabuye, Ronald; Kirunda, Samuel; Langer, Monica; Kakembo, Nasser; Ozgediz, Doruk; Sekabira, John

doi:10.1016/j.jpedsurg.2016.07.011

Cited by 42 publications

(50 citation statements)

References 19 publications

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“…All (100%) of the patients in the AKTH Kano review were "out-born" and none was prenatally diagnosed. Similar findings have been reported from the sub-region [6,9], and other reports suggest that two-thirds of the deliveries in many LMICs are home births [1].…”

Section: Prenatal Diagnosis and Caresupporting

confidence: 88%

“…All the patients were born outside the hospital; 21 (53.8%) were septic and all were hypothermic at presentation. Earlier studies from our sub-region had shown that septicaemia and hypothermia were common causes of death in infants with gastroschisis [6,8,10]. Analysis of certain patient-related variables in this series, however, did not show any that was significantly associated with mortality (Table 4).…”

Section: Treatment Outcomecontrasting

confidence: 60%

“…This may be exacerbated by suboptimal neonatal transportation to the appropriate health facility. In many LMICs, the reported mortality is 30-100% [6][7][8], while in high-income countries (HICs), mortality in infants with major abdominal wall defects is less than 5% [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Major abdominal wall defects in the low- and middle-income setting: current status and priorities

2020

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Major congenital abdominal wall defects (gastroschisis and omphalocele) may account for up to 21% of emergency neonatal interventions in low-and middle-income countries. In many low-and middle-income countries, the reported mortality of these malformations is 30-100%, while in high-income countries, mortality in infants with major abdominal wall reaches less than 5%. This review highlights the challenges faced in the management of newborns with major congenital abdominal wall defects in the resource-limited setting. Current high-income country best practice is assessed and opportunities for appropriate priority setting and collaborations to improve outcomes are discussed.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Section: Prenatal Diagnosis and Caresupporting

confidence: 88%

Section: Treatment Outcomecontrasting

confidence: 60%

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Major abdominal wall defects in the low- and middle-income setting: current status and priorities

2020

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“…In our environment, we have observed that ultrasound often focuses on basic obstetrics parameters and evidence of fetal viability with little attention paid to the detection of congenital anomalies. The varying levels of reliability of some of the antenatal scans have also been identified as a potential problem (15). We believe that improvement in prenatal diagnosis will improve the outcome, as proper planning for delivery and prompt post partum care can be made.…”

Section: Discussionmentioning

confidence: 97%

“…We observed that about one-third of our patients had fever or sub-normal temperatures on arrival. In Kampala Uganda, Wesonga et al similarly observed that 81% of neonates with gastroschisis were born in first or second level healthcare centers, without appropriate care being initiated, and only 58% arrived within 12 h of delivery (15). The role of initial resuscitative care and transport of the surgical neonate cannot be over-emphasized.…”

Section: Discussionmentioning

confidence: 99%

Challenges and Outcome of Management of Gastroschisis at a Tertiary Institution in North-Eastern Nigeria

et al. 2020

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Trends in prevalence of gastroschisis in Brazil from 2007 to 2020: A national population‐based cross‐sectional study

Regadas

Escosteguy

Fonseca

et al. 2023

Birth Defects Research

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Background: Gastroschisis is a congenital abnormality of the abdominal wall which worldwide prevalence is increasing with time. Up to now, young maternal age is the main factor associated with gastroschisis. Brazil has a great proportion of adolescent mothers. Objectives: To estimate prevalence of gastroschisis in Brazil, explore the effect of very young maternal age, and analyze regional distribution and time trends.Methods: Cross-sectional population-based study using data from official national information systems from 2007 to 2020, covering 9,831 gastroschisis cases. Low maternal age was assessed as risk factor through odds ratio. Prevalence time trends by maternal age and geographic area were analyzed using joinpoint regression. Results: Overall prevalence of gastroschisis in Brazil was 2.47 per 10,000 births. From first to last biennium, there was a 23% relative increase. Last biennium prevalence was higher in the Central-west region and lower in the Northeast.Compared to mothers of 20-34 years old (YO), the odds-ratio for prevalence and 95% confidence intervals for gastroschisis were, as follows: (a) 10-14 YO-4.9 (4.3,5.5); (b) 15-19 3.8); and (c) 35-49 YO-0.3 (95% CI 0.3, 0.4). Conclusions: Prevalence of gastroschisis in Brazil relatively increased 23% from 2007 to 2020. This happened in all maternal age groups. Differences between regions may be associated to data quality. Young mothers had a higher prevalence of gastroschisis and still higher for those under 15 YO. Mother age over 34 YO was a protective factor.

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Gastroschisis in Uganda: Opportunities for improved survival

Cited by 42 publications

References 19 publications

Major abdominal wall defects in the low- and middle-income setting: current status and priorities

Major abdominal wall defects in the low- and middle-income setting: current status and priorities

Challenges and Outcome of Management of Gastroschisis at a Tertiary Institution in North-Eastern Nigeria

Trends in prevalence of gastroschisis in Brazil from 2007 to 2020: A national population‐based cross‐sectional study

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