Mitigating the impact of COVID-19 on children's surgery in Africa

Ihediwa, George; Ford, Kathryn; Ademuyiwa, Adesoji O; Lakhoo, Kokila

doi:10.1136/bmjgh-2020-003016

Cited by 15 publications

(14 citation statements)

References 52 publications

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“…Mazingi and colleagues identified the possible implications of the pandemic on children’s surgery in Africa. They made recommendations spanning across seven domains, including surgical rationing and provision, healthcare worker welfare, child protection, and training [ 13 ]. They also reiterated that children have unique needs and may be disproportionately affected during stressful times [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Online action planning forums to develop a roadmap to mitigate the impact of COVID-19 on the delivery of global children’s surgical care

et al. 2021

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Purpose We aimed to understand the challenges facing children’s surgical care providers globally and realistic interventions to mitigate the catastrophic impact of COVID-19 on children’s surgery. Methods Two online Action Planning Forums (APFs) were organized by the Global Initiative for Children’s Surgery (GICS) with a geographically diverse panel representing four children’s surgical, anesthesia, and nursing subspecialties. Qualitative analysis was performed to identify codes, themes, and subthemes. Results The most frequently reported challenges were delayed access to care for children; fear among the public and patients; unavailability of appropriate personal protective equipment (PPE); diversion of resources toward COVID-19 care; and interruption in student and trainee hands-on education. To address these challenges, panelists recommended human resource and funding support to minimize backlog; setting up international, multi-center studies for systematic data collection specifically for children; providing online educational opportunities for trainees and students in the form of large and small group discussions; developing best practice guidelines; and, most importantly, adapting solutions to local needs. Conclusion Identification of key challenges and interventions to mitigate the impact of the COVID-19 pandemic on global children’s surgery via an objective, targeted needs assessment serves as an essential first step. Key interventions in these areas are underway.

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Section: Introductionmentioning

confidence: 99%

Online action planning forums to develop a roadmap to mitigate the impact of COVID-19 on the delivery of global children’s surgical care

et al. 2021

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“…The system is also adapting itself as more evidence is being generated. [7][8][9][10][11] From the beginning of the outbreak in our country, we have adopted the protocol to continue only the emergency admission at our department and try conservative treatment approaches.…”

Section: Resultsmentioning

confidence: 99%

“…Different hospitals and associations have formalized protocols to ensure essential surgical service for children in need and at the same time to limit the spread of the virus and also to protect the health care workers. [7][8][9][10] At the beginning of the outbreak of SARS CoV 2 in March in our country, we have also canceled all routine surgeries for children and have been performing only emergency surgeries to limit the spread of the SARS CoV 2. Though children experience a milder course of the disease, a growing fear of being infected among the health care workers preventing full phased activity in pediatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Outcome of COVID-19 with Co-Existing Surgical Emergencies in Children: Our Initial Experiences and Recommendations

Hasan

Ali

Huq³

2020

Preprint

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Background: COVID-19 has changed the practice of surgery vividly all over the world. This has already lead to a huge burden of rescheduled pediatric surgical cases worldwide. Though children are less likely to be infected and suffer less when infected, there is a growing fear among health care workers of being self-infected, which is limiting the surgical care of children globally. This study aims to share our experiences with the outcome of COVID-19 in children who had a co-existing surgical emergency, which might help the pediatric surgeons globally to mitigate the effect of COVID 19 on pediatric surgery.Methods: This is a retrospective observational study. We reviewed the epidemiological, clinical, and laboratory data of all patients admitted in our surgery department through the emergency department and later diagnosed to have COVID-19 by RT-PCR. During April 2020 – June 2020. A nasopharyngeal swab was taken from all patients irrespective of symptoms to detect SARS CoV 2 by RT-PCR to identify and isolate asymptomatic patients and patients with atypical symptoms. We divided the test positive patients into 4 age groups for the convenience of data analysis. Data were retrieved from hospital records and analyzed using SPSS (version 25) software. Ethical permission was taken from the hospital ethical review board.Results: Total patients were 32. Seven (21.9%) of them were neonates. Twenty-four (75%) patients were male. The predominant diagnosis was acute abdomen followed by infantile hypertrophic pyloric stenosis (IHPS), myelomeningocele, and intussusception. Only two patients had mild respiratory symptoms (dry cough). Fever was present in 13 (40.6%) patients. Fourteen (43.8%) patients required surgical treatment. The mean duration of hospital stay was 5.5 days. One neonate with ARM died in the post-operative ward due to cardiac arrest. No patient had hypoxemia or organ failure. Seven health care workers (5.51%) including doctors & nurses got infected with SARS Co V2 during this period.Conclusion: Our study has revealed a milder course of COVID-19 in children with minimal infectivity even when present in association with emergency surgical conditions. This might encourage a gradual restart to mitigate the impact of COVID-19 on children’s surgery.

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“…Different hospitals and associations have formalized protocols to ensure essential surgical service for children in need and at the same time to limit the spread of the virus and also to protect the health care workers. [7][8][9][10] At the beginning of the outbreak of SARS CoV 2 in March in our country, we have also canceled all routine surgeries for children and been performing only emergency surgeries to limit the spread of the SARS CoV 2. The study aims to illustrate the outcomes we observed in children with COVID-19 who had co-existing surgical emergencies.…”

Section: Introductionmentioning

confidence: 99%

Outcome of COVID-19 with co-existing surgical emergencies in children: our initial experiences and recommendations

Hasan¹,

Ali

Huq

2020

Preprint

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Background: COVID 19 has changed the practice of surgery vividly all over the world. Pediatric surgery is not an exception. Prioritization protocols allowing us to provide emergency surgical care to the children in need while controlling the pandemic spread. The aim of this study is to share our experiences with the outcome of children with COVID 19 who had a co existing surgical emergency. Methods: This is a retrospective observational study. We reviewed the epidemiological, clinical, and laboratory data of all patients admitted in our surgery department through the emergency department and later diagnosed to have COVID 19 by RT PCR. The study duration was 3 months (April 2020 to June 2020). A nasopharyngeal swab was taken from all patients irrespective of symptoms to detect SARS CoV 2 by RT PCR with the purpose of detecting asymptomatic patients and patients with atypical symptoms. Emergency surgical services were provided immediately without delay and patients with positive test results were isolated according to the hospital protocol. We divided the test positive patients into 4 age groups for the convenience of data analysis. Data were retrieved from hospital records and analyzed using SPSS (version 25) software. Ethical permission was taken from the hospital ethical review board. Results: Total patients were 32. Seven (21.9%) of them were neonates. Twenty four (75%) patients were male. The predominant diagnosis was acute abdomen followed by infantile hypertrophic pyloric stenosis (IHPS), myelomeningocele, and intussusception. Only two patients had mild respiratory symptoms (dry cough). Fever was present in 13 (40.6%) patients. Fourteen (43.8%) patients required surgical treatment. The mean duration of hospital stay was 5.5 days. One neonate with ARM died in the postoperative ward due to cardiac arrest. No patient had hypoxemia or organ failure. Seven health care workers (5.51%) including doctors & nurses got infected with SARS Co V2 during this period. Conclusion: Our study has revealed a milder course of COVID 19 in children with minimal infectivity even when present in association with emergency surgical conditions. This might encourage a gradual restart to mitigate the impact of COVID 19 on children surgery. Keywords: COVID 19, COVID 19 in children, Children Surgery, Surgical emergency, Surgery in COVID 19 positive patients.

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Mitigating the impact of COVID-19 on children's surgery in Africa

Cited by 15 publications

References 52 publications

Online action planning forums to develop a roadmap to mitigate the impact of COVID-19 on the delivery of global children’s surgical care

Online action planning forums to develop a roadmap to mitigate the impact of COVID-19 on the delivery of global children’s surgical care

Outcome of COVID-19 with Co-Existing Surgical Emergencies in Children: Our Initial Experiences and Recommendations

Outcome of COVID-19 with co-existing surgical emergencies in children: our initial experiences and recommendations

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