Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool: Implications for paediatric surgical capacity-building

Ademuyiwa, Adesoji O; Odugbemi, T; Bode, Christopher; Elebute, OA; Alakaloko, Felix; Alabi, Eyitayo O; Bankole, OB; Ladipo‐Ajayi, Oluwaseun; Seyi‐Olajide, Justina O.; Okusanya, Babasola O; Abazie, Ogechi Helen; Ademuyiwa, Iyabo Yewande; Onwuka, Amanda; Tran, Tu M.; Makanjuola, Ayomide; Gupta, Shailvi; Ots, Riinu; Poenaru, Dan; Nwomeh, Benedict C.

doi:10.1371/journal.pone.0223423

Cited by 10 publications

(9 citation statements)

References 20 publications

(28 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, this is the first and largest study assessing underlying prevalence of surgical disease among a pediatric refugee population in sub-Saharan Africa. Other studies have focused on non-refugee populations or utilized hospital-based records to examine or estimate the burden of disease [ 8 , 11 ]. Strengths of our study included a high response rate, cluster randomized design, and large sample size.…”

Section: Discussionmentioning

confidence: 99%

“…First, the untreated burden of surgical problems among refugee children and adolescents is high. Among children in non-refugee settings, other research has suggested high burden and prevalence of surgical problems from 3.5% to 19% [ 8 , 9 , 17 – 20 ]. Our estimates of over build on this data, where in our study population, over 30% reported a history or presence of a surgical problem, and of that 30%, over half (54%) reported the problem was ongoing.…”

Section: Discussionmentioning

confidence: 99%

“…In the wake of the Lancet Commission on Global Surgery’s, global surgery has gained increase attention during the last several years with increased attention on addressing the burden of disease, surgical infrastructure, and cost effectiveness [ 5 – 7 ]. With the enormous burden of surgery especially among children, some research has emerged focusing on the pediatric burden of surgical disease [ 8 , 9 ]. Yet, still scarce is research focused on pediatric surgical conditions, and even more specifically among forced migrants, such as refugees.…”

Section: Introductionmentioning

confidence: 99%

“…Or, these studies focus on refugees who have resettled to third countries [ 12 ]. The few that have provided population level estimates using household surveys do not focus on refugee children in a conflict or post-conflict zone [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using random cluster sampling

et al. 2022

View full text Add to dashboard Cite

Importance Surgery is a foundational aspect to high functioning health care systems. In the wake of the Lancet Commission on Global Surgery, previous research has focused on defining the burden of surgical conditions among a pediatric population, however these studies often fail to include forced migrant or refugees. The goal of this study was to estimate the prevalence of pediatric surgical conditions among refugees in east Africa. Methods We used the previously validated Surgeons OverSeas Assessment of Surgical Need (SOSAS) that utilizes cross-sectional design with random cluster sampling to assess prevalence of surgical disease among participants aged 0 to 18 years in Nyarugusu refugee camp, Tanzania. We used descriptive and multivariable analyses including an average marginal effects model. Results A total of 1,658 participants were included in the study. The mean age of our sample was 8.3 ± 5.8 years. A total of 841 participants (50.7%) were male and 817 participants (49.3%) were female. A total of 513 (n = 30.9%) reported a history or presence of a problem that may be surgical in nature, and 280 (54.6%) of them reported the problem was ongoing or untreated. Overall, 16.9% had an ongoing problem that may be amenable to surgery. We found that increasing age and recent illness were associated with having a surgical problem on both our multivariable analyses. Conclusion To our knowledge, this is the first and largest study of prevalence of surgical conditions among refugee children in sub-Saharan Africa. We found that over 16% (one-in-six) of refugee children have a problem that may be amenable to surgery. Our results provide a benchmark upon which other studies in conflict or post-conflict zones with refugee or forced migrant populations may be compared.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using random cluster sampling

et al. 2022

View full text Add to dashboard Cite

show abstract

“…(7) A nationwide community survey of 1,883 children identified 81 surgical diagnoses and an estimated 2·9 million children were living with surgically correctable diseases in the country. (8) Therefore, increasing the pediatric surgical capacity in this country is a high priority.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of a Pediatric Operating Room Installation in Sub-Saharan Africa

Yap

Halid

Ukwu

et al. 2023

Preprint

View full text Add to dashboard Cite

The unmet need for pediatric surgery incurs enormous health and economic consequences globally, predominantly shouldered by Sub-Saharan Africa (SSA) where children comprise almost half of the population. Lack of economic impact data on improving pediatric surgical infrastructure in SSA precludes informed allocation of limited resources towards the most cost-effective interventions to bolster global surgery for children. We assessed the cost-effectiveness of installing and maintaining a pediatric operating room in a hospital in Nigeria with a pre-existing pediatric surgical service by constructing a decision tree model of pediatric surgical delivery at this facility over a year, comparing scenarios before and after the installation of two dedicated pediatric operating rooms (ORs), which were funded philanthropically. Health outcomes measured in disability-adjusted life years (DALYs) averted were informed by the hospital’s operative registry and prior literature. A societal perspective included costs incurred by the hospital system, charity, and patients’ families. Costs were annualized and reported in 2021 United States dollars ($). The incremental cost-effectiveness ratios (ICERs) of the annualized OR installation were presented from charity and societal perspectives. One-way and probabilistic sensitivity analyses were performed. We found that the installation and maintenance of two pediatric operating rooms averted 1145 DALYs and cost $155,509 annually. Annualized OR installation cost was $87,728 (56% of the overall cost). The ICER of the OR installation was $152 per DALY averted (95% uncertainty interval [UI] 147-156) from the societal perspective, and $77 per DALY averted (95% UI 75-81) from the charity perspective. These ICERs were well under the cost-effectiveness threshold of the country’s half-GDP per capita in 2020 ($1043) and remained cost-effective in one-way and probabilistic sensitivity analyses. Installation of additional pediatric operating rooms in SSA with pre-existing pediatric surgical capacity is therefore very cost-effective, supporting investment in children’s global surgical infrastructure as an economically sound intervention.

show abstract

Surgical Unmet Need in a Low‐Income Area of a Metropolitan City in India: A Cross‐Sectional Study

et al. 2020

View full text Add to dashboard Cite

Introduction We investigated the burden of surgical conditions, level of unmet needs and reasons for non‐utilization of surgical services in a slum of Ahmedabad, India. Methods A community‐based cross‐sectional study was carried out from August to December 2019. Inclusion criteria was age > 14 years; any type of injury/condition that requires surgery; subject has had surgery in last 1 year, and death information of family members. Data were stored and coded in Microsoft excel and exported to IBM SPSS statistics version 25 software for data analysis. Frequencies and proportions (categorical variable) are used to summarize utilization of surgical services and understanding surgical need. The Surgeons Overseas Assessment of Surgical was used to identify surgical met and unmet needs translated into local language. Open Data Kit software was used to install questionnaire in the “Tablet” to collect information and stress‐free workflow in field. Results Out of 10,330 population in 2066 households, 7914 were more than 14 years of age. 3.46% (n = 274) people needed surgery; 116 did not avail surgery and were categorized in “unmet need.” Fifty percent of individuals with surgical needs had abdominal‐ or extremities‐related problems followed by eyes surgery need (14%); back, chest and breast surgical need was 13.5%. Seventeen percent of participants with surgical needs had wounds related to injury or accident while 63% had wounds that were not related to injury. Almost all participants had gone to a physician to seek healthcare, however 42% did not avail surgical care needed for a variety of reasons. Forty‐six percent of participants needing surgical care underwent major surgical procedure, while 11% had minor procedures. Financial reasons (34.5%) and lack of trust (35.3%) were major reasons for not availing surgical care. Conclusions and Relevance Ahmedabad is a relatively high income metropolitan city, has universally free health care and multiple healthcare facilities. Despite this, we have shown that there is significant unmet need for surgical procedures in the low‐income population. A unique finding was that most patients sought a consultation but approximately 50% did not avail of the free surgical procedures under the universally free health care system in this city. We propose creation of community healthcare workers focused on surgical conditions.

show abstract

Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool: Implications for paediatric surgical capacity-building

Cited by 10 publications

References 20 publications

Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using random cluster sampling

Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using random cluster sampling

Cost-Effectiveness of a Pediatric Operating Room Installation in Sub-Saharan Africa

Surgical Unmet Need in a Low‐Income Area of a Metropolitan City in India: A Cross‐Sectional Study

Contact Info

Product

Resources

About