Quantifying the pediatric surgical need in Uganda: results of a nationwide cross-sectional, household survey

Butler, Eric; Tran, Tu M.; Fuller, Anthony T.; Brammell, Alexa; Vissoci, João Ricardo Nickenig; Andrade, Luciano de; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Ssennono, Vincent Fred; Chipman, Jeffrey G.; Galukande, Moses; Haglund, Michael M.; Smith, Emily R.

doi:10.1007/s00383-016-3957-3

Cited by 64 publications

(65 citation statements)

References 21 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Uganda, there are 0.1 surgeons per 100,000 people compared to 250 surgeons per 100,000 in the US [6]. Furthermore, only 47 of these surgeons are orthopaedic surgeons for a country of over 41 million people.…”

Section: Discussionmentioning

confidence: 99%

“…Despite increasing awareness of the burden of surgically treated conditions, there remains a paucity of information on surgical utilization in the pediatric population, with estimates that up to 85% of children in Africa have a surgically treatable condition by age 15 [5]. Butler et al found that 14% of Ugandan children had a surgically treatable condition, although only half of these are being addressed currently [6]. Little is known about which pediatric musculoskeletal conditions are contributing to this surgical burden [7,8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Alves

Penny

Kobusingye

et al. 2018

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

While population-based estimates of disease burden and resource utilization are needed, this data offers insight into burden of musculoskeletal disease for this region of Sub-Saharan Africa. We estimate that 50% of the surgical conditions could be prevented with policy changes and education regarding injection practices and early care for traumatic injuries, clubfeet, and infection. This study highlights a need to increase capacity to care for specific musculoskeletal conditions, including gluteal fibrosis, post-injection paralysis, infection, and trauma in the paediatric population of Uganda.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Alves

Penny

Kobusingye

et al. 2018

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…25 In developing countries, little attention is given to pediatric surgical disease. 3 Most child health programs fail to address injuries, congenital abnormalities, and surgical infections, leading to significant childhood death and disability. 1 This is despite the fact that pediatric surgery has been shown to be cost-effective in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide

Dewan

Baticulon

Rattani

et al. 2018

Neurosurgical Focus

View full text Add to dashboard Cite

OBJECTIVEThe presence and capability of existing pediatric neurosurgical care worldwide is unknown. The objective of this study was to solicit the expertise of specialists to quantify the geographic representation of pediatric neurosurgeons, access to specialist care, and equipment and training needs globally.METHODSA mixed-question survey was sent to surgeon members of several international neurosurgical and general pediatric surgical societies via a web-based platform. Respondents answered questions on 5 categories: surgeon demographics and training, hospital and practice details, surgical workforce and access to neurosurgical care, training and equipment needs, and desire for international collaboration. Responses were anonymized and analyzed using Stata software.RESULTSA total of 459 surgeons from 76 countries responded. Pediatric neurosurgeons in high-income and upper-middle-income countries underwent formal pediatric training at a greater rate than surgeons in low- and lower-middle-income countries (89.5% vs 54.4%). There are an estimated 2297 pediatric neurosurgeons in practice globally, with 85.6% operating in high-income and upper-middle-income countries. In low- and lower-middle-income countries, roughly 330 pediatric neurosurgeons care for a total child population of 1.2 billion. In low-income countries in Africa, the density of pediatric neurosurgeons is roughly 1 per 30 million children. A higher proportion of patients in low- and lower-middle-income countries must travel > 2 hours to seek emergency neurosurgical care, relative to high-income countries (75.6% vs 33.6%, p < 0.001). Vast basic and essential training and equipment needs exist, particularly low- and lower-middle-income countries within Africa, South America, the Eastern Mediterranean, and South-East Asia. Eighty-nine percent of respondents demonstrated an interest in international collaboration for the purposes of pediatric neurosurgical capacity building.CONCLUSIONSWide disparity in the access to pediatric neurosurgical care exists globally. In low- and lower-middle-income countries, wherein there exists the greatest burden of pediatric neurosurgical disease, there is a grossly insufficient presence of capable providers and equipped facilities. Neurosurgeons across income groups and geographic regions share a desire for collaboration and partnership.

show abstract

“…Each identified surgical condition was rated by two or more surgeons and medical/surgical trainees as surgically-treatable and non- surgically treatable conditions. Among the surgically-treatable conditions, each case was coded by surgeons or surgical trainees as treated or untreated based on whether the patient received appropriate surgical care [ 9 , 25 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

“…Using the availability of services per region, we compared three capacity estimatess for post-operative, community-based services for children with surgical needs. The base population consisted of the number of school-aged children with surgical needs, estimated from the number of children within each region and the percentage of school-aged children with surgical needs from previous reports [ 9 , 39 ]. Among these children, the three scenarios included estimates of 10%, 20%, and 30% of children with surgical needs estimated to need services post-surgery.…”

Section: Methodsmentioning

confidence: 99%

Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda

Smith

Water

Martin

et al. 2018

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

BackgroundCommunity services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and school reintegration programs for school-aged children in Uganda with identified surgical need.MethodsThis study assessed the geographic epidemiology and spatial analysis of resource availability in communities in Uganda. Participants were children with identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS). Community-based resources available to children and adolescents after surgery in Uganda were identified using publicly available data sources and searching for resources through consultation with in-country collaborators We sought resources available in all geographic regions for a variety of services.ResultsOf 1082 individuals surveyed aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based services identified, availability was greatest in the Central region and least in the Northern region, regardless of type. Assuming 30% of children with surgical needs will need services, a maximum of 50.1% of these children would have access to the needed services in the extensive capacity estimates, while only 10.0% would have access in the minimal capacity estimates. The capacity varied dramatically by region with the Northern region having much lower capacity in all scenarios as compared to the Central, Eastern, or Western regions.ConclusionsOur study found that beyond the city of Kampala in the Central region, community-based services were severely lacking for school-aged children in Uganda. Increased pediatric surgical capacity to additional hospitals in Uganda will need to be met with increased availability and access to community-based services to support recovery and community re-integration.

show abstract

Quantifying the pediatric surgical need in Uganda: results of a nationwide cross-sectional, household survey

Cited by 64 publications

References 21 publications

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Paediatric musculoskeletal disease in Kumi District, Uganda: a cross-sectional survey

Pediatric neurosurgical workforce, access to care, equipment and training needs worldwide

Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda

Contact Info

Product

Resources

About