Validation of a community-based survey assessing nonobstetric surgical conditions in Burera District, Rwanda

Linden, Allison F.; Maine, Rebecca; Hedt‐Gauthier, Bethany; Kamanzi, Emmanuel; Gauvey-Kern, Kevin; Mody, Gita N.; Ntakiyiruta, Georges; Kansayisa, Grace; Ntaganda, Edmond; Niyonkuru, Francine; Mubiligi, Joel; Mpunga, Tharcisse; Meara, John G.; Riviello, Robert

doi:10.1016/j.surg.2015.10.012

Cited by 10 publications

(21 citation statements)

References 34 publications

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“…Most patients were males, and injury was the most common diagnosis, mainly resulting from road traffic injuries and assaults. Injury has been recognized as the leading condition requiring surgical care in Rwanda and other LMICs [ 1 , 2 , 8 ]. The prevalence in our cohort is similar to a Kenyan study where 41 % of patients who visited a hospital’s emergency department were injured [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Non‐Obstetric Surgical Care at Three Rural District Hospitals in Rwanda: More Human Capacity and Surgical Equipment May Increase Operative Care

Muhirwa¹,

Habiyakare

Hedt‐Gauthier

et al. 2016

World j. surg.

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BackgroundMost mortality attributable to surgical emergencies occurs in low- and middle-income countries. District hospitals, which serve as the first-level surgical facility in rural sub-Saharan Africa, are often challenged with limited surgical capacity. This study describes the presentation, management, and outcomes of non-obstetric surgical patients at district hospitals in Rwanda.MethodsThis study included patients seeking non-obstetric surgical care at three district hospitals in rural Rwanda in 2013. Demographics, surgical conditions, patient care, and outcomes are described; operative and non-operative management were stratified by hospitals and differences assessed using Fisher’s exact test.ResultsOf the 2660 patients who sought surgical care at the three hospitals, most were males (60.7 %). Many (42.6 %) were injured and 34.7 % of injuries were through road traffic crashes. Of presenting patients, 25.3 % had an operation, with patients presenting to Butaro District Hospital significantly more likely to receive surgery (57.0 %, p < 0.001). General practitioners performed nearly all operations at Kirehe and Rwinkwavu District Hospitals (98.0 and 100.0 %, respectively), but surgeons performed 90.6 % of the operations at Butaro District Hospital. For outcomes, 39.5 % of all patients were discharged without an operation, 21.1 % received surgery and were discharged, and 21.1 % were referred to tertiary facilities for surgical care.ConclusionSignificantly more patients in Butaro, the only site with a surgeon on staff and stronger surgical infrastructure, received surgery. Availing more surgeons who can address the most common surgical needs and improving supplies and equipment may improve outcomes at other districts. Surgical task sharing is recommended as a temporary solution.

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Section: Discussionmentioning

confidence: 99%

Non‐Obstetric Surgical Care at Three Rural District Hospitals in Rwanda: More Human Capacity and Surgical Equipment May Increase Operative Care

Muhirwa¹,

Habiyakare

Hedt‐Gauthier

et al. 2016

World j. surg.

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“…The target sample size (n = 3000 individuals) was calculated for a parallel study to assess the validity of a survey tool to identify surgical disease. 14 The predicted sensitivity of the survey tool determined the study sample size. 14 In March and May 2012, 5 Rwandan physicians (3 senior surgical postgraduates and 2 general practitioners with surgical training) visited the selected households and conducted standardized physical examinations.…”

Section: Study Population and Data Collectionmentioning

confidence: 99%

Prevalence of Untreated Surgical Conditions in Rural Rwanda

et al. 2017

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“…Clinical diagnosis was not financially feasible during the time of this study's implementation. Surgically treatable problems of the groin and genitalia region are likely to be underreported40, explaining marginal prevalence of pelvic organ prolapse, fistula, groin hernias, hematuria, and urinary retention. The buttocks region include gastrointestinal diseases requiring laboratory or endoscopic workup to diagnose; they were reported low in adults 50 years and older which is likely an underestimation.…”

Section: Discussionmentioning

confidence: 99%

Surgical need among the ageing population of Uganda

et al. 2019

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Background Uganda's ageing population (age 50 years and older) will nearly double from 2015 to 2050. HIV/AIDS, diabetes, stroke among other disease processes have been studied in the elderly population. However, the burden of disease from surgically-treatable conditions is unknown. Objectives To determine the proportion of adults above 50 years with unmet surgical need and deaths attributable to probable surgically-treatable conditions. Methods A cluster randomized sample representing the national population of Uganda was enumerated. The previously validated Surgeons Overseas assessment of surgical need instrument, a head-to-toe verbal interview, was used to determine any surgically-treatable conditions in two randomly-selected living household members. Deaths were detailed by heads of households. Weighted metrics are calculated taking sampling design into consideration and Taylor series linearization was used for sampling error estimation. Results The study enumerated 425 individuals above age 50 years. The prevalence proportion of unmet surgical need was 27.8% (95%CI, 22.1–34.3). This extrapolates to 694,722 (95%CI, 552,279–857,157) individuals living with one or more surgically treatable conditions. The North sub-region was observed to have the highest prevalence proportion. Nearly two out of five household deaths (37.9%) were attributed to probable surgically treatable causes. Conclusion There is disproportionately high need for surgical care among the ageing population of Uganda with approximately 700,000 consultations needed.

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Validation of a community-based survey assessing nonobstetric surgical conditions in Burera District, Rwanda

Cited by 10 publications

References 34 publications

Non‐Obstetric Surgical Care at Three Rural District Hospitals in Rwanda: More Human Capacity and Surgical Equipment May Increase Operative Care

Non‐Obstetric Surgical Care at Three Rural District Hospitals in Rwanda: More Human Capacity and Surgical Equipment May Increase Operative Care

Prevalence of Untreated Surgical Conditions in Rural Rwanda

Surgical need among the ageing population of Uganda

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