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. 2014 Oct;60(5):352-7.
doi: 10.1093/tropej/fmu026. Epub 2014 Apr 25.

Pediatric surgical care in Lilongwe, Malawi: outcomes and opportunities for improvement

Claire E Kendig  1 , Jonathan C Samuel  1 , Carlos Varela  2 , Nelson Msiska  2 , Michelle M Kiser  3 , Sean E McLean  4 , Bruce A Cairns  3 , Anthony G Charles  5
Affiliations

Pediatric surgical care in Lilongwe, Malawi: outcomes and opportunities for improvement

Claire E Kendig et al. J Trop Pediatr. 2014 Oct.

Abstract

Background: One of the objectives of the Millennium Development Goals is to improve child health. We describe the burden of pediatric surgical disease at a tertiary hospital in Malawi.

Methods: We conducted a retrospective analysis of a pediatric surgery database at Kamuzu Central Hospital in Malawi for the calendar year 2012. Variables included patient demographics, admission diagnosis, primary surgery and outcome.

Results: A total of 1170 pediatric patients aged 0-17 years were admitted to the surgical service during the study period. The mean age was 6.9 years, and 62% were male. Trauma was the most common indication for admission (51%, n = 596), and 67% (n = 779) of all patients were managed non-operatively. Neonates and patients managed non-operatively had a significantly increased risk of mortality.

Conclusion: Only a third of patients admitted to the pediatric surgery service underwent surgery. More than half of patients with congenital anomalies did not undergo surgical intervention. Importantly, patients who underwent surgery had a survival advantage.

Keywords: low- and middle-income country; neonatal surgery; sub-Saharan Africa; training.

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Figures

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Fig. 1.
Diagnosis by age-group among pediatric surgical patients at KCH in 2012.
See this image and copyright information in PMC

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