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. 2016 Nov;32(11):1075-1085.
doi: 10.1007/s00383-016-3957-3. Epub 2016 Sep 10.

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

Elissa K Butler  1 , Tu M Tran  2 , Anthony T Fuller  3   4 , Alexa Brammell  4 , Joao Ricardo Vissoci  2   3 , Luciano de Andrade  5   6 , Fredrick Makumbi  7 , Samuel Luboga  8 , Christine Muhumuza  7 , Vincent F Ssennono  9 , Jeffrey G Chipman  10 , Moses Galukande  11 , Michael M Haglund  2   3   12 , Emily R Smith  13   14
Affiliations

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

Elissa K Butler et al. Pediatr Surg Int. 2016 Nov.

Abstract

Purpose: Little is known about the prevalence of pediatric surgical conditions in low- and middle-income countries. Many children never seek medical care, thus the true prevalence of surgical conditions in children in Uganda is unknown. The objective of this study was to determine the prevalence of surgical conditions in children in Uganda.

Methods: Using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey, we enumerated 4248 individuals in 2315 households in 105 randomly selected clusters throughout Uganda. Children aged 0-18 were included if randomly selected from the household; for those who could not answer for themselves, parents served as surrogates.

Results: Of 2176 children surveyed, 160 (7.4 %) reported a currently untreated surgical condition. Lifetime prevalence of surgical conditions was 14.0 % (305/2176). The predominant cause of surgical conditions was trauma (48.4 %), followed by wounds (19.7 %), acquired deformities (16.2 %), and burns (12.5 %). Of 90 pediatric household deaths, 31.1 % were associated with a surgically treatable proximate cause of death (28/90 deaths).

Conclusion: Although some trauma-related surgical burden among children can be adequately addressed at district hospitals, the need for diagnostics, human resources, and curative services for more severe trauma cases, congenital deformities, and masses outweighs the current capacity of hospitals and trained pediatric surgeons in Uganda.

Keywords: Community survey; Global surgery; Low- and middle-income countries; SOSAS; Sub-Saharan Africa.

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Conflict of interest statement

Compliance with ethical standards Funding source Funding was provided by the Duke Global Health Institute, Duke University Department of Neurosurgery, University of Minnesota Department of Surgery, Makerere College of Health Sciences, and Johnson and Johnson Family of Companies. Funding sources played no role in study design, data collection, data analysis, or writing of the manuscript. All authors had full access to the data and had final responsibility for the decision to submit for publication.

Figures

Fig. 1
Fig. 1
Geographic prevalence of pediatric surgical conditions in Uganda, by age. Each dot represents the proportion of pediatric surgical conditions, relative to the number of children within that region, by age group
See this image and copyright information in PMC

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