Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun;46(6):1278-1287.
doi: 10.1007/s00268-022-06505-0. Epub 2022 Mar 6.

Untreated Surgical Problems Among East African Refugees: A Cluster Randomized, Cross-Sectional Study

Zachary Obinna Enumah  1   2 , Frank Manyama  3 , Gayane Yenokyan  4 , Hilary Ngude  5 , Mohamed Yunus Rafiq  6 , Omar Juma  7 , Kent Stevens  8   5 , Joseph V Sakran  8
Affiliations

Untreated Surgical Problems Among East African Refugees: A Cluster Randomized, Cross-Sectional Study

Zachary Obinna Enumah et al. World J Surg. 2022 Jun.

Abstract

Objective: The goal of this study was to estimate the prevalence of surgical conditions among refugees in East Africa.

Background: 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 in low- and middle-income countries. Despite numbering over 80 million people globally, forced migrant populations have often been neglected from this body of research.

Methods: We administered a validated survey using random cluster sampling to determine surgical need among refugees in western Tanzania. Primary outcome was history or presence of a surgical problem. Analysis included descriptive and multivariable logistic regression including an average marginal effects model.

Results: We analyzed data from 3,574 refugee participants in East Africa. A total of 1,654 participants (46.3%) reported a history or presence of at least one problem that may be surgical in nature. Of those 1,654 participants who did report a problem 1,022 participants (61.8%) reported the problem was still ongoing. Multivariable analysis revealed several factors associated with having a surgical problem (increasing age, occupation, illness within past year).

Conclusion: To our knowledge, this is the first and largest population-based survey in estimating the prevalence of surgical disease among refugees in sub-Saharan Africa. Our results imply that more than one-in-four refugees has an ongoing surgical problem, suggesting over double the burden of surgical need in refugee populations compared to non-refugee settings.

PubMed Disclaimer

References

    1. Meara JG, Leather AJM, Hagander L et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386:569–624 - DOI
    1. Vos T, Lim SS, Abbafati C et al (2020) Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396(10258):1204–1222 - DOI
    1. Bae JY, Groen RS, Kushner AL (2011) Surgery as a public health intervention: common misconceptions versus the truth. Bull World Health Organ 89(6):394 - DOI
    1. Zilla P, Bolman RM, Yacoub MH, et al. The Cape Town Declaration on access to cardiac surgery in the developing world. J Thorac Cardiovasc Surg. Mosby Inc. 156: 2206–2209
    1. Varela C, Young S, Groen R, Banza L, Mkandawire NC, Viste A (2017) Untreated surgical conditions in Malawi: A randomised cross-sectional nationwide household survey. Malawi Med J. https://doi.org/10.4314/mmj.v29i3.1 - DOI - PubMed - PMC

Publication types

LinkOut - more resources