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. 2022 Sep 1;22(1):518.
doi: 10.1186/s12887-022-03576-9.

Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using random cluster sampling

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

Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using random cluster sampling

Zachary Obinna Enumah et al. BMC Pediatr. .

Abstract

Importance: 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 among a pediatric population, however these studies often fail to include forced migrant or refugees. The goal of this study was to estimate the prevalence of pediatric surgical conditions among refugees in east Africa.

Methods: We used the previously validated Surgeons OverSeas Assessment of Surgical Need (SOSAS) that utilizes cross-sectional design with random cluster sampling to assess prevalence of surgical disease among participants aged 0 to 18 years in Nyarugusu refugee camp, Tanzania. We used descriptive and multivariable analyses including an average marginal effects model.

Results: A total of 1,658 participants were included in the study. The mean age of our sample was 8.3 ± 5.8 years. A total of 841 participants (50.7%) were male and 817 participants (49.3%) were female. A total of 513 (n = 30.9%) reported a history or presence of a problem that may be surgical in nature, and 280 (54.6%) of them reported the problem was ongoing or untreated. Overall, 16.9% had an ongoing problem that may be amenable to surgery. We found that increasing age and recent illness were associated with having a surgical problem on both our multivariable analyses.

Conclusion: To our knowledge, this is the first and largest study of prevalence of surgical conditions among refugee children in sub-Saharan Africa. We found that over 16% (one-in-six) of refugee children have a problem that may be amenable to surgery. Our results provide a benchmark upon which other studies in conflict or post-conflict zones with refugee or forced migrant populations may be compared.

Keywords: Conflict setting; Global surgery; Pediatrics; Refugee health; Tanzania.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Age distribution of study population by sex and nationality. Underneath histogram, in the Tufte plot, diamonds represents median value, gaps represent interquartile range, and lines represent whiskers
Fig. 2
Fig. 2
Average marginal effects model on covariate effect on probability of any surgical problem. Null value of effect on probability is 0. If confidence interval crosses this null value, the result was not significant
See this image and copyright information in PMC

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