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. 2022 Nov;46(11):2585-2594.
doi: 10.1007/s00268-022-06695-7. Epub 2022 Sep 6.

PREvalence Study on Surgical COnditions (PRESSCO) 2020: A Population-Based Cross-Sectional Countrywide Survey on Surgical Conditions in Post-Ebola Outbreak Sierra Leone

Jurre van Kesteren  1   2 , Alex J van Duinen  3   4   5 , Foday Marah  5   6 , Diede van Delft  5   6   7 , Antoinette L Spector  8 , Laura D Cassidy  8 , Reinou S Groen  9   10 , Sonnia-Magba Bu-Buakei Jabbi  11 , Silleh Bah  11 , James A Medo  11 , Abubakarr Kamanda-Bongay  11 , Daniel van Leerdam  5   12 , Josien Westendorp  3   5 , Hanna M Mathéron  7   13 , Giulia L E Mönnink  13 , Jonathan Vas Nunes  7   13 , Karel C Lindenbergh  14 , Sara K Hoel  3 , Sofie M Løvdal  3 , Mia N Østensen  3 , Helene Solberg  3 , Daniel Boateng  15 , Kerstin Klipstein-Grobusch  15 , Daan van Herwaarden  16 , Janine P J Martens  16 , H Jaap Bonjer  17   18 , Osman Sankoh  11   19   20 , Martin P Grobusch  7   13   21   22   23 , Håkon A Bolkan  3   4   5 ; PRESSCO 2020 study group
Collaborators, Affiliations

PREvalence Study on Surgical COnditions (PRESSCO) 2020: A Population-Based Cross-Sectional Countrywide Survey on Surgical Conditions in Post-Ebola Outbreak Sierra Leone

Jurre van Kesteren et al. World J Surg. 2022 Nov.

Abstract

Background: Understanding the burden of diseases requiring surgical care at national levels is essential to advance universal health coverage. The PREvalence Study on Surgical COnditions (PRESSCO) 2020 is a cross-sectional household survey to estimate the prevalence of physical conditions needing surgical consultation, to investigate healthcare-seeking behavior, and to assess changes from before the West African Ebola epidemic.

Methods: This study (ISRCTN: 12353489) was built upon the Surgeons Overseas Surgical Needs Assessment (SOSAS) tool, including expansions. Seventy-five enumeration areas from 9671 nationwide clusters were sampled proportional to population size. In each cluster, 25 households were randomly assigned and visited. Need for surgical consultations was based on verbal responses and physical examination of selected household members.

Results: A total of 3,618 individuals from 1,854 households were surveyed. Compared to 2012, the prevalence of individuals reporting one or more relevant physical conditions was reduced from 25 to 6.2% (95% CI 5.4-7.0%) of the population. One-in-five conditions rendered respondents unemployed, disabled, or stigmatized. Adult males were predominantly prone to untreated surgical conditions (9.7 vs. 5.9% women; p < 0.001). Financial constraints were the predominant reason for not seeking care. Among those seeking professional health care, 86.7% underwent surgery.

Conclusion: PRESSCO 2020 is the first surgical needs household survey which compares against earlier study data. Despite the 2013-2016 Ebola outbreak, which profoundly disrupted the national healthcare system, a substantial reduction in reported surgical conditions was observed. Compared to one-time measurements, repeated household surveys yield finer granular data on the characteristics and situations of populations in need of surgical treatment.

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Figures

Fig. 1
Fig. 1
Distribution of the 75 rural and urban enumeration areas distributed across all 16 districts of Sierra Leone
Fig. 2
Fig. 2
PRESSCO 2020 flowchart providing an overview in the course of 75 enumeration areas with 25 households each to ultimately 3618 individuals that were included for analysis
See this image and copyright information in PMC

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