Pediatric Surgical Waitlist in Low Middle Income Countries During the COVID-19 Pandemic

Abstract

Introduction: Coronavirus disease-19 led to a significant reduction in surgery worldwide. Studies, however, of the effect on surgical volume for pediatric patients in low-income and middle-income countries (LMICs) are limited.

Methods: A survey was developed to estimate waitlists in LMICs for priority surgical conditions in children. The survey was piloted and revised before it was deployed over email to 19 surgeons. Pediatric surgeons at 15 different sites in eight countries in sub-Saharan Africa and Ecuador completed the survey from February 2021 to June 2021. The survey included the total number of children awaiting surgery and estimates for specific conditions. Respondents were also able to add additional procedures.

Results: Public hospitals had longer wait times than private facilities. The median waitlist was 90 patients, and the median wait time was 2 mo for elective surgeries.

Conclusions: Lengthy surgical wait times affect surgical access in LMICs. Coronavirus disease-19 had been associated with surgical delays around the world, exacerbating existing surgical backlogs. Our results revealed significant delays for elective, urgent, and emergent cases across sub-Saharan Africa. Stakeholders should consider approaches to scale the limited surgical and perioperative resources in LMICs, create mitigation strategies for future pandemics, and establish ways to monitor waitlists on an ongoing basis.

Keywords: COVID-19; Pediatric; Surgery; Surgical waitlist.

Fig. 1

Map of KidsOR sites, Descriptive analysis was performed on the wait time, waitlist size, case type, and total case numbers using the online data visualization platform Tableau (Tableau Software, Inc, Seattle, WA) and Excel.

Fig. 2

Box and Whisker Plot of Waitlist Size.

Fig. 3

Box and Whiskers Plot of Waitlist Time.