scholarly journals Spectrum of colorectal surgery operations performed in a single paediatric surgery unit in sub-Saharan Africa

2014 ◽  
Vol 11 (2) ◽  
pp. 128 ◽  
Author(s):  
TaiwoA. Lawal ◽  
DareI. Olulana ◽  
OlakayodeO. Ogundoyin
Keyword(s):  
Colorectal Surgery ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
Sub Saharan

scholarly journals Funding paediatric surgery procedures in sub-Saharan Africa

2019 ◽  
Vol 31 (3) ◽  
pp. 233-239 ◽  
Author(s):  
Sebastian O Ekenze
Keyword(s):  
Surgical Procedures ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
International Agencies ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Out Of Pocket Payments ◽  
Full Text Review ◽  
Sub Saharan ◽  
Mean Cost

BackgroundIn sub-Saharan Africa, there is a growing awareness of the burden of paediatric surgical diseases. This has highlighted the large discrepancy between the capacity to treat and the ability to afford treatment, and the effect of this problem on access to care. This review focuses on the sources and challenges of funding paediatric surgical procedures in sub-Saharan Africa. MethodsWe undertook a search for studies published between January 2007 and November 2016 that reported the specific funding of paediatric surgical procedures and were conducted in sub-Saharan Africa. Abstract screening, full-text review and data abstraction were completed and resulting data were analysed using Statistical Package for Social Sciences (SPSS) software. ResultsThirty-five studies met our inclusion criteria and were reviewed. The countries that were predominantly emphasized in the publications reviewed were Nigeria, South Africa, Kenya, Ghana and Uganda. The paediatric surgical procedures involved general paediatric surgery/urology, cardiac surgery, neurosurgery, oncology, plastics, ophthalmology, orthopaedics and otorhinolaryngology. The mean cost of these procedures ranged from 60 to 21,140 United States Dollars (USD). The source of funding for these procedures was mostly out-of-pocket payments (OOPs) by the patient’s family in 32 studies, (91.4%) and medical mission/non-governmental organizations (NGOs) in 21 (60%) studies. This pattern did not differ appreciably between the articles published in the initial and latter 5 years of the study period, although there was a trend towards a reduction in OOP funding. Improvements in healthcare funding by individual countries supported by international organizations and charities were the predominant suggested solutions to challenges in funding.ConclusionWhile considering the potential limitations created by diversity in study design, the reviewed publications indicate that funding for paediatric surgical procedures in sub-Saharan Africa is mostly by OOPs made by families of the patients. This may result in limited access to some procedures. Coordinated efforts, and collaboration between individual countries and international agencies, may help to reduce OOP funding and thus improve access to critical procedures.

Need for Paediatric Surgery Care in an Urban Area of the Gambia

2003 ◽  
Vol 33 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Stephen W Bickler ◽  
Michelle L Telfer ◽  
Boto Sanno-Duanda
Keyword(s):  
Urban Area ◽  
Cumulative Risk ◽  
Surgical Care ◽  
Presentation Rate ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
Surgical Infections ◽  
Sub Saharan ◽  
Surgical Conditions ◽  
Health Programmes

The report evaluates the need for paediatric surgical care in an urban area of sub-Saharan Africa. Seven hundred and forty-one children were treated for surgical problems from January through December 1997. The most common surgical problems were injuries (67.1%), congenital anomalies (15.0%) and surgical infections (6.7%). Forty-six per cent of children presenting with a surgical problem required a surgical procedure, 68.2% of which were classified as minor. The annual presentation rate for all surgical conditions was 543 per 10 000 children aged 0–14 years. The estimated cumulative risk for all surgical conditions is 85.4% by age 15 years. Our data suggest surgical diseases commonly affect children living in Banjul. Surgical care should be an essential component of child health programmes in developing countries.

The introduction of a paediatric ENT and anaesthesia skills course in Kilimanjaro Christian Medical Centre hospital, (KCMC), Moshi, Tanzania

2021 ◽  
pp. 004947552110166
Author(s):  
Aleksandra Kotwica ◽  
Peter Shija ◽  
Tom Hampton ◽  
David Howard
Keyword(s):  
Human Factors ◽  
Operating Theatre ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
East African ◽  
Kilimanjaro Christian Medical Centre ◽  
Working Practices ◽  
Sub Saharan ◽  
Centre Hospital ◽  
Safe Operating

Human factors and a safe operating theatre environment are of paramount importance, wherever surgery is undertaken. The majority of patients in sub-Saharan Africa do not yet have access to safe surgery. The Paediatric ENT Skills and Airway Course introduced and evaluated here was designed to improve outcomes and safety in a typical East African environment. The lectures, tutorials and practicals covered technical and non-technical skills. Responses from pre- and post-course questionnaires were evaluated as an initial surrogate for effectiveness of this course. The latter showed improvement in all taught skills and found universal recommendation. The course had been established to try to minimise morbidity and mortality after paediatric surgery at our institution, KCMC. We encouraged team co-operation in the care of patients, and recommend other centres consider similar courses building on human factors for safer operating theatre working practices.

Challenges in developing paediatric surgery in Sub-Saharan Africa

2006 ◽  
Vol 22 (5) ◽  
pp. 425-427 ◽  
Author(s):  
S. Mhando ◽  
S. Lyamuya ◽  
K. Lakhoo
Keyword(s):  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
Sub Saharan

scholarly journals Paediatric surgical outcomes in sub-Saharan Africa: a multicentre, international, prospective cohort study

2021 ◽  
Vol 6 (9) ◽  
pp. e004406
Author(s):  
Keyword(s):  
Cohort Study ◽  
Inguinal Hernia ◽  
Prospective Cohort Study ◽  
Surgical Outcomes ◽  
Prospective Cohort ◽  
Anorectal Malformation ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
Sub Saharan ◽  
Surgical Conditions

IntroductionAs childhood mortality from infectious diseases falls across sub-Saharan Africa (SSA), the burden of disease attributed to surgical conditions is increasing. However, limited data exist on paediatric surgical outcomes in SSA. We compared the outcomes of five common paediatric surgical conditions in SSA with published benchmark data from high-income countries (HICs).MethodsA multicentre, international, prospective cohort study was undertaken in hospitals providing paediatric surgical care across SSA. Data were collected on consecutive children (birth to 16 years), presenting with gastroschisis, anorectal malformation, intussusception, appendicitis or inguinal hernia, over a minimum of 1 month, between October 2016 and April 2017. Participating hospitals completed a survey on their resources available for paediatric surgery.The primary outcome was all-cause in-hospital mortality. Mortality in SSA was compared with published benchmark mortality in HICs using χ2 analysis. Generalised linear mixed models were used to identify patient-level and hospital-level factors affecting mortality. A p<0.05 was deemed significant.Results1407 children from 51 hospitals in 19 countries across SSA were studied: 111 with gastroschisis, 188 anorectal malformation, 225 intussusception, 250 appendicitis and 633 inguinal hernia. Mortality was significantly higher in SSA compared with HICs for all conditions: gastroschisis (75.5% vs 2.0%), anorectal malformation (11.2% vs 2.9%), intussusception (9.4% vs 0.2%), appendicitis (0.4% vs 0.0%) and inguinal hernia (0.2% vs 0.0%), respectively. Mortality was 41.9% (112/267) among neonates, 5.0% (20/403) in infants and 1.0% (7/720) in children. Paediatric surgical condition, higher American Society of Anesthesiologists score at primary intervention, and needing/receiving a blood transfusion were significantly associated with mortality on multivariable analysis.ConclusionMortality from common paediatric surgical conditions is unacceptably high in SSA compared with HICs, particularly for neonates. Interventions to reduce mortality should focus on improving resuscitation and timely transfer at the district level, and preoperative resuscitation and perioperative care at paediatric surgical centres.

scholarly journals Analysing the Operative Experience of Paediatric Surgical Trainees in Sub-Saharan Africa Using a Web-Based Logbook

2020 ◽  
Author(s):  
Ciaran Mooney ◽  
Sean Tierney ◽  
Eric O’Flynn ◽  
Miliard Derbew ◽  
Eric Borgstein
Keyword(s):  
Surgical Procedures ◽  
Training Programme ◽  
Median Number ◽  
Sub Saharan Africa ◽  
Paediatric Surgery ◽  
Web Based ◽  
International Joint Commission ◽  
Surgical Trainees ◽  
Operative Experience ◽  
Sub Saharan

Abstract Background The expansion of local training programmes is crucial to address the shortages of specialist paediatric surgeons across Sub-Saharan Africa. This study assesses whether the current training programme for paediatric surgery at the College of Surgeons of East, Central and Southern Africa (COSECSA) is exposing trainees to adequate numbers and types of surgical procedures, as defined by local and international guidelines. Methods Using data from the COSECSA web-based logbook, we retrospectively analysed numbers and types of operations carried out by paediatric surgical trainees at each stage of training between 2015 and 2019, comparing results with indicative case numbers from regional (COSECSA) and international (Joint Commission on Surgical Training) guidelines. Results A total of 7,616 paediatric surgical operations were recorded by 15 trainees, at different stages of training, working across five countries in Sub-Saharan Africa. Each trainee recorded a median number of 456 operations (range 56–1111), with operative experience increasing between the first and final year of training. The most commonly recorded operation was inguinal hernia (n = 1051, 13.8%). Trainees performed the majority (n = 5607, 73.6%) of operations recorded in the eLogbook themselves, assisting in the remainder. Trainees exceeded both local and international recommended case numbers for general surgical procedures, with little exposure to sub-specialities. Conclusions Trainees obtain a wide experience in common and general paediatric surgical procedures, the number of which increases during training. Post-certification may be required for those who wish to sub-specialise. The data from the logbook are useful in identifying individuals who may require additional experience and centres which should be offering increased levels of supervised surgical exposure.

RTS,S/AS01, a vaccine targeting pre-erythrocytic stages of Plasmodium falciparum

2017 ◽  
Vol 1 (6) ◽  
pp. 533-537
Author(s):  
Lorenz von Seidlein ◽  
Borimas Hanboonkunupakarn ◽  
Podjanee Jittmala ◽  
Sasithon Pukrittayakamee
Keyword(s):  
Protective Efficacy ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Phase Iii ◽  
European Medicines Agency ◽  
Older Children ◽  
Pivotal Phase ◽  
Malaria Epidemiology ◽  
Maximum Benefit ◽  
Sub Saharan

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.

Mortality and Society in Sub-Saharan Africa

1993 ◽  
Vol 47 (3) ◽  
pp. 555-556
Author(s):  
Lado Ruzicka
Keyword(s):  
Sub Saharan Africa ◽  
Sub Saharan
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