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J Trop Pediatr. 2014 Oct;60(5):352-7. doi: 10.1093/tropej/fmu026. Epub 2014 Apr 25.

Pediatric surgical care in Lilongwe, Malawi: outcomes and opportunities for improvement.

Author information

1
Department of Surgery, Division of Trauma and Critical Care Surgery, University of North Carolina, Chapel Hill, NC, USA UNC Project, Lilongwe, Malawi.
2
Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
3
Department of Surgery, Division of Trauma and Critical Care Surgery, University of North Carolina, Chapel Hill, NC, USA.
4
Department of Surgery, Division of Pediatric Surgery, University of North Carolina, Chapel Hill, NC, USA.
5
Department of Surgery, Division of Trauma and Critical Care Surgery, University of North Carolina, Chapel Hill, NC, USA UNC Project, Lilongwe, Malawi anthchar@med.unc.edu.

Abstract

BACKGROUND:

One of the objectives of the Millennium Development Goals is to improve child health. We describe the burden of pediatric surgical disease at a tertiary hospital in Malawi.

METHODS:

We conducted a retrospective analysis of a pediatric surgery database at Kamuzu Central Hospital in Malawi for the calendar year 2012. Variables included patient demographics, admission diagnosis, primary surgery and outcome.

RESULTS:

A total of 1170 pediatric patients aged 0-17 years were admitted to the surgical service during the study period. The mean age was 6.9 years, and 62% were male. Trauma was the most common indication for admission (51%, n = 596), and 67% (n = 779) of all patients were managed non-operatively. Neonates and patients managed non-operatively had a significantly increased risk of mortality.

CONCLUSION:

Only a third of patients admitted to the pediatric surgery service underwent surgery. More than half of patients with congenital anomalies did not undergo surgical intervention. Importantly, patients who underwent surgery had a survival advantage.

KEYWORDS:

low- and middle-income country; neonatal surgery; sub-Saharan Africa; training

PMID:
24771355
PMCID:
PMC4271107
DOI:
10.1093/tropej/fmu026
[Indexed for MEDLINE]
Free PMC Article

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