Claire E Kendig1, Jonathan C Samuel1, Carlos Varela2, Nelson Msiska2, Michelle M Kiser3, Sean E McLean4, Bruce A Cairns3, Anthony G Charles5. 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.
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.
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