Background/Purpose Perioperative complications cause significant pediatric morbidity and mortality in low- and lower middle -income countries. This study investigates factors associated with prolonged length of stay, 90-day readmission and in-hospital mortality among pediatric patients at Eastern Regional Hospital (ERH) in Ghana. Methods This is a retrospective review of perioperative morbidity and mortality in children < 18 years at ERH in Koforidua, Ghana. All pediatric surgeries performed between January 2015 and December 2017 were included in this study. Univariate analysis was performed using Pearson’s chi-square tests or Fisher’s exact tests. Variables that were significant on univariate analysis were included in multivariable logistic regression models adjusted for age and gender. Results We analyzed 468 patients < 18 years of age with a median length of stay (LOS) of 3 days. The 90-day readmission and in-hospital mortality rates were 138 and 17 per 1000 patients, respectively. The most common procedures were herniorrhaphy (19 %) and appendectomy (15 %). Gastrointestinal surgery, surgical trauma, surgical infection and lack of insurance were significantly associated with prolonged LOS. Young age and female gender were significantly associated with in-hospital mortality. Malaria was significantly associated with 90-day readmission. Conclusions Malaria infection is a significant risk factor for readmission, which should be investigated and treated in pediatric surgical patients in rural Ghana. Ensuring that all patients have insurance may result in shorter hospital stays. Provision of laparoscopic equipment may reduce hospital stays for patients undergoing gastrointestinal surgery. Expansion of the surgical work force, particularly pediatric surgeons, could improve perioperative survival in the very young population. Level of Evidence Retrospective comparative study.

IntroductionIn 2013, peptic ulcer disease (PUD) caused over 300 000 deaths globally. Low-income and middle-income countries are disproportionately affected. However, there is limited information regarding risk factors of perioperative mortality rates in these countries.ObjectiveTo assess perioperative mortality rates from complicated PUD in Africa and associated risk factors.DesignWe performed a systematic review and a random-effect meta-analysis of literature describing surgical management of complicated PUD in Africa. We used subgroup analysis and meta-regression analyses to investigate sources of variations in the mortality rates and to assess the risk factors contributing to mortality.ResultsFrom 95 published reports, 10 037 patients underwent surgery for complicated PUD. The majority of the ulcers (78%) were duodenal, followed by gastric (14%). Forty-one per cent of operations were for perforation, 22% for obstruction and 9% for bleeding. The operations consisted of vagotomy (38%), primary repair (34%), resection and reconstruction (12%), and drainage procedures (6%). The overall PUD mortality rate was 6.6% (95% CI 5.4% to 8.1%). It increased to 9.7% (95% CI 7.1 to 13.0) when we limited the analysis to studies published after the year 2000. The correlation was higher between perforated PUD and mortality rates (r=0.41, p<0.0001) than for bleeding PUD and mortality rates (r=0.32, p=0.001). Non-significant differences in mortality rates existed between sub-Saharan Africa (SSA) and North Africa and within SSA.ConclusionPerioperative mortality rates from complicated PUD in Africa are substantially high and could be increasing over time, and there are possible regional differences.

Background/Purpose Perioperative complications cause significant pediatric morbidity and mortality in low- and lower middle -income countries. This study investigates factors associated with prolonged length of stay, 90-day readmission and in-hospital mortality among pediatric patients in eastern Ghana. Methods This is a retrospective review of perioperative morbidity and mortality in children <18 years at Eastern Regional Hospital (ERH) in Koforidua, Ghana. All pediatric surgeries performed between January 2015 and December 2017 were included in this study and secondary analysis was performed. Results We analyzed 468 patients <18 years of age with a median length of stay (LOS) of 3 days. The readmission and in-hospital mortality rates were 138 and 17 per 1000 patients, respectively. The most common procedures were herniorrhaphy (19%) and appendectomy (15%). Major procedures, gastrointestinal surgery, surgical trauma, surgical infection and having insurance were significantly associated with prolonged LOS. Age and male gender were significantly associated with in-hospital mortality. Malaria was significantly associated with 90-day readmission. Conclusions Malaria infection is a significant and actionable risk factor for readmission in the pediatric surgical population in sub-Saharan Africa. Preventing readmission in patients with malaria could reduce readmission rates by 74%, leading to potential cost-savings and reductions in morbidity.

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The fifth annual summer research summit organized by the Center of Excellence (COE) in Health Equity, Training and Research, Baylor College of Medicine (BCM), was held on May 17, 2022. The theme of this year’s summit was ‘Academic-Community Partnerships: Change Agents for Advancing Health Equity.’ Given the ongoing pandemic, the summit was conducted virtually through digital platforms. This program was intended for both BCM and external audiences interested in advancing health equity, diversity, and inclusion in healthcare among healthcare providers and trainees, biomedical scientists, social workers, nurses, and individuals involved in talent acquisition and development, such as hiring managers (HR professionals), supervisors, college and hospital affiliate leadership and administrators, as well as diversity and inclusion excellence practitioners. We had attendees from all regions of the United States as well as from Saudi Arabia. The content in this Book of Abstracts encapsulates a summary of the research efforts by the BCM COE scholars (which includes post-baccalaureate students, medical students, clinical fellows, and junior faculty from BCM) as well as the external summit participants. The range of topics in this year’s summit was quite diverse, encompassing disparities in relation to maternal and child health (MCH), immigrant health, cancers, vaccination uptakes, and COVID-19 infections. Various solutions were ardently presented to address these disparities, including community engagement and partnerships, improvement in health literacy, and the development of novel technologies and therapeutics. With this summit, BCM continues to build on its long history of educational outreach initiatives to promote diversity in medicine by focusing on programs aimed at increasing the number of diverse and highly qualified medical professionals ready to introduce effective and innovative approaches to reduce or eliminate health disparities. These programs will improve information resources, clinical education, curricula, research, and cultural competence as they relate to minority health issues and social determinants of health. The year’s summit was a great success!   Copyright © 2022 Dongarwar et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.