Deaths associated with anaesthesia in Togo, West Africa

Maman, A. F. Ouro-Bang'na; Tomta, K; Ahouangbevi, S; Chobli, M.

doi:10.1258/004947505774938666

Cited by 146 publications

(101 citation statements)

References 5 publications

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“…Very high perioperative mortality rates have been reported for adults and children in hospitals in lowincome countries, where many avoidable deaths have been associated with failures in administrative procedures, anaesthesia and surgical care. [32][33][34][35][36][37] These studies have included deaths on the wards up to 6 days postoperatively and have shown perioperative mortality rates of 26 to 257 deaths per 10 000 operations, as well as anaesthesia complications frequently related to failures in airway management (including tracheal intubation), respiratory monitoring and in reversing paralysis after anaesthesia. [33][34][35][36][37] Children who undergo surgery in Uganda are frequently given ketamine, an effective and safe anaesthetic and analgesic agent, and since ketamine generally preserves airway patency, it is often used without tracheal intubation or paralysis.…”

Section: Discussionmentioning

confidence: 99%

Paediatric surgery and anaesthesia in south-western Uganda: a cross-sectional survey

Walker

Obua

Mouton

et al. 2010

Bull World Health Org

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Section: Discussionmentioning

confidence: 99%

Paediatric surgery and anaesthesia in south-western Uganda: a cross-sectional survey

Walker

Obua

Mouton

et al. 2010

Bull World Health Org

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“…With respect to staffing, it is no coincidence that the available numbers of labor midwives and nurse anesthetists were correlated with improvement, because both provide important lifesaving functions [14][15][16][17]. The worsening staffing ratios for many provider groups in this report are concerning.…”

Section: Discussionmentioning

confidence: 73%

Measuring the impact of a quality improvement collaboration to decrease maternal mortality in a Ghanaian regional hospital

Srofenyoh

Kassebaum

Owen

et al. 2016

Intl J Gynecology & Obste

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Objective: To evaluate the performance of a continuous quality improvement collaboration at Ridge Regional Hospital, Accra, Ghana, that aimed to halve maternal and neonatal deaths. Methods: In a quasi-experimental, pre-and post-intervention analysis, system deficiencies were analyzed and 97 improvement activities were implemented from January 2007 to December 2011. Data were collected on outcomes and implementation rates of improvement activities. Severity-adjustment models were used to calculate counterfactual mortality ratios. Regression analysis was used to determine the association between improvement activities, staffing, and maternal mortality. Results: Maternal mortality decreased by 22.4% between 2007 and 2011, from 496 to 385 per 100 000 deliveries, despite a 50% increase in deliveries and five-and three-fold increases in the proportion of pregnancies complicated by obstetric hemorrhage and hypertensive disorders of pregnancy, respectively. Case fatality rates for obstetric hemorrhage and hypertensive disorders of pregnancy decreased from 14.8% to 1.6% and 3.1% to 1.1%, respectively. The mean implementation score was 68% for the 97 improvement processes. Overall, 43 maternal deaths were prevented by the intervention; however, risk severity-adjustment models indicated that an even greater number of deaths was averted. Mortality reduction was correlated with 26 continuous quality improvement activities, and with the number of anesthesia nurses and labor midwives. Conclusion: The implementation of quality improvement activities was closely correlated with improved maternal mortality.

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“…[20][21][22] Education for mothers, caregivers, and nurses was nearly always able to lower the MFT. Different methods were used during the 5-year study.…”

Section: Discussionmentioning

confidence: 99%

Excessive fasting times: still an underaddressed challenge for African pediatrics and anesthesia?

Pollach¹,

Kapenda²,

Anusa³

et al. 2014

PHMT

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Background: Children are starved before surgery following international preoperative guidelines. Extreme fasting is still reported, but data for Africa are scarce. Starving in hot climates leads to challenges arising from dehydration, hypotension, metabolic disturbances, and complications during induction of anesthesia. The purpose of this study was to evaluate the scope of the problem, identify possible reasons for this, and propose realistic solutions. Methods: We performed eleven prospective audits between 2008 and 2013 in Malawi to improve our preoperative fasting times. In total, 631 children (aged 3 days to 13 years) were monitored. Training was provided, and the results were measured using a visual analog scale. Conclusion:Excessive preoperative fasting is an underaddressed problem in Africa. Reduction is difficult, so it has to be accepted as an ongoing task.

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Deaths associated with anaesthesia in Togo, West Africa

Cited by 146 publications

References 5 publications

Paediatric surgery and anaesthesia in south-western Uganda: a cross-sectional survey

Paediatric surgery and anaesthesia in south-western Uganda: a cross-sectional survey

Measuring the impact of a quality improvement collaboration to decrease maternal mortality in a Ghanaian regional hospital

Excessive fasting times: still an underaddressed challenge for African pediatrics and anesthesia?

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