Early Impact of COVID-19 Pandemic on Paediatric Surgical Practice in Nigeria: a National Survey of Paediatric Surgeons

Abstract

Introduction The novel Coronavirus disease has had significant impact on healthcare globally. Knowledge of this virus is evolving, definitive care is not yet known, and mortality is increasing. We assessed its initial impact on paediatric surgical practice in Nigeria, creating a benchmark for recommendations and future reference. Methods Survey of 120 paediatric surgeons from 50 centres to assess socio-demographics and specific domains of impact of COVID-19 on their services and training in Nigeria. Seventy four surgeons adequately responded. Responses have been analysed. Duplicate submissions for centres were excluded by combining and averaging the responses from centres with multiple respondents. Results Forty-six (92%) centres had suspended elective surgeries. All centres continued emergency surgeries but volume reduced in March by 31%. Eleven (22%) centres reported 13 suspended elective cases presenting as emergencies in March, accounting for 3% of total emergency surgeries. Nine (18%) centres adopted new modalities for managing selected surgical conditions: non-operative reduction of intussusception in 1(2%), antibiotic management of uncomplicated acute appendicitis in 5(10%), more conservative management of trauma and replacement of laparoscopic appendectomy with open surgery in 3(6%) respectively. Low perception of adequacy of Personal Protective Equipment (PPE) was reported in 35(70%) centres. Forty (80%) centres did not offer telemedicine for patients follow up. Twenty-nine (58%) centres had suspended academic training. Perception of safety to operate was low in 37(50%) respondents, indifferent in 24% and high in 26%. Conclusion Majority of paediatric surgical centres reported cessation of elective surgeries whilst continuing emergencies. There is however an acute decline in the volume of emergency surgeries. Adequate PPE need to be provided and preparations towards handling backlog of elective surgeries once the pandemic recedes. Further study is planned to more conclusively understand the full impact of this pandemic on children's surgery. Key words pandemic, COVID-19, children's surgery.

The Impact of COVID-19 Pandemic on Cleft Care Services at a Tertiary Health Facility in Nigeria

“…The lockdown period in his study was characterized by a sudden decrease in the number of cleft care services offered at LUTH and this finding is similar to that from other studies where there was a sudden reduction in their respective health care service during the COVID-19 pandemic. 12,22,[27][28][29][30] This was due to the suspension of all healthcare services considered non-urgent and non-essential because of the need to maintain social distancing and reduce the risk of transmission of COVID-19. This also ensures that human and material resources were judiciously channeled toward the management of the COVID-19 pandemic and non-COVID-19 emergency conditions that will require medical attention regardless of the presence of the pandemic.…”

“…This is in contrast to studies carried out during the early stages of the pandemic where poor understanding of the novel virus microbiology and transmission and the shortage of PPE lead to the cancellation of surgical operations in the face of rising COVID-19 cases. 22,27 The return of orthodontic interventions was found out to have a more rapid surge than return of surgical services. This surge is likely due to the backlog of patients needing orthodontic care and new patients with orofacial clefts coming in for orthodontic interventions.…”

Overview of the Effect of COVID-19 Pandemic on Residency Training in Surgery and Related Specialties in North-Central Nigeria

“…Firstly, hospitals had to adopt measures aimed at reducing the spread of the virus. These included reduction of the workforce present at any point in time, social distancing, deployment of surgical residents to infectious disease units [10], and suspension of elective out-patient activities [11]. Secondly, patients that would have otherwise presented for non-urgent surgical care, elected to remain at home.…”

The Development of Electronic Health and Artificial Intelligence in Surgery after the SARS-CoV-2 Pandemic—A Scoping Review

“…A study conducted by Ogundele et al revealed the necessity of developing electronic health in pediatric surgery after the SARS-CoV-2 was necessary. There was a termination of elective surgeries in Nigeria and an enormous decline in emergency surgeries performed on toddlers [ 50 ]. The reason why surgeons are not attending to their duties is that they do not feel safe operating on patients, especially those who have contracted SARS-CoV-2.…”