Prevalence of intestinal stoma complications and associated factors among children in Uganda, a cross sectional study

Abstract

Purpose: Intestinal stomas are a common procedure performed in children. They carry a high complication rate which affects the child, family and hospital. This study was aimed at documenting these complications and their associated factors. Methods: This was a cross-sectional study carried out at the paediatric surgery unit of Mulago Hospital which is the main referral hospital in Uganda over a period of one and a half months. It included 131 children whose caretakers were interviewed and children physically assessed for presence of intestinal stoma complications. Results: The mean age was 2 years (SD±1) with a male to female ratio of 1.3:1. Anorectal malformation (ARM) (77/131) was the most common indication for stoma formation followed by Hirschsprungs disease (25/131). Sigmoid colon was the most exteriorised part (104/131) followed by ileum (27/131). Children with intestinal stomas who developed complications were 83/131 with peristomal dermatitis being the most common complication (54/131) followed by stoma prolapse (5/131). The factors associated with intestinal stoma complications were stoma placement after the age of 12 months (OR 10.7, CI 1.47-17.62, p-value 0.019) and exteriolization of the ileum (CI 0-0.66, p-value 0.028). Conclusion: The prevalence of intestinal stoma complications is high in Uganda with stoma placement after the age of one year and having an ileostomy as the associated factors. Sigmoid divided colostomies and prioritization of children with ileostomies for stoma reversal will help to significantly reduce intestinal stoma complications.