The “Other” Neglected Diseases in Global Public Health: Surgical Conditions in Sub-Saharan Africa

Ozgediz, Doruk; Riviello, Robert

doi:10.1371/journal.pmed.0050121

Cited by 148 publications

(126 citation statements)

References 28 publications

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“…Although strengthening surgical services is not routinely emphasized from a public health perspective, the proportion of patients utilizing surgical services in this study population underscores the need for surgical services in this setting. This finding in Cameroon adds to the growing evidence that surgical services are a neglected priority in improving health systems in low-and middle-income countries [30][31][32]. Information on the cost incurred by patients to obtain treatment can be difficult to obtain and is often useful in the evaluation of the impact of injury on vulnerable populations.…”

Section: Discussionmentioning

confidence: 91%

Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon

et al. 2014

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Introduction Injury rates in sub-Saharan Africa are among the highest in the world, but prospective, registrybased reports from Cameroon are limited. We aimed to create a prospective trauma registry to expand the data elements collected on injury at a busy tertiary center in Yaoundé Cameroon. Methods Details of the injury context, presentation, care, cost, and disposition from the emergency department (ED) were gathered over a 6-month period, by trained research assistants using a structured questionnaire. Bivariate and multivariate models were built to explore variable relationships and outcomes.Results There were 2,855 injured patients in 6 months, comprising almost half of all ED visits. Mean age was 30 years; 73 % were male. Injury mechanism was road traffic injury in 59 %, fall in 7 %, penetrating trauma in 6 %, and animal bites in 4 %. Of these, 1,974 (69 %) were discharged home, 517 (18 %) taken to the operating room, and 14 (1 %) to the intensive care unit. The body areas most severely injured were pelvis and extremity in 43 %, head in 30 %, chest in 4 %, and abdomen in 3 %. The estimated injury severity score (eISS) was\9 in 60 %, 9-24 in 35 %, and[25 in 2 %. Mortality was 0.7 %. In the multivariate analysis, independent predictors of mortality were eISS C9 and Glasgow Coma Score B12. Road traffic injury was an independent predictor for the need to have surgery. Trauma registry results were presented to the Ministry of Health in Cameroon, prompting the formation of a National Injury Committee. Conclusions Injuries comprise a significant proportion of ED visits and utilization of surgical services in Yaoundé. A prospective approach allows for more extensive information. Thorough data from a prospective trauma registry can be used successfully to advocate for policy towards prevention and treatment of injuries.

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Section: Discussionmentioning

confidence: 91%

Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon

et al. 2014

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“…[1][2][3] In many developing countries, numerous patients who require basic surgical treatment never reach a healthcare facility, and those who do, encounter inadequate surgical resources. [4] The full extent of the global burden of surgical disease is to a large extent unknown. It has been estimated that >2 billion people worldwide do not have access to the most basic surgical care.…”

Section: Researchmentioning

confidence: 99%

Geographical maldistribution of surgical resources in South Africa: A review of the number of hospitals, hospital beds and surgical beds

Dell

Kahn

2017

S Afr Med J

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Corresponding author: A J Dell (angelajdell@gmail.com) Background. The global burden of surgical disease has been studied to a limited extent. Despite the proven benefits of surgery, surgical services remain poorly resourced. Contributing to this global crisis is the critical lack of data regarding available resources. Objective. To analyse the distribution of some resources necessary for the provision of surgical care. The distribution and number of surgical resources (number of surgical beds) relative to the general resources (number of hospitals and total number of beds) in South Africa were analysed. Methods. All hospitals in the country, including those in the public and private sectors, were contacted, and the total number of hospitals, the level of care (district v. regional v. tertiary), the total number of hospital beds, and the number of surgical beds were determined. The data were analysed according to the provincial distribution and the public v. private sector distribution relative to the size of the population. Results. A total of 544 hospitals were included in the study -327 in the public sector and 217 in the private sector. The public sector hospitals included 257 district-, 49 regional-and 21 tertiary-level hospitals. Nationally, there were 1 hospital, 187 hospital beds and 42 surgi cal beds per 100 000 population. Gauteng Province (GP), the Eastern Cape, KwaZulu-Natal (KZN) and the Western Cape had the most hospitals and GP had the largest number of private hospitals. GP and KZN had the largest total number of beds (n=29 181 and n=22 889, respectively) and number of surgical beds (n=7 289 and n=4 651, respectively). GP had the largest number of private surgical beds (n=4 837). There was a marked variation in the number of hospitals, total number of beds, and number of surgical beds among provinces. Conclusion. This study provided an estimation of the number of hospitals, total number of beds, and number of surgical beds, and showed a marked variation among provinces and between the public and private sectors.

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“…30,31 Surgical and anaesthetic skills contribute significantly to reductions in maternal and child mortality but are in short supply in Africa. [32][33][34] For health facilities to manage obstetric emergencies correctly they need well-trained, well-supervised, skilled and equipped staff. In many African countries (Ethiopia, Mozambique, Malawi, Tanzania), non-physician clinicians have been successfully trained to carry out caesarean sections and provide anaesthesia for maternity cases.…”

Section: Addressing Skills and Resource Gapsmentioning

confidence: 99%

Activism: working to reduce maternal mortality through civil society and health professional alliances in sub-Saharan Africa

Ray¹,

Madzimbamuto

Fonn

2012

Reproductive Health Matters

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The “Other” Neglected Diseases in Global Public Health: Surgical Conditions in Sub-Saharan Africa

Abstract: Doruk Ozgediz and Robert Riviello discuss the burden of premature death and disability and the economic burden of surgical conditions in Africa.

Cited by 148 publications

References 28 publications

Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon

Analysis of Prospective Trauma Registry Data in Francophone Africa: A Pilot Study from Cameroon

Geographical maldistribution of surgical resources in South Africa: A review of the number of hospitals, hospital beds and surgical beds

Activism: working to reduce maternal mortality through civil society and health professional alliances in sub-Saharan Africa

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