ABSTRACT
Introduction: In Rwanda, as in other Sub-Saharan Africa countries, there is insufficient data on pediatric surgical conditions. Despite the lack of Pediatric Surgeons and Pediatric Anesthesiologists, Kigali and Butare University Teaching Hospitals receive and manage children with surgical conditions. Some of these patients could benefit from the expertise of specialists trained in Pediatric surgical conditions. Purpose: The aim of this study is to describe the pattern of pediatric surgery in Rwanda and to determine the prevalence of pediatric surgical conditions that require the expertise of a Pediatric Surgeon. Methods: This is a retrospective study carried out between August, 2013 and July, 2014. Data were obtained from theater books and operative database. Data analysis was done by SPSS 16 and MS Excel. Results: From August, 2013 to July, 2014, a total number of 1274 children were operated at Butare and Kigali University Teaching Hospitals. 391 (30.7) were female and 883 (69.3) were male, with a male to female ratio of 2.2:1. The age ranged between 1 day and 16 years, Mean age was 6.4 ± 4.9 years. Children under fie were 45.1%. 857 (67%) children needed the Pediatric Surgery specialty expertise. 369 (29%) patients were operated at Butare University Teaching Hospital, while 905 (71%) were operated from Kigali University Teaching Hospital. Trauma and burn: 466 (36.58%), congenital anomaly: 298 (23.39%) and Surgical infections: 188 (14.76%) were the three common diagnoses in pediatric surgery.Conclusion: Training of Pediatric Surgery sub-specialists, Anesthesiologists and Nurses will provide improved care in Rwanda. Education in trauma prevention, early screening and management of congenital anomalies, will improve service delivery to children with surgical conditions in Rwanda
Subject(s)
Hospitals, Teaching , Laparotomy , Pediatrics , Rwanda , Surgical Procedures, Operative/epidemiologyABSTRACT
Background : Pediatric surgical emergencies are associated with higher morbidity and mortality. The aim of this study is to describe the epidemiology of non-trauma related pediatric abdominal surgical emergencies in our centre and determine the indicators for survival in a cohort of patients. Patients and Methods : A retrospective study of children aged 1 day to 15 years who presented with non-trauma related abdominal emergencies at the Lagos University Teaching Hospital (LUTH). Results : There were 129 children. The median age at presentation was 5 months (range: 1 day-15 years). There were 104 males and 25 females. Sixty-four (49.6) patients presented within 48 hours of the onset of the symptoms while 65 (50.4) presented after 48 hours. Intestinal obstruction is the commonest indication for pediatric emergency surgery in our centre accounting for 76 patients (58.9). Appendicitis is the second most common indication for emergency surgery with 13 patients (10.1). Thirteen patients (10.1) had postoperative complications. There were 13 deaths in all (10.1mortality rate). Eleven out of 43 (25.6) neonates died compared with 2 (2.3) out of 86 patients in the other age groups (P=0.002). Seven out of 107 (6.5) patients that had surgery within 72 hours died while 5/22 (22.7) patients died who had surgery after 72 hours (P=0.003). There were 4 mortalities (28.6) among patients with postoperative complications compared with 9 (7.8) mortalities among 116 patients without any postoperative complications (Pp=0.001). Conclusion : Intestinal obstruction is the commonest pediatric surgical emergency seen in LUTH. Neonatal age; admission to surgery intervention time 72 hours; and severe postoperative complications are associated with high mortality