Title

Outcomes and unmet need for neonatal surgery in a resource-limited environment: estimates of global health disparities from Kampala, Uganda.

Document Type

Article

Publication Date

12-1-2014

Institution/Department

Surgery, Pediatrics

Journal Title

Journal of pediatric surgery

MeSH Headings

Female, Health Services Needs and Demand, Healthcare Disparities, Humans, Infant, Newborn, Male, Poverty, Prospective Studies, Surgical Procedures, Operative, Uganda

ISSN

1531-5037

Abstract

PURPOSE: Reported outcomes of neonatal surgery in low-income countries (LICs) are poor. We examined epidemiology, outcomes, and met and unmet need of neonatal surgical diseases in Uganda.

METHODS: Pediatric general surgical admissions and consults from January 1, 2012, to December 31, 2012, at a national referral center in Uganda were analyzed using a prospective database. Outcomes were compared with high-income countries (HICs), and met and unmet need was estimated using burden of disease metrics (disability-adjusted life years or DALYs).

RESULTS: 23% (167/724) of patients were neonates, and 68% of these survived. Median age of presentation was 5days, and 53% underwent surgery. 88% survived postoperatively, while 55% died without surgery (p

CONCLUSIONS: More than two thirds of surgical neonates survived despite late presentation and lack of critical care. Epidemiology and outcomes differ greatly with HICs. A high burden of hidden mortality exists, and only a negligible fraction of the population need for neonatal surgery is met by health services.

First Page

1825

Last Page

1830

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