Gupta Shailvi, Ranjit Anju, Shrestha Ritesh, Wong Evan G, Robinson William C, Shrestha Sunil, Nwomeh Benedict C, Groen Reinou S, Kushner Adam L
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,
World J Surg. 2014 Dec;38(12):3041-6. doi: 10.1007/s00268-014-2753-2.
The Surgeons OverSeas assessment of surgical need (SOSAS) tool, a population-based survey on surgical conditions in low- and middle-income countries (LMICs), was performed in Sierra Leone and Rwanda. This pilot study in Nepal is the initial implementation of the SOSAS survey in South Asia.
A pilot study of SOSAS, modified for Nepal's needs and reprogrammed using mobile data collection software, was undertaken in Pokhara in January 2014. Cluster randomized sampling was utilized to interview 100 individuals in 50 households within two wards of Pokhara, one rural and one urban. The first portion of the survey retrieved demographic data, including household members and time to nearest health facilities. The second portion interviewed two randomly selected individuals from each household, inquiring about surgical conditions covering six anatomical regions.
The pilot SOSAS in Nepal was easily completed over 3 days, including training of 18 Nepali interns over 2 days. The response rate was 100 %. A total of 13 respondents had a current surgical need (face 4, chest 1, back 1, abdomen 1, groin 3, extremity 3), although eight reported there was no need for surgical care. Five respondents (5 %) had a current unmet surgical need.
The SOSAS pilot study in Nepal was successfully conducted, demonstrating the feasibility of performing SOSAS in South Asia. The estimated 5 % current unmet surgical need will be used for sample size calculation for the full country survey. Utilizing and improving on the SOSAS tool to measure the prevalence of surgical conditions in Nepal will help enumerate the global surgical burden of disease.
外科医生海外手术需求评估（SOSAS）工具是一项针对低收入和中等收入国家（LMICs）外科疾病的基于人群的调查，已在塞拉利昂和卢旺达开展。尼泊尔的这项试点研究是SOSAS调查在南亚的首次实施。
2014年1月，在博卡拉开展了针对尼泊尔需求进行修改并使用移动数据收集软件重新编程的SOSAS试点研究。采用整群随机抽样方法，在博卡拉的两个行政区（一个农村和一个城市）的50户家庭中访谈了100个人。调查的第一部分收集了人口统计学数据，包括家庭成员和到最近医疗机构的时间。第二部分访谈了每户随机选择的两个人，询问了涵盖六个解剖区域的外科疾病情况。
尼泊尔的SOSAS试点在3天内轻松完成，包括在2天内对18名尼泊尔实习生进行培训。回复率为100%。共有13名受访者目前有手术需求（面部4例、胸部1例、背部1例、腹部1例、腹股沟3例、四肢3例），尽管有8人报告无需手术治疗。5名受访者（5%）目前有未满足的手术需求。
尼泊尔的SOSAS试点研究成功开展，证明了在南亚开展SOSAS的可行性。估计目前5%未满足的手术需求将用于全国性调查的样本量计算。利用并改进SOSAS工具来衡量尼泊尔外科疾病的患病率将有助于统计全球外科疾病负担。
