Butler Elissa K, Tran Tu M, Fuller Anthony T, Brammell Alexa, Vissoci Joao Ricardo, de Andrade Luciano, Makumbi Fredrick, Luboga Samuel, Muhumuza Christine, Ssennono Vincent F, Chipman Jeffrey G, Galukande Moses, Haglund Michael M, Smith Emily R
Department of Surgery, University of Washington, Seattle, WA, USA.
Duke University Global Health Institute, 310 Trent Drive, Durham, NC, 27710, USA.
Pediatr Surg Int. 2016 Nov;32(11):1075-1085. doi: 10.1007/s00383-016-3957-3. Epub 2016 Sep 10.
Little is known about the prevalence of pediatric surgical conditions in low- and middle-income countries. Many children never seek medical care, thus the true prevalence of surgical conditions in children in Uganda is unknown. The objective of this study was to determine the prevalence of surgical conditions in children in Uganda.
Using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey, we enumerated 4248 individuals in 2315 households in 105 randomly selected clusters throughout Uganda. Children aged 0-18 were included if randomly selected from the household; for those who could not answer for themselves, parents served as surrogates.
Of 2176 children surveyed, 160 (7.4 %) reported a currently untreated surgical condition. Lifetime prevalence of surgical conditions was 14.0 % (305/2176). The predominant cause of surgical conditions was trauma (48.4 %), followed by wounds (19.7 %), acquired deformities (16.2 %), and burns (12.5 %). Of 90 pediatric household deaths, 31.1 % were associated with a surgically treatable proximate cause of death (28/90 deaths).
Although some trauma-related surgical burden among children can be adequately addressed at district hospitals, the need for diagnostics, human resources, and curative services for more severe trauma cases, congenital deformities, and masses outweighs the current capacity of hospitals and trained pediatric surgeons in Uganda.
关于低收入和中等收入国家小儿外科疾病的患病率，人们了解甚少。许多儿童从未寻求过医疗护理，因此乌干达儿童外科疾病的真实患病率尚不清楚。本研究的目的是确定乌干达儿童外科疾病的患病率。
我们采用海外外科医生手术需求评估（SOSAS）调查，在乌干达随机选取的105个群组中的2315户家庭中，对4248人进行了统计。如果是从家庭中随机选取的0至18岁儿童则纳入研究；对于那些无法自行回答的儿童，由家长作为代理人。
在接受调查的2176名儿童中，160名（7.4%）报告有目前未治疗的外科疾病。外科疾病的终生患病率为14.0%（305/2176）。外科疾病的主要原因是创伤（48.4%），其次是伤口（19.7%）、后天畸形（16.2%）和烧伤（12.5%）。在90例小儿家庭死亡病例中，31.1%与可通过手术治疗的直接死因相关（28/90例死亡）。
尽管地区医院能够充分应对一些儿童创伤相关的手术负担，但对于更严重的创伤病例、先天性畸形和肿块的诊断、人力资源及治疗服务的需求，超过了乌干达目前医院和训练有素的小儿外科医生的能力。
