Duke Global Health Institute, Duke University, Durham, North Carolina.
Edna Adan University Hospital, Hargeisa, Somaliland.
JAMA Netw Open. 2019 Jan 4;2(1):e186857. doi: 10.1001/jamanetworkopen.2018.6857.
Although surgical conditions are increasingly recognized as causing a significant health care burden among adults in low- and middle-income countries (LMICs), the burden of surgical conditions among children in LMICs remains poorly defined.
To estimate the prevalence of pediatric surgical conditions across Somaliland using a nationwide community-based household survey.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study was conducted through a national community-based sampling survey from August through December 2017 in Somaliland. Participants were 1503 children surveyed using the Surgeons OverSeas Assessment of Surgical Need (SOSAS).
The SOSAS survey contains 2 components, including a section on household demographics, deaths, and financial information and sections querying children's history of surgical conditions.
In this cross-sectional study that included 1503 children (55.6% male; mean [SE] age, 6.4 [0.1] years), 221 surgical conditions were identified among 196 children, yielding a mean (SE) prevalence of pediatric surgical conditions of 12.2% (1.5%). Only 53 of these 221 surgical conditions (23.7%) had been surgically corrected at the time of the survey. The most common conditions encountered were congenital anomalies (33.8%) and wound-related injuries (24.6%). Nationally, an estimated 256 745 children have surgical conditions, with an estimated 88 345 to 199 639 children having unmet surgical needs.
Using national sampling, this study found that children have a high burden of surgical conditions in Somaliland. These data highlight the need for a scale-up of pediatric surgical infrastructure and resources to provide the needed surgical care for children in LMICs.
尽管手术条件越来越被认为是造成中低收入国家（LMICs）成年人健康负担的一个重要因素，但 LMICs 中儿童的手术条件负担仍未得到充分定义。
使用全国范围的社区家庭调查来估计索马里兰儿童的外科疾病患病率。
设计、设置和参与者：这项横断面研究是在 2017 年 8 月至 12 月期间通过全国社区基础抽样调查在索马里兰进行的。参与者是使用外科医生海外手术需求评估（SOSAS）调查的 1503 名儿童。
SOSAS 调查包含两个部分，一部分是家庭人口统计学、死亡和财务信息，另一部分是询问儿童手术条件的历史。
在这项包括 1503 名儿童（55.6%为男性；平均[SE]年龄 6.4[0.1]岁）的横断面研究中，在 196 名儿童中发现了 221 种手术条件，得出儿科手术条件的平均（SE）患病率为 12.2%（1.5%）。在调查时，这些 221 种手术条件中只有 53 种（23.7%）得到了手术矫正。最常见的情况是先天性异常（33.8%）和伤口相关损伤（24.6%）。在全国范围内，估计有 256745 名儿童患有外科疾病，估计有 88345 至 199639 名儿童有未满足的外科需求。
使用全国抽样，本研究发现索马里兰儿童的手术条件负担很高。这些数据强调需要扩大儿科外科基础设施和资源，为 LMICs 的儿童提供所需的外科护理。
