SynthesisWorld journal of surgery2012
Systematic review of met and unmet need of surgical disease in rural sub-Saharan Africa.
Synthesis in World journal of surgery, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 5 syntheses or guidelines pooled it, 124 citations in OpenAlex.
- Cost-effectiveness of surgical interventions in low-income and middle-income countries: a systematic review and critical analysis of recent evidence.BMJ global health · 2024Pooled it
- Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review.World journal of surgery · 2023Pooled it
- International guidelines for groin hernia management.Hernia : the journal of hernias and abdominal wall surgery · 2018Guideline
- Systematic Review of Postgraduate Surgical Education in Low- and Middle-Income Countries.World journal of surgery · 2016Pooled it
- Guidelines for surgeons on establishing projects in low-income countries.World journal of surgery · 2013Guideline
- Outcomes after elective inguinal hernia repair with mesh performed by associate clinicians versus medical doctors in Sierra Leone: 5-year follow-up of a randomized clinical trial.The British journal of surgery · 2025Trial
- Standardised Competency-Based Training of Medical Doctors and Associate Clinicians in Inguinal Repair with Mesh in Sierra Leone.World journal of surgery · 2023Trial
- An estimate of hernia prevalence in Sierra Leone from a nationwide community survey.Hernia : the journal of hernias and abdominal wall surgery · 2014Trial
- Prospective results of locally delivered low-cost mesh inguinal hernia repair in a low resource setting.Hernia : the journal of hernias and abdominal wall surgery · 2026Observational
- Mapping Plastic Reconstructive Surgical Needs and Access Barriers in Sub-Saharan Africa: A Scoping Review.World journal of surgery · 2026Article
- Challenges and enablers in accessing paediatric inguinal hernia surgical care in Sierra Leone: a qualitative exploratory study.BMJ open · 2026Article
- Understanding factors that impact patient access and engagement with biomedical and traditional care for hip fractures in The Gambia: An ethnographic study using a social ecological model.PLOS global public health · 2026Article
- Groin hernia.Nature reviews. Disease primers · 2025Review
- The impact of surgical task-sharing in Sierra Leone: a nationwide longitudinal observational study on surgical workforce and volume, 2012-2023.BMJ global health · 2025Observational
- Access to specialist plastic surgery in rural vs. Urban areas of Africa.BMC surgery · 2024Review
- Caesarean sections among east African refugees and their host population: a 20-year retrospective study in western Tanzania.African health sciences · 2024Article
- GAPS Phase III: incorporation of capacity based weighting in the global assessment for pediatric surgery.Pediatric surgery international · 2024Article
- Long-Term Outcomes Following Inguinal Hernia Repair With Mesh Performed by Medical Doctors and Surgeons in Ghana.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Prevalence, incidence, repair rate, and morbidity of groin hernias in Sierra Leone: cross-sectional household study.BJS open · 2023Article
- Needs assessment study of postgraduate surgical education in Sudan: Trainees perspective.PloS one · 2023Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLittle is known about the burden of surgical disease in rural sub-Saharan Africa, where district and rural hospitals are the main providers of care. The present study sought to analyze what is known about the met and unmet need of surgical disease.
methodsThe PubMed and EMBASE databases were searched for studies of surveys in rural areas, information on surgical admissions, and operations performed within rural and district hospitals. Data were extrapolated to calculate the amount of surgical disease per 100,000 population and the number of operations performed per 100,000 population. These extrapolations were used to estimate the total, the met, and the unmet need of surgical disease.
resultsThe estimated overall incidence of nonfatal injury is at least 1,690/100,000 population per year. Morbidity as a result of injury is up to 190/100,000 population per year, and the annual mortality from injury is 53-92/100,000. District hospitals perform 6 fracture reductions (95% CI: 0.1-12)/100,000 population per year and 14 laparotomies (95% CI: 7-21)/100,000 per year. The incidence of peritonitis and bowel obstruction is unknown, although it may be as high as 1,364/100,000 population for the acute abdomen. The annual total need for inguinal hernia repair is estimated to be a minimum of 205/100,000 population. The average district hospital performs 30 hernia repairs (95% CI: 18-41)/100,000 population per year, leaving an unmet need of 175/100,000 population annually.
conclusionsDistrict hospitals are not meeting the surgical needs of the populations they serve. Urgent intervention is required to build up their capacity, to train healthcare personnel in safe surgery and anesthesia, and to overcome obstacles to timely emergency care.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.