ArticleBMJ global health2021
Paediatric surgical outcomes in sub-Saharan Africa: a multicentre, international, prospective cohort study.
Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Catalysing global surgery: a meta-research study on factors affecting surgical research collaborations with Africa.Systematic reviews · 2024Pooled it
- Practicing for life: landscape and priorities for simulation-based education in global children's surgery.Pediatric surgery international · 2026Article
- Perioperative mortality in pediatric non-cardiac surgery in Ethiopia: a systematic review and meta-analysis.Perioperative medicine (London, England) · 2026Article
- Development of paediatric surgical care in Sierra Leone: a repeated nationwide cross-sectional study from 2012 to 2023.BMJ public health · 2026Article
- Improved mortality in gastroschisis patients after implementation of a standardized management bundle in central Malawi: A single-center follow-up at four years.Journal of pediatric surgery · 2026Article
- Article
- Predictors of mortality and short-term outcomes after emergency pediatric abdominal surgery in South-Western Uganda.World journal of pediatric surgery · 2026Article
- SAFE SURGERY AND SAFE ANAESTHESIA IN AFRICA: A CROSS-SECTIONAL STUDY TO ASSESS THE KNOWLEDGE, ATTITUDE AND AVAILABILITY OF THE WHO SAFE SURGERY CHECKLIST TO THE MEMBERS OF THE SURGICAL TEAM.Annals of Ibadan postgraduate medicine · 2025Article
- Surgical outcome of pediatric intestinal obstruction in Amhara comprehensive specialized hospitals, September 2024.BMC surgery · 2025Article
- Prevalence and patterns of pediatric surgical pathologies in three referral hospitals in Cameroon.Frontiers in surgery · 2025Article
- Global survey on point-of-care ultrasound (pocus) use in child surgery.Pediatric surgery international · 2024Article
- Increasing access to pediatric surgical care: Assessing district hospital readiness in rural Rwanda.World journal of surgery · 2024Article
- 28-day perioperative pediatric mortality and its predictors in a tertiary teaching hospital in Ethiopia: a prospective cohort study.European journal of medical research · 2024Article
- Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa.PLOS global public health · 2024Article
- Developing a novel laparoscopic training model during the Covid-19 pandemic in a resource-limited setting.Surgery in practice and science · 2023Article
- Critical shortage of capacity to deliver safe paediatric surgery in sub-Saharan Africa: evidence from 67 hospitals in Malawi, Zambia, and Tanzania.Frontiers in pediatrics · 2023Article
- Prevalence and outcomes of pediatric surgical conditions at Connaught Hospital in Freetown: a retrospective study.World journal of pediatric surgery · 2023Article
- Long-Term Outcomes of Patients with Digestive Tract Congenital Anomalies and Their Caregivers in Uganda: A Cohort Study.Sage open pediatricsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
Abstract
introductionAs childhood mortality from infectious diseases falls across sub-Saharan Africa (SSA), the burden of disease attributed to surgical conditions is increasing. However, limited data exist on paediatric surgical outcomes in SSA. We compared the outcomes of five common paediatric surgical conditions in SSA with published benchmark data from high-income countries (HICs).
methodsA multicentre, international, prospective cohort study was undertaken in hospitals providing paediatric surgical care across SSA. Data were collected on consecutive children (birth to 16 years), presenting with gastroschisis, anorectal malformation, intussusception, appendicitis or inguinal hernia, over a minimum of 1 month, between October 2016 and April 2017. Participating hospitals completed a survey on their resources available for paediatric surgery.The primary outcome was all-cause in-hospital mortality. Mortality in SSA was compared with published benchmark mortality in HICs using χ
results1407 children from 51 hospitals in 19 countries across SSA were studied: 111 with gastroschisis, 188 anorectal malformation, 225 intussusception, 250 appendicitis and 633 inguinal hernia. Mortality was significantly higher in SSA compared with HICs for all conditions: gastroschisis (75.5% vs 2.0%), anorectal malformation (11.2% vs 2.9%), intussusception (9.4% vs 0.2%), appendicitis (0.4% vs 0.0%) and inguinal hernia (0.2% vs 0.0%), respectively. Mortality was 41.9% (112/267) among neonates, 5.0% (20/403) in infants and 1.0% (7/720) in children. Paediatric surgical condition, higher American Society of Anesthesiologists score at primary intervention, and needing/receiving a blood transfusion were significantly associated with mortality on multivariable analysis.
conclusionMortality from common paediatric surgical conditions is unacceptably high in SSA compared with HICs, particularly for neonates. Interventions to reduce mortality should focus on improving resuscitation and timely transfer at the district level, and preoperative resuscitation and perioperative care at paediatric surgical centres.
Indexed as
Identifiers
What OpenQuestion holds
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.