Evidence map›Paper›PMID 39700891›Full record

ArticleThe Journal of surgical research2025

Delays in Care for Children With Low Anorectal Malformations in Southwestern Uganda.

Felix Oyania, Caroline Q Stephens, Sarah Ullrich, Meera Kotagal, Daniel Kisitu, Francis Bajunirwe, Doruk E Ozgediz, Dan Poenaru

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of surgical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Felix OyaniaDivision of Pediatric Surgery, Department of Surgery, Mbarara University of Science and Technology, Mbarara, Uganda; Center for Health Equity in Surgery and Anesthesia, University of California, San Francisco, California. Electronic address: oyafel@icloud.com.
Caroline Q StephensCenter for Health Equity in Surgery and Anesthesia, University of California, San Francisco, California.
Sarah UllrichDepartment of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Meera KotagalDepartment of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Daniel KisituDivision of Pediatric Surgery, Department of Surgery, Mbarara University of Science and Technology, Mbarara, Uganda.
Francis BajunirweDivision of Pediatric Surgery, Department of Surgery, Mbarara University of Science and Technology, Mbarara, Uganda.
Doruk E OzgedizCenter for Health Equity in Surgery and Anesthesia, University of California, San Francisco, California.
Dan PoenaruPediatric Surgery, McGill University, Montreal, Quebec, Canada.

Funding

University of California Launching Future Leaders in Global Health Research Training ProgramD43TW009343 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CRAIG R COHEN, Sung-Jae Lee · 2017 to 2026
$14.7M
FIC NIH HHS D43 TW009343
6 · The paper itself

Abstract

introductionDisparities in anorectal malformation (ARM) outcomes between high- and low-income countries may be due to delayed diagnosis in the latter setting. The Three Delays model, comprising delays in seeking, accessing, and receiving care, provides a framework for exploring these challenges. We sought to examine the frequency and nature of the preoperative delays in children presenting for surgical correction of low ARMs.

methodsWe conducted a cross-sectional study examining the delays in care among children with low ARMs in Southwestern Uganda between June 2021 and July 2023. Delayed diagnosis was defined as a diagnosis made >48 h of life. Potential associated factors such as caregiver, community, and aspect of health-care system factors were examined. Statistical significance was set at P < 0.05.

resultsA total of 80 patients were included in the study. The median age at diagnosis was 29.2 d. In 82% of patients, the parents diagnosed the abnormality and 74% experienced delayed diagnosis. Among delays in seeking care, 23% of caregivers reported no knowledge of their child's disease. For delays in reaching care, 37% encountered financial problems, and 28% lacked an appropriate diagnosis from a health center, contributing to delays in receiving care.

conclusionsDelays in care are frequent for children with low ARMs. Finances and caregivers' and health-care workers' knowledge contribute significantly to these delays. To mitigate these delays, we recommend improving referral processes, prioritizing newborn screening examinations, advocating for a national child health insurance policy, and enhancing the training of primary health-care providers.

Indexed as

Anorectal MalformationsDelayed DiagnosisHealthcare DisparitiesHealth Services AccessibilityTime-to-TreatmentChildChild, PreschoolCross-Sectional StudiesFemaleHumansInfantInfant, NewbornMalePatient Acceptance of Health CareUgandaAnorectal malformationsDelayed diagnosisHealth services accessibilityLow-income countryTreatment delay

Identifiers

PMID39700891
PMCPMC11779581

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Registered trials

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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.