Evidence map›Paper›PMID 40913246›Full record

ArticleWorld journal of surgery2025

Current Landscape of Children's Surgery in Africa: A Multicenter Analysis of 16,000 Cases.

Phillip J Hsu, Madeleine Carroll, Alan Zambeli-Ljepovic, Bolusefe Tijesuni Olatunji-Banire, Pawan Mathew, Jason Axt, Thierno Diallo, Mekonen Eshete, Bertille Ki, Joseph Macharia and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgery, 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

15 authors.

Phillip J HsuDepartment of Surgery, University of Michigan, Ann Arbor, Michigan, USA.ORCID https://orcid.org/0000-0002-3405-8046
Madeleine CarrollDepartment of Surgery, Yale University, New Haven, Connecticut, USA.
Alan Zambeli-LjepovicDepartment of Surgery, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0003-4255-2527
Bolusefe Tijesuni Olatunji-BanireKids Operating Room, Edinburgh, Scotland.
Pawan MathewDepartment of Surgery, Yale University, New Haven, Connecticut, USA.
Jason AxtDepartment of Surgery, Kijabe Hospital, Kijabe, Kenya.
Thierno DialloDepartment of Surgery, Hôpital Général Idrissa Pouye, Dakar, Senegal.
Mekonen EsheteSurgical Department, School of Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
Bertille KiCHU Pediatrique Charles de Gaulle, Ouagadougou, Burkina Faso.
Joseph MachariaDepartment of Surgery, Meru Teaching and Referral Hospital, Meru, Kenya.
George NgockDepartment of Surgery, Mbingo Hospital, Baingo, Cameroon.
Absalat SerawitYekatit 12 Hospital Medical College Plastic and Reconstructive Surgery Department, Addis Ababa, Ethiopia.
Emma BryceKids Operating Room, Edinburgh, Scotland.
Doruk OzgedizDepartment of Surgery, University of California San Francisco, San Francisco, California, USA.
Maija CheungKids Operating Room, Edinburgh, Scotland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough prior studies have estimated the burden of pediatric surgical disease in low- and middle-income countries (LMICs) through statistical modeling and hospital- or household-based surveys, few large-scale descriptions of procedures and outcomes have been published. We aimed to describe the epidemiology and outcomes of children's surgical care at multiple centers across Africa.

methodsPerioperative clinical data were collected prospectively from 2018 to 2023 at 17 hospitals in 11 African countries using a preexisting tool. Data came from children (age < 18 years) who underwent a surgical procedure in facilities equipped by the NGO Kids Operating Room. Data were stored on REDCap and descriptively analyzed.

results16,454 procedures were performed, with a higher frequency of procedures performed in younger children than in older children (mean age 4.5 years). Congenital malformations, acquired genitourinary conditions, and acquired gastrointestinal conditions made up the most common diagnoses. We found a mortality rate of 3.7%, with higher mortality in neonates compared to younger children; conditions associated with the greatest mortality included congenital conditions, intestinal perforation, burns, and intussusception. Emergent operations were associated with much higher rates of mortality than elective operations.

conclusionsFor the first time at this scale, we have assessed the epidemiology and outcomes of pediatric surgical care in LMICs. Findings were consistent with studies on the burden of disease, with a larger proportion of younger children accessing surgery, comparable mortality to other African studies, and higher mortality than in HICs. Future research and multilevel advocacy are needed to identify gaps in care and to design more effective interventions to reduce global disparities in access to surgical care for children.

Indexed as

Surgical Procedures, OperativeAdolescentAfricaChildChild, PreschoolFemaleHumansInfantInfant, NewbornMaleProspective StudiesepidemiologyLMICoutcomespediatric surgery

Identifiers

PMID40913246
PMCPMC12582145

What OpenQuestion holds

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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.