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2015 ; 12
(1
): 1-6
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gab.com Text
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Epidemiology, management and outcome of gastroschisis in Sub-Saharan Africa:
Results of an international survey
#MMPMID25659541
Wright NJ
; Zani A
; Ade-Ajayi N
Afr J Paediatr Surg
2015[Jan]; 12
(1
): 1-6
PMID25659541
show ga
BACKGROUND: The aim was to compare gastroschisis (GS) epidemiology, management
and outcome in low-income countries (LIC) in Sub-Saharan Africa (SSA) with
middle- (MIC) and high-income countries (HIC). MATERIALS AND METHODS: A
10-question survey was administered at the 2012 Pan-African Paediatric Surgery
Association Congress. RESULTS are presented as median (range); differences were
analysed using contingency tests. RESULTS: A total of 82 delegates (28 countries
[66 institutions]) were divided into LIC (n = 11), MIC (n = 6) and HIC (n = 11).
In LIC, there were fewer surgeons and more patients. LIC reported 22 cases
(1-184) GS/institution/year, compared to 12 cases (3-23)/institution/year in MICs
and 15 cases (1-100)/institution/year in HICs. Antenatal screening was less
readily available in LIC. Access to parenteral nutrition and neonatal intensive
care in LIC was 36% and 19%, compared to 100% in HIC. Primary closure rates were
similar in LIC and HIC at 58% and 54%, respectively; however, the majority of
staged closure utilised custom silos in LIC and preformed silos in HIC. In LIC,
mortality was reported as >75% by 61% delegates and 50-75% by 33%, compared to
<25% by 100% of HIC delegates (P < 0.0001). CONCLUSIONS: Gastroschisis is a
problem encountered by surgeons in SSA. Mortality is high and resources in many
centres inadequate. We propose the implementation of a combined epidemiological
research, service delivery training and resource provision programme to help
improve our understanding of GS in SSA whilst attempting to improve outcome.
|*Disease Management
[MESH]
|*Surveys and Questionnaires
[MESH]
|Africa South of the Sahara/epidemiology
[MESH]
|Digestive System Surgical Procedures/*methods
[MESH]