Child deaths from surgical conditions such as birth defects are too high in sub-Saharan Africa compared to high-income countries due to lack of attention to surgical diseases in children in the region, study finds .
Researchers looked at some of the most common surgical conditions in children, including hernias, appendicitis, and intestinal abnormalities, such as blockages. These can be present from birth or acquired at a later stage.
These conditions lead to preventable deaths if not properly managed. Most children with intestinal obstruction will die of hunger and thirst if left untreated. However, timely surgeries can help relieve these blockages and lead to a fully productive life. “
William Appeadu-Mensah, study co-author and senior lecturer, Department of Surgery, University of Ghana
Globally, 1.7 billion children do not have access to safe and affordable surgical care when they need it, according to Appeadu-Mensah. âSub-Saharan Africa, where up to 50 percent of the population are children, accounts for nearly a third of the global burden of surgical disease and half of the deaths of children under five globally,â he adds. -he.
The study published in the BMJ Global Health newspaper This month was undertaken in 51 hospitals providing pediatric surgical care in 19 countries in sub-Saharan Africa, covering the period from October 2016 to April 2017.
Researchers have identified pediatric surgical conditions such as gastroschisis – where the stomach wall separates – and anorectal malformation, a congenital malformation of the anus that negatively impacts normal bowel movement. The researchers also compared the deaths of children up to 16 years of age with those of children the same age in high-income countries.
According to the study, deaths from gastroschisis and anorectal malformation were 75.5% and 11.2% in sub-Saharan Africa, compared with 2% and 3% respectively in high-income countries.
Appeadu-Mensah tells SciDev.Net that it is necessary to increase investments and actions to improve surgical care in sub-Saharan Africa if the region is to end preventable deaths in newborns and children under five by 2030, as the target the sustainable development goals.
Appeadu-Mensah says policymakers should do more to provide resources to help diagnose and manage children when they are born with surgical conditions.
Stephen Tabiri, co-author and dean of the Faculty of Medicine at the University of Development Studies in Ghana, says birth defects are now the fifth leading cause of death in children under five globally, the Most deaths occurring during the neonatal period.
Birth defects involving the intestinal tract have particularly high death rates in low- and middle-income countries, as many require emergency surgical care after birth, Tabiri adds.
âIn high-income countries, most women have an antenatal ultrasound to assess birth defects,â says Tabiri. “If identified, it allows the woman to deliver in a hospital with surgical child care so the baby can receive help from birth.”
Seyram Wordui, pediatrician at Korle Bu University Hospital in Ghana, calls for skills transfer from high-income countries to sub-Saharan Africa.
“There must also be partnerships between different medical specialties to detect fetal abnormalities,” he explains, adding that this would lead to improved and early diagnoses of pediatric surgical conditions.
PaedSurg Africa Research Collaboration (2021) Results of pediatric surgery in sub-Saharan Africa: an international multicenter prospective cohort study. BMJ Global Health. doi.org/10.1136/bmjgh-2020-004406.