Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: a cross-sectional survey
Abstract Background In low-income and middle-income countries, surgical epidemiology is largely undefined at the population level, with operative logs and hospital records serving as a proxy. This study assesses the distribution of surgical conditions that contribute the largest burden of surgical d...
Gespeichert in:
| Veröffentlicht in: | The Lancet (British edition) 2015-04, Vol.385, p.S9-S9 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | S9 |
|---|---|
| container_issue | |
| container_start_page | S9 |
| container_title | The Lancet (British edition) |
| container_volume | 385 |
| creator | Linden, Allison F, Dr Maine, Rebecca, MD Hedt-Gauthier, Bethany L, PhD Kamanzi, Emmanual Mody, Gita, MD Ntakiyiruta, Georges, MD Kansayisa, Grace, MS Ntaganda, Edmond, MD Niyonkuru, Francine, MD Mubiligi, Joel, MD Mpunga, Tharcisse, MD Meara, John G, MD Riviello, Robert, MD |
| description | Abstract Background In low-income and middle-income countries, surgical epidemiology is largely undefined at the population level, with operative logs and hospital records serving as a proxy. This study assesses the distribution of surgical conditions that contribute the largest burden of surgical disease in Burera District, in northern Rwanda. We hypothesise that our results would yield higher rates of surgical disease than current estimates (from 2006) for similar low-income countries, which are 295 per 100 000 people. Methods In March and May, 2012, we performed a cross-sectional study in Burera District, randomly sampling 30 villages with probability proportionate to size and randomly sampling 23 households within the selected villages. Six Rwandan surgical postgraduates and physicians conducted physical examinations on all eligible participants in sampled households. Participants were assessed for injuries or wounds, hernias, hydroceles, breast mass, neck mass, obstetric fistula, undescended testes, hypospadias, hydrocephalus, cleft lip or palate, and club foot. Ethical approval was obtained from Boston Children's Hospital (Boston, MA, USA) and the Rwandan National Ethics Committee (Kigali, Rwanda). Informed consent was obtained from all participants. Findings Of the 2165 examined individuals, the overall prevalence of any surgical condition was 12% (95% CI 9·2–14·9) or 12 009 per 100 000 people. Injuries or wounds accounted for 55% of the prevalence and hernias or hydroceles accounted for 40%, followed by neck mass (4·2%), undescended testes (1·9%), breast mass (1·2%), club foot (1%), hypospadias (0·6%), hydrocephalus (0·6%), cleft lip or palate (0%), and obstetric fistula (0%). When comparing study participant characteristics, no statistical difference in overall prevalence was noted when examining sex, wealth, education, and travel time to the nearest hospital. Total rates of surgically treatable disease yielded a statistically significant difference compared with current estimates (p |
| doi_str_mv | 10.1016/S0140-6736(15)60804-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1708899772</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0140673615608042</els_id><sourcerecordid>3666571441</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2931-633caa6ecf5a35f0d4a7ecfb73a992e143551eb94ed693d4e388f5cd43dd350a3</originalsourceid><addsrcrecordid>eNqFkV1rFDEUhkNR2m3tT1AC3rTg1GTyNdOLitZqhYKgFbwL2eRMSZ1JtslMZf-9md1aoTdehcBznuS8L0IvKTmhhMq33wnlpJKKySMqjiVpCK_qHbSgXPFKcPXzGVo8IntoP-dbQgiXROyivVoyyiilCzRcrLyDwcc-3qxx7PAUxgRmBIdDDFVc5hHG5C3OU7rx1vTY-QwmA_YBf5gSJIM_-jwj4xv87bcJzpxig22KOVcZ7OhjKFNl_B7WL9DzzvQZDh_OA_Tj08X1-WV19fXzl_P3V5WtW0YryZg1RoLthGGiI44bVS5LxUzb1kA5E4LCsuXgZMscB9Y0nbCOM-eYIIYdoKOtd5Xi3QR51IPPFvreBIhT1lSRpmlbpeqCvn6C3sYplS8XSirRCsGlLJTYUpu9EnR6lfxg0lpTouc-9KYPPYetqdCbPvRsf_Vgn5YDuMepvwUU4N0WgBLHvYeks_UQLDifSnjaRf_fJ86eGGzvw1zVL1hD_reNzrUmW8nsoGJjqNkfmzKvxw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1675955466</pqid></control><display><type>article</type><title>Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: a cross-sectional survey</title><source>Elsevier ScienceDirect Journals</source><creator>Linden, Allison F, Dr ; Maine, Rebecca, MD ; Hedt-Gauthier, Bethany L, PhD ; Kamanzi, Emmanual ; Mody, Gita, MD ; Ntakiyiruta, Georges, MD ; Kansayisa, Grace, MS ; Ntaganda, Edmond, MD ; Niyonkuru, Francine, MD ; Mubiligi, Joel, MD ; Mpunga, Tharcisse, MD ; Meara, John G, MD ; Riviello, Robert, MD</creator><creatorcontrib>Linden, Allison F, Dr ; Maine, Rebecca, MD ; Hedt-Gauthier, Bethany L, PhD ; Kamanzi, Emmanual ; Mody, Gita, MD ; Ntakiyiruta, Georges, MD ; Kansayisa, Grace, MS ; Ntaganda, Edmond, MD ; Niyonkuru, Francine, MD ; Mubiligi, Joel, MD ; Mpunga, Tharcisse, MD ; Meara, John G, MD ; Riviello, Robert, MD</creatorcontrib><description>Abstract Background In low-income and middle-income countries, surgical epidemiology is largely undefined at the population level, with operative logs and hospital records serving as a proxy. This study assesses the distribution of surgical conditions that contribute the largest burden of surgical disease in Burera District, in northern Rwanda. We hypothesise that our results would yield higher rates of surgical disease than current estimates (from 2006) for similar low-income countries, which are 295 per 100 000 people. Methods In March and May, 2012, we performed a cross-sectional study in Burera District, randomly sampling 30 villages with probability proportionate to size and randomly sampling 23 households within the selected villages. Six Rwandan surgical postgraduates and physicians conducted physical examinations on all eligible participants in sampled households. Participants were assessed for injuries or wounds, hernias, hydroceles, breast mass, neck mass, obstetric fistula, undescended testes, hypospadias, hydrocephalus, cleft lip or palate, and club foot. Ethical approval was obtained from Boston Children's Hospital (Boston, MA, USA) and the Rwandan National Ethics Committee (Kigali, Rwanda). Informed consent was obtained from all participants. Findings Of the 2165 examined individuals, the overall prevalence of any surgical condition was 12% (95% CI 9·2–14·9) or 12 009 per 100 000 people. Injuries or wounds accounted for 55% of the prevalence and hernias or hydroceles accounted for 40%, followed by neck mass (4·2%), undescended testes (1·9%), breast mass (1·2%), club foot (1%), hypospadias (0·6%), hydrocephalus (0·6%), cleft lip or palate (0%), and obstetric fistula (0%). When comparing study participant characteristics, no statistical difference in overall prevalence was noted when examining sex, wealth, education, and travel time to the nearest hospital. Total rates of surgically treatable disease yielded a statistically significant difference compared with current estimates (p<0·001). Interpretation Rates of surgically treatable disease are significantly higher than previous estimates in comparable low-income countries. The prevalence of surgically treatable disease is evenly distributed across demographic parameters. From these results, we conclude that strengthening the Rwandan health system's surgical capacity, particularly in rural areas, could have meaningful affect on the entire population. Further community-based surgical epidemiological studies are needed in low-income and middle-income countries to provide the best data available for health system planning. Funding The Harvard Sheldon Traveling Fellowship.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(15)60804-2</identifier><identifier>PMID: 26313111</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Epidemiology ; Households ; Injuries ; Internal Medicine ; Low income areas ; Rural areas</subject><ispartof>The Lancet (British edition), 2015-04, Vol.385, p.S9-S9</ispartof><rights>Elsevier Ltd</rights><rights>2015 Elsevier Ltd</rights><rights>Copyright © 2015 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Apr 27, 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2931-633caa6ecf5a35f0d4a7ecfb73a992e143551eb94ed693d4e388f5cd43dd350a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673615608042$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26313111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Linden, Allison F, Dr</creatorcontrib><creatorcontrib>Maine, Rebecca, MD</creatorcontrib><creatorcontrib>Hedt-Gauthier, Bethany L, PhD</creatorcontrib><creatorcontrib>Kamanzi, Emmanual</creatorcontrib><creatorcontrib>Mody, Gita, MD</creatorcontrib><creatorcontrib>Ntakiyiruta, Georges, MD</creatorcontrib><creatorcontrib>Kansayisa, Grace, MS</creatorcontrib><creatorcontrib>Ntaganda, Edmond, MD</creatorcontrib><creatorcontrib>Niyonkuru, Francine, MD</creatorcontrib><creatorcontrib>Mubiligi, Joel, MD</creatorcontrib><creatorcontrib>Mpunga, Tharcisse, MD</creatorcontrib><creatorcontrib>Meara, John G, MD</creatorcontrib><creatorcontrib>Riviello, Robert, MD</creatorcontrib><title>Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: a cross-sectional survey</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Abstract Background In low-income and middle-income countries, surgical epidemiology is largely undefined at the population level, with operative logs and hospital records serving as a proxy. This study assesses the distribution of surgical conditions that contribute the largest burden of surgical disease in Burera District, in northern Rwanda. We hypothesise that our results would yield higher rates of surgical disease than current estimates (from 2006) for similar low-income countries, which are 295 per 100 000 people. Methods In March and May, 2012, we performed a cross-sectional study in Burera District, randomly sampling 30 villages with probability proportionate to size and randomly sampling 23 households within the selected villages. Six Rwandan surgical postgraduates and physicians conducted physical examinations on all eligible participants in sampled households. Participants were assessed for injuries or wounds, hernias, hydroceles, breast mass, neck mass, obstetric fistula, undescended testes, hypospadias, hydrocephalus, cleft lip or palate, and club foot. Ethical approval was obtained from Boston Children's Hospital (Boston, MA, USA) and the Rwandan National Ethics Committee (Kigali, Rwanda). Informed consent was obtained from all participants. Findings Of the 2165 examined individuals, the overall prevalence of any surgical condition was 12% (95% CI 9·2–14·9) or 12 009 per 100 000 people. Injuries or wounds accounted for 55% of the prevalence and hernias or hydroceles accounted for 40%, followed by neck mass (4·2%), undescended testes (1·9%), breast mass (1·2%), club foot (1%), hypospadias (0·6%), hydrocephalus (0·6%), cleft lip or palate (0%), and obstetric fistula (0%). When comparing study participant characteristics, no statistical difference in overall prevalence was noted when examining sex, wealth, education, and travel time to the nearest hospital. Total rates of surgically treatable disease yielded a statistically significant difference compared with current estimates (p<0·001). Interpretation Rates of surgically treatable disease are significantly higher than previous estimates in comparable low-income countries. The prevalence of surgically treatable disease is evenly distributed across demographic parameters. From these results, we conclude that strengthening the Rwandan health system's surgical capacity, particularly in rural areas, could have meaningful affect on the entire population. Further community-based surgical epidemiological studies are needed in low-income and middle-income countries to provide the best data available for health system planning. Funding The Harvard Sheldon Traveling Fellowship.</description><subject>Epidemiology</subject><subject>Households</subject><subject>Injuries</subject><subject>Internal Medicine</subject><subject>Low income areas</subject><subject>Rural areas</subject><issn>0140-6736</issn><issn>1474-547X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkV1rFDEUhkNR2m3tT1AC3rTg1GTyNdOLitZqhYKgFbwL2eRMSZ1JtslMZf-9md1aoTdehcBznuS8L0IvKTmhhMq33wnlpJKKySMqjiVpCK_qHbSgXPFKcPXzGVo8IntoP-dbQgiXROyivVoyyiilCzRcrLyDwcc-3qxx7PAUxgRmBIdDDFVc5hHG5C3OU7rx1vTY-QwmA_YBf5gSJIM_-jwj4xv87bcJzpxig22KOVcZ7OhjKFNl_B7WL9DzzvQZDh_OA_Tj08X1-WV19fXzl_P3V5WtW0YryZg1RoLthGGiI44bVS5LxUzb1kA5E4LCsuXgZMscB9Y0nbCOM-eYIIYdoKOtd5Xi3QR51IPPFvreBIhT1lSRpmlbpeqCvn6C3sYplS8XSirRCsGlLJTYUpu9EnR6lfxg0lpTouc-9KYPPYetqdCbPvRsf_Vgn5YDuMepvwUU4N0WgBLHvYeks_UQLDifSnjaRf_fJ86eGGzvw1zVL1hD_reNzrUmW8nsoGJjqNkfmzKvxw</recordid><startdate>20150427</startdate><enddate>20150427</enddate><creator>Linden, Allison F, Dr</creator><creator>Maine, Rebecca, MD</creator><creator>Hedt-Gauthier, Bethany L, PhD</creator><creator>Kamanzi, Emmanual</creator><creator>Mody, Gita, MD</creator><creator>Ntakiyiruta, Georges, MD</creator><creator>Kansayisa, Grace, MS</creator><creator>Ntaganda, Edmond, MD</creator><creator>Niyonkuru, Francine, MD</creator><creator>Mubiligi, Joel, MD</creator><creator>Mpunga, Tharcisse, MD</creator><creator>Meara, John G, MD</creator><creator>Riviello, Robert, MD</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TT</scope><scope>0TZ</scope><scope>0U~</scope><scope>3V.</scope><scope>7QL</scope><scope>7QP</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8C2</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>KB~</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQGLB</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20150427</creationdate><title>Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: a cross-sectional survey</title><author>Linden, Allison F, Dr ; Maine, Rebecca, MD ; Hedt-Gauthier, Bethany L, PhD ; Kamanzi, Emmanual ; Mody, Gita, MD ; Ntakiyiruta, Georges, MD ; Kansayisa, Grace, MS ; Ntaganda, Edmond, MD ; Niyonkuru, Francine, MD ; Mubiligi, Joel, MD ; Mpunga, Tharcisse, MD ; Meara, John G, MD ; Riviello, Robert, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2931-633caa6ecf5a35f0d4a7ecfb73a992e143551eb94ed693d4e388f5cd43dd350a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Epidemiology</topic><topic>Households</topic><topic>Injuries</topic><topic>Internal Medicine</topic><topic>Low income areas</topic><topic>Rural areas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Linden, Allison F, Dr</creatorcontrib><creatorcontrib>Maine, Rebecca, MD</creatorcontrib><creatorcontrib>Hedt-Gauthier, Bethany L, PhD</creatorcontrib><creatorcontrib>Kamanzi, Emmanual</creatorcontrib><creatorcontrib>Mody, Gita, MD</creatorcontrib><creatorcontrib>Ntakiyiruta, Georges, MD</creatorcontrib><creatorcontrib>Kansayisa, Grace, MS</creatorcontrib><creatorcontrib>Ntaganda, Edmond, MD</creatorcontrib><creatorcontrib>Niyonkuru, Francine, MD</creatorcontrib><creatorcontrib>Mubiligi, Joel, MD</creatorcontrib><creatorcontrib>Mpunga, Tharcisse, MD</creatorcontrib><creatorcontrib>Meara, John G, MD</creatorcontrib><creatorcontrib>Riviello, Robert, MD</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>News PRO</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Global News & ABI/Inform Professional</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Lancet Titles</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Newsstand Professional</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Applied & Life Sciences</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Linden, Allison F, Dr</au><au>Maine, Rebecca, MD</au><au>Hedt-Gauthier, Bethany L, PhD</au><au>Kamanzi, Emmanual</au><au>Mody, Gita, MD</au><au>Ntakiyiruta, Georges, MD</au><au>Kansayisa, Grace, MS</au><au>Ntaganda, Edmond, MD</au><au>Niyonkuru, Francine, MD</au><au>Mubiligi, Joel, MD</au><au>Mpunga, Tharcisse, MD</au><au>Meara, John G, MD</au><au>Riviello, Robert, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: a cross-sectional survey</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>2015-04-27</date><risdate>2015</risdate><volume>385</volume><spage>S9</spage><epage>S9</epage><pages>S9-S9</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Abstract Background In low-income and middle-income countries, surgical epidemiology is largely undefined at the population level, with operative logs and hospital records serving as a proxy. This study assesses the distribution of surgical conditions that contribute the largest burden of surgical disease in Burera District, in northern Rwanda. We hypothesise that our results would yield higher rates of surgical disease than current estimates (from 2006) for similar low-income countries, which are 295 per 100 000 people. Methods In March and May, 2012, we performed a cross-sectional study in Burera District, randomly sampling 30 villages with probability proportionate to size and randomly sampling 23 households within the selected villages. Six Rwandan surgical postgraduates and physicians conducted physical examinations on all eligible participants in sampled households. Participants were assessed for injuries or wounds, hernias, hydroceles, breast mass, neck mass, obstetric fistula, undescended testes, hypospadias, hydrocephalus, cleft lip or palate, and club foot. Ethical approval was obtained from Boston Children's Hospital (Boston, MA, USA) and the Rwandan National Ethics Committee (Kigali, Rwanda). Informed consent was obtained from all participants. Findings Of the 2165 examined individuals, the overall prevalence of any surgical condition was 12% (95% CI 9·2–14·9) or 12 009 per 100 000 people. Injuries or wounds accounted for 55% of the prevalence and hernias or hydroceles accounted for 40%, followed by neck mass (4·2%), undescended testes (1·9%), breast mass (1·2%), club foot (1%), hypospadias (0·6%), hydrocephalus (0·6%), cleft lip or palate (0%), and obstetric fistula (0%). When comparing study participant characteristics, no statistical difference in overall prevalence was noted when examining sex, wealth, education, and travel time to the nearest hospital. Total rates of surgically treatable disease yielded a statistically significant difference compared with current estimates (p<0·001). Interpretation Rates of surgically treatable disease are significantly higher than previous estimates in comparable low-income countries. The prevalence of surgically treatable disease is evenly distributed across demographic parameters. From these results, we conclude that strengthening the Rwandan health system's surgical capacity, particularly in rural areas, could have meaningful affect on the entire population. Further community-based surgical epidemiological studies are needed in low-income and middle-income countries to provide the best data available for health system planning. Funding The Harvard Sheldon Traveling Fellowship.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26313111</pmid><doi>10.1016/S0140-6736(15)60804-2</doi></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 2015-04, Vol.385, p.S9-S9 |
| issn | 0140-6736 1474-547X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1708899772 |
| source | Elsevier ScienceDirect Journals |
| subjects | Epidemiology Households Injuries Internal Medicine Low income areas Rural areas |
| title | Epidemiology of untreated non-obstetric surgical disease in Burera District, Rwanda: a cross-sectional survey |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T20%3A07%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Epidemiology%20of%20untreated%20non-obstetric%20surgical%20disease%20in%20Burera%20District,%20Rwanda:%20a%20cross-sectional%20survey&rft.jtitle=The%20Lancet%20(British%20edition)&rft.au=Linden,%20Allison%20F,%20Dr&rft.date=2015-04-27&rft.volume=385&rft.spage=S9&rft.epage=S9&rft.pages=S9-S9&rft.issn=0140-6736&rft.eissn=1474-547X&rft.coden=LANCAO&rft_id=info:doi/10.1016/S0140-6736(15)60804-2&rft_dat=%3Cproquest_cross%3E3666571441%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1675955466&rft_id=info:pmid/26313111&rft_els_id=1_s2_0_S0140673615608042&rfr_iscdi=true |