Epidemiology of Pediatric Surgical Conditions Observed in a First-Level Hospital in Burundi.

Marianna Gortan,Costanza Tognon,Protais Harakaneza,Mimico Mulemangabo,Paola Caravaggi,Mwajuma Nshimirimana,Gordien Nzeyimana,Piergiorgio Gamba,Daniela Dalla Gasperina,Jean Marie Vianney Butoyi,Gian Battista Parigi,Giulia Brooks,Joel Nkurunziza,Sylvestre Bambara

doi:10.3389/fped.2021.681478

Marianna Gortan, Costanza Tognon + Show 12 more

Open Access

https://doi.org/10.3389/fped.2021.681478

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Abstract

Background: Little is known about the surgical conditions affecting the pediatric population in low-income countries. In this article we describe the epidemiology of pediatric surgical diseases observed in Mutoyi hospital, a first-level hospital in Burundi.Methods and Findings: We retrospectively reviewed the records of all children (0–14 years) admitted to the Surgery ward from January 2017 to December 2017. We also reviewed the records of all the patients admitted to the Neonatology ward in 2017 and among them we selected the ones in which a surgical diagnosis was present. Five hundred twenty-eight children were admitted to the surgical ward during the study period. The most common conditions requiring hospitalization were abscesses (29.09%), fractures (13.59%), osteomyelitis (9.76%), burns (5.40%) and head injuries (4.36%). The average length of stay was 16 days. Fifty-six newborns were admitted to the Neonatology ward for a surgical condition; 29% of them had an abscess.Conclusions: Conditions requiring surgical care are frequent in Burundian children and have a completely different spectrum from the western ones. This is due on one side to an under-diagnosis of certain conditions caused by the lack of diagnostic tools and on the other to the living conditions of the population. This difference should lead to intervention plans tailored on the actual necessities of the country and not on the western ones.

Highlights

Little is known about the surgical conditions affecting the pediatric population in low-income countries [1, 2]
In this article we describe the epidemiology of pediatric surgical diseases observed in Mutoyi hospital, a first-level hospital in Burundi
There is an important paucity of healthcare workers, with 1 medical doctor every 21,035 inhabitants, and an even lower surgeons-per-population ratio with 0.18 surgeons per 100,000, a ratio which sharply differs from the target set by the Lancet Commission Global Surgery 2030 of 40 surgeons for 100,000 inhabitants [12,13,14]

Summary

Introduction

Little is known about the surgical conditions affecting the pediatric population in low-income countries [1, 2]. It is estimated that 1.7 billion children lack access to surgical care in Low and Middle Income Countries (LMICs) [4]. Bickler in the 90s and The Lancet Commission on Global Surgery more recently have asserted that data assessing the actual need of surgical care in low-income countries are urgently needed in order to be able to properly take action [3, 5, 6]. For what concerns Burundi, a research on PubMed found no data about the spectrum of the surgical conditions affecting children living in the country, or about the burden of these conditions on the Burundian health system. Little is known about the surgical conditions affecting the pediatric population in low-income countries. In this article we describe the epidemiology of pediatric surgical diseases observed in Mutoyi hospital, a first-level hospital in Burundi

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