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Year : 2015  |  Volume : 12  |  Issue : 1  |  Page : 1-6

Epidemiology, management and outcome of gastroschisis in Sub-Saharan Africa: Results of an international survey

Department of Paediatric Surgery, Kings College Hospital, London, United Kingdom

Correspondence Address:
Niyi Ade-Ajayi
Consultant Paediatric Surgeon, Department of Paediatric Surgery, Kings College Hospital, Denmark Hill, London, SE5 9RS
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0189-6725.150924

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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.

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