Aim of the study: Hospital-based records are often used to estimate prevalence of medical need; however, in low-resource settings, many medical needs never present to the hospital setting. Relying on hospital-based estimates of illness might lead to a severe underestimation of medical need in these communities. Rather, community-based prevalence studies may better estimate surgical need and enable proper allocation of resources and prioritization of needs. This pioneer study aims to document the prevalence of common surgical conditions using a community-based study in a diverse rural and urban population in a LMIC.
Methods: A descriptive cross-sectional, community-based study to determine the prevalence of congenital and acquired surgical conditions among children in a diverse rural-urban area of a LMIC was conducted. Households, defined as one or more persons "who eat from the same pot" or slept under the same roof the night before the interview, were randomized for inclusion in the study. Data was collected using an adapted and modified version of the interviewer-administered questionnaire - Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool. Data was analysed using the REDCap analytic tool.
Main results: Eight-hundred-and-fifty-six households were surveyed with 2027 children. Ninety surgical pathologies were identified among the children, suggesting a prevalence rate of 4.4%. The most common conditions were umbilical hernias (7/1000), inguinal hernias (5/1000), injuries (4/1000), abscesses/furuncle (3/1000), hydroceles (2/1000) and undescended testes (2/1000). Children with surgical pathologies had similar sociodemographic characteristics to healthy children in the sampled population.
Conclusion: The most common congenital surgical conditions in our setting are umbilical and groin hernias, while injuries account for the most common acquired condition. With an estimated national population of 90 million children and 80 paediatric surgeons, the surgical burden to surgeon ratio is 49,500:1. This suggests an acute need for training of more paediatric surgeons