Abstract
Resources for neonatal surgery vary hugely between the developed countries and Africa. Due to the burden of other childhood diseases, neonatal surgery is of low priority to health-care budget holders in the developing countries. Admissions to two linked neonatal surgical institutions in Africa and Europe are compared to draw attention to the need of newborn care in developing countries. In a 3-year period, there have been 528 neonatal surgical admissions to the Kilimanjaro Christian Medical Centre (KCMC), Tanzania. During the same period, 707 surgical neonates were admitted to the John Radcliffe Hospital, UK (JRH). Conditions more commonly seen in the JRH include necrotising enterocolitis (NEC) (10.2 vs 0%), gastrochisis (5.5 vs 0.9%), congenital diaphragmatic hernia (2.4 vs 0.4%), congenital lung cysts (1.6 vs 0.4%), meconium ileus (2.4 vs 0%), malrotation (2.7 vs 0.6%) and abdominal/pelvic cysts (1.1 vs 0%). Conditions more commonly seen in KCMC include anorectal malformation (9.5 vs 4.7%), sacrococcygeal teratoma (2.3 vs 0.3%), Hirschsprung’s disease (10.2 vs 4.5%), branchial fistula (0.9 vs 0%), haemangioma (2.1 vs 0%) and cystic hygroma (2.1 vs 1.0%). The spectrum of neonatal surgical admissions in our two institutions varied. We believe this is attributable to availability of antenatal diagnosis, primary health-care, transport facilities, genetics as well as survival of delayed presentation. This study demonstrates the extent and spectrum of neonatal surgical pathology in this part of Africa and highlights the need for newborn surgical care in developing countries.
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References
The world factbook (2007) United States Central Intelligence Agency, https://www.cia.gov/library/publications/the-world-factbook/ 2007
Kleigman RM, Fanaroff AA (1981) Neonatal necrotising enterocolitis: a nine-year experience. Am J Dis Child 135:603–607
Voss M, Moore SW, van der Merwe I et al (1998) Fulminanting necrotising enterocolitis: outcome and prognostic factors. Pediatr Surg Int 13:576–580. doi:10.1007/s003830050407
Banieghbal B, Schoeman L, Kalk F et al (2002) Surgical indications and strategies for necrotizing enterocolitis in low income countries. World J Surg 26:444–447. doi:10.1007/s00268-001-0246-6
Adeyemi D (1989) Neonatal intestinal obstruction in a developing tropical country: patterns, problems, and prognosis. J Trop Pediatr 35:66–70
Hamosh A, FitzSimmons S, Macek M (1998) Comparison of the clinical manifestations of cystic fibrosis in black and white patients. J Pediatr 132:255–259. doi:10.1016/S0022-3476(98)70441-X
Padoa C, Goldman A, Jenkins T et al (1999) Cystic fibrosis carrier frequencies in populations of African origin. J Med Genet 36:41–44
Westwood T, Brown R (2006) Cystic fibrosis in black patients: Western Cape experiences. S Afr Med J 96:288–289
Penman DG, Fisher RM, Noblett HR et al (1998) Increase in incidence of gastroschisis in the South West of England in 1995. Br J Obstet Gynaecol 105:328–331
Torfs CP, Velie EM, Oechsli FW et al (1994) A population-based study of gastroschisis: demographic, pregnancy, and lifestyle risk factors. Teratology 50:44–53. doi:10.1002/tera.1420500107
Eggink B, Richardson C, Malloy M et al (2006) Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas. J Pediatr Surg 41:1103–8. doi:10.1016/j.jpedsurg.2006.02.008
Mhando S, Lyamuya S, Lakhoo K (2006) Challenges in developing paediatric surgery in sub-Saharan Africa. Pediatr Surg Int 22:425–427. doi:10.1007/s00383-006-1669-9
Goldberg EL (1984) An Epidemiological study of Hirschsprung’s disease. Int J Epidemiol 13:479–485. doi:10.1093/ije/13.4.479
Mhando S, Young B, Lakhoo K. (2008) The scope of emergency paediatric surgery in Tanzania. PSI 24:219–222
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Nandi, B., Mungongo, C. & Lakhoo, K. A comparison of neonatal surgical admissions between two linked surgical departments in Africa and Europe. Pediatr Surg Int 24, 939–942 (2008). https://doi.org/10.1007/s00383-008-2177-x
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DOI: https://doi.org/10.1007/s00383-008-2177-x