Faculty Collaboration Database

Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: The Médecins Sans Frontières Operations Centre Brussels experience. J Pediatr Surg 2016 Apr;51(4):659-69

Date

10/12/2015

Pubmed ID

26454469

Pubmed Central ID

PMC5860656

DOI

10.1016/j.jpedsurg.2015.08.063

Scopus ID

2-s2.0-84951039485 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

PURPOSE: Pediatric surgical care is deficient in developing countries disrupted by crisis. We aimed to describe pediatric surgical care at Médecins Sans Frontières-Brussels (MSF-OCB) projects to inform resource allocation and define the pediatric-specific skillset necessary for humanitarian surgical teams.

METHODS: Procedures performed by MSF-OCB from July 2008 to December 2014 were reviewed. Project characteristics, patient demographics and clinical data were described. Multivariable logistic regression was performed to determine predictors of perioperative death.

RESULTS: Of 109,828 procedures, 26,284 were performed for 24,576 children (22% of all procedures). The most common pediatric operative indication was trauma (13,984; 57%). Nine percent of all surgical indications were due to violence (e.g., land mines, firearms, gender-based violence, etc.). The majority of procedures (19,582; 75%) were general surgical, followed by orthopedic (4350; 17%), and obstetric/gynecologic/urologic (2135; 8%). Perioperative death was low (42; 0.17%); independent predictors of death included age <1year, use of general anesthesia with a definitive airway, and operation during conflict.

CONCLUSION: Surgical care for children comprised nearly a quarter of all procedures performed by MSF-OCB between 2008 and 2014. Attention to trauma surgery and infant perioperative care is particularly needed. These findings are important when resourcing projects and training surgical staff for humanitarian missions.

Author List

Flynn-O'Brien KT, Trelles M, Dominguez L, Hassani GH, Akemani C, Naseer A, Ntawukiruwabo IB, Kushner AL, Rothstein DH, Stewart BT

Author

Katherine T. Flynn-O'Brien MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Altruism
Child
Clinical Competence
Developing Countries
Emergencies
Female
Health Care Rationing
Humans
Infant
Infant, Newborn
Logistic Models
Male
Needs Assessment
Pediatrics
Retrospective Studies
Specialties, Surgical
Surgical Procedures, Operative