• Michael H Livingston, Jennifer DCruz, Julia Pemberton, Doruk Ozgediz, and Dan Poenaru.
• McMaster Pediatric Surgery Research Collaborative, Hamilton, Ontario, Canada; Clinician Investigator Program, McMaster University, Hamilton, Ontario, Canada; Division of General Surgery, Western University, London, Ontario, Canada.
• J. Pediatr. Surg. 2015 May 1;50(5):760-4.

BackgroundThere are ongoing efforts to improve the quality of surgical care for children in low and middle-income countries (LMICs) in Africa. The purpose of this study was to review the recent literature and estimate the mortality associated with pediatric surgical conditions in this setting.MethodsWe completed a comprehensive search for studies that: (1) reported outcomes associated with pediatric surgical conditions; (2) were conducted in LMICs in Africa; and (3) were published between 2007 and 2012. Abstract screening, full-text review, and data abstraction were completed in duplicate. Mortality rates were pooled using a random effects model.ResultsOut of 2085 abstracts, 292 were selected for textual review, and 107 underwent complete data abstraction. Only 74 (68%) of these reported mortality explicitly. The highest pooled mortality rates were seen with esophageal atresia (72%), midgut volvulus (36%), and jejunoileal atresia (35%). Pooled mortality was 17% for congenital conditions and 9% for acquired disease. The overall mortality rate for all conditions was 12%.ConclusionsMortality following pediatric surgical conditions in LMICs in Africa remains high, especially for congenital conditions in neonates. Future studies should report mortality explicitly and provide accurate follow-up data whenever possible.Copyright © 2015 Elsevier Inc. All rights reserved.

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