Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey
Abstract Background Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical condition...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-020-09575-8 |
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| author | Carlos Varela Sven Young Reinou S. Groen Leonard Banza Nyengo Mkandawire Bente Elisabeth Moen Asgaut Viste |
| author_facet | Carlos Varela Sven Young Reinou S. Groen Leonard Banza Nyengo Mkandawire Bente Elisabeth Moen Asgaut Viste |
| author_sort | Carlos Varela |
| collection | DOAJ |
| description | Abstract Background Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility. Methods The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey. Results The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care. Conclusion In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi. |
| first_indexed | 2024-04-13T13:46:31Z |
| format | Article |
| id | doaj.art-32fafbd4d6ef41f0859f06d440224b89 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-13T13:46:31Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-32fafbd4d6ef41f0859f06d440224b892022-12-22T02:44:28ZengBMCBMC Public Health1471-24582020-09-012011810.1186/s12889-020-09575-8Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household surveyCarlos Varela0Sven Young1Reinou S. Groen2Leonard Banza3Nyengo Mkandawire4Bente Elisabeth Moen5Asgaut Viste6Department of Surgery, Kamuzu Central HospitalDepartment of Surgery, Kamuzu Central HospitalDepartment of Obstetrics and Gynaecology, Johns Hopkins MedicineDepartment of Surgery, Kamuzu Central HospitalDepartment of Surgery, University of Malawi, College of MedicineDepartment of Clinical Medicine, Centre for International Health, Department of Global Public Health and Primary Care, University of BergenDepartment of Clinical Medicine, Centre for International Health, Department of Global Public Health and Primary Care, University of BergenAbstract Background Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility. Methods The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey. Results The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care. Conclusion In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi.http://link.springer.com/article/10.1186/s12889-020-09575-8SurgicalDeathsNational surveySOSAS |
| spellingShingle | Carlos Varela Sven Young Reinou S. Groen Leonard Banza Nyengo Mkandawire Bente Elisabeth Moen Asgaut Viste Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey BMC Public Health Surgical Deaths National survey SOSAS |
| title | Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey |
| title_full | Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey |
| title_fullStr | Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey |
| title_full_unstemmed | Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey |
| title_short | Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey |
| title_sort | deaths from surgical conditions in malawi a randomised cross sectional nationwide household survey |
| topic | Surgical Deaths National survey SOSAS |
| url | http://link.springer.com/article/10.1186/s12889-020-09575-8 |
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