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Burden of surgical congenital anomalies in Kenya: a population-based study
Victor K Wu1, Dan Poenaru, Marten J Poley
1BethanyKids at Kijabe Hospital, Kijabe, Kenya.
Insights
Congenital malformations affect 6.3 per 1000 children in Kenya, with clubfoot being most common and spina bifida causing the highest disease burden. This study provides crucial data for improving pediatric surgical care in Africa.
Area of Science:
- Global Health
- Pediatric Surgery
- Epidemiology
Background:
- Congenital malformations represent a significant global health burden, contributing 25 million disability-adjusted life years (DALYs) in children worldwide.
- Estimating the burden of pediatric surgical disease in Africa is hindered by a lack of population-based data.
- This study addresses this gap by focusing on Kenya.
Purpose of the Study:
- To estimate the prevalence of common congenital surgical malformations in Kenyan children.
- To determine the disease burden, measured in DALYs, associated with these conditions.
- To inform strategies for reducing surgical disease burden in resource-limited settings.
Main Methods:
- Community volunteers conducted random household surveys across Kenya.
- Caregivers identified congenital malformations in children using a photographic portfolio.
- Disability-adjusted life years (DALYs) were calculated using life expectancy tables and established disability weights.
Main Results:
- Surveys included 5559 children across 1909 households (56% rural).
- The overall prevalence of congenital malformations was 6.3 per 1000 children.
- Clubfoot was the most prevalent condition; spina bifida presented the highest disease burden (54-120 DALYs per 1000 children).
Conclusions:
- This is the first study to report on the prevalence and disease burden of selected congenital surgical malformations in Kenyan children.
- Findings highlight the significant unmet need for surgical care in resource-limited regions.
- The data will guide interventions to mitigate the impact of these conditions.
Background:
Congenital malformations are a significant component of the global burden of disease among children, accounting for 25 million disability-adjusted life years (DALYs) worldwide. Unfortunately, efforts to estimate the burden of pediatric surgical disease in Africa are limited by the absence of population-based data. The objective of this study was to estimate both the prevalence and the disease burden of several common congenital surgical malformations among children in Kenya.
Methods:
Community volunteers randomly surveyed households at sites across Kenya. Caretakers were asked to identify on a photographic portfolio, several congenital malformations present among the children in their household, including club foot, hypospadias, hydrocephalus, spina bifida/encephalocele, cleft lip, bladder exstrophy and imperforate anus. DALYs were then calculated based on life expectancy tables and published and estimated disability weights for the conditions encountered.
Results:
The caregivers of 5559 children (54% female) were surveyed in 1909 households, 56% of which were rural, 31% suburban and 12% urban. The overall prevalence of congenital malformations was 6.3 per 1000 children, amounting to 54-120 DALYs per 1000 children, depending on the life tables used. The most prevalent condition in the survey was club foot, whereas spina bifida had the highest burden of disease.
Discussion:
This study is the first to document the prevalence of selected surgical congenital malformations among children in Kenya and the burden of disease associated with them. The results will serve to inform strategies aimed at reducing the unmet burden of surgical disease in resource-limited regions.
