Treating pediatric colorectal patients in low and middle income settings: Creative adaptation to the resources...

Area of Science:

• Pediatric surgery
• Colorectal surgery
• Global health

Background:

• Colorectal disease in children in low- and middle-income countries (LMIC) often presents late, leading to increased complications and limited follow-up.
• Infectious diseases like tuberculosis (TB), human immunodeficiency virus (HIV), and human papilloma virus (HPV) are prevalent and complicate primary colorectal conditions.
• Perineal trauma from various causes and endemic conditions present unique challenges in LMIC settings.

Purpose of the Study:

• To discuss the unique profiles of pediatric colorectal diseases in LMIC.
• To highlight the impact of infectious diseases and trauma on colorectal care.
• To explore adaptations needed for resource-poor healthcare settings.

Main Methods:

• Review of existing literature and clinical observations on pediatric colorectal diseases in LMIC.
• Discussion of specific endemic conditions and their management challenges.
• Analysis of the impact of socioeconomic factors on colorectal care.

Main Results:

• Late presentation and complications are characteristic of pediatric colorectal diseases in LMIC.
• Infectious agents (TB, HIV, HPV) and perineal trauma significantly affect wound healing and surgical outcomes.
• Unique conditions like congenital pouch colon and H-type rectal fistulae require specialized management.

Conclusions:

• Pediatric colorectal care in LMIC requires creative adaptations due to unique disease profiles and resource limitations.
• Addressing socioeconomic factors and endemic conditions is crucial for optimizing treatment.
• Further research is needed to understand and manage specific endemic colorectal diseases in LMIC.