Related Experiment Video
Updated: Aug 30, 2025
Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
Published on: September 11, 2018
Prevalence of pediatric surgical problems among east African refugees: estimates from a cross-sectional survey using
Zachary Obinna Enumah1,2, Mohamed Yunus Rafiq3,4, Daniel Rhee5
1Department of Surgery, Johns Hopkins Global Surgery Initiative (JHGSI), Johns Hopkins Hospital, Tower 110 Doctor's Lounge, 600 N. Wolfe Street, Baltimore, MD, 21287, USA. zoe@jhmi.edu.
Insights
Over 16% of refugee children in East Africa have untreated surgical conditions. This study highlights a critical gap in pediatric surgical care for vulnerable populations, emphasizing the need for targeted interventions.
Area of Science:
- Global Health
- Pediatric Surgery
- Forced Migration Studies
Background:
- Surgery is vital for healthcare systems, but research on pediatric surgical conditions often excludes refugees.
- The Lancet Commission on Global Surgery highlighted the need to address surgical burdens in underserved populations.
Purpose of the Study:
- To estimate the prevalence of pediatric surgical conditions among refugees in East Africa.
- To provide data on the burden of surgical disease in a vulnerable pediatric population.
Main Methods:
- A cross-sectional study using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) tool.
- Random cluster sampling was employed in Nyarugusu refugee camp, Tanzania, involving 1,658 children aged 0-18 years.
- Descriptive and multivariable analyses, including an average marginal effects model, were conducted.
Main Results:
- 513 participants (30.9%) reported a potential surgical issue, with 280 (54.6%) untreated or ongoing.
- Overall, 16.9% of refugee children had an ongoing, potentially treatable surgical problem.
- Increasing age and recent illness were associated with having a surgical problem.
Conclusions:
- This is the first and largest study on surgical conditions in refugee children in sub-Saharan Africa.
- Approximately one-in-six refugee children experience a condition amenable to surgery.
- The findings establish a benchmark for future research in conflict zones and refugee settings.
Importance:
Surgery is a foundational aspect to high functioning health care systems. In the wake of the Lancet Commission on Global Surgery, previous research has focused on defining the burden of surgical conditions among a pediatric population, however these studies often fail to include forced migrant or refugees. The goal of this study was to estimate the prevalence of pediatric surgical conditions among refugees in east Africa.
Methods:
We used the previously validated Surgeons OverSeas Assessment of Surgical Need (SOSAS) that utilizes cross-sectional design with random cluster sampling to assess prevalence of surgical disease among participants aged 0 to 18 years in Nyarugusu refugee camp, Tanzania. We used descriptive and multivariable analyses including an average marginal effects model.
Results:
A total of 1,658 participants were included in the study. The mean age of our sample was 8.3 ± 5.8 years. A total of 841 participants (50.7%) were male and 817 participants (49.3%) were female. A total of 513 (n = 30.9%) reported a history or presence of a problem that may be surgical in nature, and 280 (54.6%) of them reported the problem was ongoing or untreated. Overall, 16.9% had an ongoing problem that may be amenable to surgery. We found that increasing age and recent illness were associated with having a surgical problem on both our multivariable analyses.
Conclusion:
To our knowledge, this is the first and largest study of prevalence of surgical conditions among refugee children in sub-Saharan Africa. We found that over 16% (one-in-six) of refugee children have a problem that may be amenable to surgery. Our results provide a benchmark upon which other studies in conflict or post-conflict zones with refugee or forced migrant populations may be compared.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:20Cluster Sampling Method
To choose a cluster sample, divide the population into clusters (groups) and then randomly select some of the clusters. All the members from these clusters are in the cluster sample. For example, if you randomly sample four departments from your...
01:23Sampling Plans
Random sampling is a method where each member of the population has an equal chance of being selected for the sample. It involves selecting individuals randomly, often using random number generators or lottery-type methods. For example, when analyzing the properties of a...