Pediatric Surgical Waitlist in Low Middle Income Countries During the COVID-19 Pandemic
Greg Klazura1, Paul Park2, Ava Yap2
1Department of Surgery, University of Illinois at Chicago, Chicago, Illinois; UCSF Center for Health Equity in Surgery and Anesthesia, San Francisco, California.
Insights
The COVID-19 pandemic caused significant surgical delays for children in low- and middle-income countries (LMICs). Median waitlists reached 90 patients, impacting access to essential pediatric surgeries.
Area of Science:
- Global Health
- Surgical Outcomes
- Pediatric Surgery
Background:
- The COVID-19 pandemic drastically reduced global surgical procedures.
- Limited data exists on its impact on pediatric surgical volumes in low- and middle-income countries (LMICs).
Purpose of the Study:
- To estimate surgical waitlists for pediatric patients in LMICs.
- To assess the impact of the pandemic on surgical access for children.
Main Methods:
- A survey was developed and distributed to pediatric surgeons in sub-Saharan Africa and Ecuador.
- Data collected from 15 sites on waitlist numbers and specific surgical conditions.
Main Results:
- The median waitlist comprised 90 pediatric patients.
- Median wait times for elective surgeries were 2 months.
- Public hospitals experienced longer wait times than private facilities.
Conclusions:
- Extended surgical wait times significantly hinder pediatric surgical access in LMICs.
- The pandemic exacerbated existing surgical backlogs, causing delays for elective, urgent, and emergent cases.
- Strategies are needed to scale resources, mitigate future pandemic impacts, and monitor waitlists.
Introduction:
Coronavirus disease-19 led to a significant reduction in surgery worldwide. Studies, however, of the effect on surgical volume for pediatric patients in low-income and middle-income countries (LMICs) are limited.
Methods:
A survey was developed to estimate waitlists in LMICs for priority surgical conditions in children. The survey was piloted and revised before it was deployed over email to 19 surgeons. Pediatric surgeons at 15 different sites in eight countries in sub-Saharan Africa and Ecuador completed the survey from February 2021 to June 2021. The survey included the total number of children awaiting surgery and estimates for specific conditions. Respondents were also able to add additional procedures.
Results:
Public hospitals had longer wait times than private facilities. The median waitlist was 90 patients, and the median wait time was 2 mo for elective surgeries.
Conclusions:
Lengthy surgical wait times affect surgical access in LMICs. Coronavirus disease-19 had been associated with surgical delays around the world, exacerbating existing surgical backlogs. Our results revealed significant delays for elective, urgent, and emergent cases across sub-Saharan Africa. Stakeholders should consider approaches to scale the limited surgical and perioperative resources in LMICs, create mitigation strategies for future pandemics, and establish ways to monitor waitlists on an ongoing basis.
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