Anorectal malformations in low and middle-income countries- spectrum, burden and management

Area of Science:

• Pediatric Surgery
• Global Health
• Congenital Anomalies

Background:

• Anorectal malformation (ARM) is a congenital anomaly with well-documented clinical presentations and management protocols.
• However, experiences in low- and middle-income countries (LMICs) are significantly influenced by unique social, cultural, and economic factors.
• These factors often result in delayed presentation and management of ARM cases.

Purpose of the Study:

• To explore the spectrum of anorectal malformation from a global surgery perspective.
• To outline the specific burdens and challenges faced in resource-constrained environments.
• To discuss adapted management strategies for successful outcomes in LMICs.

Main Methods:

• Review of existing literature on anorectal malformation in LMICs.
• Analysis of the impact of socioeconomic factors on clinical presentation and management.
• Exploration of global surgery principles applied to ARM treatment.

Main Results:

• Delayed diagnosis is common in LMICs, often associated with sepsis and increased need for emergency resuscitation.
• Resource limitations necessitate modifications in surgical and postoperative care protocols.
• Adaptations in management aim to mitigate increased morbidity and mortality rates.

Conclusions:

• Successful management of anorectal malformation in LMICs requires tailored approaches considering local constraints.
• Global surgery initiatives are crucial for improving outcomes in resource-limited settings.
• Addressing socioeconomic barriers is essential for timely diagnosis and effective treatment of ARM.