Metabolic and Bariatric Surgery in Togo: A National Survey Among Physicians

Obesity has been defined as a pandemic for several years, and its management is multidisciplinary with an important role for surgeons. The aim of this survey is to assess the level of knowledge of Togolese trained doctors on metabolic and bariatric surgery (MBS) and its feasibility in Togo.

A national Google Form®, cross-sectional survey including medical doctors residing in Togo, or Togolese, volunteers from September 9 to 30, 2023; assessed subjective and objective knowledge of MBS, perceptions regarding indications, referral pathways, and barriers. The data were processed by Epi Info 7.2.5 software.

90 physicians responded with a male predominance (sex ratio M/F = 7.18) and a median age of 34 years. MBS was assumed to be known by 73 practitioners (81.11%). The evaluation criteria showed that the level of MBS-knowledge was complete for 31 physicians (34.44%); average for 32 physicians (35.56%), and insufficient for 27 physicians (30%). In the univariate model, significant predictors of higher MBS-knowledge score were: specialist (P = .0052), higher professional level (P = .0214), and good answer to multi-disciplinary team specialist (P < .0001). There were 75 doctors (83.33%) who validated the feasibility of MBS in Togo. Morbidly obese and financially wealthy patients were indicated by 54.44% of physicians. Concerning care, 61 physicians (67.78%) would be willing to entrust their patient to a specialist residing in Togo.

Physicians in Togo show insufficient objective knowledge and misconceptions regarding MBS. Strengthened training, national guidelines, and clear referral pathways are needed.