Infections in pediatric surgical practice in low- and middle-income countries: Resource-adapted clinical...

Pediatric infections in low- and middle-income countries (LMICs) represent a substantial proportion of the pediatric surgical burden. Overall in-hospital mortality for surgically treated infections is 12.5 %. The incidence, morbidity, and mortality associated with pediatric infections are all higher in LMICs due to delayed presentation, lack of access to primary care, and a greater incidence of communicable diseases. Over 1.7 billion children and adolescents do not have access to safe, timely, and affordable surgical care, and a disproportionate number of these children reside in LMICs making them a vulnerable population. Within this context, pediatric surgeons are frequently required to make diagnostic and therapeutic decisions in the setting of limited supportive infrastructure. This review examines common infectious conditions encountered in pediatric surgical practice in LMICs through the lens of resource-adapted decision-making, highlighting how constraints in diagnostics, operative capacity, anesthesia, and postoperative support shape management strategies and outcomes.