Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12306/1560
Title: Acute care surgery in Rwanda: Operative epidemiology and geographic variations in access to care
Authors: Kyamanywa, Patrick
Keywords: Surgery
Rwanda
Surgical Management
Hospital Emergency Issues
The Centre Hospitalier Universitaire de Kigali (CHUK)
Issue Date: 2015
Publisher: Elsevier Inc
Series/Report no.: Surgery;vol(n.a) p.1-7
Abstract: Background. Surgical management of emergent, life-threatening diseases is an important public health priority. The objectives of this study were to (1) describe acute care general surgery procedures performed at the largest referral hospital in Rwanda and (2) understand the geographic distribution of disease presentations and referral patterns. Methods. We performed a retrospective review of prospectively collected acute care surgery cases performed at the Centre Hospitalier Universitaire de Kigali (CHUK) in Rwanda between June 1 and December 1, 2011. Using Pearson’s v 2 test and the Fisher exact test, we compared cases originating from within Kigali and transfers from other provinces. Geospatial analyses also were used to further describe transfer patterns. Results. During the study period, 2,758 surgical interventions were performed, of which 25.6% (707/ 2,758) were general surgery operations. Of these, 45.4% (321/707) met the definition of acute care surgery. Only about one-third---32.3% (92/285)---of patients resided within Kigali, whereas about twothirds--- 67.7% (193/285)---were transferred from other provinces. Most patients transferred from other provinces were younger than 18 years of age (40.4%; 78/193), and 83.0% (39/47) of patients older than 50 years of age originated from outside of Kigali. Specific operative indications and surgical procedures varied substantially between patients from Kigali and patients transferred from other provinces. Conclusion. Emergency surgical conditions remain important contributors to the global burden of disease, particularly in low- and middle-income countries. Geographic variations exist in terms of operative diagnoses and procedures, which implies a need for improved access to surgical care at the district level with defined transfer mechanisms to greater-level care facilities when needed.
Description: Dr. Patrick Kamanywa who is the current Vice Chancellor of KIU-Western Campus authored the article with other various authors.
URI: http://hdl.handle.net/20.500.12306/1560
Appears in Collections:Clinical Medicine and Dentistry

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