Acute care surgery in Rwanda: Operative epidemiology and geographic variations in access to care

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dc.contributor.authorKyamanywa, Patrick
dc.date.accessioned2019-02-14T08:51:15Z
dc.date.available2019-02-14T08:51:15Z
dc.date.issued2015
dc.descriptionDr. Patrick Kamanywa who is the current Vice Chancellor of KIU-Western Campus authored the article with other various authors.en_US
dc.description.abstractBackground. 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.en_US
dc.identifier.urihttp://hdl.handle.net/20.500.12306/1560
dc.language.isoenen_US
dc.publisherElsevier Incen_US
dc.relation.ispartofseriesSurgery;vol(n.a) p.1-7
dc.subjectSurgeryen_US
dc.subjectRwandaen_US
dc.subjectSurgical Managementen_US
dc.subjectHospital Emergency Issuesen_US
dc.subjectThe Centre Hospitalier Universitaire de Kigali (CHUK)en_US
dc.titleAcute care surgery in Rwanda: Operative epidemiology and geographic variations in access to careen_US
dc.typeArticleen_US
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