Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool: Implications for paediatric surgical capacity-building

Autoři: Adesoji O. Ademuyiwa aff001;  Tinuola O. Odugbemi aff003;  Christopher O. Bode aff001;  Olumide A. Elebute aff001;  Felix M. Alakaloko aff002;  Eyitayo O. Alabi aff001;  Olufemi Bankole aff001;  Oluwaseun Ladipo-Ajayi aff002;  Justina O. Seyi-Olajide aff002;  Babasola Okusanya aff006;  Ogechi Abazie aff008;  Iyabo Y. Ademuyiwa aff008;  Amanda Onwuka aff009;  Tu Tran aff010;  Ayomide Makanjuola aff002;  Shailvi Gupta aff012;  Riinu Ots aff013;  Ewen M. Harrison aff013;  Dan Poenaru aff014;  Benedict C. Nwomeh aff015
Působiště autorů: Department of Surgery, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria aff001;  Paediatric Surgery Unit, Department of Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria aff002;  Department of Community Health and Primary Care, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria aff003;  Department of Orthopaedics and Trauma, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria aff004;  Neurosurgery Unit, Department of Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria aff005;  Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria aff006;  Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria aff007;  Department of Nursing Science, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria aff008;  Centre for Surgical Outcomes Research, and Centre for Innovation in Paediatric Practice, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America aff009;  SOSAS Uganda, Duke University Division of Global Neurosurgery, Durham, North Carolina, United States of America aff010;  University of Minnesota Medical School, Minneapolis, Minnesota, United States of America aff011;  University of California San Francisco East Bay; Surgeons Overseas; San Francisco, California, United States of America aff012;  Department of Surgery, University of Edinburgh, Edinburgh, United Kingdom aff013;  McGill University Health Centre and Montreal Children’s Hospital, Montreal, Canada aff014;  Nationwide Children’s Hospital, Columbus, Ohio, United States of America aff015
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article



In many low- and middle-income countries, data on the prevalence of surgical diseases have been derived primarily from hospital-based studies, which may lead to an underestimation of disease burden within the community. Community-based prevalence studies may provide better estimates of surgical need to enable proper resource allocation and prioritization of needs. This study aims to assess the prevalence of common surgical conditions among children in a diverse rural and urban population in Nigeria.


Descriptive cross-sectional, community-based study to determine the prevalence of congenital and acquired surgical conditions among children in a diverse rural-urban area of Nigeria was conducted. Households, defined as one or more persons ‘who eat from the same pot’ or slept under the same roof the night before the interview, were randomized for inclusion in the study. Data was collected using an adapted and modified version of the interviewer-administered questionnaire—Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool and analysed using the REDCap web-based analytic application.

Main results

Eight-hundred-and-fifty-six households were surveyed, comprising 1,883 children. Eighty-one conditions were identified, the most common being umbilical hernias (20), inguinal hernias (13), and wound injuries to the extremities (9). The prevalence per 10,000 children was 85 for umbilical hernias (95% CI: 47, 123), and 61 for inguinal hernias (95% CI: 34, 88). The prevalence of hydroceles and undescended testes was comparable at 22 and 26 per 10,000 children, respectively. Children with surgical conditions had similar sociodemographic characteristics to healthy children in the study population.


The most common congenital surgical conditions in our setting were umbilical hernias, while injuries were the most common acquired conditions. From our study, it is estimated that there will be about 2.9 million children with surgically correctable conditions in the nation. This suggests an acute need for training more paediatric surgeons.

Klíčová slova:

Children – Nigeria – Pediatric surgery – Pediatrics – Surgeons – Surgical and invasive medical procedures – Hernia – Congenital disorders


1. Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569–624. doi: 10.1016/S0140-6736(15)60160-X 25924834

2. Ademuyiwa AO, Bode CO, Adesanya OA, Elebute OA. Non-trauma related paediatric abdominal surgical emergencies in Lagos, Nigeria: Epidemiology and indicators of survival. Niger Med J. 2012;53(2):76–9. doi: 10.4103/0300-1652.103546 23271850

3. Herlevic VC, Mowad R, Miller JK, Darensburg NA, Li BD, Kim RH. Breast cancer outcomes in a population with high prevalence of obesity. J Surg Res. 2015;198(2):371–6. doi: 10.1016/j.jss.2015.03.088 25959832

4. Shivaji T, Lee A, Dougall N, McMillan T, Stark C. The epidemiology of hospital treated traumatic brain injury in Scotland. BMC Neurol. 2014;14:2. doi: 10.1186/1471-2377-14-2 24386897

5. Last JM, Adelaide DP. The iceberg: 'completing the clinical picture' in general practice. 1963. Int J Epidemiol. 2013;42(6):1608–13. doi: 10.1093/ije/dyt113 24415602

6. Groen RS, Samai M, Stewart KA, Cassidy LD, Kamara TB, Yambasu SE, et al. Untreated surgical conditions in Sierra Leone: a cluster randomised, cross-sectional, countrywide survey. Lancet. 2012;380(9847):1082–7. doi: 10.1016/S0140-6736(12)61081-2 22898076

7. Groen RS, Samai M, Petroze RT, Kamara TB, Yambasu SE, Calland JF, et al. Pilot testing of a population-based surgical survey tool in Sierra Leone. World J Surg. 2012;36(4):771–4. doi: 10.1007/s00268-012-1448-9 22311139

8. National Population Commission and ICF International. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International. 2014:pp19

9. Groen RS. Surgeon Overseas Assessment of Surgical Need (SOSAS): a logistical guideline for SOSAS.

10. Fuller AT, Butler EK, Tran TM, Makumbi F, Luboga S, Muhumza C, et al. Surgeons OverSeas Assessment of Surgical Need (SOSAS) Uganda: Update for Household Survey. World J Surg. 2015;39(12):2900–7. doi: 10.1007/s00268-015-3191-5 26316109

11. Gupta S, Ranjit A, Shrestha R, Wong EG, Robinson WC, Shrestha S, et al. Surgical needs of Nepal: pilot study of population based survey in Pokhara, Nepal. World J Surg. 2014;38(12):3041–6. doi: 10.1007/s00268-014-2753-2 25189447

12. Petroze RT, Groen RS, Niyonkuru F, Mallory M, Ntaganda E, Joharifard S, et al. Estimating operative disease prevalence in a low-income country: results of a nationwide population survey in Rwanda. Surgery. 2013;153(4):457–64. doi: 10.1016/j.surg.2012.10.001 23253378

13. Alakaloko FM, St-Louis E, Ademuyiwa AO, Poenaru D, Bode C. Determination of visual portfolio for Surgeons’ OverSeas Assessment of Surgical Needs Nigeria study: Consensus generation through an e-Delphi process. Niger J Surg 2019;25:30–5. doi: 10.4103/njs.NJS_30_18 31007509

14. website: REDcap. available at Accessed 4 April, 2017.

15. Goodman LF, St-Louis E, Yousef Y, Cheung M, Ure B, Ozgediz D, et al. The Global Initiative for Children's Surgery: Optimal Resources for Improving Care. Eur J Pediatr Surg. 2018;28(1):51–9. doi: 10.1055/s-0037-1604399 28806850

16. National Population Commission. Nigeria's population hit 198million. http://populationgovng. 2018:

17. opendataforafrica. Nigeria population census 2006: population distribution by age. opendataforafrica. 2018;

18. Ameh EA, Nmadu PT. Major complications of omphalitis in Neonates and Infants. Paediatric Surgery International. 2002 (18); 413–416.

19. Muniraman H, Sardesai T, Sardesai S. Disorders of the umbilical cord. Paediatrics in Review. 2018 (39)7; 332–341

20. Bowling K HN, Cox P, Srinivas G. Management of paediatric hernia. BMJ. 2017;359:j4484. doi: 10.1136/bmj.j4484 29051195

21. Burcharth J, Pedersen M, Bisgaard T, Pedersen C, Rosenberg J. Nationwide prevalence of groin hernia repair. PLoS One. 2013;8(1):e54367. doi: 10.1371/journal.pone.0054367 23342139

22. Wan S, Wang Y, Gu S. Epidemiology of male genital abnormalities: a population study. Pediatrics. 2014;133(3):e624–7. doi: 10.1542/peds.2013-2285 24567010

23. Nisale SS, Warad, Sanjay P. Study of prevalence of hernia, hydrocele and other surgical problems among school children. International Surgery Journal. 2016;3(4):2066–70.

24. WHO. Injuries and Violence: the facts 2014. WHO Key Facts. 2014.

25. Chandran A, Hyder AA, Peek-Asa C. The global burden of unintentional injuries and an agenda for progress. Epidemiol Rev. 2010;32:110–20. doi: 10.1093/epirev/mxq009 20570956

26. Omeihe O. Africa needs more paediatric surgeons, says group. The Nation newspaper. 23 September 2016. Accessed 2nd May 2019

27. O'Neill JA Jr.1, Gautam S, Geiger JD, Ein SH, Holder TM, Bloss RS, Krummel TM. A longitudinal analysis of the pediatric surgeon workforce. Ann Surg. 2000;232(3):442–53. doi: 10.1097/00000658-200009000-00016 10973394

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2019 Číslo 10
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