2024
Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa
Yap A, Halid S, Ukwu N, Laverde R, Park P, Klazura G, Bryce E, Cheung M, Marseille E, Ozgediz D, Ameh E. Cost-effectiveness of a pediatric operating room installation in Sub-Saharan Africa. PLOS Global Public Health 2024, 4: e0001748. PMID: 38536860, PMCID: PMC10971580, DOI: 10.1371/journal.pgph.0001748.Peer-Reviewed Original ResearchDisability-adjusted life yearsPediatric operating roomIncremental cost-effectiveness ratioSub-Saharan AfricaSurgical infrastructureProbabilistic sensitivity analysesOperating roomLocal healthcare systemCost-effective interventionPayor perspectiveCost-effectiveSub-SaharanHealth outcomesPediatric surgical servicesSurgical capacityCost-effectiveness thresholdPatient's familyCost-effectiveness ratioHealthcare systemLack of knowledgeGlobal surgerySurgical deliveryUnited States dollarsLife yearsSurgical services
2023
Out-of-pocket costs and catastrophic healthcare expenditure for families of children requiring surgery in sub-Saharan Africa
Yap A, Olatunji B, Negash S, Mweru D, Kisembo S, Masumbuko F, Ameh E, Lebbie A, Bvulani B, Hansen E, Philipo G, Carroll M, Hsu P, Bryce E, Cheung M, Fedatto M, Laverde R, Ozgediz D. Out-of-pocket costs and catastrophic healthcare expenditure for families of children requiring surgery in sub-Saharan Africa. Surgery 2023, 174: 567-573. PMID: 37385869, DOI: 10.1016/j.surg.2023.05.010.Peer-Reviewed Original ResearchConceptsCatastrophic healthcare expenditureFamilies of childrenHealthcare expendituresChildren's surgeryPocket costsPediatric surgical patientsMultivariate logistic regressionPediatric operating roomIntensive resource utilizationPocket healthcare costsUniversal healthcare coverageChart reviewSurgical patientsSubgroup analysisClinical dataAfrican hospitalsHealthcare costsEconomic burdenMedian annual incomeSurgeryOlder ageLogistic regressionHealthcare coverageOperating roomOlder children
2021
Performing Bariatric Surgery on Previously COVID+ Patients Is Safe and Effective
Cheung MS, Ying L, Duffy AJ, Ghiassi S, Nadzam G, Roberts KE, Morton JM. Performing Bariatric Surgery on Previously COVID+ Patients Is Safe and Effective. Obesity Surgery 2021, 31: 5082-5084. PMID: 34453312, PMCID: PMC8396140, DOI: 10.1007/s11695-021-05659-5.Peer-Reviewed Original ResearchThe Role of Positron Emission Tomography in Bariatric Surgery Research: a Review
Bini J, Norcross M, Cheung M, Duffy A. The Role of Positron Emission Tomography in Bariatric Surgery Research: a Review. Obesity Surgery 2021, 31: 4592-4606. PMID: 34304378, DOI: 10.1007/s11695-021-05576-7.Peer-Reviewed Original ResearchConceptsPositron emission tomographyBariatric surgeryEmission tomographyBariatric surgery researchMalabsorption of foodBlood flowWhole-body PET imagingRadioligand developmentWeight lossPET imagingAmount of foodSurgery researchPhysiological effectsSurgeryPicomolar concentrationsTomographyRadioactive moleculesMetabolismMalabsorptionObesityPatientsFoodStomachPharmacologyReceptorsAccess to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals
Grabski DF, Ajiko M, Kayima P, Ruzgar N, Nyeko D, Fitzgerald TN, Langer M, Cheung M, Cigliano B, D'Agostino S, Baird R, Duffy D, Tumukunde J, Nabukenya M, Ogwang M, Kisa P, Sekabira J, Kakembo N, Ozgediz D. Access to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals. Surgery 2021, 170: 1397-1404. PMID: 34130809, DOI: 10.1016/j.surg.2021.05.007.Peer-Reviewed Original ResearchConceptsPediatric surgical capacityRural regional hospitalGeneral surgeonsSurgical capacitySurgery admissionsMiddle-income countriesSurgical guidelinesRegional hospitalPediatric surgeryAnesthesia providersRegional Referral HospitalProspective clinical databasePediatric surgical servicesPediatric surgical careGeneral surgery casesMajority of casesHospital mortalityPrimary outcomeReferral hospitalSurgical infectionsClinical outcomesSurgery casesHernia repairSurgical careSurgical procedures
2020
Development of an Operative Trauma Course in Uganda—A Report of a Three-Year Experience
Ullrich SJ, DeWane MP, Cheung M, Fleming M, Namugga MM, Fu W, Kurigamba G, Kabuye R, Mabweijano J, Galukande M, Ozgediz D, Pei KY. Development of an Operative Trauma Course in Uganda—A Report of a Three-Year Experience. Journal Of Surgical Research 2020, 256: 520-527. PMID: 32799000, DOI: 10.1016/j.jss.2020.07.024.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultChildChild, PreschoolClinical CompetenceCurriculumFemaleHealth ResourcesHumansInjury Severity ScoreInterdisciplinary PlacementInternship and ResidencyMaleMiddle AgedSurgeonsSurgical Procedures, OperativeSurveys and QuestionnairesTraumatologyTreatment OutcomeUgandaWounds and InjuriesYoung AdultConceptsOperative techniqueTrauma courseInitial patient evaluationThree-year experienceLow-resource settingsHealth care systemBedside interventionsRoad traffic crashesPatient demographicsClinical outcomesPatient evaluationLiver repairHead CTLeading causePractice patternsDiagnostic imagingLow-income countriesSecond-year surgical residentsStudy periodCare systemResident practiceSurgical residentsLaparotomySignificant differencesPatientsThe Three Delays’ Impact in Uganda: The Disease Burden and Operative Backlog at a New Pediatric Surgery Outpatient Clinic of a Tertiary Center
Ruzgar N, Godier-Furnemont A, Kakembo N, Cheung M, Ullrich S, Nabirye A, Nambooze H, Kisa P, Muzira A, Sekabira J, Ozgediz D. The Three Delays’ Impact in Uganda: The Disease Burden and Operative Backlog at a New Pediatric Surgery Outpatient Clinic of a Tertiary Center. Pediatrics 2020, 146: 278-279. DOI: 10.1542/peds.146.1ma4.278.Peer-Reviewed Original ResearchNavigating the COVID-19 Pandemic
Ullrich S, Cheung M, Namugga M, Sion M, Ozgediz D, Yoo P. Navigating the COVID-19 Pandemic. Annals Of Surgery 2020, 272: e216-e218. PMID: 32520740, PMCID: PMC7299091, DOI: 10.1097/sla.0000000000004115.Peer-Reviewed Original ResearchBurden of emergency pediatric surgical procedures on surgical capacity in Uganda: a new metric for health system performance
Grabski D, Kakembo N, Situma M, Cheung M, Shikanda A, Okello I, Kisa P, Muzira A, Sekabira J, Ozgediz D. Burden of emergency pediatric surgical procedures on surgical capacity in Uganda: a new metric for health system performance. Surgery 2020, 167: 668-674. PMID: 31973913, DOI: 10.1016/j.surg.2019.12.002.Peer-Reviewed Original ResearchMeSH KeywordsBenchmarkingChild, PreschoolDatabases, FactualDigestive System AbnormalitiesEmergency Service, HospitalEmergency TreatmentFemaleHealth ResourcesHernia, InguinalHospital MortalityHumansInfantInfant, NewbornMaleProspective StudiesQuality Indicators, Health CareSurgical Procedures, OperativeUgandaConceptsMiddle-income countriesSurgical capacitySurgical acuityReferral hospitalElective casesInguinal herniaSurgical diseaseSurgical proceduresCongenital malformationsMulago National Referral HospitalMbarara Regional Referral HospitalPediatric surgical admissionsRatio of emergencyHealth metricsNational Referral HospitalRegional Referral HospitalPediatric surgical patientsPediatric surgical proceduresPediatric surgical capacityElective surgical casesTime of repairHealth system performanceSurgery groupSurgical admissionsDefinitive repair
2019
Design, implementation and long-term follow-up of a context specific trauma training course in Uganda: Lessons learned and future directions
Ullrich SJ, Kilyewala C, Lipnick MS, Cheung M, Namugga M, Muwanguzi P, DeWane MP, Muzira A, Tumukunde J, Kabagambe M, Kebba N, Galukande M, Mabweijano J, Ozgediz D. Design, implementation and long-term follow-up of a context specific trauma training course in Uganda: Lessons learned and future directions. The American Journal Of Surgery 2019, 219: 263-268. PMID: 31732117, DOI: 10.1016/j.amjsurg.2019.10.048.Peer-Reviewed Original ResearchBurden of Surgical Infections in a Tertiary-Care Pediatric Surgery Service in Uganda
Kakembo N, Grabski DF, Fitzgerald TN, Muzira A, Cheung M, Kisa P, Sekabira J, Ozgediz D. Burden of Surgical Infections in a Tertiary-Care Pediatric Surgery Service in Uganda. Surgical Infections 2019, 21: 130-135. PMID: 31560249, DOI: 10.1089/sur.2019.045.Peer-Reviewed Original ResearchConceptsHospital mortality rateMortality rateSurgical interventionSurgery departmentSurgical careChildren’s Surgery DepartmentProspective surgical databaseTyphoid intestinal perforationTertiary referral hospitalPediatric surgery serviceBurden of infectionChildren's surgical careHigh mortality rateAbdominal sepsisIntestinal perforationAspiration pneumoniaOperative interventionMiddle-income countriesReferral hospitalSurgical infectionsSurgery serviceSurgical databaseIleocolic intussusceptionPrimary infectionSurgical diseaseBurden and Outcomes of Neonatal Surgery in Uganda: Results of a Five-Year Prospective Study
Ullrich SJ, Kakembo N, Grabski DF, Cheung M, Kisa P, Nabukenya M, Tumukunde J, Fitzgerald TN, Langer M, Situma M, Sekabira J, Ozgediz D. Burden and Outcomes of Neonatal Surgery in Uganda: Results of a Five-Year Prospective Study. Journal Of Surgical Research 2019, 246: 93-99. PMID: 31562991, DOI: 10.1016/j.jss.2019.08.015.Peer-Reviewed Original ResearchMeSH KeywordsCost of IllnessCost-Benefit AnalysisFemaleHealth Services AccessibilityHealth Services Needs and DemandHealth WorkforceHospital MortalityHospitals, PediatricHumansInfant, NewbornInfant, Newborn, DiseasesMaleProspective StudiesQuality-Adjusted Life YearsSurgical Procedures, OperativeSurvival RateUgandaConceptsDisability-adjusted life yearsNeonatal surgeryUnmet needLife yearsFive-year prospective studyNeonatal surgical conditionsNeonatal surgical admissionsHealth care systemPotential additional benefitNeonatal admissionsPostoperative mortalitySurgical admissionsSurgical coverageImproved survivalMedian ageMiddle-income countriesOverall mortalityProspective studySurgical interventionAnorectal malformationsSurgical conditionsCongenital anomaliesHigh-income countriesPediatric anesthesiologistsSurgical careCorrection to: Epidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda
Cheung M, Kakembo N, Ruzgar N, Grabski D, Ullrich S, Muzira A, Kisa P, Sekabira J, Ozgediz D. Correction to: Epidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda. Pediatric Surgery International 2019, 35: 1291-1291. PMID: 31520139, DOI: 10.1007/s00383-019-04550-w.Peer-Reviewed Original ResearchEpidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda
Cheung M, Kakembo N, Rizgar N, Grabski D, Ullrich S, Muzira A, Kisa P, Sekabira J, Ozgediz D. Epidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda. Pediatric Surgery International 2019, 35: 1279-1289. PMID: 31324976, DOI: 10.1007/s00383-019-04520-2.Peer-Reviewed Original ResearchConceptsMortality rateTertiary centerCongenital anomaliesHigh-income countriesChild underwent surgeryCongenital anomaly groupsPediatric surgical admissionsPost-operative mortalityTertiary referral hospitalPediatric surgical conditionsPediatric surgical diseasesHigh mortality rateInfant congenital anomaliesSurgical admissionsUnderwent surgeryIntestinal atresiaMiddle-income countriesReferral hospitalCommon diagnosisAnorectal malformationsSurgical conditionsSurgical diseaseHigh burdenAnomaly groupOngoing quality improvementPediatric intussusception in Uganda: differences in management and outcomes with high-income countries
Akello VV, Cheung M, Kurigamba G, Semakula D, Healy JM, Grabski D, Kakembo N, Ozgediz D, Sekabira J. Pediatric intussusception in Uganda: differences in management and outcomes with high-income countries. Journal Of Pediatric Surgery 2019, 55: 530-534. PMID: 31351705, DOI: 10.1016/j.jpedsurg.2019.07.003.Peer-Reviewed Original ResearchConceptsNon-referred patientsPediatric intussusceptionPrimary anastomosisHigh-income countriesTertiary referral hospitalProspective case seriesTreatment of intussusceptionGlobal pediatric surgeryIntussusception casesMedian durationFebrile patientsReferral hospitalSurgical treatmentCase seriesSurgical interventionManual reductionFemale ratioHealth facilitiesPediatric surgeryMortality ratePatientsHigh operativeIntussusceptionResectionAverage durationUnifying Children's Surgery and Anesthesia Stakeholders Across Institutions and Clinical Disciplines: Challenges and Solutions from Uganda.
Kisa P, Grabski DF, Ozgediz D, Ajiko M, Aspide R, Baird R, Barker G, Birabwa-Male D, Blair G, Cameron B, Cheung M, Cigliano B, Cunningham D, D'Agostino S, Duffy D, Evans F, Fitzgerald TN, Galiwango G, Gerolmini D, Gerolmini M, Kakembo N, Kambugu JB, Lakhoo K, Langer M, Muhumuza MF, Muzira A, Nabukenya MT, Naik-Mathuria B, Nakku D, Nankunda J, Ogwang M, Okello I, Penny N, Reimer E, Sabatini C, Sekabira J, Situma M, Ssenyonga P, Tumukunde J, Villalona G. Unifying Children's Surgery and Anesthesia Stakeholders Across Institutions and Clinical Disciplines: Challenges and Solutions from Uganda. World Journal Of Surgery 2019, 43: 1435-1449. PMID: 30617561, DOI: 10.1007/s00268-018-04905-9.Peer-Reviewed Original ResearchBarriers to Pediatric Surgical Care in Low-Income Countries: The Three Delays' Impact in Uganda
Kakembo N, Godier-Furnemont A, Nabirye A, Cheung M, Kisa P, Muzira A, Sekabira J, Ozgediz D. Barriers to Pediatric Surgical Care in Low-Income Countries: The Three Delays' Impact in Uganda. Journal Of Surgical Research 2019, 242: 193-199. PMID: 31085367, DOI: 10.1016/j.jss.2019.03.058.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildChild, PreschoolFemaleHealth ExpendituresHealth Services AccessibilityHealth Services Needs and DemandHospitals, PediatricHumansInfantInfant, NewbornMaleOutpatient Clinics, HospitalPatient Acceptance of Health CareProspective StudiesSocioeconomic FactorsSurgical Procedures, OperativeTertiary Care CentersTime-to-TreatmentUgandaConceptsPediatric surgery outpatient clinicPediatric surgical careSurgical careSurgery outpatient clinicMajority of patientsTime of presentationPosterior sagittal anorectoplastyDefinitive surgical careCatastrophic health expenditureColostomy closureHealthcare visitsPatient ageOutpatient databaseTertiary hospitalClinic patientsOutpatient clinicSagittal anorectoplastyDefinitive carePatient expendituresHealth facilitiesPatientsCurrent visitCurrent medical issuesLow-income countriesCareBest Buy in Public Health or Luxury Expense?
Yap A, Cheung M, Muzira A, Healy J, Kakembo N, Kisa P, Cunningham D, Youngson G, Sekabira J, Yaesoubi R, Ozgediz D. Best Buy in Public Health or Luxury Expense? Annals Of Surgery 2019, Publish Ahead of Print: &na;. PMID: 30907755, PMCID: PMC6752983, DOI: 10.1097/sla.0000000000003263.Peer-Reviewed Original ResearchConceptsIncremental cost-effectiveness ratioPediatric operating roomOperating roomLife yearsPatient outcome dataPediatric surgical diseasesCost-effectiveness ratioProbabilistic sensitivity analysesDefinitive treatmentPreventable morbiditySaharan AfricaSurgical diseasePatient's perspectiveOutcome dataSurgical infrastructureSocietal perspectiveLow-income countriesPublic healthPediatricsBest buyInterventionDisabilityHospital spaceHeavy burdenYears
2018
From procedure to poverty: out-of-pocket and catastrophic expenditure for pediatric surgery in Uganda
Yap A, Cheung M, Kakembo N, Kisa P, Muzira A, Sekabira J, Ozgediz D. From procedure to poverty: out-of-pocket and catastrophic expenditure for pediatric surgery in Uganda. Journal Of Surgical Research 2018, 232: 484-491. PMID: 30463761, DOI: 10.1016/j.jss.2018.05.077.Peer-Reviewed Original ResearchConceptsHospital stayCatastrophic health care expenditurePediatric populationPatient's familyIndirect costsMedian indirect costMedian OOP costsPediatric surgical wardDirect costsDirect medical costsPediatric surgical servicesMedian direct costPediatric surgical proceduresDirect nonmedical costsHealth care expendituresPercent of respondentsPostoperative patientsSurgical wardsMulago HospitalSurgical deliveryPercent of familiesSurgical proceduresPediatric surgeryNonmedical costsSurgical servicesA Cost-Effectiveness Analysis of a Pediatric Operating Room in Uganda
Yap A, Muzira A, Cheung M, Healy J, Kakembo N, Kisa P, Cunningham D, Youngson G, Sekabira J, Yaesoubi R, Ozgediz D. A Cost-Effectiveness Analysis of a Pediatric Operating Room in Uganda. Surgery 2018, 164: 953-959. PMID: 29801729, PMCID: PMC6399742, DOI: 10.1016/j.surg.2018.03.023.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentChildChild, PreschoolCost-Benefit AnalysisDecision Making, OrganizationalDecision TreesFemaleHealth Services AccessibilityHealth Services Needs and DemandHumansInfantInfant, NewbornLife ExpectancyMaleModels, EconomicMonte Carlo MethodOperating RoomsQuality-Adjusted Life YearsSurgical Procedures, OperativeTreatment OutcomeUgandaConceptsIncremental cost-effectiveness ratioProbabilistic sensitivity analysesCost-effectiveness ratioPediatric operating roomDisability-adjusted life-year avertedStatistical life approachNet economic benefitsCost-effectiveness thresholdLife-year avertedCost-effectiveness analysisAverage life expectancySub-Saharan AfricaMonetary benefitsSensitivity analysisWorthwhile investmentEconomic benefitsOne-wayLow-income settingsTree templatePediatric surgical capacityLife approachFuture decisionsLife expectancyCostInvestment