2021
Access 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 differencesPatientsBurden 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 careEpidemiology 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 durationBarriers 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
A 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
2017
Disparity in access and outcomes for emergency neonatal surgery: intestinal atresia in Kampala, Uganda
Cairo S, Kakembo N, Kisa P, Muzira A, Cheung M, Healy J, Ozgediz D, Sekabira J. Disparity in access and outcomes for emergency neonatal surgery: intestinal atresia in Kampala, Uganda. Pediatric Surgery International 2017, 33: 907-915. PMID: 28677072, DOI: 10.1007/s00383-017-4120-5.Peer-Reviewed Original ResearchConceptsNeonatal intestinal obstructionDuodenal atresiaHigh-income countriesEmergency neonatal surgeryMethodsA retrospective reviewPoor nutrition statusMajority of deathsHigh-income country settingsUnderwent surgeryAnastomotic leakIntestinal obstructionPatient characteristicsSurgical complicationsClinical courseColonic atresiaIntestinal atresiaOverall mortalityRetrospective reviewSurgical morbidityCase seriesNeonatal surgeryPatient chartsSurgical databaseHigh morbidityLate presentation