Background Noncommunicable diseases, including those requiring surgical care, are increasingly straining low- and middle-income countries. Globally, 11% of all disability-adjusted life-years lost result from conditions requiring surgery; however, little is known about country-specific burden. We piloted a household-based survey in a periurban district of Uganda to estimate the prevalence of surgical conditions and to identify logistical challenges. Methods Our sample comprised 57 households in 5 enumeration areas in the Wakiso District, in central Uganda. Our survey tool was the Surgeons OverSeas Assessment of Surgical need. A household representative completed demographic and household death information, and 2 randomly selected household members completed questions on surgical conditions. Results Of 96 participants, 6 (6.3%; 95% CI, 2.3-13.1) had an existing, untreated surgical condition. The lifetime prevalence of surgical conditions was 26% (25/96). The most common barrier to access to care was lack of financial resources. Of the 3 deaths reported, 2 were associated with surgery. The mean household interview time was 36 minutes. The greatest challenge was efficient coordination with local team members and government officials. Conclusion In this setting, the current prevalence of surgical conditions was nearly 1 in 10 persons, and lifetime occurrence was high, at 1 in 4 persons. Addressable challenges led to question revisions and a change in the data collection platform. A full-country study is both feasible and necessary to characterize the met and unmet need for surgical care in Uganda.
Bibliographical noteFunding Information:
Funding was provided by the Duke Global Health Institute and, in part, by the Doris Duke Charitable Foundation through a grant supporting the Doris Duke International Clinical Research Fellows Program at the University of Minnesota. E.K.B. is a Doris Duke International Clinical Research Fellow. The authors thank the Uganda Bureau of Statistics for offering methodological advice and for providing randomized EAs. The authors thank the Uganda Ministry of Health and the Makerere University College of Health Sciences for institutional support. The authors thank Surgeons OverSeas for providing the survey tool as well as technical and logistical advice. The authors thank Mary Knatterud for critical review of the manuscript. Finally, the authors thank the enumerators and field supervisors for their dedication to data quality.
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Copyright 2015 Elsevier B.V., All rights reserved.