Background: Uganda’s ageing population (age 50 years and older) will nearly double from 2015 to 2050. HIV/AIDS, diabetes, stroke among other disease processes have been studied in the elderly population. However, the burden of disease from surgically- treatable conditions is unknown. Objectives: To determine the proportion of adults above 50 years with unmet surgical need and deaths attributable to probable surgically-treatable conditions. Methods: A cluster randomized sample representing the national population of Uganda was enumerated. The previously validated Surgeons Overseas assessment of surgical need instrument, a head-to-toe verbal interview, was used to determine any surgically- treatable conditions in two randomly-selected living household members. Deaths were detailed by heads of households. Weighted metrics are calculated taking sampling design into consideration and Taylor series linearization was used for sampling error estimation. Results: The study enumerated 425 individuals above age 50 years. The prevalence proportion of unmet surgical need was 27.8% (95%CI, 22.1-34.3). This extrapolates to 694,722 (95%CI, 552,279-857,157) individuals living with one or more surgically treatable conditions. The North sub-region was observed to have the highest prevalence proportion. Nearly two out of five household deaths (37.9%) were attributed to probable surgically treatable causes. Conclusion: There is disproportionately high need for surgical care among the ageing population of Uganda with approximately 700,000 consultations needed.
Bibliographical noteFunding Information:
This work would not be possible without the Uganda Bureau of Statistics collaboration and assistance in sampling design, guidance on implementing health surveys, and consultation in the analysis phase. We thank the UganUganda Ministry of Health Office of the Director of Planning and Makerere College of Health Sciences Office of the Principal for institutional support. We thank the enumerators and field supervisors for their dedication to data quality and the field supervisors for their leadership of implementation: Samuel Kagongwe, Mark Kashaija, Sheila Kisakye, Mable Luzze, Hassard Sempeera. SOSAS Uganda was the first population survey to benefit from the generous collaboration of the Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health, whose visionary leaders Professors Scott Radloff and Amy Tsui have made such collaborations possible. We are grateful to the Surgeons OverSeas organization, Dr. Reinou Groen, Dr. Shailvi Gupta, Dr. Adam Kushner, for guidance from initial design to numerous manuscripts. We dedicate this report in memory of Mr. Allan Ssekindi and Ms. Irene Tusiime, whose lives were tragically cut short. Funding for this national survey was provided by the Duke Global Health Institute, Duke University Department of Neurosurgery, University of Minnesota Department of Surgery, Makerere University College of Health Sciences, and Johnson and Johnson Family of Companies. Funding sources played no role in study design, data collection, data analysis, or writing of the manuscript. All authors had full access to the data and executed their decision to submit this manuscript to your journal for publication.
- Ageing population
- Surgical need