Epidemiology and mortality of pediatric surgical conditions: insights from a tertiary center in Uganda

  • Maija CheungEmail author
  • Nasser Kakembo
  • Nensi Rizgar
  • David Grabski
  • Sarah Ullrich
  • Arlene Muzira
  • Phyllis Kisa
  • John Sekabira
  • Doruk Ozgediz
Original Article



The burden of pediatric surgical disease is largely unknown in low- and middle-income countries such as Uganda where access to care is limited.


Implementation of a locally led database in January 2012 at a Ugandan tertiary referral hospital, and review of 3465 prospectively collected pediatric surgical admissions from January 2012 to August 2016.


2090 children (60.3%) underwent surgery during admission. 59% were male and 41% female. 28.6% of admissions were in neonates and 50.4% were in children less than 1 year old. Congenital anomalies including Hirschsprung’s, anorectal malformations, intestinal atresias, omphalocele, and gastroschisis were the most common diagnoses (38.6%) followed by infections (15.0%) and tumors (8.6%). Mortality rates were substantially higher than those of high-income countries; for example, gastroschisis and intussusception had mortality rates of 90.1% and 19.7%, respectively. Post-operative mortality was highest in the congenital anomalies group (15.0%).


There is a high burden of infant congenital anomalies with higher mortality rates compared to high-income countries. The unit performs primarily specialized procedures appropriate for a tertiary center. We hope that these data will facilitate evaluation of ongoing quality improvement and capacity-building initiatives.


Global surgery Burden of disease Pediatric surgery Surgical outcomes Uganda 



Griffin Coghill for his work on the data audit examining cases between February 2016 and August 2016.


There was no external funding for this study.

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest for any of the authors.

Research involving human participants and/or animals

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

No informed consent was necessary for this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgeryYale University School of MedicineNew HavenUSA
  2. 2.Yale University School of MedicineNew HavenUSA
  3. 3.Department of SurgeryUniversity of Virginia School of MedicineCharlottesvilleUSA
  4. 4.Department of SurgeryMakerere University, Mulago HospitalKampalaUganda

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