Optimizing care for ugandans with untreated abdominal surgical conditions

Elissa K. Butler, Tu M. Tran, Anthony T. Fuller, Christine Muhumuza, Sarah Williams, Joao R.N. Vissoci, Samuel Luboga, Michael M. Haglund, Fredrick Makumbi, Moses Galukande, Jeffrey G Chipman

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1 Scopus citations


Background: Abdominal operations account for a majority of surgical volume in low-income countries, yet population-level prevalence data on surgically treatable abdominal conditions are scarce. Objective: In this study, our objective was to quantify the burden of surgically treatable abdominal conditions in Uganda. Methods: In 2014, we administered a two-stage cluster-randomized Surgeons OverSeas Assessment of Surgical Need survey to 4,248 individuals in 105 randomly selected clusters (representing the national population of Uganda). Findings: Of the 4,248 respondents, 185 reported at least one surgically treatable abdominal condition in their lifetime, giving an estimated lifetime prevalence of 3.7% (95% CI: 3.0 to 4.6%). Of those 185 respondents, 76 reported an untreated condition, giving an untreated prevalence of 1.7% (95% CI: 1.3 to 2.3%). Obstructed labor (52.9%) accounted for most of the 238 abdominal conditions reported and was untreated in only 5.6% of reported conditions. In contrast, 73.3% of reported abdominal masses were untreated. Conclusions: Individuals in Uganda with nonobstetric abdominal surgical conditions are disproportionately undertreated. Major health system investments in obstetric surgical capacity have been beneficial, but our data suggest that further investments should aim at matching overall surgical care capacity with surgical need, rather than focusing on a single operation for obstructed labor.

Original languageEnglish (US)
Article number50
JournalAnnals of global health
Issue number1
StatePublished - 2019

Bibliographical note

Funding Information:
Duke Global Health Institute, Duke University Department of Neurosurgery, University of Minnesota Department of Surgery, Makerere University College of Health Sciences, and Johnson & Johnson Family of Companies. The funding sources did not directly influence or direct any element of study design, data collection, data analysis, or authorship.

Publisher Copyright:
© 2019 The Author(s).


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