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Burden of surgically correctable disabilities among children in the Dadaab Refugee Camp.

Abstract：

BACKGROUND:Surgery is increasingly recognized as a means to reduce the morbidity and mortality of disabling impairments in resource-limited environments. We sought to estimate the burden of surgically correctable disabling impairments and the cost-effectiveness of their treatment among children in a large refugee camp. METHODS:This is a chart review of all patients aged 0-18 years from Dadaab Refugee Camp (Kenya) treated at a facility primarily responsible for providing pediatric surgical care in the region. Total disability-adjusted life years (DALYs) averted were calculated using life expectancy tables and established or estimated disability weights. A sensitivity analysis was performed using various life expectancy tables. Delayed averted DALYs caused by delay in care were also estimated. Inpatient costs were collected to perform a cost-effectiveness analysis. RESULTS:Between 2005 and 2011 a total of 640 procedures were performed on 341 patients. The median age at surgery was 4.6 years, and 33 % of the children treated were female. Only 13.5 % of surgeries estimated as required for common congenital surgical conditions were actually performed. The total number of DALYs averted ranged from 4,136 to 9,529 (6.4-14.8 per patient), depending on the calculation method used. Cost-effectiveness analysis resulted in values of $40-$88 per DALY. CONCLUSIONS:The burden of pediatric surgical disabling impairments in refugee camps is substantial. Surgical intervention to address this burden is both feasible and cost-effective. Such intervention can significantly decrease the burden of disability among children affected by armed conflicts.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Wu VK,Poenaru D

doi

10.1007/s00268-012-1899-z

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

1536-43

issue

7

eissn

0364-2313

issn

1432-2323

journal_volume

37

pub_type

杂志文章

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