Browsing by Author "Niyonkuru, Francine"

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    Estimating Operative Disease Prevalence in a Low-income Country: Results of a Nationwide Population Survey in Rwanda
    (MOSBY-ELSEVIER , 360 PARK AVENUE SOUTH, NEW YORK, USA, NY, 10010-1710, 2013) Petroze, Robin T; Groen, Reinou S; Niyonkuru, Francine; Mallory, Melissa; Ntaganda, Edmond; Joharifard, Shahrzad; Guterbock, Thomas M; Kushner, Adam L; Kyamanywa, Patrick; Calland, J Forrest
    Background. Operative disease is estimated to contribute to 11% of the global burden of disease, but no studies have correlated this figure to operative burden at the community level. We describe a survey tool that evaluates population-based prevalence of operative conditions and its first full-country implementation in Rwanda. Methods. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool is a cross-sectional, cluster-based population survey designed to measure conditions that may necessitate an operative consultation or intervention. Household surveys in Rwanda were conducted in October 2011 in 52 clusters nationwide. Data were population-weighted and analyzed with the use of descriptive statistics. Results. A total of 1626 households (3175 individuals) were sampled with a 99% response rate. 41.2% (95% confidence interval [95 CI%] 38.8–43.6%) of the population has had at least one operative condition during their lifetime, 14.8% (95% CI 13.3–16.5%) had an operative condition during the previous 12 months, and 6.4% (95% CI 5.6–7.3%) of the population were determined to have a current operative condition. A total of 55.3% of the current operative need was found in female respondents and 40.3% in children younger than 15 years of age. A total of 32.9% of household deaths in the previous year may have been related to operative conditions, and 55.0% of responding households lacked funds for transport to the nearest hospital providing general practitioner operative services. Conclusion. The SOSAS survey tool provides important insight into the burden of operative disease in the community. Our results show a high need for operative care, which has important implications for the global operative community as well as for local health system strengthening in Rwanda. (Surgery 2012)
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    Estimating Pediatric Surgical Need in Developing Countries: A Household Survey in Rwanda
    (W B Saunders Co-Elsevier Inc , 1600 John F Kennedy Boulevard, Ste 1800, Philadelphia, Usa, Pa, 19103-2899, 2014) Petroze, Robin T; Calland, J Forrest; Niyonkuru, Francine; Groen, Reinou S; Kyamanywa, Patrick; Li, Yue; Guterbock, Thomas M; Rodgers, Bradley M; Rasmussen, Sara K
    Purpose Surgical services for children are often absent in resource-limited settings. Identifying the prevalence of surgical disease at the community level is important for developing evidence-based pediatric surgical services and training. We hypothesize that the untreated surgical conditions in the pediatric population are largely uncharacterized and that such burden is significant and poorly understood. Furthermore, no such data exist at the population level to describe this population. Methods We conducted a nationwide cross-sectional cluster-based population survey to estimate the magnitude of surgical disease in Rwanda. Conducted as a verbal questionnaire, questions included representative congenital, acquired, malignant and injury-related conditions. Pediatric responses were analyzed using descriptive statistics and univariate analysis. Results A total of 1626 households (3175 individuals) were sampled with a 99% response rate; 51.1% of all individuals surveyed were younger than age 18. An estimated 50.5% of the total current surgical need occurs in children. Of all Rwandan children, 6.3% (95% CI 5.4%–7.4%), an estimated 341,164 individuals, were identified to have a potentially treatable surgical condition at the time of the interview. The geographic distribution of surgical conditions significantly differed between adults and children (p < 0.001). Conclusions The results emphasize the magnitude of the pediatric surgery need as well as the need for improved education and resources. This may be useful in developing a collaborative local training program.