A retrospective review of gastroschisis epidemiology and referral patterns in northern Ghana

Purpose To describe the epidemiology and referral patterns of gastroschisis patients in northern Ghana. Methods A hospital-based retrospective review was undertaken at Tamale Teaching Hospital (TTH) Neonatal Intensive Care Unit (NICU) between 2014 and 2019. Data from gastroschisis patients were comp...

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Bibliographic Details
Published in:Pediatric surgery international 2021-08, Vol.37 (8), p.1069-1078
Main Authors: Abdul-Mumin, Alhassan, Cotache-Condor, Cesia, Owusu, Sheila A., Grimm, Andie, Mahama, Haruna, Wright, Naomi, Abantanga, Francis A., Smith, Emily R., Tabiri, Stephen
Format: Article
Language:English
Subjects:
Annual reports
Birth weight
Births
Data collection
Demographics
Epidemiology
Gastrointestinal surgery
Infant mortality
Intensive care
Medical referrals
Medicine
Medicine & Public Health
Original Article
Patients
Pediatric Surgery
Pediatrics
Spatial analysis
Surgery
Teaching hospitals
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Summary:Purpose To describe the epidemiology and referral patterns of gastroschisis patients in northern Ghana. Methods A hospital-based retrospective review was undertaken at Tamale Teaching Hospital (TTH) Neonatal Intensive Care Unit (NICU) between 2014 and 2019. Data from gastroschisis patients were compared to patients with other surgical diagnoses. Descriptive and inferential statistics were performed with SAS. Referral flow maps were made with ArcGIS. Results From a total of 360 neonates admitted with surgical conditions, 12 (3%) were diagnosed with gastroschisis. Around 91% ( n  = 10) of gastroschisis patients were referred from other hospitals, traveling 4 h, on average. Referral patterns showed gastroschisis patients were admitted from three regions, whereas patients with other surgical diagnoses were admitted from eight regions. Only 6% (12/201) of expected gastroschisis cases were reported during the 6-year period in all regions. All gastroschisis deaths occurred within the first week of life. Conclusions Improving access to surgical care and reducing neonatal mortality related to gastroschisis in northern Ghana is critical. This study provides a baseline to inform future gastroschisis interventions at TTH. Priority areas may include special management of low birth weight newborns, better referral systems, empowerment of community health workers, and increasing access to timely, affordable, and safe neonatal transport.
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-021-04898-y