TY  - JOUR
PY  - 2015//
TI  - Surgery for children in low-income countries affected by humanitarian emergencies from 2008 to 2014: the Médecins Sans Frontières Operations Centre Brussels experience
JO  - Journal of pediatric surgery
A1  - Flynn-O'Brien, Katherine T.
A1  - Trelles, Miguel
A1  - Dominguez, Lynette
A1  - Hassani, Ghulam Hiadar
A1  - Akemani, Clemence
A1  - Naseer, Aamer
A1  - Ntawukiruwabo, Innocent Bagura
A1  - Kushner, Adam L.
A1  - Rothstein, David H.
A1  - Stewart, Barclay T.
SP  - 659
EP  - 669
VL  - 51
IS  - 4
N2  - PURPOSE: Pediatric surgical care is deficient in developing countries disrupted by crisis. We aimed to describe pediatric surgical care at Médecins Sans Frontières-Brussels (MSF-OCB) projects to inform resource allocation and define the pediatric-specific skillset necessary for humanitarian surgical teams. <br><br>METHODS: Procedures performed by MSF-OCB from July 2008 to December 2014 were reviewed. Project characteristics, patient demographics and clinical data were described. Multivariable logistic regression was performed to determine predictors of perioperative death. <br><br>RESULTS: Of 109,828 procedures, 26,284 were performed for 24,576 children (22% of all procedures). The most common pediatric operative indication was trauma (13,984; 57%). Nine percent of all surgical indications were due to violence (e.g., land mines, firearms, gender-based violence, etc.). The majority of procedures (19,582; 75%) were general surgical, followed by orthopedic (4350; 17%), and obstetric/gynecologic/urologic (2135; 8%). Perioperative death was low (42; 0.17%); independent predictors of death included age <1year, use of general anesthesia with a definitive airway, and operation during conflict. <br><br>CONCLUSION: Surgical care for children comprised nearly a quarter of all procedures performed by MSF-OCB between 2008 and 2014. Attention to trauma surgery and infant perioperative care is particularly needed. These findings are important when resourcing projects and training surgical staff for humanitarian missions.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3468
UR  - http://dx.doi.org/10.1016/j.jpedsurg.2015.08.063
ID  - ref1
ER  -