Global MedicineValidation of a community-based survey assessing nonobstetric surgical conditions in Burera District, Rwanda
Section snippets
Methods
A structured interview questionnaire to assess for the presence or absence of 10 index surgical conditions was created (Table I). Households in the Burera District were sampled randomly with inclusion of all individuals within the household. Results from the questionnaire were compared with the “gold standard” of a physician physical examination of participants included in the survey.
Results
Of the 690 households eligible for the study, 668 consented to the survey, yielding 2,990 individuals whose data were collected with the structured interview tool (Figure). Of these, 2,094 individuals (70%) were available for physical examinations. The study results are limited to these individuals available for both the survey and the physical examination.
Of the 2,094 study participants (from the 668 households), 27% (n = 561) responded for themselves on the structured interview. For the
Discussion
Community-based studies are important for understanding the true need for surgical care in many countries. This is especially relevant in low-income countries where operative logs and health management information systems data on procedures performed provide insufficient estimates because of widespread lack of access to surgical care. This study sought to validate a community-based survey for collecting surgical data in a rural district in Rwanda. Results revealed a low sensitivity and a high
References (46)
- et al.
Alternative projections of mortality and disability by cause 1990–2020: global burden of disease study
Lancet
(1997) - et al.
An estimation of the global volume of surgery: a modeling strategy based on available data
Lancet
(2008) - et al.
Global operating theatre distribution and pulse oximetry supply: an estimation from reported data
Lancet
(2010) - et al.
Untreated surgical conditions in Sierra Leone: a cluster randomized, cross-sectional, countrywide survey
Lancet
(2012) - et al.
Estimating operative disease prevalence in a low-income country: results of a nationwide population survey in Rwanda
Surgery
(2013) - et al.
Development and validation of a ten-item questionnaire with explanatory illustrations to assess upper extremity disorders: favorable effect of illustrations in the item reduction process
J Orthop Sci
(2011) - et al.
Obstetric fistula in low-income countries
Int J Gynaecol Obstet
(2009) - et al.
Prevalence of hydrocele as a rapid diagnostic index for lymphatic filariasis
Trans R Soc Trop Med Hyg
(1998) - et al.
Agreement between patient survey and medical chart: pitfalls in measurement strategies for hernia recurrence
Surgery
(2011) - et al.
Surgery and global health: a view from beyond the OR
World J Surg
(2008)
Primary care: now more than ever. (World Health Report)
Major and minor surgery output at district level in Kenya: review and issues in need of further research
Afr J Health Sci
Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana
World J Surg
Output of major surgery in developing countries
Trop Geogr Med
Essential surgery at the district hospital: a retrospective descriptive analysis in three African countries
PLoS Med
Human resource and funding constraints for essential surgery in district hospitals in Africa: a retrospective cross-sectional survey
PLoS Med
Surgery
Key concepts for estimating the burden of surgical conditions and the unmet need for surgical care
World J Surg
Development and validation of a questionnaire to identify severe maternal morbidity in epidemiological surveys
Reprod Health
Low utilization of formal medical services by injured persons in a developing nation: health service data underestimate the importance of trauma
J Trauma
Injury, disability and access to care in Rwanda: results of a nationwide cross-sectional population study
World J Surg
Untreated head and neck surgical disease in Sierra Leone: a cross-sectional, countrywide survey
Otolaryngol Head Neck Surg
Prevalence of breast masses and barriers to care: results from a population-based survey in Rwanda and Sierra Leone
J Surg Oncol
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Institution of origination: Harvard Medical School.
Funding: Harvard Sheldon Traveling Fellowship. This was used to assist with data collection.
This manuscript was part of the Lancet Commission on Global Surgery.
B.L.H.-G. received support from the Department of Global Health and Social Medicine Research Core at Harvard Medical School.
Conflict of Interest: All authors report no biomedical financial interests or potential conflicts of interest.