{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:37:05Z","timestamp":1791545825930,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although prior studies have estimated the burden of pediatric surgical disease in low\u2010 and middle\u2010income countries (LMICs) through statistical modeling and hospital\u2010 or household\u2010based surveys, few large\u2010scale descriptions of procedures and outcomes have been published. We aimed to describe the epidemiology and outcomes of children's surgical care at multiple centers across Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Perioperative clinical data were collected prospectively from 2018 to 2023 at 17 hospitals in 11 African countries using a preexisting tool. Data came from children (age &lt; 18 years) who underwent a surgical procedure in facilities equipped by the NGO Kids Operating Room. Data were stored on REDCap and descriptively analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>16,454 procedures were performed, with a higher frequency of procedures performed in younger children than in older children (mean age 4.5\u00a0years). Congenital malformations, acquired genitourinary conditions, and acquired gastrointestinal conditions made up the most common diagnoses. We found a mortality rate of 3.7%, with higher mortality in neonates compared to younger children; conditions associated with the greatest mortality included congenital conditions, intestinal perforation, burns, and intussusception. Emergent operations were associated with much higher rates of mortality than elective operations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For the first time at this scale, we have assessed the epidemiology and outcomes of pediatric surgical care in LMICs. Findings were consistent with studies on the burden of disease, with a larger proportion of younger children accessing surgery, comparable mortality to other African studies, and higher mortality than in HICs. Future research and multilevel advocacy are needed to identify gaps in care and to design more effective interventions to reduce global disparities in access to surgical care for children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70066","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T03:54:06Z","timestamp":1757130846000},"page":"3163-3172","source":"Crossref","is-referenced-by-count":4,"title":["Current Landscape of Children's Surgery in Africa: A Multicenter Analysis of 16,000 Cases"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3405-8046","authenticated-orcid":false,"given":"Phillip J.","family":"Hsu","sequence":"first","affiliation":[{"name":"Department of Surgery University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4255-2527","authenticated-orcid":false,"given":"Alan","family":"Zambeli\u2010Ljepovic","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bolusefe Tijesuni","family":"Olatunji\u2010Banire","sequence":"additional","affiliation":[{"name":"Kids Operating Room  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawan","family":"Mathew","sequence":"additional","affiliation":[{"name":"Department of Surgery Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Axt","sequence":"additional","affiliation":[{"name":"Department of Surgery Kijabe Hospital  Kijabe Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierno","family":"Diallo","sequence":"additional","affiliation":[{"name":"Department of Surgery H\u00f4pital G\u00e9n\u00e9ral Idrissa Pouye  Dakar Senegal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekonen","family":"Eshete","sequence":"additional","affiliation":[{"name":"Surgical Department School of Medicine Addis Ababa University College of Health Sciences  Addis Ababa Ethiopia"},{"name":"Yekatit 12 Hospital Medical College Plastic and Reconstructive Surgery Department  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertille","family":"Ki","sequence":"additional","affiliation":[{"name":"CHU Pediatrique Charles de Gaulle  Ouagadougou Burkina Faso"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Macharia","sequence":"additional","affiliation":[{"name":"Department of Surgery Meru Teaching and Referral Hospital  Meru Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Ngock","sequence":"additional","affiliation":[{"name":"Department of Surgery Mbingo Hospital  Baingo Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Absalat","family":"Serawit","sequence":"additional","affiliation":[{"name":"Yekatit 12 Hospital Medical College Plastic and Reconstructive Surgery Department  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Bryce","sequence":"additional","affiliation":[{"name":"Kids Operating Room  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doruk","family":"Ozgediz","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maija","family":"Cheung","sequence":"additional","affiliation":[{"name":"Kids Operating Room  Edinburgh Scotland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010018\u201004887\u20108"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(21)00767\u20104"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2015.09.004"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(15)60830\u20103"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/aln.0000000000003070"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001\u2010023\u201001613\u20106"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(24)00103\u2010x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.01.059"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383\u2010015\u20103684\u20101"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383\u2010016\u20103957\u20103"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20101996\u20107"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo\u20102022\u2010001603"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010022\u201006503\u20102"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2022.09.021"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0170968"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887\u2010022\u201003576\u20109"},{"key":"e_1_2_10_18_1","article-title":"Surgery and the First 8000 Days of Life: A Review","volume":"18","author":"Seyi\u2010Olajide J.","year":"2024","journal-title":"International Health"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010019\u201005340\u20100"},{"key":"e_1_2_10_20_1","volume-title":"Accelerate Progress Towards Reducing Maternal, Newborn and Child Mortality in Order to Achieve Sustainable Development Goal Targets 3.1 and 3.2","author":"The Seventy\u2010Seventh World Health Assembly","year":"2024"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383\u2010024\u201005748\u20103"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.02.012"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010019\u201004991\u20103"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.03.058"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.146.1ma4.278"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995\u2010016\u20102210\u2010y"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/aco.0000000000001122"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0187293"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2023.05.010"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010022\u201006463\u20107"},{"key":"e_1_2_10_31_1","unstructured":"Global Initiative for Children\u2019s Surgery Africa Surgical Initiative 2030[Internet] (2023) https:\/\/www.globalchildrenssurgery.org\/download\/dakar\u2010declaration\u2010africa\u2010surgical\u2010initiative\u20102030\/."},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003635"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2024.111407"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2024.2354002"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sempedsurg.2023.151355"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010023\u201007229\u20105"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.xcs.0000893820.38417.54"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0093784"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2005.12.004"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/mpg.0000000000002487"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyz028"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010023\u201007097\u2010z"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.2147\/phmt.s451832"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1136\/wjps\u20102022\u2010000473"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41182\u2010021\u201000385\u20101"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000005105"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70066","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/wjs.70066","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.70066","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T11:10:05Z","timestamp":1771153805000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.70066"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":45,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/wjs.70066"],"URL":"https:\/\/doi.org\/10.1002\/wjs.70066","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}