{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T18:49:03Z","timestamp":1763837343144,"version":"3.44.0"},"reference-count":31,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006317","name":"Association for Academic Surgery","doi-asserted-by":"publisher","award":["Global Surgery Research Fellowship"],"award-info":[{"award-number":["Global Surgery Research Fellowship"]}],"id":[{"id":"10.13039\/100006317","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ruth L. Kirschstein National Research Service Award","award":["2T32AR67708-6"],"award-info":[{"award-number":["2T32AR67708-6"]}]},{"DOI":"10.13039\/100001949","name":"American Society of Tropical Medicine and Hygiene","doi-asserted-by":"publisher","award":["Benjamin Keane Fellowship"],"award-info":[{"award-number":["Benjamin Keane Fellowship"]}],"id":[{"id":"10.13039\/100001949","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Johns Hopkins School of Medicine Deans Summer Research Fellowship","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["World Jnl Ped Surgery"],"accepted":{"date-parts":[[2023,4,24]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There are 103 million displaced people worldwide, 41% of whom are children. Data on the provision of surgery in humanitarian settings are limited. Even scarcer is literature on pediatric surgery performed in humanitarian settings, particularly protracted humanitarian settings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed patterns, procedures, and indications for pediatric surgery among children in Nyarugusu Refugee Camp using a 20-year retrospective dataset.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1221 pediatric surgical procedures were performed over the study period. Teenagers between the ages of 12 and 17 years were the most common age group undergoing surgery (n=991; 81%). A quarter of the procedures were performed on local Tanzanian children seeking care in the camp (n=301; 25%). The most common procedures performed were cesarean sections (n=858; 70%), herniorrhaphies (n=197; 16%), and exploratory laparotomies (n=55; 5%). Refugees were more likely to undergo exploratory laparotomy (n=47; 5%) than Tanzanian children (n=7; 2%; p=0.032). The most common indications for exploratory laparotomy were acute abdomen (n=24; 44%), intestinal obstruction (n=10; 18%), and peritonitis (n=9; 16%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is a significant volume of basic pediatric general surgery performed in the Nyarugusu Camp. Services are used by both refugees and local Tanzanians. We hope this research will inspire further advocacy and research on pediatric surgical services in humanitarian settings worldwide and illuminate the need for including pediatric refugee surgery within the growing global surgery movement.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/wjps-2022-000528","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T09:15:16Z","timestamp":1687338916000},"page":"e000528","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Patterns, procedures, and indications for pediatric surgery in a Tanzanian Refugee Camp: a 20-year experience"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7890-1018","authenticated-orcid":false,"given":"Sarah","family":"Rapaport","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary Obinna","family":"Enumah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilary","family":"Ngude","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S","family":"Rhee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Lekey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J","family":"Winch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph V","family":"Sakran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kent A","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"2025081810054145000_6.3.e000528.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60160-X"},{"key":"2025081810054145000_6.3.e000528.2","doi-asserted-by":"crossref","first-page":"254","DOI":"10.2471\/BLT.18.216028","article-title":"Estimates of number of children and adolescents without access to surgical care","volume":"97","author":"Mullapudi","year":"2019","journal-title":"Bull World Health Organ"},{"key":"2025081810054145000_6.3.e000528.3","first-page":"829","article-title":"Surgical services for children in developing countries","volume":"80","author":"Bickler","year":"2002","journal-title":"Bull World Health Organ"},{"key":"2025081810054145000_6.3.e000528.4","unstructured":"UNHCR . Refugees UNHC for. UNHCR-refugee statistics. Available: https:\/\/www.unhcr.org\/refugee-statistics\/ [Accessed 30 Apr 2021]."},{"key":"2025081810054145000_6.3.e000528.5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1080\/13623699.2019.1635279","article-title":"Multi-trauma injuries and level of preparedness in transit refugee camps: a case in idomeni, Greece","volume":"35","author":"Gargavanis","year":"2019","journal-title":"Med Confl Surviv"},{"key":"2025081810054145000_6.3.e000528.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-014-0424-5"},{"key":"2025081810054145000_6.3.e000528.7","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1505-5-12","article-title":"Providing surgical care in Somalia: a model of task shifting","volume":"5","author":"Chu","year":"2011","journal-title":"Confl Health"},{"key":"2025081810054145000_6.3.e000528.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12893-021-01365-2","article-title":"Epidemiology of surgery in a protracted humanitarian setting: a 20-year retrospective study of Nyarugusu Refugee Camp, Kigoma, Western Tanzania","volume":"21","author":"Rapaport","year":"2021","journal-title":"BMC Surg"},{"key":"2025081810054145000_6.3.e000528.9","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1505-6-5","article-title":"Evaluation of a surgical service in the chronic phase of a refugee camp: an example from the Thai-Myanmar border","volume":"6","author":"Weerasuriya","year":"2012","journal-title":"Confl Health"},{"key":"2025081810054145000_6.3.e000528.10","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1505-4-6","article-title":"Surgical care for the direct and indirect victims of violence in the eastern Democratic Republic of Congo","volume":"4","author":"Chu","year":"2010","journal-title":"Confl Health"},{"key":"2025081810054145000_6.3.e000528.11","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.1007\/s00268-012-1899-z","article-title":"Burden of surgically correctable disabilities among children in the Dadaab Refugee Camp","volume":"37","author":"Wu","year":"2013","journal-title":"World J Surg"},{"key":"2025081810054145000_6.3.e000528.12","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1001\/jamasurg.2015.1928","article-title":"Surgical care of pediatric patients in the humanitarian setting: the M\u00e9decins sans Fronti\u00e8res experience, 2012-2013","volume":"150","author":"Trudeau","year":"2015","journal-title":"JAMA Surg"},{"key":"2025081810054145000_6.3.e000528.13","unstructured":"ReliefWeb . Tanzania refugee population update (as of 28 February 2021)-United Republic of Tanzania. Available: https:\/\/reliefweb.int\/report\/united-republic-tanzania\/tanzania-refugee-population-update-28-february-2021 [Accessed 14 May 2021]."},{"key":"2025081810054145000_6.3.e000528.14","unstructured":"ReliefWeb . North-West Tanzania-nyarugusu refugee cAMP profile (31 July 2018)-United Republic of Tanzania. Available: https:\/\/reliefweb.int\/report\/united-republic-tanzania\/north-west-tanzania-nyarugusu-refugee-camp-profile-31-july-2018 [Accessed 22 Mar 2021]."},{"key":"2025081810054145000_6.3.e000528.15","unstructured":"UNHCR . Refugees UNHC for. UNHCR\u2019s principles and guidance for referral health care for refugees and other persons of concern. Available: https:\/\/www.unhcr.org\/protection\/health\/4b4c4fca9\/unhcrs-principles-guidance-referral-health-care-refugees-other-persons.html [Accessed 22 Mar 2021]."},{"key":"2025081810054145000_6.3.e000528.16","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-022-03576-9","article-title":"Prevalence of pediatric surgical problems among East African refugees: estimates from a cross-sectional survey using random cluster sampling","volume":"22","author":"Enumah","year":"2022","journal-title":"BMC Pediatr"},{"key":"2025081810054145000_6.3.e000528.17","doi-asserted-by":"crossref","DOI":"10.11604\/pamj.2022.41.76.32559","article-title":"Patterns of referral for refugees in Western Tanzania: a retrospective review","volume":"41","author":"Abrahim","year":"2022","journal-title":"Pan Afr Med J"},{"key":"2025081810054145000_6.3.e000528.18","doi-asserted-by":"crossref","first-page":"114837","DOI":"10.1016\/j.socscimed.2022.114837","article-title":"Therapeutic citizens or therapeutic refugees? An examination of triage, refugeehood, and referral health care in Tanzania","volume":"298","author":"Enumah","year":"2022","journal-title":"Soc Sci Med"},{"key":"2025081810054145000_6.3.e000528.19","doi-asserted-by":"crossref","first-page":"3224","DOI":"10.1007\/s00268-020-05603-1","article-title":"Surgical needs of internally displaced persons in Kerenik, West Darfur, Sudan","volume":"44","author":"Kuwayama","year":"2020","journal-title":"World J Surg"},{"key":"2025081810054145000_6.3.e000528.20","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1093\/jbcr\/irz080","article-title":"Pediatric burns among refugee communities in Lebanon: evidence to inform policies and programs","volume":"40","author":"Al-Hajj","year":"2019","journal-title":"J Burn Care Res"},{"key":"2025081810054145000_6.3.e000528.21","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.jpedsurg.2014.01.059","article-title":"Estimating pediatric surgical need in developing countries: a household survey in Rwanda","volume":"49","author":"Petroze","year":"2014","journal-title":"J Pediatr Surg"},{"key":"2025081810054145000_6.3.e000528.22","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-042969","article-title":"Geospatial analysis of pediatric surgical need and geographical access to care in Somaliland: a cross-sectional study","volume":"11","author":"Cotache-Condor","year":"2021","journal-title":"BMJ Open"},{"key":"2025081810054145000_6.3.e000528.23","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-013-1996-7"},{"key":"2025081810054145000_6.3.e000528.24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0223423","article-title":"Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool: implications for paediatric surgical capacity-building","volume":"14","author":"Ademuyiwa","year":"2019","journal-title":"PLoS One"},{"key":"2025081810054145000_6.3.e000528.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0205132","article-title":"Rural and urban differences in treatment status among children with surgical conditions in Uganda","volume":"13","author":"Bearden","year":"2018","journal-title":"PLoS One"},{"key":"2025081810054145000_6.3.e000528.26","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-018-04887-8"},{"key":"2025081810054145000_6.3.e000528.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-045981","article-title":"Global and regional overview of the inclusion of paediatric surgery in the National health plans of 124 countries: an ecological study","volume":"11","author":"Landrum","year":"2021","journal-title":"BMJ Open"},{"key":"2025081810054145000_6.3.e000528.28","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1007\/s00268-020-05892-6","article-title":"Analysing the operative experience of paediatric surgical trainees in sub-Saharan Africa using a web-based logbook","volume":"45","author":"Mooney","year":"2021","journal-title":"World J Surg"},{"key":"2025081810054145000_6.3.e000528.29","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s00383-021-05027-5","article-title":"Training low-middle-income (LMIC) pediatric surgeons in a high-income country (HIC) program","volume":"38","author":"Baird","year":"2022","journal-title":"Pediatr Surg Int"},{"key":"2025081810054145000_6.3.e000528.30","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1016\/j.jpedsurg.2019.11.012","article-title":"North American pediatric surgery fellows\u2019 preparedness for humanitarian surgery","volume":"55","author":"Traynor","year":"2020","journal-title":"J Pediatr Surg"},{"key":"2025081810054145000_6.3.e000528.31","unstructured":"KidsOR . First ever children\u2019s operating room in a refugee camp. Available: https:\/\/www.kidsor.org\/news\/the-worlds-first-childrens-operating-room-in-a-refugee-camp\/ [Accessed 25 Jan 2022]."}],"container-title":["World Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/wjps-2022-000528","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T17:05:52Z","timestamp":1755536752000},"score":1,"resource":{"primary":{"URL":"https:\/\/wjps.bmj.com\/lookup\/doi\/10.1136\/wjps-2022-000528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,6,21]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/wjps-2022-000528"],"URL":"https:\/\/doi.org\/10.1136\/wjps-2022-000528","relation":{},"ISSN":["2516-5410"],"issn-type":[{"type":"electronic","value":"2516-5410"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}