{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T15:07:16Z","timestamp":1777907236010,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T00:00:00Z","timestamp":1558310400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Trop Doct"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>In sub-Saharan Africa, there is a high burden of paediatric surgical conditions and a paucity of data regarding outcomes of congenital colorectal anomalies. A retrospective, descriptive analysis utilizing the Kamuzu Central Hospital (Lilongwe, Malawi) paediatric acute care surgery database (age\u2009\u2264\u200918 years) over 44 months was performed. Of the 133 children presenting, 82 had Hirschsprung disease (HD) (2.4\u2009\u00b1\u20092.7 years) and 51 had anorectal malformations (ARM) (1.8\u2009\u00b1\u20092.4 years). Of the latter, 51.0% underwent surgery, mainly exploratory laparotomy (n\u2009=\u200915, 57.7%) and posterior sagittal anorectoplasty (n\u2009=\u20097, 26.9%). Of those with HD, 50.0% underwent operative intervention (77.3% boys), including exploratory laparotomy (n\u2009=\u200917, 41.5%) and definitive pull-through (n\u2009=\u20098, 19.5%). A dearth of expert paediatric surgeons and limited exposure to paediatric conditions in general surgeons limits definitive surgery. An emphasis on paediatric surgical training and improvement of referral networks for definitive therapy will improve patient outcomes.<\/jats:p>","DOI":"10.1177\/0049475519851010","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T01:50:35Z","timestamp":1558403435000},"page":"256-259","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Characteristics and outcomes in paediatric patients presenting with congenital colorectal diseases in sub-Saharan Africa"],"prefix":"10.1177","volume":"49","author":[{"given":"Laura","family":"Purcell","sequence":"first","affiliation":[{"name":"General Surgery Resident, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Ngwira","sequence":"additional","affiliation":[{"name":"General Surgery Resident, Kamuzu Central Hospital, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared","family":"Gallaher","sequence":"additional","affiliation":[{"name":"General Surgery Resident, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce","family":"Cairns","sequence":"additional","affiliation":[{"name":"Consultant Surgeon, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7332-4354","authenticated-orcid":false,"given":"Anthony","family":"Charles","sequence":"additional","affiliation":[{"name":"Consultant Surgeon, Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"},{"name":"Consultant Surgeon, Kamuzu Central Hospital, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,5,20]]},"reference":[{"key":"bibr1-0049475519851010","volume-title":"Congenital anomalies: fact sheet no. 370","author":"World Health Organization","year":"2012"},{"key":"bibr2-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.03.001"},{"key":"bibr3-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951113001194"},{"key":"bibr4-0049475519851010","first-page":"269","volume":"5","author":"Trusler GA","year":"1962","journal-title":"Can J Surg"},{"key":"bibr5-0049475519851010","doi-asserted-by":"crossref","unstructured":"Teltelbaum DH and Coran AG. Hirschsprung Disease and Related Neuro-muscular Disorders of the Intestine. In: O\u2019Neill JA Jr, Fonkasrud EW, Conan AG, et\u00a0al. (eds).\n                      Hirschsprung\u2019s Disease and Related Neuromuscular Disorders of the Intestine\n                      . 6th ed. Philadelphia, PA: Mosby-Elsevier, 2006: 1514\u20131559.","DOI":"10.1016\/B978-0-323-02842-4.50102-9"},{"key":"bibr6-0049475519851010","first-page":"96","volume":"64","author":"Meza-Valencia BE","year":"2005","journal-title":"Hirschsprung\u2019s disease in the U.S. associated Pacific Islands: more common than expected. 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Congenital abnormalities of rectum and anus.\n                      Curr Probl Surg\n                      1965: 1\u201364.","DOI":"10.1016\/S0011-3840(77)80068-3"},{"key":"bibr13-0049475519851010","doi-asserted-by":"publisher","DOI":"10.4103\/0189-6725.132802"},{"key":"bibr14-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-010-2641-2"},{"key":"bibr15-0049475519851010","doi-asserted-by":"publisher","DOI":"10.4103\/0971-9261.43023"},{"key":"bibr16-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(00)00491-8"},{"key":"bibr17-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1016\/S1479-666X(07)80083-7"},{"key":"bibr18-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0229-6"},{"key":"bibr19-0049475519851010","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3280c60c78"},{"key":"bibr20-0049475519851010","volume":"62","author":"Hodges SC","year":"2007","journal-title":"Anaesthesia"}],"container-title":["Tropical Doctor"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0049475519851010","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0049475519851010","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0049475519851010","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:31:42Z","timestamp":1777642302000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0049475519851010"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,20]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1177\/0049475519851010"],"URL":"https:\/\/doi.org\/10.1177\/0049475519851010","relation":{},"ISSN":["0049-4755","1758-1133"],"issn-type":[{"value":"0049-4755","type":"print"},{"value":"1758-1133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,20]]}}}