The burden of waiting: DALYs accrued from delayed access to pediatric surgery in Kenya and Canada

Journal of Pediatric Surgery
Dan PoenaruBrian H Cameron

Abstract

Disability-adjusted life years (DALYs) have become the standard metric for estimating burden of disease (BoD), but have not yet been applied to delayed access to surgical procedures. This study estimates the DALYs accrued from delayed access to surgical care in two pediatric surgical units in Kenya and Canada. Records of operations for 13 congenital health states in a Kenyan and a Canadian hospital were prospectively collected for 2012. DALYs caused by delayed presentation were estimated using disability weights and ideal and actual age at surgery. 1208 first-time procedures in general surgery, neurosurgery, plastic surgery, and urology were included. Delays were longest in general surgery and longer in Kenya than in Canada in all specialties. The longest delays in Kenya were for orchidopexy (72 months) and anorectoplasty (PSARP) (74 months), and in Canada for orchidopexy (40 months). Corresponding total delayed BoD was highest in general surgery and neurosurgery and higher again in Kenya than in Canada (484 cf. 84 DALYs). Estimating BoD resulting from delayed surgery is feasible and reflects both late presentation and limited access to care. Further exploration of these factors can make delayed DALYs a useful measure of health...Continue Reading

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Citations

Feb 3, 2016·Seminars in Pediatric Surgery·Doruk OzgedizDan Poenaru
Feb 3, 2016·Seminars in Pediatric Surgery·Sarah L M GreenbergStephen W Bickler
Feb 15, 2018·World Journal of Surgery·Emily R SmithUNKNOWN Global Initiative for Children’s Surgery
Dec 1, 2018·World Journal of Surgery·Dan Poenaru, Justina Onyioza Seyi-Olajide
Oct 28, 2019·World Journal of Surgery·Emily R SmithUNKNOWN Global Initiative for Children’s Surgery
Jul 2, 2020·Global Health, Science and Practice·Isaac WassermanLubna Samad
Sep 6, 2020·The Journal of Craniofacial Surgery·Alan T MakhoulPeter M Nthumba

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