Epidemiology and Outcomes of Pediatric Surgical Patients at a Tertiary Hospital in Northern Tanzania

Abstract

Background: Over 1.7 billion children and adolescents around the world lack access to safe and affordable surgical care, mostly in low- and middle-income countries (LMICs), where children and adolescents can account for up to half of a country’s population. Yet, the burden of surgical needs for children in Tanzania is still poorly defined. The aim of this study is to assess the epidemiology and outcomes of pediatric surgical procedures performed over one year at the Kilimanjaro Christian Medical Centre, Moshi, Tanzania.Methods: We reviewed the medical and surgical records of all children (< 16 years of age) who underwent surgery between January 1st, 2022 and December 31st, 2022 at the Kilimanjaro Christian Medical Centre. Descriptive statistics were used to assess demographic and clinical characteristics. Geospatial mapping tools were used to visualize the distribution of the patient’s district of origin. Results: We collected data on 2031 children, 59.8% (n = 1215) of whom were male, and more than half were between 1 and 5 years old (58.6%, [n = 1191]). In terms of procedure type, half of the procedures were tonsillectomies/adenoidectomies (51.1%), followed by laparotomies (3.4%), and ventriculoperitoneal shunts (3.2%). We identified 33 deaths prior to discharge. Children from uninsured families and those under one year old were more likely to have traveled longer, visited another health facility, and required an emergency procedure compared to children from insured families and other age groups. Conclusion: Being a child who is under one year old and from an uninsured family is associated with more urgent procedures and poorer outcomes, highlighting disparities in access to surgery for children in Northern Tanzania. Resource mobilization to provide financial protection for families who seek surgical care and health system strengthening at lower-level hospitals are crucial to addressing inequitable and unaffordable access to surgical care and improving health outcomes for children across Tanzania.