| Title |
Quality of Surgery in Malawi: Comparison of Patient‐Reported Outcomes After Hernia Surgery Between District and Central Hospitals
|
|---|---|
| Published in |
World Journal of Surgery, December 2017
|
| DOI | 10.1007/s00268-017-4385-9 |
| Pubmed ID | |
| Authors |
Jakub Gajewski, Ronan Conroy, Leon Bijlmakers, Gerald Mwapasa, Tracey McCauley, Eric Borgstein, Ruairi Brugha |
| Abstract |
District hospitals in Africa could meet the essential surgical needs of rural populations. However, evidence on outcomes is needed to justify investment in this option, given that surgery at district hospitals in some African countries is usually undertaken by non-physician clinicians. Baseline and 2-3-month follow-up measurements were undertaken on 98 patients who had undergone hernia repairs at four district and two central hospitals in Malawi, using a modified quality-of-life tool. There was no significant difference in outcomes between district and central hospital cases, where a good outcome was defined as no more than one severe and three mild symptoms. Outcomes were marginally inferior at district hospitals (OR 0.79, 95% CI 0.63-1.0). However, in the 46 cases that underwent elective surgery at district hospitals, baseline scores for severe symptoms were worse (mean = 3.5) than in the 23 elective central hospital cases (mean = 2.5), p = 0.004. Also, the mean change (improvement) in symptom score was higher in district versus central hospital cases (3.9 vs. 2.3). The study results support the case for investing in district hospital surgery in sub-Saharan Africa to increase access to essential surgical care for rural populations. This could free up specialists to undertake more complex and referred cases and reduce emergency presentations. It will require investments in training and resources for district hospitals and in supervision from higher levels. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 46 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 17% |
| Student > Bachelor | 6 | 13% |
| Researcher | 5 | 11% |
| Other | 3 | 7% |
| Student > Postgraduate | 3 | 7% |
| Other | 9 | 20% |
| Unknown | 12 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 20 | 43% |
| Nursing and Health Professions | 4 | 9% |
| Social Sciences | 2 | 4% |
| Decision Sciences | 2 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 3 | 7% |
| Unknown | 14 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 12 December 2017.
All research outputs
#13,883,666
of 23,011,300 outputs
Outputs from World Journal of Surgery
#2,684
of 4,261 outputs
Outputs of similar age
#224,421
of 439,586 outputs
Outputs of similar age from World Journal of Surgery
#59
of 96 outputs
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So far Altmetric has tracked 4,261 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
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We're also able to compare this research output to 96 others from the same source and published within six weeks on either side of this one. This one is in the 37th percentile – i.e., 37% of its contemporaries scored the same or lower than it.