Paediatric elective surgical conditions as seen at a referral hospital in Kumasi, Ghana

Background: Data on paediatric surgical conditions in sub-Saharan countries, including Ghana, are scanty and sketchy. Using hospital-based data, it is possible to assess the epidemiology of diseases among children, and the morbidity and mortality rates. Methods: Between January 1997 and December 2000, records of 1200 children treated consecutively with elective surgery at Komfo Anokye Teaching Hospital in Kumasi, Ghana, were analysed for name, age, sex, postoperative diagnosis, procedure carried out and outcome of treatment Results: The ages of the children ranged from 0 to 14 years, with a mean age of 3.5 years (95% confidence interval: 3.3-3.7) with a boy/girl ratio of 3.1:1. Congenital anomalies were the most common problem (83%), followed by tumours (4%), cysts (3%), uncircumcised penis (2%), and lymphadenopathy of varying aetiologies (2%). The most common congenital anomaly was inguinal hernia, and the rarest, biliary atresia. Eighty-two percent of the children in this series were treated as day-care cases. Overall mortality in the series was 0.8%. Conclusions: The data reviewed here demonstrate that there is a wide range of surgical conditions among children in the developing world. This poses a significant health-care problem and calls for improved management of such paediatric surgical problems to prevent high morbidity and mortality rates in African children.