title: Burden of surgical congenital anomalies in Kenya: a population-based study.
abstract: BACKGROUND
  Congenital malformations are a significant component of the global burden of disease among children, accounting for 25 million disability-adjusted life years (DALYs) worldwide. Unfortunately, efforts to estimate the burden of pediatric surgical disease in Africa are limited by the absence of population-based data. The objective of this study was to estimate both the prevalence and the disease burden of several common congenital surgical malformations among children in Kenya.
  
  
  METHODS
  Community volunteers randomly surveyed households at sites across Kenya. Caretakers were asked to identify on a photographic portfolio, several congenital malformations present among the children in their household, including club foot, hypospadias, hydrocephalus, spina bifida/encephalocele, cleft lip, bladder exstrophy and imperforate anus. DALYs were then calculated based on life expectancy tables and published and estimated disability weights for the conditions encountered.
  
  
  RESULTS
  The caregivers of 5559 children (54% female) were surveyed in 1909 households, 56% of which were rural, 31% suburban and 12% urban. The overall prevalence of congenital malformations was 6.3 per 1000 children, amounting to 54-120 DALYs per 1000 children, depending on the life tables used. The most prevalent condition in the survey was club foot, whereas spina bifida had the highest burden of disease.
  
  
  CONCLUSIONS
  This study is the first to document the prevalence of selected surgical congenital malformations among children in Kenya and the burden of disease associated with them. The results will serve to inform strategies aimed at reducing the unmet burden of surgical disease in resource-limited regions.
authors: BethanyKids at Kijabe Hospital, Kijabe, Kenya.
authors: Victor K
authors: VK
authors: Wu
authors: Dan
authors: D
authors: Poenaru
authors: Marten J
authors: MJ
authors: Poley
mesh_terms: D000013:Congenital Abnormalities / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D010372:Pediatrics; D011159:Population Surveillance; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D011897:Random Allocation; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data
keywords: Africa; burden of disease; congenital malformations; pediatric surgery; population survey