title: Untreated head and neck surgical disease in Sierra Leone: a cross-sectional, countrywide survey.
abstract: OBJECTIVE
  Demonstrate how the Surgeons OverSeas Assessment of Surgical Need (SOSAS) can be used to determine the burden of head and neck (H&N) surgical disease in developing countries and identify reasons for untreated disease.
  
  
  METHODS
  Cluster randomized, cross-sectional, countrywide survey.
  
  
  METHODS
  Sierra Leone.
  
  
  METHODS
  The survey was administered to 75 of 9671 enumeration areas in Sierra Leone between January 9 and February 3, 2012, with 25 households in each cluster randomly selected for the survey. A household representative and 2 randomly selected household members were interviewed. Need for surgical care was based on participants' responses to whether they had an H&N condition that they believed needed surgical care.
  
  
  RESULTS
  Of 1875 households, data were analyzed for 1843 (98%), with 3645 total respondents. Seven hundred and one H&N surgical conditions were reported as occurring during the lifetime of the 3645 respondents (19.2%).The current prevalence of H&N conditions in need of a surgical consultation was 11.8%. No money (60.1%) was the most common reason respondents reported for not receiving medical care. A bivariate analysis demonstrated that age, village type, education, and type of condition may be predictors for seeking health care and/or receiving surgical care.
  
  
  CONCLUSIONS
  These results show limited access for patients to be evaluated for a potential H&N surgical condition in Sierra Leone. The true incidence of untreated surgical disease is unknown as most respondents were not evaluated by a surgeon. This survey could be used in other countries as health care professionals assess surgical needs throughout the world.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA.
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Van Buren
authors.affiliation: Surgeon OverSeas, New York, New York, USA Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: Reinou S
authors.initials: RS
authors.lastname: Groen
authors.affiliation: Surgeon OverSeas, New York, New York, USA Department of Surgery, Columbia University, New York, New York, USA Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
authors.affiliation: College of Medicine and Allied Health Science, Freetown, Sierra Leone.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Samai
authors.affiliation: Department of Surgery, Connaught Hospital, Freetown, Sierra Leone.
authors.forename: Thaim B
authors.initials: TB
authors.lastname: Kamara
authors.affiliation: Division of Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
authors.forename: Jian
authors.initials: J
authors.lastname: Ying
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA jeremy.meier@imail.org.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Meier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010038:Otorhinolaryngologic Diseases / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D015995:Prevalence; D012807:Sierra Leone / Q000453:epidemiology; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: developing countries; global health