title: Pilot study of a population-based survey to assess the prevalence of surgical conditions in Uganda.
abstract: BACKGROUND
  Noncommunicable diseases, including those requiring surgical care, are increasingly straining low- and middle-income countries. Globally, 11% of all disability-adjusted life-years lost result from conditions requiring surgery; however, little is known about country-specific burden. We piloted a household-based survey in a periurban district of Uganda to estimate the prevalence of surgical conditions and to identify logistical challenges.
  
  
  METHODS
  Our sample comprised 57 households in 5 enumeration areas in the Wakiso District, in central Uganda. Our survey tool was the Surgeons OverSeas Assessment of Surgical need. A household representative completed demographic and household death information, and 2 randomly selected household members completed questions on surgical conditions.
  
  
  RESULTS
  Of 96 participants, 6 (6.3%; 95% CI, 2.3-13.1) had an existing, untreated surgical condition. The lifetime prevalence of surgical conditions was 26% (25/96). The most common barrier to access to care was lack of financial resources. Of the 3 deaths reported, 2 were associated with surgery. The mean household interview time was 36 minutes. The greatest challenge was efficient coordination with local team members and government officials.
  
  
  CONCLUSIONS
  In this setting, the current prevalence of surgical conditions was nearly 1 in 10 persons, and lifetime occurrence was high, at 1 in 4 persons. Addressable challenges led to question revisions and a change in the data collection platform. A full-country study is both feasible and necessary to characterize the met and unmet need for surgical care in Uganda.
authors.affiliation: University of Minnesota Medical School, Minneapolis, MN.
authors.forename: Elissa K
authors.initials: EK
authors.lastname: Butler
authors.affiliation: Duke University Global Health Institute, Durham, NC.
authors.forename: Tu M
authors.initials: TM
authors.lastname: Tran
authors.affiliation: Duke University Global Health Institute, Durham, NC; Duke University Medical School, Durham, NC.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Fuller
authors.affiliation: Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Fredrick
authors.initials: F
authors.lastname: Makumbi
authors.affiliation: Department of Anatomy, Makerere University School of Medicine, Kampala, Uganda.
authors.forename: Samuel
authors.initials: S
authors.lastname: Luboga
authors.affiliation: Makerere University School of Public Health, Kampala, Uganda.
authors.forename: Sheila
authors.initials: S
authors.lastname: Kisakye
authors.affiliation: Department of Anatomy, Makerere University School of Medicine, Kampala, Uganda; Division of Neurosurgery, Duke University, Durham, NC.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Haglund
authors.affiliation: Department of Surgery, University of Minnesota, Minneapolis, MN.
authors.forename: Jeffrey G
authors.initials: JG
authors.lastname: Chipman
authors.affiliation: Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda. Electronic address: mosesg@img.co.ug.
authors.forename: Moses
authors.initials: M
authors.lastname: Galukande
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014454:Uganda / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult