African patients twice likely to die after surgery —Report

Patients in African hospitals are twice likely to die after surgery compared to the average patient in other parts of the world, experts have said in a new report.

In a new survey, experts found that one in five surgical patients in Africa developed a complication around the time of surgery, following which, one in 10 patients died. The findings were published in The Lancet.

The survey, which covered 11,422 patients in 247 hospitals in 25 low- and middle-income countries between February and May last year, found that these deaths occur more in patients that are young and who had undergone minor after surgery.

Countries involved in this African surgical outcomes study included South Africa, Nigeria, Zimbabwe, Namibia, Mali, Madagascar, Niger, Uganda, Benin, Ghana and Togo.

While most deaths occurred in the days following surgery, it said that these were probably preventable since majority of the complications were due to infections.

The study, which is believed to be the most comprehensive assessment of its kind in Africa, added that African surgical hospitals are under-resourced with far below the recommended number of specialist surgeons, obstetricians and anaesthesiologists.

“A quarter of hospitals do not have a reliable oxygen source; a third do not have reliable electricity; 70 per cent do not have a pulse oximeter, and 47 per cent do not have dedicated postoperative care,” it declared.

Although the number of surgical procedures carried out in Africa is far below the country’s essential surgical needs and the global average, it said that the few that were done tend to be on urgent or emergency basis rather than scheduled elective surgeries.

While a third of these surgeries in Africa were caesarean deliveries, that 95 per cent of these deaths occurred after surgery, they said indicated the need to improve the safety of care around the time of surgery.

Reporting on the implications of its findings, they said: “the most alarming finding was how few people actually received surgery, “ adding that this is unacceptably low in Africa.

“Although strategies to improve perioperative care processes and structural quality are urgently needed, and might be easier to implement in the short term, the absence of surgery in Africa represents a silent killer that probably claims more lives.

Identified barriers to accessing surgery in LMICs include cost, distance to care, and fear of surgery.”

It is estimated that two-thirds of the world’s population do not have access to safe, affordable, and timely surgical care. Around 16·9 million people die from conditions that require surgical care each year, most of them in low-income and middle-income countries (LMICs).