EN
TÜRKÇE
Poster - 351
Diagnosis of anorectal malformations in sub-Saharan Africa: a scoping review and analysis of the impact of the global domestic product
Florent Tshibwid A Zeng 1, Roland-Fabrice Mbiki Yema 2, Ena Ngandu Keita 3, Gracia Mitonga Kamwangen 4, Nathalie Dinganga Kapessa 1, Sébastien Mbuyi-Musanzayi 1
1 University of Lubumbashi, Faculty of Medicine, Department of Surgery, Lubumbashi, Democratic Republic of the Congo
2 Deido District Hospital, Douala, Cameroon
3 Jason Sendwe Provincial Referral Hospital, Department of Surgery, Lubumbashi, Democratic Republic of the Congo
4 Mwangeji Provincial Referral Hospital, Department of Surgery, Kolwezi, Democratic Republic of the Congo
Purpose: To summarize diagnostic aspects of anorectal malformations (ARM) in sub-Saharan Africa (SSA) and analyze the impact of the global domestic product (GDP).
Methods: Using PubMed, we conducted a scoping review by screening reports published from 2006 to 2023. Statistical tests were used to compare variables according to the three GDP groups: Low-, lower-middle-, and upper-middle income countries (LICs, LMICs, UMICs), with significance set at p<0.05.
Results: Twenty-three studies reporting 3344 patients were included. The sex ratio was 1.3:1. The mean age at diagnosis ranged from 1 day to 13.9 years. The Krickenbeck classification was used in 14 studies (60.8%). Rectovestibular fistula was reported with higher frequency in LICs vs UMICs (95% CI [4.872, 29.818], p=0.013). The existence of a screening protocol for AA increased with GDP (p=0.005). Reported frequency of AA was lower in LICs vs UMICs ([-64.016, -23.470], p<0.001) and in LIMCs vs UMIC ([-61.878, -30.872], p<0.001). Urogenital malformations were reported at a lower frequency in LICs vs UMICs ([-33.459, -3.802], p=0.026) and in LMICs vs UMICs ([-28.697, -4.678], p=0.041). Cardiovascular anomalies had lower frequency in LICs vs UMICs ([-31.954, -5.504], p=0.011) and in LMICs vs UMICs ([-29.410, -2.965], p=0.021).
Conclusion: Diagnosis of ARM in SSA is often delayed, with non-systematic use of the Krickenbeck classification. Lower GDP groups have fewer screening protocols for AA and report lower rates in LICs and LMICs compared to UMICs.