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Research publications in high impact scientific scientific journals have established the APORG as an important contributor to the evidence on the safety and quality of peri-operative care in African LMICs.
The infectious disease COVID-19, caused by coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has caused significant disruption in surgical services to patients globally. Data from the COVIDSurg Cohort Study suggest mortality rates of patients infected with SARS-Cov-2 in the perioperative period of up to 25.6% in emergency surgery and 18.9% in elective surgery. Based on estimates by the COVIDSurg Collaborative, large numbers of elective surgical procedures are cancelled. The COVID-19 pandemic has forced healthcare providers to ‘shift from patient-centred ethics to public health ethics’. This has had impact on pre-operative testing for COVID-19, and scheduling of surgery. Currently, a provisional recommendation to delay surgery for at least four weeks after a positive COVID test, exists. Weighing the risk of surgery and potential complications during the COVID-19 pandemic, against the benefit of undergoing a surgical procedure to improve quality of life, remains difficult. A study to determine the long term effect of the pandemic on patient-reported outcome may provide guidance on how to safely return to surgical activity that are again more focussed on individualized care. There is also the opportunity to record outcomes that are currently accepted as the standard for understanding longer term recovery after surgery.
A prospective observational cohort study aiming to recruit patients 18 years and older presenting for any surgical procedure at South African hospitals from July 2021 to July 2023. Data will be collected by patients using a digital platform. De-identified data will be extracted from the database at predetermined intervals, and made available to the principal investigator for analysis. Logistic regression models will be constructed to identify factors independently associated with these outcomes and to adjust for differences in confounding factors.
Access to safe surgery is a basic human right. This is highlighted by the work of the Lancet Commission on Global Surgery. There is a large burden of surgical disease in the paediatric surgical population with a large unmet need. In Africa, children comprise a significant proportion of the population with approximately 50% of the population being ≤19 years old. Limited data from Africa suggests the risk factors for, incidence and outcomes associated with paediatric surgical complications differ from HICs.
The African Surgical Outcomes Study (ASOS) has described surgical outcomes in adult patients in Africa.
There is a need to determine the burden of the complications in paediatric surgical patients in Africa, and the risk factors for and the type of complications experienced. If we do this, we will be able to target appropriate interventions to improve surgical outcomes for children in Africa. We have the capacity to do this important work, through the African Perioperative Research Group (APORG) group.