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Research Letter
December 28, 2016

Mortality After Peritonitis in Sub-Saharan AfricaAn Issue of Access to Care

Author Affiliations
  • 1Department of Surgery, University of North Carolina School of Medicine, Chapel Hill
  • 2Department of Surgery, North Carolina Jaycee Burn Center, University of North Carolina School of Medicine, Chapel Hill
  • 3Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
JAMA Surg. Published online December 28, 2016. doi:10.1001/jamasurg.2016.4638

There is a lack of access to emergency surgical care in developing countries despite a burden of surgical disease.1 Health care systems are overwhelmed by the high volume of patients who need acute care and by insufficient capacity because of a lack of appropriate prehospital care, surgery-capable clinicians, and basic health care delivery infrastructures.2 Compared with high-income countries where mortality from peritonitis is less than 5%, mortality in this resource-poor setting is nearly 20%.1,3 These patients are particularly susceptible because of a lack of the prerequisite surgical infrastructure, which includes prompt triage and diagnosis, early transfer to a higher level of care, timely surgical intervention, and critical care services.4 This study identifies outcomes of patients with peritonitis and factors that contribute to mortality.

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