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.
Gallaher JR, Cairns B, Varela C, Charles AG. Mortality After Peritonitis in Sub-Saharan AfricaAn Issue of Access to Care. JAMA Surg. Published online December 28, 2016. doi:10.1001/jamasurg.2016.4638