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Research Letter
September 2018

Undertreated Medical Conditions vs Trauma as Primary Indications for Amputation at a Referral Hospital in Cameroon

Author Affiliations
  • 1Department of Surgery, Stanford University, Stanford, California
  • 2Currently a medical student at Stanford School of Medicine, Palo Alto, California
  • 3Department of Surgery, Mbingo Baptist Hospital, Bamenda, Cameroon
  • 4Department of Surgery, Palo Alto Veterans Affairs Health Care System, Palo Alto, California
JAMA Surg. 2018;153(9):858-860. doi:10.1001/jamasurg.2018.1059

Historically, amputations in sub-Saharan Africa (SSA) were performed to address pathologic changes due to traumatic injury.1 However, SSA countries are currently experiencing the epidemiologic double burden of disease; as treatment for and education about infectious diseases improve, these countries are increasingly faced with a transition to noncommunicable chronic diseases (NCDs), including diabetes and peripheral vascular disease.2 This transition is attributed to longer life expectancy and greater exposure to risk factors that include smoking, poor diet, and sedentary lifestyle.2 We hypothesized that NCDs have overtaken trauma as the primary cause for amputation in SSA, with postoperative mortality driven by untreated or undertreated medical conditions.

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