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  1. Article ; Online: The impact of the COVID-19 pandemic on paediatric surgical volumes in Africa: A retrospective observational study.

    Mazingi, Dennis / Shinondo, Patricia / Ihediwa, George / Ford, Kathryn / Ademuyiwa, Adesoji / Lakhoo, Kokila

    Journal of pediatric surgery

    2022  Volume 58, Issue 2, Page(s) 275–281

    Abstract: Background: The aim of this study is to investigate the impact that COVID-19 had on the pattern and trend of surgical volumes, urgency and reason for surgery during the first 6 months of the pandemic in sub-Saharan Africa.: Methods: This ... ...

    Abstract Background: The aim of this study is to investigate the impact that COVID-19 had on the pattern and trend of surgical volumes, urgency and reason for surgery during the first 6 months of the pandemic in sub-Saharan Africa.
    Methods: This retrospective facility-based study involved collection of paediatric operation data from operating theatre records across 5 hospitals from 3 countries: Zimbabwe, Zambia and Nigeria over the first half of 2019 and 2020 for comparison. Data concerning diagnosis, procedure, anaesthesia, grade, speciality, NCEPOD classification and indication was collected. The respective dates of enactment of cancellation policies in each country were used to compare changes in weekly median surgical case volume before cancellation using the Wilcoxon Sign-Rank Test.
    Results: A total of 1821 procedures were recorded over the study period. Surgical volumes experienced a precipitous drop overall from a median of 100 cases/week to 50 cases/week coinciding with cancellation of surgical electives. Median accumulated weekly procedures before COVID-related cancellation were significantly different from those after cancellation (p = 0.027). Emergency surgery fell by 23.3% while electives fell by 78,9% (P = 0.042). The most common primary indication for surgery was injury which experienced a 30.5% drop in number of procedures, only exceeded by congenital surgery which dropped 34.7%.
    Conclusions: The effects of surgical cancellations during the covid-19 pandemic are particularly devastating in African countries where the unmet need and surgical caseload are high. Continued cancellations that have since occurred will cause similar drops in surgical case volume that these health systems may not have the resilience to recover from.
    Level of evidence: Level II.
    MeSH term(s) Child ; Humans ; COVID-19/epidemiology ; Pandemics ; Retrospective Studies ; Hospitals ; Nigeria
    Language English
    Publishing date 2022-10-31
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2022.10.047
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    Zs.A 607: Show issues Location:
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  2. Article ; Online: Building back better children's surgical services toward universal health coverage: Perspectives from Bangladesh and Zimbabwe.

    Mazingi, Dennis / Chowdhury, Tanvir Kabir / Aziz, Tasmiah Tahera / Tamanna, Nowrin / Lakhoo, Kokila / Banu, Tahmina / Mustafa, Saqif

    Frontiers in public health

    2023  Volume 11, Page(s) 1073319

    Abstract: Introduction: This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Children's surgical services are crucial, yet underappreciated, for children's health and must be sufficiently ... ...

    Abstract Introduction: This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Children's surgical services are crucial, yet underappreciated, for children's health and must be sufficiently addressed to make and sustain progress toward universal health coverage (UHC). Despite their considerable burden and socioeconomic cost, surgical diseases have been relatively neglected in favor of communicable diseases living up to their inauspicious moniker: 'the neglected stepchild of global health'. This article aims to raise awareness around children's surgical diseases and offers perspectives from two prototypical LMICs on strengthening surgical services in the context of health systems recovery following the COVID-19 experience to make and sustain progress toward UHC.
    Approach: We used a focused literature review supplemented by the perspectives of local experts and the 6-components framework for surgical systems planning to present two case studies of Bangladesh and Zimbabwe. The lived experiences of the authors are used to describe the impact of COVID-19 on respective surgical systems and offer perspectives on building back the health system and recovering essential health services for sustainability and resilience.
    Findings: We found that limited high-level policy and planning instruments, an overburdened and under-resourced health and allied workforce, underdeveloped surgical infrastructure (from key utilities to essential medical products), lack of locally generated research, and the specter of prohibitively high out-of-pocket costs for children's surgery are common challenges in both countries that have been exacerbated by the COVID-19 pandemic.
    Discussion: Continued chronic underinvestment and inattention to children's surgical diseases coupled with the devastating effect of the COVID-19 pandemic threaten progress toward key global health objectives. Urgent attention and investment in the context of health systems recovery is needed from policy to practice levels to improve infrastructure; attract, retain and train the surgical and allied health workforce; and improve service delivery access with equity considerations to meet the 2030 Lancet Commission goals, and make and sustain progress toward UHC and the SDGs.
    MeSH term(s) Child ; Humans ; COVID-19/epidemiology ; Universal Health Insurance ; Bangladesh ; Zimbabwe ; Pandemics
    Language English
    Publishing date 2023-01-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.1073319
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  3. Article: Morel-Lavallée lesion in a 12-month-old child: A case report and literature review.

    Mazingi, Dennis / Jakanani, George C / Mushayavanhu, Prudance

    International journal of surgery case reports

    2018  Volume 49, Page(s) 180–184

    Abstract: Introduction: The Morel-Lavallée lesion is an infrequently described, post-traumatic closed de-gloving wound that results from separation of the skin and subcutaneous tissues from the underlying deep fascia as a result of shearing forces that tear ... ...

    Abstract Introduction: The Morel-Lavallée lesion is an infrequently described, post-traumatic closed de-gloving wound that results from separation of the skin and subcutaneous tissues from the underlying deep fascia as a result of shearing forces that tear perforating vessels and lymphatics. This condition is rare in children and to our knowledge it represents the youngest case of Morel-Lavallée lesion yet reported.
    Presentation of case: We report on a twelve-month-old girl who presented after a motor vehicle accident with a tender fluctuant mass of the back and buttocks. Computed tomography revealed a large but discrete fluid collection between the subcutaneous fat and the deep fascial planes, extending from the posterior thoracic paraspinal soft tissues to the right gluteal region. A diagnosis of Morel-Lavallée lesion was made. This patient was managed with serial ultrasound-guided percutaneous drainage and compression bandages. The patient did well and was subsequently discharged. There was no recurrence of the lesion on follow-up.
    Discussion: The Morel-Lavallée lesion is a rare consequence of abrupt high impact trauma. There is no accepted management approach and a variety of conservative as well as surgical options exist. Goals of management include drainage, debridement and meticulous dead space management to prevent recurrence.
    Conclusion: The Morel-Lavallée lesion is a rare finding in children involved in high impact trauma and prompt intervention is crucial to prevent complications. Image-guided drainage is a rational management approach with excellent outcomes.
    Language English
    Publishing date 2018-07-12
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2018.07.005
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  4. Article ; Online: Surgical applications of ultrasound use in low- and middle-income countries: A systematic review.

    Navarro, Sergio M / Shaikh, Hashim / Abdi, Hodan / Keil, Evan J / Odusanya, Simisola / Stewart, Kelsey A / Tuyishime, Eugene / Mazingi, Dennis / Tuttle, Todd M

    Australasian journal of ultrasound in medicine

    2022  Volume 25, Issue 2, Page(s) 80–97

    Abstract: Background: Ultrasound is a portable technology able to deploy health care effectively in low resource settings. This study presents a systematic review to determine trends in the utility and applicability of this technology in low- and middle-income ... ...

    Abstract Background: Ultrasound is a portable technology able to deploy health care effectively in low resource settings. This study presents a systematic review to determine trends in the utility and applicability of this technology in low- and middle-income countries (LMIC), specifically for surgical applications. The review includes characterising and evaluating trends in the geographic and specialty-specific use of ultrasound pertaining to surgical disease.
    Methods: The databases such as Medline OVID, EMBASE and Cochrane were searched from 2010 through March 2019 for studies available in English, French and Spanish. Commentaries, opinion articles, reviews and book chapters were excluded. A categorical analysis of ultrasound use for surgical disease in LMICs was conducted.
    Results: A total of 6276 articles were identified, with 4563 studies included for the final review. A total of 221 studies were selected researching ultrasound use in LMICs to treat surgical disease. Most studies identified ultrasound usage focused on general surgery, acute care surgery and surgical ICU topics (52%, 115) followed by computed tomography surgery studies (20%, 44). Most studies were retrospective in nature, with 81% (180) of research studies generated in four countries (India, Pakistan, Nigeria and Egypt). Ultrasound proved to be a feasible technique for utility in pre-operative diagnosis, cost-effectiveness and prediction of surgical outcomes. Findings are limited by the limited number of randomised clinical trials reported.
    Conclusion and global health implications: Our systematic literature review of ultrasound use in LMICs demonstrates the growing utilisation of this relatively low-cost, portable imaging technology in low resource settings for surgical disease.
    Language English
    Publishing date 2022-06-01
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2843953-3
    ISSN 2205-0140 ; 1836-6864
    ISSN (online) 2205-0140
    ISSN 1836-6864
    DOI 10.1002/ajum.12302
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  5. Article ; Online: A Case Report of a Bite From the Nile Crocodile (Crocodylus niloticus) Managed with Regional Anesthesia.

    Mazingi, Dennis / Mbanje, Chenesa / Muguti, Godfrey I / Chitiyo, Sabastain T

    Wilderness & environmental medicine

    2019  Volume 30, Issue 4, Page(s) 441–445

    Abstract: Crocodile attack injuries plague communities near bodies of water and continue to be an infrequent but significant form of trauma encountered in our medical facility. Regional anesthesia techniques are a novel adjunct to treatment and may facilitate ... ...

    Abstract Crocodile attack injuries plague communities near bodies of water and continue to be an infrequent but significant form of trauma encountered in our medical facility. Regional anesthesia techniques are a novel adjunct to treatment and may facilitate simplified definitive management and better utilization of constrained operating room resources. We report a case of an adult male who presented with a large lower extremity wound after a crocodile bite. The patient was managed with initial debridement and irrigation and serial wound care entirely under regional anesthesia at the bedside. The patient did not develop wound infection, eventually receiving a skin graft with good functional outcomes. Regional anesthesia techniques are increasingly being used in the trauma setting, and their versatility allows for their use in multiple settings, by practitioners with limited experience and in resource-limited environments. No specific guidelines exist for performance of neuraxial techniques in the setting of animal bite injuries, but concerns about infectious complications have been raised. Regional anesthesia techniques may be useful in the management of extremity trauma due to crocodile attacks without infectious complications. They may reduce utilization of theatre resources and reduce opioid requirements.
    MeSH term(s) Adult ; Alligators and Crocodiles ; Animals ; Bites and Stings/etiology ; Bites and Stings/pathology ; Bites and Stings/therapy ; Humans ; Leg/pathology ; Male ; Skin Transplantation
    Language English
    Publishing date 2019-10-22
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1238909-2
    ISSN 1545-1534 ; 1080-6032
    ISSN (online) 1545-1534
    ISSN 1080-6032
    DOI 10.1016/j.wem.2019.06.013
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 3025: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: Exploring the Impact of COVID-19 on Progress Towards Achieving Global Surgery Goals.

    Mazingi, Dennis / Navarro, Sergio / Bobel, Matthew C / Dube, Andile / Mbanje, Chenesa / Lavy, Chris

    World journal of surgery

    2020  Volume 44, Issue 8, Page(s) 2451–2457

    Abstract: Introduction: In the 5 months since it began, the COVID-19 pandemic has placed extraordinary demands on health systems around the world including surgery. Competing health objectives and resource redeployment threaten to retard the scale-up of surgical ... ...

    Abstract Introduction: In the 5 months since it began, the COVID-19 pandemic has placed extraordinary demands on health systems around the world including surgery. Competing health objectives and resource redeployment threaten to retard the scale-up of surgical services in low- and middle-income countries where access to safe, affordable and timely care is low. The key aspiration of the Lancet Commission on global surgery was promotion of resilience in surgical systems. The current pandemic provides an opportunity to stress-test those systems and identify fault-lines that may not be easily apparent outside of times of crisis.
    Methods: We endeavoured to explore vulnerable points in surgical systems learning from the experience of past outbreaks, using examples from the current pandemic, and make recommendations for future health emergencies. The 6-component framework for surgical systems planning was used to categorise the effects of COVID-19 on surgical systems, with a particular focus on low- and middle-income countries. Key vulnerabilities were identified and recommendations were made for the current pandemic and for the future.
    Results: Multiple stress points were identified throughout all of the 6 components of surgical systems. The impact is expected to be highest in the workforce, service delivery and infrastructure domains. Innovative new technologies should be employed to allow consistent, high-quality surgical care to continue even in times of crisis.
    Conclusions: If robust progress towards global surgery goals for 2030 is to continue, the stress points identified should be reinforced. An ongoing process of reappraisal and fortification will keep surgical systems in low- and middle-income countries responsive to "old threats and new challenges". Multiple opportunities exist to help realise the dream of surgical systems resilient to external shocks.
    MeSH term(s) Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Emergencies ; Goals ; Health Resources ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1007/s00268-020-05627-7
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    Zs.A 1336: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: A descriptive study of the trends of COVID-19 in Zimbabwe from March-June 2020: policy and strategy implications.

    Murewanhema, Grant / Burukai, Trouble / Mazingi, Dennis / Maunganidze, Fabian / Mufunda, Jacob / Munodawafa, Davison / Pote, William

    The Pan African medical journal

    2020  Volume 37, Issue Suppl 1, Page(s) 33

    Abstract: Introduction: the first cases of COVID-19 were reported in China in December 2019. Since then, the disease has evolved to become a global pandemic. Zimbabwe reported its first case on 20: Methods: data were collected from daily situation reports that ...

    Abstract Introduction: the first cases of COVID-19 were reported in China in December 2019. Since then, the disease has evolved to become a global pandemic. Zimbabwe reported its first case on 20
    Methods: data were collected from daily situation reports that were published by the Zimbabwean Ministry of Health and Child Care from 20
    Results: as of 27
    Conclusion: the epidemiological trends of COVID-19 experienced in Zimbabwe between March and June 2020 are somewhat different from what has been observed elsewhere. Further research to determine the reasons for the differences is warranted, to inform public health practice and tailor make suitable interventions.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; Health Policy ; Humans ; Time Factors ; Zimbabwe/epidemiology
    Language English
    Publishing date 2020-11-09
    Publishing country Uganda
    Document type Journal Article
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.supp.2020.37.33.25835
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  8. Article: Mitigating the impact of COVID-19 on children's surgery in Africa.

    Mazingi, Dennis / Ihediwa, George / Ford, Kathryn / Ademuyiwa, Adesoji O / Lakhoo, Kokila

    BMJ global health

    2020  Volume 5, Issue 6

    MeSH term(s) Africa ; Betacoronavirus ; COVID-19 ; Child ; Child Welfare ; Coronavirus Infections ; General Surgery/education ; General Surgery/organization & administration ; Health Care Rationing ; Health Personnel ; Hospitalization ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Surgery Department, Hospital/organization & administration ; Surgery Department, Hospital/standards
    Keywords covid19
    Language English
    Publishing date 2020-06-08
    Publishing country England
    Document type Editorial
    ISSN 2059-7908
    ISSN 2059-7908
    DOI 10.1136/bmjgh-2020-003016
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  9. Article ; Online: Anorectal malformations in low and middle-income countries- spectrum, burden and management.

    Sharma, Shilpa / Mazingi, Dennis / Imam, Sharif / Chowdhury, Tanvir Kabir / Saldaña, Lily J / Mashavave, Noxolo Z / Olivos, Maricarmen / Chowdhury, Tameem Shafayat / Hoque, Mozammel / Correa, Catalina / Banu, Tahmina

    Seminars in pediatric surgery

    2023  Volume 32, Issue 6, Page(s) 151349

    Abstract: The clinical presentation, diagnosis and management of anorectal malformation has been well described in the literature, however the experience with these conditions in low-and middle-income countries is often shaped in unique ways due to the social, ... ...

    Abstract The clinical presentation, diagnosis and management of anorectal malformation has been well described in the literature, however the experience with these conditions in low-and middle-income countries is often shaped in unique ways due to the social, cultural and economic factors at work in these regions. This leads to adaptation of modifications in management options for these babies that usually present as delayed cases with added poor prognostic factors like sepsis leading to need for emergency resuscitation and overall increased morbidity and mortality. This article explores the anomaly from a global surgery lens and outlines the spectrum of the anomaly, burden faced in the resource constrained environment and the management options adopted for successful management under the available circumstances.
    MeSH term(s) Humans ; Anorectal Malformations/therapy ; Anorectal Malformations/surgery ; Developing Countries
    Language English
    Publishing date 2023-11-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1133381-9
    ISSN 1532-9453 ; 1055-8586
    ISSN (online) 1532-9453
    ISSN 1055-8586
    DOI 10.1016/j.sempedsurg.2023.151349
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    Zs.A 3544: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  10. Article: Maffucci's syndrome in association with giant tubular adenoma of the breast: Case report and literature review.

    Mazingi, Dennis / Mbanje, Chenesa / Jakanani, George / Muguti, Godfrey I / Mandizvidza, Valentine / Bopoto, Shingi

    International journal of surgery case reports

    2019  Volume 63, Page(s) 147–152

    Abstract: Introduction: Maffucci's syndrome is a rare congenital, non-hereditary mesodermal dysplasia characterised by multiple enchondromas and vascular lesions. To our knowledge this is the first report of tubular adenoma of the breast in association with ... ...

    Abstract Introduction: Maffucci's syndrome is a rare congenital, non-hereditary mesodermal dysplasia characterised by multiple enchondromas and vascular lesions. To our knowledge this is the first report of tubular adenoma of the breast in association with Maffucci's syndrome.
    Presentation of case: We report a 31-year-old female who presented with a large, ulcerated slow-growing painless breast mass. She had also sustained two pathological fractures during childhood as well as progressive deformity and limb shortening on the right side of the body. Skeletal survey revealed enchondromas exclusively on the right side in association with phleboliths. Excision of the breast mass was performed. Histological examination of the breast lesion revealed a diagnosis of tubular adenoma, core biopsy of the bony lesions confirmed enchondromas and a cutaneous haemangioma was excised from the abdominal wall.
    Discussion: Tubular adenoma of the breast is a rare benign tumour. When large they may cause ulceration leading to diagnostic and management dilemmas. Patients with Maffucci's Syndrome require lifelong surveillance for the development of malignancy.
    Conclusion: Tubular adenomas of the breast carry no risk of malignancy. However, malignancy remains high on the differential list when the skin is ulcerated. Ulceration can also be caused by pressure necrosis in benign tumours. This diagnostic dilemma can lead to unnecessarily radical surgery.
    Language English
    Publishing date 2019-09-23
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2210-2612
    ISSN 2210-2612
    DOI 10.1016/j.ijscr.2019.09.012
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