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Abstract
BACKGROUND Globally, schistosomiasis affects at least 240 million people each year with a high proportion of cases in sub-Saharan Africa. The infection presents a wide range of symptoms mainly at the gastrointestinal and urogenital level. Cases of schistosomiasis-related appendicitis are seldom reported. The aim of the present study is to identify the prevalence of schistosomiasis-related appendicitis in Beira, Mozambique and compare to global prevalence. METHODS We retrospectively reviewed all cases of appendicitis recorded from January 2017 to March 2020 at a single pathology department located in Beira in order to assess the prevalence of schistosomiasis. Moreover, we performed a systematic review on the prevalence of schistosomiasis-related appendicitis in all countries. FINDINGS A total of 145 appendicitis cases in Beira showed a 13.1% prevalence of schistosomal-related appendicitis. The mean age of patients was 29.1 years, and 14 (73.7%) were male. The systematic review identified 20 studies with 34,790 inpatients with schistosomiasis-related appendicitis with a global prevalence of 1.31% (95% confidence interval (CI): 0.72 to 2.06); a high heterogeneity (I2 = 96.0%) was observed. Studies carried out in Africa reported a significantly higher prevalence of schistosomiasis-related appendicitis (2.75%; 95% CI: 1.28 to 4.68) than those in Middle East (0.49%; 95% CI: 0.18 to 0.95) (p for interaction < 0.0001). CONCLUSIONS Schistosomiasis infection should be considered as possible cause of appendicitis not only in endemic areas but also in developed countries. Considering that prevention is the best way to control the infection, more efforts should be put in place in order to increase the prevention coverage and avoid the cascading implications for health. This is even more so important in this Coronavirus Disease 2019 (COVID-19) era where the majority of attention and funds are used to fight the pandemic.
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Affiliation(s)
- Mateus Zacarias
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | | | | | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
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Pizzol D, Trott M, Grabovac I, Antunes M, Colangelo AC, Ippoliti S, Ilie CP, Carrie A, Veronese N, Smith L. Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review. Int J Environ Res Public Health 2021; 18:ijerph18115796. [PMID: 34071312 PMCID: PMC8198316 DOI: 10.3390/ijerph18115796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/16/2022]
Abstract
Laparoscopy is a procedure that ultimately reduces hospital stay time and speeds up post-operative recovery. It is mainly performed in high-income countries but its implementation in many low- and middle-income countries (LMICs) is increasing. However, no aggregate data exist regarding the outcomes of this procedure in resource-limited settings. We retrospectively reviewed all cases of laparoscopy recorded from January 2007 to March 2017 at the Department of Surgery of Beira to assess the related outcomes. Moreover, we performed a systematic review of the laparoscopic practices and outcomes in low-income countries. Data from the Department of Surgery of Beira identified 363 laparoscopic procedures, mainly relating to gynecological diseases, cholelithiasis, and appendicectomy with only a 1.6% complication rate (6 cases) and a 1.9% conversion rate (7 cases) to open surgery. The systematic review showed a pooled risk of overall complications significantly lower in laparoscopic vs. open appendicectomy (OR = 0.43; 95% CI 0.19-0.97; I2 = 85.7%) and a significantly lower risk of infection (OR = 0.53; 95% CI 0.43-0.65; I2 = 0.00%). The pooled SMD in operation duration in laparoscopic vs. open appendectomy was 0.58 (95% CI -0.00; 1.15; I2 = 96.52), while the pooled SMD in hospitalization days was -1.35 (95% CI -1.87; -0.82; I2 = 96.41). Laparoscopy is an expensive procedure to adopt as it requires new equipment and specialized trained health workers. However, it could reduce post-operative costs and complications, especially in terms of infections. It is crucial to increase its accessibility, acceptability, and quality particularly in LMICs, especially during this COVID-19 era when the reduction of patient hospitalization is essential.
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Affiliation(s)
- Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum 11111, Sudan
- Correspondence: ; Tel.: +39-366-873-1237
| | - Mike Trott
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK; (M.T.); (L.S.)
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna 1010, Austria;
| | - Mario Antunes
- Department of Surgery, Central Hospital of Beira, Beira 13016, Mozambique;
- Department of Surgery, Catholic University of Mozambique, Beira 13016, Mozambique
| | - Anna Claudia Colangelo
- Department of Surgery and Organ Transplantation, University of Padua, 35125 Padua, Italy;
| | - Simona Ippoliti
- Department of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UK; (S.I.); (C.P.I.); (A.C.)
| | - Cristian Petre Ilie
- Department of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UK; (S.I.); (C.P.I.); (A.C.)
| | - Anne Carrie
- Department of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UK; (S.I.); (C.P.I.); (A.C.)
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90121 Palermo, Italy;
| | - Lee Smith
- The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK; (M.T.); (L.S.)
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Santoro GA, Colangelo AC, Pelizzo P, Cian R, Zanus G. Imaging modalities for pelvic floor disorders. Ann Laparosc Endosc Surg 2021. [DOI: 10.21037/ales-21-44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Colangelo AC, Pizzol D, Antunes M. Anal high-grade and late-stage cancer management in low-income setting: a case report. J Surg Case Rep 2020; 2020:rjaa423. [PMID: 33149887 PMCID: PMC7593111 DOI: 10.1093/jscr/rjaa423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/15/2020] [Indexed: 11/12/2022] Open
Abstract
The burden of cancer is increasing in sub-Saharan Africa due to ageing, common risk factors and population growth. Anal cancer is a human papillomavirus-related rare disease with an incidence rate of 1.8 per 100 000 persons overall with an increasing incidence of by 2% per year in the last three decades. Despite that gold standard management is well described, in low-income countries, there is no possibility for a proper management. We presented a late-stage anal cancer case that reflects the urgent necessity to create the adequate condition for the development of effective oncologic approach including prevention, diagnosis and management.
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Affiliation(s)
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Mario Antunes
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
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Schiavone M, Pizzol D, Colangelo AC, Antunes M. Conservative management of Cantrell syndrome: a case report. J Surg Case Rep 2020; 2020:rjaa100. [PMID: 32509265 PMCID: PMC7263755 DOI: 10.1093/jscr/rjaa100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/27/2020] [Accepted: 03/28/2020] [Indexed: 11/13/2022] Open
Abstract
Cantrell syndrome (CS) is defined as congenital combination of five anomalies: defects at the lower part of the sternum, anterior diaphragm, midline supraumbilical abdominal wall, diaphragmatic pericardium and ectopia cordis. Antenatal screening should be performed to make an accurate prenatal diagnosis. The prognosis is usually poor with a high mortality early in life. The gold standard management is surgery but its prognosis remains poor. In many low-income settings prenatal examinations and surgery treatment are not possible. In the present case, we report a not surgery managed baby affected by CS, with good clinical conditions after 5 months.
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Affiliation(s)
- Marcella Schiavone
- Department of Emergency and Organ Transplantation-Section of Thoracic Surgery, University of Bari, Bari, Italy
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | | | - Mario Antunes
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
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Calgaro S, Colangelo AC, Otchirov S, Pizzol D, Antunes M. Failed ventriculoperitoneal shunt as treatment of infantile hydrocephalus. World Jnl Ped Surgery 2020; 3:e000123. [DOI: 10.1136/wjps-2020-000123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 11/04/2022] Open
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Antunes M, Pizzol D, Schiavone M, Colangelo AC. Giant mesenteric cyst: Successful management in low-resource setting. Int J Surg Case Rep 2020; 70:185-187. [PMID: 32417736 PMCID: PMC7229401 DOI: 10.1016/j.ijscr.2020.04.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/19/2020] [Accepted: 04/19/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Mesenteric cysts are rare, generally benign intra-abdominal lesions with a wide range of presentation in terms of size, clinical presentation, etiology, radiological features, and pathological characteristics. PRESENTATION OF CASE We reported a case of giant mesenteric cyst in a 16-month-old girl successfully managed in a low-resource setting. DISCUSSION This case is particularly important not only due to the rarity of the presented case, but also for the highlighted aspects from a public health point of view. We faced of the problem of a late stage disease and the lack of preoperative diagnosis due to cultural and economic reasons and the weaknesses of healthcare systems, as in the majority of low- and middle-income countries. CONCLUSION Despite all these limitation, this case illustrates that complex, rare diseases can also be managed successfully in a low-resource setting. It is mandatory to strengthen and improve the health system both in terms of equipment both in terms of public health policies in order to offer a better and more effective quality of care to patients also in low-income countries.
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Affiliation(s)
- Mario Antunes
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique.
| | - Marcella Schiavone
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique; Department of Emergency and Organ Transplantation-Section of Thoracic Surgery, University of Bari, Bari, Italy
| | - Anna Claudia Colangelo
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique; Department of Surgery and Organ Transplantation, University of Padua, Padua, Italy
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Vaz I, Starforth L, Pizzol D, Colangelo AC. Vescicovaginal fistula management in low-income setting: a complicated case report. J Surg Case Rep 2019; 2019:rjz198. [PMID: 31240096 PMCID: PMC6587336 DOI: 10.1093/jscr/rjz198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/04/2019] [Indexed: 11/19/2022] Open
Abstract
Obstetric vescicovaginal (VVF) fistulas, most of all as consequences of prolonged neglected obstructed labor, occurs mainly in low-income countries. Considering the limited resources, both of trained specialists and equipments, fistulas have a devastating impact on affected women and their families from physical, social and economic point of view. However, also in low-income settings, fistulas prevalence and consequences could be reduced with focused interventions addressed to pregnant women during antenatal visits and to surgeons which face of these particular diseases. We report a case of obstetric VVF, related to a prolonged labor, treated by surgery and managed with satisfying results in a low-income setting.
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Affiliation(s)
- Igor Vaz
- Department of Urology, Central Hospital of Maputo, Mozambique
| | - Lenny Starforth
- Department of Urology, Central Hospital of Maputo, Mozambique
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique
| | - Anna Claudia Colangelo
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique.,Department of Surgery and Organ Transplantation, University of Padua, Padua, Italy
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Antunes M, Pizzol D, Zambon M, Colangelo AC. Giant ovarian fibroma with associated Meigs syndrome in low resources setting. J Surg Case Rep 2019; 2019:rjz143. [PMID: 31231501 PMCID: PMC6582404 DOI: 10.1093/jscr/rjz143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 01/14/2023] Open
Abstract
Meigs' syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites and pleural effusion. It very uncommon and diagnosis is made difficult by symptoms that usually mimic disseminated malignancy. The gold standard treatment is laparotomy and, by definition of the syndrome, after tumor removal, the symptoms resolves and the patients become asymptomatic. We presented a giant ovarian fibroma with associated Meigs syndrome, successfully managed in a low resources setting.
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Affiliation(s)
- Mario Antunes
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique
| | - Mattia Zambon
- Department of Surgery and Organ Transplantation, University of Padua, Padua, Italy
| | - Anna Claudia Colangelo
- Operational Research Unit, Doctors with Africa Cuamm, Mozambique.,Department of Surgery and Organ Transplantation, University of Padua, Padua, Italy
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Miranda H, Colangelo AC, Antunes M, Schiavone M, Merigliano S, Pizzol D. Giant elephantiasis and inguino-scrotal hernia. PLoS Negl Trop Dis 2017; 11:e0005494. [PMID: 28617809 PMCID: PMC5472255 DOI: 10.1371/journal.pntd.0005494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Helder Miranda
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
| | - Anna Claudia Colangelo
- Department of Surgery and Organ Transplantation, University of Padua, Padua, Italy
- Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique
- * E-mail:
| | - Mario Antunes
- Department of Surgery, Central Hospital of Beira, Beira, Mozambique
| | - Marcella Schiavone
- Department of Emergency and Organ Transplantation, Section of Thoracic Surgery, University of Bari, Bari, Italy
| | - Stefano Merigliano
- Department of Surgery and Organ Transplantation, University of Padua, Padua, Italy
| | - Damiano Pizzol
- Operational Research Unit, Doctors with Africa Cuamm, Beira, Mozambique
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