East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
Vol. 22, No. 3, 2017, pp. 21-28
Bioline Code: js17029
Full paper language: English
Document type: Research Article
Document available free of charge
East and Central African Journal of Surgery, Vol. 22, No. 3, 2017, pp. 21-28
© Copyright 2017 - East and Central African Journal of Surgery
Epidemiological study of peritonitis among children and factors predicting mortality at a tertiary referral hospital in Rwanda|
Mutabazi, Emmanuel; Bonane, Alex; Ndibanje, Alain J. & Rickard, Jennifer
Background: Peritonitis is a commonly encountered paediatric surgical emergency. We
conducted this study to identify common causes of peritonitis among Rwandan children and
factors affecting morbidity and mortality.
Methods: The study sample consisted of children with peritonitis who underwent surgical
treatment at a tertiary referral hospital in Rwanda from 1 September 2015 to 28 February
2016. Collected data included sociodemographic, clinical, paraclinical, management, and
outcome information. The analysis included Pearson's chi-square test and multivariate
logistic regression to determine factors associated with morbidity and mortality.
Results: Of 63 patients, 28 were female. Ages ranged from 4 months to 15 years, with a mean
of 8.8 years. Seventy-three percent of patients presented within the first week of symptom
onset. Appendicular perforation (25.4%) and gangrenous intussusception (23.8%) were the
most common causes of peritonitis.
Fourteen patients (22.2%) died. On multivariate analysis, factors associated with mortality
included sepsis (odds ratio [OR] = 11.60; 95% confidence interval [CI] = 2.15 to 62.5; P =
0.004) and intensive care unit (ICU) admission (OR = 7.38; 95% CI = 1.20 to 45.3; P = 0.031).
Conclusions: Peritonitis among children is common and bears significant morbidity and
mortality at our centre. Training of healthcare providers in district hospitals for early
recognition of peritonitis, and improved ICU care availability may reduce mortality
secondary to peritonitis in children.
epidemiology; peritonitis; paediatric surgery; Rwanda