Skip to main content

Emily R Smith

Assistant Professor in Emergency Medicine
Emergency Medicine
310 Trent Drive, Room 302, Durham, NC 27708

Selected Publications


GAPS phase II: development and pilot results of the global assessment in pediatric surgery, an evidence-based pediatric surgical capacity assessment tool for low-resource settings.

Journal Article Pediatr Surg Int · June 19, 2024 PURPOSE: Pediatric surgical care in low- and middle-income countries is often hindered by systemic gaps in healthcare resources, infrastructure, training, and organization. This study aims to develop and validate the Global Assessment of Pediatric Surgery ... Full text Link to item Cite

Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study.

Journal Article BMC Cancer · April 12, 2024 INTRODUCTION: The SARS-CoV-2 (COVID-19) pandemic has strained healthcare systems and presented unique challenges for children requiring cancer care, particularly in low- and middle-income countries. This study aimed to assess the impact of the COVID-19 pan ... Full text Link to item Cite

Scaling up antivenom for snakebite envenoming in the Brazilian Amazon: a cost-effectiveness analysis.

Journal Article Lancet Reg Health Am · January 2024 BACKGROUND: Snakebite envenoming (SBE) affects nearly three million people yearly, causing up to 180,000 deaths and 400,000 cases of permanent disability. Brazil's state of Amazonas is a global hotspot for SBE, with one of the highest annual incidence rate ... Full text Link to item Cite

Modeling the global impact of reducing out-of-pocket costs for children's surgical care.

Journal Article PLOS Glob Public Health · 2024 Over 1.7 billion children lack access to surgical care, mostly in low- and middle-income countries (LMICs), with substantial risks of catastrophic health expenditures (CHE) and impoverishment. Increasing interest in reducing out-of-pocket (OOP) expenditure ... Full text Link to item Cite

Impact of the COVID-19 pandemic on perinatal care and outcomes: A retrospective study in a tertiary hospital in Northern Ghana.

Journal Article PLoS One · 2024 BACKGROUND: Perinatal mortality remains a global challenge. This challenge may be worsened by the negative effects of the COVID-19 pandemic on maternal and child health. OBJECTIVES: Examine the impact of the COVID-19 pandemic on perinatal care and outcomes ... Full text Link to item Cite

Understanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods study.

Journal Article PLoS One · 2024 BACKGROUND: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-ma ... Full text Link to item Cite

Towards attainment of the 2030 goal for childhood cancer survival for the World Health Organization Global Initiative for Childhood Cancer: An ecological, cross-sectional study.

Journal Article PLOS Glob Public Health · 2024 The World Health Organization (WHO) recently launched the Global Initiative for Childhood Cancer (GICC), with the goal of attaining at least 60% cancer survival for children worldwide by the year 2030. This study aims to describe the global patterns of chi ... Full text Link to item Cite

Assessment of anesthesia capacity for children in Somaliland.

Journal Article PLOS Glob Public Health · 2024 The burden of pediatric surgical conditions in Somaliland is high and the pediatric anesthesia capacity across the country remains poorly understood. The international standards developed by the World Health Organization and World Federation of Societies o ... Full text Link to item Cite

Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model.

Journal Article PLoS One · 2024 BACKGROUND: Trauma and injury present a significant global burden-one that is exacerbated in low- and middle-income settings like Tanzania. Our study aimed to describe the landscape of acute injury care and financial toxicity in the Kilimanjaro region by l ... Full text Link to item Cite

An analysis of the inclusion of ear and hearing care in national health policies, strategies and plans.

Journal Article Health Policy Plan · June 16, 2023 Ear- and hearing-related conditions pose a significant global health burden, yet public health policy surrounding ear and hearing care (EHC) in low- and middle-income countries is poorly understood. The present study aims to characterize the inclusion of E ... Full text Link to item Cite

Evaluating the status of the Lancet Commission on Global Surgery indicators for India.

Journal Article Lancet Reg Health Southeast Asia · June 2023 For universal surgical, obstetric, trauma, and anesthesia care by 2030, the Lancet Commission on Global Surgery (LCoGS) suggested tracking six indicators. We reviewed academic and policy literature to investigate the current state of LCoGS indicators in In ... Full text Link to item Cite

Childhood and Adolescent Cancer Care at a Tertiary Hospital in Northern Tanzania: A Retrospective Study.

Journal Article JCO Glob Oncol · June 2023 PURPOSE: Over 400,000 children are diagnosed with cancer around the world each year, with over 80% of these children residing in low- and middle-income countries. This study aims to summarize the epidemiology and care patterns of newly diagnosed childhood ... Full text Link to item Cite

Does reducing out-of-pocket costs for children's surgical care protect families from poverty in Somaliland? A cross-sectional, national, economic evaluation modelling study.

Journal Article BMJ Open · May 2, 2023 OBJECTIVES: An estimated 1.7 billion children around the world do not have access to safe, affordable and timely surgical care, with the financing through out-of-pocket (OOP) expenses being one of the main barriers to care. Our study modelled the impact of ... Full text Link to item Cite

Picture Cards Versus Physical Examination: A Proof-of-Concept Study to Improve the SOSAS Survey Tool.

Journal Article J Surg Res · April 2023 INTRODUCTION: The Surgeons OverSeas Assessment of Surgical Needs (SOSAS) survey tool is used to determine the unmet surgical needs in the community and has been validated in several countries. A major weakness is the absence of an objective assessment to v ... Full text Link to item Cite

Delays in cancer care for children in low-income and middle-income countries: development of a composite vulnerability index.

Journal Article Lancet Glob Health · April 2023 BACKGROUND: Early access to diagnosis and care is essential to improve rates of survival from childhood cancer, particularly in low-income and middle-income countries (LMICs). Composite indices are increasingly used to compare country performance in many h ... Full text Link to item Cite

Determinants of delayed childhood cancer care in low- and middle-income countries: A systematic review.

Journal Article Pediatr Blood Cancer · March 2023 Early access to care is essential to improve survival rates for childhood cancer. This study evaluates the determinants of delays in childhood cancer care in low- and middle-income countries (LMICs) through a systematic review of the literature. We propose ... Full text Link to item Cite

Delays in care for hydrocephalus and spina bifida at a tertiary hospital in Somaliland.

Journal Article World J Pediatr Surg · 2023 BACKGROUND: Childhood neurosurgical conditions such as hydrocephalus and spina bifida represent a significant burden of death and disability worldwide, particularly in low and middle-income countries. However, there are limited data on the disease prevalen ... Full text Link to item Cite

Prevalence and outcomes of pediatric surgical conditions at Connaught Hospital in Freetown: a retrospective study.

Journal Article World J Pediatr Surg · 2023 BACKGROUND: Sub-Saharan Africa experiences a disproportionate amount of pediatric surgical disease, with 80% of children lacking access to timely, affordable, and safe surgical care. This study aims to characterize the burden of disease and outcomes of ped ... Full text Link to item Cite

GAPS phase II: development and pilot results of the global assessment in pediatric surgery, an evidence-based pediatric surgical capacity assessment tool for low-resource settings.

Journal Article Pediatr Surg Int · June 19, 2024 PURPOSE: Pediatric surgical care in low- and middle-income countries is often hindered by systemic gaps in healthcare resources, infrastructure, training, and organization. This study aims to develop and validate the Global Assessment of Pediatric Surgery ... Full text Link to item Cite

Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study.

Journal Article BMC Cancer · April 12, 2024 INTRODUCTION: The SARS-CoV-2 (COVID-19) pandemic has strained healthcare systems and presented unique challenges for children requiring cancer care, particularly in low- and middle-income countries. This study aimed to assess the impact of the COVID-19 pan ... Full text Link to item Cite

Scaling up antivenom for snakebite envenoming in the Brazilian Amazon: a cost-effectiveness analysis.

Journal Article Lancet Reg Health Am · January 2024 BACKGROUND: Snakebite envenoming (SBE) affects nearly three million people yearly, causing up to 180,000 deaths and 400,000 cases of permanent disability. Brazil's state of Amazonas is a global hotspot for SBE, with one of the highest annual incidence rate ... Full text Link to item Cite

Modeling the global impact of reducing out-of-pocket costs for children's surgical care.

Journal Article PLOS Glob Public Health · 2024 Over 1.7 billion children lack access to surgical care, mostly in low- and middle-income countries (LMICs), with substantial risks of catastrophic health expenditures (CHE) and impoverishment. Increasing interest in reducing out-of-pocket (OOP) expenditure ... Full text Link to item Cite

Impact of the COVID-19 pandemic on perinatal care and outcomes: A retrospective study in a tertiary hospital in Northern Ghana.

Journal Article PLoS One · 2024 BACKGROUND: Perinatal mortality remains a global challenge. This challenge may be worsened by the negative effects of the COVID-19 pandemic on maternal and child health. OBJECTIVES: Examine the impact of the COVID-19 pandemic on perinatal care and outcomes ... Full text Link to item Cite

Understanding family-level decision-making when seeking access to acute surgical care for children: Protocol for a cross-sectional mixed methods study.

Journal Article PLoS One · 2024 BACKGROUND: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-ma ... Full text Link to item Cite

Towards attainment of the 2030 goal for childhood cancer survival for the World Health Organization Global Initiative for Childhood Cancer: An ecological, cross-sectional study.

Journal Article PLOS Glob Public Health · 2024 The World Health Organization (WHO) recently launched the Global Initiative for Childhood Cancer (GICC), with the goal of attaining at least 60% cancer survival for children worldwide by the year 2030. This study aims to describe the global patterns of chi ... Full text Link to item Cite

Assessment of anesthesia capacity for children in Somaliland.

Journal Article PLOS Glob Public Health · 2024 The burden of pediatric surgical conditions in Somaliland is high and the pediatric anesthesia capacity across the country remains poorly understood. The international standards developed by the World Health Organization and World Federation of Societies o ... Full text Link to item Cite

Financial toxicity and acute injury in the Kilimanjaro region: An application of the Three Delays Model.

Journal Article PLoS One · 2024 BACKGROUND: Trauma and injury present a significant global burden-one that is exacerbated in low- and middle-income settings like Tanzania. Our study aimed to describe the landscape of acute injury care and financial toxicity in the Kilimanjaro region by l ... Full text Link to item Cite

An analysis of the inclusion of ear and hearing care in national health policies, strategies and plans.

Journal Article Health Policy Plan · June 16, 2023 Ear- and hearing-related conditions pose a significant global health burden, yet public health policy surrounding ear and hearing care (EHC) in low- and middle-income countries is poorly understood. The present study aims to characterize the inclusion of E ... Full text Link to item Cite

Evaluating the status of the Lancet Commission on Global Surgery indicators for India.

Journal Article Lancet Reg Health Southeast Asia · June 2023 For universal surgical, obstetric, trauma, and anesthesia care by 2030, the Lancet Commission on Global Surgery (LCoGS) suggested tracking six indicators. We reviewed academic and policy literature to investigate the current state of LCoGS indicators in In ... Full text Link to item Cite

Childhood and Adolescent Cancer Care at a Tertiary Hospital in Northern Tanzania: A Retrospective Study.

Journal Article JCO Glob Oncol · June 2023 PURPOSE: Over 400,000 children are diagnosed with cancer around the world each year, with over 80% of these children residing in low- and middle-income countries. This study aims to summarize the epidemiology and care patterns of newly diagnosed childhood ... Full text Link to item Cite

Does reducing out-of-pocket costs for children's surgical care protect families from poverty in Somaliland? A cross-sectional, national, economic evaluation modelling study.

Journal Article BMJ Open · May 2, 2023 OBJECTIVES: An estimated 1.7 billion children around the world do not have access to safe, affordable and timely surgical care, with the financing through out-of-pocket (OOP) expenses being one of the main barriers to care. Our study modelled the impact of ... Full text Link to item Cite

Picture Cards Versus Physical Examination: A Proof-of-Concept Study to Improve the SOSAS Survey Tool.

Journal Article J Surg Res · April 2023 INTRODUCTION: The Surgeons OverSeas Assessment of Surgical Needs (SOSAS) survey tool is used to determine the unmet surgical needs in the community and has been validated in several countries. A major weakness is the absence of an objective assessment to v ... Full text Link to item Cite

Delays in cancer care for children in low-income and middle-income countries: development of a composite vulnerability index.

Journal Article Lancet Glob Health · April 2023 BACKGROUND: Early access to diagnosis and care is essential to improve rates of survival from childhood cancer, particularly in low-income and middle-income countries (LMICs). Composite indices are increasingly used to compare country performance in many h ... Full text Link to item Cite

Determinants of delayed childhood cancer care in low- and middle-income countries: A systematic review.

Journal Article Pediatr Blood Cancer · March 2023 Early access to care is essential to improve survival rates for childhood cancer. This study evaluates the determinants of delays in childhood cancer care in low- and middle-income countries (LMICs) through a systematic review of the literature. We propose ... Full text Link to item Cite

Delays in care for hydrocephalus and spina bifida at a tertiary hospital in Somaliland.

Journal Article World J Pediatr Surg · 2023 BACKGROUND: Childhood neurosurgical conditions such as hydrocephalus and spina bifida represent a significant burden of death and disability worldwide, particularly in low and middle-income countries. However, there are limited data on the disease prevalen ... Full text Link to item Cite

Prevalence and outcomes of pediatric surgical conditions at Connaught Hospital in Freetown: a retrospective study.

Journal Article World J Pediatr Surg · 2023 BACKGROUND: Sub-Saharan Africa experiences a disproportionate amount of pediatric surgical disease, with 80% of children lacking access to timely, affordable, and safe surgical care. This study aims to characterize the burden of disease and outcomes of ped ... Full text Link to item Cite

Prioritization of surgical, obstetric, trauma, and anesthesia care in India over seven decades: A systematic analysis of policy documents.

Journal Article PLOS global public health · January 2023 Improving access to surgical care in India requires policy-level prioritization of surgical, obstetric, trauma, and anesthesia (SOTA) care. We quantified SOTA care prioritization in the last seven decades by analyzing India's national policy and programmat ... Full text Cite

Mapping of clinical management resources for snakebites and other animal envenomings in the Brazilian Amazon.

Journal Article Toxicon X · December 2022 Snakebite envenomings (SBEs) and other envenomings triggered by venomous animals (VAEs) represent a significant disease burden in Brazil, with 29,152 SBEs reported in 2021 alone with nearly half of those occurring in the remote Brazilian Amazon. In 2021, B ... Full text Link to item Cite

Modeling the Scale-up of Surgical Services for Children with Surgically Treatable Congenital Conditions in Somaliland.

Journal Article World J Surg · October 2022 BACKGROUND: Congenital conditions comprise a significant portion of the global burden of surgical conditions in children. In Somaliland, over 250,000 children do not receive required surgical care annually, although the estimated costs and benefits of scal ... Full text Link to item Cite

Defining Surgical Workforce Density Targets to Meet Child and Neonatal Mortality Rate Targets in the Age of the Sustainable Development Goals: A Global Cross-Sectional Study.

Journal Article World J Surg · September 2022 OBJECTIVES: To reduce preventable deaths of newborns and children, the United Nations set a target rate per 1000 live births of 12 for neonatal mortality (NMR) and 25 for under-5 mortality (U5MR). The purpose of this paper is to define the minimum surgical ... Full text Link to item Cite

Factors contributing to delayed childhood cancer care in low- and middle-income countries: A systematic review protocol.

Journal Article Pediatr Blood Cancer · May 2022 BACKGROUND: Significant disparities exist for timely access to cancer care for children, with the highest disparities in low- and middle-income countries (LMICs). This study aims to conduct a systematic review that identifies the factors contributing to de ... Full text Link to item Cite

Challenges with pediatric surgical financing and universal health coverage in Guatemala: A qualitative analysis.

Journal Article PLOS Glob Public Health · 2022 The financing of surgical care for children in low- and middle-income countries (LMICs) remains challenging and may restrict adherence to universal health coverage (UHC) frameworks. Our aims were to describe Guatemala's national pediatric surgical financin ... Full text Link to item Cite

Potentially Avertable Child Mortality Associated with Surgical Workforce Scale-up in Low- and Middle-Income Countries: A Global Study.

Conference World J Surg · September 2021 BACKGROUND: Expansion of access to surgical care can improve health outcomes, although the impact that scale-up of the surgical workforce will have on child mortality is poorly defined. In this study, we estimate the number of child deaths potentially aver ... Full text Link to item Cite

A retrospective review of gastroschisis epidemiology and referral patterns in northern Ghana.

Journal Article Pediatr Surg Int · August 2021 PURPOSE: To describe the epidemiology and referral patterns of gastroschisis patients in northern Ghana. METHODS: A hospital-based retrospective review was undertaken at Tamale Teaching Hospital (TTH) Neonatal Intensive Care Unit (NICU) between 2014 and 20 ... Full text Link to item Cite

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study.

Journal Article Lancet · July 24, 2021 BACKGROUND: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on the ... Full text Link to item Cite

Geospatial analysis of pediatric surgical need and geographical access to care in Somaliland: a cross-sectional study.

Journal Article BMJ Open · July 21, 2021 BACKGROUND: The global burden of disease in children is large and disproportionally affects low-income and middle-income countries (LMICs). Geospatial analysis offers powerful tools to quantify and visualise disparities in surgical care in LMICs. Our study ... Full text Link to item Cite

Perceived barriers and supports to accessing community-based services for Uganda's pediatric post-surgical population.

Journal Article Disabil Rehabil · July 2021 BACKGROUND: Access to pediatric surgical intervention in low-income countries is expanding, but investments in post-surgical care have received less attention. This study explored the barriers and supports for school-aged children to access post-surgical, ... Full text Open Access Link to item Cite

Global and regional overview of the inclusion of paediatric surgery in the national health plans of 124 countries: an ecological study.

Journal Article BMJ Open · June 16, 2021 OBJECTIVE: This study evaluates the priority given to surgical care for children within national health policies, strategies and plans (NHPSPs). PARTICIPANTS AND SETTING: We reviewed the NHPSPs available in the WHO's Country Planning Cycle Database. Countr ... Full text Link to item Cite

Development of an Interactive Global Surgery Course for Interdisciplinary Learners.

Journal Article Ann Glob Health · March 31, 2021 INTRODUCTION: Global surgical care is increasingly recognized in the global health agenda and requires multidisciplinary engagement. Despite high interest among medical students, residents and other learners, many surgical faculty and health experts remain ... Full text Open Access Link to item Cite

Decrease in Admissions and Change in the Diagnostic Landscape in a Newborn Care Unit in Northern Ghana During the COVID-19 Pandemic

Journal Article Frontiers in Pediatrics · March 25, 2021 Background: The coronavirus disease (COVID-19) has spread worldwide with an increasing number of patients, including pregnant women and neonates. This study aims to evaluate morbidity and mortality in the COVID-19 era compared to the preceding year in the ... Full text Cite

Timing and causes of neonatal mortality in Tamale Teaching Hospital, Ghana: A retrospective study.

Journal Article PLoS One · 2021 Neonatal deaths now account for more than two-thirds of all deaths in the first year of life and for about half of all deaths in children under-five years. Sub-Saharan Africa accounts up to 41% of the total burden of neonatal deaths worldwide. Our study ai ... Full text Link to item Cite

Interpreting the Lancet surgical indicators in Somaliland: a cross-sectional study.

Journal Article BMJ Open · December 29, 2020 BACKGROUND: The unmet burden of surgical care is high in low-income and middle-income countries. The Lancet Commission on Global Surgery (LCoGS) proposed six indicators to guide the development of national plans for improving and monitoring access to essen ... Full text Link to item Cite

Top 10 Resources in Global Surgery.

Journal Article Glob Health Sci Pract · September 30, 2020 This resource list could serve to orient those interested in global surgery and could be supplemented with resources advocating for global surgery from clinical, population health, or policy perspectives. ... Full text Link to item Cite

Barriers to Surgical Care Among Children in Somaliland: An Application of the Three Delays Framework.

Journal Article World J Surg · June 2020 BACKGROUND: There are complex barriers that increase delays to surgical care in low- and middle-income countries, particularly among the vulnerable population of children. Understanding these barriers to surgical care can result in targeted and strategic i ... Full text Link to item Cite

Towards defining the surgical workforce for children: a geospatial analysis in Brazil.

Journal Article BMJ Open · March 24, 2020 OBJECTIVES: The optimal size of the health workforce for children's surgical care around the world remains poorly defined. The goal of this study was to characterise the surgical workforce for children across Brazil, and to identify associations between th ... Full text Link to item Cite

Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland.

Journal Article World J Surg · March 2020 BACKGROUND: Delayed access to surgical care for congenital conditions in low- and middle-income countries is associated with increased risk of death and life-long disabilities, although the actual burden of delayed access to care is unknown. Our goal was t ... Full text Link to item Cite

Burden of Neonatal Surgical Conditions in Northern Ghana.

Journal Article World J Surg · January 2020 BACKGROUND: Congenital anomalies have risen to become the fifth leading cause of under-five mortality globally. The majority of deaths and disability occur in low- and middle-income countries including Ghana. This 3-year retrospective review aimed to defin ... Full text Link to item Cite

Provision of Surgical Care for Children Across Somaliland: Challenges and Policy Guidance.

Journal Article World J Surg · November 2019 BACKGROUND: Existing data suggest a large burden of surgical conditions in low- and middle-income countries (LMICs). However, surgical care for children in LMICs remains poorly understood. Our goal was to define the hospital infrastructure, workforce, and ... Full text Link to item Cite

Management and outcomes of gastrointestinal congenital anomalies in low, middle and high income countries: protocol for a multicentre, international, prospective cohort study.

Journal Article BMJ Open · September 3, 2019 INTRODUCTION: Congenital anomalies are the fifth leading cause of death in children <5 years of age globally, contributing an estimated half a million deaths per year. Very limited literature exists from low and middle income countries (LMICs) where most o ... Full text Link to item Cite

Global Initiative for Children's Surgery: A Model of Global Collaboration to Advance the Surgical Care of Children.

Journal Article World J Surg · June 2019 BACKGROUND: Recommendations by the Lancet Commission on Global Surgery regarding surgical care in low- and middle-income countries (LMICs) require development to address the needs of children. The Global Initiative for Children's Surgery (GICS) was founded ... Full text Link to item Cite

Is Global Pediatric Surgery a Good Investment?

Journal Article World J Surg · June 2019 Investing in surgery has been highlighted as integral to strengthening overall health systems and increasing economic prosperity in low-income and middle-income countries (LMICs). The provision of surgical care in LMICs not only affects economies on a macr ... Full text Link to item Cite

A systematic review of capacity assessment tools in pediatric surgery: Global Assessment in Pediatric Surgery (GAPS) Phase I.

Journal Article J Pediatr Surg · April 2019 BACKGROUND: The Lancet Commission on Global Surgery highlighted global surgical need but offered little insight into the specific surgical challenges of children in low-resource settings. Efforts to strengthen the quality of global pediatric surgical care ... Full text Link to item Cite

Prevalence of Pediatric Surgical Conditions Across Somaliland.

Journal Article JAMA Netw Open · January 4, 2019 IMPORTANCE: Although surgical conditions are increasingly recognized as causing a significant health care burden among adults in low- and middle-income countries (LMICs), the burden of surgical conditions among children in LMICs remains poorly defined. OBJ ... Full text Link to item Cite

The contribution of pediatric surgery to poverty trajectories in Somaliland.

Journal Article PLoS One · 2019 BACKGROUND: The provision of health care in low-income and middle-income countries (LMICs) is recognized as a significant contributor to economic growth and also impacts individual families at a microeconomic level. The primary goal of our study was to exa ... Full text Link to item Cite

Disparities in surgical care for children across Brazil: Use of geospatial analysis.

Journal Article PLoS One · 2019 BACKGROUND: Health systems for surgical care for children in low- and middle-income countries remain poorly understood. Our goal was to characterize the delivery of surgical care for children across Brazil and to identify associations between surgical reso ... Full text Link to item Cite

Population-based rates, timing, and causes of maternal deaths, stillbirths, and neonatal deaths in south Asia and sub-Saharan Africa: a multi-country prospective cohort study.

Journal Article Lancet Glob Health · December 2018 BACKGROUND: Modelled mortality estimates have been useful for health programmes in low-income and middle-income countries. However, these estimates are often based on sparse and low-quality data. We aimed to generate high quality data about the burden, tim ... Full text Link to item Cite

Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda.

Journal Article BMC Health Serv Res · September 20, 2018 BACKGROUND: Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and s ... Full text Open Access Link to item Cite

Disability Weights for Pediatric Surgical Procedures: A Systematic Review and Analysis.

Journal Article World J Surg · September 2018 BACKGROUND: Metrics to measure the burden of surgical conditions, such as disability weights (DWs), are poorly defined, particularly for pediatric conditions. To summarize the literature on DWs of children's surgical conditions, we performed a systematic r ... Full text Link to item Cite

Road traffic injuries: Cross-sectional cluster randomized countrywide population data from 4 low-income countries.

Journal Article Int J Surg · April 2018 INTRODUCTION: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income cou ... Full text Link to item Cite

Prevalence of Surgically Untreated Face, Head, and Neck Conditions in Uganda: A Cross-Sectional Nationwide Household Survey.

Journal Article World Neurosurg · February 2018 BACKGROUND: The Surgeons OverSeas Assessment of Surgical Need tool (SOSAS) was created to evaluate the burden of surgically treatable conditions in low- and middle-income countries. The goal of our study is to describe the face, head, and neck (FHN) condit ... Full text Link to item Cite

Pediatric traumatic brain injury at Mbarara Regional Referral Hospital, Uganda.

Journal Article J Clin Neurosci · January 2018 BACKGROUND: In Uganda, TBI constitute the majority of neurosurgical admissions and deaths specially in the pediatric population. This study aims to determine the factors associated with poor outcome among pediatric TBI cases at a major referral hospital in ... Full text Link to item Cite

A systematic review and quality analysis of pediatric traumatic brain injury clinical practice guidelines.

Journal Article PLoS One · 2018 BACKGROUND: Traumatic brain injuries (TBI) are a significant cause of mortality and morbidity for children globally. Adherence to evidence-based treatment guidelines have been shown to improve TBI outcomes. To inform the creation of a pediatric TBI managem ... Full text Link to item Cite

Rural and urban differences in treatment status among children with surgical conditions in Uganda.

Journal Article PLoS One · 2018 BACKGROUND: In low and middle-income countries, approximately 85% of children have a surgically treatable condition before the age of 15. Within these countries, the burden of pediatric surgical conditions falls heaviest on those in rural areas. The object ... Full text Link to item Cite

Pilot Use of a Novel Tool to Assess Neurosurgical Capacity in Uganda.

Journal Article World Neurosurg · December 2017 INTRODUCTION: There is a significant burden of unmet surgical need in many low- and middle-income countries (>80% in parts of Africa). This need is even larger for specialties such as neurosurgery. Surgical capacity tools have been developed and used to as ... Full text Link to item Cite

Geospatial analysis of unmet pediatric surgical need in Uganda.

Journal Article J Pediatr Surg · October 2017 BACKGROUND: In low- and middle-income countries (LMICs), an estimated 85% of children do not have access to surgical care. The objective of the current study was to determine the geographic distribution of surgical conditions among children throughout Ugan ... Full text Link to item Cite

Early Antiretroviral Therapy Initiation and Mortality Among Infants Diagnosed With HIV in the First 12 Weeks of Life: Experiences From Kinshasa, DR Congo and Blantyre, Malawi.

Journal Article Pediatr Infect Dis J · July 2017 BACKGROUND: Based on clinical trial results, the World Health Organization recommends infant HIV testing at age 4-6 weeks and immediate antiretroviral therapy (ART) initiation in all HIV-infected infants. Little is known about the outcomes of HIV-infected ... Full text Link to item Cite

Epidemiology and Characteristics of Neurosurgical Conditions at Mbarara Regional Referral Hospital.

Journal Article World Neurosurg · June 2017 BACKGROUND: The unmet surgical need, specifically neurosurgical need, in Uganda is significant, yet only 2 public hospitals currently perform neurosurgery in the country. This study examines the epidemiology and outcomes of neurosurgical conditions present ... Full text Link to item Cite

Providing online weight management in Primary Care: a mixed methods process evaluation of healthcare practitioners' experiences of using and supporting patients using POWeR.

Journal Article Implement Sci · May 25, 2017 BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ ... Full text Link to item Cite

Performance of HIV Rapid Tests Among Breastfeeding, Malawian Infants.

Journal Article Pediatr Infect Dis J · April 2017 INTRODUCTION: Timely, accurate and affordable testing algorithms at point-of-care are critical for early infant HIV diagnosis and initiation of antiretroviral therapy in the postpartum period. We aimed to assess the utility of HIV rapid tests for young, br ... Full text Link to item Cite

Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

Journal Article J Neurosurg Pediatr · March 2017 OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quali ... Full text Link to item Cite

Timing of HIV Seroreversion Among HIV-Exposed, Breastfed Infants in Malawi: Type of HIV Rapid Test Matters.

Journal Article Matern Child Health J · February 2017 Introduction Rapid HIV serological tests are a cost-effective, point-of-care test among HIV exposed infants but cannot distinguish between maternal and infant antibodies. The lack of data on the timing of decay of maternal antibodies in young infants hinde ... Full text Link to item Cite

Randomised controlled trial and economic analysis of an internet-based weight management programme: POWeR+ (Positive Online Weight Reduction).

Journal Article Health Technol Assess · January 2017 BACKGROUND: Behavioural counselling with intensive follow-up for obesity is effective, but in resource-constrained primary care settings briefer approaches are needed. OBJECTIVES: To estimate the clinical effectiveness and cost-effectiveness of an internet ... Full text Link to item Cite

Epidemiology of pediatric surgical needs in low-income countries.

Journal Article PLoS One · 2017 OBJECTIVE: According to recent estimates, at least 11% of the total global burden of disease is attributable to surgically-treatable diseases. In children, the burden is even more striking with up to 85% of children in low-income and middle-income countrie ... Full text Link to item Cite

Pediatric Neurosurgical Outcomes Following a Neurosurgery Health System Intervention at Mulago National Referral Hospital in Uganda.

Journal Article World Neurosurg · November 2016 OBJECTIVE: Pediatric neurosurgical cases have been identified as an important target for impacting health disparities in Uganda, with over 50% of the population being less than 15 years of age. The objective of the present study was to evaluate the effects ... Full text Link to item Cite

Quantifying the pediatric surgical need in Uganda: results of a nationwide cross-sectional, household survey.

Journal Article Pediatr Surg Int · November 2016 PURPOSE: Little is known about the prevalence of pediatric surgical conditions in low- and middle-income countries. Many children never seek medical care, thus the true prevalence of surgical conditions in children in Uganda is unknown. The objective of th ... Full text Link to item Cite

An internet-based intervention with brief nurse support to manage obesity in primary care (POWeR+): a pragmatic, parallel-group, randomised controlled trial.

Journal Article Lancet Diabetes Endocrinol · October 2016 BACKGROUND: The obesity epidemic has major public health consequences. Expert dietetic and behavioural counselling with intensive follow-up is effective, but resource requirements severely restrict widespread implementation in primary care, where most pati ... Full text Link to item Cite

Economic Analysis of Children's Surgical Care in Low- and Middle-Income Countries: A Systematic Review and Analysis.

Journal Article PLoS One · 2016 BACKGROUND: Understanding the economic value of health interventions is essential for policy makers to make informed resource allocation decisions. The objective of this systematic review was to summarize available information on the economic impact of chi ... Full text Open Access Link to item Cite

A Model Program of Community-Based Supports for Older Adults at Risk of Nursing Facility Placement.

Journal Article J Am Geriatr Soc · December 2015 Transitioning an older adult into a nursing facility is a major life event for older adults (care recipients, CRs) and their family caregivers (CGs). This article describes the implementation of a community living program and presents findings on important ... Full text Link to item Cite

Randomised controlled feasibility trial of a web-based weight management intervention with nurse support for obese patients in primary care.

Journal Article Int J Behav Nutr Phys Act · May 21, 2014 BACKGROUND: There is a need for cost-effective weight management interventions that primary care can deliver to reduce the morbidity caused by obesity. Automated web-based interventions might provide a solution, but evidence suggests that they may be ineff ... Full text Link to item Cite

Implementing an evidence-based caregiver intervention within an integrated healthcare system.

Journal Article Transl Behav Med · June 2012 The complexity of dementia care combined with the lack of care experience and external support systems creates unique burdens for the caregiver. This article describes the initial findings from the Scott & White Family Caregiver Program (FCP), the Resource ... Full text Link to item Cite

Creating a cadre of junior investigators to address the challenges of cancer-related health disparities: lessons learned from the community networks program.

Conference J Cancer Educ · June 2012 Community-based participatory research (CBPR) initiatives such as the National Cancer Institute's Community Networks Program (CNP) (2005-2010) often emphasize training of junior investigators from underrepresented backgrounds to address health disparities. ... Full text Link to item Cite

Racial differences in follow-up of abnormal mammography findings among economically disadvantaged women.

Journal Article Cancer · December 15, 2009 BACKGROUND: In the United States, and particularly in South Carolina, African-American women suffer disproportionately higher mortality rates from breast cancer than European-American women. The timeliness of patient adherence to the follow-up of mammograp ... Full text Link to item Cite

Predictors of discharges to a nursing home in a hospital-based cohort.

Journal Article J Am Med Dir Assoc · November 2009 BACKGROUND: Nursing home (NH) placement among older adults is influenced by numerous factors and is associated with multiple problematic outcomes. Interventions to prevent or delay NH placement have mainly been researched in the community. However, predict ... Full text Link to item Cite

Engaging communities in evidence-based interventions for dementia caregivers.

Journal Article Fam Community Health · 2009 Caring for a family member with dementia is associated with unique stressors and burdens related to caregiving. Delivering interventions with proven efficacy to dementia caregivers remains a challenge because of the complexity of providing psychosocial sup ... Full text Link to item Cite

Breast cancer survival among economically disadvantaged women: the influences of delayed diagnosis and treatment on mortality.

Journal Article Cancer Epidemiol Biomarkers Prev · October 2008 Breast cancer affects thousands each year in the United States, and disproportionately affects certain subgroups. For example, the incidence of breast cancer in South Carolina is lower in African American compared with European American women by approximat ... Full text Link to item Cite

Food store types, availability, and cost of foods in a rural environment.

Journal Article J Am Diet Assoc · November 2007 OBJECTIVE: To characterize the built nutritional environment in terms of types and number of food stores, availability, and cost of selected food items in a rural area. DESIGN: A cross-sectional survey of food stores conducted in 2004. SUBJECTS/SETTING: We ... Full text Link to item Cite