Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study. Issue 10297 (24th July 2021)

• Record Type: Journal Article
• Authors: Wright, Naomi Jane; Leather, Andrew J.M.; Ade-Ajayi, Niyi; Sevdalis, Nick; Davies, Justine; Poenaru, Dan; Ameh, Emmanuel; Ademuyiwa, Adesoji; Lakhoo, Kokila; Smith, Emily Rose; Douiri, Abdel; Elstad, Maria; Sim, Marcus; Riboni, Cristiana; Martinez-Leo, Bruno; Akhbari, Melika; Tabiri, Stephen; Mitul, Ashrarur; Aziz, Dayang Anita Abdul; Fachin, Camila; Niyukuri, Alliance; Arshad, Muhammad; Ibrahim, Fowzia; Moitt, Natalie; Doheim, Mohamed Fahmy; Thompson, Hannah; Ubhi, Harmony; Williams, Isabelle; Hashim, Sophia; Philipo, Godfrey Sama; Herrera, Laura; Yunus, Aayenah; Vervoort, Dominique; Parker, Samuel; Benaskeur, Yousra-Imane; Alser, Osaid H.; Adofo-Ansong, Nana; Alhamid, Ahmad; Salem, Hosni khairy; Saleh, Mahmoud; Elrais, Safa Abdal; Abukhalaf, Sadi; Shinondo, Patricia; Nour, Ibrahim; Aydin, Emrah; Vaitkiene, Agota; Naranjo, Kelly; Dube, Andile Maqhawe; Ngwenya, Sodumisa; Yacoub, Mina A.; Kwasau, Henang; Hyman, Gabriella; Elghazaly, Shrouk Mahmoud; Al-Slaibi, Ibrahim; Hisham, Intisar; Franco, Helena; Arbab, Hana; Samad, Lubna; Soomro, Aqil; Chaudhry, Muhammad Amjad; Karim, Safina; Khattak, Muhammad Adnan Khan; Nah, Shireen Anne; Dimatatac, Doris Mae; Choo, Candy SC; Maistry, Niveshni; Mitul, Ashrarur Rahman; Hasan, Samiul; Karim, Sabbir; Yousuf, Hina; Qureshi, Taimur; Nour, Ibrahim Rabi; Al-Taher, Raed Nael; Sarhan, Osama Abdul Kareem; Garcia-Aparicio, Luis; Prat, Jordi; Blazquez-Gomez, Eva; Tarrado, Xavier; Iriondo, Martí; Bragagnini, Paolo; Rite, Segundo; Hagander, Lars; Svensson, Emma; Owusu, Sheila; Abdul-Mumin, Alhassan; Bagbio, Dominic; Ismavel, Vijay Anand; Miriam, Ann; T, Shajin; Anaya Dominguez, Marlene; Ivanov, Monica; Serban, Andreea Madalina; Derbew, Miliard; Elfiky, Mahmoud; Olivos Perez, Maricarmen; Abrunhosa Matias, Marcia; Arnaud, Alexis P; Negida, Ahmed; King, Sebastian; Fazli, Mohamad Rafi; Hamidi, Nadia; Touabti, Souhem; Chipalavela, Rossana Francisco; Lobos, Pablo; Jones, Brendan; Ljuhar, Damir; Singer, Georg; Hasan, Samiul; Cordonnier, Annelien; Jáuregui, Lorena; Zvizdic, Zlatan; Wong, Janice; St-Louis, Etienne; Shu, Qiang; Lui, Yang; Correa, Catalina; Pos, Lucie; Alcántara, Elvyn; Féliz, Erick; Zea-Salazar, Luis Enrique; Ali, Liza; Peycelon, Matthieu; Anatole, Nzanzu Kipata; Jallow, Cherno S.; Lindert, Judith; Ghosh, Dhruv; Adhiwidjaja, Cathline Freya; Tabari, Ahmad Khaleghnejad; Lotfollahzadeh, Saran; Mussein, Haidar Mohammad; Vatta, Fabrizio; Pasqua, Noemi; Kihiko, David; Gohil, Hetal; Nour, Ibrahim R.; Elhadi, Muhammed; Almada, Suad Ahmed; Verkauskas, Gilvydas; Risteski, Toni; Peñarrieta Daher, Alejandro; Outani, Oumaima; Hamill, James; Lawal, Taiwo; Mulu, Jack; Yapo, Benjamin; Saldaña, Lily; Espineda, Beda; Toczewski, Krystian; Tuyishime, Eugene; Ndayishimiye, Isaac; Raboe, Enaam; Hammond, Philip; Walker, Gregor; Djordjevic, Ivona; Chitnis, Milind; Son, Joonhyuk; Lee, Sanghoon; Hussien, Muaad; Malik, Sawazen; Ismail, Enas Musa; Boonthai, Ampaipan; Dahman, Nesrine Ben Hadj; Hall, Nigel; Castedo Camacho, Fabiola Ruth; Sobrero, Helena; Butler, Marilyn; Makhmud, Aliev; Novotny, Nathan; Hammouri, Ahmad G.; Al-Rayyes, Maisara; Bvulani, Bruce; Muraveji, Qais; Murzaie, Muhammad Yousuf; Sherzad, Ajmal; Haidari, Sayed Aman; Monawar, Abdul Baqi; Samadi, Dr. Ahmad Zia; Thiessen, Jesh; Venant, Ntakarutimana; Hospital, Sonia Inamuco; Jérémie, Niyonkuru; Mbonicura, Jean Claude; Vianney, Butoyi Jean Marie; Tadesse, Amezene; Negash, Samuel; Roberts, Charles A.; Jabang, John N.; Bah, Abdoulie; Camamra, Kajali; Correa, Armandou; Sowe, Babucarr; Gai, A.; Jaiteh, Musa; Raymond, Kwizera Jean; Mvukiyehe, Jean Paul; Itangishaka, Innocent; Kayibanda, Emmanuel; Manirambona, Emery; Lule, Joseph; Costas-Chavarri, Ainhoa; Shyaka Gashugi, Ian; Ndata, Albert; Gasana, Georges; Nezerwa, Yves Castar; Simeon, Turatsinze; Muragijimana, Jean De Dieu; Rashid, Sakina; Msuya, David; Elisante, Joseph; Solanki, Meghna; Manjira, Emmanuel; Lodhia, Jay; Jusabani, Mubashir; Tarmohamed, Murad; Koipapi, Sengua; Souhem, Touabti; Sara, Nabti; Sihem, Brahimi; Dania, Bouguermouh; Toufik, Iaiche Achour; Mounira, Baghdadi Nour el islam; Habiba, Alouani; Aragão, Liliana; Gonçalves, Victor; Lino Urquizo, Marcelo Mauricio; Varela, Maria Florencia; Mercado, Pedro; Horacio, Bonavia; Damiani, Andrea; Mac, Carlos; Putruele, Daniel; Liljesthrom, Karen; Bernaus, Marianela; Jauri, Cesar; Cripovich, Alejandrina; Bianchin, Ezequiel; Puig, Maria Gabriela; Andreussi, Lorna; Iracelay, Susana; Marcos, Dolores; Herrera, Carina; Palacios, Nelly; Avile, Romina; Serezo, Belen; Montoya, Debora; Cepeda, Rodrigo; Vaquila, Justo; Veronica, Sofficci; Pardo, Liliana; Valeria, Pelussi; Julio, Lapalma; Martin, Aranda Diego; Lucio, Palazzi; Gabriel, Comba; Marianella, Depetrini; Calderón Arancibia, José Alfredo; Huespe, Enrique; Losa, Gabriela Natalia; Arancibia Gutiérrez, Elsa; Scherl, Humberto; Gonzalez, Daniel Emilio; Baistrocchi, Valentina; Silva, Yanina; Galdeano, Marcelo; Medard, Pablo; Sueiras, Ines; Romero Manteola, Enrique; Defago, Victor Hugo; Mieres, Carlos; Alberto, Carlos; Cornelli, Fabio; Molina, Marcelo; Ravetta, Pablo; Patiño Gonzalez, Celeste Carolina; Dallegre, Maria Belen; Szklarz, Maria Tatiana; Leyba, Marcos Federico; Rivarola, Nahuel Ignacio; Charras, Maria Delia; Morales, Adriana; Caseb, Paloma; Toselli, Luzia; Millán, Carolina; Junes, Maria del Carmen; Di Siervi, Oscar; Gilardi, Jose; Simon, Soledad; Contreras, Carla Sofia; Rojas, Nair; Arnoletto, Lucia Beatriz; Blain, Otilia Eva; Bravo, Mauro Nicolas; Sanchez, Nancy; Herrera Pesara, Luciana Martina; Moreno, Maria Eugenia; Sferco, Carlos Ariel; Huq, Umama; Ferdousi, Tamanna; Al-Mamun, Abdullah; Sultana, Sadia; Mahmud, Refoyez; Mahmud, Khalid; Sayeed, Fatema; Svirsky, Alexander; Sempertegui, Denisse; Negrete, Amalia; Teran, Araceli; Sadagurschi, Mariana; Popovic, Nusret; Karavdic, Kenan; Milisic, Emir; Jonuzi, Asmir; Mesic, Amira; Terzic, Sabina; Dendusic, Nejra; Biber, Elna; Sehic, Anesa; Zvizdic, Nada; Letic, Emina; Saracevic, Adna; Hamidovic, Ajla; Selak, Nejra; Horozic, Dzan; Hukic, Lamija; Muhic, Amila; Vanis, Nedim; Sokolovic, Emir; Sabic, Adnan; Becker, Karin; Novochadlo Klüppel, Elis; dos Santos Dias, André Iván Bradley; Agulham, Miguel Angelo; Bischoff, Cristiano; Sabbatini, Stella; Fernandes de Souza, Rachel; Souza Machado, Ana Beatriz; Werneck Raposo, Juliana; da Silva Augusto, Maria Lucia; Martins, Bianca M.R.; de Souza Santos Ferreira, Mariana; Fernandes de Oliveira, Darli; Silva dos Santos, Carla; Ribeiro de Fernández y Alcázar, Fernanda; Alves Dutra da Silva, Érika; Furtado, Mariana; Tamada, Horácio; Silva Ferreira dos Santos, Marília; Lopes de Almeida, Thayná; Oliveira de Andrade, Susy; Gurgel do Amaral, Antonio Cipriano; Sartori Giovanoni, Lais; de Deus Passos Leles, Kamila; Corrêa Costa, Eduardo; Feldens, Leticia; Ferraz Schopf, Luciano; Soares de Fraga, José Carlos; Colombo de Holanda, Felipe; Brolin Santis Isolan, Paola Maria; Loyola Ferreira, Julia; Bruxel, Carla Luisa; Lopes Teixeira Ferdinando, Danielle; Zottis Barcelos, Fabricio; Baseggio, Natalia; Knorr Brenner, Nicole; Trindade Deyl, Rafael; Dure, Carolina; Nunes Kist, Iuri; Bueno Mazzuca, Rafael; Bueno Motter, Sarah; Ramos, Yna; Suzana Trein, Cristine; Rezende Rosa, Bianca; de Assis Silva, Murilo; Menin, Flavio Augusto; Semensato Carloni, Isabela Cristina; Norberto da Silva, Juliana Antinarelli; Gomes, Adriano Luis; Girão Tauffer, Mariana; Bassan Gonçalves, Paulo César; Nogueira Marques, Geraldo Magela; Moriya, Eliane; Labonia, Carla; Carrasco, Ana Lucia; Furtado Meyer, Karine; Farion-Aguiar, Luiz; Amado, Fernando; Antunes, Amanda; Silva, Elisângela; Telles, Leila; Almeida, Giovana; Belmino Gadelha, Aluísio Augusto; de Azevedo Belesa, Flavia; Gonçalves da Cunha, Jr, Acimar; Souza Barros, Beatriz; Zanellato, Josiane Bernartt; Guimarães, Patricia; Silva, Karina Ilheu da; Ribas, Bianca; Reuter, Cristina; Casado, Francis Tanise; Correa Leite, Mila Torii; Testoni, Daniela; Guinsburg, Ruth; de Campos Vieira Abib, Simone; Khodor Cury, Edson; Dornellas do Nascimento, Suely; Almeida Aguiar, Arthur; Melo Gallindo, Rodrigo; Gonçalves Borges, Carolina; Liu, Yang; Duote, Cai; Wang, Jinhu; Gao, Zhigang; Liang, Liang; Luo, Wenjuan; Zhao, Xiaoxia; Chen, Rui; Wang, Peng; Han, Yijiang; Huang, Ting; Donglai, Hu; Xiaodong, Guo; Junjie, Chen; Zhu, Libin; Wu, Guowei; Bao, Xiaozhou; Li, Haijing; Lv, Junying; Li, Zhongrong; Yong, Feng; Gao, Zhou Chong; Bai, Qiang; Tang, Weibing; Xie, Hua; Motee, Jethishka; Zhu, Jianming; Wen, Gang; Ruan, Weiwei; Li, Shungen; Chen, Lulu; Huang, Shungen; Lv, Zhibao; Lu, Jinjing; Huang, Liuming; Yu, Mengnan; Dajia, Wang; Bai, Yu Zuo; Rincon, Luis Carlos; Mancera, Juliana; Alzate Gallego, Edgar; Torres-Canchala, Laura; Silva Beltrán, Nathalia; Osorio Fory, Ghordana; Castaño Avila, Daniela; Forero Ladino, Angelica Maria; Gomez, Juanita; Jaramillo, Martha; Morales, Otto; Sanchez, Beatriz; Tinoco Guzmán, Nestor Julien; Castañeda Espinosa, Sergio; Prieto Vargas, Osbaldo; Pardo, Lina Maria; Toral, Eliana; Cáceres Aucatoma, Freud; Hinostroza, Daniel; Valencia, Santiago; Salinas, Vicente; Landivar Cino, Enrique; Ponce Fajardo, Gabriela Yulissa; Astudillo, Miguel; Garcia, Virginia; Muñoz, Guillermo; Verduga, Leonardo; Verduga, Ivan; Murillo, Ericka; Bucaram, Elena; Guayelema, Marisol; Marmol, Monica; Sanchez, Janina; Vergara, Carolina; Mena, Adriana; Velaña, Junior; Salazar, Karla; Lara, Sandra; Chiriboga, Elena; Silva, Julian; Gad, Dalia; Samy, Doaa; Elsadek, Menan Ahmed; Mohammed, Hanan Mahmoud; Abouheba, Mohamed; Ali, Karim Osamy; Rashwan, Hayssam; Fawzy, Omar Moustafa; Kamel, Tarek mohamed; Nemer, Rawan; Hassan, Mohamed Abada; Falah, Eyad Hassan; Abdelhady, Dina Sobhy; Zain, Mostafa; Ibrahim, Eman Abouzeid Abouzeid; Elsiraffy, Omar Ossama; Aboelela, Ahmed; Farag, Eman mohamed; Oshiba, Ahmed Mohamed; Emam, Omar Sameh; Attia, Alaa Mobarak; Laymouna, Moustafa A.; Ghorab, Islam Abdelmonem; Mohammed, Mansour Mkayed; Soliman, Nourhan Akram; Ghaly, Khaled Abd elrahman; Sadek, Kareem; Elsherbiny, Mohamed; Saleh, Amr; Sheir, Hesham; Wafa, Tamer; Elmenam, Mohamed Abd; Abdelmaksoud, Sherif; Reda, Ahmed; Mansour, Islam; Elzohiri, Mohamed; Waseem, Basma; Elewaily, Mohamed; El-Ghazaly, Mohammed; Elhattab, Ahmad; Shalaby, Amr; Elsaied, Adham; Adawy, Ahmad; Sadek, Mirna; Ahmed, Mahmoud Abdelfattah; Herdan, Mohamed Omar; Elassall, Gena Mohamed Hamed; Mohammed, Azhar Arabi; Takrouney, Mohammed Hamada; Essa, Tarek Mohamed; Mahmoud, Ahmed Mokhtar; Saad, Alshaimaa M.; Fouly, Mariam Albatoul Nageh; Ibrahim, Mahmoud abdelshakour; Nageh, Mohammad; Saad, Mahmoud M.; Badr, Helmy; Fouda, Mohamed Fayez; Nofal, Ahmed Hassan; Almohamady, Hisham; Arafa, Mohamed Ahmed; Amad, Mohamed; Mansour, Mohamed Awad; O'Connor, Jennifer; O'Connor, Zachary; Anatole, Nzanzu; Nkunzimana, Elysé; Machemedze, Solomon; Dieudonné, Lemfuka; Appeadu-Mensah, William; Anyomih, Theophilus Teddy Kojo; Alhassan, Priscilla; Abantanga, Francis A.; Michael, Vishal; Mary Koshy, Roshine; Raj, Ankit; Kumar, Vijay; PT, Sundeep; Prabhu, P Santosh; Vosoughi, Armin; Al-Mayoof, Ali Farooq; Fadhle, Muhamed Jassim; Joda, Ali Egab; Algabri, Hayder Nadhim Obaid; Al-Taher, Raed Nael; Abdelhamid, Sultan S.; Al-Momani, Hashem M.; Amarin, Marzouq; Zaghlol, Louay Y.; Alsaadi, Nijmeh Nasser; Qwaider, Yasmeen Z.; Qutishat, Hibah; Aliwisat, Ahmad Hasan; Arabiat, Esraa; Bsisu, Isam; Murshidi, Raghad M.; Jabaiti, Mohammad S.; Bataineh, Ziad A.; Abuhayyeh, Husam Aldean; Quran, Thekraiat M. Al; Za'nouneh, Faris J. Abu; Alebbini, Mohanad Mutasem; Qudah, Hamzah Abullah; Hussein, Omar Ghazi; Murad, Amir M.I.; Amarin, Justin Z.; Suradi, Haya H.; Alzraikat, Sayel H.; Omari, Rand Y.; Matour, Bashar M.; Al-Halbouni, Layana; Zurikat, Rajai O.; Yanis, Ahmad H.; Hussein, Sara Al; Shoubaki, Ali; Ghanem, Waleed H.; David, Kuria; Chitiavi, Soita Wycliffe; Mose, Moraa; Mugo, Robert; Ndungu, James; Mwai, Timothy; Shahbal, Swaleh; Malik, Janan; Chauhan, Nirav; Syovata, Francisa; Ochieng, Kevin; Omendo Liyenzero, Polycarp; Hussain, Syeda Ra'ana; Mugambi, Stanley; Ochieng, Roseline; Elkhazmi, Ebtesam Othman Abdulsalam; Khaled, Ala; Albozidi, Aya; Enbaya, Manal Ben; Elgammudi, Mala; Soula, Enas; Khalel, Wegden ibrahim almabrouk; Elhajjaji, Yasmine Ali; Alwaggaa, Nouriyah Ali; Ghayth, Sumayyah; Zreeg, Dafer abdulhakim .S.; Tantush, Sara Abobaker; Bibas, Fatma; Layas, Tesneem; Sharif, Randa Alamen M; Aljadidi, Wesal Omar F. Saied; Tarek, Ahmed; Ahmed, Hazem; Essamilghi, Kamila Almabrouk Mohammed; Alfoghi, Mabroka; Abuhlega, Ma'aly A.; Arrmali, Saddam; Abduljawad, Fatima Mousa; Alosta, Hasan Mustafa; Abuajaila, Abdulsalam; Abdelmutalib, Fakereldeen; Bashir, Fatma; Almengar, Inas; Annajjar, Mohammad hasan; Deyab, Abdelaziz; Elzowawi, Fathi; Krayem, Yousef; Drah, Weam; Meftah, Asma; Mohammed, Abobaker; Arrmalli, Lina Ali; Aljaboo, Hajir; Elayeb, Abdallah; Altomi, Mohamed; Altaweel, Ahmed; Tumi, Mohamed; Bazozi, Hana Milad; Shaklawoon, Aisha; Alglaib, Mohammed Meftah; Elkaloush, Abdullahn Abdousalam; Trainba, Sara; Swessi, Hisham; Alnaeri, Ali; Shnishah, Aya Essam; Mustufa, Hamassat; Gargum, Sondas Ali; Tarniba, Sara Ali; Shalluf, Hawa Ahmed; Shokri, Hajer Ali; Sarkaz, Taher L.; Tababa, Osama; Elhadi, Ahmed; Naunova, Vesna Cvetanovska; Jovcheski, Laze; Kamilovski, Marjan; Gavrilovska-Brzanov, Aleksandra; Latiff, Zarina Abdul; Pauzi, Siti Farhan Moh; Osman, Marjmin; Lim, Felicia; Bakar, Ainal Huda Abu; Zaman, Azrina SK; Ishak, Shareena; Teo, Rufinah; Qi, Dr. Tammy Teoh Han; Othman, Mohd Yusran Bin; Zahari, Dato' Dr Zakaria bin; Hassan, Zulfitri bin Md; Shan, Cheah Hui; Lechmiannandan, Abhirrami; Tamaddun, Hafatin Fairos bt; Adanan, Mohd Fitri Shukri bin Mohamed; Abdullah, Mohd Yusof bin; Junyi, Wang; Nor, Mohd. Tarmizi Mohd; Noor, Wan Ruzaimie; Hassan, Mohd Razin bin; Dalek, Noor Fa'izatul Rahil Ambok; Hashim, Hidayah Hayati binti; Zarwawi, Ahmad Zulhisyam bin; Vellusamy, V Muthualhagi M; Yuen, Quah Soong; Kannessan, Hemasutha a/p; Ramli, Najua binti; Bujarimin, Ahmad Shafiee bin; Anntinea, Jessmine; Dass, Anthony; Khalid, Hazlina Mohd.; Hanifah, Nur Atiqah binti Mohd; Jyun, Keily Wong Yue; Razak, Rahilah binti Abd; Naim, Nur Atifah binti Mohd; Hamzah, Siti Nur Aien binti Hamid; Vidal, Cristian R. Zalles; Bracho Blanchet, Eduardo; Dávila Perez, Roberto; Fernandez Portilla, Emilio; Villegas Silva, Raúl; Ibarra, Daniel; Calderon Moore, Antonio; Carrasco-Ortega, Cesar; Noguez Castillo, Monica; Herappe Mellado, Dorihela; Yanowsky Reyes, Guillermo; Gonzalez Cortez, Luis Fernando; Santana Ortiz, Rafael; Orozco Perez, Jamie; Corona C.Rivera, Jorge Román; Cardenas Ruiz Velasco, Juan Jose; Quiles Corona, Moises; Peña Padilla, Christian; Bobadilla Morales, Lucina; Corona Rivera, Alfredo; Rios Flores, Izabel Maryalexandra; Aranda Sánchez, Cristian Irela; Ambriz-González, Gabriela; Martínez Hernández Magro, Nestor; León Frutos, Francisco Javier; Cárdenas Barón, José de Jesús; González Ojeda, Alejandro; Yarza Fernández, Jessica; Porras, Juan Domingo; Aguirre-Lopez, Pastor; Sánchez Paredes, Vicente; Montalvo Marin, Arturo; Diaz Gomez, Jose Manuel; Caamal, Lorenzo Juvencio; Bulnes Mendizabal, David; Sanchez Valladares, Pablo; Garcia Martinez, Humberto; Adesanya, Opeoluwa; Olanrewaju, Moses; Adegboyega, Rilwan; Abdulraheem, Nurudeen; Aremo, Anuoluwapo; Dedeke, Florence; Chukwuemeka, Anyanwu Lofty-John; Mohammad, Mohammad Aminu; Lawalbarau, Abdullahi; Collins, Nwokoro; Ibukunolu, Ogundele; Shonubi, Amo; Ladipo-Ajayi, Oluwaseun; Elebute, Olumide Abiodun; Seyi-Olajide, Justina; Alakaloko, Felix; Ihediwa, George; Olayade, Kayode; Bode, Christopher; Ogundoyin, Olakayode; Olulana, Dare I.; Egbuchulem, Ifeanyichukwu Kelvin; Kumolalo, Felix O.; Ulasi, Ikechukwu; Ezomike, Uchechukwu Obiora; Ekenze, Sebastian Okwuchukwu; Nwankwo, Elochukwu Perpetua; Nwangwu, Emmanuel Ifeanyi; Chukwu, Isaac; Amah, Christopher Chim; Obianyo, Nene Elsie; Williams, Omolara; Osuoji, Roland Iheanyichukwu; Faboya, Omolara Moronkeji; Ajai, Olalekan Temitope; Abdulsalam, Moruf Adekunle; Agboola, Titiloye Hannah; Temilade, Bolarinwa Bolanle; Osazuwa, Maryrose; Salawu, Morayo Monsurat; Ejinkeonye, Eze Chukwuemeka; Yola, Mariya Mukhtar; Mairami, Amsa B.; Otuneye, Adekunle T.; Igoche, Matthias; Tanimola, Adebayo Gbenga; Ajao, Emmanuel Akinlabi; Agelebe, Efeturi; Olori, Samson; Mshelbwala, Philip Mari; Osagie, Olabisi; Oyinloye, Adewale; Abubakar, Auwal M; Oyebanji, Lateef; Shehu, Ibrahim; Cletus, Cyril; Bamanga, Ahmed; Suleiman, Faruk; Adamu, Sani; C.Nwosu, David; S.Alkali, Yahya; Jalo, Iliya; Rasaki, Aliu; T.Sambo, Yusuf; A.Mohammed, Kalakwa; M.Ballah, Abubakar; Modekwe, Victor; Ekwunife, Okechukwu Hyginus; Ezidiegwu, Ugochukwu S; Osuigwe, Andrew N; Ugwu, Jideofor O; Ugwunne, Chuka A; Akhter, Nadeem; Gondal, Mudassir Fayaz; Raza, Rafee; Chaudary, Ali Raza; Ali, Hassan; Nisar, Muhammad Umar; Jamal, Muhammad Umer; Pandit, Ghuri Shankar; Mumtaz, Uzma; Amjad, Muhammad Bin; Talat, Nabila; Rehman, Wajeeh ur; Saleem, Muhammad; Mirza, Muhammad Bilal; Hashim, Imran; Haider, Naveed; Hameed, Soban; Saleem, Ayesha; Dogar, Sohail; Sharif, Muhammad; Bashir, Muhammad Kashif; Naumeri, Fatima; Rani, Zarqa; Baniowda, Muath A.M.; Ba'baa', Basheer; Hassan, Majd Yousef Mohammed; Darwish, Ammar; Sehwiel, Abrar Shaheen; Shehada, Mohammed; Balousha, Abrar ghassan; Ajrami, Yara; Alzamari, Ainaa Ata Mohammad; Yaghi, Bashar; Al-saleem, Hasan Subhi Hasan Abu; Farha, Mervat Sufian Abu; Abdelhafez, Mohammad Omar Mohammad; Anaya, Firas; Qadomi, Asef belal; Odi, Abd Al-Naser Bany; Assi, Muath Abdelrahem Fuad; Sharabati, Fadwa; Abueideh, Ahmad; Beshtawi, Doha mustafa saleh; Arafat, Hasan; Khatatba, Lara Zahi Adel; Abatli, Safa' Jamal; Al-Tammam, Hiba; Jaber, Dania; Kayed, Yara Imad Omar; Abumunshar, Ali Abdelhay; Misk, Rami Anwar; Alzeer, Asmahan Mohammad Suliman; Sharabati, Mutassem; Ghazzawi, Ihsan; Darras, Osama Majed; M.Qabaja, Mahmoud; Hajajreh, Ma'alem sameer; Samarah, Yasmeen Ahmad; Yaghi, Dua Hasan; Qunaibi, Moradallah Asad Fahmi; Mayaleh, Abdelrazzaq Abu; Joubeh, Sharehan; Ebeido, Annan; Adawi, Samer; Adawi, Ihda; Alqor, Mohammad Omar Ibrahim; Arar, Ahmad Samih; Awad, Hadeel; Abu-Nejmah, Fawzi; Shabana, Osaid Shaher; Alqarajeh, Firas; Alzughayyar, Tareq Z.; Madieh, Jomana; Sbaih, Mahmoud Fuad; Alkareem, Raghad mohammad abdu; Lahlooh, Raghad abdullateef; Halabi, Yasmeen Adly; Baker, Wisam; Almusleh, Tasneem Fathi Hasan; Tahyneh, Abdulraheem Adnan Abdulraheem; Atatri, Yazid yousef mahmoud; Jamie, Najlaa Abu; Massry, Nasrallah Ashraf Al; Lubbad, Walaa; A.Nemer, Ayoub; Alser, Mohammed; Salha, Aya Azmi Shehda; Alnahhal, Khaled; Elmzyyen, Aya Mahmoud; Ghabayen, Amir Talat Sheda; Alamrain, Abdulwhhab Ayman Abu; Al-Shwaikh, Samar H.; Elshaer, Omar Adly; Shaheen, Nureddin; Fares, Jehad; Dalloul, Hisham; Qawwash, Anas; Jayyab, Mustafa abu; Ashour, Dina Ayman; Shaheen, Ahmad Ashraf; Naim, Samy Rafat Ramadan; Shiha, Eman Abu; Dammagh, Nagham Mohammed Al; Almadhoun, Walaa; Al-Salhi, Ashraf Ayman; Hammato, Abdalkarim Yhya; Salim, Jamal Mohammed; Hasanain, Doaa Khalil; Alwadia, Soha Marwan Salem; Nassar, Ismail; Al-Attar, Hala M.; Alshaikhkhalil, Haya Abdulnasser Ali; Jamie, Yasmin Mohammed Khalil Abu; Ashour, Yara shareef; Alijla, Sharif S.; Tallaa, Mohamed Anwer El; Abuattaya, Adham Ashraf; Wishah, Bisan D.M.; ALDIRAWI, MOHAMMED A.M.; Darwish, Ahmed S; Alzerei, Sulaiman T.; Wishah, Nidal; Alijla, Sharif; Garcia, Isidora; Diaz Echegaray, Marlene; Cañapataña Sahuanay, Veronica Raquel; Trigoso Mori, Fernando; Alvarado Zelada, Jackelyne; Salinas Barreto, Juan Jose; Rivera Altamirano, Porfirio; Torres Miranda, Cesar; Anicama Elias, Rocio; Rivera Alvarez, Julio; Vasquez Matos, Juan Pedro; Ayque Rosas, Fernando; Ledesma Peraza, Jesmarina; Gutarra Palomino, Andrea; Vega Centen, Stephany; Casquero, Victor; Ortiz Argomedo, María Rosa; Lapouble, Francisco; Llap Unchón, Genaro; Delgado Malaga, Florangel Patricia; Ortega Sotelo, Luis; Gamboa Kcomt, Segundo; Villalba Villalba, Araceli; Mendoza Leon, Nancy Rossana; Cardenas Alva, Loreley Raquel; Loo Neyra, Maria Susana; Alanguia Chipana, Cathy Lee; Torres Picón, Cintya Maria de Jesus; Huaytalla Quiroz, Natalia; Dominguez, Danny; Segura Calle, Carlos; Arauco, Jenny; Ormeño Calderón, Luis; Ghilardi Silva, Ximena; Fernandez Wilson, Miriam Daniela; Gutierrez Maldonado, Joan Elizabeth; Diaz Leon, Cesar; 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• Is Part Of: Lancet. Volume 398:Issue 10297(2021)
• Page Start: 325
• Page End: 339
• Publication Date: 2021-07-24
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Medicine; Electronic journals; Periodicals; 610.5
• DOI: 10.1016/S0140-6736(21)00767-4
• Languages: English
• ISSNs: 0140-6736

Abstract

Summary: 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 these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030. Funding: Wellcome Trust.