Lagos survey finds high reported mortality burden but few perceived surgical disabilities

Researchers used the Surgeons OverSeas Assessment of Surgical Need tool in a community-based household survey conducted in 2016 in Ikorodu Local Government Area, Lagos State. The survey covered 856 households and 3,984 people, including 1,986 adult informants and 1,998 children. It assessed reported deaths in the previous 12 months, surgical conditions and perceived disability attributed by respondents to a surgical condition. Years of life lost (YLL) were calculated for deaths with individual age data; years lived with disability estimates were exploratory.

Respondents reported 46 deaths—32 adults and 14 children. The crude all-cause death rate was 11.5 per 1,000 people (95% CI 8.7–15.4). Causes were unascertained for 36 deaths (78.3%). For 43 deaths with age data, estimated YLL totalled 1,681.3, averaging 39.1 years per death. Extremity conditions accounted for 91 of 169 classified adult pathology entries (53.8%). Perceived disability was reported for 20 adults (1.0%) and four children (0.2%). Estimated disability-adjusted life years were 1,682.9, more than 99% from YLL; the researchers did not estimate surgically attributable mortality.

The findings point to a substantial reported mortality burden and frequent extremity conditions, but the high proportion of deaths with unknown causes limits conclusions about deaths related to untreated surgical conditions. Disability estimates were based on perceived attribution and exploratory assumptions, including a one-year duration. The authors call for improved access to timely surgical care, referral pathways and community mortality surveillance.