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World Journal of Surgery
Published in: World Journal of Surgery 12/2023

Open Access 25-09-2023 | Appendectomy | Scientific Review

Factors Contributing to Delays to Accessing Appendectomy in Low- and Middle-Income Countries: A Scoping Review

Authors: Johnelize Louw, M. McCaul, R. English, P. S. Nyasulu, J. Davies, C. Fourie, J. Jassat, K. M. Chu

Published in: World Journal of Surgery | Issue 12/2023

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Abstract

Background

Appendicitis is one of the most common emergency surgical conditions worldwide. Delays in accessing appendectomy can lead to complications. Evidence on these delays in low- and middle-income countries (LMICs) is lacking. The aim of this review was to identify and synthesise the available evidence on delays to accessing appendectomy in LMICs.

Methods

This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews framework. The delays and their interconnectivity in LMICs were synthesised and interpreted using the Three Delays framework. We reviewed Africa Wide EBSCOhost, PubMed–Medline, Scopus, Web of Science, African Journals Online (AJOL), and Bioline databases.

Results

Our search identified 21 893 studies, of which 78 were included in the final analysis. All of the studies were quantitative. Fifty per cent of the studies included all three types of delays. Delays in seeking care were influenced by a lack of awareness of appendicitis symptoms, and the use of self and alternative medication, which could be linked to delays in receiving care, and the barrier refusal of medical treatment due to fear. Financial concerns were a barrier observed throughout the care pathway.

Conclusion

This review highlighted the need for additional studies on delays to accessing appendectomy in additional LMICs. Our review demonstrates that in LMICs, persons seeking appendectomy present late to health-care facilities due to several patient-related factors. After reaching a health-care facility, accessing appendectomy can further be delayed owing to a lack of adequate hospital resources.
Appendix
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Metadata
Title
Factors Contributing to Delays to Accessing Appendectomy in Low- and Middle-Income Countries: A Scoping Review
Authors
Johnelize Louw
M. McCaul
R. English
P. S. Nyasulu
J. Davies
C. Fourie
J. Jassat
K. M. Chu
Publication date
25-09-2023
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 12/2023
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-023-07183-2

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