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Introduction <p>Diagnosis of ARM in SSA has some particularities linked to delayed diagnosis, different proportions of ARM types, and lower frequencies of associated anomalies. With this review, we aimed to summarize diagnostic aspects of ARM in SSA and analyze its impact on the GDP.</p> Methods <p>Using PubMed, we conducted a scoping review by screening published reports from SSA institutions from 2006 to 2023. Statistical tests were used to compare variables according to three GDP groups (LICs, LMICs, UMICs), with significance set at <i>p </i>&lt; 0.05.</p> Results <p>Twenty-three studies reporting 3344 patients were included. The male to female ratio was 1.3:1. The median age at diagnosis was 0.9&#xa0;years. The Krickenbeck classification was used in 14 studies (60.8%). Rectovestibular fistulae were reported with higher frequency in LICs vs UMICs (95% CI [4.872, 29.818], <i>p</i> = 0.013). The existence of a screening protocol for AA increased with GDP (1/7 vs 4/9 vs 7/7; <i>p</i> = 0.005). The reported frequency of AA was lower in LICs vs UMICs ([-64.016, −&#xa0;23.470], <i>p</i> &lt; 0.001) and in LMICs vs UMICs ([−&#xa0;61.878, −&#xa0;30.872], <i>p</i> &lt; 0.001). Urogenital malformations were reported with lower frequency in LICs vs UMICs ([-33.459, −&#xa0;3.802], <i>p</i> = 0.026) and in LMICs vs UMICs ([−&#xa0;28.697, −&#xa0;4.678], <i>p </i>= 0.041). Cardiovascular anomalies had lower frequency in LICs vs UMICs ([−&#xa0;31.954, −&#xa0;5.504], <i>p</i> = 0.011) and in LMICs vs UMICs ([−&#xa0;29.410, −&#xa0;2.965], <i>p</i> = 0.021).</p> Conclusion <p>Diagnosis of ARM in SSA is often delayed, with non-systematic use of the Krickenbeck classification. Lower GDP group results in higher reports of rectovestibular fistula, fewer existences of screening protocol for AA, and their lower reports in LICs and LMICs compared to UMICs, especially urogenital and cardiovascular ones.</p>

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Diagnosis of anorectal malformations in Sub-Saharan Africa: a scoping review and analysis of impact of the gross domestic product

  • 期刊论文

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  • 发表日期：

    2025年10月7日

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  • Florent Tshibwid A Zeng,
  • Roland Fabrice Mbiki Yema,
  • Ena Ngandu Keita,
  • Gracia Mitonga Kamwangen,
  • Luc-Beau Ihaku Kombe,
  • Nathalie Dinganga Kapessa,
  • Sébastien Mbuyi-Musanzayi

摘要

Introduction

Diagnosis of ARM in SSA has some particularities linked to delayed diagnosis, different proportions of ARM types, and lower frequencies of associated anomalies. With this review, we aimed to summarize diagnostic aspects of ARM in SSA and analyze its impact on the GDP.

Methods

Using PubMed, we conducted a scoping review by screening published reports from SSA institutions from 2006 to 2023. Statistical tests were used to compare variables according to three GDP groups (LICs, LMICs, UMICs), with significance set at p < 0.05.

Results

Twenty-three studies reporting 3344 patients were included. The male to female ratio was 1.3:1. The median age at diagnosis was 0.9 years. The Krickenbeck classification was used in 14 studies (60.8%). Rectovestibular fistulae were reported with higher frequency in LICs vs UMICs (95% CI [4.872, 29.818], p = 0.013). The existence of a screening protocol for AA increased with GDP (1/7 vs 4/9 vs 7/7; p = 0.005). The reported frequency of AA was lower in LICs vs UMICs ([-64.016, − 23.470], p < 0.001) and in LMICs vs UMICs ([− 61.878, − 30.872], p < 0.001). Urogenital malformations were reported with lower frequency in LICs vs UMICs ([-33.459, − 3.802], p = 0.026) and in LMICs vs UMICs ([− 28.697, − 4.678], p = 0.041). Cardiovascular anomalies had lower frequency in LICs vs UMICs ([− 31.954, − 5.504], p = 0.011) and in LMICs vs UMICs ([− 29.410, − 2.965], p = 0.021).

Conclusion

Diagnosis of ARM in SSA is often delayed, with non-systematic use of the Krickenbeck classification. Lower GDP group results in higher reports of rectovestibular fistula, fewer existences of screening protocol for AA, and their lower reports in LICs and LMICs compared to UMICs, especially urogenital and cardiovascular ones.