Experiences with childhood colostomy at a tertiary hospital in Mwanza, Tanzania

  • Phillipo L. Chalya Consultant General surgeon and Lecturer in Surgery
  • Joseph B. Mabula Consultant Surgeon and Senior Lecturer
  • Emmanuel S. Kanumba General Surgeon and Lecturer in Surgery
  • Godfrey Giiti General Surgeon and Lecturer, Department of Surgery
  • Alphonce B Chandika
  • Japhet M Gilyoma senior lecturer department of surgery
Keywords: childhood, colostomy, indications, complications, management, Tanzania

Abstract

Colostomy is a common life saving procedure in children and may be attended by significant morbidity. This cross-sectional study was carried out to describe experiences with childhood colostomy outlining the common indications, complications and their management and to identify factors associated with these complications in a tertiary hospital in Mwanza, Tanzania. Data was collected using a pre-tested, coded questionnaire. A total of 134 patients were studied. Seventy-eight (58.2%) were males and females were fifty-six (41.8%) (M: F =1.4:1). Their mean age was 1.83 years (range 1 day to 10 years). Anorectal malformations and Hirschsprung’s disease were the most common indications for colostomy formation in 46.3% and 40.3%, respectively. Transverse loop colostomy was the commonest type of colostomy performed accounting for 79.1% of cases. Colostomy-related complications were recorded in 35.8% of cases. Skin excoriation and colostomy prolapse were the most common complications accounting for 19.4% and 17.9% respectively. The overall complication rate was significantly common in transverse colostomy than in sigmoid colostomy and in colostomies performed by junior doctors (P<0.001). The overall complication rate following colostomy closure was 23.4% and this was significantly associated with timing of closure and the rank of the operating surgeon (P < 0.001). The overall duration of hospitalization following colostomy closure ranged from seven to 24 days (mean = 8.60± 2.62 days). The duration of hospitalization after closure was significantly longer in patients who had complications (P<0.001). Mortality rate was 8.3%. Colostomy formation and closure in our setting are commonly associated with high morbidity and mortality resulting from improper operative technique and inadequate follow up care. To minimize these problems, proper meticulous surgical technique and adequate follow up care may decrease the incidence of complications related to colostomy.

Author Biographies

Phillipo L. Chalya, Consultant General surgeon and Lecturer in Surgery
General surgeon and Lecturer in Surgery,Department of Surgery
Joseph B. Mabula, Consultant Surgeon and Senior Lecturer
Consultant Surgeon and Senior Lecturer, Department of Surgery
Emmanuel S. Kanumba, General Surgeon and Lecturer in Surgery
General Surgeon and Lecturer, Department of Surgery
Godfrey Giiti, General Surgeon and Lecturer, Department of Surgery
General Surgeon and Lecturer, Department of Surgery
Alphonce B Chandika
Lecturer department of Surgery
Japhet M Gilyoma, senior lecturer department of surgery
senior lecturer department of surgery
Published
2011-07-10
How to Cite
ChalyaP. L., MabulaJ. B., KanumbaE. S., GiitiG., ChandikaA. B., & GilyomaJ. M. (2011). Experiences with childhood colostomy at a tertiary hospital in Mwanza, Tanzania. Tanzania Journal of Health Research, 13(3), 224-235. https://doi.org/10.4314/thrb.v13i3.56442
Section
Articles

Journal Identifiers


eISSN: 1821-9241
print ISSN: 1821-6404