Morbidity and Mortality following Traditional Uvulectomy among Children Presenting to the Muhimbili National Hospital Emergency Department in Dar es Salaam, Tanzania

الملخص EN

Background.

Traditional uvulectomy is performed as a cultural ritual or purported medical remedy.

We describe the associated emergency department (ED) presentations and outcomes.

Methods.

This was a subgroup analysis of a retrospective review of all pediatric visits to our ED in 2012.

Trained abstracters recorded demographics, clinical presentations, and outcomes.

Results.

Complete data were available for 5540/5774 (96%) visits and 56 (1.0%, 95% CI: 0.7–1.3%) were related to recent uvulectomy, median age 1.3 years (interquartile range: 7 months–2 years) and 30 (54%) were male.

Presenting complaints included cough (82%), fever (46%), and hematemesis (38%).

Clinical findings included fever (54%), tachypnea (30%), and tachycardia (25%).

35 patients (63%, 95% CI: 49–75%) received intravenous antibiotics, 11 (20%, 95% CI: 10–32%) required blood transfusion, and 3 (5%, 95% CI: 1–15%) had surgical intervention.

All were admitted to the hospital and 12 (21%, 95% CI: 12–34%) died.

By comparison, 498 (9.1%, 95% CI: 8–10%) of the 5484 children presenting for reasons unrelated to uvulectomy died (p=0.003).

Conclusion.

In our cohort, traditional uvulectomy was associated with significant morbidity and mortality.

Emergency care providers should advocate for legal and public health interventions to eliminate this dangerous practice.