Acute Appendicitis in Rural KwaZulu-Natal, South Africa

Abstract

Abstract

The Lancet commission on Global Surgery identified a huge global burden of surgical illness which is not adequately treated, as the resources needed to effectively treat these many common surgical conditions are not readily available in many regions. This review aims to provide a comprehensive overview of the epidemiology, management, and outcomes of acute appendicitis in South Africa.

Methods

A scoping search was conducted across major electronic databases to identify relevant studies published between January 2000 and December 2023. Articles reporting on the incidence, presentation, diagnostic methods, surgical interventions, and outcomes of acute appendicitis in South Africa were included.

Results

The literature review revealed an increasing incidence of acute appendicitis among African patients in South Africa, potentially linked to dietary changes accompanying urbanization. Despite advancements in surgical techniques, open appendectomy remains the primary approach, particularly in public healthcare facilities, indicating disparities in access to laparoscopic surgery. Complications such as wound infections and hospital-acquired pneumonia contribute to prolonged hospital stays, high morbidity, and high mortality. However, outcomes in private healthcare settings demonstrate higher rates of laparoscopic procedures and lower complication rates compared to public institutions.

Conclusion  

Acute appendicitis in South Africa presents unique challenges, including disparities in surgical access and outcomes between public and private healthcare sectors. Addressing these challenges requires efforts to improve healthcare infrastructure, enhance surgical training, and promote equitable access to laparoscopic techniques. Collaborative research endeavors and evidence-based interventions are essential for optimizing the management and outcomes of acute appendicitis across diverse socio-economic contexts in South Africa.