Screening for associated malformations in anorectal malformations in francophone sub-Saharan Africa: a survey to pediatric surgeons

Objective To analyze the practices and challenges of pediatric surgeons in searching for associated malformations in ARM Methods A survey among pediatric surgeons from francophone sub-Saharan Africa was conducted using Google Forms. Results The study included 114 responders from 13 countries, with a median age of 38 years and 82 males (71.9%). The median number of ARM cases managed per year by each responder was 8 cases. However, 108/114 responders (94.7%) reported not having a pediatric colorectal unit/center in their institution. Systematic screening for AM in ARM was reported by 42/114 responders (36.8%). Reasons for not performing systematic screening were dominated by the high cost of imaging investigations (51/72 responders, 70.8%) and the lack or unavailability of medical imaging equipment (36/72 responders, 50%). The most requested screening exams by responders were the cardiac US by 108/114 responders (94.5%), abdominal US by 103/114 responders (90%), and vertebral x-ray by 98/114 responders (86.3%). When screening investigations were requested, they were reported to be available before the first surgery by 21/114 responders (18.4%), due to the need for emergency surgery (74/93 responders; 79.6%) and the high cost of imaging investigations (50/93 responders; 53.8%). Conclusion Screening for AM in ARM in SSA is rarely systematic due to the high cost of imaging investigations and the lack of imaging equipment. Whenever screening exams are requested, they are exceptionally available before the first surgical procedure, mostly due to the need for emergency surgery.