n South African Journal of Child Health - Indications, medical conditions and services related to gastrostomy placement in infants and children at a tertiary hospital in South Africa




. To describe South African infants and children requiring gastrostomies in a tertiary hospital, including the indications, medical conditions and health services, during a 5-year period (2005 - 2009).

. The research design was a retrospective descriptive survey of medical records.
. A tertiary paediatric state hospital in South Africa.
. One hundred and forty-two patients between the ages of 0 and 17 years.
. Dysphagia (=80, 56%), aspiration (=70, 49%) and need for nutritional support (=63, 44%) were the most common indicators for gastrostomy placement. Most participants (=85, 75% of the subset of 114 with feeding and swallowing difficulties) presented with multiple medical conditions, and neurological impairment (=94, 82%) and gastro-intestinal problems (=96, 84%) were the most prominent. Services were required from a variety of health care professionals for a period ranging from 6 to 103 months (mean 18 months). The speech-language therapist was consulted most frequently before gastrostomy placement (85%), while the stoma sister (97%) and dietician (97%) were consulted after placement.
. South African infants and children requiring gastrostomies frequently present with multiple medical conditions and dysphagia. These children are likely to benefit from extended services provided by a specialised team of health care professionals.


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