Impact of Reducing Time Lived With Colostomies on Social Stigma Affecting Children With Anorectal Malformations in Southwestern Uganda

Part of Colorectal & Anorectal Surgery 5 items

pubmed.ncbi.nlm.nih.gov

Meera Kotagal

Background: The social stigma of families of children living with colostomies due to anorectal malformation (ARM) is significant in low-income countries (LICs). Improved access to pediatric surgery has resulted in more 1-stage ARM procedures in Southwestern Uganda, avoiding colostomy creation, but the impact on social stigma experienced by families is unknown. We hypothesized that this change would decrease the social stigma experienced by families. Methods: A single-center mixed retrospective and prospective cohort study with combined qualitative data of families of children with ARM who underwent corrective surgery compared the stigma experienced by those with colostomies to those without. The Kilifi Stigma Scale of Epilepsy (KSSE) was used to assess social stigma. Multivariable regression analysis assessed differences in the stigma experienced, controlling for age at diagnosis, rurality, distance traveled, sex, and parental education. Subgroup analysis assessed the impact of colostomy duration on stigma, stratified over parental education. Results: Patient/family dyads with 238 ARM were included; 177 (74%) received a colostomy. Most patients were male (51%), lived in rural areas (71%), and had parents with primary school education (65%). For those without a colostomy, the median KSSE was 0 (Q1-Q3 0-0), compared to 11 (Q1-Q3 3-20) for colostomy. On multivariable analysis, after controlling for age at diagnosis, rurality, distance traveled, sex, and parental education attain

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Article · Apr 2025 · 1 min read

In brief

Study in Uganda demonstrates that single-stage ARM repair without colostomy creation significantly reduces social stigma experienced by families compared to traditional staged repair with colostomy. Families without colostomies reported median stigma scores of 0 versus 11 for those with colostomies, highlighting the psychosocial benefit of improved surgical access in resource-limited settings.

Written by the GCMD Library team from the article.

Meera Kotagal

Statements in this article

The social stigma of families of children living with colostomies due to anorectal malformation is significant in low-income countries.
EstablishedBackground
Improved access to pediatric surgery has resulted in more 1-stage anorectal malformation procedures in Southwestern Uganda, avoiding colostomy creation.
EstablishedBackground
Of 238 anorectal malformation patient/family dyads included, 177 (74%) received a colostomy.
ResearchResults
Most patients were male (51%), lived in rural areas (71%), and had parents with primary school education (65%).
ResearchResults
For patients without a colostomy, the median Kilifi Stigma Scale of Epilepsy score was 0 (Q1-Q3 0-0), compared to 11 (Q1-Q3 3-20) for those with colostomy.
ResearchResults