World Journal of Surgery

, Volume 36, Issue 4, pp 771-774

First online:

Pilot Testing of a Population-based Surgical Survey Tool in Sierra Leone

  • Reinou S. GroenAffiliated withRoyal Tropical InstituteSurgeons OverSeas (SOS) Email author 
  • , Mohamed SamaiAffiliated withCollege of Medicine and Allied Health Science (COMAHS)
  • , Robin T. PetrozeAffiliated withDepartment of Surgery, University of Virginia
  • , Thaim B. KamaraAffiliated withDepartment of Surgery, Connaught Hospital Lightfoot Boston Street
  • , Sahr E. YambasuAffiliated withStatistics Sierra Leone (SSL)
  • , James F. CallandAffiliated withDepartment of Surgery, University of Virginia
  • , T. Peter KinghamAffiliated withSurgeons OverSeas (SOS)Department of Surgery, Memorial Sloan-Kettering Cancer Center
  • , Thomas M. GuterbockAffiliated withDepartment of Public Health Sciences, and Center for Survey Research, University of Virginia
  • , Barbara ChooAffiliated withSchool of Nursing, University of Virginia
    • , Adam L. KushnerAffiliated withRoyal Tropical InstituteSurgeons OverSeas (SOS)Department of Surgery, Columbia University

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The prevalence of surgical diseases in low income countries is thought to be very large, but to date no population-based survey has documented the need. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a survey tool programmed for use with iPads to measure the prevalence of surgical conditions.


To assess the appropriateness and utility of SOSAS, a pilot test was undertaken in Sierra Leone. Local medical students were trained in sampling, interviewing, and SOSAS specifics. Five clusters of 10 households were randomly selected and 100 individuals were interviewed. Problems with the tool, iPad use, and respondent answers were collected. Daily debriefings with the enumerators aimed to identify problems and ways for improvement.


Administering SOSAS via iPads was found to be easy and facilitated data entry. Quick analysis of the data allowed for rapid feedback. Although the survey has 450 possible data entry points, by using conditional formatting, the enumerators were able to collect household demographics and interview two randomly selected household members in an average of 25 min. The survey methodology was acceptable, with a response rate of 96%. Five major sections were amended after the pilot.


Pilot testing of SOSAS showed that a population-based survey measuring the prevalence of surgical disease could be undertaken in a low income country. It is recommended that SOSAS be used with a larger sample size to calculate the prevalence of surgical disease in low income countries.