World Journal of Surgery

, Volume 36, Issue 4, pp 771–774 | Cite as

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

  • Reinou S. GroenEmail author
  • Mohamed Samai
  • Robin T. Petroze
  • Thaim B. Kamara
  • Sahr E. Yambasu
  • James F. Calland
  • T. Peter Kingham
  • Thomas M. Guterbock
  • Barbara Choo
  • Adam L. Kushner



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.


Medical Student Pilot Testing Household Representative Road Traffic Injury General Health Question 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors acknowledge the contributions of Andrew A. Kamara, Andrew B. Johnney, and Prince Williams of Statistics Sierra Leone for sharing their expertise in surveying in Sierra Leone. They also acknowledge Michael M. Kamara and Lucina Bockarie for their critical contributions as enumerators for the pilot. Finally, the authors acknowledge the substantial contribution of Shahrzad Joharifard, who helped with the initial programming of the survey for iPad use.

Conflict of interest

None of the authors is funded for their contribution. Surgeons OverSeas (SOS) assisted the logistics and payment of enumerators and transportation with funding from private contributions. MOHS contributed with local transportation and administrative assistance.


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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Reinou S. Groen
    • 1
    • 2
    Email author
  • Mohamed Samai
    • 3
  • Robin T. Petroze
    • 4
  • Thaim B. Kamara
    • 5
  • Sahr E. Yambasu
    • 6
  • James F. Calland
    • 4
  • T. Peter Kingham
    • 2
    • 7
  • Thomas M. Guterbock
    • 8
  • Barbara Choo
    • 9
  • Adam L. Kushner
    • 2
    • 10
  1. 1.Royal Tropical InstituteAmsterdamThe Netherlands
  2. 2.Surgeons OverSeas (SOS)New YorkUSA
  3. 3.College of Medicine and Allied Health Science (COMAHS)FreetownSierra Leone
  4. 4.Department of SurgeryUniversity of VirginiaCharlottesvilleUSA
  5. 5.Department of SurgeryConnaught Hospital Lightfoot Boston StreetFreetown Sierra Leone
  6. 6.Statistics Sierra Leone (SSL)FreetownSierra Leone
  7. 7.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  8. 8.Department of Public Health Sciences, and Center for Survey ResearchUniversity of VirginiaCharlottesvilleUSA
  9. 9.School of NursingUniversity of VirginiaCharlottesvilleUSA
  10. 10.Department of SurgeryColumbia UniversityNew YorkUSA

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