In populations in sub-Saharan Africa, transitional changes in patterns of morbidity and mortality are taking place, with decreases in the diseases of poverty and infection, but rises in chronic diseases of prosperity, associated, however, with greater longevity. Remarkably, bowel diseases - appendicitis, diverticular disease, colon cancer - while nearly absent in rural areas, have very low incidences in urban dwellers, despite rises in risk factors, including a decreasing intake of fibre-containing foods.
This retrospective study was conducted into 1.506 patients who had been admitted to the author's hospital for suspicion of acute appendicitis, between 1971 and 1979. Indications for appendectomy were handled with generosity, and primary laparotomy was applied to 44.2 per cent of all cases. Perforated appendicitis was of low incidence, accounting for only three per cent, while no acute inflammatory lesions were recordable at all from 36 per cent of removed appendices.