A Systematic Review of Neurosurgical Care in Low-Income Countries

Weiss, Hannah; García, Roxanna M.; Omiye, Jesutofunmi A.; Vervoort, Dominique; Riestenberg, Robert; Yerneni, Ketan; Murthy, Nikhil K.; Wescott, Annie; Hutchinson, Peter J.; Rosseau, Gail

doi:10.1016/j.wnsx.2019.100068

Cited by 29 publications

(12 citation statements)

References 50 publications

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“…Also evident from these large statistical samples is the higher incidence not only of GBM but also of all types of tumors of the CNS in developed countries, compared to developing ones [ 15 ]. This fact, of course, is mainly related to access to medical care and the existence of diagnostic modalities for these nosological units, and not due to actual lower incidence [ 16 ]. Unfortunately, the lower rate of morbidity found in our country compared to the countries with high economic resources puts us in the group of countries with a relatively high rate of hidden morbidity [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Reclassification of Glioblastoma Multiforme According to the 2021 World Health Organization Classification of Central Nervous System Tumors: A Single Institution Report and Practical Significance

Stoyanov¹,

Lyutfi²,

Georgieva³

et al. 2022

Cureus

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Section: Discussionmentioning

confidence: 99%

Reclassification of Glioblastoma Multiforme According to the 2021 World Health Organization Classification of Central Nervous System Tumors: A Single Institution Report and Practical Significance

Stoyanov¹,

Lyutfi²,

Georgieva³

et al. 2022

Cureus

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“…Each year, 22.6 million individuals worldwide require neurological care due to diseases such as traumatic brain injury, stroke, brain tumor, and epilepsy, and 13.8 million of these individuals require surgical intervention (7). Traumatic brain injuries are common worldwide, with a prevalence between 55 to 69 million, but disproportionately affect individuals in low-and middle-income countries (LMICs) (8). This results in an increased neurosurgical burden of disease in LMICs.…”

Section: Global Burden Of Neurosurgical Diseases and The Disproportional Effect On Lmicsmentioning

confidence: 99%

Emphasizing the Role of Neurosurgery Within Global Health and National Health Systems: A Call to Action

et al. 2021

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Background: Worldwide, neurological disorders are the leading cause of disability-adjusted life years lost and the second leading cause of death. Despite global health capacity-building efforts, each year, 22.6 million individuals worldwide require neurosurgeon's care due to diseases such as traumatic brain injury and hydrocephalus, and 13.8 million of these individuals require surgery. It is clear that neurosurgical care is indispensable in both national and international public health discussions. This study highlights the role neurosurgeons can play in supporting the global health agenda, national surgical plans, and health strengthening systems (HSS) interventions.Methods: Guided by a literature review, the authors discuss key topics such as the global burden of neurosurgical diseases, the current state of neurosurgical care around the world and the inherent benefits of strong neurosurgical capability for health systems.Results: Neurosurgical diseases make up an important part of the global burden of diseases. Many neurosurgeons possess the sustained passion, resilience, and leadership needed to advocate for improved neurosurgical care worldwide. Neurosurgical care has been linked to 14 of the 17 Sustainable Development Goals (SDGs), thus highlighting the tremendous impact neurosurgeons can have upon HSS initiatives.Conclusion: We recommend policymakers and global health actors to: (i) increase the involvement of neurosurgeons within the global health dialogue; (ii) involve neurosurgeons in the national surgical system strengthening process; (iii) integrate neurosurgical care within the global surgery movement; and (iv) promote the training and education of neurosurgeons, especially those residing in Low-and middle-income countries, in the field of global public health.

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“…In Africa, brain tumours represent a significant burden of disease: in Sub-Saharan Africa, brain tumours represent 0.14% of disability-adjusted life years (DALYs) and 0.17% of deaths, while in North Africa, brain tumours cause 0.44% of DALYs and 0.62% of deaths [ 10 ]. However, there is a significant deficit in the literature on neurosurgical care of LGGs in Africa [ 11 ], and available reports suggest that diagnosis and management of LGGs remains a daunting task in most low- and middle-income countries (LMICs). Possible contributing factors to this deficit include the lack of access to adequate neuroimaging facilities, which prevent timely diagnosis and treatment of suspected LGG cases, the absence of surgical adjunct technologies, and lack of training in awake surgery [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Management and outcomes of low-grade gliomas in Africa: A scoping review

Ooi¹,

Koning²,

Egiz³

et al. 2022

Annals of Medicine &Amp; Surgery

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Introduction Despite recent advancements in the management of low-grade gliomas (LGGs), there is a paucity in the data within the African landscape. We aim to evaluate the epidemiology, management, and outcomes of LGGs in Africa. Methods Systematic searches of MEDLINE, Embase and African Journals Online were performed from database inception to January 27, 2021, for studies reporting on LGGs in Africa. Pooled statistics were calculated using measures of central tendency and spread. Results 554 unique studies were identified, of which 25 were included. The mean age of patients was 15.7 years (95% confidence interval (CI): 11.8–19.6) and 56.4% were male (95% CI: 55.6–62.6%). Most patients had solitary lesions (86.0%, 95% CI: 82.8–89.1%) located in the infratentorial region (71.6%, 95% CI: 66.1–77.1%). Most LGGs received histopathological diagnosis (71.7%, 95% CI: 69.2–74.2%) and astrocytoma was the most common type (81.1%, 95% CI: 78.5–83.7%). 37 patients had awake surgery (3.1%, 95% CI: 2.0–4.0%) and there were no reports of molecular pathology testing, intraoperative neuroimaging, or 5-aminolevulinic acid. Gross total resection was achieved in 74.8% (95% CI: 69.6–80.0%) and there was a recurrence rate of 1.7% (95% CI: 0.9–2.4%), with a mean follow-up of 19.4 months (95% CI: 6.9–31.9). Conclusion LGGs are underreported in Africa. We found a lag in the uptake of techniques established in high-income countries for improving patient outcomes. Future efforts will require further training and funding in molecular pathology testing and advanced surgical adjuncts.

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A Systematic Review of Neurosurgical Care in Low-Income Countries

Cited by 29 publications

References 50 publications

Reclassification of Glioblastoma Multiforme According to the 2021 World Health Organization Classification of Central Nervous System Tumors: A Single Institution Report and Practical Significance

Reclassification of Glioblastoma Multiforme According to the 2021 World Health Organization Classification of Central Nervous System Tumors: A Single Institution Report and Practical Significance

Emphasizing the Role of Neurosurgery Within Global Health and National Health Systems: A Call to Action

Management and outcomes of low-grade gliomas in Africa: A scoping review

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