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BackgroundThe College of Surgeons of East, Central, and Southern Africa (COSECSA) comprises 14 countries, many of which currently grapple with an increasing burden of cardiothoracic surgical (CTS) diseases. Health and economic implications of unaddressed CTS conditions are profound and require a robust regional response. This study aimed to define the status of CTS specialist training in the region (including the density of specialists, facilities, and active training posts), examine implications, and proffer recommendations.MethodsA desk review of COSECSA secretariat documents and program accreditation records triangulated with information from surgical societies was performed in May 2022 and September 2023 as part of education quality improvement. A modified nominal group process involving contextual experts was used to develop a relevant action framework.ResultsOnly 6 of 14 (43%) of COSECSA countries offered active training programs with annual intake of only 18 trainees. Significant training gaps existed in Burundi, Botswana, Malawi, Rwanda, South Sudan, Zambia, and Zimbabwe. Country specialist density ranged from 1 per 400,000 (Namibia) to 1 per 8,000,000 (Ethiopia). Overall, the region had 0.2 CTS specialists per million population as compared with 7.15 surgeons per million in High‐Income Countries. Surgical education experts proposed an action framework to address the training crisis including increasing investments in CTS education, establishing regional centers of excellence, retention incentives and opportunities for women, and leveraging international partnerships.ConclusionProactive investments in infrastructure, human resources, training, and collaborative efforts by national governments, regional intergovernmental organizations, and international partners are critical to expanding regional CTS training.
BackgroundThe College of Surgeons of East, Central, and Southern Africa (COSECSA) comprises 14 countries, many of which currently grapple with an increasing burden of cardiothoracic surgical (CTS) diseases. Health and economic implications of unaddressed CTS conditions are profound and require a robust regional response. This study aimed to define the status of CTS specialist training in the region (including the density of specialists, facilities, and active training posts), examine implications, and proffer recommendations.MethodsA desk review of COSECSA secretariat documents and program accreditation records triangulated with information from surgical societies was performed in May 2022 and September 2023 as part of education quality improvement. A modified nominal group process involving contextual experts was used to develop a relevant action framework.ResultsOnly 6 of 14 (43%) of COSECSA countries offered active training programs with annual intake of only 18 trainees. Significant training gaps existed in Burundi, Botswana, Malawi, Rwanda, South Sudan, Zambia, and Zimbabwe. Country specialist density ranged from 1 per 400,000 (Namibia) to 1 per 8,000,000 (Ethiopia). Overall, the region had 0.2 CTS specialists per million population as compared with 7.15 surgeons per million in High‐Income Countries. Surgical education experts proposed an action framework to address the training crisis including increasing investments in CTS education, establishing regional centers of excellence, retention incentives and opportunities for women, and leveraging international partnerships.ConclusionProactive investments in infrastructure, human resources, training, and collaborative efforts by national governments, regional intergovernmental organizations, and international partners are critical to expanding regional CTS training.
Background This study aimed to analyse the epidemiological characteristics of patients with trauma in the emergency room and provide a basis for the prevention and treatment of trauma. Methods Data on patients with trauma admitted to the emergency room between January 2013 and December 2021, including sex, age, visit time, consciousness, blood pressure, heart rate, detention, patient outcome, and prognosis, were retrospectively analysed. Results A total of 13,313 patients were admitted to the emergency room, with a male-to-female ratio of 2.51:1. Most patients were young and middle-aged, with 8518 patients, accounting for 63.98%. The monthly peak number of patients admitted to the emergency room occurred in July, September, and October, and the peak time was 11:00–21:00. The detention time of patients with trauma in the emergency room showed an extended trend, with 72.2% of patients staying for at least 3 hours in the emergency room. As age increased, the proportion of patients staying in emergency rooms ≥ 3 hours increased gradually. A total of 345 patients (2.6%) died in the emergency room, 4035 patients (30.3%) received surgical treatment, 5082 patients (38.2%) were admitted to a specialised ward for conservative treatment, 2272 patients (17.1) were kept in the emergency room, and 1579 patients (11.9%) were discharged after emergency treatment. Nonconsciousness on admission, systolic blood pressure < 110 mmHg, abnormal diastolic blood pressure, and abnormal heart rate were risk factors for death in patients with trauma in the emergency room. Conclusion The emergency department should reasonably allocate medical resources according to the main population of patients with trauma, peak hours, and peak seasons, and standardise emergency procedures. Emergency medical staff should attach importance to the assessment of patients' consciousness and vital signs and provide active treatment.
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