Neurosurgery in Ethiopia: A New Chapter and Future Prospects

Asfaw, Zerubabbel K.; Tirsit, Abenezer; Barthélemy, Ernest J.; Mesfin, Elam; Wondafrash, Mulualem; Yohannes, Dagnachew; Ashagre, Yordanos; Park, Kee; Laeke, Tsegazeab

doi:10.1016/j.wneu.2021.05.071

Cited by 17 publications

(12 citation statements)

References 23 publications

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“…Despite recent progress, the availability of neuroimaging equipment remains inadequate, with 38 computed tomography scanners and 11 magnetic resonance imaging machines for a population of 112.07 million. The geographic distribution of neurosurgical facilities is limited to 12 urban centers [ 8 ].…”

Section: Developing Pediatric Neurosurgery In Ethiopiamentioning

confidence: 99%

“…The Foundation for International Education in Neurosurgery (FIENS) was an active partner in bringing teaching faculty for the program. The program development has been described by Lund-Johansen and colleagues in 2017 [7] and has been evaluated in the African context by Asfaw and colleagues in 2021 [8]. Between 2006 and 2020, neurosurgeon density increased greater than 20-fold from 0.0022 to 0.045 neurosurgeons per 100,000 population.…”

Section: Developing Pediatric Neurosurgery In Ethiopiamentioning

confidence: 99%

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A case study of ReachAnother Foundation as a change champion for developing spina bifida neurosurgical care and advocating for primary prevention in Ethiopia

Koning¹,

Koning²,

Kancherla

et al. 2023

Childs Nerv Syst

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Spina bifida is a serious birth defect affecting the central nervous system, characterized by incomplete closure of the neural tube. Ethiopia has a very high prevalence of spina bifida, affecting about 40 cases per 10,000 births. Babies born with spina bifida require early closure surgery, done within the first 2–3 days after birth. Some babies need repeat surgeries to address complications, including hydrocephalus. Without medical care, babies have a high risk of death within the first 5 years of their life. Neurosurgical capacity for spina bifida closure surgery at birth is a relatively new development in Ethiopia. ReachAnother Foundation, a not-for-profit organization based in OR, USA, started work in Ethiopia in 2009 and has been instrumental in training neurosurgeons and improving treatment for spina bifida and hydrocephalus. Along with the development of neurosurgical care, the Foundation has invested in training multi-disciplinary teams to conduct patient aftercare and has launched a platform for improved patient outcomes research. As of year 2022, they support six spina bifida “Centers of Excellence” nationwide and are continuously advocating for primary prevention of spina bifida through mandatory fortification of staple foods in Ethiopia. This paper describes ReachAnother’s efforts in Ethiopia in a short interval of time, benefiting numerous patients and families with spina bifida and anencephaly. We document this as a case study for other countries to model where resources are limited and the prevalence of spina bifida and hydrocephalus is high, especially in Asia and Africa.

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Section: Developing Pediatric Neurosurgery In Ethiopiamentioning

confidence: 99%

Section: Developing Pediatric Neurosurgery In Ethiopiamentioning

confidence: 99%

A case study of ReachAnother Foundation as a change champion for developing spina bifida neurosurgical care and advocating for primary prevention in Ethiopia

Koning¹,

Koning²,

Kancherla

et al. 2023

Childs Nerv Syst

Self Cite

View full text Add to dashboard Cite

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“…It also improved neonatal survival, which contributed to achieving MDG4 three years prior to the deadline. To develop specialised workforce skills such as in neurosurgery and pediatric surgery, Ethiopia has initially relied on overseas partnerships [11], though over the past decades, the country has forged itself as a regional training center for several East African professionals [12]. The Federal Ministry of Health has also been able to devise large-scale, governmentdriven comprehensive health reform initiatives focused on surgical care (e.g., Saving Lives through Safe Surgery) to improve quality surgical delivery with demonstrable positive impacts on surgical leadership, logistics and supplies, building partnerships and advocacy for safe surgery.…”

Section: Surgical Care In Ethiopia Pre-conflictmentioning

confidence: 99%

Organizational peer support to enable rehabilitating surgical services in Northern Ethiopia

et al. 2023

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The ongoing violent conflict in Northern Ethiopia has caused displacement, death, and destruction. Health services infrastructure became one of the primary victims of the war, leaving millions unable to access essential surgical health services at a time when demand for surgical interventions is on the rise. Rehabilitating surgical services was identified as a priority by the federal government, regional health bureaus, and humanitarian organizations, forming an integral part in rebuilding communities after war. Under the auspices of the Federal Ministry of Health of Ethiopia, a hospital twinning program between providers in non-conflict and conflict affected areas was first introduced in December 2021, now including 13 active partnerships. The program builds on a previous best practice gained from the Ethiopian Hospital Alliance for Quality to strengthen local health care providers in regaining capabilities to serve local populations. Field experience of two hospital twinning projects have shown significant scope of organizational peer support at times of crisis, successfully enabling conflict-afflicted hospitals to regain the capacity necessary to re-introduce surgical services. While overcoming challenges such as lack of basic supplies including electricity and blood may be required to further increase the scope of this program in Northern Ethiopia, relative success highlights important lessons for similar approaches in areas affected by conflict, or natural disasters.

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“…A high proportion of affected fetuses dies in utero and ends in a spontaneous abortion [4], but many cases are live born. Surgery for neural tube defects (NTD) and hydrocephalus are the most performed neurosurgical procedures in Ethiopia [5].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of neural tube defects among pregnant women in Addis Ababa: A community-based study using prenatal ultrasound examination

Tirsit

Zewdneh

Yigeremu

et al. 2023

Preprint

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Purpose The primary aim of this study was to estimate the prevalence of NTDs at ultrasound examination in communities of Addis Ababa and secondarily to provide a description of the dysmorphology of the NTD cases. Methods We enrolled 958 pregnant women from 20 randomly selected health centers in Addis Ababa during the period from October 1, 2018 to April 30, 2019. Of these 958 women, 891 had an ultrasound examination after enrollment, with special focus on NTDs. We estimated the prevalence of NTDs and compared it with previously reported hospital-based birth prevalence estimates from Addis Ababa. Results Among 891 women, 13 had twin pregnancies. We identified 15 NTD cases among 904 fetuses, corresponding to an ultrasound-based prevalence of 166 per 10,000 (95% CI: 100–274). There were no NTD-cases among the 26 twins. Eleven had spina bifida (122 per 10,000, 95% CI: 67–219). Among the 11 fetuses with spina bifida, three had a cervical and one had a thoracolumbar defect while the anatomical site for 7 was not registered. Seven of the 11 spina bifida defects had skin covering, while two of the cervical lesions were uncovered. Conclusion We report a high prevalence of NTDs among pregnancies in communities of Addis Ababa based on screening by ultrasound. The prevalence was higher than previous hospital-based studies in Addis, and the prevalence of spina bifida was particularly high.

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Neurosurgery in Ethiopia: A New Chapter and Future Prospects

Cited by 17 publications

References 23 publications

A case study of ReachAnother Foundation as a change champion for developing spina bifida neurosurgical care and advocating for primary prevention in Ethiopia

A case study of ReachAnother Foundation as a change champion for developing spina bifida neurosurgical care and advocating for primary prevention in Ethiopia

Organizational peer support to enable rehabilitating surgical services in Northern Ethiopia

Prevalence of neural tube defects among pregnant women in Addis Ababa: A community-based study using prenatal ultrasound examination

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