The Impact of COVID-19 on Neurosurgical Services in Africa

Mahmud, Muhammad Raji; Cheserem, Beverly; Kalangu, K; Sanoussi, S.; Musara, Aaron; El-Ghandour, Nasser M F; Fieggen, Graham; Qureshi, Mahmood

doi:10.1016/j.wneu.2020.11.004

Cited by 14 publications

(9 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A separate article covers the effect of COVID-19 on neurosurgery services and the psychosocial impact on African neurosurgeons. 5 The survey was discussed by the Continental Association of African Neurosurgical Societies (CAANS) Administrative Council.…”

Section: Methodsmentioning

confidence: 99%

A Continental Survey on the Impact of COVID-19 on Neurosurgical Training in Africa

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background Containment measures for COVID-19 have affected surgical training globally. We sought to assess how neurosurgical training has been affected across Africa in April 2020. Methods A cross-sectional survey was distributed to African Neurosurgical trainees seeking to review demographics and effects of COVID on training. Results A total of 123 neurosurgery trainees responded from 23 African countries and a further 6 were abroad. A total of 91.80% were men, and 96.70% were training in public institutions. Only 41% had received training in COVID-19 with 61.79% worried that they would contract COVID-19 while performing their clinical duties. There was a marked reduction in clinical activities including a median reduction of elective surgery (−80%), clinics (−83%), and emergency surgery (−38.50%). A total of 23.58% of residents did not receive a formal salary, with 50% on less than $1000 USD gross per month. Conclusions This is the first continental survey of neurosurgery trainees in Africa. COVID-19 has significantly affected clinical and learning opportunities. There are concerns of the long-term effects on their training activities for an uncertain period of time during this pandemic. Although there has been a global increase in e-learning, there is need to evaluate if this is accessible to all trainees.

show abstract

Section: Methodsmentioning

confidence: 99%

A Continental Survey on the Impact of COVID-19 on Neurosurgical Training in Africa

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Unfortunately, data on the pandemic’s effect on surgical outcomes from other LMICs are scarce, but the available evidence suggests that surgical services have substantially decreased during COVID-19. A 2021 survey of neurosurgeons in 42 African countries revealed that over half of respondents were not performing any elective operations during the pandemic, and they reported dramatic shortages of basic personal protective equipment, including surgical masks (91%) and gloves (85%) [ 24 ]. A survey of pediatric surgeons from Nigeria demonstrated similar findings, with over 90% of centers having postponed elective operations early in the pandemic [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Reallocation of Hospital Resources During COVID‐19 Pandemic and Effect on Trauma Outcomes in a Resource‐Limited Setting

et al. 2022

View full text Add to dashboard Cite

Background The COVID-19 pandemic has caused unprecedented disruptions to surgical care worldwide, particularly in low-resource countries. We sought to characterize the association between pre-and intra-pandemic trauma clinical outcomes at a busy tertiary hospital in Malawi. Methods We analyzed trauma patients that presented to Kamuzu Central Hospital in Lilongwe, Malawi, from 2011 through July 2021. Burn patients were excluded. We compared patients based on whether they presented before or during the pandemic (defined as starting March 11, 2020, the date of the official WHO designation). We used logistic regression modeling to estimate the adjusted odds ratio of death based on presentation. Results A total of 137,867 patients presented during the study period, with 13,526 patients during the pandemic. During the pandemic, patients were more likely to be older (mean 28 vs. 25 years, p < 0.001), male (79 vs. 74%, p < 0.001), and suffer a traumatic brain injury (TBI) as their primary injury (9.7 vs. 4.9%, p < 0.001). Crude trauma-associated mortality was higher during the pandemic at 3.7% vs. 2.1% ( p < 0.001). The odds ratio of mortality during the pandemic compared to pre-pandemic presentation was 1.28 (95% CI 1.06, 1.53) adjusted for age, sex, initial AVPU score, transfer status, injury type, and mechanism. Conclusions During the pandemic, adjusted trauma-associated mortality significantly increased at a tertiary trauma center in a low-resource setting despite decreasing patient volume. Further research is urgently needed to prepare for future pandemics. Potential targets for improvement include improving pre-hospital care and transportation, planning for intensive care utilization, and addressing nursing shortages.

show abstract

“…[ 16 ] According to a survey about how Africa’s neurosurgical community has been affected by COVID-19, only 52 (16.5%) of the respondents stated they had a specific COVID-19 neurosurgery policy and only 49% felt that their response plans were satisfactory for their neurosurgical services. [ 19 ]…”

Section: Discussionmentioning

confidence: 99%

Will the high acceptance rate of coronavirus disease 2019 vaccine in Morocco accelerate the recovery of neurosurgical practice?

Zahrou¹,

M'barek²,

Belokda³

et al. 2021

Surgical Neurology International

View full text Add to dashboard Cite

Background: In developing countries, where there is a chronic shortage of neurosurgeons and medical infrastructures, the pandemic has taken a heavy toll on neurosurgical activities. In the absence of a curative treatment, reaching herd immunity through mass vaccination campaigns is the best hope we have of ending this pandemic. Therefore, the purpose of our study was first to assess the effect of coronavirus disease 2019 (COVID-19) outbreak on neurosurgical services of a Moroccan tertiary hospital. Secondarily, we aimed to describe current vaccination compliance rate in our country, and its impact on the recovery of neurosurgical practice. Methods: To examine how COVID-19 challenged the neurosurgical delivery of care in our unit, we compared emergency and elective admissions during COVID-19 and pre-COVID-19 period using the registry of neurosurgery department. Second, after evaluating vaccine acceptance rates among 1463 healthcare workers and patients admitted to our hospital, we compared the number of surgeries performed in our department after implementation of a mass vaccination campaign. Results: The overall number of procedures dropped from n = 197 (pre-COVID-19) to n = 150 during COVID-19. The number of elective surgeries declined from an average of 10.5 operations per week before COVID-19 to four surgeries per week during the COVID-19 pandemic. Conversely, an average of 3.5 emergency operations was performed each week before COVID-19 compared to 5.6 per week during the pandemic. On the other hand, our results showed that willingness to get the COVID-19 vaccine among the participants was high (81.7%) with significantly less hesitant individuals among healthcare workers (P = 0.001). This successful vaccine rollout helped resuming gradually elective surgeries in our department. Conclusion: Our study found a high acceptance rate of COVID-19 vaccines among Moroccans, which gives a glimmer of hope of restoring all our neurosurgical services. However, despite the high acceptance rate, the authorities must address concerns among hesitant individuals and raise awareness on the importance of COVID-19 immunization.

show abstract

The Impact of COVID-19 on Neurosurgical Services in Africa

Cited by 14 publications

References 12 publications

A Continental Survey on the Impact of COVID-19 on Neurosurgical Training in Africa

A Continental Survey on the Impact of COVID-19 on Neurosurgical Training in Africa

Reallocation of Hospital Resources During COVID‐19 Pandemic and Effect on Trauma Outcomes in a Resource‐Limited Setting

Will the high acceptance rate of coronavirus disease 2019 vaccine in Morocco accelerate the recovery of neurosurgical practice?

Contact Info

Product

Resources

About