Improving capacity and access to neurosurgery in sub-Saharan Africa using a twinning paradigm pioneered by the Swedish African Neurosurgical Collaboration

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Improving capacity and access to neurosurgery in sub-Saharan Africa using a twinning paradigm pioneered by the Swedish African Neurosurgical Collaboration


JournalActa Neurochir
Publication date – Jan – 2020
Authors – Enoch O. Uche, Wilfred C. Mezue, Obinna Ajuzieogu, Christopher C. Amah, Ephraim Onyia, Izuchukwu Iloabachie, Mats Ryttlefors & Magnus Tisell
KeywordsGlobal surgery; International collaboration; Neurosurgery twinning; Sub-Saharan Africa.
Open access – Yes
SpecialityNeurosurgery, Surgical Education
World region Central Africa, Southern Africa, Western Africa

Language – English
Submitted to the One Surgery Index on May 12, 2020 at 5:07 am
Abstract:

Background: The unmet need for neurosurgery in sub-Saharan Africa is staggering. Resolving this requires strategies that synergize salient local resources with tailored foreign help. This study is a trial of a twinning model adopted by the Swedish African Neurosurgical Collaboration (SANC).

Methods: A multi-step neurosurgical twinning technique, International Neurosurgical Twinning Modeled for Africa (INTIMA), developed through a collaboration between African and Swedish neurosurgical teams was adopted for a neurosurgical mission in March 2019. The pioneering steps are evaluated together with data of treated patients prospectively acquired using SPSS Chicago Inc., Version 23. Associations were analyzed using chi-square tests, while inferences were evaluated at 95% level of significance.

Results: The SANC global neurosurgery mission targeted microsurgical brain tumor resection. Fifty-five patients were operated on during the mission and subsequent 3 months. Patients’ ages ranged from 3 months to 69 years with a mean of 30.6 ± 2.1 years 95% CL. Seven cases were performed during the first mission, while 48 were performed after the mission. Compared to 3 months before SANC when only 9 brain tumors were resected, more tumors were resected (n = 25) within the 3 consecutive months from the mission (X2 = 14.2, DF = 1, P = 0.000). Thirty-day mortality following tumor resection was also lower, X2 = 4.8, DF = 1, P = 0.028.

Conclusion: Improvements in capacity and short-term outcome define our initial pioneering application of a neurosurgical twinning paradigm pioneered by SANC.

OSI Number – 20356
PMID – 31902003

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