The Coronavirus pandemic poses a significant threat to the healthcare sectors of some African countries due to poor healthcare organisation, financing, and reduced uptake of recent technological advancements. Surgical care of patients and surgical training of healthcare workers are considerably affected, due to the dearth of policies and strategic health plans, to ensure the provision of safe and affordable surgical care and continuity of training. The purpose of this study is to explore the impact of the COVID-19 pandemic on Surgery in Africa and to provide recommendations geared towards the current pandemic and for the future. This review involved a search of the electronic databases MEDLINE/PubMed and Google Scholar, and 31 papers from African countries which explored the impact of COVID-19 across different surgical specialities were screened. The cancellation rate of elective surgeries and benign conditions across some countries were seen to be as high as 74-81% with prioritisation of cancer patients and emergencies. The volume of emergency surgical cases presenting in some hospitals was reduced due to the associated lockdowns and fear of contracting the virus, while Telemedicine became increasingly adopted with newer platforms being used across some countries. The pandemic has exposed the inequities in health systems and further studies need to be done to evaluate its impact across more surgical specialities.
Objectives: COVID-19, primarily a respiratory disease, can have complications that affect all organ systems of the body. There is a paucity of systematic reviews on all the complications. In this systematic review and meta-analysis, we set out to summarize the complications of COVID-19 in all body systems and their prevalence.Methods: PubMed and Google Scholar were searched for eligible articles using predefined criteria. Database searching and extraction were performed by independent reviewers. Results:We identified 74 case reports/series and 15 observational studies. In both the case reports/series and observational studies, pulmonary complications were the most commonly reported, particularly pneumonia, followed by neurological complications in case reports/case series and hematological complications in observational studies. Atrial arrhythmias (1.7%) and acute myopericarditis (1.7%), liver injury (3.3%), acute kidney injury (8.8%), deep venous thrombosis (2.2%), ischemic stroke (12.2%), herpes zoster (1.1%), and diabetic ketoacidosis (1.1%) were the most reported cardiovascular, gastrointestinal, renal, hematological, neurological, dermatological, and endocrine complications respectively in case reports/series. However, acute myocarditis (100%), hypoproteinemia (15.9-28.8%), transient acute renal failure (49.9-90.1%), acute coagulopathy (16.5-28.4%), and ischemic stroke (1.3-3.9%) had the highest pooled prevalence for cardiovascular, gastrointestinal, renal, hematological, and neurological complications respectively in observational studies. Conclusion:The complications of COVID-19 are multi-systemic with pulmonary complications being the most commonly reported. Notwithstanding, healthcare professionals should be aware that COVID-19 is a differential diagnosis for even the rare but equally debilitating complications and should screen patients who develop these complications to rule out COVID-19 during the pandemic and beyond.
Traumatic Brain Injuries (TBI) or head injuries are injuries or trauma to the scalp and or brain caused by an outside force, usually a violent blow or collision to the head by accident or deliberate attack. It can also be called be craniocerebral trauma. TBI are examples of acquired, non-degenerative assault to the brain from an external mechanical force, causing impairment of brain functions, with or without alteration to the mental state or consciousness of the victim. This paper provides a synopsis of the epidemiology and patterns of associated injuries in mild and moderate head injuries in literature. Mild and moderate head injuries were selected because they are by far commoner than severe head injuries and the outcomes are widely varied than severe head injuries. Traumatic brain injury is a global and public health problem, which in the coming years, might be the leading cause of death in Africa. High incidence is found among the adolescent and the adult age group and gender-wise, it is common among the males of the same age group. Likewise, the provision of an ambulance system and standard healthcare facilities to manage 18 patients with a traumatic brain injury can not be overemphasized.
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