A comparison of publication to TBI burden ratio of low- and middle-income countries versus high-income countries: how can we improve worldwide care of TBI?

Tropeano, Maria Pia; Spaggiari, Riccardo; Ileyassoff, Hernán; Park, Kee B.; Kolias, Angelos G.; Hutchinson, Peter J.; Servadei, Franco

doi:10.3171/2019.8.focus19507

Cited by 58 publications

(45 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, there was a great lack of research from Sub-Saharan Africa, which is the continent with greatest burden of RTC [37]. This scenario was also reported in a recent study by Tropeano et al (2019) which compared publication to traumatic brain injury burden ratio between LMICs and HICs, and found it was the lowest in the areas of greatest burden [113]. The underlying reasons may be due to lack of research funding or the absence of relevant strategies and interventions, particularly for rehabilitation, in these countries.…”

Section: Research Gapsmentioning

confidence: 86%

Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: A scoping review

Selveindran

Tango

Khan

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background Neurotrauma is an important global health problem. The largest cause of neurotrauma worldwide is road traffic collisions (RTCs), particularly in low-and middle-income countries (LMICs). Neurotrauma and RTCs are preventable, and many preventative interventions have been implemented over the last decades, especially in high income countries (HICs). However, it is uncertain if these strategies are applicable globally due to variations in environment, resources, population, culture and infrastructure. Given this issue, this scoping review aims to identify, quantify and describe the evidence on approaches in neurotrauma and RTCs prevention, and ascertain contextual factors that influence their implementation in LMICs and HICs.Methods A systematic search was conducted using five electronic databases (MEDLINE, EMBASE, CINAHL, Global Health EBSCO, Cochrane Database of Systematic Reviews), grey literature databases, government and non-government websites, as well as bibliographic and citation searching of selected articles. The extracted data were presented using figures, tables, and accompanying narrative summaries. The results of this review were reported using the PRISMA Extension for Scoping Reviews (PRISMA-ScR).Results A total of 411 publications met the inclusion criteria, including 349 primary studies and 62 reviews. More than 80 percent of the primary studies were from HICs, and described all levels of neurotrauma prevention. Only 65 papers came from LMICs, which mostly described primary prevention, focussing on road safety. For the reviews, 41 papers (66.1%) reviewed primary, 18 tertiary (29.1%), and three secondary preventative approaches. Most of the primary papers in the reviews came from HICs (67.7%) with 5 reviews on only LMIC papers. Fifteen reviews (24.1%) included papers from both HICs and LMICs. Intervention settings ranged from nation-wide to community-based, but were not reported in 44 papers (10.8%), most of which were reviews. Contextual factors were described in 62 papers, and varied depending on the interventions.Conclusions There is a large quantity of global evidence on strategies and interventions for neurotrauma and RTCs prevention. However, less papers were from LMICs, especially on secondary and tertiary prevention. More primary research needs to be done in these countries to determine what strategies and interventions exist, and the applicability of HIC interventions in LMICs.

show abstract

Section: Research Gapsmentioning

confidence: 86%

Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: A scoping review

Selveindran

Tango

Khan

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, there was a great lack of research from Sub-Saharan Africa, which is the continent with greatest burden of RTCs [37]. This scenario was also reported in a recent study by Tropeano et al (2019) which compared publication to traumatic brain injury burden ratio between LMICs and HICs, and found it was the lowest in the areas of greatest burden [113]. The underlying reasons may be due to lack of research funding or the absence of relevant strategies and interventions, particularly for rehabilitation, in these countries.…”

Section: Research Gapsmentioning

confidence: 86%

Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: A scoping review

Selveindran

Tango

Khan

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Neurotrauma is an important global health problem. The largest cause of neurotrauma worldwide is road traffic collisions (RTCs), particularly in low-and middle-income countries (LMICs). Neurotrauma and RTCs are preventable, and many preventative interventions have been implemented over the last decades, especially in high income countries (HICs). However, it is uncertain if these strategies are applicable globally due to variations in environment, resources, population, culture and infrastructure. Given this issue, this scoping review aims to identify, quantify and describe the evidence on approaches in neurotrauma and RTCs prevention, and ascertain contextual factors that influence their implementation in LMICs and HICs.Methods: A systematic search was conducted using five electronic databases (MEDLINE, EMBASE, CINAHL, Global Health on EBSCO host, Cochrane Database of Systematic Reviews), grey literature databases, government and non-government websites, as well as bibliographic and citation searching of selected articles. The extracted data were presented using figures, tables, and accompanying narrative summaries. The results of this review were reported using the PRISMA Extension for Scoping Reviews (PRISMA-ScR).Results: A total of 411 publications met the inclusion criteria, including 349 primary studies and 62 reviews. More than 80 percent of the primary studies were from HICs, and described all levels of neurotrauma prevention. Only 65 papers came from LMICs, which mostly described primary prevention, focussing on road safety. For the reviews, 41 papers (66.1%) reviewed primary, 18 tertiary (29.1%), and three secondary preventative approaches. Most of the primary papers in the reviews came from HICs (67.7%) with 5 reviews on only LMIC papers. Fifteen reviews (24.1%) included papers from both HICs and LMICs. Intervention settings ranged from nation-wide to community-based, but were not reported in 44 papers (10.8%), most of which were reviews. Contextual factors were described in 62 papers, and varied depending on the interventions.Conclusions: There is a large quantity of global evidence on strategies and interventions for neurotrauma and RTCs prevention. However, fewer papers were from LMICs, especially on secondary and tertiary prevention. More primary research needs to be done in these countries to determine what strategies and interventions exist, and the applicability of HIC interventions in LMICs.

show abstract

“…6,20 Using 2018 population data we report 102 fully trained neurosurgeons working in 12 SSA countries, corresponding to a ratio of 1 neurosurgeon per 2.62 million people. 22 The difference in the ratio of neurosurgeons/population compared to published reports 7,8,20 can be explained by different facts. First, our study is pertinent to only 12 of the 46 United Nations-defined SSA countries, namely the 12 where the WFNS RTC graduates practice.…”

Section: Discussionmentioning

confidence: 99%

“…Upon completion of training, 90% of graduates work in low-income and 10% in lower-middle-income countries, defined by the World Bank (2019) as a Gross National Income (GNI) per capita of ≤ US$995 and US$996-$3895, respectively. 20 The cumulative population in the geograph-available to 86%, MRI to 38%, surgical microscope to 33%, endoscope to 19.1%, and neuronavigation to 0%. Three (14.3%) neurosurgeons had access to none of the above.…”

Section: Demographic Datamentioning

confidence: 99%

The impact of African-trained neurosurgeons on sub-Saharan Africa

Karekezi

Khamlichi²,

Ouahabi³

et al. 2020

Neurosurgical Focus

Self Cite

View full text Add to dashboard Cite

OBJECTIVESub-Saharan Africa (SSA) represents 17% of the world’s land, 14% of the population, and 1% of the gross domestic product. Previous reports have indicated that 81/500 African neurosurgeons (16.2%) worked in SSA—i.e., 1 neurosurgeon per 6 million inhabitants. Over the past decades, efforts have been made to improve neurosurgery availability in SSA. In this study, the authors provide an update by means of the polling of neurosurgeons who trained in North Africa and went back to practice in SSA.METHODSNeurosurgeons who had full training at the World Federation of Neurosurgical Societies (WFNS) Rabat Training Center (RTC) over the past 16 years were polled with an 18-question survey focused on demographics, practice/case types, and operating room equipment availability.RESULTSData collected from all 21 (100%) WFNS RTC graduates showed that all neurosurgeons returned to work to SSA in 12 different countries, 90% working in low-income and 10% in lower-middle-income countries, defined by the World Bank as a Gross National Income per capita of ≤ US$995 and US$996–$3895, respectively. The cumulative population in the geographical areas in which they practice is 267 million, with a total of 102 neurosurgeons reported, resulting in 1 neurosurgeon per 2.62 million inhabitants. Upon return to SSA, WFNS RTC graduates were employed in public/private hospitals (62%), military hospitals (14.3%), academic centers (14.3%), and private practice (9.5%). The majority reported an even split between spine and cranial and between trauma and elective; 71% performed between 50 and more than 100 neurosurgical procedures/year. Equipment available varied across the cohort. A CT scanner was available to 86%, MRI to 38%, surgical microscope to 33%, endoscope to 19.1%, and neuronavigation to 0%. Three (14.3%) neurosurgeons had access to none of the above.CONCLUSIONSNeurosurgery availability in SSA has significantly improved over the past decade thanks to the dedication of senior African neurosurgeons, organizations, and volunteers who believed in forming the new neurosurgery generation in the same continent where they practice. Challenges include limited resources and the need to continue expanding efforts in local neurosurgery training and continuing medical education. Focus on affordable and low-maintenance technology is needed.

show abstract

A comparison of publication to TBI burden ratio of low- and middle-income countries versus high-income countries: how can we improve worldwide care of TBI?

Cited by 58 publications

References 29 publications

Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: A scoping review

Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: A scoping review

Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: A scoping review

The impact of African-trained neurosurgeons on sub-Saharan Africa

Contact Info

Product

Resources

About