Needs of Young African Neurosurgeons and Residents: A Cross-Sectional Study

Abstract

Introduction: Africa has many untreated neurosurgical cases due to limited access to safe, affordable, and timely care. In this study, we surveyed young African neurosurgeons and trainees to identify challenges to training and practice.Methods: African trainees and residents were surveyed online by the Young Neurosurgeons Forum from April 25th to November 30th, 2018. The survey link was distributed via social media platforms and through professional society mailing lists. Univariate and bivariate data analyses were run and a P-value < 0.05 was considered to be statistically significant.Results: 112 respondents from 20 countries participated in this study. 98 (87.5%) were male, 63 (56.3%) were from sub-Saharan Africa, and 52 (46.4%) were residents. 39 (34.8%) had regular journal club sessions at their hospital, 100 (89.3%) did not have access to cadaver dissection labs, and 62 (55.4%) had never attended a WFNS-endorsed conference. 67.0% of respondents reported limited research opportunities and 58.9% reported limited education opportunities. Lack of mentorship (P = 0.023, Phi = 0.26), lack of access to journals (P = 0.002, Phi = 0.332), and limited access to conferences (P = 0.019, Phi = 0.369) were associated with the country income category.Conclusion: This survey identified barriers to education, research, and practice among African trainees and young neurosurgeons. The findings of this study should inform future initiatives aimed at reducing the barriers faced by this group.

Prevalence of spine surgery navigation techniques and availability in Africa: A cross-sectional study

“…A total of 31.9 % of respondents had access to stereotactic without intraoperative CT scan, 8.8 % had access to stereotactic with intraoperative CT scan, 29.2 % had access to robotic with intraoperative CT scan, and 6.2 % had access to robotic without intraoperative CT scan. These findings can be explained by the fact that most computer navigation methods in Africa use registration methods such as surface matching methods to register the patient's anatomy to the pre-operative scan, and have limited access to pre-operative fluoroscopy [ 20 ]. In a 2013 survey of 677 spine surgeons worldwide, Härtl et al [ 29 ] found 38 % of surgeons had access to computer-assisted navigation: 70 % in North America, 42 % in Europe, 42 % in Asia Pacific, and 14 % in Latin America.…”

“…In another global survey, 60.3 % of young neurosurgeons had access to an image guidance system [ 30 ]. Only 24.1 % of young neurosurgeons have access to an image guidance system for cranial or spine surgery in Africa [ 20 ]. Our findings are similar to the African investigations [ 20 , 30 ], supporting that the prevalence of spine neuronavigation is lower in Africa than in North America, Europe, and Asia Pacific.…”

“…Most African centers have access to CT scans (97.3 %) and MRIs (78.6 %) outside the operative room [ 20 ]. However, little is known about the availability of spine surgery navigation in Africa.…”

Improving medical student recruitment into neurosurgery through teaching reform

“…Neurosurgery must continue to attract the best and brightest talent to promote the continuous development and survivability of our profession [1]. The shortage of neurosurgeons in many countries has caused great social concern, which may lead to the lack of timely treatment and care of neurosurgical diseases, thus causing severe symptoms, disability, poor life quality of patients, and increasing the burden on families and society [2][3][4]. For such patients, families and healthcare center will pay substantial medical bills for maintenance treatment, nursing care, life support and rehabilitation.…”

Situating Sub-Saharan Africa Within Intra-Operative Innovations in Neurooncology

“…The intra-operative armamentarium at the disposal of the surgical neurooncologist has also widened to include neuronavigation, which has become an invaluable tool, can facilitate pre-operative fibre tracking, and be optimized/synchronized with other Intra-operative imaging modalities such as CT/MRI/ intra-operative ultrasound (IOUS). The limited availability of neuronavigation in Africa ( 2 ), SSA inclusive, makes familiarity with neuro-anatomy inevitable, ensuring the use of craniometric reference points for surgical planning, with access to soft wares such as Osirix/Horos an additional boost ( 3 , 4 ). Other innovations include microscopes of varying sophisticated functionalities, tractography, brain mapping, Fluorescence guided tumor resections, robotic assistance for tumour biopsy, and laser interstitial thermal therapy (LITT).…”