Neurosurgery Education and Development program to treat hydrocephalus and to develop neurosurgery in Africa using mobile neuroendoscopic training

Piquer, José; Qureshi, Mubashir Mahmood; Young, Paul H.; Dempsey, Robert J.

doi:10.3171/2014.10.peds14318

Cited by 39 publications

(26 citation statements)

References 28 publications

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“…The majority of the incountry neurosurgical training programs were found in subregions of Africa (8/9 [89%]), with 1 (11%) in South/ Central America. 1,2,8,9,16,17,20,22,27…”

Section: Resultsmentioning

confidence: 99%

“…Instead, the perspective of the local medical personnel was pro-vided through proxy reports from visiting neurosurgical teams or collaborating institutions. 1,2,9,16,17,20,27 The residing in-country medical staff members were thought to learn surgical techniques from visiting neurosurgeons, including proper sterilization, had increased exposure to intraoperative decision-making, and were given guidance to improve postoperative care. 17,20,27 Academic training sessions, which included access to internet resources, peer-reviewed papers, and online webinars, improved education and promoted greater confidence in treating patients.…”

Section: Local Medical Personnel Perspectivesmentioning

confidence: 99%

“…1,2,9,16,17,20,27 The residing in-country medical staff members were thought to learn surgical techniques from visiting neurosurgeons, including proper sterilization, had increased exposure to intraoperative decision-making, and were given guidance to improve postoperative care. 17,20,27 Academic training sessions, which included access to internet resources, peer-reviewed papers, and online webinars, improved education and promoted greater confidence in treating patients. 16 The most significant challenges identified were difficulties in local long-term retention of trained fellows and staff, deficient infrastructure, lack of guidelines, poor selfconfidence among local physicians, and lower compensation offered for pediatric neurosurgery in comparison to adult care.…”

Section: Local Medical Personnel Perspectivesmentioning

confidence: 99%

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Neurosurgical training and global health education: systematic review of challenges and benefits of in-country programs in the care of neural tube defects

Gandy

Castillo

Rocque

et al. 2020

Neurosurgical Focus

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OBJECTIVEThe recognition that neurosurgeons harbor great potential to advocate for the care of individuals with neural tube defects (NTDs) globally has sounded as a clear call to action; however, neurosurgical care and training in low- and middle-income countries (LMICs) present unique challenges that must be considered. The objective of this study was to systematically review publications that describe the challenges and benefits of participating in neurosurgery-related training programs in LMICs in the service of individuals with NTDs.METHODSUsing MEDLINE (PubMed), the authors conducted a systematic review of English- and Spanish-language articles published from 1974 to 2019 that describe the experiences of in-country neurosurgery-related training programs in LMICs. The inclusion criteria were as follows—1) population/exposure: US residents, US neurosurgeons, and local in-country medical staff participating in neurosurgical training programs aimed at improving healthcare for individuals with NTDs; 2) comparison: qualitative studies; and 3) outcome: description of the challenges and benefits of neurosurgical training programs. Articles meeting these criteria were assessed within a global health education conceptual framework.RESULTSNine articles met the inclusion criteria, with the majority of the in-country neurosurgical training programs being seen in subregions of Africa (8/9 [89%]) and one in South/Central America. US-based residents and neurosurgeons who participated in global health neurosurgical training had increased exposure to rare diseases not common in the US, were given the opportunity to work with a collaborative team to educate local healthcare professionals, and had increased exposure to neurosurgical procedures involved in treating NTDs. US neurosurgeons agreed that participating in international training improved their own clinical practices but also recognized that identifying international partners, travel expenses, and interference with their current practice are major barriers to participating in global health education. In contrast, the local medical personnel learned surgical techniques from visiting neurosurgeons, had increased exposure to intraoperative decision-making, and were given guidance to improve postoperative care. The most significant challenges identified were difficulties in local long-term retention of trained fellows and staff, deficient infrastructure, and lower compensation offered for pediatric neurosurgery in comparison to adult care.CONCLUSIONSThe challenges and benefits of international neurosurgical training programs need to be considered to effectively promote the development of neurosurgical care for individuals with NTDs in LMICs. In this global health paradigm, future work needs to investigate further the in-country professionals’ perspective, as well as the related outcomes.

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“…The majority of the incountry neurosurgical training programs were found in subregions of Africa (8/9 [89%]), with 1 (11%) in South/ Central America. 1,2,8,9,16,17,20,22,27…”

Section: Resultsmentioning

confidence: 99%

Section: Local Medical Personnel Perspectivesmentioning

confidence: 99%

Section: Local Medical Personnel Perspectivesmentioning

confidence: 99%

See 1 more Smart Citation

Neurosurgical training and global health education: systematic review of challenges and benefits of in-country programs in the care of neural tube defects

Gandy

Castillo

Rocque

et al. 2020

Neurosurgical Focus

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show abstract

“…Sustainable skill transfer through targeted short-term trips has been demonstrated, 10,22 and mobile training units can extend equipment and skill transfer beyond the capital cities. 32 Novel telecollaboration and internet-based tools have also demonstrated potential for continuing education following return of the visiting surgical team. 4,7 As an example, HELPLightning, a tablet-based tool for mobile merged reality and virtual interaction, is currently being implemented by CURE International for mentoring of ETV-CPC (https://www.helplightning.com).…”

Section: Discussionmentioning

confidence: 99%

State of global pediatric neurosurgery outreach: survey by the International Education Subcommittee

Davis

Rocque

Singhal

et al. 2017

Journal of Neurosurgery: Pediatrics

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OBJECTIVENeurosurgical services are increasingly recognized as essential components of surgical care worldwide. The degree of interest among neurosurgeons regarding international work, and the barriers to involvement in global neurosurgical outreach, are largely unexplored. The authors distributed a survey to members of the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Pediatric Neurosurgery to assess the state of global outreach among its members and to identify barriers to involvement.METHODSAn internet-based questionnaire was developed by the International Education Subcommittee of the AANS/CNS Joint Section on Pediatric Neurosurgery and distributed to pediatric neurosurgeons via the AANS/CNS Joint Section email contact list. Participants were surveyed on their involvement in global neurosurgical outreach, geographic location, nature of the participation, and barriers to further involvement.RESULTSA 35.3% response rate was obtained, with 116 respondents completing the survey. Sixty-one percent have performed or taught neurosurgery in a developing country, and 49% travel at least annually. Africa was the most common region (54%), followed by South America (30%), through 29 separate organizing entities. Hydrocephalus was the most commonly treated condition (88%), followed by spinal dysraphism (74%), and tumor (68%). Most respondents obtained follow-up through communications from local surgeons (77%). Seventy-one percent believed the international experience improved their practice, and 74% were very or extremely interested in working elsewhere. Interference with current practice (61%), cost (44%), and difficulty identifying international partners (43%) were the most commonly cited barriers to participation.CONCLUSIONSAny coordinated effort to expand global neurosurgical capacity begins with appreciation for the current state of outreach efforts. Increasing participation in global outreach will require addressing both real and perceived barriers to involvement. Creation and curation of a centralized online database of ongoing projects to facilitate coordination and involvement may be beneficial.

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“…22 Furthermore, in sub-Saharan Africa, it is estimated that more than 100,000 newborns annually develop hydrocephalus before 1 year of age. 46 In Nigeria, hydrocephalus accounts for 32% of congenital neurosurgical conditions; 4 in Kenya, hydrocephalus represents the highest surgical burden of disease in male children; 78 and in Uganda, hydrocephalus accounts for 59% of neurosurgical conditions. 67 With more than half of Africa's population younger than 18 years, it is remarkable that fewer than 10% of neurosurgeons have subspecialty training in pediatric neurosurgery.…”

Section: Increased Health Demand In Minimally Resourced Settingsmentioning

confidence: 99%

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions

Muir

Wang

Warf

2016

FOC

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OBJECTIVE Pediatric hydrocephalus is one of the most common neurosurgical conditions and is a major contributor to the global burden of surgically treatable diseases. Significant health disparities exist for the treatment of hydrocephalus in developing nations due to a combination of medical, environmental, and socioeconomic factors. This review aims to provide the international neurosurgery community with an overview of the current challenges and future directions of neurosurgical care for children with hydrocephalus in low-income countries. METHODS The authors conducted a literature review around the topic of pediatric hydrocephalus in the context of global surgery, the unique challenges to creating access to care in low-income countries, and current international efforts to address the problem. RESULTS Developing countries face the greatest burden of pediatric hydrocephalus due to high birth rates and greater risk of neonatal infections. This burden is related to more general global health challenges, including malnutrition, infectious diseases, maternal and perinatal risk factors, and education gaps. Unique challenges pertaining to the treatment of hydrocephalus in the developing world include a preponderance of postinfectious hydrocephalus, limited resources, and restricted access to neurosurgical care. In the 21st century, several organizations have established programs that provide hydrocephalus treatment and neurosurgical training in Africa, Central and South America, Haiti, and Southeast Asia. These international efforts have employed various models to achieve the goals of providing safe, sustainable, and cost-effective treatment. CONCLUSIONS Broader commitment from the pediatric neurosurgery community, increased funding, public education, surgeon training, and ongoing surgical innovation will be needed to meaningfully address the global burden of untreated hydrocephalus.

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Neurosurgery Education and Development program to treat hydrocephalus and to develop neurosurgery in Africa using mobile neuroendoscopic training

Cited by 39 publications

References 28 publications

Neurosurgical training and global health education: systematic review of challenges and benefits of in-country programs in the care of neural tube defects

Neurosurgical training and global health education: systematic review of challenges and benefits of in-country programs in the care of neural tube defects

State of global pediatric neurosurgery outreach: survey by the International Education Subcommittee

Global surgery for pediatric hydrocephalus in the developing world: a review of the history, challenges, and future directions

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