Problématique des hémorragies méningées dans les pays en développement : cas du Togo

Ahanogbe, K.M.H.; Belo, Mofou; Beketi, A.K.; Kpelao, Stéphane; Doléagbénou, Komlan A.

doi:10.1016/j.neuchi.2016.06.008

Cited by 7 publications

(2 citation statements)

References 15 publications

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“…It is reported that neurosurgical centers specializing in the treatment of intracranial aneurysms and aSAH are scarce in some African countries, and those that do exist only offer open vascular aSAH treatment ( 10 ). Indeed some African centers report needing to transfer patients to departments that can provide treatment for aSAH and this is particularly true for endovascular treatment ( 3 , 11 ). This can sometimes result in patients being transferred to other countries or even another continent for appropriate treatment; albeit the literature does not mention the mode of transportation ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Continental Survey of Access to Diagnostic Tools and Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in Africa

Dokponou

Kotecha²,

Bandyopadhyay³

et al. 2021

Front. Surg.

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Rationale: Interventional neurovascular procedures are effective in lowering the burden of mortality and complications resulting from aneurysmal subarachnoid hemorrhage (aSAH). Despite the wide uptake of interventional neurovascular procedures in high-income countries, access to care in low- and middle-income countries remains limited, and little is known about accessibility in Africa. In this survey, we decided to assess access to diagnostic tools and treatment of aSAH in Africa.Methodology: A Google form e-survey was distributed to African neurosurgery centers accepting responses from January 4th to March 21st 2021. Data on accessibility to diagnostic tools, treatment methodologies, and interventional neuroradiology personnel in African centers were collected. Ninety five percent confidence intervals were computed for each variable.Results: Data was received from 36 neurosurgical centers in 16 African countries (16/54, 30%). Most centers were public institutions. Ninety four percent of the centers had the necessary resources for a lumbar puncture (LP) and a laboratory for the diagnosis of aSAH. Most centers had at least one computed tomography (CT) scanner, 81% of the centers had access to CT angiography and some had access to conventional angiography. Forty seven percent of the centers could obtain a head CT within 2 h of presentation in an emergency. Sixty one percent of centers provided clipping of intracranial aneurysms whilst only 22% of centers could perform the endovascular treatment. Sixty four percent of centers did not have an endovascular specialist.Conclusion: This survey highlights health inequity in access to endovascular treatment for aSAH. Lack of diagnostic tools to identify an aneurysm and a shortfall of qualified endovascular specialists are prime reasons for this. Our findings can inform health system strengthening policies including the acquisition of equipment and capacity building in Africa.

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Section: Introductionmentioning

confidence: 99%

Continental Survey of Access to Diagnostic Tools and Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in Africa

Dokponou

Kotecha²,

Bandyopadhyay³

et al. 2021

Front. Surg.

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“…Autopsy studies show that it contributes to 2% of all unexplained non-violent deaths and nearly 16% of all cardiovascular causes of deaths in Kenya [11]. This is despite only a third of patients in some stroke studies having radiological confirmation [10] and an even smaller number having angiographies [12]. As a result, SAH in sub-Saharan Africa is diagnosed late [13].…”

Section: Introductionmentioning

confidence: 99%

Mortality and functional outcomes after a spontaneous subarachnoid haemorrhage: A retrospective multicentre cross-sectional study in Kenya

Waweru

Gatimu

2019

PLoS ONE

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Introduction Despite a reduction in poor outcomes in recent decades, spontaneous subarachnoid haemorrhage (SAH) remains associated with severe disability and high mortality rates. The exact extent of these outcomes is however unknown in Africa. This study aimed to determine the mortality and functional outcomes of patients with SAH in Kenya. Methods We conducted a retrospective multicentre cross-sectional study involving patients admitted with SAH to three referral hospitals in Nairobi. All patients with a confirmed (primary) discharge diagnosis of first-time SAH between January 2009 and November 2017 were included (n = 158). Patients who had prior head trauma or cerebrovascular disease (n = 53) were excluded. Telephone interviews were conducted with surviving patients or their next of kin to assess out-of-hospital outcomes (including functional outcomes) based on modified Rankin Scale (mRS) scores. Chi-square and Fisher’s exact tests were used to assess associations between mortality and functional outcomes and sample characteristics. Results Of the 158 patients sampled, 38 (24.1%) died in hospital and 42 (26.6%) died within 1 month. In total, 87 patients were discharged home and followed-up in this study, of which 72 reported favourable functional outcomes (mRS ≤2). This represented 45.6% of all patients who presented alive, pointing to high numbers of unfavourable outcomes post SAH in Kenya. Conclusions Mortality following SAH remains high in Kenya. Patients who survive the initial ictus tend to do well after treatment, despite resource constraints. Limitations The study findings should be interpreted with caution because of unavoidable limitations in the primary data. These include its retrospective nature, the high number of patients lost to follow up, missing records and diagnoses, and/or possible miscoding of cases.

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Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa

Gams Massi,

Pazeu,

Motah

et al. 2024

eNeurologicalSci

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Problématique des hémorragies méningées dans les pays en développement : cas du Togo

Cited by 7 publications

References 15 publications

Continental Survey of Access to Diagnostic Tools and Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in Africa

Continental Survey of Access to Diagnostic Tools and Endovascular Management of Aneurysmal Subarachnoid Hemorrhage in Africa

Mortality and functional outcomes after a spontaneous subarachnoid haemorrhage: A retrospective multicentre cross-sectional study in Kenya

Spontaneous subarachnoid hemorrhage in a referral health Centre in Central Africa

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