The effect of the Dar es Salaam neurosurgery training course on self-reported neurosurgical knowledge and confidence

Waterkeyn, François; Woodfield, Julie; Massawe, Sylvia Leon; Mzimbiri, Juma Magogo; Shabhay, Zarina; Bureta, Costansia; Sommer, Fabian; Mndemev, Hadija; Magawa, Dorcas Gidion; Kwelukilwa, Donatila; Ndossi, Maxigama Yesaya; Kinghomella, Alpha Ajuaye; Kaale, Aingaya Jackson; Ahmed, Shamsuddin; Mtei, John; Minja, Fidelis; Moses, Moses; Medary, Branden; Hussain, Ibrahim; Ikwuegbuenyi, Chibuikem A.; Petr, Ondra; Kiloloma, Wanin Othman; Rutabasibwa, Nicephorus; Mangat, Halinder S.; Mchome, Laurent Lemeri; Härtl, Roger; Shabani, Hamisi K.

doi:10.1016/j.bas.2023.101727

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…One potential avenue for improvement is to allow local surgeons to participate in short-term spine fellowship programs, which would facilitate acquiring new skills and techniques. 47,48 Finally, there is a need to implement the consistent use of a region-specific spine trauma protocol. Standardized management protocols in health care have demonstrated benefits, including increased consistency, reduced heterogeneity in patient care, prevention of harm, improved adherence to evidence-based recommendations, reduced cognitive strain, and enhanced communication among health care providers.…”

Section: Areas Of Improvementmentioning

confidence: 99%

Presentation, Management, and Outcomes of Thoracic, Thoracolumbar, and Lumbar Spine Trauma in East Africa: A Cohort Study

Ikwuegbuenyi,

Waterkeyn,

Okembo

et al. 2024

Int J Spine Surg

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Background: Trauma to the thoracic, thoracolumbar (TL), and lumbar spine is common and can cause disability and neurological deficits. Using a cohort of patients suffering from thoracic, TL, and lumbar spine trauma in a tertiary hospital in East Africa, the current study sought to: (1) describe demographics and operative treatment patterns, (2) assess neurologic outcomes, and (3) report predictors associated with undergoing surgery, neurologic improvement, and mortality.Methods: A retrospective cohort study of patient records from September 2016 to December 2020 was conducted at a prominent East Africa referral center. The study collected data on demographics, injury, and operative characteristics. Surgical indications were assessed using the AO (Arbeitsgemeinschaft für Osteosynthesefragen) TL fracture classification system and neurological function. Logistic regression analysis identified predictors for operative treatment, neurologic improvement, and mortality.Results: The study showed that 64.9% of the 257 TL spine trauma patients underwent surgery with a median postadmission day of 17.0. The mortality rate was 1.2%. Road traffic accidents caused 43.6% of the injuries. The most common fracture pattern was AO Type A fractures (78.6%). Laminectomy and posterolateral fusion were performed in 97.6% of the surgical cases. Patients without neurological deficits (OR: 0.27, 95% CI: 0.13-0.54, P < 0.001) and those with longer delays from injury to admission were less likely to have surgery (OR: 0.95, 95% CI: 0.92-0.99, P = 0.007). The neurologic improvement rate was 11.1%. Univariate analysis showed a significant association between surgery and neurologic improvement (OR: 3.83, 95% CI: 1.27-16.61, P < 0.001). However, this finding was lost in multivariate regression.Conclusions: This study highlights various themes surrounding the management of TL spine trauma in a low-resource environment, including lower surgery rates, delays from admission to surgery, safe surgery with low mortality, and the potential for surgery to lead to neurologic improvement.Clinical Relevance: Despite challenges such as surgical delays and limited resources in East Africa, there is potential for surgical intervention to improve neurologic outcomes in thoracic, TL, and lumbar spine trauma patients.

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Section: Areas Of Improvementmentioning

confidence: 99%