The Second African Federation of Neurological Surgeons Course in the East, Central, and Southern Africa Region Held in Dar es Salaam, Tanzania, January 2011

Kahamba, J. F.; Assey, Anthony B.; Dempsey, Robert J.; Qureshi, Mahmood; Härtl, Roger

doi:10.1016/j.wneu.2011.07.021

Cited by 26 publications

(39 citation statements)

References 2 publications

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“…Tanzania has worked hard for several years now to educate allied health professionals regarding neurosurgical disease. 6, 36, 37 BMC has forged relationships with other centers to receive continuing surgical education. 4, 38 Since obtaining the preliminary 2-year registry data for analysis, BMC has made several changes that will likely improve care for future TBI patients.…”

Section: Discussionmentioning

confidence: 99%

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Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines

et al. 2017

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Background Severe traumatic brain injury (TBI) is a major cause of death and disability worldwide. However, prospective TBI data from sub-Saharan Africa are sparse. This study examines the epidemiology, and explores management of severe TBI patients and adherence to the Brain Trauma Foundation (BTF) Guidelines at a tertiary care referral hospital in Tanzania. Methods Patients with severe TBI hospitalized at Bugando Medical Centre, Mwanza, Tanzania, were recorded in a prospective registry. Epidemiological, clinical, treatment and outcome data were recorded. Results Between September 2013 and October 2015, 371 patients with TBI were admitted. 33% (115/371) had severe TBI. Mean age was 32.0±20.1 years, and the majority were male (80.0%). Vehicular injuries were the most common cause of injury (65.2%). Half of the patients (47.8%) were hospitalized on the same day as their injury. Only 49.6% underwent computed tomography (CT) of the brain, and 58.3% were admitted to the intensive care unit (ICU). Continuous arterial blood pressure (cABP) monitoring and intracranial pressure (ICP) monitoring were not performed on any patient. 38.3% of patients with severe TBI received hyperosmolar therapy and 35.7% underwent craniotomy. Two-week mortality was 34.8%. Conclusion Mortality of patients with severe TBI at Bugando Medical Center, Tanzania, is approximately twice that in high-income countries. ICU care, CT imaging, cABP and ICP monitoring are underutilized or unavailable in the tertiary referral hospital setting. Improving outcomes after severe TBI will require concerted investment in pre-hospital care as well as improvement in availability of ICU resources, CT imaging and expertise in multidisciplinary care.

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Section: Discussionmentioning

confidence: 99%

“…This includes lectures, workstations and hands-on surgical training. 36 This has been coupled with providing scholarships for surgeon candidates from Tanzania to visit and train at our hospital by observing different surgical techniques and having access to cadaveric laboratory.…”

Section: Discussionmentioning

confidence: 99%

Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines

et al. 2017

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“…8 In Dar es Salaam, the Tanzania Neurosurgery Project from Weill-Cornell Medical College has organized visits by neurosurgical fellows from overseas, weekly telecast conferences with local surgeons, and a yearly Neurotrauma Meeting, currently one of the most important scientific forums for neurosurgery in East Africa. 11,23 Finally, with a different approach, the Duke East Africa Neurosurgery Program, spearheaded by Dr. Michael Haglund, has been successfully training neurosurgeons in Kampala, Uganda. Since 2015, they have also been partnering with the Mbarara Hospital, located in the Southwest region of the country.…”

Section: Discussionmentioning

confidence: 99%

The challenges and opportunities of global neurosurgery in East Africa: the Neurosurgery Education and Development model

Leidinger¹,

Extremera

Kim³

et al. 2018

Neurosurgical Focus

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OBJECTIVEThe objective of this study was to describe the experience of a volunteering neurosurgeon during an 18-week stay at the Neurosurgery Education and Development (NED) Institute and to report the general situation regarding the development of neurosurgery in Zanzibar, identifying the challenges and opportunities and explaining the NED Foundation’s model for safe practice and sustainability.METHODSThe NED Foundation deployed the volunteer neurosurgeon coordinator (NC) for an 18-week stay at the NED Institute at the Mnazi Mmoja Hospital, Stonetown, Zanzibar. The main roles of the NC were as follows: management of patients, reinforcement of weekly academic activities, coordination of international surgical camps, and identification of opportunities for improvement. The improvement opportunities were categorized as clinical, administrative, and sociocultural and were based on observations made by the NC as well as on interviews with local doctors, administrators, and government officials.RESULTSDuring the 18-week period, the NC visited 460 patients and performed 85 surgical procedures. Four surgical camps were coordinated on-site. Academic activities were conducted weekly. The most significant challenges encountered were an intense workload, deficient infrastructure, lack of self-confidence among local physicians, deficiencies in technical support and repairs of broken equipment, and lack of guidelines. Through a series of interviews, the sociocultural factors influencing the NED Foundation’s intervention were determined. Factors identified for success were the activity of neurosurgical societies in East Africa; structured pan-African neurosurgical training; the support of the Foundation for International Education in Neurological Surgery (FIENS) and the College of Surgeons of East, Central and Southern Africa (COSECSA); motivated personnel; and the Revolutionary Government of Zanzibar’s willingness to collaborate with the NED Foundation.CONCLUSIONSInternational collaboration programs should balance local challenges and opportunities in order to effectively promote the development of neurosurgery in East Africa. Support and endorsement should be sought to harness shared resources and experience. Determining the caregiving and educational objectives within the logistic, administrative, social, and cultural framework of the target hospital is paramount to success.

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“…This means that even formally trained neurosurgeons in LMICs require some level of education and skills transfer when global neurosurgery efforts bring modern equipment that they have not used in years, or ever. 31,48 Second, education of the next generation of interested students becomes exceedingly challenging when you are the only neurosurgeon in your district, region, or country. Global neurosurgery programs allow for interested students to learn and become interested in neurosurgery, and many trips have lecture series embedded that discuss common neurosurgical conditions and man- agement.…”

Section: Education (Improve Care Provision)mentioning

confidence: 99%

Global neurosurgery: innovators, strategies, and the way forward

Haglund

Fuller

2019

Journal of Neurosurgery

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Around the world today, low- and middle-income countries (LMICs) have not benefited from advancements in neurosurgery; most have minimal or even no neurosurgical capacity in their entire country. In this paper, the authors examine in broad strokes the different ways in which individuals, organizations, and universities engage in global neurosurgery to address the global challenges faced in many LMICs. Key strategies include surgical camps, educational programs, training programs, health system strengthening projects, health policy changes/development, and advocacy. Global neurosurgery has begun coalescing with large strides taken to develop a coherent voice for this work. This large-scale collaboration via multilateral, multinational engagement is the only true solution to the issues we face in global neurosurgery. Key players have begun to come together toward this ultimate solution, and the future of global neurosurgery is bright.

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The Second African Federation of Neurological Surgeons Course in the East, Central, and Southern Africa Region Held in Dar es Salaam, Tanzania, January 2011

Cited by 26 publications

References 2 publications

Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines

Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines

The challenges and opportunities of global neurosurgery in East Africa: the Neurosurgery Education and Development model

Global neurosurgery: innovators, strategies, and the way forward

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