1
|
Wagstaff DT, Bulamba F, Fernando R. Obstetric anaesthesia over the next 10 years: Africa and Middle East. Int J Obstet Anesth 2023; 55:103877. [PMID: 37076357 DOI: 10.1016/j.ijoa.2023.103877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 04/21/2023]
Abstract
Maternal and neonatal health outcomes vary within Africa and the Middle East. Despite substantial improvements over the past 20 years, there are persisting inequities in access to, and the quality of, obstetric anaesthetic care. These are most noticeable in Sub-Saharan Africa which has only 3% of the world's healthcare workforce but approximately two-thirds of global maternal deaths. Improvements are being made by: improving access; increasing numbers of trained staff; delivering accessible training; gathering data; conducting research and quality improvement activities; using innovative technologies; and forming productive collaborations. Further improvements will be needed to cope with increasing demand, the impacts of climate change and potential future pandemics.
Collapse
|
2
|
Kluyts HL, Bedwell GJ, Bedada AG, Fadalla T, Hewitt-Smith A, Mbwele BA, Mrara B, Omigbodun A, Omoshoro-Jones J, Turton EW, Belachew FK, Chu K, Cloete E, Ekwen G, Elfagieh MA, Elfiky M, Maimbo M, Morais A, Mpirimbanyi C, Munlemvo D, Ndarukwa P, Smalle I, Torborg A, Ulisubisya M, Fawzy M, Gobin V, Mbeki M, Ngumi Z, Patel-Mujajati U, Sama HD, Tumukunde J, Antwi-Kusi A, Basenaro A, Lamacraft G, Madzimbamuto F, Maswime S, Msosa V, Mulwafu W, Youssouf C, Pearse R, Biccard BM. Determining the Minimum Dataset for Surgical Patients in Africa: A Delphi Study. World J Surg 2023; 47:581-592. [PMID: 36380103 DOI: 10.1007/s00268-022-06815-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is often difficult for clinicians in African low- and middle-income countries middle-income countries to access useful aggregated data to identify areas for quality improvement. The aim of this Delphi study was to develop a standardised perioperative dataset for use in a registry. METHODS A Delphi method was followed to achieve consensus on the data points to include in a minimum perioperative dataset. The study consisted of two electronic surveys, followed by an online discussion and a final electronic survey (four Rounds). RESULTS Forty-one members of the African Perioperative Research Group participated in the process. Forty data points were deemed important and feasible to include in a minimum dataset for electronic capturing during the perioperative workflow by clinicians. A smaller dataset consisting of eight variables to define risk-adjusted perioperative mortality rate was also described. CONCLUSIONS The minimum perioperative dataset can be used in a collaborative effort to establish a resource accessible to African clinicians in improving quality of care.
Collapse
Affiliation(s)
- Hyla-Louise Kluyts
- Department Anaesthesiology, Dr George Mukhari Academic Hospital, Sefako Makgatho Health Sciences University, Molotlegi Street, Ga-Rankuwa, Pretoria, South Africa.
| | - Gillian J Bedwell
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Alemayehu G Bedada
- Department of Surgery, Faculty of Medicine, Princess Marina Hospital, University of Botswana, Corner of Notwane and Mobuto Road, Gaborone, Botswana
| | - Tarig Fadalla
- Ribat Neurospine Center, Ribat University Hospital, The National Ribat University, Nile Street Burri, Khartoum, Sudan
| | - Adam Hewitt-Smith
- Department of Anaesthesia and Critical Care, Faculty of Health Sciences, Busitema University, Mbale Campus, Mbale, Uganda
| | - Bernard A Mbwele
- Department of Epidemiology, Mbeya Zonal Referral Hospital, University of Dar Es Salaam, Mbeya, Tanzania
| | - Busisiwe Mrara
- Department of Anaesthesiology, Nelson Mandela Academic Hospital, Walter Sisulu University, Sissons Street Campus, Fortgale, Mthatha, Eastern Cape, South Africa
| | - Akinyinka Omigbodun
- College of Medicine, University College Hospital Ibadan, University of Ibadan, Ibadan, Nigeria
| | - Jones Omoshoro-Jones
- Department of Surgery, Chris Hani-Baragwanath Academic Hospital, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Edwin W Turton
- Faculty of Health Sciences, University of the Free State and Pelonomi Tertiary Hospital, PO Box 339 (G67), Bloemfontein, South Africa
| | | | - Kathryn Chu
- Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Esther Cloete
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Gerald Ekwen
- JJ Dosen County Referral Hospital, Maryland, Liberia
| | | | | | | | - Atilio Morais
- Departamento de Cirurgias Faculdade De Medicina, College of Cardiovascular and Thoracic Surgery, Hospital Central de Maputo, Universidade Eduardo Mondlane, Maputo, Mozambique
| | | | - Dolly Munlemvo
- University Hospital of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pisirai Ndarukwa
- Bindura University of Science Education, Bindura, Zimbabwe.,School of Nursing and Public Health, University of Kwa-Zulu Natal, Durban, South Africa
| | - Isaac Smalle
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Hospital, Freetown, Sierra Leone
| | - Alexandra Torborg
- Discipline of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of Kwa-Zulu Natal, Durban, South Africa
| | - Mpoki Ulisubisya
- Hubert Kairuki Memorial University, Mbeya Zonal Referral Hospital, Mbeya, Tanzania
| | - Maher Fawzy
- Faculty of Medicine, Cairo University Hospitals, Cairo University, Cairo, Egypt
| | - Veekash Gobin
- Jawaharall Nehru Hospital, Ministry of Health and Wellness, Rose Belle, Mauritius
| | - Motselisi Mbeki
- Kalafong Provincial Tertiary Hospital, University of Pretoria, Pretoria, South Africa
| | - Zipporah Ngumi
- School of Medicine, Kenyatta National Hospital, University of Nairobi, Nairobi, Kenya
| | | | - Hamza D Sama
- Anesthesia Resuscitation and Critical Care Medicine, Sylvanus Olympio University Teaching Hospital, Lomé, Togo
| | - Janat Tumukunde
- College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Apollo Basenaro
- MPH Ministry of Health and Social Services, Windhoek, Namibia
| | | | | | - Salome Maswime
- Department of Global Surgery, University of Cape Town, Cape Town, South Africa
| | | | - Wakisa Mulwafu
- Kamuzu University of Health Sciences, Queen Elizabeth Central Hospital Blantyre, Blantyre, Malawi
| | | | - Rupert Pearse
- Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Bruce M Biccard
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
3
|
Kifle F, Kifleyohanes T, Moore J, Teshome A, Biccard BM. Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review. World J Surg 2023; 47:1387-1396. [PMID: 36656359 PMCID: PMC10156757 DOI: 10.1007/s00268-023-06909-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 01/20/2023]
Abstract
Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.
Collapse
Affiliation(s)
- Fitsum Kifle
- Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa. .,College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia. .,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia.
| | - Tewodros Kifleyohanes
- College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia
| | - Jolene Moore
- College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia
| | | | - Bruce M Biccard
- Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia.,Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape, South Africa
| |
Collapse
|
4
|
Ndikontar Kwinji R, Evans F, Gray RM. Challenges with pediatric anesthesia and intraoperative ventilation of the child in the resource-constrained setting. Paediatr Anaesth 2022; 32:372-379. [PMID: 34861089 DOI: 10.1111/pan.14353] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/29/2021] [Accepted: 12/01/2021] [Indexed: 01/31/2023]
Abstract
The systemic challenges in providing safe anesthesia, including safe ventilation, to children in resource-constrained settings are many. For anesthesia providers caring for children, the lack of appropriate equipment, inadequate anesthesia workforce and deficiencies in postoperative care are especially difficult. The clinical decisions made by anesthesia providers around when and how to ventilate a child for surgery are influenced by all of these factors and can result in patient management which may vary significantly from that in a high-resource setting. This educational review considers the intraoperative ventilation of a small child in a resource-constrained setting and discusses specific challenges and context-sensitive solutions.
Collapse
Affiliation(s)
- Raymond Ndikontar Kwinji
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon.,Department of Anesthesia and Intensive Care, Yaounde Gyneco Obstetric and Pediatric Hospital, Yaounde, Cameroon
| | - Faye Evans
- The Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Rebecca M Gray
- Division of Paediatric Anaesthesia, Department of Anaesthesia and Perioperative Medicine, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa.,Division of Global Surgery, Department of Surgery, University of Cape Town, Rondebosch, South Africa
| |
Collapse
|
5
|
Kifle F, Durieux ME. A Pan-African perioperative care registries network – collaborative efforts to share learning and maximise opportunities. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2022. [DOI: 10.36303/sajaa.2022.28.1.2780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- F Kifle
- Division of Global Surgery, University of Cape Town,
South Africa
- Network for Perioperative and Critical Care (N4PCc),
Ethiopia
| | - ME Durieux
- Department of Anesthesiology, University of Virginia,
United States of America
| |
Collapse
|
6
|
Fossum M, Cohen MZ, Tønnessen VH, Hamre MD, Ødegaard ALV, Lind I, Olsen Håheim K, Opsal A. Clinical Nurses Research Priorities in Hospital Settings: A Delphi Survey. West J Nurs Res 2021; 44:780-787. [PMID: 34039083 PMCID: PMC9234779 DOI: 10.1177/01939459211017919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to identify the research priorities of clinical nurses to
develop a research program at a health care services system that includes three
hospitals. A Delphi survey was emailed to all clinical nurses in two rounds. The
Delphi method was used to collect data from the nurses in regards to their
priority research themes, and the data were analyzed using descriptive and
comparative statistics. A total of 933 clinical nurses returned the first round
of the Delphi survey and 543 nurses answered the second round. Clinical nurses
identified 89 potential research themes. Patient safety and ethical challenges
were the two highest ranked research priorities. The 40 highest ranked priority
research themes were closely associated with issues concerning patient care and
ethics. However, the nurses also gave high ratings to issues relating to the
work environment, questions about technology implementation, and patient
involvement in clinical care decisions.
Collapse
Affiliation(s)
- Mariann Fossum
- Centre for Caring Research-Southern Norway, University of Agder, Grimstad, Norway
| | - Marlene Z Cohen
- VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA.,University of Nebraska Medical Center, Omaha, NE, USA
| | | | | | | | | | | | - Anne Opsal
- Centre for Caring Research-Southern Norway, University of Agder, Grimstad, Norway.,Sorlandet Hospital, Kristiansand, Norway
| |
Collapse
|
7
|
Sund G, Lipnick M, Law T, Wollner E, Rwibuka G. Anaesthesia facility evaluation : a Whatsapp survey of hospitals in Burundi. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.2.2456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
8
|
Addressing priorities for surgical research in Africa: implementation of a multicentre cloud-based peri-operative registry in Ethiopia. Anaesthesia 2021; 76:933-939. [PMID: 33492690 PMCID: PMC8248420 DOI: 10.1111/anae.15394] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
In resource‐constrained settings, where inequalities in access to and quality of surgical care results in excess mortality, peri‐operative care registries are uncommon. A south‐south collaboration supported the implementation of a context specific, clinician‐led, multicentre real‐time peri‐operative registry in Ethiopia. Peri‐operative information, including the Ethiopian Ministry of Health’s national ‘Saving Lives through Safe Surgery initiative’, was linked to real‐time dashboards, providing clinicians and administrators with information on service utilisation, surgical access, national surgical key performance indicators and measures of quality of care. We recruited four hospitals representing 285 in‐patient beds from the Amhara and Southern Nations Nationalities and Peoples regions and Addis Ababa city, and reported on 1748 consecutive surgical cases from April 2019 to April 2020. Key performance indicators included: compliance with the World Health Organization’s Surgical Safety Checklist in 1595 (92.1%) surgical cases; adverse events during anaesthesia in 33 (3.1%) cases; and surgical site infections in 21 (2.0%) patients. This collaboration has successfully implemented a multicentre digital surgical registry that can enable measurement of key performance indicators for surgery and evaluation of peri‐operative outcomes. The peri‐operative registry is currently being rolled out across the Amhara region and Addis Ababa city administration. It will provide continuous granular healthcare information necessary to empower clinicians to drive context‐specific priorities for service improvement and research, in collaboration with national stakeholders and international research consortiums.
Collapse
Affiliation(s)
-
- Debre Birhan University and Debre Birhan Comprehensive Specialized Hospital, Ethiopia
| |
Collapse
|
9
|
Kanmounye US, Tochie JN, Mbonda A, Wafo CK, Daya L, Atem TH, Nyalundja AD, Eyaman DC. Systematic review and bibliometric analysis of African anesthesia and critical care medicine research part II: a scientometric analysis of the 116 most cited articles. BMC Anesthesiol 2021; 21:24. [PMID: 33478391 PMCID: PMC7819185 DOI: 10.1186/s12871-021-01246-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 01/13/2021] [Indexed: 11/10/2022] Open
Abstract
Background Scientometrics is used to assess the impact of research in several health fields, including Anesthesia and Critical Care Medicine. The purpose of this study was to identify contributors to highly-cited African Anesthesia and Critical Care Medicine research. Methods The authors searched Web of Science from inception to May 4, 2020, for articles on and about Anesthesia and Critical Care Medicine in Africa with ≥2 citations. Quantitative (H-index) and qualitative (descriptive analysis of yearly publications and interpretation of document, co-authorship, author country, and keyword) bibliometric analyses were done. Results The search strategy returned 116 articles with a median of 5 (IQR: 3–12) citations on Web of Science. Articles were published in Anesthesia and Analgesia (18, 15.5%), World Journal of Surgery (13, 11.2%), and South African Medical Journal (8, 6.9%). Most (74, 63.8%) articles were published on or after 2013. Seven authors had more than 1 article in the top 116 articles: Epiu I (3, 2.6%), Elobu AE (2, 1.7%), Fenton PM (2, 1.7%), Kibwana S (2, 1.7%), Rukewe A (2, 1.7%), Sama HD (2, 1.7%), and Zoumenou E (2, 1.7%). The bibliometric coupling analysis of documents highlighted 10 clusters, with the most significant nodes being Biccard BM, 2018; Baker T, 2013; Llewellyn RL, 2009; Nigussie S, 2014; and Aziato L, 2015. Dubowitz G (5) and Ozgediz D (4) had the highest H-indices among the authors referenced by the most-cited African Anesthesia and Critical Care Medicine articles. The U.S.A., England, and Uganda had the strongest collaboration links among the articles, and most articles focused on perioperative care. Conclusion This study highlighted trends in top-cited African articles and African and non-African academic institutions’ contributions to these articles. Supplementary Information The online version contains supplementary material available at 10.1186/s12871-021-01246-4.
Collapse
Affiliation(s)
- Ulrick Sidney Kanmounye
- Department of Research, Association of Future African Neurosurgeons, Yaounde, Cameroon. .,Department of Neurosurgery, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo.
| | - Joel Noutakdie Tochie
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Human Research Education and Networking, Yaounde, Cameroon
| | - Aimé Mbonda
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Surgery Unit, District Hospital of Batouri, Batouri, Cameroon.,Department of Research, International Student Surgical Network, Yaounde, Cameroon
| | - Cynthia Kévine Wafo
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Leonid Daya
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Department of Research, International Student Surgical Network, Yaounde, Cameroon
| | - Thompson Hope Atem
- Department of Internal Medicine, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo
| | - Arsène Daniel Nyalundja
- Department of Research, Association of Future African Neurosurgeons, Yaounde, Cameroon.,Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Daniel Cheryl Eyaman
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| |
Collapse
|
10
|
Yang Y, Moore A, Gaupp FL, Ahuja R, Sanyika C, Makris GC. A call to action; an open letter to WHO from the international interventional radiology community. CVIR Endovasc 2021; 4:3. [PMID: 33394198 PMCID: PMC7780208 DOI: 10.1186/s42155-020-00195-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yi Yang
- Department of Radiology, Aventura Hospital and Medical Center, Aventura, Florida, USA
| | - Andrew Moore
- Department of Radiology, Integris Baptist Medical Center, Oklahoma City, USA
| | - Fabian Laage Gaupp
- Vascular and Interventional Radiology Department, Yale New Heaven Medical Center, Connecticut, New Haven, USA
| | - Rakesh Ahuja
- Department of Radiology, Einstein Medical Center, Philadelphia, USA
| | - Charles Sanyika
- Department of Radiology, Donald Gordon Medical centre, Johannesburg, South Africa
| | - Gregory C Makris
- Vascular and Interventional Radiology Department, Guy's and St Thomas' Hospital, NHS Foundation Trust, London, UK. .,Alfa Institute of Biomedical Sciences, Neapoleos 9, Marousi, Athens, Greece.
| |
Collapse
|
11
|
Haider MA, Burks FN, Cassell A, Jalloh M. The Role of Organizations like IVUmed in Developing Centers of Excellence. CURRENT BLADDER DYSFUNCTION REPORTS 2020. [DOI: 10.1007/s11884-020-00603-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Kanmounye US, Tochie JN, Mbonda A, Wafo CK, Daya L, Atem TH, Nyalundja AD, Eyaman DC. Systematic review and bibliometric analysis of African anesthesia and critical care medicine research part I: hierarchy of evidence and scholarly productivity. BMC Anesthesiol 2020; 20:247. [PMID: 32988363 PMCID: PMC7523301 DOI: 10.1186/s12871-020-01167-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research is an essential component of Anesthesia, and the contributions of researchers and institutions can be appreciated from the analysis of scholarly outputs. Such analyses help identify major contributors and trends in publication. Little is known about the state of Anesthesia and Critical Care Medicine (A.C.C.M.) research in Africa. We aimed to describe African A.C.C.M. research's current landscape by determining its productivity per country and point towards possible ideas for improvement. METHODS The authors searched PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to May 4, 2020, for articles on or about A.C.C.M. in Africa. Studies were selected based on their titles and abstracts. Rayyan software was later on used for data management in the review selection process. Then, the full-text of eligible articles were screened. Data were extracted, and the number of articles per physician anesthesia providers and provider density were calculated. Kruskal Wallis test and Spearman's correlation were used, and a P-value < 0.05 was considered statistically significant. RESULTS Of the 4690 articles, only 886 (18.9%) were included in the analysis. The articles were published between 1946 and 2020 in 278 target journals. 55 (6.2%) articles were published in the South African Journal of Surgery, 51 (5.8%) in Anesthesia and Analgesia, and 46 (5.2%) in Anaesthesia. 291 (32.8%) studies were cross-sectional. 195 (22.0%) first authors were from Nigeria, 118 (13.3%) from South Africa, and 88 (9.9%) from the U.S.A. Malawi (1.67), Togo (1.06), and Sierra Leone (1.00) had the highest number of articles per provider. Whereas Ethiopia (580.00), Nigeria (336.21), and Malawi (333.33) had the highest number of articles per provider density. CONCLUSION We identified the most and least productive African countries in A.C.C.M. research and a low-quality hierarchy of evidence in these publications. Hence, the study's findings may aid in driving the A.C.C.M. research agenda and capacity building in Africa.
Collapse
Affiliation(s)
- Ulrick Sidney Kanmounye
- Department of Research, Association of Future African Neurosurgeons, Kinshasa, Democratic Republic of Congo. .,Department of Neurosurgery, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo.
| | - Joel Noutakdie Tochie
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Human Research Education and Networking, Yaounde, Cameroon
| | - Aimé Mbonda
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Surgery Unit, District Hospital of Batouri, Batouri, Cameroon.,Department of Research, International Student Surgical Network, Yaounde, Cameroon
| | - Cynthia Kévine Wafo
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Leonid Daya
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.,Department of Research, International Student Surgical Network, Yaounde, Cameroon
| | - Thompson Hope Atem
- Department of Internal Medicine, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo
| | - Arsène Daniel Nyalundja
- Department of Research, Association of Future African Neurosurgeons, Kinshasa, Democratic Republic of Congo.,Faculty of Medicine, Catholic University of Bukavu, Bukavu, Democratic Republic of Congo
| | - Daniel Cheryl Eyaman
- Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| |
Collapse
|
13
|
Adde HA, van Duinen AJ, Oghogho MD, Dunbar NK, Tehmeh LG, Hampaye TC, Salvesen Ø, Weiser TG, Bolkan HA. Impact of surgical infrastructure and personnel on volume and availability of essential surgical procedures in Liberia. BJS Open 2020; 4:1246-1255. [PMID: 32949120 PMCID: PMC7709357 DOI: 10.1002/bjs5.50349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/28/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Essential surgical procedures rank among the most cost-effective of all healthcare interventions. The aim of this study was to enumerate surgical volumes in Liberia, quantify surgical infrastructure, personnel and availability of essential surgical procedures, describe surgical facilities, and assess the influence of human resources and infrastructure on surgical volumes. METHODS An observational countrywide survey was done in Liberia between 20 September and 8 November 2018. All healthcare facilities performing surgical procedures requiring general, regional or local anaesthesia in an operating theatre between September 2017 and August 2018 were eligible for inclusion. Information on facility infrastructure and human resources was collected by interviewing key personnel. Data on surgical volumes were extracted from operating theatre log books. RESULTS Of 70 healthcare facilities initially identified as possible surgical facilities, 52 confirmed operative capacity and were eligible for inclusion; all but one shared surgical data. A national surgical volume of 462 operations per 100 000 population was estimated. The median hospital offered nine of 26 essential surgical procedures. Unequal distributions of surgical infrastructure, personnel, and essential surgical procedures were identified between facilities. In multivariable regression analysis, surgical human resources (β = 0·60, 95 per cent c.i. 0·34 to 0·87; P < 0·001) and infrastructure (β = 0·03, 0·02 to 0·04; P < 0·001) were found to be strongly associated with operative volumes. CONCLUSION The availability of essential surgical procedures in Liberia is extremely low. Descriptive tools can quantify inequalities, guide resource allocation, and highlight rational investment areas.
Collapse
Affiliation(s)
- H. A. Adde
- Department of Clinical and Molecular MedicineFaculty of Medicine and Health Sciences, NTNU — Norwegian University of Science and TechnologyTrondheimNorway
- Department of Surgery, St Olav's HospitalTrondheim University HospitalTrondheimNorway
| | - A. J. van Duinen
- Department of Clinical and Molecular MedicineFaculty of Medicine and Health Sciences, NTNU — Norwegian University of Science and TechnologyTrondheimNorway
- Department of Surgery, St Olav's HospitalTrondheim University HospitalTrondheimNorway
| | - M. D. Oghogho
- Department of Clinical and Molecular MedicineFaculty of Medicine and Health Sciences, NTNU — Norwegian University of Science and TechnologyTrondheimNorway
| | | | - L. G. Tehmeh
- Quality Management Unit, Ministry of HealthMonroviaLiberia
| | | | - Ø. Salvesen
- Department of Public Health and NursingFaculty of Medicine and Health Sciences, NTNU — Norwegian University of Science and TechnologyTrondheimNorway
| | - T. G. Weiser
- Department of SurgeryStanford University Medical CenterCaliforniaUSA
- Department of Clinical SurgeryUniversity of EdinburghEdinburghUK
| | - H. A. Bolkan
- Department of Clinical and Molecular MedicineFaculty of Medicine and Health Sciences, NTNU — Norwegian University of Science and TechnologyTrondheimNorway
- Department of Surgery, St Olav's HospitalTrondheim University HospitalTrondheimNorway
| |
Collapse
|