Public Awareness, Knowledge of Availability, And Willingness to Use Neurosurgical Care Services in Africa: A Cross-Sectional E-Survey Protocol

Partnering with Foundations, Philanthropy, and Universities with Programs Supported by Local Physicians and Eventually Local Physicians Taking Ownership

This article provides a thorough analysis of the evolution and current state of global neurosurgery, emphasizing the transformative power of partnerships between various stakeholders to address the stark inequities in neurosurgical care, especially in LMICs. It discusses the transition from reliance on short-term medical missions to the development of sustainable, locally led neurosurgical programs through education, training, and infrastructure development. The article highlights the importance of long-term educational exchanges, innovative digital learning platforms, and strategic collaborations with foundations, philanthropic organizations, and academic institutions to build local capacities, enhance global neurosurgical competency, and promote self-sufficiency in neurosurgical care across different regions.

Delays in Presentation After Traumatic Spinal Cord Injury-A Systematic Review

BACKGROUND

Prompt surgical decompression after traumatic spinal cord injury (TSCI) may be associated with improved sensorimotor outcomes. Delays in presentation may prevent timely decompression after TSCI.

OBJECTIVE

To systematically review existing studies investigating delays in presentation after TSCI in low- and middle-income countries (LMICs) and high-income countries (HICs).

METHODS

A systematic review was conducted and studies featuring quantitative or qualitative data on prehospital delays in TSCI presentation were included. Studies lacking quantitative or qualitative data on prehospital delays in TSCI presentation, case reports or series with <5 patients, review articles, or animal studies were excluded from our analysis.

RESULTS

After exclusion criteria were applied, 24 studies were retained, most of which were retrospective. Eleven studies were from LMICs and 13 were from HICs. Patients with TSCI in LMICs were younger than those in HICs, and most patients were male in both groups. A greater proportion of patients with TSCI in studies from LMICs presented >24 hours after injury (HIC average proportion, 12.0%; LMIC average proportion, 49.9%; P = 0.01). Financial barriers, lack of patient awareness and education, and prehospital transportation barriers were more often cited as reasons for delays in LMICs than in HICs, with prehospital transportation barriers cited as a reason for delay by every LMIC study included in this review.

CONCLUSIONS

Disparities in prehospital infrastructure between HICs and LMICs subject more patients in LMICs to increased delays in presentation to care.