دانلود رایگان مقاله انگلیسی جراحی مغز و اعصاب در شرق آفریقا: مبانی - الزویر 2018

This article is the first in a series of 3 articles that seek to provide readers with an understanding of the development of neurosurgery in East Africa (Foundations), the challenges that arise in providing neurosurgical care in developing countries (Challenges), and an overview of traditional and novel approaches to overcoming these challenges to improve healthcare in the region (Innovations). We review the history and evolution of neurosurgery as a clinical specialty in East Africa. We also review Kenya, Uganda, and Tanzania in some detail and highlight contributions of individuals and local and regional organizations that helped to develop and shape neurosurgical care in East Africa. Neurosurgery has developed steadily as advanced techniques have been adopted by local surgeons who trained abroad, and foreign surgeons who have dedicated part of their careers in local hospitals. New medical schools and surgical training programs have been established through regional and international partnerships, and the era of regional specialty surgical training has just begun. As more surgical specialists complete training, a comprehensive estimation of disease burden facing the neurosurgical field is important. We present an overview with specific reference to neurotrauma and neural tube defects, both of which are of epidemiologic importance as they gain not only greater recognition, but increased diagnoses and demands for treatment. Neurosurgery in East Africa is poised to blossom as it seeks to address the growing needs of a growing subspecialty.

CONCLUSION

Neurosurgery as a specialty in East Africa is still at an early stage. Main challenges include the difficulties with hospital and operating room infrastructure, lack of emergency services, intensive care medicine, and imaging modalities. The establishment of national training programs is helping to kick-start the practice of neurosurgery in several regional centers. However, systematic data on neurosurgical disease burden remain somewhat scarce and indirectly obtained. Establishing national registries to record disease burden will be extremely effective in helping direct financial resources appropriately. As the global epidemic of injuries grows, East Africa must be prepared to handle this, as well as other widely prevalent neurosurgical diseases that are now being more frequently recognized. The future of neurosurgery can only be brighter as the region strives for self-reliance in the field.