The pattern of neurosurgical disorders in rural northern Tanzania: a prospective hospital-based study
Andrea Sylvia Winkler1, Anthony Tluway, David Slottje
1Interdisciplinary Centre for Palliative Medicine and Department of Neurology, Ludwig-Maximilians-University, Munich, Germany. drawinkler@yahoo.com.au
Background/Objectives:
The prudent allocation of neurosurgical resources and training efforts requires an understanding of prevalence and clinical pattern of neurosurgical disorders in a particular region. The aim of our study was to assess the hospital-based prevalence of neurosurgical disease in the setting of rural sub-Saharan Africa.
Methods:
The study was conducted at Haydom Lutheran Hospital in northern Tanzania. Over a period of 8 months, all patients suspected of having neurologic or neurosurgical disorders were seen by a neurologist in consecutive order. Patients were assessed clinically and with plain radiographs, a computed tomography scanner was not available.
Results:
Of 8676 admissions, 151 patients (1.7%) were given a neurosurgical diagnosis. The most frequent diagnoses were traumatic brain injury (n=90), followed by tuberculosis of the spine (n=22), spina bifida (n=14), space-occupying cerebral lesion (n=13), and hydrocephalus (n=12). The overall mortality was 10.6%; it was especially high in patients with hydrocephalus (25%), space-occupying cerebral lesions (54%), and spina bifida (29%).
Conclusions:
Initial neurosurgical training and resource allocation in sub-Saharan Africa should focus on neurotrauma, spinal infections, congenital malformations, and hydrocephalus.
