• Ulrick S Kanmounye, Stéphane Nguembu, Dylan Djiofack, Yvan Zolo, Franklin Tétinou, Nathalie Ghomsi, Bello Figuim, and Ignatius Esene.
• Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Department, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo, Cameroon.
• Neurol India. 2021 Jan 1; 69 (1): 12-20.

BackgroundLow- and middle-income countries (LMICs) bear the majority of the neurosurgical burden of diseases but lack the resources to meet these needs.ObjectiveAs we increase access to neurosurgical care in LMICs, we must understand patient attitudes toward neurosurgery.Methods And MaterialPubMed, LILACS, and African Journals Online databases were searched systematically from inception to January 4, 2020, for studies on neurosurgical patient perceptions in LMICs. The articles found were blindly reviewed with Rayyan by two authors. The two authors resolved conflicts between themselves, and when this was not possible, a third reviewer was consulted. All the articles included were then appraised, and the results were summarized.ResultsSix of the 1,175 articles met the inclusion criteria. The studies were set in Brazil, Ethiopia, India, Nigeria, South Korea, and Sub-Saharan Africa. Four of the studies (50%) were phenomenological studies, and the other two were grounded theory and narrative. The studies identified patient attitudes toward neurosurgical practitioners, diseases, and interventions. Ethiopian and Nigerian patients believed cranial diseases to be otherworldly and resorted to traditional medicine or spiritual healing first, whereas Brazilian patients were more comfortable with cranial diseases and even more so if they had had a previous craniotomy. The Indian paper was a recount of a neurosurgeon's experience as a spine patient.ConclusionsThere are few studies on neurosurgery patient perception in LMICs. LMIC neurosurgeons should be encouraged to study their patient beliefs concerning neurosurgical diseases and interventions, as this can explain health-seeking behaviors.

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