• World Neurosurg · Aug 2024

    Operative Epidemiology of the First Five Years in a New African Neurosurgery Training Centre: The Experience in Rural Kenya at Tenwek Hospital 2016 to 2021.

    • Ndaro Daniel Bulenga, Aaron Miller, Ben Ojakapeli, Emmanuel W Wekesa, Josephat Mburu, Ivy Barasa, Hugh P Sims-Williams, Fraser C Henderson, and William R Copeland.
    • Department of Neurosurgery, Tenwek Hospital, Bomet, Kenya. Electronic address: ndarodaniel@gmail.com.
    • World Neurosurg. 2024 Aug 1; 188: e376e381e376-e381.

    BackgroundOne strategy to increase the availability of neurosurgical services in underserved regions within Sub-Saharan African countries is to create new residency training programs outside of cosmopolitan cities where programs may already exist. In 2016 Tenwek Hospital in rural western Kenya began offering full-time neurosurgical services and in 2020 inaugurated a residency training program. This review highlights the operative epidemiology of the first 5 years of the hospital's neurosurgical department.MethodsA retrospective review of all cases performed by a neurosurgeon at Tenwek Hospital between September 2016 and February 2022 was performed. Patient demographics, surgical indications, length of stay, and in-hospital mortality rates were collected.ResultsA total of 1756 cases were retrievable. Of these, 1006 (57.3%) were male and mean age was 30 years (range 1 day to 97 years). Mean length of stay was 11 ± 2 days and in-hospital mortality rate was 4.4% (77 patients). The most common pathologies in children comprised hydrocephalus and spina bifida (42.5% and 21.1%, respectively); in adults, cranial trauma (28.2%), oncology (25.2%), and degenerative spine (18.5%) were most common. Trauma was the leading cause of death.ConclusionsThe neurosurgical caseload of a rural hospital in an underserved area can provide not only an adequate neurosurgical volume, but a robust and varied exposure that is necessary for training safe and competent surgeons who are willing to remain in their countries of origin.Copyright © 2024 Elsevier Inc. All rights reserved.

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