• Stéphane Nguembu, Ulrick Sidney Kanmounye, Francklin Tétinou, Dylan Djiofack, and Régis Takoukam.
• Neurosurgery Unit, Department of Surgery, Laquintinie Hospital, Douala, Cameroon; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon.
• World Neurosurg. 2020 Jul 1; 139: e774-e783.

BackgroundAlthough nontraumatic diseases affect fewer people than traumatic neurosurgical diseases, they require expertise more often. The authors sought to understand the barriers to nontraumatic neurosurgical diseases (NTNSDs) in a country with limited access to neurosurgical care.MethodsThis cross-sectional study with retrospective data collection was carried out in 2 Cameroonian reference hospitals for a year. Multiple imputations were used to generate data for the missing variables-death and discharge with sequelae. Bivariate relationships were evaluated using the chi-square and Mann-Whitney U tests. Odds ratios were equally calculated, and the results were considered significant for a P value <0.05.ResultsNTNSDs represented 44.1% of neurosurgical activity. Our study included 177 patients with a mean age of 43.7 ± 21.2 years. More than half (53.1%) were female, 78% lived in a different region from that of the neurosurgical center, 18.1% had health insurance, 39.5% were referrals, and the mean symptom-to-admission delay was 409.0 ± 1301.7 days. Most (87%) of the patients had undergone at least 1 of the diagnostic examinations prescribed to them. Men (P = 0.029) and rural dwellers (P = 0.017) had shorter symptom-to-admission delays than women and urban dwellers, respectively. The mean length of stay was 18.2 ± 13.4, and 80.8% of patients were treated surgically. Thirty-one (17.5%) patients died in the hospital: 9 were treated surgically, and 22 were treated conservatively or expectantly.ConclusionsPatients with NTNSD present at the definitive care facilities late. This delay is attributable to financial and geographic barriers.Copyright © 2020 Elsevier Inc. All rights reserved.

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