• World Neurosurg · Aug 2020

    Observational Study

    The Burden of Neurosurgical Diseases in a Rural Southwestern Nigeria Setting.

    • Toyin Ayofe Oyemolade, James Ayokunle Balogun, Mojirade Abiola Akinkunmi, Oluwakemi Comfort Ogunyileka, Folawemimo Mercy Arogundade, and Ayodele Joy Olusola.
    • Division of Neurosurgery, Department of Surgery, Federal Medical Center, Owo, Nigeria. Electronic address: toyinmolade@yahoo.com.
    • World Neurosurg. 2020 Aug 1; 140: e148-e152.

    BackgroundMost of the few neurosurgeons in Nigeria are clustered in the urban centers. Consequently, a large proportion of the population who live in the rural areas have no direct access to neurosurgical care. This study aims to describe the burden of neurosurgical diseases in a rural neurosurgical service in Nigeria.MethodsThis was a prospective observational study of all neurosurgical patients managed at our center between August 2018 and July 2019. Data were analyzed with SPSS version 20 (IBM, Armonk, New York, USA).ResultsThe study cohort comprised 379 patients, including 267 males and 112 females (male:female ratio 2.4:1). The mean age was 35.71 ± 20.08 years (range, 35 hours to 100 years). More than one-half of the patients (55.6%) were age 20-49 years. Head injury was the most common presentation, occurring alone in 256 patients (67.55%) and in combination with spinal cord injury in 30 patients (7.92%). Brain tumors were present in 19 patients (5.01%), spinal cord injury in 15 patients (3.96%), degenerative spine disease in 9 patients (2.38%), and hydrocephalus in 5 patients (1.32%). Surgical intervention was performed in 21 patients (5.54%). The outcome of treatment was good in 251 patients (66.22%); 34 patients (8.97%) were referred to other facilities, 43 patients (11.35%) were discharged against medical advice, mostly because of economic reasons and poor medical insight, and 31 patients (8.18%) died.ConclusionsTrauma is the most common indication for neurosurgical care in our service. Poverty and poor medical insight remain formidable obstacles to maximizing the benefits of available neurosurgical care in developing countries.Copyright © 2020 Elsevier Inc. All rights reserved.

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