Young Neurosurgeons Forum Committee (in collaboration with the Young African Neurosurgeons Forum)

22 February 2021

Young Neurosurgeons Forum Committee
(in collaboration with the Young African Neurosurgeons Forum)

Angelos Kolias, Chair, and Ignatius Esene, Correspondent
and
Nqobile Thango, Beverly Cheserem, Tsegazeab Laeke, Mahmood Qureshi

Traumatic brain injury (TBI) is the leading cause of injury-related deaths globally. Dewan et al. reported that Lower-and-Middle Income Countries (LMIC), carry three times the burden of TBI compared to high-income countries (HIC)¹. When one looks at the global incidence rate of TBI, it becomes evident that the incidence is greater in countries with a high calibre of data capturing. Head and spine injuries within LMIC’s attribute to the highest proportion of the unmet neurosurgical operative burden, with almost 5 million cases per year that fall within this category². These facts make it difficult to ignore the fact that TBI is a silent pandemic in LMIC’s and lives in the shadows of infectious diseases, which are better reported.

In collaboration with the WFNS Young Neurosurgeons Committee, the Young African Neurosurgeons Forum hosted a symposium on Traumatic Brain Injury: Africa’s Silent Pandemic. It was a four-hour virtual webinar held on January 23 2021.

The symposium highlighted the burden of disease that goes unrecorded on our continent, Africa. A team of young neurosurgeons (YN) from LMICs submitted abstracts (original scientific study, Clinical case presentation or policy and advocacy report). The abstracts were grouped into four sessions, chaired by world-experts in the field, as follows:

Evidence-based guidelines in traumatic brain injury:During this session Professor Franco Servadei (WFNS President) highlighted the global burden of TBI, and the need for neurosurgeons in LMICs to improve TBI management and increase research output.
Research Priorities in Neurotrauma:Professor Anthony Figaji (ISPN Secretary) gave a thought-provoking talk highlighting the benefits and obstacles to research in LMIC. He also highlighted the importance of empowering LMICs when collaborating with HICs to ensure growth and sustainability.
Traumatic brain injury outcome measures:Dr Angelos Kolias (Chair WFNS YNF) gave a riveting presentation on the importance of documenting and reporting patient’s clinical outcomes. He highlighted the various measures at the neurosurgeon’s disposal when conducting TBI research.
The role of policy and governance in improving TBI management in LMIC’s: Prof Kee Park (WFNS GNC Chair) called attention to the global burden of neurosurgical diseases and how they are an “unmet need.” He also explained the vision of the “Comprehensive policy recommendations for head and spine injury care in LMICs” which is a collaboration between LMICs and HICs.

Other presentations revolved around the management of TBI in the African context, the role of decompressive craniectomy in Africa, management of gunshot injuries, TBI database management, and building a neurosurgical workforce.

Fig 1. Topographical map depicting the number of young neurosurgeons who presented their abstracts (chairperson’s excluded)

Fig 2. Attendees from LMIC N=463, HIC N=54 largest number from the United States (N=18).

The symposium had 516 registrants composed of 85 % (N=463) from LMICs and 12% (N=54) from HICs. We had 277 attendees, including from countries outside the African continent such as Iraq, Mongolia, Thailand and Russia (rate of attendance =54%). The topographical map (Fig 1) shows the regional distribution of our speakers, which included young neurosurgeons from across the globe. The bar-graph (Fig 2) depicts attendees' heterogeneity, which included neurosurgeons and anaesthetists, critical care specialists and medical students from across the globe.

There were 20 presentations from young neurosurgeons, of whom 17 were young Africans from 11 African countries.

This 4-hour webinar was a great success. A video of the event and the program can be found on the following link: Young African Neurosurgeons Forum YouTube Channel: https://www.youtube.com/channel/UCPLYEkIyDXu75E1ysYPZKfg

The global goal is that no one should experience undue discomfort, deprivation, disability or death due to head injury regardless of demographical location.

We hope to continue building capacity, collaborations and creating opportunities for young Neurosurgeons to be able to gain greater exposure for their work in order to contribute to bridging the knowledge gap on critical global public health problems.

References:

Dewan MC, Rattani A, Fieggen G, Arraez MA, Servadei F, Boop FA, et al: Global neurosurgery: the current capacity and deficit in the provision of essential neurosurgical care. Executive Summary of the Global Neurosurgery Initiative at the Program in Global Surgery and Social Change. Journal of Neurosurgery 130:1055-1064, 2018.
Park KB, Johnson WD, Dempsey RJ: Global neurosurgery: the unmet need.