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Nthumba PM, Odhiambo M, Pusic A, Kamau S, Rohde C, Onyango O, Gosman A, Vyas R, Nthumba MN. The State of Surgical Research in Sub-Saharan Africa: An Urgent Call for Surgical Research Trainers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5903. [PMID: 38881962 PMCID: PMC11177832 DOI: 10.1097/gox.0000000000005903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/01/2024] [Indexed: 06/18/2024]
Abstract
Background Surgery in low- and middle-income countries (LMICs) is poorly developed because of years of neglect. Sustained research on global surgery led to its recognition as an indivisible and indispensable part of primary healthcare in 2015. However, this has had little visible effect on surgical ecosystems within LMICs, especially in sub-Saharan Africa (SSA). SSA surgical research systems strengthening, which includes skills transfer, with local priority setting driving the research agenda, is needed to propel global surgery into the future. Methods The authors performed a literature review of the state of surgical research within SSA and also report the initial efforts of two research training nonprofits to empower young African surgeons with research skills. Results Surgical research in SSA is disadvantaged even before it is birthed, facing monumental challenges at every stage of development, from research agenda determination to funding, study execution, and publication. Compared with a global output of 17.49 publications per 100,000 population, SSA produces 0.9 (P < 0.0001). The Surgeons in Humanitarian Alliance for Reconstructive, Research, and Education and Enabling Africa Clinical Health Research programs are involved in the longitudinal research mentorship of surgical residents within SSA; the improved quality of research and successful publications by participants suggest nascent steps in growing young surgical scientists. Conclusions In the absence of an existing surgical research infrastructure within LMICs, global surgery research trainers should link up and collaborate to help develop a surgical research community that will provide the local data required to help transform the SSA surgical ecosystem.
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Affiliation(s)
- Peter M Nthumba
- From the Department of Plastic Surgery, AIC Kijabe Hospital, Kijabe, Kenya
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tenn
- Department of Plastic Surgery, Baylor College of Medicine, Temple, Tex
- EACH Research, University of Nairobi, Nairobi, Kenya
| | - Moses Odhiambo
- From the Department of Plastic Surgery, AIC Kijabe Hospital, Kijabe, Kenya
- EACH Research, University of Nairobi, Nairobi, Kenya
| | - Andrea Pusic
- Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Stephen Kamau
- EACH Research, University of Nairobi, Nairobi, Kenya
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Christine Rohde
- Division of Plastic and Reconstructive Surgery, Columbia University Medical Center, New York, N.Y
| | - Onesmus Onyango
- EACH Research, University of Nairobi, Nairobi, Kenya
- Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Amanda Gosman
- Department of Plastic Surgery, UC San Diego School of Medicine, Calif
| | - Raj Vyas
- Department of Plastic Surgery, UC Irvine, School of Medicine, Irvine, Calif
| | - Michelle N Nthumba
- EACH Research, University of Nairobi, Nairobi, Kenya
- African Women's Studies Centre, University of Nairobi, Nairobi, Kenya
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Ranganathan P, Dare A, Harrison EM, Kingham TP, Mutebi M, Parham G, Sullivan R, Pramesh CS. Inequities in global cancer surgery: Challenges and solutions. J Surg Oncol 2024; 129:150-158. [PMID: 38073139 DOI: 10.1002/jso.27551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
The disparity in access to and quality of surgical cancer care between high and low resource settings impacts immediate and long-term oncological outcomes. With cancer incidence and mortality set to increase rapidly in the next few decades, we examine the factors leading to inequities in global cancer surgery, and look at potential solutions to overcome these challenges.
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Affiliation(s)
- Priya Ranganathan
- Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anna Dare
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Ewen M Harrison
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - T Peter Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Groesbeck Parham
- Department of Obstetrics and Gynecology, Charles Drew University of Science and Medicine, Los Angeles, California, USA
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Zambia, Lusaka, Zambia
| | - Richard Sullivan
- School of Cancer Sciences, Centre for Cancer Society and Public Health, Institute of Cancer Policy, King's College London, London, UK
| | - C S Pramesh
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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Patil P, Nathani P, Bakker J, Van Duinen A, Bhushan P, Shukla M, Chalise S, Roy N, Gadgil A. Authors' Reply: Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review. World J Surg 2023; 47:3439-3440. [PMID: 37755500 DOI: 10.1007/s00268-023-07171-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/28/2023]
Affiliation(s)
- Priti Patil
- Department of Statistics, Bhabha Atomic Research Center Hospital, Mumbai, India
| | - Priyansh Nathani
- Hinduhridaysamrat Balasaheb Thackeray Medical College and Dr Rustom, Narsi Cooper Municipal General Hospital, Mumbai, India
| | - Juul Bakker
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Alex Van Duinen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Pranav Bhushan
- Department of Public Health, Institute of Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Minal Shukla
- Department of Maternal health, UNICEF, Bhopal, India
| | - Samir Chalise
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Nobhojit Roy
- Department of Global Public Health, Karolinska Institute, Solna, Sweden.
| | - Anita Gadgil
- Department of Surgery, Bhabha Atomic Research Centre Hospital, WHO Collaborating Centre for Research in Surgical Care Delivery in LMICs, Mumbai, India
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Zadey S. Letter to Editor: Are LMICs Achieving the Lancet Commission Global Benchmark for Surgical Volumes? A Systematic Review. World J Surg 2023; 47:3437-3438. [PMID: 37528271 DOI: 10.1007/s00268-023-07136-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/03/2023]
Affiliation(s)
- Siddhesh Zadey
- Association for Socially Applicable Research (ASAR) Office, D2 Sai Heritage, New DP Road, Aundh, Pune, Maharashtra, 411007, India.
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