Barriers and incentives for conducting research amongst the ophthalmologists in Sub-Sahara Africa

Global prevalence and years lived with disability (YLDs) of cataract in 204 countries and territories: findings from the Global Burden of Disease Study 2021

BACKGROUND

Cataracts, the leading cause of blindness globally, significantly impair vision and quality of life, particularly among the elderly. Despite advancements in cataract surgery, challenges in accessibility and economic disparities hinder the reduction of cataract burden, especially in low-income regions. This study examines the global prevalence and years lived with disability (YLDs) due to cataracts from 1990 to 2021, providing insights to inform public health strategies.

METHODS

Utilizing data from the Global Burden of Disease (GBD) Study 2021, we analysed cataract prevalence and YLDs across 204 countries and territories. The estimates were stratified by age, sex, region, and Socio-Demographic Index (SDI) and compared across different time periods. Age-standardized rates (ASRs) and average annual percentage changes (AAPCs) were calculated to evaluate trends.

RESULTS

From 1990 to 2021, the global YLDs due to cataracts increased from 3.42 million to 6.55 million, a 91.8% rise. Most countries exhibited an increase in YLDs, with notable surges in low-SDI regions like Sub-Saharan Africa and South Asia. The AAPC for age-standardized prevalence rate (ASPR) was slightly positive globally, while the age-standardized YLD rate (ASYR) showed a decreasing trend, indicating improved cataract management. High-SDI regions experienced minor ASPR increases but significant ASYR reductions, reflecting effective interventions. Conversely, low-SDI regions saw declines in both ASPR and ASYR, though disparities persisted.

CONCLUSION

The burden of cataracts remains substantial, with significant increases in YLDs driven by aging populations and improved diagnostic capabilities. Effective management strategies have reduced ASYRs, particularly in high-SDI regions. Addressing cataract burden in low-SDI regions requires enhanced healthcare access, targeted public health interventions, and global support. These findings underscore the need for continued investment in cataract prevention and treatment to mitigate the global impact.

Research capacity, motivators and barriers to conducting research among healthcare providers in Tanzania's public health system: a mixed methods study

BACKGROUND

Building health research capacity in low- and middle-income countries is essential to achieving universal access to safe, high-quality healthcare. It can enable healthcare workers to conduct locally relevant research and apply findings to strengthen their health delivery systems. However, lack of funding, experience, know-how, and weak research infrastructures hinders their ability. Understanding research capacity, engagement, and contextual factors that either promote or obstruct research efforts by healthcare workers can inform national strategies aimed at building research capacity.

METHODS

We used a convergent mixed-methods study design to understand research capacity and research engagement of healthcare workers in Tanzania's public health system, including the barriers, motivators, and facilitators to conducting research. Our sample included 462 randomly selected healthcare workers from 45 facilities. We conducted surveys and interviews to capture data in five categories: (1) healthcare workers research capacity; (2) research engagement; (3) barriers, motivators, and facilitators; (4) interest in conducting research; and (5) institutional research capacity. We assessed quantitative and qualitative data using frequency and thematic analysis, respectively; we merged the data to identify recurring and unifying concepts.

RESULTS

Respondents reported low experience and confidence in quantitative (34% and 28.7%, respectively) and qualitative research methods (34.5% and 19.6%, respectively). Less than half (44%) of healthcare workers engaged in research. Engagement in research was positively associated with: working at a District Hospital or above (p = 0.006), having a university degree or more (p = 0.007), and previous research experience (p = 0.001); it was negatively associated with female sex (p = 0.033). Barriers to conducting research included lack of research funding, time, skills, opportunities to practice, and research infrastructure. Motivators and facilitators included a desire to address health problems, professional development, and local and international collaborations. Almost all healthcare workers (92%) indicated interest in building their research capacity.

CONCLUSION

Individual and institutional research capacity and engagement among healthcare workers in Tanzania is low, despite high interest for capacity building. We propose a fourfold pathway for building research capacity in Tanzania through (1) high-quality research training and mentorship; (2) strengthening research infrastructure, funding, and coordination; (3) implementing policies and strategies that stimulate engagement; and (4) strengthening local and international collaborations.

Perceived attitudes and barriers towards medical research: a survey of Jordanian interns, residents, and other postgraduates

PURPOSE

We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output.

METHODS

Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish.

RESULTS

A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341-8.307), age (OR, 1.087; 95% CI, 1.019-1.159), academic standing (OR, 1.730; 95% CI, 1.103-2.715), and confidence (OR, 1.086; 95% CI, 1.009-1.169) were positive predictors of publication in peer reviewed journals.

CONCLUSION

The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance.

Characteristics of the clinical and global neurosurgical research publications from Africa: A scoping review

Introduction

Scientific research has a direct, profound impact on healthcare systems worldwide. While an upward trend can be observed in the number of produced papers in the neurosurgical specialty, disparities still exist between African neurosurgeons on one side and between African neurosurgeons and neurosurgeons from high income countries, on the other.

Research question

This study aims to analyze neurosurgical research produced in Africa to identify gaps in the literature and provide recommendations for aspiring African neurosurgeons for essential research areas.

Materials and methods

Four electronic databases (PubMed, Scopus, Web of Science, and Embase) were systematically searched for relevant articles on neurosurgery published by African authors. The three main inclusion criteria were: Articles published in the Neurosurgical field, articles published by African authors (whether first authors or co-authors) and articles published in Africa. Data extracted included the study design, scope, neurosurgical subspecialty, and the authors' nationalities.

Results

A total of 982 articles were included in the analysis. Of these articles, 889 (90.6%) were primary, 48 (4.9%) secondary, and 44 (4.5%) other types of research. Global Neurosurgery papers represent 7% of African neurosurgery research output. Most common primary studies included retrospective cohort (32.4%), case reports (28.3%), and prospective cohort (13.8%) studies. The most common secondary research articles were literature reviews (4.9%), letters to the editor (1.2%), and systematic reviews and meta-analyses (0.8%). Common research areas were neuro-oncology 242 (24.7%), spinal surgery 157 (16%), and cerebrovascular (14%). The most common nationalities of the first authors were Egyptian (32.4%), Moroccan (15%), and Nigerian (14.2%).

Discussion and conclusion

This study identifies increased African authorship in neurosurgical research in recent years. Nevertheless, many countries still lack representation in the neurosurgical research scene.Furthermore, a high percentage of the published papers is of low evidence. Therefore, we recommend that African neurosurgical researchers focus more on clinical trials and systematic reviews that directly translate to improving clinical practice. African neurosurgeons should also consider more collaboration between African authors.

Model for enhancing the research conducted by the university medical staff: Participatory action research

This study employed mixed methods with a participatory action research approach to explore factors currently undermining the conduction of research and to develop strategies to boost research productivity. A questionnaire was distributed to 64 staff members of the Department of Anesthesiology at a university-based hospital. Thirty-nine staff members (60.9%) gave informed consent and responses. Staff views were also collected through focus group discussions. The staff reported that limited research methodology skills, time management, and complex managerial processes were the limitations. Age, attitudes, and performance expectancy were significantly correlated with research productivity. A regression analysis demonstrated that age and performance expectancy significantly influenced research productivity. A Business Model Canvas (BMC) was implemented to gain insight into the goal of enhancing the conduct of research. Business Model Innovation (BMI) established a strategy to improve research productivity. The concept, comprising personal reinforcement (P), aiding systems (A), and a lifting-up of the value of research (L), the PAL concept, was considered key to enhancing the conduct of research, with the BMC providing details and integrating with the BMI. To upgrade the research performance, the involvement of management is imperative, and future action will involve the implementation of a BMI model to increase research productivity.

Evaluating scientific research barriers by gender and other characteristics from the perspective of ophthalmologists in Turkey: A multicenter survey study

BACKGROUND/AIM

The ever-increasing population and life expectancy worldwide increase the prevalence of ophthalmic diseases, and the need for ophthalmic research expands accordingly. In our study, we aimed to evaluate many aspects of the barriers, especially gender disparities, confronting ophthalmologists who aspire to conduct scientific research (SR).

MATERIALS AND METHODS

In this descriptive quantitative study, we distributed an online questionnaire to ophthalmologists in Turkey with 21 questions presented on a five-point Likert scale and two open-ended questions. The survey was prepared with Google forms. Participants were recruited via e-mail and social networks. A multicenter survey was conducted between January 29 and February 20, 2021, and a total of 210 valid responses were recorded.

RESULTS

Participants' responses were grouped into four types of barriers: motivation, time constraints, research support, and competence. Participants' motivation to conduct research was above average (3.54±0.96), but most stated that they have time constraints (3.74±0.97). Participants did not agree that there is adequate support for research (2.35±0.76), and they self assessed their level of the required competence to be average (2.87±1.08). Women were more motivated to do SR than men (p = 0.008), but there were no statistically significant differences between women and men in terms of time constraints, research support, and level of competence (p = 0.853, p = 0.482, and p = 0.558, respectively). Although there is no statistically significant difference between men and women regarding time constraints, female physicians mentioned more about the barriers arising from their personal responsibilities (p = 0.038).

CONCLUSIONS

Our study revealed that ophthalmologists are enthusiastic about doing SR but encounter obstacles with regard to time availability and research support. In addition, there is a need to reinforce competence in SR. Although female physicians are more motivated than men, they must deal with competing domestic responsibilities.

A systematic review of cases of West African crystalline maculopathy

AIM

West African crystalline maculopathy (WACM) is, reportedly, a rare condition whose aetiology remains unclear. This study aims to describe the epidemiology, summarizing the identified risk factors and clinical characteristics of cases of WACM, with the goal of highlighting presentation patterns and the clinical course of the condition.

METHODS

A comprehensive PubMed, Medline, EMBASE, Web of Science, OMIM and Google scholar search of all articles written in English, and non-English language articles with abstract translated to English on WACM was carried out. Only full case reports and series were included. Data reviewed included epidemiology, risk factors, clinical presentations, imaging characteristics, management and prognosis of WACM. Information on the location of the study was also extracted.

RESULTS

Ten studies - seven case reports and three case series - comprising of 30 patients were included. The patients were from West, Central and North-east Africa, with all the studies carried out in North America and Europe. The majority of the patients (76.7%) had diabetes mellitus, 80% had a vascular retinopathy (diabetic retinopathy, sickle cell retinopathy, familial exudative vitreoretinopathy and branch retinal vein occlusion) and 50% had macular oedema. There was no report of associated visual impairment or retinal degeneration. Clinical improvement in the number of crystals was documented in two cases with retinal laser photocoagulation for associated vascular retinopathies. Clinical observation was employed by most clinicians.

CONCLUSION

West African crystalline retinopathy is a seemingly innocuous condition affecting black or African people, who were also born in Africa. The majority of the patients have a vascular retinopathy. Longitudinal studies, particularly in Africa, may be required to elucidate the aetiology, as well as the long-term prognosis, of the crystals.

Systematic review and bibliometric analysis of African anesthesia and critical care medicine research part II: a scientometric analysis of the 116 most cited articles

Background

Scientometrics is used to assess the impact of research in several health fields, including Anesthesia and Critical Care Medicine. The purpose of this study was to identify contributors to highly-cited African Anesthesia and Critical Care Medicine research.

Methods

The authors searched Web of Science from inception to May 4, 2020, for articles on and about Anesthesia and Critical Care Medicine in Africa with ≥2 citations. Quantitative (H-index) and qualitative (descriptive analysis of yearly publications and interpretation of document, co-authorship, author country, and keyword) bibliometric analyses were done.

Results

The search strategy returned 116 articles with a median of 5 (IQR: 3–12) citations on Web of Science. Articles were published in Anesthesia and Analgesia (18, 15.5%), World Journal of Surgery (13, 11.2%), and South African Medical Journal (8, 6.9%). Most (74, 63.8%) articles were published on or after 2013. Seven authors had more than 1 article in the top 116 articles: Epiu I (3, 2.6%), Elobu AE (2, 1.7%), Fenton PM (2, 1.7%), Kibwana S (2, 1.7%), Rukewe A (2, 1.7%), Sama HD (2, 1.7%), and Zoumenou E (2, 1.7%). The bibliometric coupling analysis of documents highlighted 10 clusters, with the most significant nodes being Biccard BM, 2018; Baker T, 2013; Llewellyn RL, 2009; Nigussie S, 2014; and Aziato L, 2015. Dubowitz G (5) and Ozgediz D (4) had the highest H-indices among the authors referenced by the most-cited African Anesthesia and Critical Care Medicine articles. The U.S.A., England, and Uganda had the strongest collaboration links among the articles, and most articles focused on perioperative care.

Conclusion

This study highlighted trends in top-cited African articles and African and non-African academic institutions’ contributions to these articles.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12871-021-01246-4.

Systematic review and bibliometric analysis of African anesthesia and critical care medicine research part I: hierarchy of evidence and scholarly productivity

BACKGROUND

Research is an essential component of Anesthesia, and the contributions of researchers and institutions can be appreciated from the analysis of scholarly outputs. Such analyses help identify major contributors and trends in publication. Little is known about the state of Anesthesia and Critical Care Medicine (A.C.C.M.) research in Africa. We aimed to describe African A.C.C.M. research's current landscape by determining its productivity per country and point towards possible ideas for improvement.

METHODS

The authors searched PubMed, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception to May 4, 2020, for articles on or about A.C.C.M. in Africa. Studies were selected based on their titles and abstracts. Rayyan software was later on used for data management in the review selection process. Then, the full-text of eligible articles were screened. Data were extracted, and the number of articles per physician anesthesia providers and provider density were calculated. Kruskal Wallis test and Spearman's correlation were used, and a P-value < 0.05 was considered statistically significant.

RESULTS

Of the 4690 articles, only 886 (18.9%) were included in the analysis. The articles were published between 1946 and 2020 in 278 target journals. 55 (6.2%) articles were published in the South African Journal of Surgery, 51 (5.8%) in Anesthesia and Analgesia, and 46 (5.2%) in Anaesthesia. 291 (32.8%) studies were cross-sectional. 195 (22.0%) first authors were from Nigeria, 118 (13.3%) from South Africa, and 88 (9.9%) from the U.S.A. Malawi (1.67), Togo (1.06), and Sierra Leone (1.00) had the highest number of articles per provider. Whereas Ethiopia (580.00), Nigeria (336.21), and Malawi (333.33) had the highest number of articles per provider density.

CONCLUSION

We identified the most and least productive African countries in A.C.C.M. research and a low-quality hierarchy of evidence in these publications. Hence, the study's findings may aid in driving the A.C.C.M. research agenda and capacity building in Africa.

Has the Reporting Quality of Systematic Review Abstracts in Nursing Improved Since the Release of PRISMA for Abstracts? A Survey of High-Profile Nursing Journals

BACKGROUND

The PRISMA for Abstracts (PRISMA-A) was developed to guide authors to present a structured abstract. However, the adherence of abstracts to these guidelines in some areas was of concern.

AIMS

To determine whether the publication of PRISMA-A resulted in an improvement in the abstracts reported with nursing systematic reviews (SRs).

METHODS

This was a cross-sectional study. We searched PubMed for randomized controlled trials-based SRs published in top-tier nursing journals. A PRISMA-A checklist was used to assess abstracts in the SR included. Total score on checklists, comparison of total scores between two periods, and effect factors were analyzed.

RESULTS

Overall, abstract reporting compliance with PRISMA-A has not improved significantly with the time span. Of the 81 SRs, 74.1% were structured. About half reported eligibility criteria, information sources, and description of the effect as recommended. Registration status was reported only in 4.9%. The reporting quality was significantly higher for journals with higher impact factors (p < .001).

LINKING EVIDENCE TO ACTION

Although not inclusive of all SRs in the nursing field, our sample reflects the general trend that there was no significant improvement in the compliance of SR abstracts reported in nursing with the release of PRISMA-A. There is room for improvement, as most items have not been fully reported.