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1. Antimicrobial resistance control activities at a tertiary hospital in a low-resource setting: an example of Queen Elizabeth Central Hospital in Malawi

Author

Patrick Kamalo, Pui-Ying Iroh Tam, Thokozani Noniwa, Chikumbutso Mpanga, Chanizya Mulambia, Ethwako Phiri, Dingase Kumwenda, Ed Phillipo, Samantha Lissauer, David Kulapani, and Christina Mwinjiwa

Subjects
antimicrobial resistance, antimicrobial stewardship, infection prevention and control, low-resource settings, low- and middle-income countries, leadership, Therapeutics. Pharmacology, RM1-950
Abstract

BackgroundAddressing AMR has been most problematic in low- and middle-income countries, which lack infrastructure, diagnostic capacity, and robust data management systems, among other factors. The implementation of locally-led efforts in a low-income country to develop sustainability and build capacity for AMR control within the existing infrastructure has not been well documented.MethodsWe detail current AMR control initiatives at Queen Elizabeth Central Hospital, a tertiary referral government hospital in Malawi with limited resources, and present the activities accomplished to date, lessons learned, and challenges ahead.ResultsThe key areas of AMR control initiatives that the group focused on included laboratory diagnostics and surveillance, antimicrobial stewardship, infection prevention and control, pharmacy, leadership, education, and funding.DiscussionThe hospital AMR Control Working Group increased awareness, built capacity, and implemented activities around AMR control throughout the hospital, in spite of the resource limitations in this setting. Our results are based on the substantial leadership provided by the working group and committed stakeholders who have taken ownership of this process.ConclusionLimited resources pose a challenge to the implementation of AMR control activities in low- and middle-income countries. Leadership is central to implementation. Future efforts will need to transition the initiative from an almost fully personal commitment to one with wider engagement to ensure sustainability.

Published
2023
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2. Evidence-Driven Policies for Sustainably Scaling Up Surgical Task-Sharing in Malawi; Comment on 'Improving Access to Surgery Through Surgical Team Mentoring – Policy Lessons From Group Model Building With Local Stakeholders in Malawi'

Author

Desmond T. Jumbam, Ulrick Kanmounye, Isabelle Citron, and Patrick Kamalo

Subjects
global surgery, task-sharing, health financing, Public aspects of medicine, RA1-1270
Abstract

This commentary discusses an article by Broekhuizen et al which assesses policy options for scaling up the SURG-Africa surgical team mentoring program in Malawi to increase access to surgical care. In modeling these scenarios, the authors assess the cost of scaling up surgical teams mentoring and the impacts of scaling the program on district hospitals (DHs) and central hospitals (CHs). The additional costs borne by DHs when increasing surgical volume remains a significant issue identified by the authors and could ultimately determine the success of the program. The piece indirectly advocates for an increased role for task-shifting. The Ministry of Health of Malawi will have to ensure the appropriate governance and regulatory processes are in place to maintain quality and accountability.

Published
2022
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3. ‘It is the child with the big head’ – Primary healthcare providers’ perceptions of paediatric hydrocephalus in Blantyre, Malawi: A qualitative study

Author

Camilla G. Aukrust, Patrick D. Kamalo, Gertrude Finyiza, Chimwemwe Mula, Blessings A. Chapweteka, Heidi E. Fjeld, and Lucinda Manda-Taylor

Subjects
Hydrocephalus, Malawi, paediatrics, global neurosurgery, IGAP, Public aspects of medicine, RA1-1270
Abstract

ABSTRACTChildren in Africa are disproportionately burdened by the neurosurgical condition hydrocephalus. In Blantyre, Malawi, paediatric hydrocephalus represents the majority of surgical procedures performed in the neurosurgical department at Queen Elizabeth Central Hospital. To reduce morbidity and mortality, timely detection followed by referral from surrounding primary health centres is crucial. Aiming to explore perceptions and identify enablers and barriers to detection and referral, we conducted a qualitative study among primary healthcare providers (n = 30) from ten health centres in Blantyre district. Using a semi-structured interview-guide, we audio-recorded and transcribed the interviews before conducting a thematic analysis. One main finding is that there is a potential to improve detection through head circumference measurements, which is the recommended way to detect hydrocephalus early, yet healthcare providers did not carry this out systematically. They described the health passport provided by the Malawian Ministry of Health as an important tool for clinical communication. However, head circumference growth charts are not included. To optimise outcomes for paediatric hydrocephalus we suggest including head circumference growth charts in the health passports. To meet the need for comprehensive management of paediatric hydrocephalus, we recommend more research from the continent, focusing on bridging the gap between primary care and neurosurgery.

Published
2023
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4. There are always two sides to every story: the LMICs perspective on Global Neurosurgery

Author

Nicolò Marchesini, Debora Garozzo, Fatos Olldashi, Jesus Lafuente, Jamil Rzaev, Jake Timothy, Kresimir Rotim, Marcel Ivanov, Magnus Tisell, Massimiliano Visocchi, Nikolaos Foroglou, Ondra Petr, Pablo Gonzalez-Lopez, Vincenzo Paternò, Enoch O. Uche, Patrick Kamalo, Ahmed Negida, Kee Park, Lukas Rasulic, and Andreas K. Demetriades

Subjects
Neurology. Diseases of the nervous system, RC346-429
Published
2023
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5. Improving competencies and skills across clinical contexts of care: a qualitative study on Malawian nurses' experiences in an institutional health and training programme

Author

Camilla Grøver Aukrust, Patrick Dongosolo Kamalo, Ruth Jane Prince, Johanne Sundby, Chimwemwe Mula, and Lucinda Manda‐Taylor

Subjects
competency, education, health education, malawi, neurosurgery, nurse practitioners, Nursing, RT1-120
Abstract

Abstract Aim To explore what competencies and skills Malawian nurses gained after participating in an institutional health and training programme in Norway and how they viewed these competencies applicable upon return to Malawi. Furthermore, to examine facilitators and challenges experienced on the exchange programme and opportunities and obstacles to make the competencies usable in own local hospital context. Design Qualitative study with an explorative design. Methods Fourteen interviews and one focus group discussion were conducted at Queen Elizabeth Central Hospital, Blantyre, Malawi, from August to September 2018. Results Competencies gained in Norway included clinical skills, teamwork, coordination and strengthened professionalism. The main finding was that the exchange programme was a transformative experience. Upon return to Malawi, the competencies gained on the exchange were helpful. However, the return was characterized by mixed emotions due to the considerable difference between the two clinical settings.

Published
2021
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6. Risk Factors for Hemorrhagic Stroke among Adults in the Democratic Republic of the Congo: A Hospital-Based Study in a Limited Resource Setting

Author

Jacques Mbaz Musung, Placide Kambola Kakoma, Marcellin Bugeme, Jeef Paul Munkemena Banze, Clarence Kaut Mukeng, Orly Ngungwa Muyumba, Berthe Mwad Kamalo, Harvey Kabulo Kapya, Ghyslain Lambo Ngongo, Laurent Kitwa, Evariste Tshibind Yav, Olivier Mukuku, and Emmanuel Kiyana Muyumba

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

Background. The prevalence of stroke is increasing in sub-Saharan Africa. The scarcity of hospital-based stroke data in Lubumbashi (in the Democratic Republic of the Congo) led to the study, which was designed to describe the epidemiology of stroke and identify risk factors associated with hemorrhagic stroke among adult patients in Lubumbashi. Methods. This was a cross-sectional study of 158 adult patients admitted for stroke in the internal medicine department of Lubumbashi University Clinics from January 2018 to December 2020. Sociodemographic and clinical features, cardiovascular risk factors, and hospital mortality were collected. A logistic regression has determined the risk of developing a hemorrhagic stroke. Results. Of 9,919 hospitalized patients, 158 had a stroke with a hospital prevalence of 1.6%; 86 (54.4%) patients had a hemorrhagic stroke while 72 (45.6%) had an ischemic stroke. Of which 41.1% (65/158) were women. The mean age was 60.8±13.3 years. Main clinical signs were hemiplegia (63.3%), headache (48.7%), speech disorders (38.6%), and dizziness (38.6%). Hypertension (82.9%) and hyperglycemia (53.2%) were the most common risk factors. Inhospital mortality was 22.8%. After logistic regression, independent predictors for developing hemorrhagic stroke were hypertension (aOR=8.19; 95% CI: 2.72–24.66; p

Published
2022
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7. Global neurosurgery over a 60-year period: Conceptual foundations, time reference, emerging Co-ordinates and prospects for collaborative interventions in low and middle income countries

Author

E.O. Uche, Jimmy Sundblom, Uko Kalu Uko, Patrick Kamalo, Alvin Nah Doe, Linn Eriksson, Ulrika Sandvik, David F Revesz, Mats Ryttlefors, and Magnus Tisell

Subjects
Global neurosurgery, Grid references, Volunteerism, Collaboration, Advocacy, Global neurosurgery profile, Neurology. Diseases of the nervous system, RC346-429
Abstract

Introduction: We evaluated salient initiatives invested in global neurosurgery over a 60-year period, Research question: What are the Phases, Achievements, Challenges, and Lessons of Global Neurosurgery. Methods: A 60-year retrospective study from 1960 to 2020 analyzing the major phases, lessons, and progress notes. We reviewed the foundational need questions and innovated tools used to answer them. Results: Three phases defining our study period were identified. In the early phase, birthing academic units and the onset of individual volunteerism were dominant concepts. The 2nd phase is summarized by the rise of volunteerism and surgical camps.The third phase is heralded by advocacy and strategies for achieving care equity. The defining moment is the Lancet commission for global surgery summit in 2015. Lessons include the need for evaluation of the resources of recipient and donor locations using novel global surgery tools. Conclusion: Global neurosurgery over the 60-year study period is summarized by indelible touchstones of personal and group efforts as well as triumphs derived from innovations in the face of formidable challenges.

Published
2022
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9. Establishment of a high-dependency unit in Malawi

Author

Jane Mallewa, Leo Masamba, Felix Limbani, Patrick Kamalo, Marc Yves Romain Henrion, Jamie Rylance, Stephen Gordon, Ben Morton, Ndaziona Peter Banda, Edna Nsomba, Clara Ngoliwa, Sandra Antoine, Joel Gondwe, James Chirombo, Tim Baker, Chimota Phiri, Tamara Phiri, Henry Charles Mwandumba, and Kwazizira Samson Mndolo

Subjects
Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract

Adults admitted to hospital with critical illness are vulnerable and at high risk of morbidity and mortality, especially in sub-Saharan African settings where resources are severely limited. As life expectancy increases, patient demographics and healthcare needs are increasingly complex and require integrated approaches. Patient outcomes could be improved by increased critical care provision that standardises healthcare delivery, provides specialist staff and enhanced patient monitoring and facilitates some treatment modalities for organ support. In Malawi, we established a new high-dependency unit within Queen Elizabeth Central Hospital, a tertiary referral centre serving the country’s Southern region. This unit was designed in partnership with managers, clinicians, nurses and patients to address their needs. In this practice piece, we describe a participatory approach to design and implement a sustainable high-dependency unit for a low-income sub-Saharan African setting. This included: prospective agreement on remit, alignment with existing services, refurbishment of a dedicated physical space, recruitment and training of specialist nurses, development of context-sensitive clinical standard operating procedures, purchase of appropriate and durable equipment and creation of digital clinical information systems. As the global COVID-19 pandemic unfolded, we accelerated unit opening in anticipation of increased clinical requirement and describe how the high-dependency unit responded to this demand.

Published
2020
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10. Global Perspectives on Task Shifting and Task Sharing in Neurosurgery

Author

Faith C. Robertson, Ignatius N. Esene, Angelos G. Kolias, Tariq Khan, Gail Rosseau, William B. Gormley, Kee B. Park, Marike L.D. Broekman, Jeffrey Rosenfeld, Naci Balak, Ahmed Ammar, Magnus Tisel, Michael Haglund, Timothy Smith, Ivar Mendez, Jannick Brennum, Stephen Honeybul, Akira Matsumara, Severien Muneza, Andres Rubiano, Patrick Kamalo, Graham Fieggen, Basant Misra, Gene Bolles, David Adelson, Robert Dempsey, Peter Hutchinson, Alexandrina Nikova, Osama Ghazala, Elubabor Buno, Shibashish Bhattacharjee, Takahiro Iizuka, Jafri Malin Abdullah, Bipin Chaurasia, Eghosa Morgan, Rodolfo E. Alcedo-Guardia, Lynne Lourdes N. Lucena, Kadir Oktay, Omar Ibrahim AbdAllah, Ahlem Saihi, Gacem Abdeldjalil, Mahi Asmaa, Claudio Yampolsky, Laura P. Saladino, Francisco Mannara, Sonal Sachdev, Benjamin Price, Vincent Joris, Nourou Dine Adeniran Bankole, Edgar M. Carrasco, Mirsad Hodzic, Marcos Wagner de Sousa Porto, Robson Amorim, Igor Lima Maldonado, Bizoza Yves, Gonzalo Suarez, Felipe Constanzo, Johanna Cecilia Valdeblanquez Atencio, Karen Alexa Ruiz Mora, Juan Manuel Rodriguez Gil, Kiriakos Paraskeva, Emrah Egemen, Trevcsor Ngamasata, Jeff Ntalaja, Antoine Beltchika, Glennie Ntsambi, Goertz Mirenge Dunia, Mahmoud M. Taha, Mohamed Arnaout, Ramez Kirollos, Mohamed Kassem, Omar Elwardany, Ahmed Negida, Birhanu Dolango, Mikael Aseged, Alemu Adise Mldie, Tsegazeab Laeke, Abenezer Aklilu, Esayas Adefris, Teemu Luoto, Rezai Jahromi Behnam, Emmanuel De Schlichting, Bougaci Nassim, Pierre Bourdillon, Martin N. Stienen, Stephan Lackermair, Franziska Anna Schmidt, Juergen Konczalla, Adrien Holzgreve, Andre Sagerer, Dieter M. Weinert, Paulette Kumi, Aaron Lawson McLean, James Loan, Julian Cahill, Simon Dockrell, Fardad T. Afshari, Paul May, Alkinoos Athanasiou, Steven Papadopoulos, Edroulfo-Georgios Espinoza, Athanasios Chatzisotiriou, Pavlos Vlachogiannis, Konstantina Karabatsou, Thanasis Paschalis, Christos Tsitsipanis, Gabriel Mauricio Longo Calderan, Ronny Leiva, Harsh Deora, Sreenivas Mukkamala, Dipesh Batra, Arvind Sukumaran, Kanishk Parmar, Anuj Bahl, Amit Agrawal, Nirankar Dev, Nikhil Thakur, Sanjay Behari, Chandrasekhar B.V.K. Yandrapati, Ritesh Bhoot, Pragnesh Bhatt, Uday Bhaumik, Manish Agrawal, Antony Thomas, Harish Chandrappa, Ankit Mathur, Petra Wahjoepramono, Selfy Oswari, Rafid Al-Mahfoudh, Abbas Alnaji, Nidal Abuhadrous, Bakr Abo Jarad, Ibrahim Nour, Or Cohen-Inbar, Roberto Colasanti, Alfredo Conti, Giovanni Raffa, Corrado Castrioto, Matteo M. Baccanelli, Santino Ottavio Tomasi, Matteo Zoli, Andrea Veroni, Andrea Di Cristofori, Luigi Giannachi, Laura Lippa, Donatella Sgubin, Morgan Broggi, Marcello Barbato, Francesco Restelli, Mario Ganau, Graziano Taddei, Hamzeh Albadawi, Mohammed Salameh, Madieyva Gulmira, Muffaq Lashhab, Walid El Gaddafi, Mohammad Altoumi, S.M. Manvinder, Davendran Kanesen, Mario Teo, Prabu Rau Sriram, Sarah Atiqah M. Zamri, Vayara Perumall Vinodh, Moussa Denou, Adyl Melhaoui, Oumaima Outani, Mahjouba Boutarbouch, Armin Gretschel, Pradhumna Yadav, Balgopal Karmacharya, Fatih Incekara, Hugo den Boogert, Buccket Argvoello Lopez, Hassane Ali Amadou, Danjuma Sale, Sanusi Bello, Poluyi Edward, Alvan-Emeka Ukachukwu, Evaristus Nwaribe, Ikechukwu Aniaku, Aliyu Baba Ndajiwo, Olabamidele Ayodele, Gyang Markus Bot, Sunday David Ndubuisu Achebe, Bakht Jamal, Muhammad Tariq, Ghulam Farooq, Danyal Zaman Khan, Ahtesham Khizar, Zahid Hussain, Anisa Nazir, Marco Gonzales-Portillo, Jhosep Silvestre Bautista, Roland A. Torres, Abigail Javier-Lizan, Isagani Jodl G. de los Santos, Jr., Nuno Morais, Lydia Dias, Carolina Noronha, Jovelo Monteiro Silva, Alexandra Seromenho-Santos, Kiril Lozanche, Ionut Negoi, Alexandru Tascu, Danil A. Kozyrev, Dr. Menelas Nkeshimana, Claire Karekezi, Marcel Didier Ndayishyigikiye, Faisal Alabbass, Faisal Farrash, Rawan Alhazmi, Jagos Golubovic, Milan Lepifá, Rosanda Ilifá, Aleksandar Stanimirovifá, Sergio Garcia-Garcia, Carlos A. Rodriguez Arias, Ruth Lau, Juan Delgado-Fernandez, Miguel A. Arraez, C. Fernandez Mateos, Ana M. Castano Leon, Saman Wadanamby, David Bervini, Hamisi K. Shabani, Kriengsak Limpastan, Khalil Ayadi, Altay Sencer, Ali Yalcinkaya, Elif Eren, Recep Basaran, Abdulkerim Gokoglu, Vyval Mykola, Felicita Tayong, Mario Zuccarello, Carolyn Quinsey, Michael C. Dewan, Paul H. Young, Edward Laws, Jack Rock, David B. Kurland, Carrie R. Muh, Eri Dario Delgado Aguilar, Kenneth Burns, Jacob Low, Conor Keogh, Chris Uff, Alfio Spina, and Fayez Alelyani

Subjects
Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018–January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. Results: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). Conclusions: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs. Key words: Global health, Global neurosurgery, LMIC, Neurotrauma, Task sharing, Task shifting, Workforce

Published
2020
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11. Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries

Author

Faith C. Robertson, Ignatius N. Esene, Angelos G. Kolias, Patrick Kamalo, Graham Fieggen, William B. Gormley, Marike L.D. Broekman, Kee B. Park, Jeffrey Rosenfeld, Naci Balak, Ahmed Ammar, Magnus Tisel, Michael Haglund, Timothy Smith, Ivar Mendez, Jannick Brennum, Stephen Honeybul, Akira Matsumara, Severien Muneza, Andres Rubiano, Gail Rosseau, Tariq Khan, Basant Misra, Gene Bolles, David Adelson, Robert Dempsey, Peter Hutchinson, Abenezer Aklilu, Abigail Javier-Lizan, Adil Belhachmi, Ahtesham Khizar, Alexandru Tascu, Ali Yalcinkaya, Aliyu Baba Ndajiwo, Alvan-Emeka Ukacjukwu, Amit Agrawal, Amit Thapa, Ana C.V. Silva, Armin Gretschel, Arvind Sukumaran, Atul Vats, Bakr Abo Jarad, Balgopal Karmacharya, Bipin Chaurasia, Boon Seng Liew, Carlos A. Rodriguez Arias, Claire Karekezi, Cohen-Inbar Or, Danjuma Sale, Davendran Kanesen, Djula Djilvesi, Evarsitus Nwaribe, M. Elhaj Mahmoud, Mian Awais, Sanjay Kumar, Amos O. Adeleye, Manish Agarwal, Menelas Nkeshimana, Sunday David Ndubuisi Achebe, Walid El Gaddafi, Ece Uysal, Eghosa Morgan, Elubabor Buno, Emmanuel Sunday, Esayas Adefris, Fayez Alelyani, Felipe Constanzo, Gabriel Longo, Ghulam Farooq, Goertz Mirenge Dunia, Gyang Markus Bot, Hamisi K. Shabani, Harch Deora, Hassan Almenshawy, Hazem Kuheil, Igor Lima Maldonado, Ionut Negoi, Irfan Yousaf, Jafri Malin Abdullah, Jagos Golubovic, Khalil Ayadi, Kriengsak Limpastan, Luxwell Jokonya, Mirsad Hodzic, Mohamed Kassem, Mohammed Al-Rawi, Muhammad Tariq, Mykola Vyval, Nidal Abuhadrous, Nikolaos Syrmos, Osaid Alser, Paul H. Young, Petra Wahjoepramono, Prabu Rau Sriram, Rafik Ouchetati, Recep Basaran, Ritesh Bhoot, Robson Amorim, Rosanda Ilić, Saman Wadanamby, Samuel M. Fetene, Sanjay Behari, Satish Babu, Trung Kien Duong, Tsegazeab Laeke, Ulrick S. Kanmounye, Vladimir Komar, Ipe Vazheeparambil George, Zahid Hussain, Lynne Lourdes N. Lucena, Hugues Brieux Ekouele Mbaki, Ken-Keller Kumwenda, Djvnaba Bah, Ibrahim E. Efe, Dickson Bandoh, Yunus Kuntawi Aji, and Thomas Dakurah

Subjects
Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Because nearly 23,000 more neurosurgeons are needed globally to address 5 million essential neurosurgical cases that go untreated each year, there is an increasing interest in task-shifting and task-sharing (TS/S), delegating neurosurgical tasks to nonspecialists, particularly in low- and middle-income countries (LMICs). This global survey aimed to provide a cross-sectional understanding of the prevalence and structure of current neurosurgical TS/S practices in LMICs. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care in LMICs with a Web-based survey link via electronic mailing lists of continental societies and various neurosurgical groups, conference announcements, e-mailing lists, and social media platforms. Country-level data were analyzed by descriptive statistics. Results: The survey yielded 127 responses from 47 LMICs; 20 countries (42.6%) reported ongoing TS/S. Most TS/S procedures involved emergency interventions, the top 3 being burr holes, craniotomy for hematoma evacuation, and external ventricular drain. Most (65.0%) believed that their Ministry of Health does not endorse TS/S (24.0% unsure), and only 11% believed that TS/S training was structured. There were few opportunities for TS/S providers to continue medical education (11.6%) or maintenance of certification (9.4%, or receive remuneration (4.2%). Conclusions: TS/S is ongoing in many LMICs without substantial structure or oversight, which is concerning for patient safety. These data invite future clinical outcomes studies to assess effectiveness and discussions on policy recommendations such as standardized curricula, certification protocols, specialist oversight, and referral networks to increase the level of TS/S care and to continue to increase the specialist workforce. Key words: Capacity, Global health, Global neurosurgery, LMIC, Task-sharing, Task-shifting, Workforce

Published
2020
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12. Prévalence du surpoids et de l’obésité chez l’adolescent en milieu scolaire à Lubumbashi, République Démocratique du Congo

Author

Jacques Mbaz Musung, Emmanuel Kiyana Muyumba, Dophra Ngoy Nkulu, Placide Kambola Kakoma, Olivier Mukuku, Berthe Kon Mwad Kamalo, Clarence Kaut Mukeng, Christian Ngama Kakisingi, Francoise Kaj Malonga, Faustin Mukalenge Chenge, and Oscar Numbi Luboya

Subjects
surpoids, obésité, adolescent, prévalence, lubumbashi, Medicine
Abstract

INTRODUCTION : le surpoids et l’obésité au cours de l’adolescence constituent un problème préoccupant de santé publique à l’échelle mondiale en raison de leur retentissement potentiel sur la santé et de leur fréquence croissante. La présente étude avait pour objectif de déterminer la prévalence du surpoids et de l’obésité chez les adolescents scolarisés dans les établissements publics et privés à Lubumbashi, en République Démocratique du Congo.Méthodes: il s’agissait d’une étude transversale menée auprès de 5.341 adolescents âgés de 10 à 19 ans, dont 2.858 (53,5%) filles et 2.483 (46,5%) garçons ont constitué notre échantillon. Pour chacun d’eux, nous avons mesuré le poids et la taille puis calculé l’indice de masse corporelle (IMC).Résultats: la moyenne du poids était de 43,78 ± 11,62 kg (soit 42,39 ± 12,11 kg pour les garçons et 44,95 ± 11,04 kg pour les filles), celle de la taille était de 151,30 ± 13,09 cm (soit 151,20 ± 14,64 cm pour les garçons et 151,38 ± 11,58 cm pour les filles) et celle de l’IMC était de 18,82 ± 3,15 kg/m2 (soit 19,39 ± 3,39 kg/m2 pour les garçons et 18,17 ± 2,71 kg/m2 pour les filles). La prévalence du surpoids était de 8% et celle de l’obésité était de 1%. Les filles étaient significativement plus touchées par le surpoids (10,7% filles contre 5% garçons) et l’obésité (1,5 % filles contre 0,4% garçons) que les garçons.Conclusion: le surpoids et l’obésité chez les adolescents en milieu scolaire s’avèrent une réalité à Lubumbashi. La détermination de la prévalence du surpoids et de l’obésité pour cette catégorie d’âge au plan national est recommandable pour leurs préventions e

Published
2019
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13. Neurodevelopmental outcome in children with hydrocephalus in Malawi

Author

Pala, A, Rush, J, Kapapa, T, Wirtz, CR, Mayer, B, Micah-Bonongwe, A, Gladstone, M, and Kamalo, P

Subjects
ddc: 610, mental disorders, 610 Medical sciences, Medicine
Abstract

Objective: Pediatric hydrocephalus are one of main factors responsible for high pediatric morbidity, mortality and functional disability in low-income countries. The overview of neurodevelopmental outcomes in these regions is very limited. The aim of this pilot investigation was to evaluate neurodevelopmental[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Published
2021
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16. Global Initiative for Children’s Surgery:A Model of Global Collaboration to Advance the Surgical Care of Children

Author

Wright, N, Jensen, G, St-Louis, E, Grabski, D, Yousef, Y, Kaseje, N, Goodman, L, Anderson, J, Ameh, E, Banu, T, Bickler, S, Butler, M, Cooper, M, Gathuya, Z, Kamalo, P, Ki, B, Kumar, R, Madhuri, V, Oldham, K, Ozgediz, D, Poenaru, D, Sekabira, J, Saldaña Gallo, L, Siddiqui, S, Yapo, B, Abantanga, FA, Abdelmalak, M, Abdulraheem, N, Ade-Ajayi, N, Ismail, EA, Ademuyiwa, A, Ahmed, E, Ajike, S, Akintububo, OB, Alakaloko, F, Allen, B, Amado, V, Anbuselvan, S, Anyomih, TTK, Asakpa, L, Assegie, G, Axt, J, Ayala, R, Ayele, F, Bal, HS, Bankole, R, Beacon, T, Bokhari, Z, Borah, HK, Borgstein, E, Boyd, N, Brill, J, Budde-Schwartzman, B, Bulamba, F, Bvulani, B, Cairo, S, Campos Rodezno, JF, Caputo, M, Chitnis, M, Cheung, M, Cigliano, B, Clarke, D, Concepcion, T, Corlew, S, Cunningham, D, D’Agostino, S, Dahir, S, Deal, B, Derbew, M, Dhungel, S, Drake, D, Drum, E, Edem, B, Eguma, S, Elebute, O, Espineda, BR, Espinoza, S, Evans, F, Faboya, O, Fadhili Bake, J, Fazecas, T, Fazli, MR, Fieggen, G, Figaji, A, Fils, JL, Fitzgerald, T, Flick, R, Fossi, G, Galiwango, G, Ganey, M, Adel, MG, Sabagh, VG, Gibikote, S, Gohil, H, Greenberg, S, Gruen, R, Hagander, L, Hamid, R, Hansen, E, Harkness, W, and Lavy, C

Subjects
medicine.medical_specialty, Quality management, business.industry, Service delivery framework, MEDLINE, Commission, 030230 surgery, Subspecialty, Surgical Symposium Contribution, Surgery, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Health care, Global health, medicine, business, Working group
Abstract

Background: Recommendations by the Lancet Commission on Global Surgery regarding surgical care in low- and middle-income countries (LMICs) require development to address the needs of children. The Global Initiative for Children’s Surgery (GICS) was founded in 2016 to identify solutions to problems in children’s surgery by utilizing the expertise of practitioners from around the world. This report details this unique process and underlying principles. Methods: Three global meetings convened providers of surgical services for children. Through working group meetings, participants reviewed the status of global children’s surgery to develop priorities and identify necessary resources for implementation. Working groups were formed under LMIC leadership to address specific priorities. By creating networking opportunities, GICS has promoted the development of LMIC-LMIC and HIC-LMIC partnerships. Results: GICS members identified priorities for children’s surgical care within four pillars: infrastructure, service delivery, training and research. Guidelines for provision of care at every healthcare level based on these pillars were created. Seventeen subspecialty, LMIC chaired working groups developed the Optimal Resources for Children’s Surgery (OReCS) document. The guidelines are stratified by subspecialty and level of health care: primary health center, first-, second- and third-level hospitals, and the national children’s hospital. The OReCS document delineates the personnel, equipment, facilities, procedures, training, research and quality improvement components at all levels of care. Conclusion: Worldwide collaboration with leadership by providers from LMICs holds the promise of improving children’s surgical care. GICS will continue to evolve in order to achieve the vision of safe, affordable, timely surgical care for all children.

Published
2019

17. Abstracts of the Eighth EDCTP Forum, 6-9 November 2016.

Author

Makanga, M, Beattie, P, Breugelmans, G, Nyirenda, T, Bockarie, M, Tanner, M, Volmink, J, Hankins, C, Walzl, G, Chegou, N, Malherbe, S, Hatherill, M, Scriba, TJ, Zak, DE, Barry, CE, Kaufmann, SHE, Noor, A, Strub-Wourgaft, N, Phillips, P, Munguambe, K, Ravinetto, R, Tinto, H, Diro, E, Mahendrahata, Y, Okebe, J, Rijal, S, Garcia, C, Sundar, S, Ndayisaba, G, Sopheak, T, Ngoduc, T, Van Loen, H, Jacobs, J, D'Alessandro, U, Boelaert, M, Buvé, A, Kamalo, P, Manda-Taylor, L, Rennie, S, Mokgatla, B, Bahati, Ijsselmuiden, C, Afolabi, M, Mcgrath, N, Kampmann, B, Imoukhuede, E, Alexander, N, Larson, H, Chandramohan, D, Bojang, K, Kasaro, MP, Muluka, B, Kaunda, K, Morse, J, Westfall, A, Kapata, N, Kruuner, A, Henostroza, G, Reid, S, Alabi, A, Foguim, F, Sankarganesh, J, Bruske, E, Mfoumbi, A, Mevyann, C, Adegnika, A, Lell, B, Kranzer, K, Kremsner, P, Grobusch, M, Sabiiti, W, Ntinginya, N, Kuchaka, D, Azam, K, Kampira, E, Mtafya, B, Bowness, R, Bhatt, N, Davies, G, Kibiki, G, Gillespie, S, Lejon, V, 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Zongo, I, Ouedraogo, B, Kone, A, Sagara, I, Björkman, A, Gil, JP, Nchinda, G, Bopda, A, Nji, N, Ambada, G, Ngu, L, Tchadji, J, Sake, C, Magagoum, S, Njambe, GD, Lisom, A, Park, CG, Tait, D, Sibusiso, H, Manda, O, Croucher, K, Van Der Westhuizen, A, Mshanga, I, Levin, J, Nanvubya, A, Kibengo, F, Jaoko, W, Pala, P, Perreau, M, Namuniina, A, Kitandwe, P, Tapia, G, Serwanga, J, Yates, N, Fast, P, Mayer, B, Montefiori, D, Tomaras, G, Robb, M, Lee, C, Wagner, R, Sanders, E, Kilembe, W, Kiwanuka, N, Gilmour, J, Kuipers, H, Vooij, D, Chinyenze, K, Priddy, F, Ding, S, Hanke, T, Pantaleo, G, Ngasala, B, Jovel, I, Malmberg, M, Mmbando, B, Premji, Z, Mårtensson, A, Mwaiswelo, R, Agbor, L, Apinjoh, T, Mwanza, S, Chileshe, J, Joshi, S, Malunga, P, Manyando, C, Laufer, M, Dara, A, Niangaly, A, Sinha, I, Brodin, D, Fofana, B, Dama, S, Dembele, D, Sidibe, B, Diallo, N, Thera, M, Wright, K, Gil, J, Doumbo, O, Baraka, V, Nabasumba, C, Francis, F, Lutumba, P, Mavoko, H, Alifrangis, M, Van Geertruyden, J-P, Sissoko, S, Sangaré, C, Toure, S, Sanogo, K, Diakite, H, Doumbia, D, Haidara, K, Julé, A, Ashurst, H, Merson, L, Olliaro, P, Marsh, V, Lang, T, Guérin, P, Awuondo, K, Njenga, D, Nyakarungu, E, Titus, P, Sutamihardja, A, Lowe, B, Ogutu, B, Billingsley, P, Soulama, I, Kaboré, M, Coulibaly, A, Ouattara, M, Sanon, S, Diarra, A, Bougouma, E, Ouedraogo, A, Sombie, B, Kargougou, D, Ouattara, D, Issa, N, Tiono, A, Sirima, S, Chaponda, M, Dabira, E, Dao, F, Dara, N, Coulibaly, M, Tolo, A, Maiga, H, Ouologuem, N, Niangaly, H, Botchway, F, Wilson, N, Dickinson-Copeland, CM, Adjei, AA, Wilson, M, Stiles, JK, Hamid, MA, Awad-Elgeid, M, Nasr, A, Netongo, P, Kamdem, S, Velavan, T, Lasry, E, Diarra, M, Bamadio, A, Traore, A, Coumare, S, Soma, B, Dicko, Y, Sangare, B, Tembely, A, Traore, D, Haidara, A, Dicko, A, Diawara, E, Beavogui, A, Camara, D, Sylla, M, Yattara, M, Sow, A, Camara, GC, Diallo, S, Mombo-Ngoma, G, Remppis, J, Sievers, M, Manego, RZ, Endamne, L, Hutchinson, D, Held, J, Supan, C, Salazar, CLO, Bonkian, LN, Nahum, A, Sié, A, Abdulla, S, Cantalloube, C, Djeriou, E, Bouyou-Akotet, M, Mordmüller, B, Siribie, M, Sirima, SB, Ouattara, SM, Coulibaly, S, Kabore, JM, Amidou, D, Tekete, M, Traore, O, Haefeli, W, Borrmann, S, Kaboré, N, Kabré, Z, Nikèma, F, Compaoré, D, Somé, F, Djimdé, A, Ouédraogo, J, Chalwe, V, Miller, J, Diakité, H, Greco, B, Spangenberg, T, Kourany-Lefoll, E, Oeuvray, C, Mulry, J, Tyagarajan, K, Magsaam, B, Barnes, K, Hodel, EM, Humphreys, G, Pace, C, Banda, CG, Denti, P, Allen, E, Lalloo, D, Mwapasa, V, Terlouw, A, Mwesigwa, J, Achan, J, Jawara, M, Ditanna, G, Worwui, A, Affara, M, Koukouikila-Koussounda, F, Kombo, M, Vouvoungui, C, Ntoumi, F, Etoka-Beka, MK, Deibert, J, Poulain, P, Kobawila, S, Gueye, NG, Seda, B, Kwambai, T, Jangu, P, Samuels, A, Kuile, FT, Kariuki, S, Barry, A, Bousema, T, Okech, B, Egwang, T, Corran, P, Riley, E, Ezennia, I, Ekwunife, O, Muleba, M, Stevenson, J, Mbata, K, Coetzee, M, Norris, D, Moneke-Anyanwoke, N, Momodou, J, Clarke, E, Scott, S, Tijani, A, Djimde, M, Vaillant, M, Samouda, H, Mensah, V, Roetynck, S, Kanteh, E, Bowyer, G, Ndaw, A, Oko, F, Bliss, C, Jagne, YJ, Cortese, R, Nicosia, A, Roberts, R, D'Alessio, F, Leroy, O, Faye, B, Cisse, B, Gerry, S, Viebig, N, Lawrie, A, Ewer, K, Hill, A, Nebie, I, Tiono, AB, Sanou, G, Konate, AT, Yaro, BJ, Sodiomon, S, Honkpehedji, Y, Agobe, JCD, Zinsou, F, Mengue, J, Richie, T, Hoffman, S, Nouatin, O, Ngoa, UA, Edoa, JR, Homoet, A, Engelhon, JE, Massinga-Louembe, M, Esen, M, Theisen, M, Sim, KL, Luty, AJ, Moutairou, K, Dinko, B, King, E, Targett, G, Sutherland, C, Likhovole, C, Ouma, C, Vulule, J, Musau, S, Khayumbi, J, Okumu, A, Murithi, W, Otu, J, Gehre, F, Zingue, D, Kudzawu, S, Forson, A, Mane, M, Rabna, P, Diarra, B, Kayede, S, Adebiyi, E, Kehinde, A, Onyejepu, N, Onubogu, C, Idigbe, E, Ba, A, Diallo, A, Mboup, S, Disse, K, Kadanga, G, Dagnra, Y, Baldeh, I, Corrah, T, De Jong, B, Antonio, M, Musanabaganwa, C, Musabyimana, JP, Karita, E, Diop, B, Nambajimana, A, Dushimiyimana, V, Karame, P, Russell, J, Ndoli, J, Hategekimana, T, Sendegeya, A, Condo, J, Binagwaho, A, Okonko, I, Okerentugba, P, Opaleye, O, Awujo, E, Frank-Peterside, N, Moyo, S, Kotokwe, K, Mohammed, T, Boleo, C, Mupfumi, L, Chishala, S, Gaseitsiwe, S, Tsalaile, L, Bussmann, H, Makhema, J, Baum, M, Marlink, R, Engelbretch, S, Essex, M, Novitsky, V, Saka, E, Kalipalire, Z, Bhairavabhotla, R, Midiani, D, Sherman, J, Mgode, G, Cox, C, Bwana, D, Mtui, L, Magesa, D, Kahwa, A, Mfinanga, G, Mulder, C, Borain, N, Petersen, L, Du Plessis, J, Theron, G, Holm-Hansen, C, Tekwu, EM, Sidze, LK, Assam, JPA, Eyangoh, S, Niemann, S, Beng, VP, Frank, M, Atiadeve, S, Hilmann, D, Awoniyi, D, Baumann, R, Kriel, B, Jacobs, R, Kidd, M, Loxton, A, Kaempfer, S, Singh, M, Mwanza, W, Milimo, D, Moyo, M, Kasese, N, Cheeba-Lengwe, M, Munkondya, S, Ayles, H, De Haas, P, Muyoyeta, M, Namuganga, AR, Kizza, HM, Mendy, A, Tientcheu, L, Ayorinde, A, Coker, E, Egere, U, Coussens, A, Naude, C, Chaplin, G, Noursadeghi, M, Martineau, A, Jablonski, N, Wilkinson, R, Ouedraogo, HG, Matteelli, A, Regazzi, M, Tarnagda, G, Villani, P, Sulis, G, Diagbouga, S, Roggi, A, Giorgetti, F, Kouanda, S, Bidias, A, Ndjonka, D, Olemba, C, Souleymanou, A, Mukonzo, J, Kuteesa, R, Ogwal-Okeng, J, Gustafsson, LL, Owen, J, Bassi, P, Gashau, W, Olaf, K, Dodoo, A, Okonkwo, P, Kanki, P, Maruapula, D, Seraise, B, Einkauf, K, Reilly, A, Rowley, C, Musonda, R, Framhein, A, Mpagama, S, Semvua, H, Maboko, L, Hoelscher, M, Heinrich, N, Mulenga, L, Kaayunga, C, Davies, M-A, Egger, M, Musukuma, K, Dambe, R, Usadi, B, Ngari, M, Thitiri, J, Mwalekwa, L, Fegan, G, Berkley, J, Nsagha, D, Munamunungu, V, Bolton, C, Siyunda, A, Shilimi, J, Bucciardini, R, Fragola, V, Abegaz, T, Lucattini, S, Halifom, A, Tadesse, E, Berhe, M, Pugliese, K, De Castro, P, Terlizzi, R, Fucili, L, Di Gregorio, M, Mirra, M, Zegeye, T, Binelli, A, Vella, S, Abraham, L, Godefay, H, Rakotoarivelo, R, Raberahona, M, Randriamampionona, N, Andriamihaja, R, Rasamoelina, T, Cornet, M, De Dieu Randria, MJ, Benet, T, Vanhems, P, Andrianarivelo, MR, Chirwa, U, Michelo, C, Hamoonga, R, Wandiga, S, Oduor, P, Agaya, J, Sharma, A, Cavanaugh, S, Cain, K, Mukisa, J, Mupere, E, Worodria, W, Ngom, JT, Koro, F, Godwe, C, Adande, C, Ateugieu, R, Onana, T, Ngono, A, Kamdem, Y, Ngo-Niobe, S, Etoa, F-X, Kanengoni, M, Ruzario, S, Ndebele, P, Shana, M, Tarumbiswa, F, Musesengwa, R, Gutsire, R, Fisher, K, Thyagarajan, B, Akanbi, O, Binuyo, M, Ssengooba, W, Respeito, D, Mambuque, E, Blanco, S, Mandomando, I, Cobelens, F, Garcia-Basteiro, A, Tamene, A, Topp, S, Mwamba, C, Padian, N, Sikazwe, I, Geng, E, Holmes, C, Sikombe, K, Hantuba, Czaicki, N, Simbeza, S, Somwe, P, Umulisa, M, Ilo, J, Kestelyn, E, Uwineza, M, Agaba, S, Delvaux, T, Wijgert, J, Gethi, D, Odeny, L, Tamandjou, C, Kaindjee-Tjituka, F, Brandt, L, Cotton, M, Nel, E, Preiser, W, Andersson, M, Adepoju, A, Magana, M, Etsetowaghan, A, Chilikwazi, M, Sutcliffe, C, Thuma, P, Sinywimaanzi, K, Matakala, H, Munachoonga, P, Moss, W, Masenza, IS, Geisenberger, O, Agrea, P, Rwegoshora, F, Mahiga, H, Olomi, W, Kroidl, A, Kayode, G, Amoakoh-Coleman, M, Ansah, E, Uthman, O, Fokam, J, Santoro, M-M, Musolo, C, Chimbiri, I, Chikwenga, G, Deula, R, Massari, R, Lungu, A, Perno, C-F, Ndzengue, G, Loveline, N, Lissom, A, Flaurent, T, Sosso, S, Essomba, C, Kpeli, G, Otchere, I, Lamelas, A, Buultjens, A, Bulach, D, Baines, S, Seemann, T, Giulieri, S, Nakobu, Z, Aboagye, S, Owusu-Mireku, E, Danso, E, Hauser, J, Hinic, V, Pluschke, G, Stinear, T, Yeboah-Manu, D, Elshayeb, A, Siddig, ME, Ahmed, AA, Hussien, AE, Kabwe, M, Tembo, J, Chilukutu, L, Chilufya, M, Ngulube, F, Lukwesa, C, Enne, V, Wexner, H, Mwananyanda, L, Hamer, D, Sinyangwe, S, Ahmed, Y, Klein, N, Maeurer, M, Zumla, A, Bates, M, Beyala, L, Etienne, G, Anthony, N, Benjamin, A, Ateudjieu, J, Chibwe, B, Ojok, D, Tarr, CA, Perez, GM, Omeonga, S, Kibungu, F, Meyer, A, Lansana, P, Mayor, A, Onyango, P, Van Loggerenberg, F, Furtado, T, Boggs, L, Segrt, A, Dochez, C, Burnett, R, Mphahlele, MJ, Miiro, G, Mbidde, E, Peshu, N, Kivaya, E, Ngowi, B, Kavishe, R, Maowia, M, Sandstrom, E, Ayuo, E, Mmbaga, B, Leisegang, C, Thorpe, M, Batchilly, E, N'Guessan, J-P, Kanteh, D, Søfteland, S, Sebitloane, M, Vwalika, B, Taylor, M, Galappaththi-Arachchige, H, Holmen, S, Gundersen, SG, Ndhlovu, P, Kjetland, EF, Kombe, F, Toohey, J, Pienaar, E, Kredo, T, Cham, PM, Abubakar, I, Dondeh, BL, Vischer, N, Pfeiffer, C, Burri, C, Musukwa, K, Zürcher, S, Mwandu, T, Bauer, S, Adriko, M, Mwaura, P, Omolloh, K, Jones, C, Malecela, M, Hamidu, BA, Jenner, TE, Asiedu, LJ, Osei-Atweneboana, M, Afeke, I, Addo, P, Newman, M, Durnez, L, Eddyani, M, Ammisah, N, Abas, M, Quartey, M, Ablordey, A, Akinwale, O, Adeneye, A, Ezeugwu, S, Olukosi, Y, Adewale, B, Sulyman, M, Mafe, M, Okwuzu, J, Gyang, P, Nwafor, T, Henry, U, Musa, B, Ujah, I, Agobé, JCD, Grau-Pujol, B, Sacoor, C, Nhabomba, A, Casellas, A, Quintó, L, Subirà, C, Giné, R, Valentín, A, Muñoz, J, Nikiema, M, Ky-Ba, A, Comapore, KAM, Sangare, L, Oluremi, A, Michel, M, Camara, Y, Sanneh, B, Cuamba, I, Gutiérrez, J, Lázaro, C, Mejia, R, Adedeji, A, Folorunsho, S, Demehin, P, Akinsanya, B, Cowley, G, Da Silva, ET, Nabicassa, M, De Barros, PDP, Blif, MM, Bailey, R, Last, A, Mahendradhata, Y, Gotuzzo, E, De Nys, K, Casteels, M, Nona, SK, Lumeka, K, Todagbe, A, Djima, MM, Ukpong, M, Sagay, A, Khamofu, H, Torpey, K, Afiadigwe, E, Anenih, J, Ezechi, O, Nweneka, C, Idoko, J, Muhumuza, S, Katahoire, A, Nuwaha, F, Olsen, A, Okeyo, S, Omollo, R, Kimutai, R, Ochieng, M, Egondi, T, Moonga, C, Chileshe, C, Magwende, G, Anumudu, C, Onile, O, Oladele, V, Adebayo, A, Awobode, H, Oyeyemi, O, Odaibo, A, Kabuye, E, Lutalo, T, Njua-Yafi, C, Nkuo-Akenji, T, Anchang-Kimbi, J, Mugri, R, Chi, H, Tata, R, Njumkeng, C, Dodoo, D, Achidi, E, Fernandes, J, Bache, EB, Matakala, K, Searle, K, Greenman, M, and Rainwater-Lovett, K

Published
2017

18. Point of View: Exit ventriculoperitoneal shunt; enter endoscopic third ventriculostomy (ETV): contemporary views on hydrocephalus and their implications on management

Author

Kamalo, P

Abstract

Hydrocephalus has been known to affect humans since the birth of human medicine as it is described by Hippocrates. The management of this condition is however still dodged by challenges due to a poor understanding of its pathophysiology. The ventriculoperitoneal shunt presents considerable problems especially with respect to infection and shunt malfunction. Low income countries, that currently face the greater burden of paediatric hydrocephalus. experience an increased challenge with ventriculoperitoneal shunts due to a shortage of qualified personnel to handle shunt complications. Recent advances in neuro-endoscopic surgery have presented opportunities for alternative treatment options for hydrocephalus such as endoscopic third ventriculostomy (ETV). This paper explores the alternative views in the pathophysiology of hydrocephalus and how they explain the effectiveness of ETV in treating hydrocephalus arising from a variety of causes.

Published
2013

21. Global neurosurgery over a 60-year period: Conceptual foundations, time reference, emerging Co-ordinates and prospects for collaborative interventions in low and middle income countries

Author

Uche, E.O., Sundblom, Jimmy, Uko, Uko Kalu, Kamalo, Patrick, Nah Doe, Alvin, Eriksson, Linn, Sandvik, Ulrika, Revesz, David F, Ryttlefors, Mats, and Tisell, Magnus

Abstract

We evaluated salient initiatives invested in global neurosurgery over a 60-year period,

Published
2022
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23. Antimicrobial resistance control activities at a tertiary hospital in a low-resource setting: an example of Queen Elizabeth Central Hospital in Malawi.

Author

Kamalo P, Iroh Tam PY, Noniwa T, Mpanga C, Mulambia C, Phiri E, Kumwenda D, Phillipo E, Lissauer S, Kulapani D, and Mwinjiwa C

Abstract

Background: Addressing AMR has been most problematic in low- and middle-income countries, which lack infrastructure, diagnostic capacity, and robust data management systems, among other factors. The implementation of locally-led efforts in a low-income country to develop sustainability and build capacity for AMR control within the existing infrastructure has not been well documented., Methods: We detail current AMR control initiatives at Queen Elizabeth Central Hospital, a tertiary referral government hospital in Malawi with limited resources, and present the activities accomplished to date, lessons learned, and challenges ahead., Results: The key areas of AMR control initiatives that the group focused on included laboratory diagnostics and surveillance, antimicrobial stewardship, infection prevention and control, pharmacy, leadership, education, and funding., Discussion: The hospital AMR Control Working Group increased awareness, built capacity, and implemented activities around AMR control throughout the hospital, in spite of the resource limitations in this setting. Our results are based on the substantial leadership provided by the working group and committed stakeholders who have taken ownership of this process., Conclusion: Limited resources pose a challenge to the implementation of AMR control activities in low- and middle-income countries. Leadership is central to implementation. Future efforts will need to transition the initiative from an almost fully personal commitment to one with wider engagement to ensure sustainability., Competing Interests: Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author PI declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Published
2023
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24. Evidence-Driven Policies for Sustainably Scaling Up Surgical Task-Sharing in Malawi Comment on "Improving Access to Surgery Through Surgical Team Mentoring - Policy Lessons From Group Model Building With Local Stakeholders in Malawi".

Author

Jumbam DT, Kanmounye US, Citron I, and Kamalo P

Subjects
Humans, Malawi, Hospitals, Policy, Mentoring
Abstract

This commentary discusses an article by Broekhuizen et al which assesses policy options for scaling up the SURG-Africa surgical team mentoring program in Malawi to increase access to surgical care. In modeling these scenarios, the authors assess the cost of scaling up surgical teams mentoring and the impacts of scaling the program on district hospitals (DHs) and central hospitals (CHs). The additional costs borne by DHs when increasing surgical volume remains a significant issue identified by the authors and could ultimately determine the success of the program. The piece indirectly advocates for an increased role for task-shifting. The Ministry of Health of Malawi will have to ensure the appropriate governance and regulatory processes are in place to maintain quality and accountability., (© 2022 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Published
2022
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25. Establishment of a high-dependency unit in Malawi.

Author

Morton B, Banda NP, Nsomba E, Ngoliwa C, Antoine S, Gondwe J, Limbani F, Henrion MYR, Chirombo J, Baker T, Kamalo P, Phiri C, Masamba L, Phiri T, Mallewa J, Mwandumba HC, Mndolo KS, Gordon S, and Rylance J

Subjects
Critical Care Nursing education, Critical Care Nursing organization & administration, Critical Illness therapy, Hospital Design and Construction, Humans, Malawi, Quality of Health Care, Referral and Consultation, COVID-19 nursing, COVID-19 prevention & control, COVID-19 therapy, Hospital Units, Tertiary Care Centers
Abstract

Adults admitted to hospital with critical illness are vulnerable and at high risk of morbidity and mortality, especially in sub-Saharan African settings where resources are severely limited. As life expectancy increases, patient demographics and healthcare needs are increasingly complex and require integrated approaches. Patient outcomes could be improved by increased critical care provision that standardises healthcare delivery, provides specialist staff and enhanced patient monitoring and facilitates some treatment modalities for organ support. In Malawi, we established a new high-dependency unit within Queen Elizabeth Central Hospital, a tertiary referral centre serving the country's Southern region. This unit was designed in partnership with managers, clinicians, nurses and patients to address their needs. In this practice piece, we describe a participatory approach to design and implement a sustainable high-dependency unit for a low-income sub-Saharan African setting. This included: prospective agreement on remit, alignment with existing services, refurbishment of a dedicated physical space, recruitment and training of specialist nurses, development of context-sensitive clinical standard operating procedures, purchase of appropriate and durable equipment and creation of digital clinical information systems. As the global COVID-19 pandemic unfolded, we accelerated unit opening in anticipation of increased clinical requirement and describe how the high-dependency unit responded to this demand., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)

Published
2020
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26. Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries.

Author

Robertson FC, Esene IN, Kolias AG, Kamalo P, Fieggen G, Gormley WB, Broekman MLD, and Park KB

Abstract

Background: Because nearly 23,000 more neurosurgeons are needed globally to address 5 million essential neurosurgical cases that go untreated each year, there is an increasing interest in task-shifting and task-sharing (TS/S), delegating neurosurgical tasks to nonspecialists, particularly in low- and middle-income countries (LMICs). This global survey aimed to provide a cross-sectional understanding of the prevalence and structure of current neurosurgical TS/S practices in LMICs., Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care in LMICs with a Web-based survey link via electronic mailing lists of continental societies and various neurosurgical groups, conference announcements, e-mailing lists, and social media platforms. Country-level data were analyzed by descriptive statistics., Results: The survey yielded 127 responses from 47 LMICs; 20 countries (42.6%) reported ongoing TS/S. Most TS/S procedures involved emergency interventions, the top 3 being burr holes, craniotomy for hematoma evacuation, and external ventricular drain. Most (65.0%) believed that their Ministry of Health does not endorse TS/S (24.0% unsure), and only 11% believed that TS/S training was structured. There were few opportunities for TS/S providers to continue medical education (11.6%) or maintenance of certification (9.4%, or receive remuneration (4.2%)., Conclusions: TS/S is ongoing in many LMICs without substantial structure or oversight, which is concerning for patient safety. These data invite future clinical outcomes studies to assess effectiveness and discussions on policy recommendations such as standardized curricula, certification protocols, specialist oversight, and referral networks to increase the level of TS/S care and to continue to increase the specialist workforce., Competing Interests: A.G.K. is supported by the National Institute for Health Research (NIHR) Global Health Research Group on Neurotrauma. The Group was commissioned by the NIHR using Official Development Assistance funding (project 16/137/105). The views expressed in this article are those of the authors and are not necessarily those of the United Kingdom National Health Service, NIHR, or the United Kingdom Department of Health., (© 2019 The Authors.)

Published
2019
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