Sources of delayed provision of neurosurgical care in a rural kenyan setting

Surgical Neurology International
Alireza MansouriMark Bernstein

Abstract

Delay to neurosurgical care can result in significant morbidity and mortality. In this study, we aim to identify and quantify the sources of delay to neurosurgical consultation and care at a rural setting in Kenya. A mixed-methods, cross-sectional analysis of all patients admitted to the neurosurgical department at Kijabe Hospital (KH) was conducted: A retrospective analysis of admissions from October 1 to December 31, 2013 and a prospective analysis from June 2 to June 20, 2014. Sources of delay were categorized and quantified. The Kruskal-Wallis test was used to identify an overall significant difference among diagnoses. The Mann-Whitney U test was used for pairwise comparisons within groups; the Bonferroni correction was applied to the alpha level of significance (0.05) according to the number of comparisons conducted. IBM SPSS version 22.0 (SPSS, Chicago, IL) was used for statistical analyses. A total of 332 admissions were reviewed (237 retrospective, 95 prospective). The majority was pediatric admissions (median age: 3 months). Hydrocephalus (35%) and neural tube defects (NTDs; 27%) were most common. At least one source of delay was identified in 192 cases (58%); 39 (12%) were affected by multiple sources. Delay in primar...Continue Reading

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Citations

Mar 12, 2016·Journal of Neurosurgery. Pediatrics·Jonathan AworiMatthew C Davis
May 20, 2017·Journal of Neurosurgery. Pediatrics·Matthew C DavisJames M Johnston
Dec 2, 2017·Journal of Neurosurgery. Pediatrics·Franck-Emmanuel RouxFrédéric Lauwers
Feb 20, 2018·Journal of Neurosciences in Rural Practice·Pavan S UpadhyayulaJoseph D Ciacci
May 16, 2020·Journal of Neurosurgery. Pediatrics·Grace M Thiong'oA Leland Albright

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