title: The pattern of neurosurgical disorders in rural northern Tanzania: a prospective hospital-based study.
abstract: OBJECTIVE
  The prudent allocation of neurosurgical resources and training efforts requires an understanding of prevalence and clinical pattern of neurosurgical disorders in a particular region. The aim of our study was to assess the hospital-based prevalence of neurosurgical disease in the setting of rural sub-Saharan Africa.
  
  
  METHODS
  The study was conducted at Haydom Lutheran Hospital in northern Tanzania. Over a period of 8 months, all patients suspected of having neurologic or neurosurgical disorders were seen by a neurologist in consecutive order. Patients were assessed clinically and with plain radiographs, a computed tomography scanner was not available.
  
  
  RESULTS
  Of 8676 admissions, 151 patients (1.7%) were given a neurosurgical diagnosis. The most frequent diagnoses were traumatic brain injury (n=90), followed by tuberculosis of the spine (n=22), spina bifida (n=14), space-occupying cerebral lesion (n=13), and hydrocephalus (n=12). The overall mortality was 10.6%; it was especially high in patients with hydrocephalus (25%), space-occupying cerebral lesions (54%), and spina bifida (29%).
  
  
  CONCLUSIONS
  Initial neurosurgical training and resource allocation in sub-Saharan Africa should focus on neurotrauma, spinal infections, congenital malformations, and hydrocephalus.
authors.affiliation: Interdisciplinary Centre for Palliative Medicine and Department of Neurology, Ludwig-Maximilians-University, Munich, Germany. drawinkler@yahoo.com.au
authors.forename: Andrea Sylvia
authors.initials: AS
authors.lastname: Winkler
authors.forename: Anthony
authors.initials: A
authors.lastname: Tluway
authors.forename: David
authors.initials: D
authors.lastname: Slottje
authors.forename: Erich
authors.initials: E
authors.lastname: Schmutzhard
authors.forename: Roger
authors.initials: R
authors.lastname: Härtl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004503:Education, Medical, Graduate / Q000639:trends; D005260:Female; D006761:Hospitals / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009422:Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery*; D009493:Neurosurgery / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends; D011446:Prospective Studies; D012423:Rural Health / Q000639:trends*; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult