Neuro-oncology access in Sub-Saharan Africa: A literature review of challenges and opportunities

Background: Ensuring equitable access to treatments and therapies in the constantly evolving field of neuro-oncology is an imperative global health issue. With its unique demographic, cultural, socioeconomic, and infrastructure characteristics, Sub-Saharan Africa faces distinct challenges. This literature review highlights specific barriers to neuro-oncology care in the region and explores potential opportunities for enhancing access. Methods: Predetermined keyword searches were employed to screen titles and abstracts using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Inclusion criteria were studies published between January 1, 2003, and June 20, 2023, specifically addressing the capacity and challenges of neuro-oncology in the Sub-Saharan African region. The data sources queried were PubMed and Google Scholar. Systematic reviews and meta-analyses were deliberately excluded. All authors conducted independent screening and structured data extraction meticulously. Results: Our paper identified multiple challenges that impede access to quality treatment for brain tumors. These include constrained resources, insufficient training of healthcare professionals, certain cultural beliefs, and a general lack of awareness about brain tumors, all contributing to delayed diagnosis and treatment. Furthermore, the lack of detailed data on the incidence and prevalence of primary central nervous system tumors impairs the accurate assessment of disease burden and precise identification of areas requiring improvement. However, we discovered that ongoing research, advocacy, enhanced training, mentorship, and collaborative efforts present valuable opportunities for substantial progress in neuro-oncology access. Conclusions: While we provide a glimpse of the current state, we hope these results will help stimulate dialogue and catalyze initiatives to surmount highlighted obstacles and improve neuro-oncology outcomes across Sub-Saharan Africa.</p

Pattern of intracranial tumours in a tertiary hospital in Ghana

Objective: This study seeks to describe the pattern of intracranial tumours in Korle Bu Teaching Hospital (KBTH) based on patient demographics, clinical presentation, spatial distribution of tumour and histological findings.Method: The study design is retrospective and descriptive. Data was obtained from the clinical records of patients with intracranial tumours treated in our neurosurgery unit between January 2010 to December 2015, and histology reports obtained from the histopathology unit. Patients with intracranial tumours without definitive histological diagnosis were excluded.Results: Of the 102 histologically diagnosed brain tumours, out of 335 brain tumour cases seen in the period under review, 58 (56.9%) were females and 44 (43.1%) were males (p = 0.031). Gliomas were the commonest intracranial tumours - 39(38.2%) followed by Meningiomas 37(36.2%) and Pituitary Adenoma – 9(8.8%). Astrocytoma was the commonest type of Glioma comprising 30(77%) of the 39 cases. Meningotheliomatous meningioma was the commonest type of meningioma with 11 (29.7%) of 37 cases. Of the 39 Gliomas 17(43.6%) were males and 22(56.4%) were females, while for the Meningioma 17(46%) were males and 20(54%) were females. The commonest symptomwas headache (64%) and the commonest tumour location was supratentorial (77.5%). The crude incidence rate of intracranial tumours in this study was 1.34 per 100,000 populations per year.Conclusion: Gliomas are the commonest intracranial tumours seen in our series. Overall, females were more commonly affected than males in most brain tumours in this series, including both gliomas and meningiomas.Funding: Not declaredKeywords: Intracranial tumours, glioma , tumour pattern, Incidence