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 REVIEW ARTICLE
Year : 2021  |  Volume : 69  |  Issue : 1  |  Page : 12--20

Patient Attitudes toward Neurosurgery in Low- and Middle-Income Countries: A Systematic Review


1 Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Department, Faculty of Medicine, Bel Campus University of Technology, Kinshasa, Democratic Republic of Congo, Cameroon
2 Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Medicine, Higher Institute of Health Sciences, Université des Montagnes, Bangangte, Cameroon
3 Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Medicine, Higher Institute of Medical Technology, Nkolondom, Cameroon
4 Research Department, Association of Future African Neurosurgeons, Yaounde; Faculty of Health Sciences, University of Buea, Buea, Cameroon
5 Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Department, Felix Houphouet Boigny University, Abidjan, Côte d'Ivoire, Cameroon
6 Research Department, Association of Future African Neurosurgeons, Yaounde; Neurosurgery Unit, Department of Surgery, Yaounde Central Hospital, Yaounde, Cameroon
7 Neurosurgery Unit, Department of Surgery, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon

Correspondence Address:
Ulrick S Kanmounye
Kanmounye Sidney, 20 Cameron Street, Brookline, MA
Cameroon
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.310098

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Background: Low- and middle-income countries (LMICs) bear the majority of the neurosurgical burden of diseases but lack the resources to meet these needs. Objective: As we increase access to neurosurgical care in LMICs, we must understand patient attitudes toward neurosurgery. Methods and Material: PubMed, LILACS, and African Journals Online databases were searched systematically from inception to January 4, 2020, for studies on neurosurgical patient perceptions in LMICs. The articles found were blindly reviewed with Rayyan by two authors. The two authors resolved conflicts between themselves, and when this was not possible, a third reviewer was consulted. All the articles included were then appraised, and the results were summarized. Results: Six of the 1,175 articles met the inclusion criteria. The studies were set in Brazil, Ethiopia, India, Nigeria, South Korea, and Sub-Saharan Africa. Four of the studies (50%) were phenomenological studies, and the other two were grounded theory and narrative. The studies identified patient attitudes toward neurosurgical practitioners, diseases, and interventions. Ethiopian and Nigerian patients believed cranial diseases to be otherworldly and resorted to traditional medicine or spiritual healing first, whereas Brazilian patients were more comfortable with cranial diseases and even more so if they had had a previous craniotomy. The Indian paper was a recount of a neurosurgeon's experience as a spine patient. Conclusions: There are few studies on neurosurgery patient perception in LMICs. LMIC neurosurgeons should be encouraged to study their patient beliefs concerning neurosurgical diseases and interventions, as this can explain health-seeking behaviors.






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