The Current State of Primary Clinical Spine Disease Research in Sub-Saharan Africa — A Scoping Review
Charlotte F. Wahle, Maithily Diaz, Michael Oravic, Shravya Kakulamarri, Babapelumi Adejuyigbe, Chellandra Samuels, Chibuikem Anthony Ikwuegbuenyi, Romani Sabas, Drew N. Wright, Saam Morshed, Ashraf N. El Naga, Roger Härtl, Hamisi Shabani, David Shearer, David Gendelberg,Study Design
Scoping Review.
Objective
Spine research is resource-intensive and thus often performed in high-income countries. Consequently, findings may not be generalizable to low-resource areas. This study aimed to assess the current state of primary clinical spine disease research in Sub-Saharan Africa.
Methods
All spine studies published in English or French in Sub-Saharan Africa in the past 50 years with at least ten patients were included. A study quality variable was created that identified randomized studies, prospective studies, and studies that include a control group as having a higher level of scientific rigor.
Results
A total of 154 spine studies have been published from at least 26 countries since 1975 (some included multiple). There was a significant increase in research productivity after 2005 (p<0.001). The highest number of publications came from Nigeria with 52 (34%), followed by Tanzania (25 papers, 16%) and Ethiopia (12 papers, 8%).
Nearly half of studies involved collaborative partnerships. On univariate analysis, lower-income countries were more likely to engage in collaboration with other countries (OR 3.2, 95% CI: 1.2-9.8) and to receive external funding (OR 7.0, 95% CI: 2.3-20.4). Further, collaborative studies were found to produce higher quality academic publication (OR 2.0, 95% CI: 0.94-4.2).
Conclusion
There is a relative paucity of spine literature from Sub-Saharan Africa. Higher research quality was associated with collaborative engagement. These results support the development of global health partnerships that may foster high-quality research aimed at addressing the burden of spine disease in Africa.