Disparities in the Clinical Profile of Spinal Tuberculosis in Africa: A Scoping Review of Management and Outcome.

Autor: Oladeji EO; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria. Electronic address: olusolaoladejiemma@gmail.com., Enemuo TN; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Anthony-Awi TA; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Olaniyi AA; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Olaku JO; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Aransiola PB; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Salawu RA; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Adedoyin GO; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria., Olatide OO; Trauma and Orthopaedics Department, Surgery Interest Group of Africa Lagos, Nigeria.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Sep 06; Vol. 192, pp. 77-90. Date of Electronic Publication: 2024 Sep 06.
DOI: 10.1016/j.wneu.2024.09.003
Abstrakt: Background: Spinal tuberculosis (STB) is a significant contributor to nontraumatic myelopathy. There is a rising burden in Africa, in parallel with the high prevalence of human immunodeficiency virus. We conducted a scoping review to highlight the disparities in the management and outcomes of STB in Africa.
Methods: This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping review guidelines. AJOL, Embase, MEDLINE, Google Scholar, and Cochrane CENTRAL databases were searched to identify all relevant peer-reviewed articles published on the management of STB in African centers, excluding abstract-only articles, literature reviews, and meta-analyses.
Results: Sixty studies were eligible for inclusion, comprising data from 3416 patients aged 8 months to 89 years (median, 32 years). Thoracic and lumbar segments were the most commonly affected vertebral regions (thoracic = 42.7%; lumbar = 35.9%). The most common clinical features were back pain and neurological deficits. Lack of essential laboratory and imaging diagnostic infrastructure was a common problem. Patients received antitubercular therapy (ATT) for varying durations, and only 18.3% underwent surgery. A favorable outcome was achieved in 51.6% of patients, 20.3% developed a permanent disability, and the mortality rate was 2.1%. Treatment outcome was adversely affected by a high rate of late presentation and treatment default.
Conclusions: ATT remains the mainstay of treatment; however, the duration of treatment varied widely among studies. Further research is required to explore the feasibility and efficacy of short-course ATT in treating STB in the African population.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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