Fifteen years of emergency medicine literature in Africa: A scoping review

doi:10.1016/j.afjem.2019.01.006

. 2019 Mar;9(1):45-52.

doi: 10.1016/j.afjem.2019.01.006. Epub 2019 Jan 18.

Fifteen years of emergency medicine literature in Africa: A scoping review

Affiliations

¹ University of Colorado, School of Medicine, Department of Emergency Medicine, Aurora, CO, USA.
² University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
³ Beaumont Health System, Royal Oak, MI, USA.
⁴ Harvard Medical School/Massachusetts General Hospital, Department of Emergency Medicine, MA, USA.
⁵ Emory University, Department of Emergency Medicine, Atlanta, GA, USA.
⁶ Piedmont Fayette Hospital, Fayetteville, GA, USA.
⁷ University of Colorado, School of Public Health, Department of Epidemiology, Aurora, CO, USA.
⁸ Johns Hopkins University, Baltimore, MD, USA.
⁹ Komfo Anokye Teaching Hospital, Emergency Medicine Directorate, Kumasi, Ghana.
¹⁰ Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
¹¹ University of Cape Town, Division of Emergency Medicine, Observatory, Cape Town, South Africa.

PMID: 30873352
PMCID: PMC6400014
DOI: 10.1016/j.afjem.2019.01.006

Fifteen years of emergency medicine literature in Africa: A scoping review

Nee-Kofi Mould-Millman et al. Afr J Emerg Med. 2019 Mar.

. 2019 Mar;9(1):45-52.

doi: 10.1016/j.afjem.2019.01.006. Epub 2019 Jan 18.

Authors

Affiliations

¹ University of Colorado, School of Medicine, Department of Emergency Medicine, Aurora, CO, USA.
² University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
³ Beaumont Health System, Royal Oak, MI, USA.
⁴ Harvard Medical School/Massachusetts General Hospital, Department of Emergency Medicine, MA, USA.
⁵ Emory University, Department of Emergency Medicine, Atlanta, GA, USA.
⁶ Piedmont Fayette Hospital, Fayetteville, GA, USA.
⁷ University of Colorado, School of Public Health, Department of Epidemiology, Aurora, CO, USA.
⁸ Johns Hopkins University, Baltimore, MD, USA.
⁹ Komfo Anokye Teaching Hospital, Emergency Medicine Directorate, Kumasi, Ghana.
¹⁰ Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
¹¹ University of Cape Town, Division of Emergency Medicine, Observatory, Cape Town, South Africa.

PMID: 30873352
PMCID: PMC6400014
DOI: 10.1016/j.afjem.2019.01.006

Abstract

Introduction: Emergency medicine (EM) throughout Africa exists in various stages of development. The number and types of scientific EM literature can serve as a proxy indicator of EM regional development and activity. The goal of this scoping review is a preliminary assessment of potential size and scope of available African EM literature published over 15 years.

Methods: We searched five indexed international databases as well as non-indexed grey literature from 1999-2014 using key search terms including ^"Africa", "emergency medicine", "emergency medical services", and "disaster." Two trained physician reviewers independently assessed whether each article met one or more of five inclusion criteria, and discordant results were adjudicated by a senior reviewer. Articles were categorised by subject and country of origin. Publication number per country was normalised by 1,000,000 population.

Results: Of 6091 identified articles, 633 (10.4%) were included. African publications increased 10-fold from 1999 to 2013 (9 to 94 articles, respectively). Western Africa had the highest number (212, 33.5%) per region. South Africa had the largest number of articles per country (171, 27.0%) followed by Nigeria, Kenya, and Ghana. 537 (84.8%) articles pertained to facility-based EM, 188 (29.7%) to out-of-hospital emergency medicine, and 109 (17.2%) to disaster medicine. Predominant content areas were epidemiology (374, 59.1%), EM systems (321, 50.7%) and clinical care (262, 41.4%). The most common study design was observational (479, 75.7%), with only 28 (4.4%) interventional studies. All-comers (382, 59.9%) and children (91, 14.1%) were the most commonly studied patient populations. Undifferentiated (313, 49.4%) and traumatic (180, 28.4%) complaints were most common.

Conclusion: Our review revealed a considerable increase in the growth of African EM literature from 1999 to 2014. Overwhelmingly, articles were observational, studied all-comers, and focused on undifferentiated complaints. The articles discovered in this scoping review are reflective of the relatively immature and growing state of African EM.

Keywords: Africa; EM; EMS; Emergency medical services; Emergency medicine; Literature review; Scoping review.

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Figures

**Fig. 1**
Article inclusion flow diagram.

**Fig. 2**
Number of articles by country.

**Fig. 3**
Ten countries with the largest number of articles.

**Fig. 4**
15-Year trend in type of African publications.

**Fig. 5**
Breakdown of discipline and content areas in observational versus i.

See this image and copyright information in PMC

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References

1. Thind A, Hsia R, Mabweijano J, et al. Prehospital and Emergency Care. In: Debas HT, Donkor P, Gawande A, et al., editors. Essential Surgery: Disease Control Priorities, Third Edition (Volume 1). Washington (DC): The International Bank for Reconstruction and Development/The World Bank Apr 2. Chapter 14. Available from: <https://www.ncbi.nlm.nih.gov/books/NBK333513/ doi: 10.1596/978-1-4648-03...>; 2015 [accessed July-14-2017]. - PubMed
1. Reynolds T.A., Calvello E.J., Broccoli M.C. AFEM consensus conference 2013 summary: emergency care in Africa-Where are we now? Afr J Emergency Med. 2014;4(3):158–163.
1. Mould-Millman N., Naidoo R., De Vries S., Stein C., Wallis L. AFEM Consensus Conference, 201AFEM out-of-hospital emergency care workgroup consensus paper: advancing out-of-hospital emergency care in Africa-advocacy and development. Afr J Emergency Med. 2014;4(2):90–95.
1. Calvello E.J., Tenner A.G., Broccoli M.C. Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities. Emergency Med J. 2016:573–580. - PubMed
1. Razzak J.A., Kellermann A.L. Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ. 2002;80(11):900–905. - PMC - PubMed

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[1] Thind A, Hsia R, Mabweijano J, et al. Prehospital and Emergency Care. In: Debas HT, Donkor P, Gawande A, et al., editors. Essential Surgery: Disease Control Priorities, Third Edition (Volume 1). Washington (DC): The International Bank for Reconstruction and Development/The World Bank Apr 2. Chapter 14. Available from: <https://www.ncbi.nlm.nih.gov/books/NBK333513/ doi: 10.1596/978-1-4648-03...>; 2015 [accessed July-14-2017]. - PubMed

[2] Thind A, Hsia R, Mabweijano J, et al. Prehospital and Emergency Care. In: Debas HT, Donkor P, Gawande A, et al., editors. Essential Surgery: Disease Control Priorities, Third Edition (Volume 1). Washington (DC): The International Bank for Reconstruction and Development/The World Bank Apr 2. Chapter 14. Available from: <https://www.ncbi.nlm.nih.gov/books/NBK333513/ doi: 10.1596/978-1-4648-03...>; 2015 [accessed July-14-2017]. - PubMed

[3] Reynolds T.A., Calvello E.J., Broccoli M.C. AFEM consensus conference 2013 summary: emergency care in Africa-Where are we now? Afr J Emergency Med. 2014;4(3):158–163.

[4] Reynolds T.A., Calvello E.J., Broccoli M.C. AFEM consensus conference 2013 summary: emergency care in Africa-Where are we now? Afr J Emergency Med. 2014;4(3):158–163.

[5] Mould-Millman N., Naidoo R., De Vries S., Stein C., Wallis L. AFEM Consensus Conference, 201AFEM out-of-hospital emergency care workgroup consensus paper: advancing out-of-hospital emergency care in Africa-advocacy and development. Afr J Emergency Med. 2014;4(2):90–95.

[6] Mould-Millman N., Naidoo R., De Vries S., Stein C., Wallis L. AFEM Consensus Conference, 201AFEM out-of-hospital emergency care workgroup consensus paper: advancing out-of-hospital emergency care in Africa-advocacy and development. Afr J Emergency Med. 2014;4(2):90–95.

[7] Calvello E.J., Tenner A.G., Broccoli M.C. Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities. Emergency Med J. 2016:573–580. - PubMed

[8] Calvello E.J., Tenner A.G., Broccoli M.C. Operationalising emergency care delivery in sub-Saharan Africa: consensus-based recommendations for healthcare facilities. Emergency Med J. 2016:573–580. - PubMed

[9] Razzak J.A., Kellermann A.L. Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ. 2002;80(11):900–905. - PMC - PubMed

[10] Razzak J.A., Kellermann A.L. Emergency medical care in developing countries: is it worthwhile? Bull World Health Organ. 2002;80(11):900–905. - PMC - PubMed

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Fifteen years of emergency medicine literature in Africa: A scoping review

Affiliations

Fifteen years of emergency medicine literature in Africa: A scoping review

Authors

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Abstract

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