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. 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

Nee-Kofi Mould-Millman  1 , Julia Dixon  1 , Taylor W Burkholder  2 , Nana Sefa  3 , Hiren Patel  4 , Anna Q Yaffee  5 , Amarachukwu Osisanya  6 , Tolulope Oyewumi  7 , Isaac Botchey Jr  8 , Maxwell Osei-Ampofo  9 , Hendry Sawe  10 , Jay Lemery  1 , Tracy Cushing  1 , Lee A Wallis  11
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Fifteen years of emergency medicine literature in Africa: A scoping review

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

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
Fig. 1
Article inclusion flow diagram.
Fig. 2
Fig. 2
Number of articles by country.
Fig. 3
Fig. 3
Ten countries with the largest number of articles.
Fig. 4
Fig. 4
15-Year trend in type of African publications.
Fig. 5
Fig. 5
Breakdown of discipline and content areas in observational versus i.
See this image and copyright information in PMC

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