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. 2022 Sep 3;14(9):e28748.
doi: 10.7759/cureus.28748. eCollection 2022 Sep.

A Scoping Review of the Use of Improvised External Ventricular Drains in Africa

Damilola Jesuyajolu  1 , Gamaliel Aremu  1 , Olatomiwa Olukoya  1 , Kennedy Obiekwe  1 , Charles Okeke  1 , Emmanuel Edeh  1 , Terngu Moti  1 , Abdulahi Zubair  1
Affiliations

A Scoping Review of the Use of Improvised External Ventricular Drains in Africa

Damilola Jesuyajolu et al. Cureus. .

Abstract

Poor access to neurosurgical equipment is one of the problems limiting service delivery in Africa. Improvised surgical devices have long been used in Africa as replacements for high-cost standard versions. In this study, we aimed to see if improvised external ventricular drains (EVD) are being used, how these devices are made, and what their outcomes are. The PRISMA extension for scoping reviews was used in conducting this study. A search was conducted from inception to July 2022. PubMed, Ovid Embase, and African Journal Online were searched. Three studies were identified and used. The methods of making the EVD devices were compared and the incidence proportions of improvised EVD-related infections were calculated. The standard ventricular catheter was replaced by cheaper alternatives like a size 6/8 feeding tube or a 14-gauge central line catheter. The connecting tube had low-cost alternatives, and in a study, was replaced by a fluid infusion set. Aggregated outcomes from the three identified studies show that just over half of the sample survived post-EVD insertion (54%). The incidence proportion of EVD-related infections was 24%. This study describes the experience of African centers with an improvised version of the EVD devices and their outcomes. This will serve as a baseline for more research into the use of improvised EVD devices in low-resource settings.

Keywords: africa; catheter; drains; external ventricular drain (evd); hydrocephalus.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Prisma flowchart.
EVD: external ventricular drain; AJOL: African Journal Online. The flowchart has been designed by Dr. Damilola Jesuyajolu.
Figure 2
Figure 2. A schematic of the standard EVD device.
EVD: external ventricular drain. The figure has been drawn by Dr. Damilola Jesuyajolu.
See this image and copyright information in PMC

References

    1. The global neurosurgical workforce: a mixed-methods assessment of density and growth. Mukhopadhyay S, Punchak M, Rattani A, et al. https://doi.org/ J Neurosurg. 2019;130:1142–1148. - PubMed
    1. Building neurosurgical capacity in low and middle income countries. Fuller A, Tran T, Muhumuza M, Haglund MM. https://doi.org/ eNeurologicalSci. 2016;3:1–6. - PMC - PubMed
    1. The impact of African-trained neurosurgeons on sub-Saharan Africa. Karekezi C, El Khamlichi A, El Ouahabi A, et al. Neurosurg Focus. 2020;48:0. - PubMed
    1. Improvisation of surgical equipment in the surgical services of a developing country. [ Jul; 2022 ];Adejumo AA, Adeosun OA, Omoregie PO, Alayande B. http://triggered.stanford.clockss.org/ServeContent?url=http://www.njsrjo... Niger J Surg Res. 2016 17:48–52.
    1. Establishment of an external ventricular drain best practice guideline: the quest for a comprehensive, universal standard for external ventricular drain care. Hepburn-Smith M, Dynkevich I, Spektor M, Lord A, Czeisler B, Lewis A. J Neurosci Nurs. 2016;48:54–65. - PubMed

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