Abstract Details

Neurological disorders are the leading cause of disability and 2^nd leading cause of mortality worldwide and 75% of this burden occurs in low and middle income countries. In addition, African countries have the lowest neurologist per population ratio of all world regions.

To understand current neurocritical care training experiences among African healthcare workers.

Participants virtually attended the Neurocritical Care Society’s Emergency Neurological Life Support Course (ENLS) and completed a pre-course assessment with questions about demographic characteristics and prior neurocritical care training.

318 participants (46% female; 56% residents; 34% neurologists; 9.0 + 6.7 years practicing medicine) from 11 African countries completed the assessment. 97% reported prior experience caring for patients with neurocritical illnesses. 35% reported prior neurology training and, of those, majority received training as a resident, for a >6 month period, and 92% took place in Africa. Only 9% reported any prior neurocritical care training. Of those, a higher proportion did not obtain this training until they were attending physicians, and training was shorter with most lasting 1-4 weeks, and 74% took place in Africa. More than 10% of participants reported no prior training in 7/14 of ENLS topics (pharmacology, spinal cord injury, spinal cord compression, acute non-traumatic weakness, TBI, increased intercranial pressure, and airway, ventilation, and sedation). Most (93%) participants expressed a desire for training on general knowledge and management of neurological emergencies.

This survey indicates that compared to neurology training, a lower proportion of African healthcare workers received specialized neurocritical care training and this was more likely to occur at later stages of their medical career, to be of shorter duration, and to occur outside of Africa. Established neurocritical care programs, preferably earlier in training and over a longer period of time, are essential to bolstering capacity to manage the significant burden of neurocritical illnesses in African countries.