Author/Authors :
Mould-Millman, Nee-Kofi University of Colorado - School of Medicine - Department of Emergency Medicine - Aurora - CO, USA , Dixon, Julia University of Colorado - School of Medicine - Department of Emergency Medicine - Aurora - CO, USA , Cushing, Tracy University of Colorado - School of Medicine - Department of Emergency Medicine - Aurora - CO, USA , Lemery, Jay University of Colorado - School of Medicine - Department of Emergency Medicine - Aurora - CO, USA , Burkholder, Taylor W. University of Southern California - Keck School of Medicine - Los Angeles - CA, USA , Sefa, Nana Beaumont Health System - Royal Oak - MI, USA , Patel, Hiren Harvard Medical School/Massachusetts General Hospital - Department of Emergency Medicine - MA, USA , Yaffee, Anna Q. Emory University - Department of Emergency Medicine - Atlanta - GA, USA , Osisanya, Amarachukwu Piedmont Fayette Hospital - Fayetteville - GA, USA , Oyewumi, Tolulope University of Colorado - School of Public Health - Department of Epidemiology - Aurora - CO, USA , Botchey Jr., Isaac Johns Hopkins University - Baltimore - MD, USA , Osei-Ampofo, Maxwell Komfo Anokye Teaching Hospital - Emergency Medicine Directorate - Kumasi, Ghana , Sawe, Hendry Muhimbili University of Health and Allied Sciences - Dar es Salaam, Tanzania , Wallis, Lee A University of Cape Town - Division of Emergency Medicine - Observatory - Cape Town, South Africa
Abstract :
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 :
Literature review , Emergency medicine , EM , Emergency medical services , EMS , Africa , Scoping review
