Craniosynostosis in Africa: Insights from Eight Countries—A Systematic Review and Meta-Analysis

• Published in: World neurosurgery 2024-11
• Main Authors: Darko, Kwadwo, Pulido, Sonia, Haider, Muhammad Ammar, Sivakumar, Milan, Limann, Bernice, Tenkorang, Pearl, Odesanya, Okikioluwa, Odiase, Peace, Farid, Mark, Barrie, Umaru, Braga, Bruno P., Banson, Mabel, Totimeh, Teddy
• Format: Article
• Language: English
• Subjects: Africa; Craniosynostosis; Global Neurosurgery; Pediatric Neurosurgery
• ISSN: 1878-8750; 1878-8769; 1878-8769
• DOI: 10.1016/j.wneu.2024.11.116

Craniosynostosis is a congenital skull deformity that impacts development and quality of life of children if left untreated. This study aimed to evaluate literature regarding presentation, treatment and outcomes of craniosynostosis in Africa. A systematic review of the literature using PubMed/MEDLINE, SCOPUS, Web of Science and Google Scholar databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fourteen retrospective/prospective studies with 620 patients and 14 case reports involving 27 cases (8 countries) were included. In 12 articles, 56.6% of patients (317/560) were males, with a mean age of 2.4 years (CI: 1.1-3.7). Abnormal head shape was the most reported presentation in 77.8% of cases (332/427, 8 articles). Syndromic craniosynostosis was seen in 25.2% (CI: 13.7% - 36.6%) Common phenotypes were trigonocephaly in 31.5% (CI: 3.6%-59.4%), anterior plagiocephaly in 23.2% (CI: 5.1%-41.3%) and scaphocephaly in 22.1% (CI: 13.5% - 30.8%). Five-hundred-seventy-eight patients, 99.5% (CI: 99.0%-100.0%) underwent surgical treatment. Vault remodeling was performed in 72.9% patients (CI: 47.4%-98.6%). Postoperative complications included CSF leaks 5.4% (CI: 0.0%-11.6%) and surgical site infections 4.5% (CI: 0.0%-10.8%). Follow-up ranged between 0.2-40.9 months, 95.6% of cases (CI: 90.1%-100.0%) exhibited improved deformity and neurological deficits at last follow-up. The mortality rate was 3.1% (CI: 0.0%-6.9%, 2 articles). Few studies on craniosynostosis in Africa highlight the need for more research. Treatment with open techniques yields few complications and a low mortality rate. Early diagnosis and collaborative data reporting will enhance understanding of its burden and variations across Africa.