Cardiac surgery publications in Africa over the last 20 years: A literature review

Abstract

There is a significant burden of surgically correctable cardiovascular disease in Africa. The goal of this research was to review the last 20 years of literature on this topic. A systematic search was performed using PubMed, Embase and African Index Medicus for the period 1996–2016. Publications came from 29 countries, all of different income brackets. Research output increased by 15-fold over the 20-year time period, with the majority of publications authored by local teams (71.4%) compared to visiting (4.9%) and mixed teams (23.7%). Although increasing, clinical reporting on cardiac surgery is still limited. Increased publication of results should be encouraged to better benchmark capacity and improve research capacity.

Significance:

• The majority of the cardiovascular publications came from local research teams affiliated with public hospitals which suggests strong local engagement in research and cardiovascular care.
• Research output significantly increased and the share of literature from major research contributors has relatively shrunk over the study period, which suggests emerging research capacities from previously underrepresented regions.
• A demographic analysis of publications showed that studies were set in countries from all income brackets, with the majority of the studies originating from low-income countries.
• There is a need to standardise reporting of surgical outcomes which is dependent on perioperative care and maintenance of high-quality health records.
• Over half of the publications lacked evidence of outpatient follow-up or data on postoperative care, which highlights the need to focus on patient outcomes as a metric.