The review, titled Surgical Outcomes of Brain Tumours in Africa: Challenges, Progress, and Future Perspectives, highlighted significant disparities in access to specialised treatment, warning that insufficient resources and weak healthcare infrastructure continue to undermine efforts to improve survival rates across the continent.
According to the findings, 26.4 per cent of patients considered suitable for brain tumour surgery in one of the studies reviewed could not undergo the procedure because of inadequate resources. In another reported finding, 24 patients died while waiting for surgery, underscoring the potentially fatal consequences of delays in accessing specialised medical care.
The researchers identified the shortage of neurosurgeons as one of the most pressing challenges, particularly in sub-Saharan Africa, where there is approximately one neurosurgeon for every 2.62 million people.
They explained that successful brain tumour treatment depends on more than the availability of skilled surgeons. It also requires reliable diagnostic imaging, specialised anaesthesia, well-equipped operating theatres, pathology services, intensive care and rehabilitation facilities.
However, shortages of magnetic resonance imaging (MRI) and computed tomography (CT) scanners, financial constraints and geographical barriers often prevent patients from receiving timely diagnosis and treatment.
The review further noted that many patients arrive at specialist hospitals when their tumours have already grown considerably or caused severe neurological complications. Persistent headaches, seizures, visual disturbances and weakness are among the symptoms associated with brain tumours that may prompt patients to seek medical attention.
Nigerian studies highlight consequences of delayed treatment
Evidence from Nigerian studies cited in the review illustrated the dangers of late presentation, while also demonstrating the potential benefits of surgery, even when patients have advanced disease.
In one study, surgery improved vision in 14 patients with giant pituitary tumours, suggesting that intervention could still produce meaningful benefits despite the severity of their conditions.
Another study, however, reported that 85.7 per cent of patients with cranial meningiomas experienced vision loss. The study also recorded a six-month postoperative mortality rate of 20 per cent, with deaths associated with raised pressure inside the skull.
These findings highlight the importance of early diagnosis, timely referral and access to appropriate surgical and postoperative care in reducing complications and improving patients’ chances of survival.
Despite the challenges, the researchers found evidence that effective neurosurgical treatment remains achievable in resource-constrained settings when appropriate expertise and facilities are available.
A study examining awake craniotomy with brain mapping for glioma removal recorded an average tumour removal rate of 89.5 per cent, while total or subtotal removal was achieved in 85 per cent of cases. Seizures were the presenting symptom in 70 per cent of the patients studied.
The researchers attributed differences in surgical outcomes across African countries to variations in the severity of disease at presentation, the availability of medical facilities, the level of surgical expertise and the quality of postoperative care.
Limited cancer registries obscure true burden
Beyond treatment challenges, the review raised concerns about inadequate data on the prevalence and mortality associated with brain tumours in Africa.
Figures cited in the report indicated that cancer registries covered only 11 per cent of the continent’s population, making it difficult to establish reliable estimates of incidence, mortality and the overall burden of the disease.
The review estimated that sub-Saharan Africa recorded approximately 9,169 new brain tumour cases in 2020, accounting for about three per cent of global cases. Nigeria reportedly recorded 1,798 cases during the same period.
Common tumour types identified included astrocytomas, meningiomas and pituitary adenomas.
The authors cautioned that the reported figures might not reflect the actual scale of the problem because limited diagnostic capacity and incomplete cancer registration could leave many cases undetected or unrecorded.
They also called for increased genomic research involving African populations to improve understanding of genetic risk factors and potentially support more effective approaches to diagnosis and treatment.
Call for investment, specialised training
To address the gaps, the researchers urged African governments to prioritise investment in specialised neurosurgical facilities, modern medical equipment and training programmes for healthcare professionals.
They also recommended stronger partnerships with international institutions to improve surgical skills, expand research opportunities and facilitate access to advanced treatment techniques.
Other proposed measures include expanding access to diagnostic imaging, pathology services and radiotherapy, as well as deploying telemedicine to connect underserved communities with specialists.
The establishment of national and regional brain tumour registries was identified as another priority to improve data collection, guide health policy and support research into the disease burden across the continent.
The authors further advocated public awareness campaigns to encourage early diagnosis, wider health insurance coverage to reduce the financial burden on patients and regular clinical audits to strengthen surgical safety and the quality of care.
They stressed that improving outcomes would require a coordinated response involving governments, healthcare professionals, research institutions and international partners.
According to the review, sustained investment in early diagnosis, specialised surgery and comprehensive postoperative care is essential to reducing preventable deaths and improving the quality of life of people living with brain tumours across Africa.