Mabel Banson

RESEARCH, TEACHING, or OTHER INTERESTS

Neuroscience, Oncology, Surgery, Leadership and Management

Scopus Publications

Presentation, management, and outcome of traumatic spine injuries in Africa: a systematic review and meta-analysis
Kwadwo Darko, Ishav Shukla, Taimur Hassan, Mohammad Mirahmadi Eraghi, Muhammad Ammar Haider, Mina Guirguis, Michael Farid, Peace Odiase, Umaru Barrie, Salah G. Aoun,et al.
Journal of Neurosurgery Publishing Group (JNSPG)
OBJECTIVE Traumatic spinal injury (TSI) involves diverse etiologies, posing different risks among patient populations worldwide. Discrepancies in TSI treatment and outcomes between high-income countries and low- and middle-income countries highlight the critical necessity for tailored management approaches for this global challenge. This study delves into the presentation, management, and outcomes of TSI in Africa. METHODS A systematic review of the literature using PubMed, Google Scholar, and Web of Science electronic databases was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify articles describing spine trauma in Africa. RESULTS In total, 105 articles comprising 74 retrospective/prospective studies and 31 case reports/series with 11,639 patients from 16 African countries were included. Among retrospective/prospective studies, most patients were male (8543/10,538 [81.1%]) with an estimated mean (95% CI) age of 34.5 (32.6–36.3) years. Mechanism of injury included road traffic accidents (RTAs) (mean [95% CI] 49.5% [42.9%–56.0%]) followed by falls (23.2% [18.21%–28.3%]), with most injuries occurring at the cervical spine level (51.6% [44.3%–58.9%]). Regionally, cervical, thoracic, and lumbar injuries were predominant in West (mean [95% CI] 58.6% [45.3%–70.9%]), Southern (54.4% [44.3%–63.9%]), and East (23.0% [11.9%–34.8%]) Africa, respectively. Mean (95% CI) time from injury to presentation was 60.8 (23.0–98.6) hours, and the mean distance to a healthcare facility was 272.6 (220.8–324.4) km (5 articles). Of the 48 articles detailing management approaches, approximately 31.9% (95% CI 21.7%–42.2%) opted for surgery, whereas 64.1% (53.7%–74.4%) pursued conservative treatment. Overall, clinical improvement was reported in 34.1% (95% CI 26.6%–41.6%) (44 articles) of patients at last follow-up, with an estimated mortality rate of 12.1% (9.3%–15.0%) (55 articles). Regionally, clinical improvement in patients was highest in Southern Africa (39.1% [95% CI] 23.2%–55.0%), whereas West Africa had the highest mortality rate (16.9% [10.7%–23.1%]). CONCLUSIONS The authors’ review reveals that TSI in Africa is primarily caused by RTA. Significant challenges exist such as delays in access to care and surgical capacity. Regional differences in injury mechanisms, management, and outcomes exist and addressing these disparities through targeted interventions is pivotal to enhancing patient outcomes and reducing the burden of TSI in Africa.


Presentation, management and outcomes of ruptured intracranial aneurysms in Africa: A systematic review and meta-analysis
Kwadwo Darko, Grace Simmons, W. Elorm Yevudza Jr., Pearl Tenkorang, Bernice Limann, Chibueze Agwu, Simon Sackitey, Ruth Agyekum, Peace Odiase, Nana K. Darko,et al.
Elsevier BV



Craniosynostosis in Africa: Insights from 8 Countries—A Systematic Review and Meta-Analysis
Kwadwo Darko, Sonia Pulido, Muhammad Ammar Haider, Milan Sivakumar, Bernice Limann, Pearl Tenkorang, Okikioluwa Odesanya, Peace Odiase, Mark Farid, Umaru Barrie,et al.
Elsevier BV



Radiotherapy and radiosurgery for intracranial lesions in Africa: Insights from 3 country case studies: A systematic review
Ishav Shukla, Jason Wang, Mina Guirguis, Kwadwo Darko, Salah G Aoun, Umaru Barrie, Mabel Banson, and Teddy Totimeh
Oxford University Press (OUP)
Abstract Background Radiotherapy (RT) and stereotactic radiosurgery (SRS) are important treatment options for central nervous system (CNS) lesions. This review explores the current evidence on the use of radiotherapy and SRS for CNS lesions across Africa. Methods A systematic review of the literature was completed according to the PRISMA guidelines. The results were synthesized to provide an overview of the current landscape of RT and SRS, highlighting treatment gaps and areas for further research and collaboration. Results Nine studies, involving a total of 397 patients, were included. South Africa contributed the most studies with 4 (44.4%), followed by Nigeria with 3 studies (33.3%). Brain tumors were the most common lesion type, found in 88.8% of cases (95% CI: 66.9–100.0) with metastatic tumors being prevalent in 37.5% of cases (95% CI: 1.6–73.4). The breast was the most frequent origin of metastases seen in 93.67% (95% CI: 80–100). Whole brain radiation therapy was used in 33.3% of patients (95% CI: 0.7–66.0), stereotactic proton beam therapy in 33.3% (95% CI: 0.7–66.1), and gamma knife radiosurgery in 22.3% (95% CI: 0–51.1). Conclusion RT and SRS are being implemented for CNS lesions in settings across Africa. Improving access and efficiency of these treatments will require both local and international collaboration to address challenges related to resource management and distribution.


Presentation, management, and outcomes of central nervous system metastases in Africa: Systematic review and meta-analysis
Sean O’Leary, W Elorm Yevudza, Peace Odiase, Muhammad Ammar Haider, Takara Newsome-Cuby, Odesanya Okikioluwa, Kwadwo Darko, Hannah Weiss, Umaru Barrie, Mabel Banson,et al.
Oxford University Press (OUP)
Abstract Background Central nervous system (CNS) metastases are a significant health challenge, particularly in Africa. This study evaluates the preclinical characteristics, primary causes, management strategies, and outcomes of CNS metastases in Africa. Methods A systematic review of the literature was conducted using PubMed, Google Scholar, and Web of Science following PRISMA guidelines to identify studies on CNS metastases in Africa. Results Thirty-one articles were reviewed, including 28 retrospective studies and 3 case reports. The retrospective studies comprised 12 552 patients, with 681 (5.42%) diagnosed with CNS metastases. Nigeria reported the highest number of cases (323), followed by Tunisia (180). The mean patient age was 48.20 years (range: 44.48-51.93), with a higher proportion in women (69.97%, 95% confidence interval [CI]: 54.59-85.35). Common symptoms were headaches (44.87%, 95% CI: 20.76-68.97) and motor deficits (21.39%, 95% CI: 6.40-36.38). Diagnostic tools included MRI (38.27%, 95% CI: 18.08-58.47) and CT (51.28%, 95% CI: 29.13-73.42). The most common primary tumor sites were breast (41.33%, 95% CI: 24.87-57.79) and lung (14.85%, 95% CI: 4.90-24.79). Treatment strategies involved surgery (62.01%, 95% CI: 33.01-91.01), radiotherapy (68.97%, 95% CI: 41.31-96.63), and chemotherapy (60.72%, 95% CI: 32.95-88.50). Outcomes included improved disease status in 34.99% (95% CI: 13.92-56.07), mortality in 44.88% (95% CI: 20.88-68.89), and loss to follow-up in 1.83% (95% CI: 0-3.72). Conclusion CNS metastases in Africa show a higher proportion in women, with breast and lung cancers as the primary sources. Improved diagnostic and treatment strategies are essential to better patient outcomes.


12,355 Pediatric Hydrocephalus Patients in Africa: Comment on Recent Article in Journal of Neurosurgery Pediatrics
Kwadwo Darko, Abigail Jenkins, Sean O'Leary, Umaru Barrie, Donald Detchou, Mabel Banson, and Teddy Totimeh
Elsevier BV



African Women in Neurosurgery: An Exploration of Historical Perspectives, Current Realities, and Future Prospects
Naa Adzoa Adzeley Boi-Dsane, Pooja Venkatesh, Pearl Tenkorang, Oluwaseun Omoba, Bernice Limann, Amoge Opara, Adurape A. Osunjimi, Umaru Barrie, Teddy Totimeh, Ibironke Emmanuel,et al.
Elsevier BV



Presentation, management, and outcomes of pediatric hydrocephalus in Africa: a systematic review and meta-analysis of 12,355 patients
Kwadwo Darko, Mina Guirguis, Shravya Kakulamarri, Michael Farid, Pooja Venkatesh, Emmanuel Kwadwo Osei Adjei, Nancy Abu-Bonsrah, Umaru Barrie, Brett Whittemore, Salah G. Aoun,et al.
Journal of Neurosurgery Publishing Group (JNSPG)
OBJECTIVE The prevalence, management, and outcomes of hydrocephalus remain underexplored in Africa. This study aimed to analyze demographic and clinical features, evaluate treatment strategies, and assess neurological outcomes of pediatric hydrocephalus in Africa. METHODS A systematic review of the literature using the PubMed, Google Scholar, and Web of Science electronic databases was completed according to the PRISMA guidelines to identify articles describing pediatric patients in Africa with hydrocephalus. RESULTS Seventy-four retrospective and prospective studies and 33 case reports involving 12,355 patients were included. In 54 retrospective articles reporting patient demographics, 53.8% (3926/7297) were male with a mean age of 12.3 months. Nineteen studies reported macrocephaly (80.2%, 1639/2043) as the most common presentation. The etiology of hydrocephalus was reported as postinfectious (41.0%, 2303/5614) across 27 articles and congenital (48.6%, 1246/2563) in 10 articles. Eleven articles reported 46.7% (609/1305) of patients had communicating hydrocephalus while 53.3% (696/1305) had obstructive hydrocephalus. Diagnostic imaging included CT (76.1%, 2435/3202; n = 29 articles), ultrasonography (72.9%, 2043/2801; n = 15 articles), and MRI (44.8%, 549/1225; n = 11 articles). In 51 articles, 83.1% (7365/8865) of patients had ventriculoperitoneal shunting (VPS) while 33 articles described 54.1% (2795/5169) receiving endoscopic third ventriculostomy (ETV) for hydrocephalus surgical management. Postoperative complications included sepsis (6.9%, 29/421; n = 4 articles), surgical site infections (5.1%, 11/218; n = 4 articles), and CSF leaks (2.0%, 15/748; n = 8 articles). Shunt-related complications included infections (4.3%, 117/2717; n = 21 articles) and blockages (4.1%, 34/829; n = 6 studies). In 15 articles, 9.0% (301/3358) of patients with shunts had revisions. The mean follow-up duration was 18.9 ± 16.7 months with an overall mortality rate of 7.4% (397/5383; n = 29 articles). In the analysis of comparative studies, the 160 patients undergoing ETV demonstrated significantly higher odds of a successful operation (OR 1.54, 95% CI 0.51–4.69; p = 0.03) and neurological improvement at last follow-up (OR 3.36, 95% CI 0.46–24.79; p < 0.01) compared with the 158 who received VPS, but no significant differences were observed for complications and mortality between the two groups (p > 0.05). CONCLUSIONS This review offers a comprehensive summary of pediatric hydrocephalus in Africa, highlighting shunting as the primary treatment. However, the observed variations across studies highlight the need to establish standardized guidelines for reporting patient characteristics, management strategies, and outcomes to ensure consistency and comparability in articles.


Outcomes after surgery for children in Africa (ASOS-Paeds): a 14-day prospective observational cohort study
Alexandra Torborg, Heidi Meyer, Mahmoud El Fiky, Maher Fawzy, Muhammed Elhadi, Adesoji O Ademuyiwa, Babatunde Babasola Osinaike, Adam Hewitt-Smith, Mary T Nabukenya, Ronald Bisegerwa,et al.
Elsevier BV



Epilepsy Surgery for Drug-Resistant Epilepsy in Africa: A Systematic Review
Kwadwo Darko, Pearl Ohenewaa Tenkorang, Olivia Asiedu, W. Elorm Yevudza, Salim Issah, Eyako Dzantor, Marjidah Tahiru, Andrew Awuah Wireko, Sean O'Leary, Umaru Barrie,et al.
Ovid Technologies (Wolters Kluwer Health)
BACKGROUND AND OBJECTIVES: Nearly one-third of individuals with epilepsy have drug-resistant epilepsy, treated most effectively with surgery. This study aims to discuss the demographic profile, surgical access, and strategies used in drug-resistant epilepsy in Africa. METHODS: A systematic review was performed using PubMed, Google Scholar, Embase, and Web of Science in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS: Nine studies encompassing 498 patients from 6 African countries (Egypt, Kenya, Morocco, South Africa, Tunisia, and Uganda) were included. The mean Methodological Index for Non-Randomized Studies score for these articles was 9.6 ± 1.6. The average patient age was 24.9 years (95% CI: 18.9-30.8 years), with a male predominance of 53.4%. The average age of seizure onset was 10.4 years (95% CI: 6.1-14.7 years). Most patients experienced focal onset seizures (73.1%), with head trauma (33.1%) being the most reported risk factor. The predominant etiologies were hippocampal sclerosis (66.8%, 95% CI: 42.7-91), microdysgenesis (26.7%, 95% CI: 20.7-32.7), and brain tumors (22.3%, 95% CI: 6.4-38.2). Lesions were primarily located in the left hemisphere (61.9%, 95% CI: 26.7-97.1), with temporal lobe involvement in 54.8% of cases (95% CI: 28.7-80.8). Temporal lobectomy was the most frequently performed surgery (59.6%), followed by lesionectomy (9.6%). Postoperatively, 80.6% of patients achieved Engel class I outcomes, indicating seizure freedom, and long-term follow-up (1 to 5 years) showed that 70.3% maintained Engel class I outcomes. Surgical complications were reported in 8.8% of cases. CONCLUSION: These findings demonstrate the efficacy and long-term benefits of epilepsy surgery in Africa, where epilepsy is a significant public health challenge. The high rates of seizure freedom and reduced seizure frequency from surgery highlight its potential to improve the quality of life for individuals with drug-resistant epilepsy in Africa.


Neuro-oncology access in Sub-Saharan Africa: A literature review of challenges and opportunities
W Elorm Yevudza, Vincent Buckman, Kwadwo Darko, Mabel Banson, and Teddy Totimeh
Oxford University Press (OUP)
Abstract Background Ensuring equitable access to treatments and therapies in the constantly evolving field of neuro-oncology is an imperative global health issue. With its unique demographic, cultural, socioeconomic, and infrastructure characteristics, Sub-Saharan Africa faces distinct challenges. This literature review highlights specific barriers to neuro-oncology care in the region and explores potential opportunities for enhancing access. Methods Predetermined keyword searches were employed to screen titles and abstracts using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Inclusion criteria were studies published between January 1, 2003, and June 20, 2023, specifically addressing the capacity and challenges of neuro-oncology in the Sub-Saharan African region. The data sources queried were PubMed and Google Scholar. Systematic reviews and meta-analyses were deliberately excluded. All authors conducted independent screening and structured data extraction meticulously. Results Our paper identified multiple challenges that impede access to quality treatment for brain tumors. These include constrained resources, insufficient training of healthcare professionals, certain cultural beliefs, and a general lack of awareness about brain tumors, all contributing to delayed diagnosis and treatment. Furthermore, the lack of detailed data on the incidence and prevalence of primary central nervous system tumors impairs the accurate assessment of disease burden and precise identification of areas requiring improvement. However, we discovered that ongoing research, advocacy, enhanced training, mentorship, and collaborative efforts present valuable opportunities for substantial progress in neuro-oncology access. Conclusions While we provide a glimpse of the current state, we hope these results will help stimulate dialogue and catalyze initiatives to surmount highlighted obstacles and improve neuro-oncology outcomes across Sub-Saharan Africa.


Brain Tumor Programs in Asia and Africa: Current Status, Challenges, and Future Perspectives
Shweta Kedia, Mabel Banson, Beverly Cheserem, Bipin Chaurasia, Claire Karekezi, Enoch Uche, Esther Apuahe, James A. Balogun, Lynne Lourdes N. Lucena, Maguette Mbaye,et al.
Elsevier BV



Understanding the Ghanaian Neurosurgical Literature: A Scoping Review and Bibliometric Analysis
Nancy Abu-Bonsrah, Olaoluwa Ezekiel Dada, Joseline Haizel-Cobbina, Alvan Ukachukwu, Marcus Spann, Kojo Okyere Adu, Mabel Banson, Dickson Bandoh, Kwadwo Sarpong, David Dadey,et al.
Elsevier BV



Predictors of recurrence of chronic subdural haematoma in a cohort study of patients presenting in a sub-Saharan African teaching hospital
H. M. Abdullah, T. Dakurah, H. Akoto, B. Abaidoo, J. C. B. Dakubo, A. E. Yawson, G. Wepeba, P. Bankah, J. Boatey, M. Ametefe,et al.
Springer Science and Business Media LLC
Abstract Background Chronic subdural haematoma (CSDH) is a common neurological condition affecting the elderly with decreased quality of life. Recurrence leads to increase in number of hospital admissions and surgical interventions. Several factors contribute to recurrence of chronic subdural haematoma, and determination of these factors will help institute measures to reduce recurrence of CSDH, cost of care and improved quality of life. The aim of this study was to determine the predictors of recurrence of chronic subdural haematoma in a cohort of patients presenting in a Sub-Saharan African Teaching Hospital. Methods A prospective hospital-based cohort study of 62 participants who presented with CSDH and underwent burr-hole and drainage at the Neuroscience unit of the Korle-bu Teaching Hospital. The primary outcome of this study was the recurrence of CSDH within 3 months after the surgery. Data was entered into Microsoft Excel 2016 and exported to International Business Machine (IBM) Statistical Package for the Social Sciences (SPSS) version 21.0 for analysis. Predictors of recurrence of CSDH were determined using logistic regression with odds ratio calculated at the 95% confidence level and a p-value less than 0.05 accepted as statistically significant. Results There was a male preponderance of 45 (72.6%), over females of 17 (27.4%). The mean age was 63.1 ± 13.6 years. The recurrence rate of CSDH was 21.0% whilst the mortality rate was 4.8%. Facial palsy and dysphasia were associated with the recurrence of CSDH (p = 0.045, 0.029). Hypertension and bilaterality were associated with recurrence of CSDH from a univariate analysis (p = 0.039, OR = 4.865, CI = 0.975–24.285; p = 0.005, OR = 5.979, CI = 1.585–22.557). In a multivariate logistic regression analysis, bilaterality was the only independent predictor of recurrence of CSDH (p = 0.030, AOR = 5.47, CI = 1.18–25.34). Conclusions Both hypertension and bilaterality showed statistically significant association with recurrence of CSDH. However, only bilaterality proved to be an independent predictor of recurrence of CSDH in patient who underwent burr-hole and drainage.


Assessment of the Neurosurgical Capacity in Ghana: Challenges and Opportunities
Nancy Abu-Bonsrah, Teddy Totimeh, Ulrick Sidney Kanmounye, Mabel Banson, Dickson Bandoh, Kwadwo Sarpong, David Dadey, Abass Adam, Frank Nketiah-Boakye, Thomas Dakurah,et al.
Elsevier BV



Becoming a Neurosurgeon: A Perspective of the Ghanaian Female Neurosurgeon
Mabel Banson
Georg Thieme Verlag KG
AbstractChoosing a career path is not straightforward for most people, more so for the neurosurgeon. The decision-making process is influenced by knowledge of the options available, interest, and the pros and cons of the specific career path. Other factors that contribute are: previous education, family influence, exposure to mentors, and socioeconomic and cultural factors.This article is a perspective on becoming a neurosurgeon in Ghana, describing a path of determination, innovation, commitment, frustration, and the joy of making a difference—a career in Neurosurgery!