{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/42093"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/42093","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Mapping perioperative randomised controlled trials in Sub-Saharan Africa: a scoping review","abstract":"Background: Surgical and anesthesia care is an integral component of universal healthcare coverage. In Sub-Saharan Africa (SSA), 93% of the population lacks access to essential surgical services. Post-surgery mortality in Africa is double the global average. The involvement of anesthesiologists is crucial for improved outcomes. Perioperative research can produce context-specific solutions to challenges faced in the perioperative period. SSA conducts fewer randomized controlled trials (RCTs) than high-income countries, limiting its contribution to global evidence. Objectives: Our primary objectives were to document the geographical distribution of included RCTs, describe their characteristics, and evaluate the reporting quality using the Consolidated Standards of Reporting Trials (CONSORT)-2010-checklist. Methods: We followed the PRISMA Scoping Reviews (PRISMAScR) Checklist. We searched MEDLINE, the Cochrane Library, and Scopus. We identified anesthesia-related RCTs within SSA published from 2000 to 2022. Two independent reviewers screened potential studies, and extracted data in duplicate, with disagreements resolved through consensus or a third reviewer. Quantitative analysis was done with STATA 16 and we compared RCT quality pre-CONSORT-2010 to post-CONSORT-2010, using Pearson's chi-squared test or Fisher's exact test (as applicable), considering p<0.05 as statistically significant. data were summarized narratively Results: Of 3319 records, 169 eligible RCTs were identified, randomizing 45376 participants, with a mean sample size of 98. Between the years 2000 and 2022, there was an exponential trend towards an increasing number of RCTs in SSA (y = 1,5619e0,1051x). The RCTs were from 16 countries in SSA. Most studies were single-country, single-center, led by authors from Nigeria (63/169, 37.3 %) and South Africa (41/169, 24.3%). Most interventions were conducted intraoperatively (n = 125/169, 74%). Pharmacotherapy interventions were most investigated (n = 64/169, 37.9%), followed by analgesic interventions (n = 42/169, 24.9%). The surgical discipline most investigated was obstetrics (n = 51/169, 30.2%). The reporting quality was generally poor, with most RCTs not adhering to CONSORT guidelines and failing to register on a trial registry. Conclusion: This scoping review provides a comprehensive overview of anesthesia-related RCTs in SSA, highlighting limitations such as small sample sizes, under-representation of high surgical burden disciplines, and poor reporting of study outcomes. The clinical trial capacity is limited to a few countries and institutions, and the methodological quality remains poor despite reporting guidelines. There is an opportunity to enhance context-appropriate RCTs in SSA by prioritizing high-quality research through collaborative efforts. Our findings serve as a resource for researchers, funders, and policymakers in anesthesia research in Africa to improve future RCT designs and reporting.","abstract_html":"Background: Surgical and anesthesia care is an integral component of universal healthcare coverage. In Sub-Saharan Africa (SSA), 93% of the population lacks access to essential surgical services. Post-surgery mortality in Africa is double the global average. The involvement of anesthesiologists is crucial for improved outcomes. Perioperative research can produce context-specific solutions to challenges faced in the perioperative period. SSA conducts fewer randomized controlled trials (RCTs) than high-income countries, limiting its contribution to global evidence. Objectives: Our primary objectives were to document the geographical distribution of included RCTs, describe their characteristics, and evaluate the reporting quality using the Consolidated Standards of Reporting Trials (CONSORT)-2010-checklist. Methods: We followed the PRISMA Scoping Reviews (PRISMAScR) Checklist. We searched MEDLINE, the Cochrane Library, and Scopus. We identified anesthesia-related RCTs within SSA published from 2000 to 2022. Two independent reviewers screened potential studies, and extracted data in duplicate, with disagreements resolved through consensus or a third reviewer. Quantitative analysis was done with STATA 16 and we compared RCT quality pre-CONSORT-2010 to post-CONSORT-2010, using Pearson&#x27;s chi-squared test or Fisher&#x27;s exact test (as applicable), considering p&lt;0.05 as statistically significant. data were summarized narratively Results: Of 3319 records, 169 eligible RCTs were identified, randomizing 45376 participants, with a mean sample size of 98. Between the years 2000 and 2022, there was an exponential trend towards an increasing number of RCTs in SSA (y = 1,5619e0,1051x). The RCTs were from 16 countries in SSA. Most studies were single-country, single-center, led by authors from Nigeria (63/169, 37.3 %) and South Africa (41/169, 24.3%). Most interventions were conducted intraoperatively (n = 125/169, 74%). Pharmacotherapy interventions were most investigated (n = 64/169, 37.9%), followed by analgesic interventions (n = 42/169, 24.9%). The surgical discipline most investigated was obstetrics (n = 51/169, 30.2%). The reporting quality was generally poor, with most RCTs not adhering to CONSORT guidelines and failing to register on a trial registry. Conclusion: This scoping review provides a comprehensive overview of anesthesia-related RCTs in SSA, highlighting limitations such as small sample sizes, under-representation of high surgical burden disciplines, and poor reporting of study outcomes. The clinical trial capacity is limited to a few countries and institutions, and the methodological quality remains poor despite reporting guidelines. There is an opportunity to enhance context-appropriate RCTs in SSA by prioritizing high-quality research through collaborative efforts. Our findings serve as a resource for researchers, funders, and policymakers in anesthesia research in Africa to improve future RCT designs and reporting.","abstract_has_math":false,"creators":["Collier, Laila"],"institution":"Department of Anaesthesia and Perioperative Medicine","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Biccard, Bruce","Hohlfeld, ASJ"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-22T22:23:38Z","subjects":["Surgical","Anesthesia","Sub-Saharan Africa"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/42093","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Biccard, Bruce","Hohlfeld, ASJ"]},{"key":"dc:creator","label":"Author","values":["Collier, Laila"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-11-03T13:03:00Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-11-03T13:03:00Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Anaesthesia and Perioperative Medicine"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cape Town"]},{"key":"dc:type","label":"Dc Type","values":["Thesis / Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Surgical","Anesthesia","Sub-Saharan Africa"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/42093"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Surgical and anesthesia care is an integral component of universal healthcare coverage. In Sub-Saharan Africa (SSA), 93% of the population lacks access to essential surgical services. Post-surgery mortality in Africa is double the global average. The involvement of anesthesiologists is crucial for improved outcomes. Perioperative research can produce context-specific solutions to challenges faced in the perioperative period. SSA conducts fewer randomized controlled trials (RCTs) than high-income countries, limiting its contribution to global evidence. Objectives: Our primary objectives were to document the geographical distribution of included RCTs, describe their characteristics, and evaluate the reporting quality using the Consolidated Standards of Reporting Trials (CONSORT)-2010-checklist. Methods: We followed the PRISMA Scoping Reviews (PRISMAScR) Checklist. We searched MEDLINE, the Cochrane Library, and Scopus. We identified anesthesia-related RCTs within SSA published from 2000 to 2022. Two independent reviewers screened potential studies, and extracted data in duplicate, with disagreements resolved through consensus or a third reviewer. Quantitative analysis was done with STATA 16 and we compared RCT quality pre-CONSORT-2010 to post-CONSORT-2010, using Pearson's chi-squared test or Fisher's exact test (as applicable), considering p<0.05 as statistically significant. data were summarized narratively Results: Of 3319 records, 169 eligible RCTs were identified, randomizing 45376 participants, with a mean sample size of 98. Between the years 2000 and 2022, there was an exponential trend towards an increasing number of RCTs in SSA (y = 1,5619e0,1051x). The RCTs were from 16 countries in SSA. Most studies were single-country, single-center, led by authors from Nigeria (63/169, 37.3 %) and South Africa (41/169, 24.3%). Most interventions were conducted intraoperatively (n = 125/169, 74%). Pharmacotherapy interventions were most investigated (n = 64/169, 37.9%), followed by analgesic interventions (n = 42/169, 24.9%). The surgical discipline most investigated was obstetrics (n = 51/169, 30.2%). The reporting quality was generally poor, with most RCTs not adhering to CONSORT guidelines and failing to register on a trial registry. Conclusion: This scoping review provides a comprehensive overview of anesthesia-related RCTs in SSA, highlighting limitations such as small sample sizes, under-representation of high surgical burden disciplines, and poor reporting of study outcomes. The clinical trial capacity is limited to a few countries and institutions, and the methodological quality remains poor despite reporting guidelines. There is an opportunity to enhance context-appropriate RCTs in SSA by prioritizing high-quality research through collaborative efforts. Our findings serve as a resource for researchers, funders, and policymakers in anesthesia research in Africa to improve future RCT designs and reporting."]},{"key":"dc:title","label":"Title","values":["Mapping perioperative randomised controlled trials in Sub-Saharan Africa: a scoping review"]}]}],"canonical_facts":{"dc:contributor.advisor":["Biccard, Bruce","Hohlfeld, ASJ"],"dc:creator":["Collier, Laila"],"dc:date.accessioned":["2025-11-03T13:03:00Z"],"dc:date.available":["2025-11-03T13:03:00Z"],"dc:date.issued":["2025"],"dc:description.abstract":["Background: Surgical and anesthesia care is an integral component of universal healthcare coverage. In Sub-Saharan Africa (SSA), 93% of the population lacks access to essential surgical services. Post-surgery mortality in Africa is double the global average. The involvement of anesthesiologists is crucial for improved outcomes. Perioperative research can produce context-specific solutions to challenges faced in the perioperative period. SSA conducts fewer randomized controlled trials (RCTs) than high-income countries, limiting its contribution to global evidence. Objectives: Our primary objectives were to document the geographical distribution of included RCTs, describe their characteristics, and evaluate the reporting quality using the Consolidated Standards of Reporting Trials (CONSORT)-2010-checklist. Methods: We followed the PRISMA Scoping Reviews (PRISMAScR) Checklist. We searched MEDLINE, the Cochrane Library, and Scopus. We identified anesthesia-related RCTs within SSA published from 2000 to 2022. Two independent reviewers screened potential studies, and extracted data in duplicate, with disagreements resolved through consensus or a third reviewer. Quantitative analysis was done with STATA 16 and we compared RCT quality pre-CONSORT-2010 to post-CONSORT-2010, using Pearson's chi-squared test or Fisher's exact test (as applicable), considering p<0.05 as statistically significant. data were summarized narratively Results: Of 3319 records, 169 eligible RCTs were identified, randomizing 45376 participants, with a mean sample size of 98. Between the years 2000 and 2022, there was an exponential trend towards an increasing number of RCTs in SSA (y = 1,5619e0,1051x). The RCTs were from 16 countries in SSA. Most studies were single-country, single-center, led by authors from Nigeria (63/169, 37.3 %) and South Africa (41/169, 24.3%). Most interventions were conducted intraoperatively (n = 125/169, 74%). Pharmacotherapy interventions were most investigated (n = 64/169, 37.9%), followed by analgesic interventions (n = 42/169, 24.9%). The surgical discipline most investigated was obstetrics (n = 51/169, 30.2%). The reporting quality was generally poor, with most RCTs not adhering to CONSORT guidelines and failing to register on a trial registry. Conclusion: This scoping review provides a comprehensive overview of anesthesia-related RCTs in SSA, highlighting limitations such as small sample sizes, under-representation of high surgical burden disciplines, and poor reporting of study outcomes. The clinical trial capacity is limited to a few countries and institutions, and the methodological quality remains poor despite reporting guidelines. There is an opportunity to enhance context-appropriate RCTs in SSA by prioritizing high-quality research through collaborative efforts. Our findings serve as a resource for researchers, funders, and policymakers in anesthesia research in Africa to improve future RCT designs and reporting."],"dc:identifier.uri":["http://hdl.handle.net/11427/42093"],"dc:language.iso":["en"],"dc:publisher.department":["Department of Anaesthesia and Perioperative Medicine"],"dc:publisher.institution":["University of Cape Town"],"dc:subject":["Surgical","Anesthesia","Sub-Saharan Africa"],"dc:title":["Mapping perioperative randomised controlled trials in Sub-Saharan Africa: a scoping review"],"dc:type":["Thesis / Dissertation"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:38Z"}