Addis Ababa

Department of Neurosurgery, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

Knut Gustav Wester (born September 1, 1940) is a Norwegian neurosurgeon and professor. He is a from the University of Oslo, and defended his doctorate in the same place. From 1986 he has been employed at Haukeland University Hospital, eventually combined with a professorship at the University of Bergen.

In 2010 he was awarded the King's gold medal for his efforts for neurosurgery in Norway and Ethiopia.

Juhler M. Knut Wester (ed.): Arachnoid cysts : Vol 1-2, Academic Press/Elsevier, 2018 (ISBN: 978-0-12-809932-2). Acta Neurochir (Wien). 2018 Aug;160(8):1505. doi: 10.1007/s00701-018-3603-z. Epub 2018 Jun 21. PubMed PMID: 30006747.

Surveillance studies in Ethiopia show an epidemic of spina bifida and anencephaly, two major neural tube birth defects that are severe and life-threatening. Our objective was to estimate proportional reductions in current stillbirth and child mortality rates in Ethiopia through folic acid-based interventions to prevent spina bifida and anencephaly.

Using secondary data from multiple sources, we estimated percent reductions in stillbirth, neonatal, infant, and under-five child mortality rates that would have occurred in Ethiopia in the year 2016 had all folic acid-preventable spina bifida and anencephaly been prevented; and the contributions of these reductions toward Ethiopia's Year 2030 Every Newborn Action Plan (ENAP) goal on stillbirth, and sustainable development goal (SDG) on child mortality rates. The 2016 prevalence of spina bifida and anencephaly in Ethiopia was assumed as 13 per 1,000 total births, with the prevention goal reaching 0.5 per 1,000 total births.

Folic acid interventions in Ethiopia would have prevented about 41,610 cases of folic acid-preventable spina bifida and anencephaly-affected pregnancies during the year 2016. We estimate that this prevention is associated with reduction of 31,830 stillbirths and 7,335 under-five child deaths annually. The proportional contribution of this prevention toward achieving Ethiopia's ENAP goal is 54% for stillbirth, and toward SDG is 4.5% for neonatal- and 6.8% for under-five mortality.

Spina bifida and anencephaly contribute to substantial stillbirths and child death in Ethiopia. Large-scale fortification of foods like wheat flour and salt can help achieve Ethiopia's ENAP and SDG targets addressing preventable stillbirth, neonatal, and under-five mortality 1).

2: Tadele A, Woodraw S, Johnson MD. Case Report of Spinal Cord Astrocytoma Presenting with Extensive Spinal Vertebral Body Destruction. World Neurosurg X. 2019 Feb 1;2:100016. doi: 10.1016/j.wnsx.2019.100016. eCollection 2019 Apr. PubMed PMID: 31218290; PubMed Central PMCID: PMC6580895.

3: Hutchinson PJ, Kolias AG, Tajsic T, Adeleye A, Aklilu AT, Apriawan T, Bajamal AH, Barthélemy EJ, Devi BI, Bhat D, Bulters D, Chesnut R, Citerio G, Cooper DJ, Czosnyka M, Edem I, El-Ghandour NMF, Figaji A, Fountas KN, Gallagher C, Hawryluk GWJ, Iaccarino C, Joseph M, Khan T, Laeke T, Levchenko O, Liu B, Liu W, Maas A, Manley GT, Manson P, Mazzeo AT, Menon DK, Michael DB, Muehlschlegel S, Okonkwo DO, Park KB, Rosenfeld JV, Rosseau G, Rubiano AM, Shabani HK, Stocchetti N, Timmons SD, Timofeev I, Uff C, Ullman JS, Valadka A, Waran V, Wells A, Wilson MH, Servadei F. Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury : Consensus statement. Acta Neurochir (Wien). 2019 Jul;161(7):1261-1274. doi: 10.1007/s00701-019-03936-y. Epub 2019 May 28. Review. PubMed PMID: 31134383; PubMed Central PMCID: PMC6581926.

4: Laeke T, Biluts H, Sahlu A. Clinical Outcome of Operated Intracranial Meningiomas: An Ethiopian Experience. World Neurosurg. 2019 Apr 8. pii: S1878-8750(19)30993-3. doi: 10.1016/j.wneu.2019.04.002. [Epub ahead of print] PubMed PMID: 30974276.

5: Sahlu A, Laeke T, Kassahun A, Tirsit A, Debebe T, Gemechu T, Lund-Johansen M. One Hundred Skull Base Meningiomas Operated at Black Lion Specialized Hospital, Addis Ababa, Ethiopia. World Neurosurg. 2019 Mar 20. pii: S1878-8750(19)30756-9. doi: 10.1016/j.wneu.2019.03.088. [Epub ahead of print] PubMed PMID: 30902778.

6: Laeke T, Tirsit A, Debebe F, Girma B, Gere D, Park KB, Azazh A. Profile of Head Injuries: Prehospital Care, Diagnosis, and Severity in an Ethiopian Tertiary Hospital. World Neurosurg. 2019 Jul;127:e186-e192. doi: 10.1016/j.wneu.2019.03.044. Epub 2019 Mar 14. PubMed PMID: 30878740.

7: Demoz GT, Alebachew M, Legesse Y, Ayalneh B. Treatment of ventriculoperitoneal shunt infection and ventriculitis caused by Acinetobacter baumannii: a case report. J Med Case Rep. 2018 May 23;12(1):141. doi: 10.1186/s13256-018-1680-5. PubMed PMID: 29788980; PubMed Central PMCID: PMC5964891.

8: Salia SM, Mersha HB, Aklilu AT, Baleh AS, Lund-Johansen M. Predicting Dural Tear in Compound Depressed Skull Fractures: A Prospective Multicenter Correlational Study. World Neurosurg. 2018 Jun;114:e833-e839. doi: 10.1016/j.wneu.2018.03.095. Epub 2018 Mar 26. PubMed PMID: 29588245.

9: Admasu AK, Buno E. Short-Term Outcome in Subaxial Spine Injury Patients Operated on in a Resource-Limited Setting, Addis Ababa, Ethiopia. World Neurosurg. 2018 May;113:e702-e706. doi: 10.1016/j.wneu.2018.02.129. Epub 2018 Mar 3. PubMed PMID: 29510279.

10: Biccard BM, Madiba TE, Kluyts HL, Munlemvo DM, Madzimbamuto FD, Basenero A, Gordon CS, Youssouf C, Rakotoarison SR, Gobin V, Samateh AL, Sani CM, Omigbodun AO, Amanor-Boadu SD, Tumukunde JT, Esterhuizen TM, Manach YL, Forget P, Elkhogia AM, Mehyaoui RM, Zoumeno E, Ndayisaba G, Ndasi H, Ndonga AKN, Ngumi ZWW, Patel UP, Ashebir DZ, Antwi-Kusi AAK, Mbwele B, Sama HD, Elfiky M, Fawzy MA, Pearse RM; African Surgical Outcomes Study (ASOS) investigators. Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study. Lancet. 2018 Apr 21;391(10130):1589-1598. doi: 10.1016/S0140-6736(18)30001-1. Epub 2018 Jan 3. PubMed PMID: 29306587.


12: Ogbo FA, Eastwood J, Page A, Efe-Aluta O, Anago-Amanze C, Kadiri EA, Ifegwu IK, Woolfenden S, Agho KE. The impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African countries with high diarrhoea mortality. Public Health Nutr. 2017 Dec;20(17):3109-3119. doi: 10.1017/S1368980017002567. Epub 2017 Oct 5. PubMed PMID: 28980521.

13: Lund-Johansen M, Dahl JW, Eilertsen GM, Wester K. Establishment of neurosurgery training in Ethiopia. Tidsskr Nor Laegeforen. 2017 Sep 18;137(17). doi: 10.4045/tidsskr.17.0282. Print 2017 Sep 19. Norwegian. PubMed PMID: 28925232.

14: Argaw NA, Shumbash KZ, Asfaw AA, Hawaze S. Assessment of surgical antimicrobial prophylaxis in Orthopaedics and Traumatology Surgical Unit of a Tertiary Care Teaching Hospital in Addis Ababa. BMC Res Notes. 2017 Apr 20;10(1):160. doi: 10.1186/s13104-017-2475-2. PubMed PMID: 28427474; PubMed Central PMCID: PMC5397704.

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16: Laeke T, Tirsit A, Biluts H, Murali D, Wester K. Pediatric Hydrocephalus in Ethiopia: Treatment Failures and Infections: A Hospital-Based, Retrospective Study. World Neurosurg. 2017 Apr;100:30-37. doi: 10.1016/j.wneu.2016.12.112. Epub 2017 Jan 3. PubMed PMID: 28057596.

17: Lund-Johansen M, Laeke T, Tirsit A, Munie T, Abebe M, Sahlu A, Biluts H, Wester K. An Ethiopian Training Program in Neurosurgery with Norwegian Support. World Neurosurg. 2017 Mar;99:403-408. doi: 10.1016/j.wneu.2016.12.051. Epub 2016 Dec 23. PubMed PMID: 28017754.

18: Hutschenreuther A, Bigl M, Hemdan NY, Debebe T, Gaunitz F, Birkenmeier G. Modulation of GLO1 Expression Affects Malignant Properties of Cells. Int J Mol Sci. 2016 Dec 18;17(12). pii: E2133. doi: 10.3390/ijms17122133. PubMed PMID: 27999356; PubMed Central PMCID: PMC5187933.

19: Nega W, Damte M, Girma Y, Desta G, Hailemariam M. Craniopagus parasiticus - a parasitic head protruding from temporal area of cranium: a case report. J Med Case Rep. 2016 Dec 1;10(1):340. PubMed PMID: 27906038; PubMed Central PMCID: PMC5134060.

20: Zewdie A, Tesema H, Aklilu AT, Teklemariam TL, Zewdu T, Ashagre Y, Bizuneh Y, Azazh A, Hassen GW. Bedside ultrasound as a simple non-invasive method of assessing intracranial pressure in a limited resource setting. Afr J Emerg Med. 2016 Sep;6(3):e1-e4. doi: 10.1016/j.afjem.2016.06.002. Epub 2016 Jul 22. PubMed PMID: 30456086; PubMed Central PMCID: PMC6234191.

21: Shifa J, Abebe W, Bekele N, Habte D. A case of bilateral visual loss after spinal cord surgery. Pan Afr Med J. 2016 Mar 24;23:119. doi: 10.11604/pamj.2016.23.119.8443. eCollection 2016. PubMed PMID: 27279946; PubMed Central PMCID: PMC4885694.

22: Eriksen AA, Johnsen JS, Tennøe AH, Tirsit A, Laeke T, Amare EB, Wester K. Implementing Routine Head Circumference Measurements in Addis Ababa, Ethiopia: Means and Challenges. World Neurosurg. 2016 Jul;91:592-596.e2. doi: 10.1016/j.wneu.2016.04.132. Epub 2016 May 9. PubMed PMID: 27185652.

23: Biluts H, Admasu AK. Outcome of Endoscopic Third Ventriculostomy in Pediatric Patients at Zewditu Memorial Hospital, Ethiopia. World Neurosurg. 2016 Aug;92:360-365. doi: 10.1016/j.wneu.2016.04.114. Epub 2016 May 11. PubMed PMID: 27157284.

24: Sahlu A, Mesfin B, Tirsit A, Wester K. Spinal cord compression secondary to vertebral echinococcosis. J Neurosci Rural Pract. 2016 Jan-Mar;7(1):143-6. doi: 10.4103/0976-3147.165357. PubMed PMID: 26933365; PubMed Central PMCID: PMC4750316.

25: Sahlu A, Mesfin B, Tirsit A, Debebe T, Wester K. Parasitic twin–a supernumerary limb associated with spinal malformations. A case report. Acta Neurochir (Wien). 2016 Mar;158(3):611-4. doi: 10.1007/s00701-016-2710-y. Epub 2016 Jan 26. PubMed PMID: 26811301.

26: Biluts H, Abebe M, Laeke T, Tirsit A, Belete A. PATTERN OF SPINE AND SPINAL CORD INJURIES IN TIKUR ANBESSA HOSPITAL, ETHIOPIA. Ethiop Med J. 2015 Apr;53(2):75-82. PubMed PMID: 26591295.

27: Amare EB, Idsøe M, Wiksnes M, Moss T, Roelants M, Shimelis D, Júlíusson PB, Kiserud T, Wester K. Reference Ranges for Head Circumference in Ethiopian Children 0-2 Years of Age. World Neurosurg. 2015 Dec;84(6):1566-71.e1-2. doi: 10.1016/j.wneu.2015.08.045. Epub 2015 Sep 3. PubMed PMID: 26342781.

28: Lehre MA, Eriksen LM, Tirsit A, Bekele S, Petros S, Park KB, Bøthun ML, Wester K. Outcome in patients undergoing surgery for spinal injury in an Ethiopian hospital. J Neurosurg Spine. 2015 Dec;23(6):772-9. doi: 10.3171/2015.3.SPINE141282. Epub 2015 Sep 4. PubMed PMID: 26340379.

29: Yee B, Chi NW, Hansen LA, Lee RR, U HS, Savides TJ, Vinetz JM. Strongyloides stercoralis Hyperinfection Syndrome Presenting as Severe, Recurrent Gastrointestinal Bleeding, Leading to a Diagnosis of Cushing Disease. Am J Trop Med Hyg. 2015 Oct;93(4):822-7. doi: 10.4269/ajtmh.15-0355. Epub 2015 Jul 20. PubMed PMID: 26195463; PubMed Central PMCID: PMC4596606.

30: Poenaru D, Pemberton J, Cameron BH. The burden of waiting: DALYs accrued from delayed access to pediatric surgery in Kenya and Canada. J Pediatr Surg. 2015 May;50(5):765-70. doi: 10.1016/j.jpedsurg.2015.02.033. Epub 2015 Feb 20. PubMed PMID: 25783371.

31: Nemani VM, Kim HJ, Bjerke-Kroll BT, Yagi M, Sacramento-Dominguez C, Akoto H, Papadopoulos EC, Sanchez-Perez-Grueso F, Pellise F, Nguyen JT, Wulff I, Ayamga J, Mahmud R, Hodes RM, Boachie-Adjei O; FOCOS Spine Study Group. Preoperative halo-gravity traction for severe spinal deformities at an SRS-GOP site in West Africa: protocols, complications, and results. Spine (Phila Pa 1976). 2015 Feb 1;40(3):153-61. doi: 10.1097/BRS.0000000000000675. PubMed PMID: 25668334.

32: Chowdhury T, Mendelowith D, Golanov E, Spiriev T, Arasho B, Sandu N, Sadr-Eshkevari P, Meuwly C, Schaller B; Trigemino-Cardiac Reflex Examination Group. Trigeminocardiac reflex: the current clinical and physiological knowledge. J Neurosurg Anesthesiol. 2015 Apr;27(2):136-47. doi: 10.1097/ANA.0000000000000065. Review. PubMed PMID: 25602626.

33: Biluts H, Laeke T. Microscopic transphneoidal surgery experence from christian Medical Center Addis Abeba Ethiopia. Ethiop Med J. 2014 Apr;52(2):67-76. PubMed PMID: 25588287.

34: Cadotte DW, Sedney C, Djimbaye H, Bernstein M. A qualitative assessment of the benefits and challenges of international neurosurgical teaching collaboration in Ethiopia. World Neurosurg. 2014 Dec;82(6):980-6. doi: 10.1016/j.wneu.2014.09.001. Epub 2014 Sep 6. PubMed PMID: 25196401.

35: Bramall A, Djimbaye H, Tolessa C, Biluts H, Abebe M, Bernstein M. Attitudes toward neurosurgery in a low-income country: a qualitative study. World Neurosurg. 2014 Nov;82(5):560-6. doi: 10.1016/j.wneu.2014.05.015. Epub 2014 May 14. PubMed PMID: 24836580.

36: Scharer V, Hafner R, Ciurea A, Henning L, Somoskovi A, Weber R, Fehr J. [Limitations of medicine:diagnosis and therapy of «inflammatory» back pain]. Praxis (Bern 1994). 2014 Mar 12;103(6):337-40. Review. German. PubMed PMID: 24712089.

37: Michael BH, Kebede T, Biluts H, Affefa G, Schneider J, Freidberg SR. Concentric craniotomy: removal of tumor involving the skull and the intracranial space. World Neurosurg. 2014 Mar-Apr;81(3-4):651.e15-6. doi: 10.1016/j.wneu.2013.06.006. Epub 2013 Jun 26. PubMed PMID: 23811069.

38: Cadotte DW, Blankstein M, Bekele A, Dessalegn S, Pain C, Derbew M, Bernstein M, Howard A. Establishing a surgical partnership between Addis Ababa, Ethiopia, and Toronto, Canada. Can J Surg. 2013 Jun;56(3):E19-23. doi: 10.1503/cjs.027011. PubMed PMID: 23706853; PubMed Central PMCID: PMC3672439.

39: Biluts H, Munie T, Abebe M. Review of lumbar disc diseases at Tikur Anbessa Hospital. Ethiop Med J. 2012 Jan;50(1):57-65. PubMed PMID: 22519162.

40: Kahamba JF, Assey AB, Dempsey RJ, Qureshi MM, Härtl R. The second African Federation of Neurological Surgeons course in the East, Central, and Southern Africa region held in Dar es Salaam, Tanzania, January 2011. World Neurosurg. 2013 Sep-Oct;80(3-4):255-9. doi: 10.1016/j.wneu.2011.07.021. Epub 2011 Nov 7. PubMed PMID: 22120325.

41: Bagan M. The Foundation for International Education in Neurological Surgery. World Neurosurg. 2010 Apr;73(4):289. doi: 10.1016/j.wneu.2010.03.007. PubMed PMID: 20849780.

42: Cadotte DW, Viswanathan A, Cadotte A, Bernstein M, Munie T, Freidberg SR; East African Neurosurgical Research Collaboration. The consequence of delayed neurosurgical care at Tikur Anbessa Hospital, Addis Ababa, Ethiopia. World Neurosurg. 2010 Apr;73(4):270-5. doi: 10.1016/j.wneu.2010.02.017. PubMed PMID: 20849776.

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44: El-Sayed AM, Hadley C, Tessema F, Tegegn A, Cowan JA Jr, Galea S. Back and neck pain and psychopathology in rural sub-Saharan Africa: evidence from the Gilgel Gibe Growth and Development Study, Ethiopia. Spine (Phila Pa 1976). 2010 Mar 15;35(6):684-9. doi: 10.1097/BRS.0b013e3181b4926e. PubMed PMID: 20139812; PubMed Central PMCID: PMC2891327.

45: Biluts H, Bekele A, Kottiso B, Enqueselassie F, Munie T. In-patient surgical mortality in Tikur Anbessa Hospital: a five-year review. Ethiop Med J. 2009 Jan;47(2):135-42. PubMed PMID: 19743793.

46: Krcméry V, Fedor-Freybergh PG. Neuroinfections in developed versus developing countries. Neuro Endocrinol Lett. 2007 Jun;28 Suppl 2:5-6. PubMed PMID: 17558364.

47: Biluts H, Munie T. Intramedullary cavernous haemangioma of spinal cord: a case report and literature review. Ethiop Med J. 2006 Jul;44(3):287-90. Review. PubMed PMID: 17447396.

48: Munie T. Surgical management of carpal tunnel syndrome in neurosurgery practice in Ethiopia and review of literature. Ethiop Med J. 2005 Apr;43(2):79-83. PubMed PMID: 16370536.

49: Munie T. Management of cervical ribs causing neurogenic thoracic outlet syndrome: a ten year experience in the neurosurgery unit, Tikur Anbessa Hospital. Ethiop Med J. 2003 Jul;41(3):227-33. PubMed PMID: 15227888.

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Dixon M, Kancherla V, Magana T, Mulugeta A, Oakley GP Jr. High potential for reducing folic acid-preventable spina bifida and anencephaly, and related stillbirth and child mortality, in Ethiopia. Birth Defects Res. 2019 Aug 19. doi: 10.1002/bdr2.1584. [Epub ahead of print] Review. PubMed PMID: 31424635.
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