A narrative review of brain tumour epidemiology, surgical management, and system-level challenges in Kenya (2000-2024)

Abstract

Background: Brain tumours represent a significant health challenge worldwide, with a disproportionate impact in resource-limited settings. This narrative review highlights what is known about the epidemiology, surgical management, and systemic challenges associated with brain tumour care in Kenya. Methods: This narrative review was based on a comprehensive search of peer-reviewed publications, institutional reports and national statistics. The search, conducted from 2000 to 2024, utilized key databases including, PubMed, Google Scholar, African Journals Online (AJOL) and Web of Science, with search terms like (“brain tumours” OR “brain tumors”) AND Kenya AND (“epidemiology” OR “neurosurgery” OR “challenges”). The analysis was qualitative, focusing on synthesizing patterns and themes related to epidemiology, surgical care and healthcare system barriers. Results: The literature, primarily composed of retrospective hospital-based series, indicates that in Kenya, adults represent a higher proportion of cases (71.8%) than children (28.2%). The most common adult tumours are meningiomas and gliomas, while gliomas and medulloblastomas are common in paediatric patients. Surgical intervention is a cornerstone of management, with outcomes often limited by the extent of resection and a lack of access to adjuvant therapies. Key challenges identified included delayed patient presentation, shortage of neurosurgical specialists (39 neurosurgeons in 2022), and limited access to essential infrastructure like imaging, intensive care units, and radiotherapy centers, most of which were concentrated in urban areas. Conclusion: Brain tumour care in Kenya is hindered by a shortage of neurosurgical personnel, delayed patient presentations, and a lack of equitable access to diagnostic and therapeutic resources. While surgical intervention is effective, its impact is limited by systemic challenges. To improve care, it is necessary to invest in infrastructure, decentralize neurosurgical services, enhance capacity building for healthcare professionals, and increase public awareness