Focusing on the Trend in Africa. Comment on Black, P. Publishing Urologic Research from Low- and Middle-Income Countries. Soc. Int. Urol. J. 2024, 5, 225–226

In a recently published Editorial, Black [1] addressed the publication of urological research originating from low- and middle-income countries (LMICs). Observations and recommendations were made to advance research in these countries and to identify and define the roles of various stakeholders. His conclusion is clear, and was articulated as follows: “The objective of urologic research is to advance our understanding of urologic diseases, improve diagnostic and treatment modalities, and ultimately enhance patient outcomes. We cannot leave out patients in LMIC in this mission. Overcoming the barriers to urologic research in LMIC is a monumental task that will require collective action and commitment from governments, policymakers, researchers, and healthcare professionals”.

This publication caught the attention of a group of urologists practicing in various geographic regions of Africa. Based on this and after a discussion, a commentary will be made with a focus on trends in Africa.

A bibliometric study focusing on the global contributions to the field of urology was published by Majzoub et al. [2]. In this study, it was reported that, in 2015, 10,489 articles were published. The African contribution was 1.9%. This finding corroborates the observation made by Hammad et al. [3] in 2014, who emphasized that data concerning the nature and type of research published in the field of urology in developing countries are very limited, citing the United Arab Emirates as an example. Although a recent increase in the number of articles published in urology has been observed globally.

In Africa, there are several journals dedicated solely to urological research. These include the African Journal of Urology, African Urology, Egyptian Journal of Urology, Kenyan Journal of Urology, Revue Africaine d’Urologie et d’Andrologie, and Nigerian Journal of Urology. The oldest with continuous publication is the African Journal of Urology. As of 22 June 2024, it is the only African journal focused on urology ranked in Scimago’s urology category, where it is placed 84th out of 117 journals. An analysis of its 2020 issues reveals that a total of 87 articles were published, of which 53 originated from Africa, representing approximately 61%. The country with the highest number of publications is Egypt (n = 24), followed by Nigeria (n = 11) and South Africa (n = 10). Two publications came from Algeria and Ghana. Countries such as Morocco, Uganda, the Republic of Congo, and Zambia each contributed one publication. This observation corroborates the findings of Black et al. [1], who stated that Egyptian researchers have a strong publication record and disseminate their work in numerous journals other than SIUJ. This can be attributed to the country’s large population and the number of urologists [3].

It is evident that medical research is crucial for studying local epidemiology and the impact of various diseases at the national level, thereby aiding in the planning of future strategies [3]. In the fight against cancer, national cancer registries are necessary to guide prevention and management policies. This requires strengthening the capacity for data production, analysis, and interpretation [4]. The lack of information hinders certain types of large-scale research that could be of high quality and have a direct impact. This partly explains why most Sub-Saharan studies on cancer-related subjects are single-center, retrospective, and descriptive. Additionally, the absence of laboratories and funding prevents the conduct of experimental studies, as reported by other authors.

Africa comprises 53 countries, among which 19, predominantly francophone, are affiliated with the Conseil Africain et Malgache pour l’Enseignement Supérieur (CAMES), in English anglais African and Malagasy Council for Higher Education. CAMES is tasked with coordinating higher education and research systems to harmonize programs and recruitment standards across member countries’ higher education and research institutions. To this end, CAMES regularly publishes a list of journals in which most academic researchers aim to publish their work to enhance their ratings in the aggregation competition evaluations (https://www.lecames.org/ accessed on 24 June 2024). Another notable aspect is that most researchers publishing in Africa are university-affiliated, primarily serving as faculty members. Statistically, there are fewer faculty members in specialized fields in Africa. The majority of research outputs are derived from the transformation of medical students’ theses into bursaries. Few researchers establish independent research projects outside this framework.

In Kenya, for instance, Ogeng’o et al. [5] surveyed 150 medical students regarding medical research, finding that only 13.7% had engaged in writing research papers. Among the barriers to publication, they identified a lack of mentors, inadequate training in research methodology, and insufficient funding. Additionally, there is a dearth of research groups, leading to a lack of continuity in research within specific fields, as research activities are typically spearheaded by specific individuals with a research orientation. When these individuals leave, the research efforts often cease. This observation of insufficient training and research capacity has been noted by other authors [3]. Regarding funding, most major journals waive publication fees for works originating from low- or middle-income countries.

Academic exchange programs can be a valuable asset for enabling developing countries to advance in research and publication. In Africa, English-speaking countries, with greater opportunities for university exchanges and cooperation, are ranked higher in terms of both the quantity and quality of academic work compared to French-speaking countries. The language barrier can now be easily overcome through the use of translation software and artificial intelligence. There is a significant correlation between the origin of the published article and the region of the publishing journal [3].

Urology is advancing, and the research landscape must evolve accordingly. However, in Africa, particularly in certain regions, the practice remains traditional. The scientific environment and the scarcity of resources dedicated to research hinder the execution and publication of high-quality studies that could be featured in prestigious international journals.