The process of research begins with grant-writing and concludes with publication. According to a recent study, in resource-poor settings, in-country national research and publications change clinical practice [1]. One way to promote the visibility of these publications is for them to be peer reviewed and indexed in MEDLINE/PubMed. This process is fundamental not only to scientific progress, but to promoting the widespread communication of novel discoveries from low- and middle-income countries to the rest of the world.
Worldwide scientific publishing activity over the past decade indicates that most countries in Sub-Saharan Africa (SSA) have low levels of publication [2]. In a recent analysis, 31 of the world's 193 countries produce 97.5% of the world's most cited papers. South Africa, at number 29, is the only Sub-Saharan African country on this list [3], but little is known about the comparative volume of publications among the different countries in SSA.
This study examined authorship in MEDLINE-indexed journal publications by Sub-Saharan African first authors as one metric of high-quality health research output. MEDLINE is the bibliographic database of the National Library of Medicine (NLM) at the US National Institutes of Health. Publication trends over a decade were tracked with two key objectives in mind:
to approximate the research publishing landscape in the region, with special attention paid to country-specific (i.e., national) journals and
to contrast the publication volume of the most productive country in SSA with publishing practices of other comparable countries outside the region.
Methods
In the first phase of the study, the authors obtained information from NLM's List of Journals Indexed to identify those journals indexed in the MEDLINE/PubMed database that were published in SSA countries. Exploratory searches were first conducted in the Author Affiliation field to identify address-specific search terms for each country, and country-specific search strategies were developed. Searches were then performed to retrieve citations to research papers only with first author affiliations for each SSA country. Editorials, letters, and news items were excluded for the study. Author affiliation information for secondary authors is not included in MEDLINE/PubMed.
Searches were limited by publication date to each year from 1995 to 2004. Similar searches were conducted for New Zealand, Mexico, Croatia, and Turkey. The second phase of the study examined specific topics of research among the research publications, focusing on the five major causes of death in the top-ten producing countries, as determined by the World Health Organization. These were HIV/AIDS, malaria, parasitic diseases, cancer, and cardiovascular disease [4]. The number of articles published on each of the five topics was obtained by searching MEDLINE/PubMed using Medical Subject Headings (MeSH) at the most general level for each topic and including all narrower terms. Both human and nonhuman studies were included. Each MeSH search was combined using Boolean “AND” logic with the same country searches used to determine publication rates by country over the ten-year period.