The characteristics of traumatic spinal cord injuries at a referral hospital in Northern Tanzania (original) (raw)
Related papers
Global Health Action, 2017
Background: Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania. Objective: To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting. Methods: Records for patients with traumatic spinal cord injury for five consecutive years (2010-2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients' condition on discharge were recorded and analyzed descriptively. Results: The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most documented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%. Conclusion: Prevention of traumatic spinal cord injury in Northeast Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.
African Health Sciences, 2021
Background: Clinical complications following spinal cord injury are a big concern as they account for increased cost of rehabilitation, poor outcomes and mortality. Objective: To describe the occurrence of traumatic spinal cord injury and associated clinical complications during hospi- talisation in North-East Tanzania. Method: Prospective data were collected from all persons with traumatic spinal cord injury from North-East Tanzania from their admission to discharge from the hospital. Neurological progress and complications were assessed routinely. Data were captured using a form that incorporated the components of the core data set of the International Spinal Cord Society and were analysed descriptively. Results: A total of 87 persons with traumatic spinal cord injury were admitted at the hospital with a mean age of 40.2 ± 15.8 years. There were 69 (79.3%) males, and 58 (66.6%) of the injuries resulted from falls. Spasms (41 patients, 47.1%), neuropathic pain (40 patients, 46%), a...
Traumatic spinal cord injury in Botswana: characteristics, aetiology and mortality
Spinal cord, 2015
Descriptive study with a cross-sectional design. To describe the epidemiology of traumatic spinal cord injuries (TSCIs) in Botswana, with a specific focus on road traffic crashes (RTC). Main public referral hospital, Gaborone, Botswana. Two samples were included. Sample one described the epidemiology and included patients admitted during a 2-year period with acute TSCI. Sample two included only patients with TSCI due to RTC. Annual incidence was 13 per million population. Epidemiology of TSCI: 49 patients were included, 71% male, age ranging from 4 to 81 years, 80% ⩽ 45 years. Tetraplegia was more common than paraplegia (59/41%), and 39% had C1-C4 level of injury. The main cause of TSCI was RTC (68%), followed by assault (16%) and falls (10%). Mortality was 20%, where all, but one, had tetraplegia (18%). Median time from injury to spinal surgery was 12 days, with longer time for women, 16 days compared with 8 for men. Burst tire was the primary cause of RTC resulting in a TSCI, foll...
Patterns of Traumatic Spinal Injuries in the Developing World: A Five-Year Longitudinal Review
Asian Spine Journal, 2022
A 5-year longitudinal study documenting and comparing patterns of traumatic spinal injuries (TSIs) observed in developing countries. Overview of Literature: Current knowledge of the patterns and epidemiology of TSI are based on evidence from developed countries and there is a lack of data from developing countries to enable a comparison of information to formulate healthcare policies. Methods: A review of case records of all patients treated at a tertiary level trauma center over a 5-year period (2015-2019) was performed. Epidemiological, clinical, and radiological data were analyzed. Results: The incidence of spinal trauma was 6.2% (2,065/33,072) among all trauma patients. Among these 2,065 patients, the mean age was 43.4±16.3 years and 77.3% (n=1,596) were aged 21-60 years. The major cause of injury was falls (52.1%, n=1,069) and 49.8% were high-energy falls (>10 feet). In patients with TSI due to falls, injuries occurred at the workplace (n=376), home (n=309), trees (n=151), wells (n=77), and electric poles (n=57). Road traffic accidents contributed to 42% (n=862) of TSIs and predominantly affected motorcyclists (52%, n=467). Around half (53.5%, n=1,005) of all patients were in the lower socioeconomic strata. The most common injury level was thoracic region (37.2%, n=769). Spinal cord injury (SCI) occurred in 49% (n=1,011) of patients and 49.7% (n=1,028) had injuries associated with other organs. Conclusions: Our study indicated different demographic patterns and epidemiological features of TSI compared with the Western literature, including a preponderance of young male patients, falls from heights, motorcycle accidents, and a larger percentage of SCI. The high number of falls at workplace indicates a lack of knowledge among the public and policy makers about safety measures.
Pan Arab Journal of Neurosurgery
BACKGROUND: Traumatic spinal cord injury is a relatively common neurosurgical emergency. It is a significant cause of disability and mortality among the younger age and productive age group. OBJECTIVE: The aim of this study was to determine the prevalence and outcome of traumatic spinal cord injury (TSCI) in patients managed at Irrua Specialist Teaching Hospital (ISTH.), a tertiary health institution in a rural community in Nigeria. PATIENTS AND METHODS: This study was a 5-year descriptive retrospective study between January 2015 and December 2019.The study was carried out for the period of 18 months at Irrua Specialist Teaching Hospital (ISTH), from the time of ethical approval. Information of patients who had traumatic spinal cord injury that met the inclusion criteria were retrieved, collated and analyzed using the statistical packages for the social sciences (SPSS) (version 21, Chicago, Illinois). A test of significance of association between dependent and independent variables was done using the Chi-square. A p-value of <0.05 was considered statistically significant. RESULTS: From the 1,945 trauma cases managed between 2015-2019, 234 patients had TSCI and 101 patients met the inclusion criteria, which shows a prevalence of 5.2%. The main age of the patients was 39.94 years. The most affected age group was 18-35 years accounting for 43.6% of cases. Result showed male to female ratio of 4.6:1. Civil servants and drivers were most commonly affected. The majority of the cases were due to road traffic accidents (RTA), accounting for 63.4%. of cases, while the least was due to gunshot injuries, accounting for just 1%. Mortality rate was 9.9%. Association between Glasgow coma scale at admission and Glasgow outcome score at discharge was not statistically significant (p=0.59). CONCLUSION: Traumatic spinal injury has been shown to affect most commonly the productive age group. The prevalence was similar to some studies in Nigeria and lower when compared to that observed from studies in developed countries. There was no statistically significant association between Glasgow coma scale at admission and outcome at discharge.
The Internet Journal of Orthopedic Surgery, 2007
Background: Spinal Cord Injury (SCI) is still a major cause of morbidity and mortality in our environment. It posses a management challenge to the Orthopaedic surgeons in an environment of scarce manpower and specialized facilities. Aim: To establish the pattern of SCI in Calabar and contribute to the existing national data on this injury as well as highlighting the deficiencies in our peculiar environment with a view to improving them. Methods: A prospective research protocol by questionnaire was designed for all patients presenting with spinal cord injury at the University of Calabar Teaching between February 2005 and January 2006. The parameters of study included patients' demographics, mode and pattern of injuries, neurologic grade pre and post treatment, complications and clinical outcome. Results: Fourteen spinal cord injured patients were admitted during the study period. Mean age was 36years with a male/female ratio of 4:1. Motor vehicle accidents were the most common cause 12 (85.7%). Thirteen (93%) patients were transported to the hospital by bus/car while one patient was brought on a motor cycle. None of the victims of road traffic accident wore protective device nor had any proper pre-hospital care. The commonest site of injury was the lumbar region 6 (43%) while cervical and thoracic regions contributed 5 (35.7%) and 3(21.4%) respectively. Clinical presentation were; paraplegia 11 (78.6%), quadriplegia 2 (14.3%) and spinal shock 1 (7%). Treatment included cast/braces support, drugs and Physiotherapy. Associated injuries included limb factures-4, head injuries-1, rib fractures-1, Splenic-1, bowel injuries-1 and soft tissue lacerations in 2 patients. Mean interval between injury and presentation at hospital was 2 days (2hrs-30days) while the duration of stay in hospital ranged between 4 to 20 weeks. Mortality was 2 (14.3%) Conclusion: Public enlightenment on road safety measures and use of proper protective devices including seat belts and helmet could reduce the high morbidity associated with Spinal cord injuries. More spinal centres and training of more trauma/neurosurgeons are needed.
Burden of traumatic spinal cord injury in Africa: a scoping review protocol
Journal of Surgical Protocols and Research Methodologies
Trauma accounts for about 90% of spinal cord injuries worldwide. Traumatic spinal cord injury (TSCI) is recognized as a neurotrauma of global health priority due to the preventability of the injuries and the specialized and expensive medical and surgical care they necessitate. This study protocol guides the comprehensive and exhaustive review of the literature concerning the epidemiology, management and outcomes of TSCIs in Africa. This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. The search strategy was performed primarily on PubMed and OVID Embase. A secondary literature search was carried out on African Journal Online and Google Scholar. All observational studies on the prevalence/incidence, presentation, management and outcomes of TSCIs in African countries were included. The following study types were excluded: literature reviews, meta-analyses, case reports, abstract-only articles, conference proceedings, randomiz...
A Fifteen Years Retrospective Study of Spinal Cord Injury in South-Eastern Nigeria
EC ORTHOPAEDICS, 2018
Spinal cord injury (SCI) is an insult to the spinal cord resulting in change, either temporary or permanent in its normal motor, sensory or autonomic function. However, literature has been mute on prevalence, pattern and mechanism of spinal cord injury (SCI) in SouthEastern Nigeria unlike the many papers on pattern of spinal cord injury. The purpose of this study was to establish the prevalence of SCI with a view of contributing to the emerging National data on the rising prevalence of this injury and to highlight the deficiencies in our country and suggest ways of improving them. This retrospective review of 263 case files, was conducted at four hospitals in SouthEastern Nigeria, from 1 st January, 2001 to 31 st December, 2015. A total of 263 cases of spinal cord injury over the 15-year period were studied. There were 209 (79.5%) males and 54 (20.5%) females. Road traffic accident accounted for 135 (51.3%), whereas fall accounted for 89 (33.8%). Thoracic spine was affected in 132 (83.3%) of patients. The peak age of occurrence was at 21-30 years (94) (35.7%). A total of 147 (55.9%) of the injuries were of ASIA (American Spinal Injury Association) A. There was a significant association between sex difference and mechanism of injury (P = 0.001). The prevalence rate was 31.8%. Spinal injuries in SouthEastern Nigeria occurred mostly in young adult males affecting mainly the thoracic spine. Road traffic-related incidents were the leading mechanism.