Soham Bandyopadhyay1, Michal Kawka2, Katya Marks3, Georgia C Richards4, Elliott H Taylor5, Sanskrithi Sravanam6, Tatjana Petrinic7, Nqobile Thango8, Anthony Figaji8, Noel Peter9, Kokila Lakhoo9. 1. Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom. Electronic address: Soham.bandyopadhyay@yahoo.co.uk. 2. Department of Medicine, Imperial College London, London, United Kingdom. 3. Oxford Medical School, University of Oxford, Oxford, United Kingdom. 4. Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom. 5. Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom; Global Surgery Division, University of Cape Town, Cape Town, South Africa. 6. Department of Medicine, University of Cambridge, Cambridge, United Kingdom. 7. Bodleian Libraries, University of Oxford, Oxford, United Kingdom. 8. Division of Neurosurgery, Neuroscience Institute, University of Cape Town, Red Cross Children's Hospital, Rondebosch, Cape Town, South Africa. 9. Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom.
Abstract
BACKGROUND: The burden of pediatric traumatic brain injury (pTBI) in low- and middle-income countries (LMICs) is unknown. To fill this gap, we conducted a review that aimed to characterize the causes of pTBI in LMICs, and their reported associated mortality and morbidity. METHODS: A systematic review was conducted. MEDLINE, Embase, Global Health, and Global Index Medicus were searched from January 2000 to May 2020. Observational or experimental studies on pTBI of individuals aged between 0 and 16 years in LMICs were included. The causes of pTBI and morbidity data were descriptively analyzed, and case fatality rates were calculated. PROSPERO ID: CRD42020171276. RESULTS: A total of 136 studies were included. Fifty-seven studies were at high risk of bias. Of the remaining studies, 170,224 cases of pTBI were reported in 32 LMICs. The odds of having a pTBI were 1.8 times higher (95% confidence interval, 1.6-2.0) in males. The odds of a pTBI being mild were 4.4 times higher (95% confidence interval, 1.9-6.8) than a pTBI being moderate or severe. Road traffic accidents were the most common cause (n = 16,275/41,979; 39%) of pTBIs. On discharge, 24% of patients (n = 4385/17,930) had a reduction in their normal mental or physical function. The median case fatality rate was 7.3 (interquartile range, 2.1-7.7). CONCLUSIONS: Less than a quarter (n = 32) of all LMICs have published high-quality data on the volume and burden of pTBI. From the limited data available, young male children are at a high risk of pTBIs in LMICs, particularly after road traffic accidents.
BACKGROUND: The burden of pediatric traumatic brain injury (pTBI) in low- and middle-income countries (LMICs) is unknown. To fill this gap, we conducted a review that aimed to characterize the causes of pTBI in LMICs, and their reported associated mortality and morbidity. METHODS: A systematic review was conducted. MEDLINE, Embase, Global Health, and Global Index Medicus were searched from January 2000 to May 2020. Observational or experimental studies on pTBI of individuals aged between 0 and 16 years in LMICs were included. The causes of pTBI and morbidity data were descriptively analyzed, and case fatality rates were calculated. PROSPERO ID: CRD42020171276. RESULTS: A total of 136 studies were included. Fifty-seven studies were at high risk of bias. Of the remaining studies, 170,224 cases of pTBI were reported in 32 LMICs. The odds of having a pTBI were 1.8 times higher (95% confidence interval, 1.6-2.0) in males. The odds of a pTBI being mild were 4.4 times higher (95% confidence interval, 1.9-6.8) than a pTBI being moderate or severe. Road traffic accidents were the most common cause (n = 16,275/41,979; 39%) of pTBIs. On discharge, 24% of patients (n = 4385/17,930) had a reduction in their normal mental or physical function. The median case fatality rate was 7.3 (interquartile range, 2.1-7.7). CONCLUSIONS: Less than a quarter (n = 32) of all LMICs have published high-quality data on the volume and burden of pTBI. From the limited data available, young male children are at a high risk of pTBIs in LMICs, particularly after road traffic accidents.
Authors: Clara Ballerini; Alfred K Njamnshi; Sharon L Juliano; Rajesh N Kalaria; Roberto Furlan; Rufus O Akinyemi Journal: Front Immunol Date: 2022-06-13 Impact factor: 8.786