A prospective registry evaluating the epidemiology and clinical care of traumatic brain injury patients presenting to a regional referral hospital in Moshi, Tanzania: challenges and the way forward

Staton, Catherine A.; Msilanga, Daniel; Kiwango, George; Vissoci, João Ricardo Nickenig; Andrade, Luciano de; Lester, Rebecca; Hocker, M.; Gerardo, Charles J.; Mvungi, Mark

doi:10.1080/17457300.2015.1061562

Cited by 74 publications

(103 citation statements)

References 28 publications

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“…Only 35% of all RTIs from this police data set were associated with motorcycle use. This is somewhat lower than local hospital-based data which demonstrates that 49% of road traffic crash victims who present for care of a traumatic brain injury were on a motorcycle 17 . This discrepancy may be due to underreporting of RTIs involving motorcycles, as motorcycle crashes have been shown to be subject to underreporting bias 28,29 .…”

Section: Discussionmentioning

confidence: 62%

“…This increase in road traffic has presumably led to an increase in RTCs and RTIs. In one recent study, approximately two-thirds of traumatic brain injuries presenting for care at the local hospital were from RTIs 17 . In order to design effective strategies to reduce morbidity and mortality from RTIs in cities like Moshi across the developing world, more data is needed regarding regional epidemiology, underlying causative factors, and socioeconomic burdens of RTCs in these settings.…”

Section: Introductionmentioning

confidence: 99%

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The epidemiology and hotspots of road traffic injuries in Moshi, Tanzania: An observational study

Reardon

Andrade

Hertz

et al. 2017

Injury

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Road traffic injuries (RTIs) continue to increase with the proliferation of motor vehicles, especially in low-income countries where safe road infrastructure is lacking Knowing where and why RTIs occur would allow for increased safety and prevention planning. In this study, police records of 300 motor vehicle collisions which occurred between February 2013 and January 2014 in Moshi, Tanzania, were reviewed. Analysis of variables including victim age, gender, type of collision, conditions, and use of safety equipment were analyzed. Geographic information system (GIS) analysis was performed to identify areas with the most collisions. Most injuries occurred at four intersections on two main corridor. Car crashes represented 48% of reports while motorcycle collisions were 35% of reports. Victims were predominantly male. The majority (64%) of RTI victims in cars used seatbelts while only 43% of motorcyclists wore helmets; none of those who used the helmet or seatbelt suffered a grievous injury. These data demonstrate that RTIs in Moshi occur in predictable high traffic locations. RTIs injure victims of all backgrounds and safety equipment is not universally utilized. More investment is needed in improved data collection methods, and a greater emphasis on intersection safety is needed to reduce these preventable injuries.

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Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

The epidemiology and hotspots of road traffic injuries in Moshi, Tanzania: An observational study

Reardon

Andrade

Hertz

et al. 2017

Injury

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“…In Moshi, Tanzania, a smaller city than Mwanza, among prospectively enrolled severe TBI patients the mortality was 47.0%, however, there is no trained neurosurgeon at Moshi. 27 In a retrospective chart study from Uganda, the mortality was 25.8%. 28 The 2-week mortality in the recent BEST-TRIP trial conducted in South America was 21–30% and at 6-months 40% in severe TBI patients.…”

Section: Discussionmentioning

confidence: 99%

Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines

et al. 2017

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Background Severe traumatic brain injury (TBI) is a major cause of death and disability worldwide. However, prospective TBI data from sub-Saharan Africa are sparse. This study examines the epidemiology, and explores management of severe TBI patients and adherence to the Brain Trauma Foundation (BTF) Guidelines at a tertiary care referral hospital in Tanzania. Methods Patients with severe TBI hospitalized at Bugando Medical Centre, Mwanza, Tanzania, were recorded in a prospective registry. Epidemiological, clinical, treatment and outcome data were recorded. Results Between September 2013 and October 2015, 371 patients with TBI were admitted. 33% (115/371) had severe TBI. Mean age was 32.0±20.1 years, and the majority were male (80.0%). Vehicular injuries were the most common cause of injury (65.2%). Half of the patients (47.8%) were hospitalized on the same day as their injury. Only 49.6% underwent computed tomography (CT) of the brain, and 58.3% were admitted to the intensive care unit (ICU). Continuous arterial blood pressure (cABP) monitoring and intracranial pressure (ICP) monitoring were not performed on any patient. 38.3% of patients with severe TBI received hyperosmolar therapy and 35.7% underwent craniotomy. Two-week mortality was 34.8%. Conclusion Mortality of patients with severe TBI at Bugando Medical Center, Tanzania, is approximately twice that in high-income countries. ICU care, CT imaging, cABP and ICP monitoring are underutilized or unavailable in the tertiary referral hospital setting. Improving outcomes after severe TBI will require concerted investment in pre-hospital care as well as improvement in availability of ICU resources, CT imaging and expertise in multidisciplinary care.

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“…(Michaels et al, 2000) In the sam e study, 42% of patients reported symptoms suffering from a severe TBI (GCS < 9) and 75% from a mild TBI (GCS > 13 (Staton et al, 2017).…”

Section: Mental Healthmentioning

confidence: 99%

“…Injuries like severe burns can suffering from a severe TBI (GCS < 9) and 75% from a mild TBI (GCS > 13 (Staton et al, 2017).…”

Section: Painmentioning

confidence: 99%

Post-hospital Care for People Recovering from Acute Injuries in Low and Middle Income Countries: 5 Domains of Health Management

Toomey¹,

El-Gabri²,

Vissoci³

et al. 2017

GeS

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Injury is a leading cause of death and disability globally. After an acute hospitalizatio n for an injury, a care transition model has been shown to reduce mortality and morbidity but these are uncommon in a low and middle income setting. When planning a post hospitalization care plan, many health management factors shoul d be taken into account as they can impact outcome. This manuscript delineates a 5 Domains of Healthcare Management or '5 Domains' which sho uld be addressed in this care transition model. The literature behind each of these domains and their impact on post hospitalizatio n outco mes along with a case study of a care transition plan for a low income country is described.Keywords: Transitio n of Care, Global Health, Injury, Health Outcomes, Low and Middle Income Countries Funding: Dr. Staton would like to acknowledge salary support funding from the Fogarty Internatio nal Center (Staton, K01 TW010000 -01A1). Figure 1). Each of these domains will be assessed at individual, institutional, community and culture levels in conjunction with the model propo sed. Functioning, but they also had better scores Rev i sta El etr ôn ic a Ge st ão & PHYSICAL FUNCTION MENTAL HEALTHA myriad of reaso ns including changes in physical and social functioning, and chronic pain can lead to mental health concerns which are very common following an injury. PAINApart from the initial pain tha t occurs during an injury or trauma, long -term pain as a direct result of injury is a majo r concern. Injuries like severe burns can suffering from a severe TBI (GCS < 9) and 75% from a mild TBI (GCS > 13 (Staton et al., 2017). COMORBIDITIESv. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7v. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7 MENTAL H E A L T HWe Currently, this project is been piloted in Brazil with a TBI po pulation. SUBSTANCE USEData was collected fo r two separate cohorts of injury patients and traumatic brain injury This intervention will be applicable for alcohol but we ho pe to adopt it for use fo r other substances as well. PAINOf the trauma patients we have followed up with so far, 14% hav e persistent pain. Medley, A., Seth, P., Pathak, S., Howard, A. A., DeLuca, N., Matiko, E., . . . Makyao, N. (2014). Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania, Kenya, and Namibia. AID S care, 26(10), 1288 -1297. Rev i sta El etr ôn ic a Ge st ão & Soc ied ad ev. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7 Rev i sta El etr ôn ic a Ge st ão & Soc ied ad ev. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7 Rev i sta El etr ôn ic a Ge st ão & Soc ied ad ev. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7

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A prospective registry evaluating the epidemiology and clinical care of traumatic brain injury patients presenting to a regional referral hospital in Moshi, Tanzania: challenges and the way forward

Cited by 74 publications

References 28 publications

The epidemiology and hotspots of road traffic injuries in Moshi, Tanzania: An observational study

The epidemiology and hotspots of road traffic injuries in Moshi, Tanzania: An observational study

Severe Traumatic Brain Injury at a Tertiary Referral Center in Tanzania: Epidemiology and Adherence to Brain Trauma Foundation Guidelines

Post-hospital Care for People Recovering from Acute Injuries in Low and Middle Income Countries: 5 Domains of Health Management

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