Pediatric neurotrauma in Kathmandu, Nepal: implications for injury management and control

Mukhida, Karim; Sharma, Mohan Raj; Shilpakar, Sushil Krishna

doi:10.1007/s00381-005-1235-0

Cited by 20 publications

(12 citation statements)

References 49 publications

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“…A study from Nepal found that patients in rural areas took on average 30 h longer to obtain definitive neurosurgical care than their urban counterparts [11]. While the present study could not examine these differences, the limited availability of emergency medical facilities in rural Fiji mean these differences are also likely to exist in Fiji.…”

Section: Discussionmentioning

confidence: 73%

Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

et al. 2012

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Background: Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown. Methods: Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004–2005). Results: In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30–44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by ‘hit by person or object’ and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15–29-year-olds road traffic crashes, and in adults aged 30–44 years or 45 years and older ‘hit by person or object’. Among the two major ethnic groups, Fijians had higher rates of falls and ‘hit by person or object’ and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population. Conclusion: Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30–44 years in this study has not been noted previously. The high case fatality rate prior to admission to the hospital requires urgent attention.

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Section: Discussionmentioning

confidence: 73%

Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

et al. 2012

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“…32,69,70 In contrast, Map 2 also demonstrates a high proportion of paraplegia secondary to high falls in Asia, South (Pakistan, Bangladesh and Nepal) as well as a component of low falls (Bangladesh). [71][72][73] Violence-related TSCI occurs in regions of conflict or high availability of weapons (gunshot wounds and stabbings). 7,46,74 The Maps reveal a band of violence through North and South America into Southern Africa and the Middle East.…”

Section: Discussionmentioning

confidence: 99%

“…In developing countries, low falls resulting in TSCI occur while carrying heavy loads on head in young people. 73,80 TSCI due to crush factors from collapse of ceiling in poorly regulated mining activities is common in many developing countries. 79 Diving into water of unknown depths results in high proportions of tetraplegia in rivers and coastal regions.…”

Section: Discussionmentioning

confidence: 99%

The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate

Lee

Cripps

Fitzharris³

et al. 2013

Spinal Cord

709

458

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“…26 Data from Bangladesh also had high number of falls (63%), out of which 43% of the falls involved falls from trees and 20% while carrying heavy loads. 27 Mukhida 28 provided statistics for people in Nepal under the age of 19, in which 61% of SCI was due to falls (mainly from rooftops as opposed to trees in the rest of the region). Incidence data are inadequate for this region.…”

Section: Asia Southmentioning

confidence: 99%

A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention

et al. 2010

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Study design: Literature review. Objectives: To map traumatic spinal cord injury (TSCI) globally and provide a framework for an ongoing repository of data for prevention. Setting: An initiative of the ISCoS Prevention Committee. Methods: The results obtained from the search of Medline/Embase using search phrases: TSCI incidence, aetiology, prevalence and survival were analysed. Stratification of data into green/yellow/red quality 'zones' allowed comparison between data. Results: Reported global prevalence of TSCI is insufficient (236-1009 per million). Incidence data was comparable only for regions in North America (39 per million), Western Europe (15 per million) and Australia (16 per million). The major cause of TSCI in these regions involves four-wheeled motor vehicles, in contrast to South-east Asia where two-wheeled (and non-standard) road transport predominates. Southern Asia and Oceania have falls from rooftops and trees as the primary cause. Highfall rates are also seen in developed regions with aged populations (Japan/Western Europe). Violence/ self-harm (mainly firearm-related) was higher in North America (15%) than either Western Europe (6%) or Australia (2%). Sub-Saharan Africa has the highest reported violence-related TSCI in the world (38%). Rates are also high in north Africa/Middle East (24%) and Latin America (22%). Developed countries have significantly improved TSCI survival compared with developing countries, particularly for tetraplegia. Developing countries have the highest 1-year mortality rates and in some countries in sub-Saharan Africa the occurrence of a spinal injury is likely to be a fatal condition within a year. Conclusion: Missing prevalence and insufficient incidence data is a recurrent feature of this review. The piecemeal approach to epidemiological reporting of TSCI, particularly failing to include sound regional denominators has exhausted its utility. Minimum data collection standards are required.

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Pediatric neurotrauma in Kathmandu, Nepal: implications for injury management and control

Cited by 20 publications

References 49 publications

Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate

A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention

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