The characteristics of cervical spinal cord trauma at a North Tanzanian Referral Hospital: a retrospective hospital based study

Abstract

Introduction Surviving a traumatic cervical Spinal Cord Injury (SCI) has an immense effect on an individual's physical function and independence. It also predisposes them to financial, social, psychological and several medical complications throughout their life. In high-income countries, improved multidisciplinary care has led to better long term outcomes, however in low-income countries, the burden of the condition and its associated mortality remain high. The aim of this study was to illustrate the sociodemographic and clinical characteristics of cervical level Traumatic Spinal Cord Injuries (TSCIs) at Kilimanjaro Christian Medical Centre (KCMC) in northern Tanzania. Methods This was a retrospective hospital-based study of 105 cervical TSCI cases admitted to KCMC from January 2012 to December 2016. Results We included 105 patients in the study cohort, with a male preponderance of 86.7%, giving a male-to-female ratio of 6.5:1. The mean age at injury was 44.1 years. Overall, 65.7% were farmers and 69 patients were from within the Kilimanjaro region. Road Traffic Crashes (RTCs) accounted for 47.6% of the injuries, 17.9% had associated injuries, 38.1% sustained complete TSCIs and 45.7% developed secondary complications during the ward stay. The mortality rate before discharge from hospital care was 35.2%. Conclusion The majority of patients were males from a low socioeconomic background and the most common cause of injury was RTCs. The secondary complication rates and mortality rates before discharge from hospital care are high.

Physical Health Conditions in Persons with Spinal Cord Injury Across 21 Countries Worldwide

“…Few studies have, to our prior knowledge, reported prevalence rates of secondary health conditions in low-and middle-income countries. Some recent studies of people living with SCI in low-and middle-income countries reported lower prevalence rates of secondary health conditions (28,29). Furthermore, a recent systematic review concluded that inequality in income in more developed countries lead to significantly higher odds of secondary outcomes (9).…”

Ox cart accidents as a cause of spinal cord injury in Tanzania

“…However, in the ongoing prospective study a substantial number (between 4 and 11%) of cases results from more uncommon causes. More of these peculiar causes were mentioned in other studies from the same setting [18]. Amongst these statistics is a sub-group of patients with a rather peculiar mode on injury: ox cart accidents.…”

“…Worldwide, two leading causes of TSCIs are road traffic accidents and falls [15]. Literature from North East Tanzania lists fall (especially from trees) and Road Traffic Crashes as the leading causes of TSCI [16][17][18]. However, in the ongoing prospective study a substantial number (between 4 and 11%) of cases results from more uncommon causes.…”

Epidemiological Analysis of 459 Patients Hospitalized With Traumatic Spinal Cord Injury in Suzhou City, China

“…A systematic review published in 2014 showed that the proportion of men with spinal-cord injury is higher than that of women [16] . A survey by Fanuel et al showed that the ratio of male:female with cervical spinal cord trauma on Mount Kilimanjaro in Tanzania, Africa, is 6.5:1 [17] , while that in Japan has remained 3:1 over the past 30 years [3] . A study by Chen et al in China showed that the ratio of male:female with TSCI is 3.4:1 in the Guangdong Province [19] .…”