The epidemiology of traumatic brain injuries sustained by children under 10 years of age presenting to a tertiary hospital in Soweto, South Africa

Abstract

Traumatic brain injury (TBI) in the paediatric population is a significant contributor to death and disability worldwide. It is estimated that every year >3 million children are affected by TBI globally. Incidence rates vary between countries, with the lowest rates in northern European countries (Sweden 12 per 100 000) and the highest rate reported from Australia (280 per 100 000). The term TBI encompasses a broad range of injuries to the skull and underlying brain resulting from external forces applied to the head. [1,2] In the paediatric population in sub-Saharan African countries, death and disability from TBI are still superseded by infectious disease. [3] Mechanisms of injury differ by region and are affected by socioeconomic factors, but in general, falls, road traffic collisions (RTCs), being 'struck by/against objects' and assault/nonaccidental injury (NAI) are responsible for the majority of cases. [1,[4][5][6][7][8] Severe TBI can result in long-term disability, placing a significant burden on families, caregivers and the healthcare system. [5,6] Children have the added impact of long-term sequelae from injuring the developing brain, with recent recognition that even mild TBI can cause persistent neurocognitive and behavioural alterations. [9][10][11] Epidemiological studies investigating injury patterns, risk factors and resource use for paediatric TBI have been conducted throughout the world. [3,5,12,13] In South Africa (SA), where a high rate of traumatic injury is well documented, children have received little attention compared with their adult counterparts. [14,15] There have only been a few SA hospital-based studies examining paediatric TBI, hence the motivation for the present study. [4,14,16] Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, Gauteng Province, is a tertiary-level institution serving an area of 200 km 2 inhabited by 1.7 million people, of whom 25.7% are children aged <14 years. [17] The Department of Paediatric Surgery at CHBAH addresses the general surgical needs of all children admitted up to 10 years of age. This age cut-off was arbitrarily set in the 1990s owing to staffing and resource constraints (Prof. K Lakhoo, personal communication, 8 October 2020). Paediatric trauma admissions are This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Etiological factors and patterns of maxillofacial trauma among school-going children: A cross-sectional study at Khyber College of Dentistry, Peshawar

“…Orbital fractures are more prevalent in adolescent and young adult males with the mean age being 32 years for adult males and 12.5 years for children, primarily affecting the boys. Besides sports-related injuries, motor vehicle collisions, assaults, and occupational injuries are the primary causes of orbital fractures [14]. Resultantly, one of the primary purposes of the current research was to establish the factors that contribute to the development of maxillofacial trauma in school-aged children.…”

Clinical balance assessment tools for children with hearing loss: A scoping review

“…Falls are the most common cause of hospitalizations (30%) and 15% visits to the emergency department in children (14). In a low-middle income country like South African, falls were the found to be the second cause of unintentional injury to children (15).…”