Traumatic paraplegia in Zaria, Nigeria: the case for a centre for injuries of the spine

Abstract

the period June 19 7 3 to June 1982. The records are unfortunately incomplete. All but three of the patients were treated conservatively. The mean hospital stay was 3 months. Facilities for adequate management including rehabilitation were lacking. Twelve patients (25 per cent) died within 10 weeks of admission, 30 developed bed sores and all had urinary tract infection beginning whilst in hospital. Wheelchairs could not be provided by the hospital for those who did not recover motor function and most of the patients could not afford to buy them. Most of the patients treated earlier in the series were lost to follow up. In the last 12 months of the period under review, 15 patients were treated using much the same facilities as existed in previous years. There was no hospital mortality during this period, and although urinary tract infection could not be prevented, only two of the patients (13 per cent) developed bed sores. It is suggested that the establishment of a Centre for Injuries of the Spine, with the direct involvement of the Government through the Ministry of Social Welfare, in the management of these patients will definitely improve the overall results.

A follow-up study of patients with spinal cord injury in Sierra Leone

“…One study had an impressive 97% loss to follow-up of discharged patients [8]. Hospital mortality was around 25% for three studies [3,4,13], as low as 10% in one study [9], and as high as 34.4% in another [8]. All authors seemed in agreement that by far the major cause of death was septiceamia secondary to infected pressure sores or urosepsis.…”

“…Other series report data from the period in hospital but not from the post-discharge period [3,4,[8][9][10]13]. The 29.2% hospital mortality in this series is in line with other studies from the region [3,4,13] and approximately three times higher than in the series from Brazil, a much more affluent developing country [1]. Four patients were lost to follow-up because they came from remote rural areas or refugee camps.…”

The health condition of spinal cord injuries in two Afghan towns

“…Long hospitalisation is found in India, 75 days, 11 Croatia, 160 days 17 and Nigeria, 90 days. 18 Major secondary complications of SCI, such as pneumonia, pulmonary emboli and septicaemia, result in early mortality and the more so in the Afghan set-up. Pneumonia is the principal cause of death for persons with SCI above 55 years of age and injury from nonintentional accidents and suicide for those below 55 years of age.…”

“…Appropriate preventive care reduced the prevalence of pressure sores with 13% in Nigeria. 18 Counselling regarding proper nursing technique and hygiene could decrease urinary tract infection incidence with 65% in the US. 20 The Afghan individuals with SCI consider achieving pregnancy as decisive in the satisfaction with sex life.…”

Problems, struggles and some success with spinal cord injury in Zimbabwe

“…About 60% of them had decubitus ulcers and all had urinary tract infections. 5 Of a group of traumatic paraplegics admitted to the National Rehabilitation Centre (in Zimbabwe) between 1988 and 1994 7% demised during the hospitalisation period from septicaemia as a result of decubitus ulcers. (Mortality ®gures from other institutions are unfortunately not available).…”