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Citation
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Bandyopadhyay S, Kawka M, Marks K, Richards GC, Taylor EH, Sravanam S, Petrinic T, Thango N, Figaji A, Peter N, Lakhoo K. World Neurosurg. 2021; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: The burden of paediatric traumatic brain injury (pTBI) in low-and-middle-income countries (LMICs) is unknown. To fill this gap, we conducted a review that aimed to characterise the causes of pTBI in LMICs, and their reported associated mortality and morbidity.
METHODS: A systematic review was conducted. MEDLINE, EMBASE, Global Health, and Global Index Medicus were searched from January 2000 to May 2020. Observational or experimental studies on pTBI of individuals aged between 0 and 16 years in LMICs were included. The causes of pTBI and morbidity data were descriptively analysed, and case fatality rates were calculated. PROSPERO ID: CRD42020171276.
RESULTS: 136 studies were included. 57 studies were at high risk of bias. Of the remaining studies, there were reported 170224 cases of pTBI in 32 LMICs. The odds of having a pTBI was 1.8 times higher (95% CI: 1.6, 2.0) in males. The odds of a pTBI being mild was 4.4 times higher (95% CI: 1.9, 6.8) than a pTBI being moderate or severe. Road traffic accidents were the most common cause (n = 16275/41979, 39%) of pTBIs. On discharge, 24% of patients (n = 4385/17930) had a reduction in their normal mental or physical function. The median case fatality rate was 7.3 (IQR: 2.1 to 7.7).
CONCLUSIONS: Less than a quarter (n= 32) of all LMICs have published high quality data on the volume and burden of pTBI. From the limited data available, young male children are at a high-risk of pTBIs in LMICs, particularly following road traffic accidents.
Language: en |