A one-year prospective study on the occurrence of traumatic spinal cord injury and clinical complications during hospitalisation in North-East Tanzania

African Health Sciences, 2021 · DOI: https://dx.doi.org/10.4314/ahs.v21i2.39 · Published: June 1, 2021

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

This study investigated traumatic spinal cord injuries (TSCI) and related health issues in a Tanzanian hospital. Over a year, they tracked patients with TSCI, noting problems like pain, spasms, and infections that complicated their care. The findings highlight that TSCI is relatively common in the area and that in-hospital complications are frequent and can hinder rehabilitation efforts.

Study Duration

1 Year

Participants

87 persons with traumatic spinal cord injury

Evidence Level

Prospective study

Key Findings

1
The annual incidence rate of traumatic spinal cord injury in the Kilimanjaro region was found to be at least 38 cases per million population.
2
Spasms (47.1%), neuropathic pain (46%), and constipation (40.2%) were identified as the most commonly reported complications during hospitalization.
3
Pressure ulcers (PUs) had a prevalence of 37.9%, with the calcaneus (heel bone) being the most common site of occurrence.

Research Summary

This study describes the occurrence of TSCI and prevailing complications during hospitalization in one rural area of Tanzania. The incidence of traumatic spinal cord injury in the Kilimanjaro region is relatively high and in-hospital complications are prevalent and are worth addressing for successful rehabilitation. SCI-related complications were identified by clinical observation (PUs), patient reports (spasms and neuropathic pain), and laboratory or radiological confirmations (respiratory infection, UTI, and deep venous thrombosis).

Practical Implications

Trauma Prevention Strategies

Identification of factors associated with falls and road traffic accidents such as alcohol consumption prior to the incident, environmental and occupational hazards is a pre-requisite to prevention of TSCI.

Community-Based Evacuation and Transportation

There ought to be a development of community-based evacuation and transportation service for injured persons as well as up-to-date trauma registries in these settings in order to obtain more conclusive statistics with fewer missing cases.

Early and Appropriate Pain Management

It is strongly recommended that pain should be managed appropriately as early as possible to minimize the risk of chronicity.

Study Limitations

1
Hospital-based study may underestimate TSCI magnitude due to patients dying before reaching the hospital.
2
Possibility of injured persons staying at home and self-medicating or seeking alternative traditional treatments, leading to underestimation.
3
Common shortfalls in most epidemiological studies from low-income countries.

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