Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

GLOBAL HEALTH ACTION, 2017 · DOI: https://doi.org/10.1080/16549716.2017.1355604 · Published: January 1, 2017

Spinal Cord Injury Rehabilitation Public Health

Simple Explanation

Traumatic spinal cord injury (TSCI) is a sudden forceful damage to the spinal nerves resulting in temporary or permanent paralysis, bladder and bowel dysfunction and autonomic imbalance among other consequences. A person with spinal cord injury is at immediate risk of respiratory and cardiac failure which may lead to death in the acute phase. Those who survive the acute phase, faces a lifelong risk of secondary complications such as pressure ulcers, urinary tract infections, deep venous thrombosis, contractures, chronic pain and spasms.

Study Duration

5 years (2010-2014)

Participants

288 patients registered with traumatic spinal cord injury

Evidence Level

Not specified

Key Findings

1
Falls (particularly from height) were the leading cause of TSCI followed by road traffic accidents.
2
Male teenagers and young adults aged between 16 and 45 years were the most affected.
3
In hospital mortality was 24.4% and the commonest comorbidities were pressure ulcers and respiratory complications.

Research Summary

This is the first study on magnitude and clinical outcomes of TSCI in the north-east region of Tanzania. The estimated annual incidence reported in this study (more than 26 persons per million population) is relatively high as compared to the reported globally and in low income countries (23 and 25.5 persons per million population) respectively Falls (especially from height) is the major cause of TSCI in this region, which is also as reported in some parts of India, Estonia, Pakistan, Turkey, Oceania and southern Asia

Practical Implications

Prevention Strategies

Prevention of traumatic spinal cord injury in North-east Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults.

Healthcare Focus

Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.

Further Research

A prospective study that includes admission and follow-up of newly injured persons would provide more conclusive epidemiological data for Kilimanjaro.

Study Limitations

1
Missing cases and patient records leading to statistically inconclusive epidemiological results.
2
Lack of comprehensive data collection on all cases of TSCI admitted in the specified period.
3
Absence of information or inconsistency in the use of internationally recommended patient progress assessment tools for SCI in most of the records.

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