Khan A, Prince M, Brayne C, Prina A M
Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, United Kingdom.
King's College London, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, De Crespigny Park, London, SE5 8AF, United Kingdom.
PLoS One. 2015 Jul 6;10(7):e0132229. doi: 10.1371/journal.pone.0132229. eCollection 2015.
Traumatic brain injury (TBI) is a growing public health problem around the world, yet there is little information on the prevalence of head injury in low and middle income countries (LMICs). We utilised data collected by the 10/66 research group to investigate the lifetime prevalence of head injury in defined sites in low and middle income countries, its risk factors and its relationship with disability.
We analysed data from one-phase cross-sectional surveys of all residents aged 65 years and older (n = 16430) distributed across twelve sites in eight low and middle income countries (China, Cuba, Dominican Republic, India, Venezuela, Mexico, Peru, and Puerto Rico). Self-reported cases of head injury with loss of consciousness were identified during the interview. A sensitivity analysis including data provided by informants of people with dementia was also used to estimate the impact of this information on the estimates. Prevalence ratios (PR) from Poisson regressions were used to identify associated risk factors.
The standardised lifetime prevalence of TBI ranged from 0.3% in China to 14.6% in rural Mexico and Venezuela. Being male (PR: 1.6, 95% CI: 1.29-1.82), younger (PR: 0.95, 95% CI: 0.92-0.99), with lower education (PR 0.91, 95% CI: 0.86-0.96), and having fewer assets (PR 0.92, 95% CI: 0.88-0.96), was associated with a higher prevalence of TBI when pooling estimates across sites.
Our analysis revealed that the prevalence of TBI in LMICs is similar to that of developed nations. Considering the growing impact of TBI on health resources in these countries, there is an urgent need for further research.
创伤性脑损伤（TBI）是全球范围内日益严重的公共卫生问题，但关于低收入和中等收入国家（LMICs）头部损伤患病率的信息却很少。我们利用10/66研究小组收集的数据，调查低收入和中等收入国家特定地区头部损伤的终生患病率、危险因素及其与残疾的关系。
我们分析了来自八个低收入和中等收入国家（中国、古巴、多米尼加共和国、印度、委内瑞拉、墨西哥、秘鲁和波多黎各）12个地点的所有65岁及以上居民（n = 16430）的一阶段横断面调查数据。在访谈过程中确定了自我报告的伴有意识丧失的头部损伤病例。还进行了一项敏感性分析，纳入了痴呆症患者 informant 提供的数据，以评估这些信息对估计值的影响。采用泊松回归的患病率比（PR）来确定相关危险因素。
TBI的标准化终生患病率在中国为0.3%，在墨西哥农村和委内瑞拉为14.6%。汇总各地点的估计值后发现，男性（PR：1.6，95% CI：1.29 - 1.82）、较年轻（PR：0.95，95% CI：0.92 - 0.99）、教育程度较低（PR 0.91，95% CI：0.86 - 0.96）以及资产较少（PR 0.92，95% CI：0.88 - 0.9^）与TBI的较高患病率相关。
我们的分析表明，低收入和中等收入国家TBI的患病率与发达国家相似。考虑到TBI对这些国家卫生资源的影响日益增大，迫切需要进一步研究。
