Moshi Haleluya, Sundelin Gunnevi, Sahlen Klas-Göran, Sörlin Ann
a Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden.
b Faculty of Rehabilitation Medicine, Physiotherapy Department , Kilimanjaro Christian Medical University College , Moshi , Tanzania.
Glob Health Action. 2017;10(1):1355604. doi: 10.1080/16549716.2017.1355604.
Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania.
To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting.
Records for patients with traumatic spinal cord injury for five consecutive years (2010-2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients' condition on discharge were recorded and analyzed descriptively.
The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most documented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%.
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. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.
创伤性脊髓损伤的原因、严重程度和后果在很大程度上取决于特定地区的地理环境、基础设施、社会经济和文化活动。关于非洲农村地区，特别是坦桑尼亚创伤性脊髓损伤情况的文献匮乏，而这些文献对于预防和康复这种健康状况至关重要。
描述创伤性脊髓损伤的发病率、病因和临床结果，以及在不发达地区进行回顾性研究的相关问题。
回顾性收集了乞力马扎罗基督教医疗中心连续五年（2010 - 2014年）创伤性脊髓损伤患者的记录，这些记录来自入院病房和健康记录档案。记录并描述性分析了社会人口统计学信息、病因、并发症以及患者出院时的状况。
病房的入院登记簿记录了2010年1月至2014年12月期间288例新的创伤性脊髓损伤病例。在登记簿记录的288例病例中，男性224例，女性64例，平均年龄39.1（39.1 ± 16.3）岁，其中大多数196例（68.1%）年龄在16至45岁之间。对医院档案的检索提供了213份完整的患者记录，其中损伤的主要原因是跌倒104例（48.8%），其次是道路交通事故73例（34.3%）。颈椎81例（39.9%）和腰椎71例（34.74%）脊髓节段受影响最为严重。乞力马扎罗地区（人口1,640,087）的年发病率估计超过每百万人口26人。记录最多的并发症是压疮42例（19.7%）、呼吸并发症32例（15.0%）和多种并发症28例（13.1%）。平均住院时间为64.2 ± 54.3天，死亡率为24.4%。
在坦桑尼亚东北部预防创伤性脊髓损伤应将跌倒（特别是从高处跌落）视为主要原因，目标人群为青少年男性和青年男性。应解决压疮、呼吸并发症、院内死亡率以及轮椅供应等问题。
