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埃塞俄比亚创伤性脑损伤的流行病学:患病率、机制及结局的系统评价与荟萃分析

Epidemiology of Traumatic brain injury in Ethiopia: A systematic review and meta-analysis of prevalence, mechanisms, and outcomes.

作者信息

Molla Yohannis Derbew, Alemu Hirut Tesfahun

机构信息

Department of Surgery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

PLoS One. 2025 May 30;20(5):e0322641. doi: 10.1371/journal.pone.0322641. eCollection 2025.

Abstract

INTRODUCTION

Traumatic brain injury (TBI) is a major cause morbidity and mortality globally. In Ethiopia, the prevalence of TBI is high, driven by factors such as road traffic incidents (RTIs), assaults, and falls. However, comprehensive data regarding the epidemiology, causes, severity, and outcomes of TBI in Ethiopia remain limited. This scarcity hinders the formulation of evidence-based interventions and policies that are specifically tailored to this context. Therefore, this systematic review and meta-analysis was conducted to provide pooled estimates on the prevalence, causes, severity, complications, and outcomes associated with TBI.

METHOD

A comprehensive review of existing literature was carried out by searching through PubMed, Scopus, Web of Science and EMBASE to gather studies published until September 2024. The inclusion criteria were centered on studies that discussed the frequency, causes, risk factors and results of brain injury, in Ethiopia. The quality of the studies included in the review was evaluated using the Joanna Briggs Institute (JBI) critical appraisal checklist. We utilized Stata 17 statistical software for analysis. To address the heterogeneity observed among the studies, random-effects models were employed.

RESULTS

The pooled prevalence of TBI among patients presented with trauma was approximately 30.5%. The average age of the patients was 27.48 ± 2.047 years. The main causes for TBI were assaults 36% (CI: 0.28-0.44) road traffic incidents 35% (CI: 0.28-0.41) and falls 21% (CI: 0.15-0.27). Mild TBI made up 57% while moderate and severe TBI accounted for 25% and 18%, respectively. Complications, such as post-traumatic seizures and infections, were reported in 17% of cases. Additionally, the overall mortality rate was 12%. However, significant variability was observed among studies.

CONCLUSION

The meta-analysis underscores the impact of TBI, in Ethiopia with high mortality rates and associated challenges. The results underscore the pressing requirement for measures to decrease TBIs linked to accidents and violence while also enhancing emergency services access and strengthening neurosurgeons capabilities, in Ethiopian medical facilities.

摘要

引言

创伤性脑损伤(TBI)是全球发病和死亡的主要原因。在埃塞俄比亚,由于道路交通事故(RTIs)、袭击和跌倒等因素,TBI的患病率很高。然而,关于埃塞俄比亚TBI的流行病学、病因、严重程度和结局的综合数据仍然有限。这种数据匮乏阻碍了制定针对该背景的循证干预措施和政策。因此,进行了这项系统评价和荟萃分析,以提供与TBI相关的患病率、病因、严重程度、并发症和结局的汇总估计。

方法

通过检索PubMed、Scopus、科学网和EMBASE对现有文献进行全面回顾,以收集截至2024年9月发表的研究。纳入标准集中在讨论埃塞俄比亚脑损伤的频率、病因、危险因素和结果的研究。使用乔安娜·布里格斯研究所(JBI)批判性评价清单评估纳入综述的研究质量。我们使用Stata 17统计软件进行分析。为了解决研究中观察到的异质性,采用了随机效应模型。

结果

创伤患者中TBI的汇总患病率约为30.5%。患者的平均年龄为27.48±2.047岁。TBI的主要原因是袭击占36%(CI:0.28 - 0.44)、道路交通事故占35%(CI:0.28 - 0.41)和跌倒占21%(CI:0.15 - 0.27)。轻度TBI占57%,而中度和重度TBI分别占25%和18%。17%的病例报告了并发症,如创伤后癫痫发作和感染。此外,总体死亡率为12%。然而,研究之间观察到显著差异。

结论

荟萃分析强调了埃塞俄比亚TBI的影响,其死亡率高且存在相关挑战。结果强调迫切需要采取措施减少与事故和暴力相关的TBI,同时在埃塞俄比亚医疗设施中增加紧急服务的可及性并加强神经外科医生的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0bc/12124570/f6516dd7e89f/pone.0322641.g001.jpg

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