Mechanism of Pediatric Traumatic Brain Injury in Southwestern Uganda: a Prospective Cohort of 100 patients

Abstract

Background: RTIs, falls and violence contribute to more than two thirds of pediatric TBIs in SSA. In this study, we sought to assess mechanisms of pediatric TBI in an effort to propose interventions for more effective pediatric head injury prevention. Methods: A cohort of 100 patients who were <18 years treated at MRRH between November 2016 and June 2017 were enrolled in the study. Information on etiology of injury was obtained via a questionnaire administered to patient caretakers at the time of admission. Results: The mean age was found to be 7.5 years (SD 5.2) and 38% were female. In our sample, 61% had CT imaging done, of which 88.5% had a positive finding. A majority of patients presented with a mild head injury (55%). RTIs were the predominant mechanism of injury across age groups 14 (75%). Across all age groups, falls were responsible for a greater proportion of injuries in children aged 10-14 years (13.3%), while the highest proportion of intentional injuries was reported in age group 10-14 and 15-17 years, 20% and 31.3%, respectively. Patients involved in pedestrian RTIs were significantly younger compared to those injured in non-pedestrian RTIs. Most parents (87.9%) were not with their children at the time of a pedestrian RTI. Conclusion: In Southwestern Uganda, the majority of pediatric neurotrauma patients are injured pedestrians, with no adult supervision at the time of the injury. Conducting a public awareness and education campaign on the necessity of child supervision is critical to decreasing pediatric head injuries in Uganda.