Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries

Document Type : Review Article

Authors

1 Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA

2 Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA

3 Technical University of Munich, Munich, Germany

4 Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA

5 School of Medicine, University of Glasgow, Glasgow, UK

6 Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA

Abstract

Background 
Injury is a major global health problem, causing >5 800 000 deaths annually and widespread disability largely attributable to neurotrauma. 89% of trauma deaths occur in low- and middle-income countries (LMICs), however data on neurotrauma epidemiology in LMICs is lacking. In order to support neurotrauma surveillance efforts, we present a review and analysis of data dictionaries from national registries in LMICs.

Methods 
We performed a scoping review to identify existing national trauma registries for all LMICs. Inclusion/exclusion criteria included articles published since 1991 describing national registry neurotrauma data capture methods in LMICs. Data sources included PubMed and Google Scholar using the terms “trauma/neurotrauma registry” and country name. Resulting registries were analyzed for neurotrauma-specific data dictionaries. These findings were augmented by data from direct contact of neurotrauma organizations, health ministries, and key informants from a convenience sample. These data were then compared to the World Health Organization (WHO) minimum dataset for injury (MDI) from the international registry for trauma and emergency care (IRTEC).

Results 
We identified 15 LMICs with 16 total national trauma registries tracking neurotrauma-specific data elements. Among these, Cameroon had the highest concordance with the MDI, followed by Colombia, Iran, Myanmar and Thailand. The MDI elements least often found in the data dictionaries included helmet use, and alcohol level. Data dictionaries differed significantly among LMICs. Common elements included Glasgow Coma Score, mechanism of injury, anatomical site of injury and injury severity scores. Limitations included low response rate in direct contact methods.

Conclusion 
Significant heterogeneity was observed between the neurotrauma data dictionaries, as well as a spectrum of concordance or discordance with the MDI. Findings offer a contextually relevant menu of possible neurotrauma data elements that LMICs can consider tracking nationally to enhance neurotrauma surveillance and care systems. Standardization of nationwide neurotrauma data collection can facilitate international comparisons and bidirectional learning among healthcare governments.

Highlights

 

Commentaries Published on this Paper

 

  • Neurotrauma Registries in Low- and Middle-Income Countries for Building Organized Neurotrauma Care: The LATINO Registry Experience; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

        Abstract | PDF

 

  • Global Neurotrauma Surveillance: Are National Databases Overrated?; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

        Abstract | PDF

 

  • Towards Improved Organizational Governance of Neurotrauma Surveillance; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

        Abstract | PDF

 

  • The Role of Registries in Neurotrauma Research: Translating Data Into Health Policy That Enhances Patient Care; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

        Abstract | PDF

 

  • National Trauma Registries in LMICs: Long-Overdue Priority; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

        Abstract | PDF

 

  • National Neurotrauma Registry Data in Low- and Middle-Income Countries – Current Status and Future Requirements; Comment on “Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries”

        Abstract | PDF

 

Authors' Response to the Commentaries

 

  • Advancing Global Neurotrauma Surveillance Through National Registries: A Response to Recent Commentaries

        Abstract | PDF

 

Keywords

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International Journal of Health Policy and Management
Volume 11, Issue 11
November 2022
Pages 2373-2380

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History

  • Receive Date: 08 March 2021
  • Revise Date: 10 November 2021
  • Accept Date: 05 December 2021
  • First Publish Date: 06 December 2021

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