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

Background  Injury is a major global health problem, causing >۵ ۸۰۰ ۰۰۰ deaths annually and widespread disability largely attributable to neurotrauma. ۸۹% 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 ۱۹۹۱ 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 ۱۵ LMICs with ۱۶ 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.

Keywords:

Global Neurosurgery , Traumatic Brain Injury , Surveillance , Neurotrauma , Trauma Registry , Health Systems