Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda

Paul Bangirana, Bruno Giordani, Olive Kobusingye, Letisia Murungyi, Charles Mock, Chandy John, Richard Idro

Research output: Contribution to journalArticle

Abstract

Background: Traumatic brain injuries in Uganda are on the increase, however little is known about the neuropsychological outcomes in survivors. This study characterized patients with traumatic brain injury (TBI) and the associated six-month neuropsychological outcomes in a Ugandan tertiary hospital. Methods: Patients admitted at Mulago Hospital with head injury from November 2015 to April 2016 were prospectively enrolled during admission and followed up at six months after discharge to assess cognition, posttraumatic stress symptoms (PTSS), depression symptoms and physical disability. The outcomes were compared to a non-head-injury group recruited from among the caretakers, siblings and neighbours of the patients with age and sex entered as covariates. Results: One hundred and seventy-one patients and 145 non-head injury participants were enrolled. The age range for the whole sample was 1 to 69 years with the non-head injury group being older (mean age (SD) 33.34 (13.35) vs 29.34 (14.13) years of age, p = 0.01). Overall, motorcycle crashes (36/171, 38.6%) and being hit by an object (58/171, 33.9%) were the leading causes of TBI. Head injury from falls occurred more frequently in children < 18 years (13.8% vs 2.8%, p = 0.03). In adults 18 years and older, patients had higher rates of neurocognitive impairment (28.4% vs 6.6%, p < 0.0001), PTSS (43.9% vs 7.9%, p < 0.0001), depression symptoms (55.4% vs 10%, p < 0.0001) and physical disability (7.2% vs 0%, p = 0.002). Lower Glasgow Coma Score (GCS) on admission was associated with neurocognitive impairment (11.6 vs 13.1, p = 0.04) and physical disability (10 vs 12.9, p = 0.01) six months later. Conclusion: This first such study in the East-African region shows that depth of coma on admission in TBI is associated with neurocognitive impairment and physical disability.

Original languageEnglish (US)
Article number18
JournalBMC Neurology
Volume19
Issue number1
DOIs
StatePublished - Feb 4 2019
Externally publishedYes

Fingerprint

Uganda
Coma
Craniocerebral Trauma
Wounds and Injuries
Depression
Motorcycles
Tertiary Care Centers
Cognition
Survivors
Siblings
Traumatic Brain Injury

Keywords

  • Anxiety
  • Brain injury
  • Cognition
  • Depression
  • Physical disability
  • Traffic crashes

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Bangirana, P., Giordani, B., Kobusingye, O., Murungyi, L., Mock, C., John, C., & Idro, R. (2019). Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda. BMC Neurology, 19(1), [18]. https://doi.org/10.1186/s12883-019-1246-1

Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda. / Bangirana, Paul; Giordani, Bruno; Kobusingye, Olive; Murungyi, Letisia; Mock, Charles; John, Chandy; Idro, Richard.

In: BMC Neurology, Vol. 19, No. 1, 18, 04.02.2019.

Research output: Contribution to journalArticle

Bangirana, P, Giordani, B, Kobusingye, O, Murungyi, L, Mock, C, John, C & Idro, R 2019, 'Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda', BMC Neurology, vol. 19, no. 1, 18. https://doi.org/10.1186/s12883-019-1246-1
Bangirana, Paul ; Giordani, Bruno ; Kobusingye, Olive ; Murungyi, Letisia ; Mock, Charles ; John, Chandy ; Idro, Richard. / Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda. In: BMC Neurology. 2019 ; Vol. 19, No. 1.
@article{82872c30cfcd49a38e46115a3b34964f,
title = "Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda",
abstract = "Background: Traumatic brain injuries in Uganda are on the increase, however little is known about the neuropsychological outcomes in survivors. This study characterized patients with traumatic brain injury (TBI) and the associated six-month neuropsychological outcomes in a Ugandan tertiary hospital. Methods: Patients admitted at Mulago Hospital with head injury from November 2015 to April 2016 were prospectively enrolled during admission and followed up at six months after discharge to assess cognition, posttraumatic stress symptoms (PTSS), depression symptoms and physical disability. The outcomes were compared to a non-head-injury group recruited from among the caretakers, siblings and neighbours of the patients with age and sex entered as covariates. Results: One hundred and seventy-one patients and 145 non-head injury participants were enrolled. The age range for the whole sample was 1 to 69 years with the non-head injury group being older (mean age (SD) 33.34 (13.35) vs 29.34 (14.13) years of age, p = 0.01). Overall, motorcycle crashes (36/171, 38.6{\%}) and being hit by an object (58/171, 33.9{\%}) were the leading causes of TBI. Head injury from falls occurred more frequently in children < 18 years (13.8{\%} vs 2.8{\%}, p = 0.03). In adults 18 years and older, patients had higher rates of neurocognitive impairment (28.4{\%} vs 6.6{\%}, p < 0.0001), PTSS (43.9{\%} vs 7.9{\%}, p < 0.0001), depression symptoms (55.4{\%} vs 10{\%}, p < 0.0001) and physical disability (7.2{\%} vs 0{\%}, p = 0.002). Lower Glasgow Coma Score (GCS) on admission was associated with neurocognitive impairment (11.6 vs 13.1, p = 0.04) and physical disability (10 vs 12.9, p = 0.01) six months later. Conclusion: This first such study in the East-African region shows that depth of coma on admission in TBI is associated with neurocognitive impairment and physical disability.",
keywords = "Anxiety, Brain injury, Cognition, Depression, Physical disability, Traffic crashes",
author = "Paul Bangirana and Bruno Giordani and Olive Kobusingye and Letisia Murungyi and Charles Mock and Chandy John and Richard Idro",
year = "2019",
month = "2",
day = "4",
doi = "10.1186/s12883-019-1246-1",
language = "English (US)",
volume = "19",
journal = "BMC Neurology",
issn = "1471-2377",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Patterns of traumatic brain injury and six-month neuropsychological outcomes in Uganda

AU - Bangirana, Paul

AU - Giordani, Bruno

AU - Kobusingye, Olive

AU - Murungyi, Letisia

AU - Mock, Charles

AU - John, Chandy

AU - Idro, Richard

PY - 2019/2/4

Y1 - 2019/2/4

N2 - Background: Traumatic brain injuries in Uganda are on the increase, however little is known about the neuropsychological outcomes in survivors. This study characterized patients with traumatic brain injury (TBI) and the associated six-month neuropsychological outcomes in a Ugandan tertiary hospital. Methods: Patients admitted at Mulago Hospital with head injury from November 2015 to April 2016 were prospectively enrolled during admission and followed up at six months after discharge to assess cognition, posttraumatic stress symptoms (PTSS), depression symptoms and physical disability. The outcomes were compared to a non-head-injury group recruited from among the caretakers, siblings and neighbours of the patients with age and sex entered as covariates. Results: One hundred and seventy-one patients and 145 non-head injury participants were enrolled. The age range for the whole sample was 1 to 69 years with the non-head injury group being older (mean age (SD) 33.34 (13.35) vs 29.34 (14.13) years of age, p = 0.01). Overall, motorcycle crashes (36/171, 38.6%) and being hit by an object (58/171, 33.9%) were the leading causes of TBI. Head injury from falls occurred more frequently in children < 18 years (13.8% vs 2.8%, p = 0.03). In adults 18 years and older, patients had higher rates of neurocognitive impairment (28.4% vs 6.6%, p < 0.0001), PTSS (43.9% vs 7.9%, p < 0.0001), depression symptoms (55.4% vs 10%, p < 0.0001) and physical disability (7.2% vs 0%, p = 0.002). Lower Glasgow Coma Score (GCS) on admission was associated with neurocognitive impairment (11.6 vs 13.1, p = 0.04) and physical disability (10 vs 12.9, p = 0.01) six months later. Conclusion: This first such study in the East-African region shows that depth of coma on admission in TBI is associated with neurocognitive impairment and physical disability.

AB - Background: Traumatic brain injuries in Uganda are on the increase, however little is known about the neuropsychological outcomes in survivors. This study characterized patients with traumatic brain injury (TBI) and the associated six-month neuropsychological outcomes in a Ugandan tertiary hospital. Methods: Patients admitted at Mulago Hospital with head injury from November 2015 to April 2016 were prospectively enrolled during admission and followed up at six months after discharge to assess cognition, posttraumatic stress symptoms (PTSS), depression symptoms and physical disability. The outcomes were compared to a non-head-injury group recruited from among the caretakers, siblings and neighbours of the patients with age and sex entered as covariates. Results: One hundred and seventy-one patients and 145 non-head injury participants were enrolled. The age range for the whole sample was 1 to 69 years with the non-head injury group being older (mean age (SD) 33.34 (13.35) vs 29.34 (14.13) years of age, p = 0.01). Overall, motorcycle crashes (36/171, 38.6%) and being hit by an object (58/171, 33.9%) were the leading causes of TBI. Head injury from falls occurred more frequently in children < 18 years (13.8% vs 2.8%, p = 0.03). In adults 18 years and older, patients had higher rates of neurocognitive impairment (28.4% vs 6.6%, p < 0.0001), PTSS (43.9% vs 7.9%, p < 0.0001), depression symptoms (55.4% vs 10%, p < 0.0001) and physical disability (7.2% vs 0%, p = 0.002). Lower Glasgow Coma Score (GCS) on admission was associated with neurocognitive impairment (11.6 vs 13.1, p = 0.04) and physical disability (10 vs 12.9, p = 0.01) six months later. Conclusion: This first such study in the East-African region shows that depth of coma on admission in TBI is associated with neurocognitive impairment and physical disability.

KW - Anxiety

KW - Brain injury

KW - Cognition

KW - Depression

KW - Physical disability

KW - Traffic crashes

UR - http://www.scopus.com/inward/record.url?scp=85061161087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061161087&partnerID=8YFLogxK

U2 - 10.1186/s12883-019-1246-1

DO - 10.1186/s12883-019-1246-1

M3 - Article

VL - 19

JO - BMC Neurology

JF - BMC Neurology

SN - 1471-2377

IS - 1

M1 - 18

ER -