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Al-Hajj S, Farran SH, Dekmak B, Hneiny L, Abou Abbas H, Hassoun A, Youness N, Ghalayini S, Abou Khalil N, Lecky F, Shahjouieh S, Ghamlouche L, Nasrallah Z, Kobeissy F. Pediatric Traumatic Brain Injury in the Middle East and North Africa Region: A Systematic Review and Meta-Analysis to Assess Characteristics, Mechanisms, and Risk Factors. Neurotrauma Rep 2023; 4:693-714. [PMID: 37908319 PMCID: PMC10615069 DOI: 10.1089/neur.2023.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023] Open
Abstract
Pediatric traumatic brain injury (pTBI) represents a major cause of child injuries in the Middle East and North Africa (MENA) region. This review aims to assess pTBIs in the MENA region and reports their clinical severity and outcomes. A search was conducted using major electronic databases, including Medline/Ovid, PubMed, EMBASE, Web of Science, and SCOPUS. Abstracts were screened independently and in duplicate to detect original research. The objective and study findings for each article were recorded, along with the mechanism of pTBI, patient age and sex, injury assessment tool(s) used, and outcome. A total of 1345 articles were retrieved, of which 152 met the criteria for full-text review, and 32 were included in this review. Males predominantly suffered from pTBIs (78%). Motor vehicle accidents, followed by child abuse, were the leading causes of pTBI. Overall, 0.39% of cases were mild, 0.58% moderate, 16.25% severe, and 82.27% unclassified. The mortality rate was 13.11%. Most studies used the computed tomography scan, Glasgow Coma Scale, Abbreviated Injury Scale, and Injury Severity Score as investigation methods. This review reports on the alarming rate of child-abuse-related pTBI and offers further understanding of pTBI-associated risk factors and insight into the development of strategies to reduce their occurrence, as well as policies to promote child well-being.
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Affiliation(s)
- Samar Al-Hajj
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Sarah H. Farran
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Batoul Dekmak
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Layal Hneiny
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Hussein Abou Abbas
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Aya Hassoun
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nadine Youness
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Sarah Ghalayini
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nour Abou Khalil
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fiona Lecky
- Centre for Urgent and Emergency Care Research, University of Sheffield, Sheffield, United Kingdom
| | - Shima Shahjouieh
- Department of Neurosurgery, University of New Mexico, New Mexico
| | - Layal Ghamlouche
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zainab Nasrallah
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Biology Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Department of Neurobiology, Center for Neurotrauma, Multiomics & Biomarkers (CNMB), Neuroscience Institute, Morehouse School of Medicine, Atlanta, Georgia, USA
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The nature and consequences of camel-related injuries: A scoping review with special reference to Arab Middle Eastern countries. Injury 2022; 53:1319-1328. [PMID: 35101258 DOI: 10.1016/j.injury.2022.01.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/03/2022] [Accepted: 01/22/2022] [Indexed: 02/02/2023]
Abstract
Animal-related injuries are a substantial but under-reported, emerging public health problem contributing considerably to worldwide morbidity and death. Understanding the behavior of big animals may help in injury prevention. Camels are large long-neck ungulates of the genus Camelus that have been domesticated for millennia as a mode of transportation, race, and food source. Camel-related injuries are not well studied when compared with other animals' injuries. Camels can occasionally be very hostile to humans, inflicting serious injuries. These injuries can be caused by camel bites, falls from their backs, kicks, or collisions with motor vehicles. The relative magnitude of each mechanism has never been extensively studied in the literature. Furthermore, the incidence of camel-related injuries is not well reported worldwide. Camels remain a potential cause of serious injuries and a public health problem for some countries in the Middle East. There are gaps in the incidence, risk factors and mechanism, distribution of camel-related injuries. We aimed to summarize the data and draw conclusions pertaining not just to the most common mechanism of injury but to demographics, incidence, severity, and appropriate methods of prevention of camel-related injuries. This scoping review findings will help for better understanding of the nature and consequences of camel-related injuries, and to improve the existing preventive and management strategies.
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Al-Hajj S, Hammoud Z, Colnaric J, Ataya M, Macaron MM, Kadi K, Harati H, Phipps H, Mondello S, Tamim H, Abou Abbass H, Kobeissy F. Characterization of Traumatic Brain Injury Research in the Middle East and North Africa Region: A Systematic Review. Neuroepidemiology 2021; 55:1-12. [PMID: 33567436 DOI: 10.1159/000511554] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/09/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Traumatic brain injury (TBI) represents a major health concern worldwide with a large impact in the Middle East and North Africa (MENA) region as a consequence of protracted wars and conflicts that adversely affect the general population. Currently, systematic TBI studies in the MENA region are lacking, nonetheless they are immensely needed to enhance trauma management and increase survival rates among TBI patients. This systematic review aims to characterize TBI in the MENA region to guide future policy choices and research efforts and inform tailored guidelines capable of improving TBI management and patient treatment and outcome. Furthermore, it will serve as a road map to evaluate and assess knowledge of trauma impact on regional health systems that can be adopted by health-care providers to raise awareness and improve trauma care. METHODS We conducted a comprehensive search strategy of several databases including MEDLINE/Ovid, PubMed, Embase, Scopus, CINAHL, Google Scholar, and the grey literature in accordance with the PROSPERO systematic review protocol CRD42017058952. Abstracts were screened, and selected eligible studies were reviewed independently by 2 reviewers. We collected demographics information along with TBI characteristics, mortality rates, and regional distribution. Data were extracted using REDCap and checked for accuracy. RESULTS The search strategy yielded 23,385 citations; 147 studies met the eligibility criteria and were included in this review. Motor vehicle accident (MVA) was the leading cause of TBI (41%) in the MENA region, followed by the military- (15.6%) and fall- (8.8%) related TBI. Males predominantly suffer from TBI-related injuries (85%), with a high prevalence of MVA- and military-related TBI injuries. The TBI mortality rate was 12.9%. The leading causes of mortality were MVA (68%), military (20.5%), and assault (2.9%). The vast majority of reported TBI severity was mild (63.1%) compared to moderate (10.7%) and severe TBI (20.2%). Patients mainly underwent a Glasgow Coma Scale assessment (22.1%), followed by computed tomography scan (8.9%) and surgery (4.1%). CONCLUSIONS Despite its clinical, social, and economic burden, the evidence of TBI research in the MENA region is scarce. Further research and high-quality epidemiological studies are urgently needed to gain a deep understanding of the TBI burden in the region, facilitate the allocation of adequate resources, implement effective preventive and intervention strategies and advise on the TBI patient management as reflective on the TBI patterns and modes.
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Affiliation(s)
- Samar Al-Hajj
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Zeinab Hammoud
- Health Management and Policy Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Jure Colnaric
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya Ataya
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Marie Michele Macaron
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Kamil Kadi
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Hayat Harati
- Neuroscience Research Center, Faculty of Medicine, Lebanese University, Beirut, Lebanon
| | | | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hussein Abou Abbass
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
- Neuroscience Research Center, Faculty of Medicine, Lebanese University, Beirut, Lebanon
- Department of Surgery, Makassed General Hospital, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon,
- Program for Neurotrauma, Neuroproteomics and Biomarkers Research, Departments of Emergency Medicine, Psychiatry, Neuroscience and Chemistry, University of Florida, Gainesville, Florida, USA,
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Abu-Zidan FM, Hefny AF, Eid HO, Bashir MO, Branicki FJ. Camel-related injuries: prospective study of 212 patients. World J Surg 2013; 36:2384-9. [PMID: 22689019 DOI: 10.1007/s00268-012-1673-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Camel-related injuries have been less well studied than other animal-related injuries. We aimed to study prospectively the incidence, mechanism, distribution of injury, and outcome of patients admitted to hospital with camel-related injuries in Al-Ain, United Arab Emirates. METHODS All patients who were admitted to Al-Ain Hospital with a camel-related injury were prospectively studied during the period of October 2001 to January 2010. Patient's demography, time of injury, mechanism of injury, and distribution and severity of injury were studied. RESULTS A total of 212 patients, all male, with a median age of 28 years (5-89 years) were studied. The estimated incidence of hospitalized camel-related injured patients in Al-Ain City was 6.88 per 100,000 population per year. Camel kicks were most common (36.8 %) followed by a fall from a camel (26.4 %) and camel bites (25.0 %). Camel kicks and falling from a camel were more common during the hot month of August, and camel bites were more common during the rutting season (November to February). Patients with a kick-related injury had a significantly higher rate of maxillofacial fractures compared with other mechanisms. Spinal injuries occurred significantly more often in vehicle occupants who collided with camels compared with other mechanisms (3/7 compared with 7/205, p = 0.0022, Fisher's exact test). Twelve patients (5.7 %) were admitted to the intensive care unit. The mean hospital stay was 8.6 days (1-103 days). Two patients died (overall mortality 1 %). CONCLUSIONS Understanding the biomechanisms and patterns of injury and correlating them with the behavior of the camel is important for identification and prevention of camel-related injuries.
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Affiliation(s)
- Fikri M Abu-Zidan
- Trauma Group, Department of Surgery, Faculty of Medicine and Health Sciences, UAE University, PO Box 17666, Al-Ain, United Arab Emirates.
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Abstract
OBJECTIVE To study the effects of a law banning children from taking part in camel racing on child camel jockey injuries in Al-Ain City, United Arab Emirates. DESIGN Prospective study. SETTING University Teaching Hospital. PATIENTS All patients who were admitted to Al-Ain Hospital and were injured while riding camels were prospectively studied between January 1, 2002, and December 31, 2009. ASSESSMENT OF RISK FACTORS Two periods, before the law and after its introduction, were compared. MAIN OUTCOME MEASURES Pediatric injuries, their anatomical distribution, and severity of injury. RESULTS Fifty-four patients were studied, and all were males. There were 13 children and 41 adults. All children were camel jockeys except 1 child who was riding a camel for fun. None of the adult camel riders was a camel jockey. The median (range) age of patients admitted before the law was 12.5 (5-45) years, which was significantly less compared with 27.2 (20-40) years after its introduction (P = 0.001, Mann-Whitney test). All 13 children sustained their injuries before the law was implemented, whereas 12 of 41 adults sustained their injuries before the legislation was in place (P < 0.0001, Fisher exact test). The total length of hospital stay of patients was significantly reduced after the law enforcement (P < 0.01, Mann-Whitney test). CONCLUSIONS Our findings emphasize the important role of law enforcement in injury prevention, illustrated by the replacement of children by robot substitutes. This is possibly one of the few examples where child injury has been completely prevented by legislation.
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Ralli G, Francesca A, Antonio L, Giuseppe N. Post-traumatic camel-related benign paroxysmal positional vertigo. Travel Med Infect Dis 2010; 8:207-9. [DOI: 10.1016/j.tmaid.2010.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 06/30/2010] [Accepted: 07/05/2010] [Indexed: 10/19/2022]
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