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Barthélemy EJ, Hackenberg AEC, Lepard J, Ashby J, Baron RB, Cohen E, Corley J, Park KB. Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries. Int J Health Policy Manag 2022; 11:2373-2380. [PMID: 35021612 PMCID: PMC9818108 DOI: 10.34172/ijhpm.2021.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 12/05/2021] [Indexed: 01/21/2023] Open
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.
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Affiliation(s)
- Ernest J. Barthélemy
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Anna E. C. Hackenberg
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Technical University of Munich, Munich, Germany
| | - Jacob Lepard
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joanna Ashby
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- School of Medicine, University of Glasgow, Glasgow, UK
| | - Rebecca B. Baron
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Ella Cohen
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Jacquelyn Corley
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Kee B. Park
- Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
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Malta DC, de Morais OL, Cardoso LSDM, Veloso GA, de Andrade FMD, Vasconcelos AMN, de Lima CM, Ribeiro ALP, Naghavi M. Road traffic injuries and deaths and the achievement of UN Sustainable Development Goals in Brazil: results from the Global Burden of Disease Study, 1990 to 2019. Rev Soc Bras Med Trop 2022; 55:e0261. [PMID: 35107524 PMCID: PMC9038143 DOI: 10.1590/0037-8682-0261-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/29/2021] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Brazil ranks 5th in the number of deaths due to road injuries. This study aimed to analyze mortality and disabilities resulting from road injuries in Brazil, and to assess the Sustainable Development Goals (SDG) target of reducing deaths due to road injuries by 50% by 2030. METHODS This descriptive and exploratory study used the estimates from the Global Burden of Disease 2019: indicators of mortality, premature deaths, and disabilities according to sex, age group, and type of transport for 1990, 2015, and 2019. Time trends in mortality rates from 1990 to 2019 were assessed, and a projection for 2030 was calculated, applying a linear regression model. RESULTS Deaths due to road injuries were 44,236 in 1990, and 44,529 in 2019, representing a 43% reduction in mortality rates. The highest rates were in the North, Northeast, and Midwest regions of Brazil, in males and young adults. A 77% reduction was observed in mortality rates for pedestrians and an increase of 53% for motorcyclists and of 54% for cyclists during the period. In terms of motorcycle road injuries, the mortality rate for men increased from 7.3/100,000 (1990) to 11.7/100,000 inhabitants (2019). The rates of premature deaths and disabilities were also higher for men when compared to women. Amputations, fractures, spinal cord injuries, and head trauma were the main types of road injuries. The projections for 2030 show that Brazil might not reach the SDG target. CONCLUSIONS Despite the decline in mortality rates, the 2030 Agenda's target might not be achieved.
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Departamento de Enfermagem
Materno Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
| | | | | | - Guilherme Augusto Veloso
- Universidade Federal de Minas Gerais, Departamento de Estatística,
Programa de Pós-Graduação em Estatística, Belo Horizonte, MG, Brasil
| | - Fabiana Martins Dias de Andrade
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Programa de Pós-Graduação em Saúde Pública, Belo Horizonte, MG, Brasil
| | | | | | - Antonio Luiz Pinho Ribeiro
- Universidade Federal de Minas Gerais, Faculdade de Medicina,
Hospital das Clínicas, Belo Horizonte, MG, Brasil
| | - Mohsen Naghavi
- University of Washington, Institute for Health Metrics and
Evaluation, Seattle, Washington, USA
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Conceição GMDS, Alencar GP, Latorre MDRDDO. [Time trend in hospitalizations from motor vehicle accidents in the city of São Paulo, Brazil, 2000-2019]. CAD SAUDE PUBLICA 2021; 37:e00036320. [PMID: 34816949 DOI: 10.1590/0102-311x00036320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 04/26/2021] [Indexed: 11/22/2022] Open
Abstract
This study assessed the hospitalization rates from motor vehicle accidents in the Brazilian Unified National Health System (SUS) in residents of the city of São Paulo, Brazil, from 2000 to 2019, according to sex, age bracket, and means of transportation (pedestrians, cyclists, motorcyclists, and motor vehicle occupants). A segmented regression model with negative binomial response was adjusted with inflection points to accommodate possible changes in trends. 189,765 hospitalizations were recorded during the study period, mostly males (80.5%) and from 20 to 49 years of age (71.2%). The most frequent type of accident involved motorcyclists (42.8%), followed by run-over pedestrians (33.7%). In general, the period from 2000 to 2007 was marked by increasing hospitalization rates from motor vehicle accidents involving all means of transportation, in both sexes, and in most age brackets. The year when the rates stopped increasing (or in some cases began to drop) differed according to the means of transportation. For vehicle occupants and cyclists, the trend in most age brackets turned downward in 2008, but the same did not happen with pedestrians and motorcyclists until 2012. Starting in 2015, the decline stopped in pedestrians, and the rates in cyclists turned upward again in most age brackets. For motorcyclists, the rates turned upward again in men 20 to 59 years of age (7.2% per year, exceeding 140 per 100,000 inhabitants in 2019) and in women 15 to 39 years of age (4.9% per year). The benefits of traffic safety measures implemented thus far in Brazil may have reached their limit, so that the current control and prevention measures need to be revised.
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Use of prehospital, hospitalization and presence of sequelae and/or disability in road traffic injury victims in Brazil. PLoS One 2021; 16:e0249895. [PMID: 33861788 PMCID: PMC8051756 DOI: 10.1371/journal.pone.0249895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 03/26/2021] [Indexed: 11/22/2022] Open
Abstract
Objective To estimate the prevalence and analyze the association between sociodemographic and behavioral variables with the use of prehospital care, hospitalization and sequelae and/or disability in victims of road traffic accidents victims in Brazil. Methods Data from the National Health Survey conducted in 2013 in Brazil were used. Data were collected through a direct household survey. The research sample consisted of 1,840 individuals who reported road traffic accidents in the previous 12 months. Poisson regression analysis was used to evaluate the factors associated with the use of prehospital care services, hospitalization, and the presence of sequelae and/or disability. Results The prevalence of road traffic accidents victims who received prehospital care was 13.0% (95% Confidence Interval [95% CI]: 10.3–16.3) and the factors associated with this outcome were: residing in the Northeast or North region of Brazil; residing in rural areas; and being a motorcycle occupant at the moment of the road traffic accident. The frequency of hospitalization was 7.7% (95% CI: 6.0–10.0) and the associated factors were: age between 40 and 59 years; being a motorcycle occupant or pedestrian and having received on-site care at the moment of the road traffic accident. The prevalence of sequelae and/or disability was 15.1% (95% CI: 12.5–18.2) and the associated factors were: age range between 30 and 39 years or 40 and 59 years; being a motorcycle occupant, being a pedestrian or belonging to other category of modes of transport and having received on-site care at the moment of the road traffic accident. Conclusion The study allowed to evaluate the factors associated with prehospital care, hospitalization and presence of sequelae and/or disability in the victims of road traffic accident and the results can guide the implementation of interventions that prioritize the population exposed to the highest risk of road traffic accident injuries and with less access to prehospital and hospital care services in Brazil.
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Características de acidentes e padrões de lesões em motociclistas hospitalizados: estudo retrospectivo de emergência. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao0115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Sousa RAD, Sousa CMDS, Silva FRSE, Rodrigues MTP, Cardoso ODO, Mascarenhas MDM. Tendência temporal e distribuição espacial da mortalidade por acidentes de trânsito no Piauí, 2000-2017. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2020; 29:e2019558. [DOI: 10.1590/s1679-49742020000500005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 07/09/2020] [Indexed: 03/29/2023] Open
Abstract
Resumo Objetivo: Analisar a tendência temporal e a distribuição espacial da mortalidade por acidentes de trânsito (AT) no Piauí, de 2000 a 2017. Métodos: Estudo ecológico de séries temporais, com dados do Sistema de Informações sobre Mortalidade (SIM), referentes à mortalidade por AT em residentes do estado do Piauí, segundo sexo, faixa etária e município. Empregou-se regressão de Prais-Winsten. Resultados: Registraram-se 14.396 óbitos, com taxa de mortalidade por 100 mil habitantes de 13,9 em 2000 e 30,6 em 2017. Houve aumento significativo na taxa de mortalidade por AT (variação percentual anual [VPA] de 6,4% – IC95% 4,3;8,7), maior entre motociclistas (VPA=14,7% – IC95% 9,7;20,0) e entre ocupantes de veículos (VPA=15,2 – IC95% 10,5;20,2). Conclusão: Houve aumento significativo da mortalidade por AT no Piauí, principalmente de motociclistas e ocupantes de veículos. São necessárias ações para promover a segurança viária e prevenir mortes no trânsito.
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Lima TFD, Macena RHM, Mota RMS. Acidentes Automobilísticos no Brasil em 2017: estudo ecológico dos anos de vida perdidos por incapacidade. SAÚDE EM DEBATE 2019. [DOI: 10.1590/0103-1104201912314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Este estudo se propõe a descrever o impacto dos Acidentes Automobilísticos no Brasil, no ano de 2017, sobre os anos de vida perdidos ajustados por incapacidade. Estudo ecológico, com dados secundários da Global Health Data Exchange (Global Burden of Disease 2017) disponibilizados pelo Institute for Health Metricsand Evaluation. Os dados foram obtidos utilizando filtros de causa (ferimentos na estrada por veículo automotor), localização (global, Brasil e sul da América Latina) e indivíduos de ambos os sexos, com idades entre 15 e 49 anos. Foram considerados os anos de vida perdidos por incapacidade e a taxa de mortes por 100 mil habitantes. Os dados foram exportados para o Excel® for Windows 2010 e analisados conforme a literatura. Observa-se, no Brasil, um decréscimo nas taxas de óbitos (19,68%) e de anos de vida perdidos por incapacidade (22,10%) por acidente automobilístico entre indivíduos de ambos os sexos, com idades entre 15 e 49 anos, porém mostram-se superiores as taxas globais e do sul da América Latina. Estudos como este são importantes para o aperfeiçoamento e o direcionamento de politicas públicas específicas, para formular e implementar estratégias de promoção e prevenção da saúde de segurança no trânsito.
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Ladeira RM, Malta DC, Morais OLD, Montenegro MDMS, Soares AM, Vasconcelos CH, Mooney M, Naghavi M. Road traffic accidents: Global Burden of Disease study, Brazil and federated units, 1990 and 2015. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 20Suppl 01:157-170. [PMID: 28658380 DOI: 10.1590/1980-5497201700050013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 03/10/2017] [Indexed: 11/22/2022] Open
Abstract
Objective: To describe the global burden of disease due to road traffic accidents in Brazil and federated units in 1990 and 2015. Methods: This is an analysis of secondary data from the 2015 Global Burden of Disease study estimates. The following estimates were used: standardized mortality rates and years of life lost by death or disability, potential years of life lost due to premature death, and years of unhealthy living conditions. The Mortality Information System was the main source of death data. Underreporting and redistribution of ill-defined causes and nonspecific codes were corrected. Results: Around 52,326 deaths due to road traffic accidents were estimated in Brazil in 2015. From 1990 to 2015, mortality rates decreased from 36.9 to 24.8/100 thousand people, a reduction of 32.8%. Tocantins and Piauí have the highest mortality risks among the federated units (FU), with 41.7/100 and 33.1/100 thousand people, respectively. They both present the highest rates of potential years of life lost due to premature deaths. Conclusion: Road traffic accidents are a public health problem. Using death- or disability-adjusted life years in studies of these causes is important because there are still no sources to know the magnitude of sequelae, as well as the weight of early deaths. Since its data are updated every year, the Global Burden of Disease study may provide evidence to formulate traffic security and health attention policies, which are guided to the needs of the federated units and of different groups of traffic users.
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Affiliation(s)
| | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno-Infantil e Saúde Publica, Escola de Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil
| | - Otaliba Libânio de Morais
- Departamento de Saúde Coletiva, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás - Goiânia (GO), Brasil
| | - Marli de Mesquita Silva Montenegro
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção à Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Adauto Martins Soares
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção à Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Cíntia Honório Vasconcelos
- Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção à Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde - Brasília (DF), Brasil
| | - Meghan Mooney
- Institute for Health Metrics and Evaluation - Seattle, Estados Unidos
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation - Seattle, Estados Unidos
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Pinto LW, Ribeiro AP, Bahia CA, Freitas MGD. Urgent and emergency care for pedestrians injured in Brazilian traffic. CIENCIA & SAUDE COLETIVA 2016; 21:3673-3682. [PMID: 27925108 DOI: 10.1590/1413-812320152112.17722016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/22/2016] [Indexed: 11/21/2022] Open
Abstract
This paper aimed to describe the epidemiological profile of pedestrians injured in traffic accidents treated at urgent and emergency facilities participating in the 2014VIVA Survey and the characterization of these events and consequences for these victims. This is a cross-sectional study conducted in the period from September to November 2014 in 24 Brazilian state capitals and the Federal District. We analyzed variables that characterize the victim, the accident and its severity and case outcome. We calculated simple and relative frequencies and performed a bivariate analysis by gender and age group. We used the Rao-Scott test with a 5% significance level in order to verify the independence of variables. Results show that 34.3% of attendances were for individuals aged 20-39 years, 54.2% had brown skin and 35.9% of individuals had up to 4 years of schooling. Run-overs occurred mainly at night (33.6%) and in the afternoon (31.3%). Most cases resulted in discharge in all age groups, but 41.6% of the elderly (60 years and over) required hospitalization. We stress the need for public investment, prioritizing pedestrian circulation in traffic and road infrastructure planning.
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Affiliation(s)
- Liana Wernersbach Pinto
- Departamento de Estudos sobre Violência e Saúde, Fiocruz. Av. Brasil 4036/7°, Manguinhos. 21040-210 Rio de Janeiro RJ Brasil
| | - Adalgisa Peixoto Ribeiro
- Departamento de Estudos sobre Violência e Saúde, Fiocruz. Av. Brasil 4036/7°, Manguinhos. 21040-210 Rio de Janeiro RJ Brasil
| | - Camila Alves Bahia
- Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil
| | - Mariana Gonçalves de Freitas
- Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Secretaria de Vigilância em Saúde, Ministério da Saúde. Brasília DF Brasil
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