Severe traumatic brain injuries secondary to motor vehicle crashes in two Namibian regions: A retrospective review

Paulus Ambunda; Andrit Lourens

doi:10.1016/j.afjem.2022.04.009

Severe traumatic brain injuries secondary to motor vehicle crashes in two Namibian regions: A retrospective review

Afr J Emerg Med. 2022 Sep;12(3):225-230. doi: 10.1016/j.afjem.2022.04.009. Epub 2022 Jun 7.

Authors

Paulus Ambunda^{1

2}, Andrit Lourens³

Affiliations

¹ Motor Vehicle Accident Fund of Namibia, Windhoek, Namibia.
² Department of Health Sciences, Faculty of Health, Applied Sciences and Natural Resources, Namibia University of Science and Technology, Windhoek, Namibia.
³ Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Abstract

Introduction: Traumatic Brain Injuries (TBIs) are a leading cause of morbidity and mortality among trauma patients globally, with motor vehicle crashes (MVCs) being a major contributor. Namibia had a World Health Organization (WHO) estimated MVC-related fatality rate of 30.4 per 100 000 population in 2016, higher than that of the African continent, while no epidemiological studies describing the distribution and determinants of TBIs exist in the country. The study aimed to describe the characteristics of adult patients (≥18 years) with severe TBI secondary to MVCs which occurred in two regions of Namibia between the years 2014-2018.

Methods: A retrospective descriptive observational study was conducted in adult patients who sustained severe TBIs secondary to MVCs in two Namibian regions. The inclusion criteria were patients ≥18 years with a severe (as described on the Motor Vehicle Accident Fund system) MVC-related TBI who sustained an injury in the Otjozondjupa or Khomas regions between the years 2014-2018.

Results: A total of 87 patients met the inclusion criteria, 65 (74.7%) from the Khomas region, and 22 (25.3%) from the Otjozondjupa region. The overall mean age of patients was 34 years (SD 11.79), most were male (n = 78. 89.7%) and 55.2% (n = 48) of all patients sustained an isolated TBI. The majority of the patients were admitted to a state healthcare facility (n = 52, 59.8%). Pedestrians were the most injured (n = 34, 52.3%) in the Khomas region while vehicle drivers were the most injured (n = 11, 50%) in the Otjozondjupa Region. A total of 34 (39.1%) patients died and 53 (60.9%) were discharged from hospital. Overall, there were no statistically significant relationships between patient outcomes and independent variables.

Conclusions: The study was to our knowledge the first to describe the epidemiology of TBIs in Namibia. Young individuals are the main people who sustained TBIs, which may subsequently place a socio-economic burden on the country. There is however limited research in Namibia to guide healthcare planning.

Keywords: ECC, Emergency Communications Centre; Head injury; Head trauma; LMICs, Low- and middle-income countries; MVCs; MVCs, Motor Vehicle Crashes; Severe; TBI; TBIs, Trauma Brain Injuries; Traumatic brain injury; WHO, World Health Organization.