Cognitive impairment following traumatic brain injury in Uganda: Prevalence and associated factors

Timothy Mwanje Kintu; Vanessa Katengeke; Ronald Kamoga; Tricia Nguyen; Josephine Nambi Najjuma; David Kitya; Edith K Wakida; Celestino Obua; Godfrey Zari Rukundo

doi:10.1371/journal.pgph.0001459

Cognitive impairment following traumatic brain injury in Uganda: Prevalence and associated factors

PLOS Glob Public Health. 2023 Feb 6;3(2):e0001459. doi: 10.1371/journal.pgph.0001459. eCollection 2023.

Authors

Affiliations

¹ Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
² Office of Research Administration, Mbarara University of Science and Technology, Mbarara, Uganda.
³ California University of Science and Medicine, Colton, California, United States of America.
⁴ Department of Neurosurgery, Mbarara University of Science and Technology, Mbarara, Uganda.
⁵ Department of Medical Education, California University of Science and Medicine, Colton, California, United States of America.
⁶ Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.

Abstract

Background: As the burden of dementia continues to rise in sub-Saharan Africa, it is crucial to develop an evidence base for potentially modifiable risk factors such as Traumatic Brain Injury (TBI). Cognitive impairment may result from TBI and since it is an established prodromal form of dementia, we investigated the burden of cognitive impairment and associated factors in persons with a history of TBI in southwestern Uganda.

Methods: This was a community-based quantitative study with a cross-sectional design among 189 persons with a history of TBI in southwestern Uganda. Data were collected by the research team in March and June 2022 and entered into Kobo Toolbox before being transferred to RStudio version 4.1.0 for cleaning and analysis. Data were analyzed at a 5% level of significance.

Results: Most study participants had some form of cognitive impairment (56.1%), with 43.1% of the participants having mild cognitive impairment (MCI). Cognitive impairment was associated with older age (p-value<0.001); loss of consciousness following the TBI (p-value = 0.019) and a history of tobacco use (p-value = 0.003). As a measure of severity of the TBI, loss of consciousness (aOR = 4.09; CI = 1.57-11.76; p<0.01) and older age (aOR = 1.04; CI = 1.01-1.07; p<0.01) were identified as risk factors for cognitive impairment.

Conclusion: There is a high burden of cognitive impairment among individuals with a history of TBI in southwestern Uganda, and most associated risk factors are potentially modifiable. Long-term follow-up of TBI patients would enable early identification of some risks. Patients with TBI could benefit from behavioural modifications such as restriction of alcohol intake and tobacco use to slow down the progression into dementia.

Copyright: © 2023 Kintu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

Research reported in this publication was supported by the Fogarty International Center (U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy (S/GAC) and the President’s Emergency Plan for AIDS Relief (PEPFAR) of the National Institutes of Health under Award Number 3R25TW011210 (Supplement). The project name is: ‘Alzheimer’s Disease and Related Dementias Health Professions Training Initiative (ARDHePTI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.