1408. Neurotrauma surveillance in national registries of low- and middle income countries: A Review of Data Dictionaries

Authors: Anna Elisabeth Christina Hackenberg; Ernest Barthélemy; Joanna Ashby; Jacquelyn Corley, MD; Jacob Lepard, MD; Kee Park, MD (Munich, Germany)


Injury is a major global health problem, annually causing >5,800,000 deaths annually and disability in millions more largely attributable to traumatic brain injury. 89% of trauma deaths occur in low-and-middle-income countries (LMICs). Improvement in global trauma care could prevent 2 million deaths annually in LMICs. We present a literature review and survey-based analysis of existing data dictionaries used for TBI surveillance in national registries of LMICs.


Utilizing the Joanna Briggs Institute (JBI) framework, we performed a literature review to identify existing national registries for all World Bank-defined LMICs. Objectives, inclusion / exclusion criteria and methods were specified and documented prior to data collection. Data sources included PubMed, Google Scholar and Google using the terms “trauma/neurotrauma registry” and country name, as well as direct telephone/e-mail contact of key informants and LMIC ministries of health.


We identified six LMICs with national trauma registries tracking TBI-specific data elements: China, India, Iran, Thailand, Myanmar and Colombia. TBI elements in the Colombian database were kept in a dedicated national neurotrauma registry. There were 18 TBI-specific data elements identified in all databases, collectively. The most commonly shared data elements were GCS score(4/4), mental status(3/4) and helmet use(3/4). The Colombian neurotrauma database included 10 unique TBI-related elements. Databases from India and China each included a single unique element, and another shared element, all relating to, “body part injured.”


Preliminary results of our search strategy indicate that an exceedingly small number of LMICs collect data elements for neurotrauma surveillance. Moreover, significant heterogeneity was observed between the neurotrauma elements of each data dictionary.  Survey of these frameworks can be used to guide the development of TBI surveillance systems in LMICs.