Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention: a scoping review

Abstract

Background: Neurotrauma is an important global health problem. The largest cause of neurotrauma worldwide is road traffic collisions (RTCs), particularly in low-and middle-income countries (LMICs). Neurotrauma and RTCs are preventable, and many preventative interventions have been implemented over the last decades, especially in high-income countries (HICs). However, it is uncertain if these strategies are applicable globally due to variations in environment, resources, population, culture and infrastructure. Given this issue, this scoping review aims to identify, quantify and describe the evidence on approaches in neurotrauma and RTCs prevention, and ascertain contextual factors that influence their implementation in LMICs and HICs. Methods: A systematic search was conducted using five electronic databases (MEDLINE, EMBASE, CINAHL, Global Health on EBSCO host, Cochrane Database of Systematic Reviews), grey literature databases, government and non-government websites, as well as bibliographic and citation searching of selected articles. The extracted data were presented using figures, tables, and accompanying narrative summaries. The results of this review were reported using the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Barriers to neurotrauma care in low- to middle-income countries: an international survey of neurotrauma providers

“…For example, by incorporating public education initiatives aimed at increasing the likelihood of appropriately seeking care, individual providers can increase the impact of international neurosurgical efforts. 23,35 Thus, our findings suggest that by participating in international neurosurgical education, one finds themself addressing the full spectrum of socioeconomic obstacles at both national and local levels.…”

“…16,20,22 The availability of ambulance services has been shown to be limited not only by the number of vehicles available, but also by the number of staff trained in prehospital resuscitation to gency services. 23 In Malawi, animal-drawn carts were found to be the most common mode of transport to a primary health facility, with female heads of households most affected by a lack of finances to travel to the hospital. 24 This is consistent with literature showing that while delays exist within HICs, significantly greater delays are seen along every stage of the care continuum in LMICs and are frequently associated with greater morbidity and mortality.…”

“…Practical approaches in which some of these needs can be addressed by the neurosurgical community include public education campaigns regarding TBI prevention and treatment, along with assistance in the design of prehospital care infrastructure as part of the larger trauma and neurosurgical system. 23,34,35 Additionally, much work can be accomplished by neurosurgeons through organized advocacy efforts to improve local economic development, financial assistance for national surgical systems development, and allocation of hospital resources for neurosurgical patients. 32,36 Notably, our data suggest that many neurotrauma patients do not successfully seek or reach care because of the factors described above and are therefore less likely to have neurosurgical consultations.…”

Factores asociados al requerimiento de rehabilitación física en los peatones sobrevivientes de atropello en Perú, 2016 - 2021

“…Si bien, las estrategias y políticas públicas de seguridad vial se centran en sanciones de tráfico y señalización en carreteras, no se abordan tópicos como la educación vial de peatones, incluso Selveindran et al señalan la falta de investigaciones en países de ingresos bajos y medios sobre las estrategias implementadas (28) . Por tanto, es necesario dirigir acciones de seguridad vial hacia los transeúntes (29) y comprender los factores que influyen en sus decisiones arriesgadas (30) , ya que, a pesar de las leyes de tránsito, las víctimas por accidentes aumentan (26) . Promover el respeto al peatón como requisito para obtener la licencia de condu-cir y mejorar dicho proceso, podría reducir los accidentes.…”

The Role of Registries in Neurotrauma Research: Translating Data into Health Policy That Enhances Patient Care; Comment on "Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries"

“…Neurosurgeons can further contribute to evidence-informed policy-making, bringing their expertise to preventative approaches and protocols. In a review about neurotrauma and randomized controlled trials preventions regarding both high-income countries (HICs) and LMICs 10 including over 400 articles (the majority coming from HICs) the most common preventative approach was legislation/policy, followed by helmet use, in both HICs and LMICs. The most evident discrepancies were in the use of technology and in prehospital care, which were lacking in LMICs.…”