Secondary health conditions in people with spinal cord injury in South Africa: Prevalence and associated factors

Abstract

Spinal cord injury (SCI) is a devastating condition, causing severe disability and contributing to the global health burden. [1] There is no national data base for SCI in South Africa (SA). However, the Global Burden of Disease Study 2016 estimated the prevalence of SCI at 206/100 000. [1] This figure could be an underestimate, given that apart from traumatic injuries, several other conditions such as HIV and tuberculosis contribute to the burden of disease. [2] SCI has longterm consequences affecting the individual's health, their family, and the health system. [3,4] Several studies have reported a high prevalence of secondary health conditions (SHCs) in people with SCI. The spectrum of SHCs includes pain, respiratory problems, oedema, autonomic dysreflexia, pressure sores, spasms, depression, contractures, and sexual, bowel and bladder problems. [5,6] The prevalence of SHCs increases with the length of time individuals have lived with SCI. [7] In the early stages of SCI, the prevalence of SHCs ranges from 50% to 78%, [8] increasing to 89 -98.5% 4 -10 years after SCI. [5,9] Several modifiable and non-modifiable risk factors influence the development of SHCs. [10] Non-modifiable risk factors associated with their development include gender, age and SCI profile (type, level, completeness, and time since injury). [7,11] Females are more at risk for bladder dysfunction and depression [11] and tend to report greater pain severity than males. [7] Males with SCI are more at risk for sexual problems and pressure sores. [11] Older age is associated with pain, sexual problems and sleep problems. [11] People with complete lesions This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

The prevalence and profile of spinal cord injury in public healthcare rehabilitation units in Gauteng, South Africa

“…Those with injuries as a result of transportation may also be compensated by the country's Road Accident Fund and have received their rehabilitation in the private healthcare sector. Patients with complete injuries experience more functional fallout, are at higher risk of secondary complications and have a higher risk of mortality post discharge [36][37][38]. There is a need to strengthen access to rehabilitation care with focussed and appropriate planning of rehabilitation services minimising poor health outcomes in those with SCI.…”