The burden of paediatric traumatic brain injury (pTBI) in low-and-middle-income countries (LMICs) is unknown. To fill this gap, we conducted a review that aimed to characterise the causes of pTBI in LMICs, and their reported associated mortality and morbidity.
A systematic review was conducted. MEDLINE, EMBASE, Global Health, and Global Index Medicus were searched from January 2000 to May 2020. Observational or experimental studies on pTBI of individuals aged between 0 and 16 years in LMICs were included. The causes of pTBI and morbidity data were descriptively analysed, and case fatality rates were calculated.
136 studies were included. 57 studies were at high risk of bias. Of the remaining studies, there were reported 170224 cases of pTBI in 32 LMICs. The odds of having a pTBI was 1.8 times higher (95% CI: 1.6, 2.0) in males. The odds of a pTBI being mild was 4.4 times higher (95% CI: 1.9, 6.8) than a pTBI being moderate or severe. Road traffic accidents were the most common cause (n = 16275/41979, 39%) of pTBIs. On discharge, 24% of patients (n = 4385/17930) had a reduction in their normal mental or physical function. The median case fatality rate was 7.3 (IQR: 2.1 to 7.7).
Less than a quarter (n= 32) of all LMICs have published high quality data on the volume and burden of pTBI. From the limited data available, young male children are at a high-risk of pTBIs in LMICs, particularly following road traffic accidents.

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