Traumatic Brain Injury Across the Lifespan in Zambia

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Project Summary/Abstract The overall goal of the Traumatic Brain Injury Across the Lifespan in Zambia (TBI-Zambia) program is to define the health and economic burden of traumatic brain injuries across the lifespan in Zambia. We will do this by strengthening the local data infrastructure with an electronic registry on traumatic brain injuries (Brain Injury Registry of Lusaka (BraiL)) to collect data on all TBI seen at the University Teaching Hospital. Our approach will involve close collaboration between Milken Institute School of Public Health, the George Washington University (GW), USA, the University of Zambia School of Public Health (UNZA) and its University Teaching Hospital (UTH), Lusaka, Zambia. GW and UNZA share a documented commitment to research training, expertise in application of electronic registries in injuries and health services research, as well as a history of productive collaborative work. UNZA and UTH share a commitment to providing the highest quality service to the under-privileged communities in Zambia, and focus on optimizing outcomes in low-resource settings. Our proposal will leverage the shared interest in understanding the impact of trauma and brain disorders and strengthening research capacity and tackle two critical gaps in addressing these health concerns – create national, disaggregated data on TBI, define their risks and vulnerable groups and the impact of potential interventions and develop a core group of clinicians with research and data management skills. Our TBI-Zambia collaboration will help strengthen capacity within UNZA/UTH and Zambia to apply these methodologies to other areas of health care. The specific aims of this proposal are: (1) To Define core variables and digital platforms for a data registry focused on traumatic brain injuries in Zambia; (2) To Pilot-test a digital traumatic brain injury registry at University Teaching Hospital, University of Zambia for a year; and (3) To Develop a core group of clinicians with research skills and data analysis capacity at University Teaching Hospital, University of Zambia. We will apply the results of the study to reduce the growing burden of TBI across the lifespan and propose a larger intervention study by the end of two years. With TBI patients as our focus, we will develop digital registry, which will be implemented in the Surgical Emergency Unit (where all trauma patients are received, assessed and treatment is initiated) of UTH. Information on the epidemiology of the brain injury, occurrence, nature, type and outcomes of TBI including risk factor analysis and seasonal variation will be collected through 12-month prospective data collection process. The data will be crucial for evaluating future interventions and outlining policy recommendations. To strengthen the response to TBI, we will develop research capacity among clinicians (surgeons, trauma surgeons, neurosurgeons) in Zambia through hand-on onsite training, short-term workshops and online courses.