title: Traumatic spinal cord injury in Botswana: characteristics, aetiology and mortality.
abstract: METHODS
  Descriptive study with a cross-sectional design.
  
  
  OBJECTIVE
  To describe the epidemiology of traumatic spinal cord injuries (TSCIs) in Botswana, with a specific focus on road traffic crashes (RTC).
  
  
  METHODS
  Main public referral hospital, Gaborone, Botswana.
  
  
  METHODS
  Two samples were included. Sample one described the epidemiology and included patients admitted during a 2-year period with acute TSCI. Sample two included only patients with TSCI due to RTC.
  
  
  RESULTS
  Annual incidence was 13 per million population. Epidemiology of TSCI: 49 patients were included, 71% male, age ranging from 4 to 81 years, 80% ⩽ 45 years. Tetraplegia was more common than paraplegia (59/41%), and 39% had C1-C4 level of injury. The main cause of TSCI was RTC (68%), followed by assault (16%) and falls (10%). Mortality was 20%, where all, but one, had tetraplegia (18%). Median time from injury to spinal surgery was 12 days, with longer time for women, 16 days compared with 8 for men. Burst tire was the primary cause of RTC resulting in a TSCI, followed by hitting animals on the road. The majority had been passengers and 72% were involved in single crashes.
  
  
  CONCLUSIONS
  The most common cause for TSCI was RTC, followed by assault. In-hospital mortality was high and the waiting period from the time of accident to spinal surgery was long, especially for women. The aetiology and high mortality of TSCI in Botswana indicate that improvements in roadway safety and medical care may decrease the TSCI incidence and mortality.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
authors.forename: I
authors.initials: I
authors.lastname: Löfvenmark
authors.affiliation: 1] Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden [2] Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Norrbrink
authors.affiliation: Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Nilsson-Wikmar
authors.affiliation: 1] Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden [2] Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Hultling
authors.affiliation: Spinalis Botswana SCI-Rehabilitation Project, Gaborone, Botswana.
authors.forename: S
authors.initials: S
authors.lastname: Chakandinakira
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Hasselberg
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D001902:Botswana / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000453:epidemiology / Q000503:physiopathology; D011782:Quadriplegia / Q000453:epidemiology / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D061665:Time-to-Treatment; D055815:Young Adult