title: Lifetime Prevalence and Factors Associated with Head Injury among Older People in Low and Middle Income Countries: A 10/66 Study.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is a growing public health problem around the world, yet there is little information on the prevalence of head injury in low and middle income countries (LMICs). We utilised data collected by the 10/66 research group to investigate the lifetime prevalence of head injury in defined sites in low and middle income countries, its risk factors and its relationship with disability.
  
  
  METHODS
  We analysed data from one-phase cross-sectional surveys of all residents aged 65 years and older (n = 16430) distributed across twelve sites in eight low and middle income countries (China, Cuba, Dominican Republic, India, Venezuela, Mexico, Peru, and Puerto Rico). Self-reported cases of head injury with loss of consciousness were identified during the interview. A sensitivity analysis including data provided by informants of people with dementia was also used to estimate the impact of this information on the estimates. Prevalence ratios (PR) from Poisson regressions were used to identify associated risk factors.
  
  
  RESULTS
  The standardised lifetime prevalence of TBI ranged from 0.3% in China to 14.6% in rural Mexico and Venezuela. Being male (PR: 1.6, 95% CI: 1.29-1.82), younger (PR: 0.95, 95% CI: 0.92-0.99), with lower education (PR 0.91, 95% CI: 0.86-0.96), and having fewer assets (PR 0.92, 95% CI: 0.88-0.96), was associated with a higher prevalence of TBI when pooling estimates across sites.
  
  
  CONCLUSIONS
  Our analysis revealed that the prevalence of TBI in LMICs is similar to that of developed nations. Considering the growing impact of TBI on health resources in these countries, there is an urgent need for further research.
authors.affiliation: Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Khan
authors.affiliation: King's College London, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, De Crespigny Park, London, SE5 8AF, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Prince
authors.affiliation: Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, United Kingdom.
authors.forename: C
authors.initials: C
authors.lastname: Brayne
authors.affiliation: Institute of Public Health, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR, United Kingdom; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Health Service and Population Research Department, Centre for Global Mental Health, De Crespigny Park, London, SE5 8AF, United Kingdom.
authors.forename: A M
authors.initials: AM
authors.lastname: Prina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000209:etiology; D003430:Cross-Sectional Studies; D003462:Cuba / Q000453:epidemiology; D003906:Developing Countries; D006233:Persons with Disabilities; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D010568:Peru / Q000453:epidemiology; D011203:Poverty; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D014687:Venezuela / Q000453:epidemiology