{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:42:02Z","timestamp":1777927322153,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","issue":"5-6","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>\n                    National regulations to curb the coronavirus disease 2019 (COVID-19) transmission and health care resource reallocation may have impacted incidence and treatment for neurotrauma, including traumatic brain injury (TBI) and spinal trauma, but these trends have not been characterized in Sub-Saharan Africa. This study analyzes differences in epidemiology, management, and outcomes preceding and during the COVID-19 pandemic for neurotrauma patients in a Rwandan tertiary hospital. The study setting was the Centre Hospitalier Universitaire de Kigali (CHUK), Rwanda's national referral hospital. Adult injury patients presenting to the CHUK Emergency Department (ED) were prospectively enrolled from January 27, 2020 to June 28, 2020. Study personnel collected data on demographics, injury characteristics, serial neurological examinations, treatment, and outcomes. Differences in patients before (January 27, 2020 to March 21, 2020) and during (June 1, 2020 to June 28, 2020) the COVID-19 pandemic were assessed using chi-squared and Mann-Whitney\n                    <jats:italic toggle=\"yes\">U<\/jats:italic>\n                    tests. The study population included 216 patients with neurotrauma (83.8% TBI, 8.3% spine trauma, and 7.9% with both). Mean age was 34.1 years (standard deviation [SD]\u2009=\u200912.5) and 77.8% were male. Patients predominantly experienced injury following a road traffic accident (RTA; 65.7%). Weekly volume for TBI (mean\u2009=\u200916.5 vs. 17.1,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.819) and spine trauma (mean\u2009=\u20092.0 vs. 3.4,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.086) was similar between study periods. During the pandemic, patients had lower Glasgow Coma Scale (GCS) scores (mean\u2009=\u200913.8 vs. 14.3,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.068) and Kampala Trauma Scores (KTS; mean\u2009=\u200914.0 vs. 14.3,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.097) on arrival, denoting higher injury severity, but these differences only approached significance. Patients treated during the pandemic period had higher occurrence of hemorrhage, contusion, or fracture on computed tomography (CT) imaging (47.1% vs. 26.7%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.003) and neurological decline (18.6% vs. 7.5%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.016). Hospitalizations also increased significantly during COVID-19 (54.6% vs. 39.9%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.048). Craniotomy rates doubled during the pandemic period (25.7% vs. 13.7%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.003), but mortality was unchanged (5.5% vs. 5.7%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.944). Neurotrauma volume remained unchanged at CHUK during the COVID-19 pandemic, but presenting patients had higher injury acuity and craniotomy rates. These findings may inform care during pandemic conditions in Rwanda and similar settings.\n                  <\/jats:p>","DOI":"10.1089\/neu.2022.0166","type":"journal-article","created":{"date-parts":[[2022,11,3]],"date-time":"2022-11-03T08:37:38Z","timestamp":1667464658000},"page":"536-546","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Trends in Neurotrauma Epidemiology, Management, and Outcomes during the COVID-19 Pandemic in Kigali, Rwanda"],"prefix":"10.1177","volume":"40","author":[{"given":"Oliver Y.","family":"Tang","sequence":"first","affiliation":[{"name":"Division of Global Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."},{"name":"Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Uwamahoro","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Emergency Medicine, and Critical Care, University of Rwanda, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catalina","family":"Gonz\u00e1lez Marqu\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aly","family":"Beeman","sequence":"additional","affiliation":[{"name":"Division of Global Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."},{"name":"Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enyonam","family":"Odoom","sequence":"additional","affiliation":[{"name":"Division of Global Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."},{"name":"Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Ndebwanimana","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Emergency Medicine, and Critical Care, University of Rwanda, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Uwamahoro","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Emergency Medicine, and Critical Care, University of Rwanda, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mediatrice","family":"Niyonsaba","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Emergency Medicine, and Critical Care, University of Rwanda, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Apollinaire","family":"Nzabahimana","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Emergency Medicine, and Critical Care, University of Rwanda, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silas","family":"Munyanziza","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Emergency Medicine, and Critical Care, University of Rwanda, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Nshuti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Faisal Hospital, Kigali, Rwanda."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Spandana","family":"Jarmale","sequence":"additional","affiliation":[{"name":"Division of Global Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew H.","family":"Stephen","sequence":"additional","affiliation":[{"name":"Division of Global Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam R.","family":"Aluisio","sequence":"additional","affiliation":[{"name":"Division of Global Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."},{"name":"Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,3,1]]},"reference":[{"issue":"1","key":"e_1_3_5_2_2","first-page":"e6","article-title":"A Comparison between the Ability of Revised Trauma Score and Kampala Trauma Score in predicting mortality; a meta-analysis","volume":"7","author":"Manoochehry S","year":"2019","unstructured":"Manoochehry S, , Vafabin M, , Bitaraf S, et al. 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