{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:44:54Z","timestamp":1792032294853,"version":"4.4.0"},"reference-count":29,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Traumatic brain injury (TBI) is a significant public health concern in low-income countries. This study assesses the economic burden of TBI in Togo, estimating both direct and indirect costs and identifying key cost drivers.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a cross-sectional study at CHU Sylvanus Olympio in Lom\u00e9 from January to December 2022, including patients with complete medical and financial records. Direct medical costs included expenditures directly related to hospital-based medical care from admission to discharge, consultation fees, laboratory investigations, radiological examinations, medications, surgical procedures, intensive care charges, and hospitalization fees. Indirect costs included nonmedical and productivity-related expenses incurred during hospitalization: transportation, food, communication expenses, and loss of income for both patients and caregivers due to missed workdays.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n A total of 219 patients were analyzed (mean age 37.3 \u00b1 14.1 years; 81.7% male). Road traffic accidents accounted for 86.7% of TBIs, with motorcycles involved in the vast majority. The median total cost of care was USD 512 (IQR: 380\u2013890), and the mean cost was USD 648 \u00b1 478 \u2014 approximately 7.1 times the national monthly minimum wage. Direct medical costs constituted the largest share of expenditures, particularly treatment-related items. Intensive care unit admission, surgical intervention, and longer hospital stay were all significantly associated with higher total costs (\n p<\/jats:italic>\n < 0.005).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n TBI management imposes a substantial financial burden in this tertiary hospital setting in Togo. Resource-intensive care, particularly surgery, intensive care admission, and longer hospital stay, significantly increases costs. Broader studies are needed to assess the full national and long-term economic burden of TBI. The financial burden of TBI management in our setting is considerable, particularly given limited health insurance coverage. TBI management imposes a substantial economic burden in this tertiary hospital setting, with costs significantly driven by intensive care admission, surgical intervention, and prolonged hospitalization.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_573_2025","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T08:22:27Z","timestamp":1783671747000},"page":"390","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Economic burden and cost drivers of traumatic brain injury"],"prefix":"10.25259","volume":"17","author":[{"given":"Agb\u00e9ko Komlan","family":"Doleagbenou","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, CHR Lom\u00e9 Commune, Togo"},{"name":"Department of Neurosurgery, Centre Hospitalier Universitaire Sylvanus Olympio, Lom\u00e9, Togo"},{"name":"Department of Neurosurgery, Universit\u00e9 de Douala, Douala, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Assogba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Centre Hospitalier Universitaire Sylvanus Olympio, Lom\u00e9, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kisito","family":"Quenum","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e9 de Parakou, Borgou, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Djoubairou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Universit\u00e9 de Douala, Douala, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kpelao","family":"Essossinam","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Centre Hospitalier Universitaire Sylvanus Olympio, Lom\u00e9, Togo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"10.25259\/SNI_573_2025\/ref-1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.4103\/jwas.jwas_2_24","article-title":"Pattern of road traffic injuries presenting at a tertiary hospital in north-central Nigeria","volume":"15","author":"Afolabi","year":"2025","journal-title":"J West Afr Coll Surg"},{"key":"10.25259\/SNI_573_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1186\/s12889-019-7800-3","article-title":"The costs of traumatic head injury and associated factors at university of Gondar specialized referral hospital, Northwest Ethiopia","volume":"19","author":"Asmamaw","year":"2019","journal-title":"BMC Public Health"},{"key":"10.25259\/SNI_573_2025\/ref-3","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1017\/S1049023X23006088","article-title":"Prehospital emergency care in low-and middle-income countries: A systematic review","volume":"38","author":"Bhattarai","year":"2023","journal-title":"Prehosp Disaster Med"},{"key":"10.25259\/SNI_573_2025\/ref-4","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/ije\/dyn189","article-title":"Patient outcome after traumatic brain injury in high-, middle-and low-income countries: Analysis of data on 8927 patients in 46 countries","volume":"38","author":"De Silva","year":"2009","journal-title":"Int J Epidemiol"},{"key":"10.25259\/SNI_573_2025\/ref-5","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.3171\/2017.11.JNS171500","article-title":"Global neurosurgery: The current capacity and deficit in the provision of essential neurosurgical care. 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