long term psychosocial outcomes and associated factors in children with traumatic brain injury in mulago – a cross sectional study

Description

Background: According to World Health Organization (WHO), Traumatic Brain Injury (TBI) is a leading cause of sudden death and disability amongst young people. About 28% of children managed from Mulago national Referral Hospital (MNRH) report some form of disability 1 year post injury. While studies elsewhere have demonstrated deficits in the psychosocial outcomes in children with TBI, there is limited work to this effect in Mulago. We aimed to establish the psychosocial outcomes, especially school performance, emotional and social outcomes of children following TBI, and hence provide insight into the rehabilitative needs of these children. Objective: To determine the psychosocial outcomes and associated factors in children managed for TBI in MNRH Methods: This was a cross sectional study carried out in the Neurosurgical unit of MNRH, Uganda. Following ethical approval from the Makerere School of Medicine Research Ethics Committee, caretakers of children of 6 years to 17 completed years of age previously managed for TBI in MNRH between 2017 to 2018 were contacted and invited to be part of the study. A PedsQL questionnaire parent-proxy was administered to them. Data collected were analyzed using STATA version 14.0. Linear regression was used to determine factors associated with psychosocial outcomes. P values less than 0.05 were used. .Results: A total of 116 children were included in the study. The overall mean psychosocial outcome of this sample was 82 (SD = 22.74). Using one SD below the mean score as the cut-off standard for at risk status for poor psychosocial function, 85.7% of the children had good psychosocial function, while 14.3% had poor psychosocial function. Longer time of two years post TBI (adjusted β = 1.36, p=0.012) and absence of concurrent injuries ( adjusted β= 0.30, p=0.025)were positively associated with psychosocial function, while TBI severity was negatively associated with psychosocial function TBI (adjustedβ= -0.36, p=0.041). Conclusion: Children managed for TBI in MNRH continue to have psychosocial sequelae 1 -2 years following injury. Care from child psychologists, behavioral therapy, and rehabilitative services may be beneficial to children with severe deficits, so as to improve their quality of life. Key words: traumatic Brain Injury, Psychosocial outcome.