Traumatic brain injury in Sierra Leone: Epidemiological burden and the urgent case for neurosurgical investment.

Introduction: Traumatic brain injury (TBI) represents a significant worldwide public health concern. Research question: We evaluated the prevalence of TBI documented over 5 years at Connaught Teaching Hospital in Freetown, Sierra Leone. Materials and methods: A retrospective chart review was conducted of all patients presenting with neurologic or neurosurgical conditions from January 2019 through December 2023. All available paper charts were reviewed. All patients diagnosed with traumatic brain injury were included in the present study. Results: Between 2019 and 2023, Connaught Hospital evaluated 899 patients with TBI, the majority of whom were men between the ages of 21 and 40. The most common diagnosis was mild traumatic brain injury (45.3%) followed by severe head injury (16.0%). Road traffic accident was the most frequent cause of TBI (65.0%). Only twelve people had surgical treatment, none of which was neurosurgical. 48.8% of patients had a documented improvement in GCS at time of discharge, and there was a 11.4% in-hospital mortality rate. Discussion and conclusion: Africa's trauma systems face numerous challenges, particularly neuro-related cases. The lack of specialists and equipment is a major problem in the region. TBI is very common in Sierra Leone, has a significant negative influence on young people's lives, and is comparable to that of other developing countries in the area. There is an urgent need for more research and systems development given the increasing burden of TBI on health resources in these nations.