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. 2023 Oct 17;4(1):693-714.
doi: 10.1089/neur.2023.0007. eCollection 2023.

Pediatric Traumatic Brain Injury in the Middle East and North Africa Region: A Systematic Review and Meta-Analysis to Assess Characteristics, Mechanisms, and Risk Factors

Samar Al-Hajj  1 , Sarah H Farran  2 , Batoul Dekmak  2 , Layal Hneiny  3 , Hussein Abou Abbas  4 , Aya Hassoun  5 , Nadine Youness  2 , Sarah Ghalayini  2 , Nour Abou Khalil  1 , Fiona Lecky  6 , Shima Shahjouieh  7 , Layal Ghamlouche  1 , Zainab Nasrallah  2 , Firas Kobeissy  8   9
Affiliations

Pediatric Traumatic Brain Injury in the Middle East and North Africa Region: A Systematic Review and Meta-Analysis to Assess Characteristics, Mechanisms, and Risk Factors

Samar Al-Hajj et al. Neurotrauma Rep. .

Abstract

Pediatric traumatic brain injury (pTBI) represents a major cause of child injuries in the Middle East and North Africa (MENA) region. This review aims to assess pTBIs in the MENA region and reports their clinical severity and outcomes. A search was conducted using major electronic databases, including Medline/Ovid, PubMed, EMBASE, Web of Science, and SCOPUS. Abstracts were screened independently and in duplicate to detect original research. The objective and study findings for each article were recorded, along with the mechanism of pTBI, patient age and sex, injury assessment tool(s) used, and outcome. A total of 1345 articles were retrieved, of which 152 met the criteria for full-text review, and 32 were included in this review. Males predominantly suffered from pTBIs (78%). Motor vehicle accidents, followed by child abuse, were the leading causes of pTBI. Overall, 0.39% of cases were mild, 0.58% moderate, 16.25% severe, and 82.27% unclassified. The mortality rate was 13.11%. Most studies used the computed tomography scan, Glasgow Coma Scale, Abbreviated Injury Scale, and Injury Severity Score as investigation methods. This review reports on the alarming rate of child-abuse-related pTBI and offers further understanding of pTBI-associated risk factors and insight into the development of strategies to reduce their occurrence, as well as policies to promote child well-being.

Keywords: MENA; meta-analysis; pediatric traumatic brain injury; systemic review.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
PRISMA flow diagram for pediatric TBI in the MENA region showing the selection process, number of documents screened, evaluated for eligibility, and included and reasons for exclusion after screening. CINAHL, Current Index to Nursing & Allied Health Literature; MENA, Middle East and North Africa; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; TBI, traumatic brain injury; WOS, Web of Science.
FIG. 2.
FIG. 2.
Age distribution of traumatic brain injuries (years) across different studies conducted in different countries within the MENA region. MENA, Middle East and North Africa.
FIG. 3.
FIG. 3.
Length of hospital stay distribution of pediatric traumatic brain injuries (day).
FIG. 4.
FIG. 4.
Total sex distribution of pediatric traumatic brain injury cases across included studies within the MENA region (%). MENA, Middle East and North Africa.
FIG. 5.
FIG. 5.
Meta-analysis of pediatric Traumatic Brain Injury.
FIG. 6.
FIG. 6.
Meta-analysis of pediatric Traumatic Brain Injury with subgroup analysis by the setting of injury. Incidents include multiple causes, Motor Vehicle Accidents (MVA), camel-related injuries.
FIG. 7.
FIG. 7.
Meta-analysis of pediatric Traumatic Brain Injury with subgroup analysis by country income.
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