The Epidemiology of Traumatic Spinal Cord Injury among Adults on the African Continent, 2010-2024: A Scoping Review.

STUDY

DESIGN

Scoping Review

OBJECTIVES

This scoping review aimed to synthesise existing literature on the epidemiology of traumatic spinal cord injury (TSCI) in adult populations in African low- and middle-income countries (LMICs) between 2010 and 2024, focusing on incidence, prevalence, causes, mortality, and associated demographic determinants.

SETTING

Hospitals and community settings across African LMICs, including South Africa, Tanzania, Nigeria, Rwanda, Botswana, and Ethiopia.

METHODS

Following the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines, a systematic search was conducted across six databases and grey literature sources. The Population-Concept-Context (PCC) framework guided study selection. Eligible studies included all epidemiological designs focused on adults (≥18 years) with TSCI in African LMICs.

RESULTS

Fifteen studies met the inclusion criteria. South Africa and Tanzania contributed most of the evidence. Most studies employed hospital-based retrospective or cohort designs. TSCI predominantly affected males (71-89%) aged 30-45 years. Road traffic accidents (RTAs) were the leading cause of injury in most countries (up to 77.6%), followed by falls. South Africa was an outlier, where violence-related TSCI was most prevalent (up to 62%). Incidence ranged from 13 to 76 per million per year, with very limited prevalence data. Mortality ranged widely, from 1.2% to 93.8%, depending on the setting and timing of assessment.

CONCLUSIONS

This review highlights the urgent need for improved surveillance and context-specific interventions for TSCI in Africa. The demographic and aetiological consistency across studies underscores shared risk factors, while the geographic and methodological gaps point to the need for broader, population-level research and inclusive health system responses.