Traumatic brain injuries in people falling from trees in Ziguinchor: a pathology in a rural area of a developing country

Abstract

Background

Traumatic brain injury (TBI) in people falling from trees is a condition rarely reported in the literature and is often observed in rural areas of developing countries such as Senegal. Ziguinchor, a heavily forested and agricultural region, experiences seasonal fruit harvesting activities that expose populations to the risk of falling from trees. The aim of our study was to highlight the epidemiological, diagnostic, therapeutic, evolutionary, and prognostic aspects of this pathology in Ziguinchor over a period of 3 years and 8 months, with the goal of identifying preventive measures.

Materials and methods

This was a cross-sectional retrospective, descriptive, and analytical study conducted from April 1, 2019, to December 31, 2022. The study included complete records of patients admitted for TBI due to falling from trees at the neurosurgery unit of Ziguinchor Regional Hospital. Morbidity refers to all the subsequent effects of trauma, often described as functional sequelae.

Results

Among 83 patients, 72 were male, with an average age of 17.7 ± 13.1 years. There was a statistically significant correlation between season (quarter) and the type of tree involved (P = 0.012). The average fall height was 4 ± 2.9 m. Most patients (77.6%) had a Glasgow Coma Scale (GCS) Score ≥ 13. There was a significant relationship between fall height and the presence of scalp wounds (P = 0.023). The average hospital stay was 7.5 ± 6.3 days (range: 1–30 days). The mortality rate was 8.4%, and the morbidity rate was 12%.

Conclusion

Climbing trees remains a hazardous activity, as it can lead to falls, causing injuries such as traumatic brain injuries. Educational programs should focus on safe practices for fruit and leaf harvesting to prevent injuries associated with these activities.