Spinal Cord Injury In Bangladesh Research Articles

Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023.

The study aims to explore the demographic and clinical characteristics of persons with spinal cord injury (SCI) in Bangladesh. A total of 3035 persons with SCI spanning from 2018 to 2022 were included in this cross-sectional study. Information about demographic and clinical variables was obtained from the medical records and verified through telephone calls to ensure accuracy and consistency. Approximately half (48.30%) of the study participants were located in Dhaka Division. The average age of persons with SCI was 38.3 years, with a standard deviation of 15.9 years, and the largest proportion (33.4%) fell within the age range of 18-30 years. Males outnumbered females by nearly 2.5 times. In the study, 59.6% had suffered traumatic injuries, whereas 40.4% had SCI attributable to disease-related causes; 58.1% were diagnosed with tetraplegia and 40.1% with paraplegia. Fall from height (42.1%) and road traffic trauma (27%) were the most common causes of traumatic injuries. Degenerative myelopathy (41.1%) was the most frequent cause of non-traumatic SCI, followed by tumors (27.7%) and tuberculosis (TB; 14.8%). Both traumatic (58.3%) and degenerative (56.7%) causes of SCI commonly affected the cervical spine, whereas TB (24.4%) and tumors (47.5%) had a higher incidence of affecting the dorsal spine. In the absence of a registry or national database for patients with SCI in Bangladesh, this study would serve as representative data for future studies.

Influence of Environmental Barrier on Participation Among Persons with Spinal Cord Injury in Bangladesh

Introduction: Persons with SCI experience limitations of activity and inabilities in their early age in comparison with non-injured individual and also experience difficulties in participation in personal and social life. The participation has significant relationship with environment that’s why improving participation in the socio-cultural context can advance their personal satisfaction adequately for people with spinal cord injury. Disability, individual and environmental factors are considered as indicators of participation. Objectives: To explore the perceive impact of environmental barriers on participation of community dwelling individuals with spinal cord injury in Bangladesh. Methodology: A qualitative study design was selected by the researcher to carry out the research. All dimensions of each individual were completed at one theme in time. Data were collected within a short period of time. The target population was the persons with spinal cord injury discharged from a rehabilitation center and living in the community and data collected by purposive sampling. Results: From the transcriptions, researcher identified 15 environmental factors that influenced participation among individuals with SCI. Approximately there are some causes which straightly influence the participation and some causes through others. Conclusion: Participation have to ensure throw ensure accessibility and removing barrier. The participation of persons with disabilities in the formulation and application of public strategy is perceived as indispensable in dropping poverty and confirming their rights. Exclusionary guidelines not only put burden on the country socio-economically, but also create psychological barricades for people with disabilities to explore full potential.

A community-based intervention to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh (CIVIC): a randomised trial

Study designRandomised controlled trial.ObjectivesTo determine the effectiveness of a sustainable community-based intervention designed to prevent serious complications and death 2 years after discharge in people with spinal cord injury in Bangladesh.SettingBangladesh.MethodsA pragmatic randomised controlled trial was undertaken. People who had sustained a spinal cord injury in the preceding 2 years, were wheelchair-dependent, and were about to be discharged from hospital in Bangladesh were recruited and randomised to an Intervention or Control group using a concealed allocation procedure stratified by level of lesion (tetraplegia/paraplegia). Participants in the Intervention group received 36 phone calls and three home visits over the first 2 years following discharge. All participants received usual post-discharge care. Survival status and date of death were determined by blinded assessors 2 years after randomisation.ResultsBetween July 2015 and March 2018, 410 participants were randomised (204 to Intervention, 206 to Control). There was no loss to follow up. At 2 years, 15 (7.4%) participants in the Intervention group and 16 (7.8%) participants in the Control group had died (hazard ratio from unadjusted Cox model = 0.93 [95% CI, 0.46 to 1.89]; p from log rank test 0.85). There were no clinically important or statistically significant average causal effects of intervention on the incidence or severity of complications.ConclusionA program of community-based care for people with recent spinal cord injury in Bangladesh involving frequent phone contact and occasional in-person contact with a health professional after discharge from hospital is no better at preventing death at 2 years than usual care.

Understanding how a community-based intervention for people with spinal cord injury in Bangladesh was delivered as part of a randomised controlled trial: a process evaluation

DesignMixed methods studySettingCommunity, BangladeshObjectivesTo understand how a community-based intervention for people with spinal cord injury (SCI) in Bangladesh was delivered as part of a randomised controlled trial and to gauge the perceptions of participants and healthcare professionals to the intervention.MethodsA community-based intervention was administered to 204 participants as part of a large randomised controlled trial (called the CIVIC trial). Case-managers followed-up participants with regular telephone calls and home visits over the first 2 years after discharge. The following data were collected alongside the trial: (i) chart audit of telephone calls and home visits (ii) recordings of 20 telephone calls (iii) interviews with 14 Intervention participants and four healthcare professionals including three case-managers.ResultsParticipants received the target number of telephone calls and home visits. Pressure injuries were identified as a problem during at least one telephone call by 43% of participants. Participants and case-managers valued regular telephone calls and home visits, and believed that calls and visits prevented complications and alleviated social isolation. Participants trusted case-managers and were confident in the care and advice provided. Case-managers expressed concerns that people with SCI in Bangladesh face many problems impacting on well-being and motivation stemming from poverty, limited employment opportunities, societal attitudes and inaccessible environments.ConclusionA community-based intervention involving regular telephone calls and home visits was administered as intended and was well received by the recipients of the care. Nonetheless, people with SCI in Bangladesh face economic and social problems which cannot be fully addressed by this type of intervention alone.

Endeavouring sustainable participation: Post-discharge adaptation process of occupational participation among persons with spinal cord injury in Bangladesh

ABSTRACTAgainst a background of high levels of morbidity, mortality, and social exclusion among persons with SCI in Bangladesh, the aim of this research was to identify and describe how these persons experienced adaptation of occupations after discharge from an in-patient rehabilitation hospital. Following ethnographic interviewing and observation, the data of 19 adults with SCI were analysed by an iterative process of constant comparative analysis. The research identified three outcomes of adaptation, (1) creating opportunities for daily occupations, (2) reintegrating daily occupations, and (3) striving for sustainability; and seven doing processes of adaptation, (a) solving problems using local materials and knowledge, (b) reframing one’s situation, (c) adapting the environment (d) recreating routines and habits, (e) evolving vocational and social roles, (f) forming reciprocity, and (g) producing additional roles. These results show that sustainable participation in occupation requires support that enhances adaptation and eliminates maladaptation among persons with SCI living in Bangladesh.

A prediction model to identify people with spinal cord injury who areat high risk of dying within 5 years of discharge from hospital in Bangladesh.

Mixed retrospective and prospective cohort study. To determine 5-year survival after hospitalisation with spinal cord injury (SCI) in Bangladesh and to develop a prediction model to identify people athigh risk of dying within 5 years. Bangladesh. Medical records were used to identify people with SCI admitted to a hospital in Bangladesh in 2011. Participants or their family members were contacted >5 years after discharge to determine vital status or date of death. Survival from time of discharge was estimated with Kaplan-Meier curves. A linear model of the log odds of death within 5 years of discharge was constructed and internally validated. Of the 345 people who were admitted and survived to discharge in 2011, 342 (99%) were accounted for 5 years later: 74 (22%) had died (survival = 78%; 95% CI 74-82%). Sixty nine of the 223 participants who were wheelchair-dependent at discharge had died (survival = 69%; 95% CI 62-75%). A parsimonious model predicted survival as a function of age and mode of mobility at discharge (wheelchair-dependent or ambulant). The odds of dying increased by a factor of 1.6 (95% CI, 1.3-2.0) with every decade of age and by a factor of 12.6 (95% CI, 4.8-32.9) if wheelchair-dependent. The model had good calibration and discrimination. The risk of dying after discharge from hospital with SCI in Bangladesh is high, especially among older, wheelchair-dependent people. A simple prediction model discriminates those at highrisk of dying within 5 years.

Protocol for process evaluation of CIVIC randomised controlled trial: Community-based InterVentions to prevent serIous Complications following spinal cord injury in Bangladesh

IntroductionPeople with spinal cord injuries in low-income and middle-income countries are highly vulnerable to life-threatening complications in the period immediately after discharge from hospital. We are conducting a randomised controlled...

Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh.

Cross-sectional study. To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions. Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury. This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh.

Bull Attack as A Cause of Spinal Cord Injury in Bangladesh - Does it Really Matters?

Bull Attack as A Cause of Spinal Cord Injury in Bangladesh - Does it Really Matters?

Epidemiology of Spinal Cord Injury in Bangladesh: A Five Year Observation from a Rehabilitation Center

Background: Spinal Cord injury, whether traumatic or non-traumatic, is a devastating and debilitating neurological condition and the incidence of spinal cord injury is increasing with time. It was aimed to look into the epidemiology of spinal cord injury in Bangladesh as a preliminary step towards the prevention of this condition and the related complications. Methods: Records of all admitted patients with spinal injuries from January 2011 to June 2016 were collected from the medical records of the Center for Rehabilitation of the Paralysed (CRP) hospital. Records were found of total 2184 respondents and data were analyzed by Statistical Package of Social Science (SPSS) 16 version and Microsoft Excel Software 2007 version. Results: Among 2184 respondents 86.8% (n=1897) were male; most of the patients were in their 3rd decade which consisted 25.7%, 1513 (69.2%) of the respondent were from rural area. About 52% (n=1136) had the diagnosis of traumatic paraplegia and 42.6% (n=932) had traumatic tetraplegia. 992 of the participants (45.4%) had fall from height and Road traffic accident was the second common cause having the distribution of 567 patients (25.9%). Regarding the extent of injury, 59.8% (n=1292) participants had complete injury that is category A in ASIA scale. Conclusion: Despite being a single center based study, this extensive epidemiological data can direct as a base line and further large scale study would better to generalize the result.

A pilot randomised trial of community-based care following discharge from hospital with a recent spinal cord injury in Bangladesh

Objectives: To explore the feasibility of conducting a full trial designed to determine the effectiveness of a model of community-based care for people with spinal cord injury in Bangladesh. Study Design: A pilot randomised trial. Setting: Community, Bangladesh. Subjects: Participants were 30 people with recent spinal cord injury who were wheelchair-dependent and soon to be discharged from hospital. Intervention: Participants randomised to the intervention group received a package of care involving regular telephone contact and three home visits over two years. Participants randomised to the control group received usual care consisting of a telephone call and an optional home visit. Main measures: Participants were assessed at baseline and two years after randomization. The primary outcome was mortality and secondary outcomes were measures of complications, depression, participation and quality of life. Results: A total of 24 participants had a complete spinal cord injury and six participants had an incomplete spinal cord injury. Median (interquartile) age and time since injury at baseline were 31 years (24 to 36) and 7 months (4 to 13), respectively. Two participants, one in each group, died. Five participants had pressure ulcers at two years. There were no notable impediments to the conduct of the trial and no significant protocol violations. The phone calls and home visits were delivered according to the protocol 87% and 100% of the time, respectively. Follow-up data were 99% complete. Conclusion: This pilot trial demonstrates the feasibility of a full clinical trial of 410 participants, which has recently commenced. Sponsorship: University of Sydney, Australia.

Community-based InterVentions to prevent serIous Complications (CIVIC) following spinal cord injury in Bangladesh: protocol of a randomised controlled trial

IntroductionIn low-income and middle-income countries, people with spinal cord injury (SCI) are vulnerable to life-threatening complications after they are discharged from hospital. The aim of this trial is to determine...

Two-year survival following discharge from hospital after spinal cord injury in Bangladesh.

Mixed retrospective-prospective cohort study. To determine 2-year survival following discharge from hospital after spinal cord injury in Bangladesh. Bangladesh. Medical records were used to identify all patients admitted in 2011 with a recent spinal cord injury to the Centre for Rehabilitation of the Paralysed, a large Bangladeshi hospital that specialises in care of people with spinal cord injury. Patients or their families were subsequently visited or contacted by telephone in 2014. Vital status and, where relevant, date and cause of death were determined by verbal autopsy. 350 of 371 people admitted with a recent spinal cord injury in 2011 were discharged alive from hospital. All but eleven were accounted for two years after discharge (97% follow-up). Two-year survival was 87% (95% CI 83% to 90%). Two-year survival of those who were wheelchair-dependent was 81% (95% CI 76% to 86%). The most common cause of death was sepsis due to pressure ulcers. In Bangladesh, approximately one in five people with spinal cord injury who are wheelchair-dependent die within two years of discharge from hospital. Most deaths are due to sepsis from potentially preventable pressure ulcers.

Low assistive technologies for persons with spinal cord injury (SCI) in Bangladesh

Assistive technology can play an important role in allowing a person with spinal cord injury (SCI) to live as independently as possible. The Centre for the Rehabilitation of the Paralysed (CRP) is the only specialized hospital and rehabilitation center in Bangladesh providing rehabilitation for people with SCI. Occupational therapists working in the multidisciplinary team in the Inpatient Unit at CRP play an important role in recommending appropriate assistive technologies for people with SCI. As most of the people with SCI in Bangladesh come from a low socioeconomic background, occupational therapists need to consider low cost assistive technologies. Occupational therapists design and provide a wide range of assistive devices to maximize performance in self-care, productivity, and leisure for people with different levels of SCI. Case examples demonstrate clients’ use of assistive technologies in their local communities. Currently, there is a very limited amount of research on low cost assistive devices in Bangladesh. Thus, ongoing research is required in this area.

Sexual Health of Women with Spinal Cord Injury in Bangladesh

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