Every year, brain and spine injuries cost 127 low- and middle-income countries an estimated $3 trillion in lost economic welfare. This research group will expand its focus from traumatic injuries to include stroke, brain infections, and cerebrospinal fluid disorders—five conditions that together cause a massive burden of death and disability in the world’s poorest regions. Why this matters: Most research on acquired brain and spine injury comes from wealthy countries, yet the vast majority of cases occur in places with weak health systems, few surgeons, and little data. This project will map existing care, test new treatments through randomised trials, and build registries across 24 countries to fill that knowledge gap. If successful, the work could directly change how nurses, therapists, and surgeons manage these injuries in resource-limited settings. It aims to influence health ministries’ policies on surgical care and rehabilitation, and to create a lasting network of researchers who can continue improving outcomes long after the grant ends. The projects also target UN sustainable development goals for health and wellbeing.
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Background: Injuries to the brain and spine have profound consequences and are an important contributor to death and disability worldwide. The term ‘acquired’ brain and spine injury encompasses traumatic injuries (e.g. due to road traffic accidents, falls) and non-traumatic injuries (e.g. stroke, brain infections, CSF disorders/hydrocephalus etc). Many of these acquired injuries are treated with surgery. The burden of disease of ABSI is greatest in LMICs with severe economic consequences. A recently published value of lost economic welfare model estimated that 127 LMICs experienced $3 trillion US dollars in economic welfare losses in 2015 due to ABSI that can be treated surgically. Thus, research into ABSI is urgently required. Aim: We aim to expand the previously funded NIHR Global Health Research Group on Neurotrauma to focus on five conditions (traumatic brain injury, traumatic spine injury, stroke, brain infections, CSF disorders/hydrocephalus) causing a substantial burden of disease in LMICs. We will retain the successful theme-based format (Mapping care; Understanding Care; Generating and implementing innovation; Capacity building). We aim to pay particular attention to the role of nurses, allied health professionals and rehabilitation services in the care of patients with these conditions. Method: 16 projects under 4 themes will be undertaken. The projects have a diverse methodology from qualitative research, registries, observational cohort studies to interventional randomised trials. The projects span over 24 countries and involve a diverse skill set and a multi-disciplinary team (clinicians, nurses, allied health professionals, public health researchers, and patients). In addition, we will continue supporting the Global TBI registry. Impact: This proposal tackles 5 key conditions by defining the scale of the problem and by evaluating / developing innovative ways of addressing unmet needs. There is also a large component dedicated to education and training. Through ongoing engagement with stakeholders (e.g. ministries of health, hospital management etc) we aim to significantly influence health policy. Furthermore, the networks created will establish a sustainable platform for global health researchers to flourish for years to come. Finally, many of our projects directly address the UN sustainable development goals by promoting wellbeing for all.
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