Review of Trauma Data in Conflict Middle East and North Africa Nations: An Appeal for Registry Sharing.

INTRODUCTION: Traumatic injury is a global health burden. 90% of injury related deaths occur in low- and middle-income countries (LMICs) and this unequal distribution is worsened in countries operating within conflict, especially the Middle East and North Africa (MENA). Civilian mortality is increasingly common on the modern battlefield, but injuries sustained by civilians are poorly documented, presenting a significant barrier to the medical treatment of this population. METHODS: We conducted a systematic search of databases and gray literature repositories to identify records that described trauma databases with information regarding injuries sustained by civilians and in the MENA countries suffering from a conflict in the 21st century: Lebanon, Gaza/West Bank, Syria, Iraq, Yemen, and Libya. Data were extracted from the included articles, compiled, and statistical as well as bibliometric analysis was performed. RESULTS: Only 12% of studies analyzed data collected for a timeframe longer than 10 ys. While the rate of data collection occurred within the 6 MENA countries 89% of the time, together these countries together house only 11% of the trauma registries containing data on their civilians (2.4% Lebanon, 2.4% Palestine, 1.6% Iraq, 1.6% Yemen, 1.6% Syria, 1.6% Libya). Location of dataset could not be identified for 1.6%. In contrast, the USA contains 75% of the data registries cited in our publication cohort; UK holds 6%; Israel holds 3% of the trauma data; Turkey and Jordan combined also hold another 3% of trauma data. CONCLUSIONS: The present study seeks to reveal what trauma data, if any, is being collected in the MENA conflict countries, who is collecting these data, and what benefits the data collection may have in reducing trauma mortality. Our analysis identified primarily Trauma data that are collected are likely largely inaccessible to clinicians and researchers within the countries described as they are housed by entities outside of the countries of interest.

Duke Scholars

Author Tamara Noel Fitzgerald Surgery, Pediatric General Surgery

Author Beth Blackwood