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Background: Traumatic spinal cord injury (TSCI) is not only a life-threatening but also life changing event that happens suddenly, the effects extends beyond the TSCI survivors to include their families. In Rwanda to the best knowledge of authors, there is no published information on the epidemiology of TSCI. The aim of this study was therefore to determine the incidence rate, etiology and injury characteristics of TSCI., Methods: All survivors of acute TSCI who met the inclusion criteria were prospectively recruited for a one-year period. The International Spinal Cord Injury Core Data Set was used to collect the minimum set of variables to facilitate worldwide comparison of epidemiological data, while the International Standards for the Neurological Classification was used to categorize TSCI according to the American Spinal Injury Association Impairment Scale (AIS). Data were collected by trained physiotherapists., Study Design: A prospective, open-ended, cohort study design., Setting: All referral hospitals within the Republic of Rwanda., Results: Overall, 122 adult individuals sustained a TSCI between 10th October 2019 until 9th October 2020 and all consented to take part in the study. The male-to-female ratio was 3.9:1, and the mean age was 42.5 (SD = ±14.8) years. The crude incidence rate of TSCI was 22.2 per million people (95% CI, 18.4-26.5) with significant differences in sex-adjusted rates for all age groups while men 46 years of age and older presented with the highest incidence. The leading causes of TSCI were falls (73.8%), followed by road traffic accidents (18.9%). Moreover, SCI lesions of the cervical region ( n  = 69) were the most common, followed by the lumbosacral region ( n  = 27). Fifty-one (41.8%) participants were diagnosed as complete injury, i.e., AIS A, while incomplete injury category C constituted 35 (28.7%)., Conclusion: The incidence and etiology of TSCI in Rwanda are comparable to worldwide estimates and figures. Largely, the etiology of TSCI are preventable as it is caused due to falls and road traffic accidents. There is a need to consider preventive strategies and policies on activities that predispose people to falls. Policies should focus largely on occupational health and safety in both formal and informal sectors of work., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kanyoni, Wikmar, Philips, Joseph and Tumusiime.)

Background: The provision of specialized care in a time-sensitive manner has shown to be crucial for survival and recovery of functioning after a traumatic spinal cord injury (TSCI). However, little is known about the provision of TSCI care in different international contexts; information which is required for strengthening policy and practice. Aims: The overarching aim of this study will be to explore health care processes and outcomes of TSCI care in South Africa and Sweden. Specific aims will be to: (1) describe acute processes of TSCI care, (2) determine acute- and long-term outcomes of TSCI care, and (3) identify predictors for survival, secondary complications, and functioning 12 months post-injury. Methods: A prospective (regional), population-based cohort study where adults with an acute TSCI will be recruited over at least a 1-year period from the City of Cape Town, South Africa, and Stockholm, Sweden. The anticipated sample size inclusive of both international contexts will be 200 participants-based on a power calculation for detecting differences in mortality. Information on the nature and timing of processes of acute care (e.g., transfer logistics, spinal surgery, and specialized SCI care) will be collected on acute care admission and discharge using a standardized form. Survival status, secondary complications, neurological symptoms, functional status, activity, and participation as well as health-related quality of life will be collected at discharge from SCI acute care and at 12-months post-injury. Secondary complications and functioning will be compared between South Africa and Sweden using inferential statistics. To address mortality specifically, the indirect standardization method for differences in mortality between contexts will be used whereby Stockholm will serve as standard for specialize care. For the assessment of factors related to mortality and other outcomes (e.g., neurological and secondary health conditions) multivariate regression analyses will be used to determine independent risk factors. Conclusion: This study offers a unique investigation of the relationship between health care processes and outcomes of TSCI care with the aim of strengthening management guidelines for SCI in South Africa and Sweden.