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Trauma registries play an important role in building capacity for trauma systems. Regularly, trauma registries exist in high-income countries (HICs) but not in low- and middle-income countries (LMICs). Neurotrauma includes common conditions, like traumatic brain injuries (TBIs) and spinal cord injuries. The development of organized neurotrauma care is crucial for improving the quality of care in less-resourced areas. The recent article published in International Journal of Health Policy and Management by Barthélemy et al entitled "Neurotrauma Surveillance in National Registries of Low- and Middle-Income Countries: A Scoping Review and Comparative Analysis of Data Dictionaries" adds an important body of literature to improve understanding of the importance of these types of efforts by promoting organized neurotrauma care systems in LMICs. Here, we provide a short commentary based on our experience with the Latin America and the Caribbean Neurotrauma Registry (LATINO-TBI) in the Latin America (LATAM) region.

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Objectives Latin America is among several regions of the world that lacks robust data on injuries due to neurotrauma. This research project sought to investigate a multi-institution brain injury registry in Colombia, South America, by conducting a qualitative study to identify factors affecting the creation and implementation of a multi-institution TBI registry in Colombia before the establishment of the current registry. Methods Key informant interviews and participant observation identified barriers and facilitators to the creation of a TBI registry at three health care institutions in this upper-middle-income country in South America. Results The study identified barriers to implementation involving incomplete clinical data, limited resources, lack of information and technology (IT) support, time constraints, and difficulties with ethical approval. These barriers mirrored similar results from other studies of registry implementation in low- and middle-income countries (LMICs). Ease of use and integration of data collection into the clinical workflow, local support for the registry, personal motivation, and the potential future uses of the registry to improve care and guide research were identified as facilitators to implementation. Stakeholders identified local champions and support from the administration at each institution as essential to the success of the project. Conclusion Barriers for implementation of a neurotrauma registry in Colombia include incomplete clinical data, limited resources and lack of IT support. Some factors for improving the implementation process include local support, personal motivation and potential uses of the registry data to improve care locally. Information from this study may help to guide future efforts to establish neurotrauma registries in Latin America and in LMICs.

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Introducción: el trauma ocular constituye una causa importante de morbilidad visual en todo el mundo. Se estima que 55 millones de traumas oculares ocurren cada año a pesar de ser prevenibles en la mayoría de los casos. Objetivo: Caracterizar el perfi l clínico y epidemiológico de los pacientes con trauma ocular, en diferentes ciudades de Colombia, entre junio de 2013 y enero de 2018. Diseño del estudio: observacional descriptivo, estudio transversal. Método: es un estudio observacional, descriptivo, cuya población objetivo fueron pacientes con trauma ocular, atendidos en diferentes centros y hospitales en Colombia, por los servicios de retina entre junio de 2013 y enero de 2018. Se diseñó un formulario de preguntas por medio de Google forms y se analizaron diferentes variables, apoyándonos en el Birmingham Eye Trauma Terminology System. Los datos fueron llenados principalmente por retinólogos. Resultados: se recolectaron datos de 619 pacientes entre junio 2013 y enero 2018, el rango de edad fue entre 16-30 años, en su mayoría hombres. La ciudad en donde se registraron la mayoría de los pacientes fue Cali. El compromiso de la agudeza visual (AV) fue severo en la mayoría de los casos (MM-PL) y el mecanismo más común fue el accidente laboral. La lesión más registrada fue la contusión ocular. La mayoría de los pacientes no usaba protección al momento del trauma. Conclusión: el trauma ocular se presentó más comúnmente en hombres, jóvenes en accidentes de tipo laboral. Presentaron compromiso severo de la AV, predominando la visión de MM a PL. Es el primer reporte de un estudio de sus características en Colombia, dando recomendaciones específicas al ministerio de salud y estimulando al registro de más datos a nivel nacional para lograr prevenir las causas más importantes de trauma.

Background: eye trauma is an important cause of visual morbidity worldwide. An estimated 55 million eye traumas occur each year despite being preventable in most cases. 3% of these lead to blindness. Objective: to characterize the clinical and epidemiological profi le of patients with ocular trauma, in diff erent cities of Colombia, between June 2013 and January 2018. Study design: cross-sectional. Method: it is an observational, descriptive study, whose target population was patients with ocular trauma, attended in different centers and hospitals in Colombia, for retina services between June 2013 and January 2018. A question form was designed using Google forms and diff erent variables were analyzed, based on the Birmingham Eye Trauma Terminology System. The data was filled mainly by retinologists, who receive patients referred from the emergency department. Results: data were collected from 619 patients between June 2013 and January 2018, the most common age range was between 16-30 years, mostly men. The city where the majority of patients registered was in Cali. The commitment of visual acuity was severe in most cases (MM-PL). The most common mechanism of trauma was the occupational accident and the most common lesion was ocular contusion. Most patients did not use protection at the time of the trauma. Conclusion: ocular trauma occurs most commonly in men, young people and in work-related accidents. They presented severe compromise of visual acuity, predominantly the vision of MM to PL. It is the fi rst report of a study of its characteristics in Colombia, giving specifi c recommendations to the ministry of health and encouraging the registry of more data at a national level to prevent the most important causes of trauma.

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Background: In Peru, 11% of deaths are due to trauma. Iquitos is a large underserved Peruvian city isolated from central resources by its geography. Our objective was to implement a locally driven trauma registry to sustainably improve trauma healthcare in this region. Methods: All trauma patients presenting to the main regional referral hospital were included in the trauma registry. A pilot study retrospectively analyzed data from the first two months after implementation. Results: From March to April 2013, 572 trauma patients were entered into the database. Average age was 26.9 years. Ten percent of patients presented more than 24 hours after injury. Most common mechanisms of injury were falls (25.5%), motor vehicle collisions (23.3%), and blunt assault (10.5%). Interim analysis revealed that 99% of patients were entered into the database. However, documentation of vital signs was poor: 42% of patients had temperature, 26% had oxygen saturation documented. After reporting to registry staff, a significant increase in temperature (42 to 97%, P < 0.001) and oxygen saturation (26 to 92%, P < 0.001) documentation was observed. Conclusion: A trauma registry is possible to implement in a resource-poor setting. Future efforts will focus on analysis of data to enhance prevention and treatment of injuries in Iquitos.