Bull attack as a cause of spinal cord injury in Bangladesh - Does it really matters?

Letter to Editor

Dear Sir,

Spinal cord injury (SCI) is a debilitating condition which has profound impact over physical, mental, domestic and social life of an individual [1, 2]. Globally a trend has been observed that most of the traumatic spinal cord injuries result from either road traffic accident or fall from height [1, 3, 4, 5]. There are also variations in the cause of SCI in respect of area, culture and so on.

Bangladesh, a developing country of South-Asia region, despite being burdened with a population of about 160 million [1, 2, 6] has attained compelling achievement in health sector [3]. Evidence from available literatures, trauma of different modalities along with some non- traumatic causes are the principle element of SCI in Bangladesh. Specialized center like Centre for Rehabilitation of the Paralyzed (CRP) is a well- renowned institute which plays a pivotal role in rehabilitation of the SCI patients in Bangladesh [2]. A recent study reported that approximately 390 patients per annum with injury to the spinal cord were admitted to the CRP [2].

Trauma was found to be the main cause of SCI and the incidence was 94.8% [2]. Among the traumatic causes fall from height is the most common cause [1, 2]. Interestingly bull attack was found to be as one the causes of SCI in Bangladesh. As reported by Rahman et al. [2] bull attack was found to be associated with SCI in about 2% (n=40) in five year duration from a single rehabilitation centre. Sporting injury, violence and often gunshot injury are also reported in United States [5] and in Sub-Saharan Africa collapsed tunnel during illegal mining is also reported [4]. These reports presented the variations of SCI cause in different aspects. Though various countries like the United State, Spain, Mexico, and Australia have a much higher number of livestock handling in comparison to Bangladesh yet bull attack or attack by animal is yet to be reported as a significant cause of traumatic SCI. Other forms of injury such as bull goring, blunt abdominal trauma was quite commonly mentioned [7] but not Spinal cord injury of any form. Whether this mode of spinal cord injury by bull attack occurred due to lack of proper knowledge of animal husbandry or unsafe mode of animal handling was not mentioned in the findings. It alerts the authors that ‘this fairly new and interesting phenomenon’ [2] might be further researched so that the cause can be addressed and awareness can be developed among the people regarding the debilitating consequences of SCI.

Conflict of Interest: None

References

1. Quadir MM, Sen K, Sultana MR, Ahmed MS, Taoheed F, et al. Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh. Int J Neurorehabilitation. 2017; 4: 244.
2. Rahman A, Ahmed S, Sultana R, Taoheed F, Andalib A, et al. Epidemiology of Spinal Cord Injury in Bangladesh: A Five Year Observation from a Rehabilitation Center. J Spine. 2017;6:367.
3. Andalib A, Arafat SMY. Practicing Pattern of Physicians in Bangladesh. Int J Perceptions Pub Health. 2016; 1(1):9-13.
4. Draulans N, Kiekens C, Roels E, Peers K. Etiology of spinal cord injuries in Sub-Saharan Africa. Spinal Cord. 2011;49(12):1148-54.
5. Fehlings M, Singh A, Tetreault L, Kalsi-Ryan S, Nouri A. Global prevalence and incidence of traumatic spinal cord injury. Clinical Epidemiology. 2014:309.
6. Arafat SMY. Anti-ulcerants: The driving force of the pharma market of Bangladesh. Int J Perceptions Public Health. 2016; 1: 1-2.
7. Rani, M., Rohit, Sharma, A. and Dikshit, P.C. Injuries by Bull Horns: Patterns And Prevention Protocols. Anil Aggrawal's Internet J Forensic Med Toxicol. 2010;11(1):1-26.