The burden of Traumatic Brain Injury (TBI) disproportionately affects low and middle income countries (LMIC), in which TBI prevalence is high and patients are twice as likely to die from their TBI as those in high income countries. LMICs in Eastern European and Central Asia are characterized by growing economies but relatively poor health infrastructures. Consequently, health needs are great, as is potential for improvement. The University of Iowa's Injury Prevention Research Center and Babes-Bolyai University's Center for Health Policy and Public Health located in Cluj-Napoca, Romania are collaborating on this proposed transnational project to increase research capacity in three LMICs, focusing on traumatic brain injury (TBI) data capacity. The project will capitalize on an existing network of research collaborations held by Babes-Bolyai University at three academic centers and hospitals located in Armenia, Georgia, and Moldova: three countries strategically located between Europe, Russia, and the Middle East. The goal of the project is to strengthen institutional research capacity and partnerships among participating countries and to lay a solid foundation on which to build evidence-based prospective research to reduce the incidence and reduce the consequences of TBI. The specific aims are to: 1) identify and describe current TBI data collection practices; 2) develop a comparable TBI registry system; and 3) to conduct comparative analyses of TBI data. The project will be implemented in a number of phases, each of which integrates participatory practices. The first phase will involve an environmental scan and comparative map that identifies current TBI reporting practices and capacity. A comprehensive registry protocol will next be developed by the research team, and implementation of the registry will occur through a monitored process to ensure high data quality. Comparative data analysis to identify the prevalence, patient and injury characteristics, and treatments and procedures will then be conducted. After completing the scope of work outlined in this proposal, we anticipate that our partner countries will have high quality, comparable TBI data and will be ready to initiate clinical and intervention trials. The proposal is innovative in that it will engage US and European experts along with practitioners in LMICs to improve TBI data infrastructure and research capacity using successful models. The project builds on a successful model of collaboration and a team with more than 25 years of experience in research and training activities, including the training of international scholars in research methodology, development of injury registry and surveillance programs, and the development of several international masters and PhD degree programs.

The burden of Traumatic Brain Injury (TBI) disproportionately affects Low- and Middle Income Countries (LMICs), as prevalence of TBI is high and patients from LMICs are twice as likely to die following TBI as in high-income countries. This project will expand successful collaboration between the US and Romania to Armenia, Georgia, and Moldova, three LMICs strategically located between Europe, Russia, and the Middle East. This project will develop hospital-based TBI registries to document the burden and characteristics of TBI, a critical step in implementing long-term studies to identify prevention priorities and improve treatment outcomes.