Serum S100B measurement as a diagnostic tool and prognosis predictor in head trauma in resource limited settings: insights from Harare, Zimbabwe

Abstract

Introduction: Traumatic brain injury (TBI) as a major cause of global morbidity and mortality. CT scan and MRI are very useful tools in the evaluation of TBI yet in resource limited settings are mostly unavailable or expensive and are therefore not readily available for the evaluation of this condition. Serum S100B proteins levels were evaluated in this study as an additional tool for TBI diagnosis and the outcomes were observed.

Materials and Methods: Using an ethically approved protocol, we recruited 90 consenting individuals: 50 TBI suspects (HIP), 20 healthy individuals (AHP) and 20 with non-neurological conditions (NNCP) from Parirenyatwa Hospital, Harare Zimbabwe. Serum S100B levels were determined by an ELISA kit. Questionnaires and clinical examination records were used to obtain participants’ demographic data.

Results: Participants’ median age was 33.0 interquartile range (IQR): 28-43 years, with more males than females being recruited (p=0.001). The major cause of TBI in this study was motor vehicle crushes (78%). Median S100B levels were significantly higher in TBI suspects compared to AHP and NNCP. High levels of serum S100 were associated with a higher mortality. A CT scan result positive for neurological damage and severe head injury based on the Glasgow Coma Scale (GCS) was associated with high serum S100B levels (p=0.003 and p=0.002 respectively). A serum S100B above 350pg/ml with a median of 442pg/ml was uniformly fatal.

Conclusion: Despite the small sample size, our study highlights the potential of S100B measurements in diagnosis and prognosis prediction for TBI cases in settings where CT scan is unavailable and or unaffordable.