Author(s): KAUX, J., TOOTH, C., FISCHER, L., LECLERC, S., KAUX, J.F., TSCHOLL, P., Institution: UNIVERSITY OF LIÈGE, Country: BELGIUM, Abstract-ID: 1133

INTRODUCTION:
Sport-related concussion is a major health concern in football, with increasing evidence linking repetitive head impacts to both short-term cognitive impairment and long-term neurodegenerative outcomes. Although international bodies have developed assessment tools and return-to-play guidelines, their implementation remains inconsistent, particularly in resource-limited settings. Little is known about how concussions are recognised and managed in West African football or about the applicability of these international tools in local contexts.
The objectives were to explore how sport-related concussions are recognised and managed in elite football settings in West Africa, and to assess the relevance and applicability of international concussion tools within these contexts.
METHODS:
This study used the grounded theory approach. Semi-structured interviews were conducted with eight physicians working with elite clubs and national football teams in Senegal, Mali, and The Gambia. Interviews were audio-recorded, transcribed verbatim, and analysed using iterative open, axial, and selective coding to identify key themes.
RESULTS:
Six interrelated themes emerged. First, the true burden of concussion remains poorly understood due to under-recognition and under-reporting, with risks often overshadowed by conditions perceived as more immediately life-threatening, such as cardiac events. Second, established protocols and tools, including the SCAT, are rarely implemented in practice. Third, organisational constraints and limited resources restrict optimal care delivery. Fourth, clinical decision-making is frequently influenced by external pressures and the absence of structured federation support. Fifth, concussion education is limited and largely theoretical. Finally, sociocultural factors—including norms surrounding toughness, gender dynamics, spiritual beliefs, and crowd expectations—substantially shape clinical practice.
CONCLUSION:
Concussion management in West African football is characterised by limited recognition, structural challenges, and strong sociocultural influences, which collectively reduce the practical relevance of existing international guidelines. Expanding access to context-sensitive education, strengthening federation-level governance (e.g., designated concussion leads), and developing culturally adapted strategies appear essential to improving concussion recognition and management in this setting.