with the focus of the survey on consequential injuries.
However, a review of injury reports by month indicated that
44% of injuries were reported in the most recent 6 months and
the rest in the next half of the 12-month period, reflecting that
there was no sharp fall in monthly recall within the time period.
Whereas ,60% of the Nigerian population lives in rural areas,
the reverse is represented in this survey population—an artefact
of the sampling technique used in the study and an over-
representation of the urban population. This may have resulted
in the bulk of significant difference between rural and urban
RTI rates. It may have also affected the distribution of
education and marital status (table 1) in the sample used in
Initially, a fatality was defined as a death within 30 days of an
RTI, but respondents in certain parts of the surveyed areas were
very sensitive to a discussion of death in this time period during
pilot testing. As a result, the definition had to be revised to
death on the scene or in the hospital, and this may have resulted
in under-reporting of deaths in the survey. The study also
provides limited classification of injury severity and treatment
consequences for injury. Although designed to capture informa-
tion from a representation of Nigeria’s diverse geopolitical
zones, this survey is not nationally representative. Although the
sample size allows estimation of RTI incidence rates, the study
was not powered to look at disaggregated analysis by gender,
age and educational status.
This survey suggests that the morbidity and mortality caused
by RTIs in Nigeria may be much higher than previously
appreciated. Given the number of Nigerian lives that are
potentially affected and lost by RTIs on an annual basis,
improved prevention measures, prioritisation of policy mea-
sures, and further exploration of accurate methods of injury
surveillance are strongly warranted.
Acknowledgements: We thank Malecki Khayesi from WHO-Geneva, for his
assistance and kind comments on earlier drafts of this paper, and Isiaka Olarewaju, for
his guidance on the project’s preliminary statistical analysis.
Funding: The study design and data collection were funded by the Africa Regional
Office of the World Health Organization.
Competing interests: None.
Contributors: ML was responsible for the study design, survey development, data
collection and outline of paper. CJ analysed data and wrote the first draft of the paper.
OCK assisted with the study design and data collection. AAH guided the study design,
data analysis, edited all drafts, and approved the final manuscript.
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What this study adds
c The population burden of road traffic injury is high in Nigeria,
at 41 per 1000 population (95% CI 34 to 49).
c Surprisingly, motorcycle injuries comprise over half of road
traffic injuries in this sample.
c There was no significant difference in the estimated road
traffic injury rates of urban and rural populations in Nigeria.
What is already known on this topic
c Road traffic injuries are an increasing cause of death and
disability in developing countries.
c Mortality due to road traffic injuries in sub-Saharan Africa is
among the highest in the world.
Injury Prevention 2009;15:157–162. doi:10.1136/ip.2008.020255 161
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