Article

The burden of road traffic injuries in Nigeria: Results of a population-based survey

World Health Organization, Abuja, Nigeria.
Injury Prevention (Impact Factor: 1.89). 06/2009; 15(3):157-62. DOI: 10.1136/ip.2008.020255
Source: PubMed

ABSTRACT

Mortality from road traffic injuries in sub-Saharan Africa is among the highest in the world, yet data from the region are sparse. To date, no multi-site population-based survey on road traffic injuries has been reported from Nigeria, the most populated country in Africa.
To explore the epidemiology of road traffic injury in Nigeria and provide data on the populations affected and risk factors for road traffic injury.
Data from a population-based survey using two-stage stratified cluster sampling. SUBJECTS/ SETTING: Road traffic injury status and demographic information were collected on 3082 respondents living in 553 households in seven of Nigeria's 37 states.
Incidence rates were estimated with confidence intervals based on a Poisson distribution; Poisson regression analysis was used to calculate relative risks for associated factors.
The overall road traffic injury rate was 41 per 1000 population (95% CI 34 to 49), and mortality from road traffic injuries was 1.6 per 1000 population (95% CI 0.5 to 3.8). Motorcycle crashes accounted for 54% of all road traffic injuries. The road traffic injury rates found for rural and urban respondents were not significantly different. Increased risk of injury was associated with male gender among those aged 18-44 years, with a relative risk of 2.96 when compared with women in the same age range (95% CI 1.72 to 5.09, p<0.001).
The road traffic injury rates found in this survey highlight a neglected public health problem in Nigeria. Simple extrapolations from this survey suggest that over 4 million people may be injured and as many as 200 000 potentially killed as the result of road traffic crashes annually in Nigeria. Appropriate interventions in both the health and transport sectors are needed to address this significant cause of morbidity and mortality in Nigeria.

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    • "As motorcyclists were at increased risk of serious injury, it is likely that motorcyclists who die at the scene are transported to the morgue rather than the hospital, suggesting that the number of deaths observed in this road user category may be underestimated. Correlation with other RTI data, such as community surveys and police and newspaper records, may clarify how much motorcycle traffic injuries contribute to morbidity and mortality in and around Yaoundé [15] [19] [25]. Indeed, police reports from the Yaoundé –Douala road section from 2004 to 2007 showed that 17% of RTI victims died without reaching the hospital, compared to 3% who died at the hospital and that 'motorcyclist' was the second highest road user category involved in collisions [8]. "
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    ABSTRACT: Background Road traffic injuries (RTIs) are a major cause of death and disability worldwide. In Cameroon, like the rest of sub-Saharan Africa, more data on RTI patterns and outcomes are needed to improve treatment and prevention. This study analyzes RTIs seen in the emergency room of the busiest trauma center in Yaoundé, Cameroon. Methods A prospective injury surveillance study was conducted in the emergency room of the Central Hospital of Yaoundé from April 15 to October 15, 2009. RTI patterns and relationships among demographic variables, road collision characteristics, injury severity, and outcomes were identified. Results A total of 1,686 RTI victims were enrolled. The mean age was 31 years, and 73% percent were male. Eighty-eight percent of road collisions occurred on paved roads. The most common user categories were ‘pedestrian’ (34%) and ‘motorcyclist’ (29%). Pedestrians were more likely to be female (p < 0.001), while motorcyclists were more likely to be male (p < 0.001). Injuries most commonly involved the pelvis and extremities (43%). Motorcyclists were more likely than other road users to have serious injuries (RR = 1.45; 95% CI: 1.25, 1.68). RTI victims of lower economic status were more likely to die than those of higher economic status. Discussion Vulnerable road users represent the majority of RTI victims in this surveillance study. The burden of RTI on hospitals in Cameroon is high and likely to increase. Data on RTI victims who present to trauma centers in low- and middle-income countries are essential to improving treatment and prevention.
    Full-text · Article · Nov 2014 · Injury
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    ABSTRACT: Introduction: Deaths due to road traffic injuries, particularly motorcycle crashes, have increased rapidly in many African nations and context-specific strategies to improve preventative behaviours are needed. Although adhering to conspicuity measures by wearing reflective safety vests is a highly effective crash prevention strategy and mandated by law among motorcycle-taxi drivers in some African countries, actual use is currently low. We aimed to test whether eliminating cost-barriers through the provision of free reflective, fluorescent motorcycle safety vests would lead to increased utilisation among a high-risk population of motorcycle-taxi drivers in Tanzania. Methods: A cluster randomised controlled trial was conducted among 180 motorcycle-taxi drivers. Participants randomised to the intervention arm (90) received free, reflective, fluorescent vests; participants randomised to the control arm (90) did not receive free vests. Participants' use of reflective vests was then observed on city streets over a three month period and differential uptake was estimated using mixed-effects logistic regression. Results: Baseline use of reflective vests was 3.3% in both arms. Seventy-nine drivers in the intervention arm and 82 drivers in the control arm were observed during follow-up. The average proportion of observations during which motorcycle drivers were using a reflective vest was 9.5% in the intervention arm, compared to 2.0% in the control arm (odds ratio: 5.5, 95% confidence interval: 1.1-26.9, p-value: 0.04). Conclusion: Although distribution of free reflective vests led to a statistically significant increase in vest usage, the absolute increase was modest. Additional strategies beyond removing economic barriers are important to augment adherence to road safety behaviours for injury prevention.
    Full-text · Article · Apr 2014 · Injury
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    • "Injury [6] [7] "
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    ABSTRACT: Introduction Deaths due to road traffic injuries, particularly motorcycle crashes, have increased rapidly in many African nations and context-specific strategies to improve preventative behaviors are needed. Although adhering to conspicuity measures by wearing reflective safety vests is a highly effective crash prevention strategy and mandated by law among motorcycle-taxi drivers in some African countries, actual use is currently low. We aimed to test whether eliminating cost-barriers through the provision of free reflective, fluorescent motorcycle safety vests would lead to increased utilization among a high-risk population of motorcycle-taxi drivers in Tanzania. Methods A cluster randomised controlled trial was conducted among 180 motorcycle-taxi drivers. Participants randomised to the intervention arm (90) received free, reflective, fluorescent vests; participants randomised to the control arm (90) did not receive free vests. Participants’ use of reflective vests was then observed on city streets over a three month period and differential uptake was estimated using mixed-effects logistic regression. Results Baseline use of reflective vests was 3.3% in both arms. Seventy-nine drivers in the intervention arm and 82 drivers in the control arm were observed during follow-up. The average proportion of observations during which motorcycle drivers were using a reflective vest was 9.5% in the intervention arm, compared to 2.0% in the control arm (odds ratio: 5.5, 95% confidence interval: 1.1-26.9, p-value: 0.04). Conclusion Although distribution of free reflective vests led to a statistically significant increase in vest usage, the absolute increase was modest. Additional strategies beyond removing economic barriers are important to augment adherence to road safety behaviors for injury prevention.
    Full-text · Article · Jan 2014 · Injury
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