Under-reporting of road traffic crash data in Ghana

Having reliable estimates of the shortfalls in road traffic crash data is an important prerequisite for setting more realistic targets for crash/casualty reduction programmes and for a better appreciation of the socio-economic significance of road traffic crashes. This study was carried out to establish realistic estimates of the overall shortfall (under-reporting) in the official crash statistics in Ghana over an eight-year period (1997–2004). Surveys were conducted at hospitals and among drivers to generate relevant alternative data which were then matched against records in police crash data files and the official database. Overall shortfalls came from two sources, namely, ‘non-reporting’ and ‘under-recording’. The results show that the level of non-reporting varied significantly with the severity of the crash from about 57% for property damage crashes through 8% for serious injury crashes to 0% for fatal crashes. Crashes involving cyclists and motorcyclists were also substantially non-reported. Under-recording on the other hand declined significantly over the period from an average of 37% in 1997–1998 to 27% in 2003–2004. Thus, the official statistics of road traffic crashes in Ghana are subject to significant shortfalls that need to be accounted for. Correction factors have therefore been suggested for adjusting the official data.     

Estimating road traffic injuries in Jinja district,Uganda, using the capture-recapture method

ABSTRACT

Road traffic injuries (RTIs) are commonly under-reported in low-and-medium-income countries. This study aimed to estimate the number of RTIs and determine the magnitude of under-reporting by traffic police and hospital registries. A two-source capture-recapture method was applied to RTI data from police and hospital registries. Seven matching variables; sex of the injured, date, place, time, day of crash and road user type were used to get the matched cases. Police independently reported 46 RTIs and the hospitals reported 206 RTIs. Using the capture-recapture analysis, both sources estimated 313 RTIs (95% CI 273–343). The police registry captured 14.4% of the estimated number of RTIs and the hospitals captured 60.4%. The estimated number of RTIs was higher than reported by either the police or the hospitals alone. Neither the police nor the hospitals provided accurate data on RTIs, calling for the strengthening of both sources of data.     

Morbidity and mortality from road traffic crashes in children in Metro West,City of Cape Town – 2014

The road traffic crash injury burden significantly impacts the lives of South African children. This study aimed to assess the fatal and non-fatal pattern of road traffic crash injury of children under 13 years old from Metro West, City of Cape Town, from 1 January until 31 December 2014. The data were stratified by age, sex and mechanism of road traffic crash. The overall mortality rate was 8.7 per 100 000 population and pedestrians contributed the most to this burden (72.5%). There were more male children involved in a road traffic crash (p?=?0.0001). The greatest proportion of fatal and non-fatal road traffic crash injuries was observed in children aged 5–9 years. Fractures contributed to the greatest rate of years lived with disability (3.0 years of life lived with disability per 100 000). Our study found that the burden of road traffic crashes primarily affects male pedestrians aged 5–9 years old.     

Prioritisation of road traffic injury interventions: results of a participative research with stakeholders in Mexico

The objective of this study is to use a qualitative approach to prioritise road traffic injury (RTI) interventions for the city of Cuernavaca in Mexico. Seven focus group discussions and two nominal groups were held with participants representing different road users and social groups. All the focus group sessions were recorded and video filmed. Processing and analysis of the information gathered was done using qualitative methods. The problem of RTIs was well recognised by members of the local community, represented by participants in this study. The participants showed knowledge of the causes and related urban development dynamics. Participants identified possible interventions, and even rated them. The participatory approach utilised generated helpful insights and it enabled the researchers to identify key local actors and issues, for example, concerns of different road users, perception of certain factors and actors as causes of RTIs, and attitudes and behaviour within a specific physical environment. A prioritised list for 18 different interventions was developed. The first one will be implemented to prevent RTIs in the youth population. Understanding the social context to analyse the problem and possible solutions as seen by the community is important when analysing public health problems because it informs decision making when developing and implementing interventions.     

Prioritisation of road traffic injury interventions: results of a participative research with stakeholders in Mexico

The objective of this study is to use a qualitative approach to prioritise road traffic injury (RTI) interventions for the city of Cuernavaca in Mexico. Seven focus group discussions and two nominal groups were held with participants representing different road users and social groups. All the focus group sessions were recorded and video filmed. Processing and analysis of the information gathered was done using qualitative methods. The problem of RTIs was well recognised by members of the local community, represented by participants in this study. The participants showed knowledge of the causes and related urban development dynamics. Participants identified possible interventions, and even rated them. The participatory approach utilised generated helpful insights and it enabled the researchers to identify key local actors and issues, for example, concerns of different road users, perception of certain factors and actors as causes of RTIs, and attitudes and behaviour within a specific physical environment. A prioritised list for 18 different interventions was developed. The first one will be implemented to prevent RTIs in the youth population. Understanding the social context to analyse the problem and possible solutions as seen by the community is important when analysing public health problems because it informs decision making when developing and implementing interventions.     

Strengthening care for injured persons in less developed countries: A case study of Ghana and Mexico

In all countries, the priority for reducing road traffic injuries should be prevention. Nonetheless, there are low-cost ways to strengthen the care of injured persons, that will help to lower the toll from road traffic. The purpose of this review was to elucidate ways to accomplish this goal in the context of less developed countries. Studies selected for this review were obtained by Medline review, selecting on key words such as trauma, injury, trauma care, essential health services, and developing country. Articles pertaining to any country and all available years were considered. In addition, the authors utilized articles from the gray literature and journals from Mexico and Ghana that are not Medline referenced. Studies surveyed point to road safety and other forms of injury prevention, as well as prehospital care, as likely priorities for developing countries. Nonetheless, hospital-based improvements can contribute to decreases in mortality and, especially, decreases in disability. For both prehospital and hospital based care, studies revealed several critical weak points to address in: (1) human resources (staffing and training); (2) physical resources (equipment, supplies, and infrastructure); and (3) administration and organization. The ‘essential services’ approach, which has contributed to progress in a variety of fields of international health, needs to be developed for the care of the injured. This would define the trauma treatment services that could realistically be made available to virtually every injured person. It would then address the inputs of human resources, physical resources, and administration necessary to assure these services optimally in the different geographic and socioeconomic environments worldwide. Finally, it would identify and target deficiencies in these inputs that need to be strengthened.     

Built environment analysis for road traffic hotspot locations in Moshi,Tanzania

Road traffic injuries (RTIs) cause significant morbidity and mortality in low- and middle-income countries. Investigation of high risk areas for RTIs is needed to guide improvements. This study provides built environmental analysis of road traffic crash hotspots within Moshi, Tanzania. Spatial analysis of police data identified 36 hotspots. Qualitative comparative analysis revealed 40% of crash sites were on local roads without night lighting and increased motorcycle density. Paved narrow roads represented 26% of hotspots and 13% were unpaved roads with uneven roadsides. Roadside unevenness was more predominate in low risk [n = 19, (90.5%)] than high risk sites [n = 7 (46.7%)]. Both low [n = 6 (28.6%)] and high risk [n = 1 (6.7%)] sites had minimal signage. All sites had informal pedestrian pathways. Little variability between risk sites suggests hazardous conditions are widespread. Findings suggest improvement in municipal infrastructure, signage and enforcement is needed to reduce RTI burden.     

Opportunities,threats and barriers to enacting mandatory child car restraint laws in Iran

Approximately one-third of Iranian children's deaths are caused by injuries. Of these, 36% result from road traffic injuries (RTIs). Both RTIs and fatalities could be reduced by using child car restraints (CCRs). Despite their demonstrated effectiveness, CCRs are not mandatory in Iran. This study was conducted to assess opportunities and barriers in enacting mandatory CCR laws in that country. Using mixed method research, a phenomenological approach was used to explore the experiences and perspectives of road safety stakeholders in regard to opportunities and threats in enacting mandatory CCR laws in Iran. The themes derived from group discussions were used to first develop a structured questionnaire, which was later distributed to and completed by study participants. The study analysis was conducted using scores and rankings from the responses to these questions. Twenty-eight stakeholders participated in the study. Most were male, aged 36.7 ± 5.6 (range 25–59). In terms of identifying the organization that should establish mandatory CCR laws, the Traffic Police Department achieved the highest score of 90 (range 0–100). The participants also thought that the Traffic Police department is responsible to monitor compliance and conduct follow-up investigations (score = 100). In regard to existing barriers in enacting CCR laws, the lack of positive Publicity by mass media and the lack of related laws received scores of 85 and 70, respectively. Enabling factors and opportunities included ‘positive regards or attitude of families towards their child's health,’ ‘officials’ commitment to support such laws' and ‘having adequate resources to raise community awareness of the importance of CCR use. These received scores of 83, 69 and 68, respectively. The results suggest that cooperation and collaboration among stakeholders including the Traffic Police, families and local communities are needed to maximize the likelihood of mandating CCR laws.     

Factors associated with single-vehicle and multi-vehicle road traffic collision injuries in Ireland

Generalised linear regression models were used to identify factors associated with fatal/serious road traffic collision injuries for single- and multi-vehicle collisions. Single-vehicle collisions and multi-vehicle collisions occurring during the hours of darkness or on a wet road surface had reduced likelihood of a fatal/serious injury. Single-vehicle ‘driver with passengers’ collisions occurring at junctions or on a hill/gradient were less likely to result in a fatal/serious injury. Multi-vehicle rear-end/angle collisions had reduced likelihood of a fatal/serious injury. Single-vehicle ‘driver only’ collisions and multi-vehicle collisions occurring on a public/bank holiday or on a hill/gradient were more likely to result in a fatal/serious injury. Single-vehicle collisions involving male drivers had increased likelihood of a fatal/serious injury and single-vehicle ‘driver with passengers’ collisions involving drivers under the age of 25 years also had increased likelihood of a fatal/serious injury. Findings can enlighten decision-makers to circumstances leading to fatal/serious injuries.     

Road traffic crashes at night-time: characteristics and risk factors

Abstract

The study was to examine the nature and risk factors associated with road traffic crashes at night in Ghana and identify potential measures to control them. Crash and injury data for the period 2013-2017 were analyzed. The fatality index and fatal crash ratio measures were employed to assess the severity of injuries among traffic participants. Statistical analysis was carried out for the variables using contingency tables and the chi-square (χ²) tests to assess statistical significance. Generally, night-time traffic crashes resulted in severer injury outcomes than crashes in the hours of daylight (χ²(2)=292.7, p?<?0.001). The relative risk of death in a night traffic crash was 1.3 times that during the daytime. The risk of death was highest among pedestrians (44%) and motorcyclist (18%) compared to bus/mini-bus occupants (16%) and car occupants (11%) and the observed percentage differences were significant (χ²(14)=2303.2, p?<?0.001). Most of the collisions (67%) occurred at the early hours of the night, between 18:00 and 22:00?hours. Poor night visibility coupled with poor visual guidance on roads are the key contributory risk factors associated with night travels. Policies must be geared towards provision of functioning street lights in built-up areas, road line markings, delineators and signage for the highways and arterial roads.     

Burden,pattern and outcomes of road traffic injuries in a rural district of India

Road traffic injuries (RTIs) are a leading public health problem and the understanding of RTIs in rural India is limited. The present report documents the burden, pattern, characteristics and outcomes of RTIs in a rural district of India using combined data sources: police and hospital. RTIs contributed for 38% of fatal and 39% of non-fatal injuries with an annual mortality rate of 18.1/100,000 population/year. Young males were affected most and two-wheeler users and pedestrians were involved in 45% and 20% of fatal crashes, respectively. Nearly half (51%) of fatal RTIs occurred on national highways of the district; 46% died immediately at the site. Among those hospitalised, 20% were under the influence of alcohol while use of helmets and seat belts was <5%. Trauma care was deficient in the district leading to greater number of referrals. Road safety should be given high importance in rural India with a focus on safe roads, safe vehicles and safe people along with trauma care.     

Global collaboration on road traffic injury prevention

Worldwide, nearly 1.2 million people are killed in road traffic crashes every year and 20 million to 50 million more are injured or disabled. These injuries account for 2.1% of global mortality and 2.6% of all disability-adjusted life years (DALYs) lost. Low- and middle-income countries account for about 85% of the deaths and 90% of the DALYs lost annually. Without appropriate action, by 2020, road traffic injuries are predicted to be the third leading contributor to the global burden of disease. The economic cost of road traffic crashes is enormous. Globally it is estimated that US$518 billion is spent on road traffic crashes with low- and middle-income countries accounting for US$65 billion--more than these countries receive in development assistance. But these costs are just the tip of the iceberg. For everyone killed, injured or disabled by a road traffic crash there are countless others deeply affected. Many families are driven into poverty by the expenses of prolonged medical care, loss of a family breadwinner or the added burden of caring for the disabled. There is an urgent need for global collaboration on road traffic injury prevention. Since 2000, WHO has stepped up its response to the road safety crisis by firstly developing a 5-year strategy for road traffic injury prevention and following this by dedicating World Health Day 2004 to road safety and launching the WHO/World Bank World Report on Road Traffic Injury Prevention at the global World Health Day event in Paris, France. This short article highlights the main messages from the World Report and the six recommendations for action on road safety at a national and international level. It goes on to briefly discuss other international achievements since World Health Day and calls for countries to take up the challenge of implementing the recommendations of the World Report.     

The burden of road traffic injuries in Kermanshah Province,Iran, in 2010–2011: GBD 2010 method

Deaths, injuries and disabilities resulting from road traffic injuries (RTIs) are a public health major concern. This study aims to calculate the burden of RTIs in Kermanshah Province in Iran. In this study to determine the years of life lost (YLL) related to RTIs, the National Death Registration and Forensics Medicine census data were employed. We use forensic medicine data to calculate the incidence of non-fatal injuries and years lost due to disability (YLD). The cause of death and non-fatal injuries was classified using ICD-10 codes and 23 groupes of global burden of diseases (GBD) 2010. The disability-adjusted life year (DALY) estimated on the guidelines of the GBD 2010 and age and sex structure was taken from the National Statistic Center for the year 2010. Overall, 70.8% of the subjects were males. The fatal and non-fatal injury rates of RTI were 51.3 and 283.6 per 100,000 persons, respectively. YLLs and YLDs were 46613 (24.5 per 1000) and 3405 (1.8 per 1000) in both sexes, respectively. The disability adjusted life years were 40711 in males, 9306 in females and 50018 in both sexes (42.5, 9.8 and 26.3 per 1000, respectively). More than 93% of DALY was from YLL (24.5 per 1000), with a small proportion for YLD (1.8 per 1000). Accounting for more than 50,000 DALY attributed to RTIs, traffic injuries is a major public health and socioeconomic problem in Kermanshah. Designing cost-effective interventions based on comprehensive and multi-sectoral programmes at the national and provincial levels can save many lives and resources that are lost every year. Undoubtedly, establishing a surveillance system at the sub-national level and measuring the burden of injuries, as in this study, can help policy-makers and planners in lessening the burden of RTIs.     

An evaluation of the red-light camera programme in the city of Dammam,the Kingdom of Saudi Arabia

This study evaluated the effectiveness of red-light cameras in Dammam, the Kingdom of Saudi Arabia. Two methods were used to assess changes in crash risk at the intersections at which the red-light camera programme had been operating. Geospatial analysis was used to visualize trends in road crash density over the geographical region of Dammam and a pre--post-camera crash analysis was undertaken. The distribution of injury crashes was greater than that of crashes which included property damage, the latter of which was concentrated around central Dammam. The five red-light cameras installed in 2012 were located outside areas of high-crash and injury density, and the total number of crashes reported in the three-month periods after installation was double that before the cameras were installed. This increase in the number of crashes also occurred at the five comparison sites (without red-light cameras), indicating a null effect. The findings from this study are contrary to previous evaluations of speed management programmes associated with red-light cameras. The study highlights the challenges in obtaining data for such research and illustrates that a reliance on overt, fixed camera's to manage speed is unlikely to deliver significant reductions in road trauma.     

Cost analysis of road traffic crashes in China

Abstract

Fatalities and injuries resulting from road traffic crashes is always a serious problem. The overall economic losses caused by road traffic crashes are beyond imagination. Including the economic cost of property damage, productivity loss, medical cost, travel delay time cost, legal cost and insurance cost, the total economic cost of traffic crashes in China in 2017 is calculated as 490.1 billion yuan (72.6 billion USD 2017), which is equivalent to 0.60% of the GDP. The cost of productivity loss accounts for the highest proportion of total economic cost, which is 72%. The second is the travel delay cost, accounting for 12% insurance cost, property damage cost and medical cost are followed. The more serious the injury, the higher the unit economic cost. The unit cost of a crash that caused only property damage is 11,274 yuan. The unit cost of a minor injured crash is 20,223 yuan. The highest unit economic cost is the unit cost of a fatal crash, which is 3,181,394 yuan. This study provides important insights into the cost-benefit analysis of China's road safety policies.     

Estimating road traffic mortality more accurately: use of the capture-recapture method in the West Azarbaijan province of Iran

The study estimates the rate of fatal road traffic injuries (RTIs) by population and road-users group in one Iranian province. The capture - recapture method was employed, using both the death register and the forensic medicine register over one year. They recorded totals of 669 and 665 RTIs respectively, giving a non-overlapping number of 897 cases. An estimate of 1018 fatalities occurred, at rates of 34 per 100,000 of the population for all road users aggregated, 10 per 100,000 for pedestrians and 25 per 100,000 for other road users. Coverage was somewhat better for victims less than 15 years of age, and also for males. The method showed 121 under-reported cases in both sources; however, it can help Iranian policy-makers to produce a good estimation of fatal RTIs number each year, when following up current RTIs-prevention programmes. Yet, given that each registry operates separately, optimum coverage will only be obtained when both sources are integrated and work together.