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.     

Bold actions needed to improve civil registration data for road traffic deaths

Abstract

Persisting problems of underreporting and poor quality of road traffic mortality data exist. Bold and sustained actions need to be undertaken by countries to improve civil registration data collection and reporting. Countries need to implement three specific actions to improve civil registration and vital statistics data systems and/or road traffic injury data collection:

• Ensure that civil registration and vital statistics systems produce high-quality cause of death data by working with the health sector to improve medical certification of cause of death and statistical coding in line with the International Classification of Diseases.

• Adopt a consistent definition of a road traffic death for use in police databases, particularly in countries with incomplete civil registration and vital statistics data, where police data are the most reliable source of information

• Link data sources – including civil registration records, police data, health records, insurance data – to improve official road traffic fatality estimates while ensuring the privacy of individual identification.

     

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.     

Applying the capture-recapture method to estimate road traffic deaths and injuries in three non-contiguous cities in the Philippines

In establishing goals for the Philippine road safety plan, police data were used. Police reports are likely underreporting. We apply capture-recapture analysis to determine expansion factors and estimate the true incidence. Three cities were visited where data on deaths (2014) and injury (January–March 2014) from hospitals, police and civil registry were collected. Matching was done to generate a final list of injured and dead individuals. The Chapman method was used for estimating the true number of cases. Police data exhibited underreporting in all site. Expansion factors of the police data range from 5.4 to 29× for deaths and 3.2 to 47× for non-fatal injuries. Expansion factors are likely useful to estimate the true incidence of road traffic injuries in areas with weak injury surveillance systems such as the Philippines.     

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.     

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.     

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.     

Ability of crime,demographic and business data to forecast areas of increased violence

ABSTRACT

Identifying geographic areas and time periods of increased violence is of considerable importance in prevention planning. This study compared the performance of multiple data sources to prospectively forecast areas of increased interpersonal violence. We used 2011–2014 data from a large metropolitan county on interpersonal violence (homicide, assault, rape and robbery) and forecasted violence at the level of census block-groups and over a one-month moving time window. Inputs to a Random Forest model included historical crime records from the police department, demographic data from the US Census Bureau, and administrative data on licensed businesses. Among 279 block groups, a model utilizing all data sources was found to prospectively improve the identification of the top 5% most violent block-group months (positive predictive value = 52.1%; negative predictive value = 97.5%; sensitivity = 43.4%; specificity = 98.2%). Predictive modelling with simple inputs can help communities more efficiently focus violence prevention resources geographically.     

Traffic law enforcement in Hyderabad,India

The aim of the study was to understand traffic law enforcement (TLE) carried out by the police to reduce non-compliance with traffic laws on the roads of Hyderabad city in India for 2001?–?2003.

The Traffic Police database of citations issued to drivers who violated traffic laws in Hyderabad was analysed for the years 2001?–?2003 to describe the TLE activities of the police, to describe and compare the TLE activities for the different types of vehicles and to compare the TLE activities for the 3 years. The violations were classified in five categories – those related to driving, parking, vehicle, document and others; and TLE into safety and other TLE.

A total of 646?161 traffic-law violations were registered in 2001, 904?447 in 2002 and 964?275 in 2003 for Hyderabad. Driving and parking violations were the most common violations registered in all 3 years, with parking violations slightly higher in 2001 (43.5%) and driving violations slightly higher in 2002 (35%) and 2003 (36.4%). Auto-rickshaws (three-wheel commercial passenger vehicles) accounted for the highest violations registered in 2001 (41.4%) whereas motorized two-wheelers had the highest registered violations in 2002 (35.5%) and 2003 (33.2%). Safety TLE activity (detecting and registering driving violations) was only one-third of all the TLE activity performed by the police in the 3 years, and disobeying traffic signals was the most common violation registered under safety TLE. Indian rupees 50 (US$1.1) were collected by way of a fine in 87% of the cases registered. Age and gender of the violators were not recorded in the database.

These data can be used for planning, monitoring and evaluating TLE in Hyderabad. These can help identify traffic control and human factors that could lead to traffic non-compliance, and help identify priorities for improving road safety. These data indicate a need to enhance the safety TLE activity of the police, to make TLE more visible in Hyderabad, and to assess the effectiveness of the current legal action as deterrence to improve road safety. Recommendations to enhance TLE within the given resources of the police are made. More effort is needed towards systematic collection and analysis of data on TLE in India to facilitate long-term improvements in TLE for safer roads.     

Costs of unintentional injuries among children in an urban slum community in Kampala city,Uganda

Abstract

Unintentional injuries cause deaths, disabilities, productivity and financial losses and disproportionately affect children in low-income settings yet their cost remains under studied. This study determined the household out-of-pocket expenditure and missed school attendance due to unintentional childhood injuries in a Ugandan slum. We used a cross-sectional household survey design. Data were collected on occurrence and associated costs of unintentional injuries during a one-year period from July 2014 to June 2015. A total of 706 (44.7%) children who had suffered from injuries were reported in the one year period. More male children (N?=?415, 58.7%) suffered injuries than females (N?=?291, 41.2%). The average out-of-pocket expenditure on treating an injury was US $24.1 [standard deviation (SD)?=?±$62.8] and mean school days lost were 25 days (SD?=?±51.8). Road traffic injuries (RTIs) resulted in higher costs [mean difference was US $51.1 (95% CI: $11.4–$90.8)] compared to injuries that, for example, occurred at school. In a Ugandan slum community, unintentional childhood injuries resulted in high out-of-pocket expenditures and missed school attendance. The costs varied widely depending on external causes of the injury. These findings highlight the need to invest in population level injury prevention interventions to reduce injury costs by households.     

Estimation of traffic accident costs: a prompted model

Traffic accidents are the reason for 25% of unnatural deaths in Iran. The main objective of this study is to find a simple model for the estimation of economic costs especially in Islamic countries (like Iran) in a straightforward manner. The model can show the magnitude of traffic accident costs with monetary equivalent. Data were collected from different sources that included traffic police records, insurance companies and hospitals. The conceptual framework, in our study, was based on the method of Ayati. He used this method for the estimation of economic costs in Iran. We promoted his method via minimum variables. Our final model has only three available variables which can be taken from insurance companies and police records. The running model showed that the traffic accident costs were US$2.2 million in 2007 for our case study route.     

Road traffic injuries in Mozambique

Road traffic injuries affect the economy, health and quality of life of the people of Mozambique. Current road safety programmes are inadequate and inefficient given the magnitude of the problem. Data reported on road traffic crashes in the period 1990 to 2000 from the National Institute for Road Safety, the traffic police and the Central Hospital of Maputo were reviewed. The burden of road traffic injuries in Mozambique is rising, with at least three people killed daily. The age group most affected is 25-38 (39.35%), followed by 16-24 (20.79%). The main causes of crashes include reckless driving, drunken driving, roads with potholes, inadequate signs, lack of protection for pedestrians, and inadequate traffic law enforcement. However, the data are not adequate to reveal the true magnitude of the problem. Data collected by different sources are incomplete and not coordinated with other sources and databases. In urban areas, however, better response to crashes, treatment of the injured, reporting and data collection is attributable to a greater concentration of police and medical facilities. Road traffic safety programmes in Mozambique are inadequate and inefficient, starting with the data collection system. Improvement of injury surveillance systems is needed to help make road traffic safety a national development agenda priority and for developing and implementing road safety policies. For road safety programmes to be effective, government must facilitate stakeholders’ involvement, and the clear definition of government activities, civil society activities and public-private partnerships need to be established.     

Measuring the road safety performance of Iranian provinces: a double-frontier DEA model and evidential reasoning approach

Abstract

Road traffic accidents are critical public issue in developing countries, and they annually waste a significant amount of Gross Domestic Product (GDP). In order to urgently consider how this problem is related to the current policies, a proper safety evaluation of regional programmes in crash reduction is fundamental to the governments. The current research aims to employ a double-frontier Data Envelopment Analysis (DEA) model to assess the productivity of Iranian regional safety programmes in reducing the number of road fatalities. The safety efficiencies of Iranian provinces are simultaneously estimated using the double frontier DEA to reflect both the optimistic and pessimistic points of view. Then, the Evidential Reasoning (ER) approach is applied to aggregate the obtained efficiency values. These provinces are ranked based on the data panel for 2014–2016. Finally, a double-frontier Malmquist productivity index (MPI) is used to comprehensively measure the safety performance of Iranian roads over a period of time.     

National burden of road traffic injuries in Argentina

More than 1.2 million people die and as many as 50 million people are injured or disabled due to road traffic injuries (RTIs) every year worldwide. The lack of reliable data hinders efforts to describe the characteristics of the issue and prioritise prevention activities. The objective was to provide a snapshot of fatal and non-fatal RTI in Argentina. We used the methodology proposed by the Global Burden of Disease Injury Expert group. External causes of deaths with unknown codes were proportionately redistributed over the known categories. In 2007 in Argentina, we estimated 5915 RTI deaths, compared with 3983 RTI deaths reported previously by the Ministry of Health, accounting for 1931 additional cases. The highest number of deaths occurred in young men (15-29 years old), although the highest RTI death rates were in the age group of 55 years and older. Four-wheeled vehicle occupants were the most common road user type killed (59.1%); vulnerable road users represented one third (29.5%) of deaths and 64% of non-fatal RTI. The national and regional estimates of RTI in Argentina should help policy makers and public-health researchers to understand the importance of RTI prevention and design specific interventions to further reduce these preventable deaths and injuries.     

Estimating national road crash fatalities using aggregate data

Injuries and fatalities from road traffic crashes have emerged a major public health challenge in Pakistan. Reliable estimates of road crash fatalities (RCF) of a country, is a vital element needed for identification and control of key risk factors, road-safety improvement efforts and prioritizing national health. Reliability of current annual RCF estimates for Pakistan becomes highly questionable due to serious underreporting. This study aimed to predict annual RCF for Pakistan using data from World Health Organization and International Road Federation sources. An ordinary least square (OLS) regression model that relates fatality rate with different explanatory variables was developed. RCF were predicted for Pakistan for year 2012 and 2013, and results were compared with national police reported estimates. Study results indicated that there is serious underreporting of RCF in Pakistan and immediate measures are needed to improve the existing road crash recording and reporting system at the national and subnational levels.     

Traffic law enforcement in Hyderabad, India

The aim of the study was to understand traffic law enforcement (TLE) carried out by the police to reduce non-compliance with traffic laws on the roads of Hyderabad city in India for 2001-2003. The Traffic Police database of citations issued to drivers who violated traffic laws in Hyderabad was analysed for the years 2001-2003 to describe the TLE activities of the police, to describe and compare the TLE activities for the different types of vehicles and to compare the TLE activities for the 3 years. The violations were classified in five categories - those related to driving, parking, vehicle, document and others; and TLE into safety and other TLE. A total of 646 161 traffic-law violations were registered in 2001, 904 447 in 2002 and 964 275 in 2003 for Hyderabad. Driving and parking violations were the most common violations registered in all 3 years, with parking violations slightly higher in 2001 (43.5%) and driving violations slightly higher in 2002 (35%) and 2003 (36.4%). Auto-rickshaws (three-wheel commercial passenger vehicles) accounted for the highest violations registered in 2001 (41.4%) whereas motorized two-wheelers had the highest registered violations in 2002 (35.5%) and 2003 (33.2%). Safety TLE activity (detecting and registering driving violations) was only one-third of all the TLE activity performed by the police in the 3 years, and disobeying traffic signals was the most common violation registered under safety TLE. Indian rupees 50 (US$1.1) were collected by way of a fine in 87% of the cases registered. Age and gender of the violators were not recorded in the database. These data can be used for planning, monitoring and evaluating TLE in Hyderabad. These can help identify traffic control and human factors that could lead to traffic noncompliance, and help identify priorities for improving road safety. These data indicate a need to enhance the safety TLE activity of the police, to make TLE more visible in Hyderabad, and to assess the effectiveness of the current legal action as deterrence to improve road safety. Recommendations to enhance TLE within the given resources of the police are made. More effort is needed towards systematic collection and analysis of data on TLE in India to facilitate long-term improvements in TLE for safer roads.     

Trustworthiness and trust: influences and implications

Abstract

This paper frames trustworthiness as the key upstream construct of trust and recognises that trust operates at two levels in services relationships, with a number of key drivers that are mediated by trustworthiness. Our findings are supported by survey data from customers of UK financial services, with the data points captured over a number of years which allow for fluctuations in trust level.

Empirically we find that trustworthiness impacts both the cognitive and affecting dimensions of trust, with the impact being greatest on cognitive trust. As a result of our findings it is possible for practitioner to implement policies to not only build trust but also deal with issues where there is a need to rebuild it, as in the case of our research setting.