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.     

Fatal motorcycle crashes: a growing public health problem in Cambodia

This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007–2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.     

Pattern of road traffic injuries in Ghana: Implications for control

Road traffic injuries and fatalities are increasing in Ghana. Police-collected crash and injury data for the period 1994-1998 were aggregated and analyzed using the MAAP5 accident analysis package developed by the Transport Research Laboratory, U.K. Published results of recent transport-related epidemiological and other surveys provided an additional data source. According to the 1994-1998 police data, road traffic crashes were a leading cause of death and injuries in Ghana. The other leading causes of death and injuries are occupational injuries which involve nonmechanized farming and tribal conflicts. The majority of road traffic fatalities (61.2%) and injuries (52.3%) occurred on roads in rural areas. About 58% more people died on roads in the rural areas than in urban areas, and generally more severe crashes occurred on rural roads compared with urban areas. Pedestrians accounted for 46.2% of all road traffic fatalities. The majority of these (66.8%) occurred in urban areas. The second leading population of road users affected was riders in passenger-ferrying buses, minibuses and trucks. The majority of these (42.8%) were killed on roads that pass through rural areas. Pedestrian casualties were overrepresented (nearly 90%) in five regions located in the southern half of the country. Efforts to tackle pedestrian safety should focus on the five regions of the country where most pedestrian fatalities occur in urban areas. Policies are also needed to protect passengers in commercially operated passenger-ferrying buses, minibuses and trucks because these vehicles carry a higher risk of being involved in fatal crashes.     

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.     

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.     

Road traffic injuries in Colombia

Road traffic injuries are a leading public health problem in Colombia. Pedestrians are the most vulnerable road users, especially in the main urban centers of Bogotá, Medellin and Cali. Data analyzed in this report include official statistics from the National Police and the National Institute of Legal Medicine and Forensic Sciences for 1996-2000, and results of a study conducted at the National University of Colombia in 2000. Methods from the Highway Capacity Manual were used for determining physical and technical variables, and a Geographical Information System tool was used for the location and spatial analysis of the road traffic crashes. Pedestrians accounted for close to 32% of injuries and 40% of the deaths from road traffic crashes. The problem of road traffic crashes existed predominately in urban areas. In the main urban centers, pedestrians constituted nearly 68% of road traffic crash victims. The high level of risky road use behaviors demonstrated by pedestrians and drivers, and inadequate infrastructure for safe mobility of pedestrians in some sections of the road network were the main contributing factors. Major improvements were achieved in Bogotá following enhancements to the municipal transport system and other policies introduced since 1995. In conclusion, policies and programs for improving road safety, in particular pedestrian safety, and strengthening urban planning are top priority.     

Road traffic accidents and policy interventions in Korea

The high rate of road traffic crashes, in conjunction with the absence of order on the road, has long been considered a critical social problem in Korea. The Korean public seems to agree that high priority ought to be placed on policies for improving road safety. Using data from government sources, this study describes what has happened in the area of road traffic crashes since 1970, the causes of traffic crashes, and the relative importance of traffic injuries as a cause of death in Korea. Road traffic crashes in Korea increased nearly eightfold, from 37,000 in 1970 to 290,481 in 2000. The fatalities increased three-fold and injuries ten-fold over the same period. Road traffic injuries were the leading cause of death for people under 29. However, through multiple policy interventions, partly in response to the 2002 FIFA World Cup, about two thousand road traffic deaths and nine thousand traffic-related disabilities were averted in 2001 alone. The policy interventions included enforcement of penalties for seven risky driving behaviours, including drunk driving and speeding, installation of traffic-monitoring cameras, financial rewards for citizens who reported traffic violations, introduction of a road safety evaluation system, correction of accident black spots in existing roads, and road safety education programs. Through multiple policy interventions, road traffic crashes in Korea were reduced in a relatively short time period, along with their associated injuries and fatalities. However, road traffic crashes still pose a major public health problem, threatening the quality of life of the Korean people.     

Road traffic injuries in Thailand: Trends,selected underlying determinants and status of intervention

Injuries and deaths from traffic crashes have become a major public health and socio-economic problem in Thailand. Injuries, fatalities and economic losses due to traffic crashes have increased with the rising level of motorization. This study analyzes hospital-based data compiled by the Ministry of Public Health, data compiled by the National Police Office and data compiled by the traffic engineering division of the Department of Highways, Ministry of Transport and Communications. Analysis reveals that 70% of the people injured or killed in traffic crashes are aged 10-39. Men are at four to five times higher risk of death and injury due to traffic crashes than women. The number and rate of traffic injury in Thailand swung from a record low during the economic recovery in the 1980’s to record a high during the bubble economy, then declined with the economic crisis in 1997. The economic costs were estimated at U.S.$1.6 billion in 1995. An urban-rural difference in traffic injuries has been recorded with a higher rural case-fatality rate. A number of known behavioral risk factors have been identified, i.e., drunk driving, speeding, substance abuse and failure to use helmets and seat belts. However, determinants of behavior need further investigation. Hazardous road locations have also been mapped. Trends of traffic injuries seem to follow trends of economic growth. Without effective policy and implementation programs to control the determinants, it is expected that traffic injuries will increase as the country recovers from economic crisis. A major pitfall to many current government programs is that they incorporate no systematic evaluation. The fragmented structure of road safety authorities further complicates collaboration and coordination. A broad coalition of stakeholders is needed to catalyze policy action.     

Gender and geographic differences in intentional and unintentional injury mortality among children in Illinois, 1988–1998

Road traffic crashes and injuries constitute a major health, economic and developmental challenge for many African countries. With only 4% of the world's motor vehicles, African roads witness more than 10% of the world total collision fatalities. With further motorisation, the number of road traffic crashes, injuries and fatalities are expected to grow. This study updates on the status, trends, causes, countermeasures and issues in traffic safety in African countries by reviewing studies published in the past 12 years. The study found that traffic fatalities continued its upward trend in recent years. Similar to those in motorised countries, the study identified that human behaviour and incapacitation account for more than 85% of the contributing factors reported by police in Africa. Unlike in developed countries, the victims of traffic casualties are primarily vulnerable road users. Pedestrians alone account for more than 40% of the total fatalities on African roads. Limited countermeasures were reported in the literature. The outcomes of these programmes are mixed and the research methods have inconsistent validity. Investigation in the feasibility of transferring proven programmes from motorised countries is suggested as an efficient measure for traffic safety improvement.     

The use of seatbelts and child restraints in three Mexican cities

Seatbelts and child restraints can reduce deaths resulting from road traffic crashes, and are one of the risk factors being targeted by the Road Safety in 10 Countries project in Mexico. This study quantifies the prevalence of restraint use in two of the intervention sites (Guadalajara-Zapopan and León) and one comparison site (Cuernavaca). Three rounds of roadside observations were conducted between November 2010 and January 2012. The overall prevalence of seatbelt use was 45.0% (95% CI = 44.3–45.7) amongst all occupants ≥10 years of age in the three cities. Child restraint use in children <5 years of age ranged from 7.9 to 17.4%. Two rounds of surveys were administered to all road traffic injury (RTI) victims presenting at a tertiary hospital in each city; RTI victims had lower seatbelt use than the general population (31% vs 42%, p = 0.037). This study demonstrates the need for further targeted intervention to increase use of these highly efficacious safety devices in Mexico.     

News and Events

Our aim is to report the findings of the initial three years of road traffic injuries (RTI) surveillance at Karachi and to compare it with previously published RTI-related data from Pakistan and other low-and middle-income countries. Data were collected through the RTI surveillance programme at Karachi (RTIRP) from the five biggest emergency departments of the city, which receive almost all the major emergencies of the city for the period September 2006 till September 2009. A total of 99,272 victims were enlisted by the RTIRP during the study period. Annual incidence of RTI is calculated to be 184.3 per 100,000 populations and mortality is 5.7 per 100,000 populations. Eighty nine per cent of victims are male and 73% are between 15 and 44 years of age. Commonest road user to be affected is riders of two wheelers (45%). Only 7% of affected motorcyclists were found to be wearing helmets at the time of the accident. Trends of injuries remained uniform over the years. Most frequent injuries were external wounds, followed by orthopaedic injuries. On the basis of our surveillance system, we have presented the largest RTI-related data from a metropolitan city of Pakistan to date.     

Initial results of Pakistan's first road traffic injury surveillance project

Our aim is to report the findings of the initial three years of road traffic injuries (RTI) surveillance at Karachi and to compare it with previously published RTI-related data from Pakistan and other low-and middle-income countries. Data were collected through the RTI surveillance programme at Karachi (RTIRP) from the five biggest emergency departments of the city, which receive almost all the major emergencies of the city for the period September 2006 till September 2009. A total of 99,272 victims were enlisted by the RTIRP during the study period. Annual incidence of RTI is calculated to be 184.3 per 100,000 populations and mortality is 5.7 per 100,000 populations. Eighty nine per cent of victims are male and 73% are between 15 and 44 years of age. Commonest road user to be affected is riders of two wheelers (45%). Only 7% of affected motorcyclists were found to be wearing helmets at the time of the accident. Trends of injuries remained uniform over the years. Most frequent injuries were external wounds, followed by orthopaedic injuries. On the basis of our surveillance system, we have presented the largest RTI-related data from a metropolitan city of Pakistan to date.     

Road traffic crashes managed by Rescue 1122 in Lahore,Pakistan

The objective of this retrospective study was to describe demographic characteristics, injury patterns and causes of road traffic crashes (RTCs) managed by Rescue 1122 in Lahore, Pakistan during the period 2005–2010. In total 123,268 RTCs were reported and responded by Rescue 1122 ambulance service during the study period. Of the 132,504 victims of RTCs, there were 67% male and 33% female subjects, and the maximum share (65%) was reported among people aged 16–35 years. Motorcyclists were involved in 45% of crashes, with over-speeding (40%) found to be the major reason of these collisions. Similarly, minor injuries (65%) and fractures (25%) were the most reported outcome of these crashes. It is concluded that data from ambulance services, if appropriately collected, can provide valuable epidemiological information to monitor RTCs in developing countries. However, in Pakistan, the collection of data as well as the registration process needs further improvement.     

Speed control in developing countries: issues,challenges and opportunities in reducing road traffic injuries

Speed has been determined to be one of the most common contributing factors in vehicle crashes. This study explores vehicle speed as a factor in the causation of road traffic crashes, using the example of Ghana. It examines the effectiveness of various speed control measures, based on policereported traffic crashes in Ghana and published works on speed control measures in both industrialized and developing countries. In Ghana, pedestrians were the main victims of road traffic injuries. The dominant driver error assigned by traffic police was loss of control, with the underlying factor being excessive vehicle speeds. The ‘speed factor’ alone accounted for more than 50% of all Ghanaian road traffic crashes between 1998 and 2000. While the enforcement of speed limits by traffic police may not be affordable for most developing countries, rumble strips and speed humps were found to be effective on Ghanaian roads. Rumble strips installed on the main Accra-Kumasi highway reduced crashes by about 35% and fatalities by about 55%. Reducing vehicle speeds may be one of the most effective interventions to stem traffic crashes in low-income countries. However, setting lower speed limits is not an effective intervention without the traffic law enforcement resources to ensure that limits are followed. Developing countries must also look to other speed reduction measures such as speed bumps and rumble strips, roads that segregate high- and low-speed users, and technological solutions such as speed governors, as well as greater public awareness of the problem.     

Hotspots of road traffic crashes in a redeveloping area of Shanghai

To identify high-risk locations (hotspots) of road traffic crashes (RTC) in a redeveloping area of Shanghai, for formulating relevant countermeasures in similar areas. After geocoding the crash locations on electronic map, assessment of spatial clustering of accidents and hotspots spatial densities was conducted following Moran's I method, the kernel density estimation, the Ripley's K-function and the network-based kernel density estimation (NKDE). A total of 21,679 RTC incidents resulting in 24,147 victims were recorded from 2010 to 2012. RTCs tended to occur among male (81.8%) aged 20–49 years old (84.9%) riding buses (60.1%) or electric bikes (16.1%) in working time (15%). The network spatial analysis pinpointed the hotspots of RTC at the street level in the Songjiang new urban area, and more RTCs occurred at road intersections than on road segments. Findings from this research may help the authorities develop efficient programmes to target high-risk locations and specific vulnerable populations.     

Investigation of contributing factors to extremely severe traffic crashes using survival theory

This study aimed to investigate the contributing factors to serious casualty crashes in China. Crashes with deaths greater than 10 people are defined as serious casualty crashes in China. The serious casualty crash data were collected from 2009 to 2014. The random forest analysis was first conducted to select the candidate variables that affect the risks of serious casualty crashes. The Bayesian random parameters accelerated failure time (AFT) model was then developed to link the probability of the serious casualty crash with road geometric conditions, pavement conditions, environmental characteristics, collision characteristics, vehicle conditions, and driver characteristics. The AFT model estimation results indicate that overload driving, country road, northwest china region, turnover crash, private car, snowy or icy road surface and sight distance conditions have significant fixed effects on the likelihood of serious casualty crashes. In addition to these fixed-parameter variables, freeway, clear weather conditions, coach drivers, and upgrade horizontal curve affect the likelihood of serious casualty crashes with varying magnitude across observations. One of the important findings is that the serious casualty crash likelihood does not always decrease with an increase in the driving experience (number of years driven). Before the inflection point of 7 years, the serious casualty crash likelihood increases as the driving experience grows. The results of this study can help to develop effective countermeasures and policy initiatives for the prevention of serious casualty crashes.