The neglected epidemic-Risk factors associated with road traffic injuries in Mozambique: Results of the 2016 INCOMAS study.

Kristjana Hrönn Ásbjörnsdóttir,Syed Masud Ahmed,André Peralta-Santos,Yoshito Kawakatsu,Orvalho Augusto,Alfredo Covele,Reed Sorensen,Bradley H Wagenaar,Stephen S Gloyd,Kenneth Sherr,Fatima Cuembelo,Sarah Gimbel

doi:10.1371/journal.pgph.0000163

Abstract

In 2019, 93% of road traffic injury related mortality occurred in low- and middle-income countries, an estimated burden of 1.3 million deaths. This problem is growing; by 2030 road traffic injury will the seventh leading cause of death globally. This study both explores factors associated with RTIs in the central region of Mozambique, as well as pinpoints geographical "hotspots" of RTI incidence. A cross-sectional, population-level survey was carried out in two provinces (Sofala and Manica) of central Mozambique where, in addition to other variables, the number of road traffic injuries sustained by the household within the previous six months, was collected. Urbanicity, household ownership of a car or motorcycle, and socio-economic strata index were included in the analysis. We calculated the prevalence rate ratios using a generalized linear regression with a Poisson distribution, as well as the spatial prevalence rate ratio using an Integrated Nested Laplace Approximation. The survey included 3,038 households, with a mean of 6.29 (SD 0.06) individuals per household. The road traffic injury rate was 6.1% [95%CI 7.1%, 5.3%]. Urban residence was associated with a 47% decrease in rate of injury. Household motorbike ownership was associated with a 92% increase in the reported rate of road traffic injury. Higher socio-economic status households were associated with a 26% increase in the rate of road traffic injury. The rural and peri-urban areas near the "Beira corridor" (national road N6) have higher rates of road traffic injuries. In Mozambique, living in the rural areas near the "Beira corridor", higher household socio-economic strata, and motorbike ownership are risk factors for road traffic injury.

Highlights

Road Traffic Injuries (RTI) represent a neglected pandemic [1, 2], accounting for more than 1.3 million deaths globally in 2019, and disproportionately affect Low and Middle-Income Countries (LMIC) [3–6]
Over 22% of RTI-affected individuals in our sample required hospitalization, 1.2% were permanently disabled, 6.5% died at the scene and 2.4% died at the hospital
When we evaluated the spatial component of RTI distribution, areas with higher prevalence rate ratio (PRR) were in the peri-urban areas, on the periphery of Beira city and Manica city

Summary

Introduction

Road Traffic Injuries (RTI) represent a neglected pandemic [1, 2], accounting for more than 1.3 million deaths globally in 2019, and disproportionately affect Low and Middle-Income Countries (LMIC) [3–6]. While 93% of RTI and related deaths occur in LMIC, these countries own just 60% of the world’s registered vehicles [7]. As RTI affects mainly working-age populations (15–64 years-old), it represents an especially devastating loss for societies, depriving countries of young, healthy individuals [2, 9]. In LMIC RTIs are especially influenced by mode of transport, which is associated with socio-economic factors, especially income [3, 9–13]. In societies with limited welfare supports and frail health systems, RTIs perpetuate cycles of poverty as they disproportionally affect those with fewer resources [9]. RTIs result in loss of income to those affected, through medical expenses, death or disability

Methods

Results

Conclusion