Road Traffic Injury Mortality Research Articles

Trends in mortality from road traffic injuries in South Korea, 1983–2017: Joinpoint regression and age-period-cohort analyses

Although mortality trends can be influenced by different ages, periods, and cohorts, few studies have demonstrated the age-period-cohort (APC) effect on road traffic injury (RTI) mortality. Moreover, APC effects in Korea have never been documented despite the high mortality rates from RTIs. This study aimed to describe the trends in mortality from RTIs and examine APC effects on RTI mortality in Korea. Using the national death certificate and census mid-year population estimates data during 1983–2017, trends in age-standardized mortality rates from RTIs were analyzed using Joinpoint regression. Intrinsic estimator regression models were used to estimate APC effects on RTI mortality. Consistent with the trend in period effects, RTI mortality increased sharply with the economic growth in the 1980s, decelerated after the implementation of road safety policies in the early 1990s, plummeted owing to the 1997–1998 financial crisis, and gradually decreased from the early 2000s. A J-shaped age effect indicated that the relative risk of road traffic death surged in people aged ≥65 years. Educational expansion from the mid-1950s turned an increasing birth cohort effect into a continuously decreasing trend after peaking around the 1938–1943 birth cohorts. The risk of road traffic death was relatively high among the Korean Generation Y, i.e., those born in 1978–1983. RTI mortality trends in Korea have been affected by diverse socioeconomic changes through cohort and period effects. Despite the recent favorable trend, RTI mortality remains high, especially among older people. Road safety policies to address the burden of RTIs require further improvement.

Forecasting global road traffic injury mortality for 2030

ObjectiveTo forecast the number and rate of deaths from road traffic injuries (RTI) in the world in 2030.MethodsThis study was a secondary analysis of annual country-level data of RTI mortality...

Estimating effects of Uber ride-sharing service on road traffic-related deaths in South Africa: a quasi-experimental study

BackgroundRoad traffic deaths are a substantial barrier to population health improvement in low-income and middle-income countries (LMICs). In South Africa, the road-traffic injury mortality (RTM) rate of 27 per 100...

Road Traffic Accidents: Development's Collateral Damage and a Major Public Health and Economic Concern

Road construction is viewed as a core development activity. The unfortunate downside of this is the increasing burden of Road traffic Injuries(RTIs). 50 years ago, the WHO was called upon to do something about the heavy human toll of RTIs. However, RTIs remain a very significant contributor to human morbidity and mortality. It is significant to note that the burden of RTIs has shifted to low and middle income countries (LMICs), which despite having only about 50% of the world's motor vehicles, account for 90% of the burden of 12.5 lakh road traffic deaths and 2 to 5 crore non fatal road traffic injuries. UN Sustainable development goal (SDG) target 3.6 is to reduce by 50% the number of deaths and injuries from road traffic crashes across the globe by 2020. This implies the saving of 50 lakh lives, the prevention of 5 crore serious injuries, and an economic benefit to the tune of over US$3 trillion. This is a major challenge. The WHO says that RTIs have a significant negative macroeconomic impact in LMICs. The loss to national GDP ranges from 1.03 percent in South Korea to 2.9 percent in Vietnam. Reducing RTI morbidity and mortality by 50% over a 24 year timeline can generate an additional flow of income equivalent to 22.2% GDP(2014) in Thailand, 15% in China, 14% in India, 7.2% in the Philippines and 7.1% in Tanzania. RTI deaths in India have consistently increased year on year from 1990 to 2015.

China's Progress in Reducing Road Traffic Mortality: An Analysis of National Surveillance Data from 2006 to 2016

Background: The United Nations (UN) proclaimed the number of global deaths and injuries from road traffic accidents by as a target of the Sustainable Development Goals (SDGs). Using national Diseases Surveillance Points (DSPs) data, we examined progress in reducing road traffic injury mortality rates from 2006 to 2016 in China. Methods: Crude and age-standardized mortality with standard errors were calculated. Joinpoint regression analysis was used to examine and quantify trends in overall and subgroup road traffic mortality from 2006 to 2016. Subgroup analyses were performed by place (urban/rural), sex, age group, geographic location (province) and road user. Findings: In 2016, the crude road traffic mortality was 9·6 per 100,000 population in China. Overall age-adjusted road traffic mortality increased from 9·8 to 15·7 per 100,000 population from 2006 to 2011, and then gradually decreased to 9·1 per 100,000 population by 2016. Subgroup mortality rates generally followed similar trends. Males, older adults, rural residents, and a few provinces (e.g. Ningxia, Guangxi, Hubei) consistently had higher road traffic mortality rates than females, younger persons, urban residents, and most provinces. Mortality changes varied across place (urban/rural), sex, age group, and geographic location (province) between 2006 and 2016, revealing large urban-rural and provincial disparities, and illuminating pedestrians as the most vulnerable road users. Deaths among occupants of cars and three-wheeled motor vehicles respectively constituted 53% and 20% of total occupant mortality from road traffic crashes between 2006 and 2016. Interpretation: Despite the continuous and substantial decrease since 2011, road traffic mortality is unlikely to reach the SDGs target of halving by 2020 in China. Systematic and sustainable efforts are needed to accelerate progress in road traffic safety in China. Funding Statement: The authors state: None declared. Declaration of Interests: The authors have no conflicts of interest to declare. Ethics Approval Satement: This analysis was approved by the ethics committee of Xiangya School of Public Health, Central South University (NO.XYGW-2017-01). Data analyses were de-identified.

Ecological study of road traffic injuries in the eastern Mediterranean region: country economic level, road user category and gender perspectives

BackgroundThe Eastern Mediterranean region has the second highest number of road traffic injury mortality rates after the African region based on 2013 data, with road traffic injuries accounting for 27% of the total injury mortality in the region. Globally the number of road traffic deaths has plateaued despite an increase in motorization, but it is uncertain whether this applies to the Region. This study investigated the regional trends in both road traffic injury mortality and morbidity and examined country-based differences considering on income level, categories of road users, and gender distribution.MethodsRegister-based ecological study linking data from Global Burden of Disease Study with the United Nations Statistics Division for population and World Bank definition for country income level. Road traffic injury mortality rates and disability-adjusted life years were compiled for all ages at country level in 1995, 2005, 2015 and combined for a regional average (n = 22) and a global average (n = 122). The data were stratified by country economic level, road user category and gender.ResultsRoad traffic injury mortality rates in the Region were higher than the global average for all three reference years but suggest a downward trend. In 2015 mortality rates were more than twice as high in low and high income countries compared to global income averages and motor vehicle occupants had a 3-fold greater mortality than the global average. Severe injuries decreased by more than half for high/middle income countries but remained high for low income countries; three times higher for males than females.ConclusionDespite a potential downward trend, inequalities in road traffic injury mortality and morbidity burden remain high in the Eastern Mediterranean region. Action needs to be intensified and targeted to implement and enforce safety measures that prevent and mitigate severe motor vehicle crashes in high income countries especially and invest in efforts to promote public, active transport for vulnerable road users in the resource poor countries of the Region.

Estimating the drink driving attributable fraction of road traffic deaths in Mexico.

To estimate the Drink Driving Attributable Fraction (DDAF) of road traffic injury mortality in car occupants in Mexico during 2010-13. A case-control study was conducted to examine the presence of alcohol in analysed body fluids of car occupants killed in fatal crashes (cases) compared with car drivers tested in alcohol-testing checkpoints who were not involved in a fatal collision (controls). Two data sets were used for the period 2010-13: the forensic module of the Epidemiological Surveillance System on Addictions that included car occupants killed in a collision (cases) and a data set from alcohol-testing at police checkpoints available for matching municipalities (controls). Mexico. The analysed study sample included 1718 car occupants killed in a traffic collision and 80 656 drivers tested at alcohol police checkpoints, all from 10 municipalities. Unadjusted and adjusted odds ratios (OR) of presence of alcohol in body fluids were obtained stratified by sex and age groups and the interaction with these two variables were assessed. The ORs were used to calculate the DDAF. It was estimated that 19.5% of car occupants' deaths due to road traffic injuries were attributable to alcohol consumption [95% confidence interval (CI)=19.1-19.9]. The adjusted OR of presence of alcohol was 6.84 (95% CI=6.06-7.71) overall. For males it was 7.21 (95% CI=6.35-8.18) and for females it was 4.45 (95% CI=3.01-6.60). The ORs were similar across younger age bands (10-19years: 9.61, 95% CI=6.72-13.73; 20-29years: 7.70, 95% CI=6.28-9.4; and 30-49years: 7.21, 95% CI=5.98-8.70); and lower but still elevated among older people (50+ years: 3.19, 95% CI=2.19-4.65). An estimated 19.5% of car occupant deaths in Mexico may have been caused by alcohol in 2010-13.

Child injury deaths linked with adult alcohol consumption: A time series analysis

ObjectiveThis paper aims to quantify the population-level associations between child injury deaths and adult (aged 15+ years) per capita alcohol consumption (PCC) and between child injury deaths and the impact of major alcohol and safety policy changes in Australia. MethodsAll child deaths due to external causes during 1910–2013, and child deaths due specifically to road crashes, assaults, suicide and other external causes, were obtained from the Australian Institute of Health and Welfare. Child (0–14 year) mortality rates were analysed in relation to PCC using an Autoregressive Integrated Moving Average model. ResultsA positive association between PCC and overall child external mortality was identified. The estimated coefficient was 0.326 (p = .002), indicating that a 10% decrease in PCC was associated with a 3.3% reduction in child injury mortality. A positive association was identified for road traffic and other child injury mortality, but not assault injuries. The introduction of compulsory seatbelt legislation in combination with random breath testing was associated with a reduction in overall injury and road traffic child mortality. Decreasing the legal drinking age was associated with an increase in the rate of other external-cause child mortality. ConclusionReducing PCC in Australia is likely to result in a small but significant reduction in the injury mortality rate of children aged 0–14 years.

Child road traffic injury mortality in Victoria, Australia (0–14 years), the need for targeted action

IntroductionExtensive efforts to reduce unintentional injury were enacted in the last three decades of the 20th century. Examination of road traffic injury mortality indicates the extent of fatal, unintentional child injuries (0–14 years) future interventions must address. Aims(1) describe in-depth child road traffic injury (RTI) deaths 2001–2012 in Victoria, Australia (2) identify the potential preventability of the RTI causes by currently available countermeasures and scope for enhanced implementation and novel solutions. MethodFatal Victorian child injury data were extracted from the National Coronial Information System (NCIS) for the 12 year period January 2001–December 2012. All on-road data was analysed. Data for passenger and pedestrian deaths was examined in depth. Associated factors were determined using univariate and pairwise analysis of factors. Published WHO key prevention strategies, and the recent literature were reviewed, focusing on the identified fatalities among children 0–14 years. ResultsFor 172 RTI deaths, head injury was the leading medical cause of death (68%). Significantly, the most vulnerable age group for both passengers and pedestrians was 0–4 years. Rural children were over-represented with children aged 0–4 years at greatest risk. Common factors for occupants were loss of control and veering to the incorrect side. For pedestrians the major factors related to rural residence and supervision. Discussion and ConclusionsThis study confirms that RTIs are complex and follow chains of events. Numerous promising interventions were identified. Wider implementation of these advanced engineering, education and enforcement strategies may further improve mortality rates in Victoria. Feasible solutions for aspects of the child pedestrian problem remain elusive. This study describes the RTI problem in greater depth than previous studies and reveals that some existing measures are not fully implemented. The need for targeted action in: 0–4 year olds; head injury; and rural regions of Victoria is highlighted. The need for a safe systems approach is paramount.

Pattern of Road Traffic Injuries in Rural Bangladesh: Burden Estimates and Risk Factors.

Globally, road traffic injury (RTI) causes 1.3 million deaths annually. Almost 90% of all RTI deaths occur in low- and middle-income countries. RTI is one of the leading causes of death in Bangladesh; the World Health Organization estimated that it kills over 21,000 people in the country annually. This study describes the current magnitude and risk factors of RTI for different age groups in rural Bangladesh. A household census was carried out in 51 unions of seven sub-districts situated in the north and central part of Bangladesh between June and November 2013, covering 1.2 million individuals. Trained data collectors collected information on fatal and nonfatal RTI events through face-to-face interviews using a set of structured pre-tested questionnaires. The recall periods for fatal and non-fatal RTI were one year and six months, respectively. The mortality and morbidity rates due to RTI were 6.8/100,000 population/year and 889/100,000 populations/six months, respectively. RTI mortality and morbidity rates were significantly higher among males compared to females. Deaths and morbidities due to RTI were highest among those in the 25–64 years age group. A higher proportion of morbidity occurred among vehicle passengers (34%) and pedestrians (18%), and more than one-third of the RTI mortality occurred among pedestrians. Twenty percent of all nonfatal RTIs were classified as severe injuries. RTI is a major public health issue in rural Bangladesh. Immediate attention is needed to reduce preventable deaths and morbidities in rural Bangladesh.

Development and pilot study road traffic injury surveillance, Kaduna Nigeria

ObjectiveWe pilot a RTI surveillance system using data from FRSC, Policemotor traffic division and Health facilities in Kaduna metropolis,Nigeria to ascertain its feasibility and generate data needed for actiontoward achieving sustainable development goals 3.6 target.IntroductionRoad Traffic Injury is common cause of unintentional injuryglobally and Low and middle income countries account for 90%of 1.3 million Road Traffic Injury (RTI) deaths. In Africa region,Nigeria accounts for 25% of RTI mortality but has no comprehensiveand reliable RTI surveillance system. Data from Federal RoadSafety Commissions (FRSC) shows gaps in RTI reporting with largedisparity with estimated value from World Health Organization.MethodsKaduna metropolis is the capital of Kaduna State with estimatedpopulation of 1.96 million. It is a major route between Abuja, theNational capital and 15 northern Nigeria states with high vehicularmovement. We adapted WHO Injury surveillance guideline andCenters for Disease Control and Prevention surveillance trainingmanual for this study. A case of RTI is any person injured or diedwithin 30 days as a result injuries incurred from vehicular collision ona public road in Kaduna Metropolis. Data collected using a pretestedquestionnaire for RTI cases at health facilities, Police and FRSC.Data were linked by deterministic method, cleaned and analysed.Frequency and proportion were calculated to characterize the RTI.The study was supported by a mini-grant from Center for DiseaseControl and Prevention.ResultsData was collected from February to April 2016. Of the 324crashes reported, 566 people injured and 66 deaths with case fatalityrate of 11.7%. Male gender accounts for 81.8% and age 20 – 39 yearswere 64.6%. Commercial drivers were 20.7%, pedestrian 21% andpassengers were 53.7%. Sixty percent of the crash occurred betweencars or buses while 21% were without collision with any vehicle orstationary objects. Of the 66 deaths reported 61(92.4%) died at crashsite. FRSC evacuated 21%, 38.6% were evacuated by other road users.No use of seat belt and crash helmets reported and only 5.1% receivedfirst aid care before reaching reporting facility. RTI Incidence peakedbetween 6:00 PM to 8:59 PM with 26 persons per hour.ConclusionsEssential to sustainable development goal 3, a multisectorRTI surveillance system that generate data for action in Kadunametropolis, Nigeria is feasible and data generated was used for actionat different levels to mitigate against the burden of RTI

Exploring data sources for road traffic injury in Cameroon: Collection and completeness of police records, newspaper reports, and a hospital trauma registry

Road traffic injury surveillance systems are a cornerstone of organized efforts at injury control. Although high-income countries rely on established trauma registries and police databases, in low- and middle-income countries, the data source that provides the best collection of road traffic injury events in specific low- and middle-income country contexts without mature surveillance systems is unclear. The objective of this study was to compare the information available on road traffic injuries in 3 data sources used for surveillance in the sub-Saharan African country of Cameroon, providing potential insight on data sources for road traffic injury surveillance in low- and middle-income countries. We assessed the number of events captured and the information available in Yaoundé, Cameroon, from 3 separate sources of data on road traffic injuries: trauma registry, police records, and newspapers. Data were collected from a single-hospital trauma registry, police records, and the 6 most widely circulated newspapers in Yaoundé during a 6-month period in 2009. The number of road traffic injury events, mortality, and other variables included commonly in injury surveillance systems were recorded. We compared these sources using descriptive analysis. Hospital, police, and newspaper sources recorded 1,686, 273, and 480 road traffic injuries, respectively. The trauma registry provided the most complete data for the majority of variables explored; however, the newspaper data source captured 2, mass casualty, train crash events unrecorded in the other sources. Police data provided the most complete information on first responders to the scene, missing in only 7%. Investing in the hospital-based trauma registry may yield the best surveillance for road traffic injuries in some low- and middle-income countries, such as Yaoundé, Cameroon; however, police and newspaper reports may serve as alternative data sources when specific information is needed.

Epidemiology of Road Traffic Injuries in Iran: Based on the Data from Disaster Management Information System (DMIS) Of the Iranian Red Crescent

Background: Road traffic injuries (RTIs) are the leading cause of injuries and the second cause of mortality in Iran. Objectives: The aim of this study was to investigate the epidemiological pattern of RTIs in Iran based on the data from disaster management information system (DMIS) of the Iranian Red Crescent. Methods: In this cross-sectional study, the pattern of RTIs in Iran was studied based on the data from DMIS in the period from 20 March 2012 to 19 February 2016 (35 months). All of the 78775 RTIs recorded were selected through census. Data analysis was done using the SPSS.16 software package. P value less than 0.05 was considered statistically significant. Results: Among the 19 types of accidents whose data are recorded, road traffic accidents with a 78775 number of occurrence (136.1 ± 86.5 per 100000 people), 186860 injuries (332.1 ± 220 per 100000 people) and 12596 deaths (22.6 ± 11.1 per 100000 people) were the highest in ranking. The most common annunciator of the accidents was the emergency. Receiving the first report of the rescue operation was most done by telephone. The mean number of the operational forces involved in RTIs per 100000 people was 529.2 ± 407. The results showed that there was a significant difference between high, moderate and low population rate provinces in the mean number of injuries cases, the mortality of RTIs and the total number of Red Crescent operational forces (P Conclusions: Considering the high occurrence of the mortality and the injuries of the RTIs compared to that of the other types of accidents, more attention to RTIs in planning and interventions seems necessary. Keywords: Road Traffic; Injuries; Accidents; Epidemiological Mortality Language: en

An exploratory investigation of child safety seat use among citizens of the United Arab Emirates

ABSTRACTChild car safety has significantly improved in Western nations with the use of proper child restraints over the last 40 years, but progress lags in other nations. High-income but developing Eastern Mediterranean countries experience one of the world's highest road traffic-injury mortality rates for children. This study provides a preliminary investigation of child safety seat utilization among United Arab Emirates (UAE) citizen parents. Cross-sectional survey research was used to determine child safety seat utilization proportions. Data were collected from a convenience sample composed of target citizens, which make up approximately 15% of the total population of the country. A total of 366 parents with at least one child younger than age 13 years participated. Despite prevalent car-seat giveaway campaigns and regardless of car-seat ownership, the overall percentage of car seat use among Emirati parents was low: less than 20% for their children younger than age 24 months. Additionally, of those who use a car seat, parents reported improper use. The UAE currently has no compulsory child safety seat legislation. The findings suggest the need for further studies on car-seat usage in the UAE, as well as intervention research to inform locally relevant and culturally appropriate public information campaigns.

Demographic and regional characteristics of road traffic injury deaths in Jiangsu Province, China.

The study investigates the magnitude and distribution of fatal road traffic injuries (RTIs) in the Chinese province of Jiangsu by road user. The 13 694 RTI deaths and years of potential life lost (YPLL) that occurred in 2012 were analysed; vulnerable and non-vulnerable road users were considered separately. Age-adjusted mortality and YPLL were compiled and the association between demographic characteristics and RTI mortality rate was analysed using negative binomial regression. The age-adjusted RTI mortality and YPLL in Jiangsu in 2012 were 18.14 (95% CI: 17.84-18.45) and 494.3 (95% CI: 492.7-496.0) per 100 000 population. Half of the deaths were among pedestrians and for vulnerable road users as a whole, male fatalities were over three times that of female (adjusted incidence rate ratio = 3.26, 95% CI: 1.89-3.77). Fatalities in the oldest age group (80+ years) were over 14 times that of the youngest one (0-9 years) (adjusted incidence rate ratio = 14.13, 95% CI: 9.49-21.01). Fatality rates in the central and northern regions surpassed that of the south. As in the rest of the country, RTIs are a considerable public health problem in Jiangsu where fatality and YPLL rates fall heavily on pedestrians, men, and older persons and are more pronounced in the less developed regions.

Global time differences in road traffic injuries among children and adolescents between and 1990 and 2013: Regional and economical perspectives from global burden of diseases study

In 2010, road traffic injuries (RTIs) are the leading cause of deaths in those aged 1-19 years globally and half of those victims are vulnerable road users (VRUs), defined as pedestrians, bicyclists and motorcyclists. Low-income countries account for the highest proportion of VRU deaths. The change in distribution of the burden of RTI during recent decades is unclear. To highlight changes over time in RTI mortality among children and adolescents VRU and non-VRU globally, by region, and by country income level between 1990 and 2013. Country-level data were extracted from the global burden of disease study, split into seven geographical regions and four income levels (low-income [LICs], lower-middle [LMICs], upper-middle [UMICs] and high-income [HICs]). Mortality rates for 1990 and 2013 were calculated considering in turn all categories of road users aggregated, VRUs and non-VRUs. For all road users aggregated, at country level RTI mortality rates decreased sharply within each country income level and each region between 1990 and 2013, but an increase of 21% was found in LMICs of Sub Saharan Africa (SSA). Mortality rates for VRUs and nVRUs also decreased remarkably except among non-VRUs from LICs where the mortality rates increased by 16%. For VRUs, the reduction in mortality rates was more than twice as high in HICs (58%) and LICs (43%) than in UMICs (20%) or LMICs (23%). Considering country income level within regions revealed increased mortality rates for non-VRUs in LICs of South Asia by (26%) and for both non-VRUs (5%) and VRUs (35%) in the LMICs of SSA There have been considerable reductions in RTI mortality rates globally and by region of the world since 1990. While there is a need for enhanced RTI prevention globally, these findings call for the intensification of preventative efforts in specific parts of the world.

Forecasting mortality of road traffic injuries in China using seasonal autoregressive integrated moving average model

PurposeRoad traffic injuries have become a major public health problem in China. This study aimed to develop statistical models for predicting road traffic deaths and to analyze seasonality of deaths in China. MethodsA seasonal autoregressive integrated moving average (SARIMA) model was used to fit the data from 2000 to 2011. Akaike Information Criterion, Bayesian Information Criterion, and mean absolute percentage error were used to evaluate the constructed models. Autocorrelation function and partial autocorrelation function of residuals and Ljung–Box test were used to compare the goodness-of-fit between the different models. The SARIMA model was used to forecast monthly road traffic deaths in 2012. ResultsThe seasonal pattern of road traffic mortality data was statistically significant in China. SARIMA (1, 1, 1) (0, 1, 1)12 model was the best fitting model among various candidate models; the Akaike Information Criterion, Bayesian Information Criterion, and mean absolute percentage error were −483.679, −475.053, and 4.937, respectively. Goodness-of-fit testing showed nonautocorrelations in the residuals of the model (Ljung–Box test, Q = 4.86, P = .993). The fitted deaths using the SARIMA (1, 1, 1) (0, 1, 1)12 model for years 2000 to 2011 closely followed the observed number of road traffic deaths for the same years. The predicted and observed deaths were also very close for 2012. ConclusionsThis study suggests that accurate forecasting of road traffic death incidence is possible using SARIMA model. The SARIMA model applied to historical road traffic deaths data could provide important evidence of burden of road traffic injuries in China.

Passengers’ safety: differences among front seat and back seat occupants in a pilot study conducted in Cluj-Napoca, Romania

Injuries suffered as a consequence of road crashes affect the safety and quality of life of all age groups and road users, especially vulnerable populations. Romania has one of the highest rates of road traffic injury mortality in the European Union; the risk of suffering a fatal road crash being 30 times higher when compared to Norway, one of the safest countries. The percentage of seat belt usage is low, only 20% for back seat occupants, although seat belt usage in the back …

Epidemiology of road traffic incidents in Peru 1973-2008: incidence, mortality, and fatality.

BackgroundThe epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973–2008, as well as their relationship to population trends such as economic growth.Methods and FindingsSecondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43–5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15–0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09–1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capitaConclusionsThe significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.

Development of forecasting models for fatal road traffic injuries

To develop the forecasting models for fatal road traffic injuries and to provide evidence for predicting the future trends on road traffic injuries. Data on the mortality of road traffic injury including factors as gender and age in different countries, were obtained from the World Health Organization Mortality Database. Other information on GDP per capita, urbanization, motorization and education were collected from online resources of World Bank, WHO, the United Nations Population Division and other agencies. We fitted logarithmic models of road traffic injury mortality by gender and age group, including predictors of GDP per capita, urbanization, motorization and education. Sex- and age-specific forecasting models developed by WHO that including GDP per capita, education and time etc. were also fitted. Coefficient of determination(R(2)) was used to compare the performance between our modes and WHO models. 2 626 sets of data were collected from 153 countries/regions for both genders, between 1965 and 2010. The forecasting models of road traffic injury mortality based on GDP per capita, motorization, urbanization and education appeared to be statistically significant(P < 0.001), and the coefficients of determination for males at the age groups of 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65+ were 22.7% , 31.1%, 51.8%, 52.3%, 44.9%, 41.8%, 40.1%, 25.5%, respectively while the coefficients for these age groups in women were 22.9%, 32.6%, 51.1%, 49.3%, 41.3%, 35.9%, 30.7%, 20.1%, respectively. The WHO models that were based on the GDP per capita, education and time variables were statistically significant (P < 0.001)and the coefficients of determination were 14.9% , 22.0%, 31.5%, 33.1% , 30.7%, 28.5%, 27.7% and 17.8% for males, but 14.1%, 20.6%, 30.4%, 31.8%, 26.7%, 24.3%, 17.3% and 8.8% for females, respectively. The forecasting models that we developed seemed to be better than those developed by WHO.