Road Traffic Related Injuries Research Articles

Orthopaedic and trauma research in Tanzania: A scoping review.

Tanzania is disproportionately burdened by musculoskeletal injuries as it faces unique challenges when dealing with trauma care. This scoping review aims to summarize and assess the current state of orthopaedic and trauma research in Tanzania. By identifying key themes, trends, and gaps in the literature, this review seeks to guide future research initiatives catered specifically to the needs of Tanzania's healthcare system. Utilizing the PRISMA-ScR protocol, OVID Medline, PubMed, and CINAHL databases were searched from inception to June 17, 2023, using keywords such as "Orthopaedics" "Trauma" and "Tanzania". One hundred and ninety-two eligible studies were included and the Arksey and O'Malley framework for scoping studies was followed. There was a notable growth of relevant publications from 2015 onward, with peaks in growth in the years 2019, 2021, and 2020. The studies employed diverse research methodologies, with cross-sectional (n = 41, 21%) and prospective studies (n = 39, 20%) being the most prevalent, and randomized-controlled trials being the least prevalent methodology, making up eight studies (4.2%). The most common study themes were trauma (n = 101, 52.6%), lower extremity (n = 31, 16%), and spine-related issues (n = 27, 14%). Only three studies looked at work-related injuries (1.6%). Road traffic injuries (RTIs) were the most common mechanism of trauma in 77.0% of the trauma focused studies. Fifty-three percent of the studies were conducted by a majority of Tanzanian authors. This scoping review highlights various trends in orthopaedic and trauma research in Tanzania, with a particular emphasis on road traffic-related injuries. Various gaps are explored, including a lack of research on work-related injuries and a paucity of experimental research. Our findings underline areas where future research is warranted. The future of orthopaedic and trauma care in Tanzania depends on the efforts and collaboration of both local and international stakeholders.

Causation, Types and Outcome of Road Traffic-related Ocular Injury in University of Llorin, Kwara, Nigeria

Introduction: Despite transportation liberating man and making him mobile, his increasing reliance on vehicular movement has conferred great facilities on him and his activities. The most profound culprit of all modes of transport is the road, of which traffic accidents are the most disturbing consequence of its use. Road traffic-related ocular injuries often have severe consequences and form a significant part of ophthalmic emergencies. These injuries may be missed and are therefore often underreported. Aim: To determine the causation, types, and outcomes of road traffic-related ocular injuries at the University of Ilorin Teaching Hospital, Kwara, Nigeria. Materials and Methods: This was a cross-sectional study conducted on 78 eyes of consecutive patients with road trafficrelated ocular injuries who presented at the Accident and Emergency unit of the University of Ilorin Teaching Hospital, Kwara, Algeria, between September 2012 and August 2013. The materials included the HOTV chart for vision assessment, which is a standardised, easy-to-use assessment method for both literate and illiterate individuals, a pen torch, direct ophthalmoscope, binocular indirect ophthalmoscope, slit lamp biomicroscope, Perkins tonometer, 2% fluorescein strip, 0.5% GuttTetracaine, and a handheld portable slit lamp ophthalmoscope. Patients’ demographics, duration of ocular injury before presentation, Visual Acuity (VA) at presentation, type of vehicle, place of injury, classification of ocular injury, treatment, and outcome on follow-up were recorded. Results: There were 78 eyes (72 patients) with road trafficrelated ocular injuries. The age range of the subjects was 3-55 years with a mean of 31.10 years. Forty-four (61.1%) patients were young men between 20-39 years. Fifty-one (70.8%) patients were males, and 21 (29.2%) were females, with a maleto-female ratio of 2.4:1. Most of the victims were traders (22, 30.6%), and fifty-two eyes (72.2%) presented within 12 hours of ocular injury. Motorcycles were associated with ocular injury in 37 (51.4%) patients. The most common injuries were of closed globe type (contusion, lamellar laceration, superficial foreign body) in 70 patients (89.7%). Conclusion: Road traffic-related injuries have increased over the past eight years in Nigeria. Males are more commonly injured in Road Traffic Injury (RTI), and motorcycles were the most common cause of injury to road users. Three out of 36 people injured in a vehicle at the time of injury used seat belts, while none of the riders and passengers on motorcycles wore helmets. The importance of prevention, the use of safety devices, and the avoidance of risk behaviors on the road need to be emphasised.

Analysis of Risky Riding Behavior Characteristics of the Related Road Traffic Injuries of Electric Bicycle Riders.

Electric bicycle (EB) riders, being vulnerable road users (VRUs), are increasingly becoming victims of road traffic injuries (RTIs). This study aimed to determine the current status and epidemiological characteristics of RTIs among EB riders through a questionnaire survey and roadside observations in Shantou to provide a scientific basis for the prevention and control of electric bicycle road traffic injuries (ERTIs). A total of 2412 EB riders were surveyed, and 34,554 cyclists were observed in the study. To analyze the relationship between riding habits and injuries among EB riders, chi-square tests and multi-factor logistic regression models were employed. The findings reveal that the prevalence of ERTIs in Shantou was 4.81%, and the most affected group was children under 16 years old, accounting for 9.84%. Risky behavior was widespread among EB riders, such as the infrequent wearing of safety helmets, carrying people on EBs, riding on sidewalks, and listening to music with headphones while bicycling. Notably, over 90% of those who wore headphones while bicycling engaged in this risky behavior. The logistic regression analysis showed that honking the horn (odds ratio (OR): 2.009, 95% CI: 1.245-3.240), riding in reverse (OR: 4.210, 95% CI: 2.631-6.737), and continuing to ride after a fault was detected (OR: 2.010, 95% CI: 1.188-3.402) all significantly increased the risk of ERTIs (all p < 0.05). Risky riding behavior was significantly less observed at traffic intersections with traffic officers than at those without (all p < 0.001).

Epidemiology and associated injuries in paediatric diaphyseal femur fractures treated at a limited resource zonal referral hospital in northern Tanzania

BackgroundDiaphyseal femur fractures contribute up to 40% of paediatric orthopaedic admissions with the World Health Organisation data showing youth are particularly vulnerable and road traffic injuries are the leading cause of death for children and young adults. Different mechanisms results to these injuries and they vary with age and geographical location of the patient. Understanding the incidence, mechanism and pattern of these injuries allows planning for preventive measures and treatment to meet modern day patient demands, generation of appropriate and timely protocols with minimum social and economic burden to the patient and family.Objectives and methodsA hospital based cross sectional study was conducted using the orthopaedic department patient registry among children aged under 18 years admitted from 2014—2018. Our research question was to determine the epidemiology of diaphyseal femur fractures and coexisting associated injuries among admitted paediatric orthopaedic patients. Patient files were reviewed from the medical records department and a data collecting sheet was used to record demographics and injury data. Odds ratios with 95% confidence intervals for associated injuries in paediatric diaphyseal femur fractures were estimated using multivariable logistic regression model.ResultsWe found the prevalence of diaphyseal femur fracture among paediatric orthopaedic admissions was 18% with the majority 111 (68.5%) being males. The leading injury mechanism was a fall (57.4%) followed by road traffic injuries (35.8%) out of which 48.3% resulted from pedestrian vs motorcycle accidents. Traumatic brain injury (TBI) was the most common associated injuries accounting for 69% of these injuries with the majority 79% occurring in patients aged 6 years and older. With age specific analysis, children in 6–12 years and 13–18 years age groups, had 8 and 11 times higher odds for associated injuries (OR 8.25, 95% CI, 1.04—65.31) p = 0.046 and (OR 10.54, 95% CI, 1.26—88.31) p = 0.031 respectively compared to those younger ≤ 2 years. Road traffic related injuries had 17 times higher odds of associated injuries when compared to fall (OR 16.73, 95% CI, 6.28—44.57) p < 0.001. 112 (69.1%) of femur fractures were treated by non-operative method out of this 90 (55.6%) by traction with delayed Spica application. The overall mean duration of hospital stay was 18.5 ± 11 days.ConclusionPedestrian vs motorcycle injuries was the leading specific cause of paediatric diaphyseal femur fractures with TBI being the common associated injury. Non-operative management was the most utilized treatment plan and contributed to ten times higher odds for a longer duration of hospital stay. Initiatives to insure children safety on roads should be strengthened in order to reduce/eliminate this burden. Application and practice of current evidence based clinical guidelines and recommendations is paramount for timely and appropriate treatment of these injuries.

Trends and Contributing Factors to Road Traffic Accidents in Douala

Introduction: An estimated 1.2 million people are killed in road traffic accidents each year, and as many as 50 million are injured, occupying 30 percent to 70 percent of orthopedic beds in developing countries hospitals. But there is limited information on the burden of RTA in Douala. Aim: The study aims at reporting the epidemiology and pattern of road traffic related injuries in Douala in the Littoral Region of Cameroon using available police and health data. Methods: This was a chart review of hospital based and police department records. The records were reviewed over a period of two years in a District hospital in Douala in the Littoral region of Cameroon and over four years in the Police Department in Douala. The data review was done for two months. The records of all patients received in the emergency department of Bonassama District hospital after a road traffic related injury were reviewed for epidemiological variables, type of vehicle involved, severity of injuries, and outcome of the management. For the police records, they were reviewed for epidemiological variables, type of vehicle involved, and the causes of accident. Results: A total of 2,062 persons were involved in 818 cases of road traffic accidents reported by the police department. The major causes of road traffic accident (RTA) included poor mastery of driving, over speeding and left driving. From the Police records, RTA involving a vehicle and motorcycle increased dramatically in the four-year period from 0.39 % (8) in 2015 to 5.82% (120) in 2018. A total of 1,883 persons with injuries from RTA were received and managed by the Bonassama District Hospital. Majority, 1,590(84.4%) [95% CI: 82.7%-86.1%] of the injuries that were managed in the health units were sustained from RTA involving the motorcycle. Most, 893(47.4%) [95% CI: 45.2%-49.7%] of the accidents occurred during the night hours. Conclusion: The available data in both health and police sectors revealed that there was an increase in the number of RTA in the years under study.

Injury inequalities in the European Region: trends cross-country and within-country and potential COVID-19 impacts

We will provide a review of the knowledge base from studies on injuries in the WHO European Region from 2010 to 2019, both cross-country and within-country, for all causes and cause-specific. The focus is whether inequalities between countries and within countries persist such that people from low socioeconomic status and from less affluent areas tend to die by injury to a greater extent than others. This has previously been observed for most causes of injury (e.g., traffic, self-directed violence, interpersonal violence, poisoning, burns) but also for several settings (e.g., home, work, transport) based on a review of socioeconomic disparities in injury risks from 1990-2006. In addition, the pandemic touches upon factors with a known impact, directly or indirectly, on the risk and social distribution of injuries (e.g. social isolation, change in transportation mode and volume, alcohohol consumption, etc.). Until the 2020-2021GBD data are available at the regional level for Europe, we hypothesise on how the pandemic may have affected the social distribution of injuries in the Region. For example, we hypothesise a significant decrease in road traffic related injuries due to lockdown measures (reduced commuting to work, 24-hour curfews). There may also be an increase in unintentional injuries related to children spending increased hours in the home environment and an increase in do-it-yourself injuries in adults. We also see a possible increase in self-harm injuries due to the mental ill health burden related to confinement and social isolation, but data thus far from single EU countries do not report an increase in suicides. We will then present a research agenda for investigating how the pandemic has affected the injury burden in the Europe Region.

Effect of COVID-19 on epidemiological characteristics of road traffic injuries in Suzhou: a retrospective study

BackgroundTo present the new trends in epidemiology of road traffic injuries (RTIs) during the Coronavirus disease 2019 (COVID-19) pandemic in Suzhou.MethodsPre-hospital records of RTIs from January to May in 2020 and the same period in 2019 were obtained from the database of Suzhou pre-hospital emergency center, Jiangsu, China. Data were extracted for analysis, including demographic characteristics, pre-hospital vital signs, transport, shock index, consciousness, pre-hospital death. A retrospective study comparing epidemiological characteristics of RTIs in Suzhou during the 5-month period in 2020 to the parallel period in 2019 was performed.ResultsA total of 7288 RTIs in 2020 and 8869 in 2019 met inclusion criteria. The overall volume of RTIs has statistical difference between the 2 years (p < 0.001), with fewer RTIs in 2020 compared with 2019. Electric bicycle related RTIs increased during the pandemic (2641, 36.24% vs 2380, 26.84%, p < 0.001), with a higher incidence of RTIs with disorder of consciousness (DOC) (7.22% vs 6.13%, p = 0.006).ConclusionsUnder the impact of COVID-19, the total number of RTIs in Suzhou from January to May 2020 decreased. This observation was coupled with a rise in electric bicycle related injuries and an increase in the incidence of RTIs with DOC.

Epidemiology of prehospital trauma deaths in Malawi: A retrospective cohort study.

IntroductionTrauma is among the leading causes of death and disability in both adults and children worldwide. In Malawi, trauma patients are commonly brought in dead (BID). We aimed to describe the prevalence, sociodemographic, and injury-related characteristics of patients BID to Kamuzu Central Hospital (KCH), a referral hospital in Lilongwe, Malawi.MethodsWe retrospectively reviewed records of all patients BID in the trauma surveillance registry at KCH from February 2008 to September 2019. We excluded patients BID that did not present to the emergency centre, and were instead taken to the mortuary directly. We used descriptive statistics to evaluate the epidemiology of patients BID.ResultsWe reviewed 106,198 trauma records and 1889 (1.8%) were BID patients. Most patients BID were male, in both adult (n = 1337/1528, 88.4%) and children (n = 231/360, 64.9%) cohorts. The mean age was 34.7 (SD 11.9) years in adults and 7.8 (SD 5.4) years in children. Among the adult BID patients, 33.2% were unemployed, 25.6% were construction workers, and 10.1% were small business owners or managers. The common injury mechanisms in adults were road traffic-related injuries (RTIs) (47.1%) and assaults (23.6%). In children, injuries resulted from RTIs (39.7%), with 74.4% of those were pedestrians hit by cars, drowning (22.9%), and burns (12.4%). In both groups, most injuries occurred on roads (60.2%) or at home (22.1%). Reported alcohol use at the time of trauma was present in 6.3%. The police (57.9%) and privately-owned vehicles (26.6%) transported most BID patients to KCH.ConclusionEfforts to reduce prehospital trauma mortality must focus on improving prehospital care, including training the police and community in basic life support and improving resources towards prehospital trauma care. Further efforts to reduce prehospital mortality must aim to decrease injuries on the roads and at home.

Effect of Covid-19 lockdown in trauma cases of Rural India

Covid-19 has shocked the world and forced almost all the countries to a dumbfounded state. This virus has minimised the movement of humans, showing changes like never seen before. Positive effects have already been seen in nature and wildlife in the form of pollution control. The adverse effects of lockdown are seen as economic collapse. In this study, all the trauma patients coming to Acharya Vinobha Bhave Rural Hospital, Wardha were included irrespective of their age and mode of trauma. Period of two weeks before and two weeks after the initiation of lockdown in India from 23rd march 2020 have been taken into consideration. Both the outpatient and emergency patients were included in our study. We have observed a significant fall on overall trauma cases as expected due to the lockdown. There was a fall in the total number of cases by around three times. Our study showed that the demography of geriatric trauma, which remained almost the same and nearly all of them were old age females. Low-velocity trauma has shown an increase after lockdown from 42% to 64%, while the total numbers of cases are still less as compared to before the lockdown. High-velocity trauma cases have been reduced from 52% to 31% after lockdown, which indicates less road traffic-related injuries. During the lockdown, however, we have seen a significant fall in head neck and face trauma when compared to the upper limb and lower limb trauma.

A Support Vector Machine Approach in Predicting Road Traffic Mortality in Malaysia

&#x0D; &#x0D; &#x0D; The traffic mortality rate is the baseline through which road safety plans of a country could be evaluated. A reliable and reasonable analysis of road traffic-related injuries and their leading causes is vital to the road safety investigation, evaluation as well as policymaking. Malaysia has the third highest fatality rate from road traffic accidents in Asia as well as in Southeast Asia. Although many researchers have attempted to provide predictive models of Road Traffic Mortality (RTM) in the country, the predictions are found to be rather unsatisfactory in forecasting the causes as well as the future road fatality. It is hypothesized that the inability of the previous models to provide a good prediction of the RTM might be attributed to the complicated and non-linear data relationship of the underlying causes of road traffic accidents. A Support Vector Machine (SVM) is demonstrated to be effective in solving both classifications as well as regression problems owing to its efficacy to cater for the non-linear relationship of a dataset. The present investigation proposed the application of SVM based model variations namely the Linear, Quadratic, Cubic, Fine, Medium, as well as Coarse Gaussian-based SVM in predicting the RTM. A dataset from 1972 to 1994 was obtained from the Malaysian road traffic database. The data were trained on the SVM model variations. It was demonstrated that the Linear-based SVM model can provide a reasonable prediction of the RTM with only a 12 % error. It is, therefore, inferred that a reasonable prediction of RTM in Malaysia could be achieved through the employment of non-conventional statistical techniques.&#x0D; &#x0D; &#x0D;

The global macroeconomic burden of road injuries: estimates and projections for 166 countries

Road injuries are among the ten leading causes of death worldwide and also impede economic wellbeing and macroeconomic performance. Beyond medical data on the incidence of road injuries and their resulting morbidity and mortality, a detailed understanding of their economic implications is a prerequisite for sound, evidence-based policy making. We aimed to determine global macroeconomic costs of road traffic injuries and their cross-country distribution. We calculated the economic burden of all road traffic-related injuries for 166 countries by use of a macroeconomic model that accounts for the effect of fatal and non-fatal injuries on labour supply, age-specific differences in education and experience of those who are affected by road accidents, and the diversion of injury-related treatment expenses from savings, which results in lower investment. We estimated that road injuries will cost the world economy US$1·8 trillion (constant 2010 US$) in 2015-30, which is equivalent to an annual tax of 0·12% on global gross domestic product. Although low-income and middle-income countries have the largest health burden, their share of the economic burden of road injuries is only 46·4% of the global loss, reflecting in part higher productivity (and earnings) in high-income countries, but also prominently higher treatment costs. Our results also indicate that treatment costs account for a greater proportion of the economic burden in high-income countries than in low-income countries. The macroeconomic burden of road injuries is sizeable and distributed unequally across countries and world regions. This finding suggests a case for nuanced policy making. Our framework should provide a good starting point for the more detailed analysis of policies both at country level and across different countries. National Institute on Aging.

Disability Weight Determination for Road Traffic Injuries in the Philippines: Metro Manila Scenario

Objective. To determine the Disability Adjusted Life Year (DALY) weights of road traffic injuries and use the DALY weights in determining the total DALYs lost in Metro Manila using available data.&#x0D; Methods. Consensus on DALY weights for each of the 31 International Classification of Diseases (ICD)10 codes related to road traffic injuries was done using Delphi Process. Experts from different fields were invited to participate in 2 rounds of discussion-and-scoring were done to obtain consensus were obtained for each DALY weight. Philippine Health Insurance Corporation (PHIC) data on the counts of the 31 ICD 10 coded claims for the years 2011, 2012, and 2013 were obtained and used to calculate the total DALY lost due to vehicular injuries for Metro-Manila.&#x0D; Results. Road traffic related injuries affected mostly young people (mean 34 yo + 15) and affected mostly men (81%). There were a total of 3,199 injuries seen in 2,573 patients. 98.1% of the patients had a &lt; 1 year type of injury with an average disability weight of 0.34154 and a total DALYs lost of 300.4. 0.5% of the patients had a ≥ 1 year type of injury with an average disability weight of 0.2726 and a total DALYs lost of 218.08.1.4% of the patients most likely died from their injuries earning a total DALYs lost of 1,440.The sum of DALYs lost is equivalent to a total of 1,958.12.&#x0D; Conclusion. The Metro Manila loses roughly Php 76.6 Million per year due to road traffic injuries and accidents. These events are highly preventable. Without proper interventions, road traffic injuries may lead to impoverishment of the young families who pick up the pieces, or are left behind.

Road traffic-related injuries need to develop capacity building to provide comprehensive care

Every year around the world, millions die on road generally from preventable causes and are major public health threat in current times with soaring figures of unnecessary and unacceptable burden of morbidity and disability. We attempted an extensive collection of published literature with specific inclusion criteria in PubMed, Cochrane, Web of Science, and WHO Global Health Library including additional search in indexed literature and website-based population survey reports. Ten percent of road accident fatalities worldwide occur in India, and in addition, more than a million are grievously injured every year. Moreover, victims with nonfatal injuries are forced to live with a range of physical and emotional disabilities with a colossal social and economic impact. In addition, the health-care costs allied with these injuries also create an immense threat to the already stretched out curative health-care load particularly in resource-poor settings of the developing third world countries. Notwithstanding such sobering data, road traffic injuries received less than optimal interest from national health planners to provide comprehensive care from primary health-care levels where maximum injuries come as first contact intervention. Injuries are not accidents and they do not occur by chance alone; like morbidity, they follow a classical model of epidemiological triad of agent-host-environment. Hence, by classifying the risk factors for injury as modifiable and nonmodifiable, it is most likely to forecast and prevent by models. There is a great need to validate brain injury biofluid biomarkers in the acute care setting such as in the emergency departments. The following core competencies are addressed in this article: Medical knowledge, Patient care and procedural skills, and Systems-based practice.

Motorcycle Related Oral and Maxillofacial Injuries Seen at Komfo Anokye Teaching Hospital, Kumasi-Ghana

Background: Motorcycle related injuries have become a major public health problem because the increased use of motorcycles has been accompanied with a corresponding increase of road traffic accidents. Objective: The purpose of this study was to evaluate the occurrence of oral and maxillofacial injuries associated with motorcycles as seen at the second largest Teaching Hospital in Ghana, the Komfo Anokye Teaching Hospital (KATH). Method and Materials: The compiled data that were reviewed for this retrospective study were obtained from the Accident and Emergency unit of KATH. These comprised 135 successive maxillofacial trauma patient records entered from August 2017 to August 2018. Results: Total number of road traffic related injuries seen at OMFS was 135 during the study period. Out of this number, 66 were related to motorcycle injuries. This represented 48.7% of the Road Traffic Accidents seen at oral and maxillofacial surgery department (OMFS). The age range was from 3 to 64 years. The average age was 26.7 years. 62 (93.9%) were males and 4 (6.1%) were females. 16 (24.2%) of the motorcycle injuries were caused by the “Okada”, 2 (3.0%) by “Pragia” and 48 (72.8%) by the “Aboboyaa”. 46 (69.7%) of the motorcycles victims were themselves the riders, 12 (18.2%) were pedestrians and 8 (12.1%) were passengers. There were 8 deaths. 6 (75.0%) of the deaths were caused by the “Aboboyaa”. “Okada” accounted for only 2 (15.0%) deaths. Concerning the riders and the passengers, only 8 (14.8%) of the victims were helmeted. The majority were unhelmeted (85.2%). Conclusion: Motorcycle transportation is the cause of many oral and maxillofacial injuries. Majority of the victims suffered multiple facial bone fractures. Males were more often affected than females and the majority were unhelmeted.

Childhood road traffic injuries in Canada \u2013 a provincial comparison of transport injury rates over time

BackgroundIn Canada, road traffic injuries are the leading cause of death among children and youth ≤19. Across the country, there is variability in road traffic injury prevention policies and legislation. Our objective was to compare pediatric road traffic related injury hospitalization and death rates across Canadian provinces.MethodsPopulation-based hospitalization and death rates per 100,000 were analyzed using data from the Discharge Database and provincial coroner’s reports. Road traffic related injuries sustained by children and youth ≤19 years were analyzed by province and cause between 2006 and 2012.ResultsThe overall transport-related injury morbidity rate for children in Canada was 70.91 per 100,000 population between 2006 and 2012. The Canadian population-based injury hospitalization rates from all transport-related causes significantly decreased from 85.51 to 58.77 per 100,000 (− 4.42; p < 0.01; − 5.42; − 3.41) during the study period. Saskatchewan had the highest overall transport related morbidity rate (135.69 per 100,000), and Ontario had the lowest (47.12 per 100,000). Similar trends were observed for mortality rates in Canada.ConclusionsTransport-related injuries among children and youth have significantly decreased in Canada from 2006 to 2012; however the rates vary by province and cause.

Epidemiological characteristics of hospital reported road traffic injuries case in Tianjin, 2013

To understand the distribution of reported road traffic injuries case in Tianjin from January to December 2013. The injury data was collected from the disease surveillance system which covered all the areas in Tianjin. All the reported injury cases were at their first medical care seeking in sentinel hospitals from 1 January 2013 to 31 December 2013. A total of 26 405 injury cases were reported, including 103 deaths (0.4%), during this period with the incidence of 263.01/100 000. The male to female ratio of the cases was 1.68: 1 and average age of the cases was (40.24 ± 17.58) years. The injuries caused by motor vehicle traffic accident accounted for 74.0% (19 547 cases) and the non-motor vehicle traffic accident caused cases accounted for 26.0% (6 858). The first four areas with higher incidence were Binhai (684.86/100 000) , Dongli (634.03/100 000) , Xiqing (519.83/100 000) and Jinnan (504.12/100 000) districts. The three districts with lower incidence were Heping (44.69/100 000), Nankai (52.36/100 000) and Hedong (64.34/100 000) districts. The mild, moderate and serious cases accounted for 59.7% (15 771 cases), 33.1% (8 747 cases) and 6.8% (1 783 cases) respectively. The differences in incidence among different districts and age groups were statistical significant (P<0.005). The death number in Tanggu district was highest, accounting for (26.21%) of the total, and age specific death number was highest in age group 45-64 years, accounting for 46.60% of the total. The case number and severity of road traffic accident caused injury varied with area and age group in Tianjin. It is necessary to develop targeted prevention and control measures to reduce the incidence of road traffic accident related injuries.

Preventing Child Pedestrian Injury: A Guide for Practitioners.

Each year, an estimated 270,000 pedestrians die from road traffic-related injuries, (worldwide) and children are among the most vulnerable. Child pedestrian injuries occur primarily in residential areas, often on the same street or in close proximity to the child's home, and 90% of injured child pedestrians are unaccompanied by an adult at the time of the injury. The cause of these injuries is a complex combination of factors related not only to characteristics of the child but also the built environment, the road configuration, features of the motor vehicle that might reduce injury, and driver behavior. Accordingly, effective interventions must incorporate education, technology, and improved infrastructure. The medical practitioner can not only provide the necessary education but can also be a powerful voice for changes in pedestrian infrastructure that make walking safer. This article explores the current state of childhood pedestrian injuries using examples from the United States and Australia. Pedestrian interventions and the role that primary care and lifestyle practitioners play in promoting safe pedestrian behaviors among their patients and their families are discussed.

Road traffic injuries in Kenya: a survey of commercial motorcycle drivers.

IntroductionMotorcycle injuries contribute a substantial number of deaths and hospital admissions in Kenya. There is paucity of data to inform prevention strategies to address the issue. Therefore, the current study sought to explore the characteristics of 2 and 3-wheeler related road traffic injuries (RTIs) in Kenya.MethodsA cross-sectional survey of motorcycle drivers involved in a RTI in the preceding 3 months was conducted in 11 urban and rural sites in Kenya's Thika town through face- to -face structured interviews. Drivers’ demographic information, comprehensive crash characteristics and socioeconomic impact of injury data were collected.ResultsOf 200 drivers injured, 98% were male, with average age of 28.4 years (SD±6.6). Of these drivers, 33% were not wearing any protective equipment. Negligence was the most reported cause of crash (33%), followed by slippery roads (21.0%) and speeding (17.5%). The risk of sustaining a bodily injury was 1.3 times higher in drivers who had not received prevention education compared to those who had received such education. People injured at night were 5 times more likely to sustain a bodily injury compared to those injured during the day. Only 8.5% of the drivers reported the injury incident to the police.ConclusionMajority of motorcycle related injuries in Thika town occur among young, productive, working-age male drivers. A high proportion of injuries are due to negligence on riding while not wearing any protective equipment compounded by lack of injury prevention education. Initiatives to foster helmet wearing, provision of high-quality affordable helmets, responsible driving and advocacy for stronger legislation, are recommended.

Trends in Electric Bike–Related Injury in China, 2004-2010

This study describes electric bike-related injuries from 2004 to 2010, and suggests injury prevention strategies to reduce electric bike-related injuries in China and other countries. Electric bike-related injuries data were obtained from the Bureau of Traffic Management at the Ministry of Public Security. Linear regression was used to identify statistically significant trends in electric bike-related injuries over the period. The results showed electric bike-related nonfatal injury rate had increased almost 4-fold and mortality rate increased 6-fold from 2004 to 2010. Linear regression showed a significant increase of 0.23 per 100 000 population per year (95% confidence interval = 0.18-0.29, P < .001) in the casualty rate from electric bike-related road traffic injuries. China will face new challenges arising from electric bike-related injuries. Programs need to be developed to prevent nonfatal injuries and fatalities caused by electric bike-related crashes in this country.

Factors affecting hospital length of stay and hospital charges associated with road traffic-related injuries in Iran

BackgroundRoad traffic injuries (RTIs) are a substantial cause of mortality and disability globally. There is little published information regarding healthcare resource utilization following RTIs, especially in low and middle-income countries (LMICs). The aim of this study was to assess total hospital charges and length of stay (LOS) associated with RTIs in Iran and to explore the association with patients’ socio-demographic characteristics, insurance status and injury-related factors (e.g. type of road users and safety equipment).MethodThe study was based on the Iranian National Trauma Registry Database (INTRD), which includes data from 14 general hospitals in eight major cities in Iran, for the years 2000 to 2004. 8,356 patients with RTI admitted to the hospitals were included in the current study. The variables extracted for the analysis included total hospital charges and length of stay, age, gender, socio-economic and insurance status, injury characteristics, medical outcome and use of safety equipment among the patients. Univariable analysis using non-parametric methods and multivariable regression analysis were performed to identify the factors associated with total hospital charges and LOS.ResultsThe mean hospital charges for the patients were 1,115,819 IRR (SD=1,831,647 IRR, US$128 ± US$210). The mean LOS for the patients was 6.8 (SD =8 days). Older age, being a bicycle rider, higher injury severity and longer LOS were associated with higher hospital charges. Longer LOS was associated with being male, having lower education level, having a medical insurance, being pedestrian or motorcyclist, being a blue-collar worker and having more severe injuries. The reported use of safety equipment was very low and did not have significant effect on the hospital charges and LOS.ConclusionThe study demonstrated that the hospital charges and LOS associated with RTI varied by age, gender, socio-economic status, insurance status, injury characteristics and health outcomes of the patients. The results of the study provide information that can be of importance in the planning and design of road traffic injury control strategies.