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Int J Surg. 2018 Apr;52:237-242. doi: 10.1016/j.ijsu.2018.02.034. Epub 2018 Feb 20.

Road traffic injuries: Cross-sectional cluster randomized countrywide population data from 4 low-income countries.

Author information

1
Department of Surgery, Howard University Hospital, Washington DC, USA. Electronic address: snabeelzafar@som.umaryland.edu.
2
Johns Hopkins Surgery Center for Outcomes Research, Baltimore, MD, USA. Electronic address: jcanner1@jhmi.edu.
3
Johns Hopkins Surgery Center for Outcomes Research, Baltimore, MD, USA; Department of Surgery, Brigham and Women's Hospital, Boston MA, USA. Electronic address: nnagara2@jhu.edu.
4
Surgeons OverSeas, New York, NY, USA. Electronic address: akushne1@jhu.edu.
5
Department of Surgery, UCSF-EB, Oakland, CA, USA. Electronic address: shailvi.gupta@gmail.com.
6
Duke Global Neurosurgery and Neuroscience, Durham, NC, USA. Electronic address: tu.tran@duke.edu.
7
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Previously Johns Hopkins Surgery Center for Outcomes Research, Baltimore, MD, USA; Department of Surgery, USA. Electronic address: drneerajanagarajan@gmail.com.
8
Department of Surgery, University of Washington, Seattle, WA, USA. Electronic address: stewarb@uw.edu.
9
Department of Surgery, Connaught Hospital, Freetown, Sierra Leone. Electronic address: thaimyangbay@yahoo.co.uk.
10
College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. Electronic address: pkyamanywa0@gmail.com.
11
Nepal Cancer Hospital and Research Center, Lalitpur, Nepal.
12
Makerere University College of Health Sciences, Kampala, Uganda. Electronic address: galukand@gmail.com.
13
Department of Surgery, University of Virginia, Charlottesville, VA, USA. Electronic address: ksa712@yahoo.com.
14
Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: bnwomeh@gmail.com.
15
Duke Global Neurosurgery and Neuroscience, Durham, NC, USA. Electronic address: emily.smith1@duke.edu.
16
Duke Global Neurosurgery and Neuroscience, Durham, NC, USA. Electronic address: michael.haglund@duke.edu.
17
Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: bnwomeh@gmail.com.
18
Alaska Native Medical Center, Anchorage, AK, USA; Affiliate Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: rsgroen@hotmail.com.
19
Surgeons OverSeas, New York, NY, USA. Electronic address: adamkushner@yahoo.com.

Abstract

INTRODUCTION:

Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income countries using nationally representative survey data.

METHODS:

The Surgeons Overseas Assessment of Surgical Needs (SOSAS) survey tool was administered in four countries: Sierra Leone, Rwanda, Nepal and Uganda. We performed nationally representative cross-sectional, cluster randomized surveys in each country. Information regarding demographics, injury characteristics, anatomic location of injury, healthcare seeking behavior, and disability from injury was collected. Data were reported with descriptive statistics and evaluated for differences between the four countries using statistical tests where appropriate.

RESULTS:

A total of 13,765 respondents from 7115 households in the four countries were surveyed. RTIs occurred in 2.2% (2.0-2.5%) of the population and accounted for 12.9% (11.5-14.2%) of all injuries incurred. The mean age was 34 years (standard deviation ±1years); 74% were male. Motorcycle crashes accounted for 44.7% of all RTIs. The body regions most affected included head/face/neck (36.5%) followed by extremity fractures (32.2%). Healthcare was sought by 78% road injured; 14.8% underwent a major procedure (requiring anesthesia). Major disability resulting in limitations of work or daily activity occurred in 38.5% (33.0-43.9%).

CONCLUSION:

RTIs account for a significant proportion of disability from injury. Younger men are most affected, raising concerns for potential detrimental consequences to local economies. Prevention initiatives are urgently needed to stem this growing burden of disease; additionally, improved access to timely emergency, trauma and surgical care may help alleviate the burden due to RTI in LMICs.

KEYWORDS:

Disability; Epidemiology; Global surgery; Road traffic injury

PMID:
29471158
DOI:
10.1016/j.ijsu.2018.02.034
[Indexed for MEDLINE]

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