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In Lebanon, the lack of quality data on road traffic injuries (RTIs) led to the implementation of a hospital-based RTI surveillance system by the Ministry of Health in in private and public-run hospitals in the Bekaa governorate. This paper aims to describe the characteristics and severity of RTIs recorded over two years during the pilot phase. It also assesses the strengths and challenges of the surveillance system, highlighting areas for enhancement. The data collected from the Emergency department (ED) was used to conduct a retrospective analysis of population-based injuries hospitalized for road traffic crashes (RTC). Designated focal persons reported injuries weekly using a standardized form, which included demographic and crash-related variables, body lesions, and vital signs. Data were coded per the International Classification of Diseases (ICD-10), entered into Epidata, and analyzed using SPSS. The RTI surveillance system was assessed using Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis. Over two years, a total of 1576 cases of RTIs were reported. The male-to-female ratio was 2.16 and the majority of RTIs (44.4%) were recorded among those aged between 15 and 29 years old. From 2013 to 2015, a decrease of 0.7% in the revised trauma score (RTS < 4) was recorded. On the contrary, an increase of 3.9% in injury severity score (ISS) that ranged between 15 and 75 was reported. The probability of survival of an injured individual at one month was improved. The hospital-based surveillance system demonstrated strengths in structured data collection and ethical considerations but faced challenges like underreporting, limited coverage, and resource constraints. Recommendations for improvement include enhancing data quality and timely reporting, ultimately supporting evidence-based road safety interventions. [ABSTRACT FROM AUTHOR]

Introduction and objective: Road Traffic Injuries (RTIs) represent the predominant cause of morbidity and mortality globally. Thus, impactful interventions and trustworthy authorities are imperative to mitigate traffic accidents. The present study seeks to assess public trust in traffic accident diminution policies and measures within the country of Iran. Method: This cross-sectional study utilized a questionnaire comprising 31 questions distributed across eight dimensions. The questionnaire's design was informed by a literature review and semi-structured interviews with experts specializing in traffic accidents. The target population consisted of Tabriz city residents, who were selected via convenience sampling. The collected data were then analyzed using SPSS-16 software, employing the T-test, One-way ANOVA, and Pearson correlation coefficient to present the study's results. structural equation modeling (SEM) was conducted using R 4-4-2 programming language. Results: A total of 681 participants completed the questionnaire, yielding a commendable response rate of 88.6%. The majority of participants were male (60.8%), and 86.2% identified as drivers, with 61.8% having experienced driving accidents. The overall score for public trust in RTIs policies was calculated to be 46.9%. The individual scores for specific domains of trust in traffic safety were as follows: safer roads (43.1%), safe vehicle (43.3%), safety laws (48.8%), safe user (51.1%), safe technology (51.5%), road safety management (46.8%). All the latent variables except education are significantly effective on public trust. Conclusion: The study findings indicate relatively low levels of public trust in RTIs policies among the Iranian population. These results emphasize the need for targeted interventions to enhance public confidence in specific aspects of traffic safety. Policymakers can use these insights to implement effective measures, thus contributing to the RTIs and the promotion of road safety in the country. [ABSTRACT FROM AUTHOR]

Background: Trend of medico legal cases is a fundamental part of the prevention of avoidable causalities in future and to study the crime rate in area. In present study an attempt is made to know the burden of medico legal cases. The aim of present study is to describe the profile, pattern and trend of medico-legal cases and identify errors in the medico-legal reports. Method: This is a Retrospective, descriptive, non-interventional study, conducted in emergency department of Government Medical College and Hospital Jalaun during the period from 1st January 2023 to 31th December 2023. This is a tertiary care teaching hospital where patients are referred from most of private hospitals. Patients from district hospitals of the region are also admitted in this college. Conclusions: In majority of places, duty of casualty medical officer is accomplished by MBBS doctor who is not expert in handling of medico legal cases. Therefore medico-legal work should be done under the direction of forensic medicine expert to avoid inaccuracy in giving the opinion. The present study showed that male out numbered female and maximum cases were of younger generation. Most common aetiology was of road traffic injuries. Such incidences can be prevented by giving awareness through proper education and training of safety standards by administrators through road safety programs. [ABSTRACT FROM AUTHOR]

Objective To provide a basis for formulating precise prevention and control strategies, the temporal and spatial aggregation characteristics of county road traffic injury mortality were analyzed, Shandong, 2012-2021. Methods The traffic injury mortality rate was calculated by using the data from the death registration and reporting system of Shandong. Geoda 1.18 and SatScan 9.7 were used for spatial autocorrelation analysis and spatiotemporal scanning analysis to explore the characteristics of spatiotemporal aggregation, and principal component regression analysis was used to explore the influencing factors. Results Road traffic injury mortality rate in Shandong from 2012 to 2021 showed an overall decreasing trend and was high in the fall. The spatial correlation existed in each year, and the "high-high" aggregation area was mainly located in the central and northwestern parts of Shandong. The spatial scan revealed the existence of four clusters across the entire population. Cluster 1 existed from March 2012 to February 2015, covering 26 districts and counties, primarily located in south-central Shandong. Similar to the total population, urban and rural areas were mainly located in the central and southern part of Shandong, and the main urban agglomeration area existed from January 2012 to December 2014, covering 19 districts and counties; The main rural agglomeration area existed from January 2012 to December 2014, covering 38 districts and counties. Principal component regression analysis showed that the variables reflecting the economic and transportation conditions had a greater impact. Among them, the number of permanent residents and the volume of passenger and freight transportation were positively correlated with the mortality rate, while others were negatively correlated. Conclusion From 2012 to 2021, the mortality rate of road traffic injuries in Shandong showed a decreasing trend. The main agglomeration area exists in the central and southern part of Shandong, and the rural agglomeration is more obvious. According to the characteristics of clustering, attention should be paid to the enforcement of laws and regulations, infrastructure construction, population flow and other factors in high-risk areas, and prevention and control strategies should be adopted or adjusted according to local conditions. [ABSTRACT FROM AUTHOR]

Background: Road traffic injuries are a major concern worldwide, with Thailand facing high accident mortality rates. Drunk driving is a key factor that requires countermeasures. Random breath testing (RBT) and mass media campaigns recommended by the World Health Organisation intend to deter such behaviour. This study aimed to evaluate the cost-effectiveness of implementing RBT in combination with mass media campaigns in Thailand. Methods: A Markov simulation model estimated the lifetime cost and health benefits of RBT with mass media campaigns compared to mass media campaigns only. Direct medical and non-medical care costs were evaluated from a societal perspective. The health outcomes were quality-adjusted life years (QALY). Costs and outcomes were discounted by 3% per year. Subgroup analyses were conducted for both sexes, different age groups, and different drinking levels. Probabilistic sensitivity analyses were conducted over 5,000 independent iterations using a predetermined distribution for each parameter. Results: This study suggested that RBT with mass media campaigns compared with mass media campaigns increases the lifetime cost by 24,486 THB per male binge drinker and 10,475 THB per female binge drinker (1 USD = 35 THB) and results in a QALY gain of 0.43 years per male binge drinker and 0.10 years per female binge drinker. The intervention yielded incremental cost-effectiveness ratios (ICERs) of 57,391 and 103,850 THB per QALY for male and female drinkers, respectively. Moreover, the intervention was cost-effective for all age groups and drinking levels. The intervention yielded the lowest ICER among male-dependent drinkers. Sensitivity analyses showed that at a willingness-to-pay (WTP) threshold of 160,000 per QALY gained, the RBT combined with mass media campaigns had a 99% probability of being optimal for male drinkers, whereas the probability for females was 91%. Conclusions: RBT and mass media campaigns in Thailand are cost-effective for all ages and drinking levels in both sexes. The intervention yielded the lowest ICER among male-dependent drinkers. Given the current Thai WTP threshold, sensitivity analyses showed that the intervention was more cost-effective for males than females. [ABSTRACT FROM AUTHOR]

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Background: Given the extensive impact of road traffic accidents (RTAs) consequences and their potential ramifications on the health of both current and future generations, this study examines the social and demographic factors that influence RTA‐related mortality among women of reproductive age. Methods: The study population consisted of cases retrieved from the database of the Legal Medicine Organization, encompassing all women aged 15–49 who succumbed to road accidents between 2011 and 2021. Results: The mean age of women in the reproductive age group from East Azerbaijan province between 2011 and 2021 was 33.67 years, with a standard deviation of 9.18. RTAs on main roads accounted for the majority of incidents (395 cases, 50.8%), with 93.7% (728 cases) attributed to road traffic. In 54.4% of these cases, the affected organ was the head and neck, and the primary cause of death in 52.1% was head trauma. Across all age groups, injuries to the neck and head were the most common, followed by injuries to the abdomen, chest, back, and sternum. Conclusion: The higher incidence of road accidents in the 25–29 age group highlights the need for targeted interventions to address risky behaviors, inexperience, and peer influences in this demographic. Our observation of passengers experiencing the highest mortality rate emphasizes the vulnerability of road users, particularly pedestrians, in traffic accidents. Pedestrian violations in the 17–30 age group further emphasize the importance of education and awareness campaigns aimed at reducing risky behavior. [ABSTRACT FROM AUTHOR]

In Saudi Arabia, motor vehicle crashes (MVCs) are a major cause of injuries, deaths and disability. To reduce levels of disability associated with road traffic injuries (RTIs), rehabilitation is crucial. However, limited information is available regarding rehabilitation services in Saudi Arabia, particularly the role of occupational therapy following RTIs. This paper explores occupational therapists' perspectives on Saudi Arabian rehabilitation services. This descriptive qualitative study included semi-structured interviews with 13 occupational therapists working in rehabilitation settings in Saudi Arabia. Reflexive thematic analysis was utilised to identify themes related to their experiences and the potential for improved rehabilitation guidelines and practices. Five themes were identified. (i) Accessibility to rehabilitation following RTI was impacted by geographical location, high service demands, social support and financial issues. (ii) Pathway to rehabilitation following RTI varied, typically physician-led, with multi-disciplinary teams in rehabilitation services. (iii) Occupational therapy role in rehabilitation is perceived as poorly understood by others. (iv) Limitation to current rehabilitation services includes few highly experienced therapists, challenges to individualised care, and underdeveloped community reintegration. (v) Research is needed for better rehabilitation services through understanding people's experiences and perspectives to improve rehabilitation services. Overall, occupational therapists highlighted that the limited number of well-established rehabilitation facilities, mostly located in the central region of Saudi Arabia, negatively impact service provision and functional outcomes. Effective utilisation of occupational therapists' insights into the challenges of rehabilitating individuals after RTIs could improve the implementation, operation, governance, and investment in rehabilitation services in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Purpose: Limb amputation is one of the oldest medical operations, dating back over 2500 years to Hippocrates' time. In developing countries like India, most of the patients are young, and trauma is the primary cause of limb amputation. The objectives of this study were to investigate the factors that can predict the outcome of patients who underwent upper or lower limb amputations. Materials and methods: This was a retrospective analysis of the prospectively collected data of patients who underwent limb amputations from January 2015 to December 2019. Results: From January 2015 to December 2019, 547 patients underwent limb amputations. Males predominated (86%). Road traffic injuries (RTI) were the most common (323, 59%) mechanism of injury. Hemorrhagic shock was present in 125 (22.9%) patients. Above-knee amputation was the most common (33%) amputation procedure performed. The correlation of hemodynamic status at presentation with the outcome was statistically significant (p-0.001). Outcome measures like delayed presentation, hemorrhagic shock, Injury severity scores (ISS), and the new injury severity scores (NISS) were statistically significant (p-0.001) when compared to the outcome. There were 47 (8.6%) mortalities during the study period. Conclusion: Factors that affected the outcome were delayed presentation, hemorrhagic shock, higher ISS, NISS, MESS scores, surgical-site infection, and associated injuries. Overall mortality during the study was 8.6%. [ABSTRACT FROM AUTHOR]

Road traffic injuries (RTIs) are increasingly claiming lives, particularly of those living in low- and middle-income countries (LMICs). To evaluate the economic consequences of RTIs, their financial impact on Gross Domestic Product (GDP) has been investigated by several studies using road safety valuation methods. This in turn has been used to quantify the resources required for investment on appropriate countermeasures to reduce the severity and frequency of RTIs. To investigate the frequency of use of road safety valuation methods in assessing the economic impact of road injuries, a robust systematic review was carried out with the aid of EPPI-reviewer software. The analysis of the evidence gathered showed that 55% of the included studies used the willingness-to-pay (WTP) method, 29% used human capital (HC), 11% used restitution cost and 5% used other methods. In high-income countries (HICs), the predominant method used was WTP, while HC was more common for middle-income countries. In addition, it was found that 49% of the studies in this field were conducted on HICs, whilst 4% focused on low-income countries (LICs). This indicates that there is a gap in the use of road safety valuation methods for LICs in the literature and therefore a need for further research. [ABSTRACT FROM AUTHOR]

The increasing incidence of road traffic injuries (RTIs) has contributed to the disability and death of millions of people on both a national and global level. This retrospective study was conducted at King Fahad University Hospital (KFUH), Khobar, Saudi Arabia, and included all patients who presented at the emergency department due to road traffic accidents (RTAs) between January 1st, 2022, and December 31st, 2022. Patient data was retrieved from the health information system at KFUH. Descriptive and inferential analysis were performed with several variables analyzed using multivariate logistic regression and factorial ANOVA (MANOVA). During this period, 921 patients were treated at the hospital's emergency department. Of these, 611 (66.3%) were men and 310 (33.7%) were women. The most frequently affected age group was 16-25, representing 427 (46.4%) cases. Most patients were Saudi citizens (837, 90.9%). Among the patients, 19 (2.1%) required surgical treatment within 24 hours of the RTA, and 29 (3.1%) were admitted to the surgical intensive care unit (SICU). There were eight fatalities, representing 0.9% of the cases. January had the highest number of RTAs (12.7%). Moreover, 463 individuals (50.3%) had some form of injury, the most common type being lacerations and abrasions (n=228, 24.8%). Upper limb fractures were the most frequent type of fracture, occurring in 73 cases (7.9%). Being male (P=0.001), non-Saudi (P=0.014), and experiencing accidents during June and July (P=0.002) were associated with an increased prevalence of injury. Mortality had a statistically significant relationship with different patient age groups (P=0.014), patient citizenship (P=0.005), and length of hospital stay (P<0.001). [ABSTRACT FROM AUTHOR]

Most road traffic crash reports published in Nepali media provide little information about their causes, impacts, or preventability. Three workshops involving 31 journalists from diverse media platforms were held using published World Health Organisation resources, to provide training in good road safety reporting. Participants were invited to complete a survey exploring their motivation for participation and knowledge gained. Thirteen (42%) participants responded, reporting the acquisition of new knowledge for content generation, finding facts, active application of learning, and purposeful communication, and an intention to apply the skills learned in their work. A before and after assessment of 94 media outputs from workshop participants found an improvement in the use of story angles and ideas recommended in WHO resources. The study suggests that journalists are interested in developing their road safety reporting skills and that running such workshops has the potential to improve responsible reporting and the promotion of road safety. [ABSTRACT FROM AUTHOR]

Background: Road traffic Injuries (RTI) are multifaceted occurrences determined by the combination of multiple factors. Also, severity levels of injuries from road traffic accidents are determined by the interaction of the composite factors. Even though most accidents are severe to fatal in developing countries, there is still a lack of extensive researches on crash severity levels and factors associated with these accidents. Hence, this study was intended to identify severity levels of road traffic injuries and determinant factors in Addis Ababa City, Ethiopia. Methods: The study was conducted in Addis Ababa, the capital city of Ethiopia, using secondary data obtained from the Addis Ababa Police Commission office. The ordinal logistic regression model was used to investigate road traffic injury severity levels and factors worsening injury severity levels using the recorded dataset from October 2017 to July 2020. Results: A total of 8458 car accidents were considered in the study, of which 15.1% were fatal, 46.7% severe, and 38.3% were slight injuries. The results of the ordinal logistic regression analysis estimation showed that being a commercial truck, college and above level educated driver, rollover crash, motorbike passengers, the crash day on Friday, and darkness were significantly associated factors with crash injury severity levels in the study area. On the contrary, driving experience (> 10 years), passenger of the vehicle, two-lane roads, and afternoon crashes were found to decrease the severity of road traffic injuries. Conclusions: Road traffic injury reduction measures should include strict law enforcement in order to maintain road traffic rules especially among commercial truckers, motorcyclists, and government vehicle drivers. Also, it is better to train drivers to be more alert and conscious in their travels, especially on turning and handling their vehicles while driving. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze the psychological characteristics underlying Chinese parents' behaviors in using child car seats and to understand their decision-making processes. Based on the theory of planned behavior (TPB), three extended variables of perceived accident severity, perceived benefits, and perceived barriers were introduced. From the perspective of social psychology, the psychological factors that influence parents' use of child car seats and their interrelationships were explored. A questionnaire was designed to collect data, including information on demographic characteristics, basic components of the TPB, and relevant extension variables. Using on online survey, 585 valid questionnaires were collected. Structural equation modeling was used to calibrate the data, and multiple group analysis was performed on the demographic variables. The extended TPB can effectively explain and predict parents' behaviors when using children's car seats. The results of the model show that parents' positive attitudes toward child safety seats (CSSs), others' recognition of their own use and perceptual control of the use of CSSs increase their willingness to use CSSs. Parents' willingness to use has a positive impact on the use of CSSs. Additionally, for the three extended variables introduced, perceived benefit significantly promoted parental intention and behavior to use CSS for children; perceived barriers significantly reduced parental use of CSS; and perceived accident severity had no significant effect on parental use of CSS. This study established the validity of the extended TPB model in predicting parents' behaviors in using car seats for their children. In addition, the current findings may provide a theoretical basis for policy development to promote CSS use. [ABSTRACT FROM AUTHOR]

Background: Road traffic injures (RTIs) are the third leading cause of death in the world after heart diseases and cancer. The aim of the present study was to determine the prevalence of spinal cord fractures (SCF) and other general orthopedic fractures (GOF) caused by road traffic injuries. Materials & Methods: This was a retrospective cross sectional study performed on patients with RTIs-related fractures or SCIs from January 2020 to January 2021. The study population consisted of the medical records of patients admitted to Imam Khomeini Hospital with a diagnosis of GOFs or SCFs. The participants were included in the study by census method. Inclusion criteria included RTIs-related orthopedic fractures or SCIs. The data was analyzed using the SPSS 16 software. Results: The study result showed, that the prevalence of two types of fracture in patients was 9.33%. Also, the prevalence of spinal cord fractures was in the form of Multiple spinal levels with a rate of 88 (32.6%) and the lowest rate was in the Dorsal spine area with a rate of 38 (14.1%). Regarding general orthopedic fractures, the result showed Multiple Orthopedic regions with a rate of 67 (24.8%) and the lowest rate was in the Pelvis region with a rate of 29 (10.7%). Conclusions: The prevalence of spinal cord and general orthopedic fractures in the examined patients was high, so it is necessary to take corrective measures to prevent traffic accidents. [ABSTRACT FROM AUTHOR]

Background: Road traffic injuries (RTIs) are a leading cause of death and unintentional injuries globally. They claim 1.35 million lives and produce up to 50 million injuries each year, causing a major drain on health systems. Despite this high burden, there is a lack of robust data on the long-term consequences of RTIs, specifically the level of disability experienced by many survivors and its impact on their everyday lives. Objective: This study aims to characterize RTIs, disability level, and related consequences affecting adult road traffic crash survivors in 5 low- and middle-income countries (LMICs). In addition, this study estimates the role of demographic and crash- and treatment-related factors in predicting adverse outcomes and disability as well as examining the disability level among patients with RTIs, likelihood of return to normal life, and the environmental factors that may influence these outcomes after discharge from the hospital. Methods: This prospective observational study was conducted at selected hospitals in Bangladesh, Cambodia, Ethiopia, Mexico, and Zambia. The study sample included all adult patients with RTIs admitted to the hospital for at least 24 hours. Consecutive sampling was performed until the minimum required sample size of 400 was reached for each participating country. Data were collected from patients or their caregivers using a hospital-based surveillance tool administered at the participating sites as well as a telephone-based follow-up instrument administered 1, 3, and 6 months after discharge. Descriptive analysis and multivariate models will be used to estimate the contribution of a range of factors in predicting adverse outcomes, disability, and return to normal life. Results: Enrollment began in June 2021 and was completed in April 2022. Follow-up data collection ended in September 2022. Data analysis is currently underway, with results expected for publication in mid-2023. Expected results include estimates of disability among patients with RTIs as well as identifying the predictors of adverse outcomes, disability, and the likelihood of return to normal life. Conclusions: Research findings will help better understand the long-term burden of disability from RTIs in the 5 LMICs and the challenges facing survivors of road traffic crashes. They will be used to inform interventions aimed at improving the health care, social, physical, and policy conditions in LMICs that can facilitate recovery and rehabilitation for patients with RTIs, reduce the burden of disability, and enhance their participation in society. [ABSTRACT FROM AUTHOR]

Road Traffic Injury (RTI) is major public health concern globally and is excessively affecting vulnerable road users in the pacific Island nations. This study aimed to explore and understand the perception of Public Transport Drivers (PTDs) on risk factors and the existing prevention strategy of RTI in Vanuatu. This study employed qualitative methods that used 31 In-Depth Interviews (IDIs) to gather data from PTDs from 14 October to 30 November 2020. Purposive sampling was used to recruit PTDs from three main municipalities, Luganville, Port Vila and Lenakel. Semi-structured open-ended questionnaire were used to gather data. Interview data was transcribed and manual thematic analysis was performed to analysis the data. Data saturation was reach from interviewing 31 PTDs who were all male. Five main themes were generated from the study including the trend of RTI, the determinants of RTI, high-risk road users, traffic law enforcement and public education. The respondents perceived that the best measures for preventing RTI include community education, enforcement of road traffic control laws and addressing specific road infrastructure issues. Changing driver behaviours, community education on road safety and enforcement of traffic laws are essential for preventing RTI in Vanuatu. [ABSTRACT FROM AUTHOR]

Road traffic injuries (RTIs) are a serious public health problem and are an important cause of disability and death worldwide. A significant proportion of traffic injuries and fatalities are among pedestrians. Reviewing and evaluating related interventions can be a practical step to implementing appropriate methods to prevent RTIs among pedestrians, a highly vulnerable group of road users. The search of articles was conducted in the electronic databases of Scopus, PubMed, ISI, Safety Lit, and CDC. Other papers were also reviewed using forward citation and backward citation. The search strategy was for studies examined from the first years of database creation until January 10, 2021, in all languages in journals with matched judgment according to the type of population, type of interventions, comparators, and results. Joanna Briggs Institute (JBI) checklists were used to determine articles' quality and assess possible biases depending on the type of study. The initial search resulted in finding 16,272 abstracts. Finally, 25 studies, including 17 randomized clinical trials (RCTs) studies, seven studies pretest/post-test interventions (PPI), and one study controlled pretest/post-test interventions (cPPI) met the inclusion criteria. Among these preventive interventional studies, 20 studies were conducted in high-income countries, three were in lower middle-income countries, one study was in upper middle-income country, and only one study was conducted in a low-income country. Most interventional studies in the field of prevention of RTIs (15 studies) had an educational/behavioral approach, designed to change pedestrian behavior and the use of this approach was also effective in improving pedestrian behavior. The legislation/law enforcement approach was used in one study and two studies used an engineering/technology approach. In studies with an engineering approach after engineering reforms, pedestrian injuries in children decreased by 37.5%. In seven studies, multifaceted interventions were used. The interventional studies that used this approach were able to improve pedestrian safe behavior. The majority of studies were based on educational/behavioral approaches and pedestrians' behavior improved notably. In addition, the majority of interventional studies were conducted in countries with high income levels. Therefore, programming for preventive interventions to attenuate RTIs is highly important in low/middle-income countries to reduce the risk of injury to vulnerable road users. These findings can be applied by policy-makers to develop educational, engineering, environmental, and law enforcement interventions and attenuate injuries sustained by pedestrians. [ABSTRACT FROM AUTHOR]

Road traffic injury (RTI) is a major public health concern in Kenya with more than 13,000 deaths estimated annually. The primary objective of this study was to design and implement an injury surveillance tool for the collection of injury data, and assess the tool's feasibility for the development of a hospital-based trauma registry in a leading Kenyan referral hospital. Secondarily, an epidemiologic profile was created to characterize RTI in the region. An injury surveillance tool was developed and implemented, on a pilot basis, in a level 5 trauma hospital, Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH), in Kisumu City, Western Kenya, for a 4-week period from 2019-07-15 to 2019-08-11. A descriptive statistical analysis summarized injury frequency counts and percentages. Over the pilot phase, 371 patients had forms completed, but 488 official injury-related hospital registrations, indicating that 117 injury patients (24%) were missed. A process evaluation of the tool implementation revealed issues in the collection protocol that required revisions, resulting in improved data form completeness rates. For the 368 cases with cause documented, the most common mechanisms of injury were RTI (46.5%; n = 171), assaults (23.9%; n = 88), and falls (14.9%; n = 55). For RTI patients, the median age was 28 years (IQR = 16) and 77% (n = 132) were males, with motorbike collision injuries (n = 91; 53.2%) the leading RTI mechanism. There were 348 injuries for 171 patients. The most common anatomical regions for RTI were the lower limb 32.8% (n = 114), upper limb (15.2%; n = 53), followed by head lacerations 8.6% (n = 30) and concussions 7.2% (n = 25). Two-thirds of patients (n = 113; 66.1%) were discharged from ED, just over a quarter (n = 46; 26.9%) were admitted to hospital and 9 patients succumbed to RTI (5.3%). This injury surveillance pilot study produced the first injury dataset in Kisumu City, demonstrating the significant magnitude of RTI in Western Kenya, the leading cause of injury for the region. This dataset can be replicated in other hospitals to create an injury surveillance system for the collection of trauma data, needed for the development of countermeasures for the reduction of trauma, as well as for quality initiatives to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives: Trauma is a prominent reason for morbidity and death in Iran. The objective of this study was to provide epidemiological and clinical features of the injured patients admitted to one of the collaborating centers of the national trauma registry of Iran (NTRI). Materials and Methods: The study was carried out at the one NTRI center from March 25, 2017, to November 20, 2020. Patients who had the NTRI criteria were included in the study. Data comprised demographics, injury information, prehospital and in-hospital information, procedures, International Classification of Diseases 10 codes, diagnoses, injury severity, and outcomes. Results: Overall, 4043 trauma patients were included in the trauma. Of whom, 3036 (75.0%) were men. There was a statistically significant association between the cause of trauma and the severity of the injury. The post hoc test results demonstrated that the percentage of the injury severity score (ISS) ≥9 in patients with falls was higher than in patients with road traffic injuries (RTI) (26.9% vs. 16.8%, P = 0.01). The univariable and multiple logistic regression analyses showed statistically significant associations between age ≥65, cause of trauma, years of school, and ISS ≥9 with intensive care units (ICU) admission. After adjusting for age and cause of trauma, the odds of ICU admission in patients with ISS ≥9 were 6.23 times more than in patients with ISS <9 (odds ratio = 6.23, 95% confidence interval [4.92--7.88]). Conclusion: The odds of ICU admission were higher in older patients (age ≥65), lower educated patients, patients with falling, and severe injuries. [ABSTRACT FROM AUTHOR]

Context: Road traffic injuries (RTIs) will become the fifth leading cause of death by 2030. It is often possible to mitigate the consequences of serious injury if victims have access to prompt, effective pre-hospital care within minutes following the crash. Aims: To find out the facilitators and barriers for providing post-crash emergency care in Road traffic injuries in district Aligarh. Settings and Design: The present study was undertaken on both the National highways (NH-91 and NH-93) and the bypass roads passing through district Aligarh of Uttar Pradesh. Subjects and Methods: All the individuals who met road traffic accidents (RTA) between the earmarked areas from 1st October 2018 to 30th November 2020 and reported for treatment to the selected hospitals were included in the study. Statistical Analysis Used: Data is presented in the form of frequency tables and percentages. Results: A total of 1126 patients were interviewed during the study period. Out of 1126, 937 (83.2%) were males, and 189 (16.8%) were females, with M:F ratio being 4.96:1. Six hundred sixty-two (58.8%) of the respondents identified the layperson or common man as the first person to respond at the time of the crash. 1110 (98.58%) respondents identified the layperson as the facilitator in providing post-crash emergency care, followed by police and roadside shopkeepers/dhabawalas. The role of the layperson in calling for help by utilizing the helpline numbers, suggesting a nearby health facility together with facilitating for transportation of the victim to the nearby health facility was appreciated by the majority of the respondents. An ambulance was the best available mode of transportation. Seven hundred thirty-three (65.10%) of the total respondents were aware of the toll-free number to be dialled in case of RTA. However, only 320 (43.70%) among them used this toll-free facility after meeting the crash. Conclusion: A layperson is the single most important facilitator for providing post-crash emergency care. [ABSTRACT FROM AUTHOR]

Background: Road traffic injuries are a significant cause of death and disability globally. However, in some countries the exact health burden caused by road traffic injuries is unknown. In Malawi, there is no central reporting mechanism for road traffic injuries and so the exact extent of the health burden caused by road traffic injuries is hard to determine. A limited number of models predict the incidence of mortality due to road traffic injury in Malawi. These estimates vary greatly, owing to differences in assumptions, and so the health burden caused on the population by road traffic injuries remains unclear. Methods: We use an individual-based model and combine an epidemiological model of road traffic injuries with a health seeking behaviour and health system model. We provide a detailed representation of road traffic injuries in Malawi, from the onset of the injury through to the final health outcome. We also investigate the effects of an assumption made by other models that multiple injuries do not contribute to health burden caused by road accidents. Results: Our model estimates an overall average incidence of mortality between 23.5 and 29.8 per 100,000 person years due to road traffic injuries and an average of 180,000 to 225,000 disability-adjusted life years (DALYs) per year between 2010 and 2020 in an estimated average population size of 1,364,000 over the 10-year period. Our estimated incidence of mortality falls within the range of other estimates currently available for Malawi, whereas our estimated number of DALYs is greater than the only other estimate available for Malawi, the GBD estimate predicting and average of 126,200 DALYs per year over the same time period. Our estimates, which account for multiple injuries, predict a 22–58% increase in overall health burden compared to the model ran as a single injury model. Conclusions: Road traffic injuries are difficult to model with conventional modelling methods, owing to the numerous types of injuries that occur. Using an individual-based model framework, we can provide a detailed representation of road traffic injuries. Our results indicate a higher health burden caused by road traffic injuries than previously estimated. [ABSTRACT FROM AUTHOR]

Introduction: Emergency response to a road traffic injury (RTI) plays a crucial role in patient survival, and the quality of the emergency response should be consistent regardless of the time of day. The aim of this study was to investigate prehospital care and survival outcomes compared between emergency response to RTI during the day and emergency response to RTI at night in Asia. Method: This cross-sectional study used data from the Pan-Asian Trauma Outcome Study (PATOS) that was conducted during 2015-2018. We included RTI patients who were transported to the emergency department (ED) by ground ambulance. That group was then categorized according to the time that the ambulance arrived on-scene. On-scene arrival during 8:00 am to 7:59 pm was defined as the daytime group, and arrival during 8:00 pm to 7:59 am was defined as the nighttime group. Multiple logistic regression was employed to identify factors associated with nighttime prehospital interventions and survival outcomes after adjustment for age, alcohol consumption, and injury severity score (ISS). Results: The final analysis included 20,105 RTI patients. Of those, 12,043 (60%) accidents occurred during the daytime, and 8,062 (40%) occurred at night. RTI patients at night were younger (mean age: 35.7 ± 17.3 vs. 39.5 ± 20.7; p < 0.001), had more alcohol consumption (15.0% vs. 4.2%; p < 0.001), and had more severe injuries (mean ISS: 6.5 ± 7.5 vs. 5.8 ± 7.0; p < 0.001) compared to the daytime group. The nighttime group had increased prehospital immobilization (adjusted odds ratio [aOR]: 1.22, 95% confidence interval [CI]: 1.14-1.31) and more prehospital intravenous (IV) access (aOR 1.36, 95%CI: 1.22-1.51). There was no significant difference in either basic or advanced airway management between the daytime and nighttime groups. The nighttime group had decreased survival in the ED (aOR: 0.80, 95%CI: 0.65-0.98); however, nighttime on-scene arrival did not impact survival to discharge (aOR: 1.10, 95%CI: 0.91-1.33). Conclusion: In the PATOS community, RTI patients that sustained their injuries at night received significantly more prehospital immobilization and IV access, and they had significantly decreased survival in the ED. The results of this study can be used to develop and enhance strategies to improve the care and outcomes of nighttime RTI in Asia. [ABSTRACT FROM AUTHOR]

Background: Micromobility sharing platforms have involved skyrocketing numbers of users in multiple countries since 2010. However, few studies have examined the overall impact of the growing micromobility market on road injuries. Method: We use road injury data from the Global Burden of Disease Study database to examine the effect of age, period, and cohort on micromobility injury-related deaths and incidence. We compared four countries that vary in demographic background and road infrastructure. By comparing the countries, we analyzed the relationship between the trends in road injuries and these factors. Results: We found an overall upward trend in micromobility injuries. A higher risk of micromobility-related injuries was witnessed in China and the US in 2015-2019, and people older than 45 showed a growing micromobility-related mortality and incidence rate in China, India, and the US. Cohorts after 1960 showed higher micromobility injury incidence risks in China and India, but the population born after 1990 in India showed a slightly lower risk compared to those before it. Conclusions: The boosted usage of micromobility devices explains these increasing trends. Road infrastructure and separated traffic ease the collisions from micromobility devices. The overall situation calls for improvement in legislation as well as road infrastructure. [ABSTRACT FROM AUTHOR]

Background: Micromobility sharing platforms have involved skyrocketing numbers of users in multiple countries since 2010. However, few studies have examined the overall impact of the growing micromobility market on road injuries.Method: We use road injury data from the Global Burden of Disease Study database to examine the effect of age, period, and cohort on micromobility injury-related deaths and incidence. We compared four countries that vary in demographic background and road infrastructure. By comparing the countries, we analyzed the relationship between the trends in road injuries and these factors.Results: We found an overall upward trend in micromobility injuries. A higher risk of micromobility-related injuries was witnessed in China and the US in 2015-2019, and people older than 45 showed a growing micromobility-related mortality and incidence rate in China, India, and the US. Cohorts after 1960 showed higher micromobility injury incidence risks in China and India, but the population born after 1990 in India showed a slightly lower risk compared to those before it.Conclusions: The boosted usage of micromobility devices explains these increasing trends. Road infrastructure and separated traffic ease the collisions from micromobility devices. The overall situation calls for improvement in legislation as well as road infrastructure. [ABSTRACT FROM AUTHOR]

Background: Limited data from low- and middle-income countries (LMICs) on the severity of road traffic injuries (RTIs) and their relation to different variables of interest are routinely obtained. Knowledge on this subject relies on evidence from high-income countries, which might not be the same as in LMICs. This information is greatly needed to advance and inform local and regional efforts towards the United Nations' Decade of Action and the Sustainable Development Goals.Methods: From May 2012 to November 2014, a RTI surveillance system was implemented in two referral hospitals in two Mexican cities, León and Guadalajara, with the objective of exploring the relationship between Injury Severity Score (ISS) and different sociodemographic characteristics of the injured as well as different variables related to the event and the environment. All individuals suffering RTIs who visited the Emergency Rooms (ER) were included after granting informed consent. A Zero-Truncated Negative Binomial Model was employed to explore the statistical association between ISS and variables of interest.Results: 3024 individuals participated in the study: 2185 (72.3%) patients from León and 839 patients (27.7%) from Guadalajara. Being male, in the 20-59 age-group, having less schooling, events occurring in Guadalajara, on Sundays, at night, and arriving at ER via public/private ambulance were all associated with an increased log count of ISS. Found a significant interaction effect (p-value< 0.05) between type of road user and alcohol intake six hours before the accident on severity of the injury (ISS). The use of illicit drugs, cellphones and safety devices during the event showed no association to ISS.Conclusions: Our study contributes to the statistical analysis of ISS obtained through RTI hospital surveillance systems. Findings might facilitate the development and evaluation of focused interventions to reduce RTIs in vulnerable users, to enhance ER services and prehospital care, and to reduce drink driving. [ABSTRACT FROM AUTHOR]

Measuring the level of disability following trauma is a key step for secondary and tertiary level trauma prevention. It can give important evidence for decision-makers and program implementers on the need for establishing rehabilitation centers. This is a longitudinal follow-up study on 235 road traffic injury survivors. Patients were followed for 12 months, and the outcome was ascertained using the brief WHODAS-II 12-item instrument at 1, 3, 6, and 12-months post-injury. The level of disability was divided into five groups from no disability to very severe based on their disability scores. Work status was assessed at each survey using a single question "are you back to work?" We employed a linear mixed model to identify disability scores changes over time and risk factors associated with disability. Statistically, a significant association was declared at p < 0.05. The overall mean disability score was 24.9 ± 11.3 at one month and 8.3 ± 6.4 after 12 months of injury. Disability score has decreased by 1.3 units over time during 12 months post-injury. Functional limitation persisted on 25–88% of participants at specific dimensions of disability at the end of the study. After a year of injury, 44% of participants didn't return to work. Injury severity score (β = 0.47, p < 0.001, length of hospital stays (β = 0.88, p < 0.005) and discharge against medical advice (β = 2.18, p < 0.001) were found to be predictors of disability following road traffic injuries. The current study demonstrated that, though there was a decrease in disability score over time, a significant number of participants were with some degree of limitation after one year of injury, and nearly half of them didn't return to work. Shortening of long waiting times and counseling services need to be considered by the hospital. Community-based Rehabilitation centers (CBR) should be expanded. Further study should be conducted to uncover the reasons for preferring traditional bone fixers over medical management. [ABSTRACT FROM AUTHOR]

Introduction: Children are prone to road traffic injuries (RTIs) while commuting to school as pedestrians, bicyclists, motorcyclists, and occupants of vehicles. Understanding these injuries is crucial for planning injury prevention programs. There is not much data available regarding RTIs among schoolchildren during commute to schools in the urban and rural areas of South India, and the current study is an attempt to explore the burden of RTIs among schoolchildren. Objectives: The aim of the study was (1) to assess the magnitude of RTIs among rural and urban school children while commuting to schools and (2) to determine factors affecting RTIs among school children. Materials and Methods: A cross-sectional study was conducted in urban and rural districts of a state in South India, a pretested, semi-structured, self-administered questionnaire was used to collect data and analyzed using SPSS version 20. Results: Magnitude of RTIs reported was similar in urban and rural districts. Children going to Government (public schools) reported more compared to the ones going to private schools. Male children and those accompanying other schoolchildren during commute to schools reported more injuries. Conclusion: Nearly one-fourth of the schoolchildren from Bangalore urban and rural districts reported RTIs during the past 12 months. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Road traffic crashes (RTCs) annually cause about 1.35 million deaths and 20-50 million injuries. Hospitals have the main role in responding to road traffic injuries (RTIs) and decreasing the number of disabilities and deaths. This study aimed to assess the preparedness of selected Iranian hospitals in responding to road traffic crashes with mass casualties. MATERIAL AND METHODS: This cross-sectional study was carried out among 13 hospitals in four provinces including Tehran, Alborz, West Azerbaijan, and Hamedan in 2019. the valid and reliable questionnaire of hospital preparedness assessment in RTIs was used for data collection (Kappa coefficient = 0.89; CVR: 0.98; CVI: 0.97). Using SPSS 16, the level of hospital preparedness was categorized into three parts as weak (less than 34%), moderate (34-66%), and high (more than 66%). RESULTS: Preparedness of the selected hospitals was at a moderate level (= 65.25%). Although the level of preparedness in the aspects of command and control (72.7%), safety and security (71.54%), infrastructure and medical equipment (74.12%), and coordination (71.15%) was satisfactory, hospitals were weak in the training and exercise aspect (48.46%). The level of access to specific equipment needed for responding to trauma injuries was high (79.56%). CONCLUSIONS: Based on the findings, a response plan is required to make hospitals more prepared to respond to road traffic injuries. The plan may include training and development, as well as health facilities preparedness in terms of structure, equipment, and human resources. In addition, assessing the effectiveness of all response plans requires exercise and practice. [ABSTRACT FROM AUTHOR]

Objective: To estimate the out-of-pocket expenditures linked to Road Traffic Injuries in Ouagadougou, Burkina Faso, as well as the prevalence of catastrophic expenditures among those out-of-pocket payments, and to identify the socio-economic determinants of catastrophic expenditures due to Road Traffic Injuries. Methods: We surveyed every admission at the only trauma unit of Ouagadougou between January and July 2015 at the time of their admission, 7 days and 30 days later. We estimate a total amount of out-of-pocket expenditures paid by each patient. We considered an expense as catastrophic when it represented 10% at least of the annual global consumption of the patient's household. We used linear models to determine if socio-economic characteristics were associated to a greater or smaller ratio between out-of-pocket payment and global annual consumption. Findings: We surveyed 1323 Road injury victims three times (admission, Days 7 and 30). They paid in average 46,547 FCFA (83.64 US dollars) for their care, which represent a catastrophic expenditure for 19% of them. Less than 5% of the sample was covered by a health insurance scheme. Household economic status is found to be the first determinant of catastrophic health expenditure occurrence, exhibiting a significant and negative on the ratio between road injury expenditures and global consumption. Conclusion: Our findings highlight the importance of developing health insurance schemes to protect poor households from the economic burden of road traffic injuries and improve equity in front of health shocks. [ABSTRACT FROM AUTHOR]

Background: Pre-hospital services are not well developed in Vietnam, especially the lack of a trauma system of care. Thus, the prognosis of traumatic out-of-hospital cardiac arrest (OHCA) might differ from that of other countries. Although the outcome in cardiac arrest following trauma is dismal, pre-hospital resuscitation efforts are not futile and seem worthwhile. Understanding the country-specific causes, risk, and prognosis of traumatic OHCA is important to reduce mortality in Vietnam. Therefore, this study aimed to investigate the survival rate from traumatic OHCA and to measure the critical components of the chain of survival following a traumatic OHCA in the country.Methods: We performed a multicenter prospective observational study of patients (> 16 years) presenting with traumatic OHCA to three central hospitals throughout Vietnam from February 2014 to December 2018. We collected data on characteristics, management, and outcomes of patients, and compared these data between patients who died before hospital discharge and patients who survived to discharge from the hospital.Results: Of 111 eligible patients with traumatic OHCA, 92 (82.9%) were male and the mean age was 39.27 years (standard deviation: 16.38). Only 5.4% (6/111) survived to discharge from the hospital. Most cardiac arrests (62.2%; 69/111) occurred on the street or highway, 31.2% (29/93) were witnessed by bystanders, and 33.7% (32/95) were given cardiopulmonary resuscitation (CPR) by a bystander. Only 29 of 111 patients (26.1%) were taken by the emergency medical services (EMS), 27 of 30 patients (90%) received pre-hospital advanced airway management, and 29 of 53 patients (54.7%) were given resuscitation attempts by EMS or private ambulance. No significant difference between patients who died before hospital discharge and patients who survived to discharge from the hospital was found for bystander CPR (33.7%, 30/89 and 33.3%, 2/6, P > 0.999; respectively) and resuscitation attempts (56.3%, 27/48, and 40.0%, 2/5, P = 0.649; respectively).Conclusion: In this study, patients with traumatic OHCA presented to the ED with a low rate of EMS utilization and low survival rates. The poor outcomes emphasize the need for increasing bystander first-aid, developing an organized trauma system of care, and developing a standard emergency first-aid program for both healthcare personnel and the community. [ABSTRACT FROM AUTHOR]

Objectives: The mortality rate from road traffic accidents (RTAs) in Nigeria is almost double that of the USA. In Nigeria, the first emergency medical services (EMS) system was established in March 2001, The Lagos State Ambulance Service (LASAMBUS). The objectives of this study are to (1) determine the burden of RTAs in Lagos, (2) assess RTA call outcomes, and (3) analyze LASAMBUS's response time and causes for delay. Methodology: We reviewed completed LASAMBUS intervention forms spanning December 2017 to May 2018. We categorized the call outcomes into five groups: I. Addressed Crash, II. No Crash (False Call), III. Crash Already Addressed, IV. Did Not Respond, and V. Other. We further explored associations between the (1) causes for delay and outcomes and (2) response times and the outcomes. Results: Overall, we analyzed 1352 intervention forms. We found that LASAMBUS did not address 53% of the RTA calls that they received. Of this, Outcome II. No Crash (False Call) accounted for 26% and Outcome III. Crash Already Addressed accounted for 22%. Self-reported causes for delay were recorded in 180 forms, representing 13.7% of the RTA burden. Traffic congestion accounted for 60% of this distribution. Conclusion: LASAMBUS response rates are significantly lower than response rates in high-income countries such as the USA and lead to increased RTA mortality rates. Eliminating causes for delay will improve both LASAMBUS effectiveness and RTA victims' health outcomes. Changing the public perception of LASAMBUS and standardizing LASAMBUS' contact information will aid this as well. [ABSTRACT FROM AUTHOR]

Background: Road-Traffic-Injuries (RTIs) are predicted to rise up to the fifth leading cause of worldwide death by 2030 and Iran has the third highest RTIs mortality among higher-middle income countries. Although the high mortality of RTI in Iran is a warning, it provides the opportunity to indirectly assess the implemented RTI-related regulations' effectiveness via high-resolution relevant statistics and, hence, Iran could serve as a guide for countries with similar context. In order to do so, we utilized this study to report the time and spatial trends of RTIs-related mortality in different age and sex groups and road user classes in Iran.Methods: Based on the national death-registration-system (DRS), cemeteries data, and the demographic characteristics, and after addressing incompleteness, we estimated mortality rates using spatiotemporal and Gaussian process regression models. We assessed Pearson seatbelt and helmet use and RTIs-attributable Age-Standardized-Morality-Rate (ASMR) associations. We also predicted RTIs-death-numbers, 2012-2020, by fitting a Generalized Additive Model to assess the status of achieving relevant sustainable development goal (SDG), namely reducing the number of RTIs-related deaths by half.Results: Overall RTIs-attributable death and ASMR at the national level increased from 12.64 [95% UI, 9.52-16.86] to 29.1 [22.76-37.14] per 100,000 people in the time period of 1990-2015. The trend consisted of an increasing segment in 1990-2003 followed by a decreasing part till 2015. The highest percentage of death belonged to the three-or-more-wheels motorized vehicles. Pedestrian injuries percentage increased significantly and the highest mortality rate occurred in 85 years and older individuals. Low prevalence of seatbelt and helmet use were observed in provinces with higher than the median ASMR due to the relevant cause of each. RTIs-attributable death number is expected to reduce by 15.99% till 2020 which is lower than the established SDG goal.Conclusions: Despite the observed substantial moderation in the RTI-ASMR, Iran is till among the leading countries in terms of the highest mortality rates in the world. The enforced regulations including speed limitations (particularly for elder pedestrians) and mandatory use of seatbelt and helmet (for young adult and male drivers) had a considerable effect on ASMR, nevertheless, the RTI burden reduction needs to be sustained and enhanced. [ABSTRACT FROM AUTHOR]

Introduction: Trauma has been the leading cause of mortality and morbidity. However, there are changes in pattern of trauma and their outcomes with time. Aim: To study the mode and nature of injury and mortality associated with trauma of head, chest and abdomen. Materials and Methods: A prospective cohort study was conducted on 1000 individuals that presented to emergency surgery ward from 2014 to 2019. Patients presented to emergency surgery ward were observed for various characteristics i.e., age group, mode of injury, site of injury, outcomes and management. Results: The mean age of patients was 33.91±16.29 years with significant male predominance (n=794, 79.4%) (p-value 0.00001). Road Traffic Injuries (RTIs) were the most common mode of trauma affecting 490 patients (49%). Head injury was the most common of all injuries (n=834). Overall mortality was 3.6% (n=36). Mortality was higher in males (p-value 0.00933) and mortality rate of 25% was seen in age group of 61- 70 years. Conclusion: RTIs followed by assaults are the most common cause of trauma and it significantly affects young male population. However, mortality rate increases with increase in age group with higher rates in older age groups. [ABSTRACT FROM AUTHOR]

Background: To present the new trends in epidemiology of road traffic injuries (RTIs) during the Coronavirus disease 2019 (COVID-19) pandemic in Suzhou.Methods: Pre-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.Results: A 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).Conclusions: Under 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. [ABSTRACT FROM AUTHOR]

Introduction: It is essential to explore ways to prevent and reduce the severity of injuries in road crashes. This study attempts at getting a ground-level understanding of perspectives surrounding road traffic injury among various stakeholders. Materials and Methods: In-depth interviews and focused group discussions were conducted over a period of 6 months among traffic police, toll booth operators, road transport officers, nurses, and intensive care specialists. The transcribed data were coded and analyzed, and a percentage of final themes as well as codes were drawn. Results: The common reasons cited for delay in transport of accident victims were fear regarding medicolegal issues among the first responders (36.9%) and delay in ambulance (41.5%). 26.1% agreed that time delay in transport can be reduced by generating awareness. Teaching first aid to the general public is essential as opined by 75% of nursing staff and 66.7% of emergency physicians. Documentation procedures (15.4%), long waiting hours (10.2%), and out-of-pocket expenditure and financial constraints (10.2%) were the commonly cited reasons for problems faced by patient bystanders. Conclusions: Creating awareness and improving access to ambulance were the two essential recommendations to prevent delay in prehospital care. Majority of the care providers and patient bystanders agreed that improving insurance coverage is essential to reduce financial constraints. [ABSTRACT FROM AUTHOR]

Background: Children 0–14 years constitute about 31.4% of Indian population, among whom the magnitude and risk factors of childhood injuries have not been adequately studied. Objective: To study the prevalence of and assess the factors associated with unintentional injuries among children aged 6 month–18 years in various regions. Methodology: This multi-centric, cross-sectional, community-based study was conducted at 11 sites across India. States included were Gujarat, Karnataka, Madhya Pradesh, Punjab, Sikkim, Tamil Nadu, Uttarakhand, and West Bengal between March, 2018 and September, 2020. A total of 2341 urban and rural households from each site were selected based on probability proportionate to size. The World Health Organization (WHO) child injury questionnaire adapted to the Indian settings was used after validation. Information on injuries was collected for previous 12 months. Definitions for types (road traffic accidents, falls, burns, poisoning, drowning, animal-related injuries) and severity of injuries was adapted from the WHO study. Information was elicited from parents/primary caregivers. Data were collected electronically, and handled with a management information system. Results: In the 25751 households studied, there were 31020 children aged 6 months–18 years. A total of 1452 children (66.1% males) had 1535 unintentional injuries (excluding minor injuries) had occurred in the preceding one year. The overall prevalence of unintentional injuries excluding minor injuries was 4.7% (95% CI: 4.4–4.9). The commonest type of injury was fall-related (842, 54.8%) and the least common was drowning (3, 0.2%). Injuries in the home environment accounted for more than 50% of cases. Conclusions: The findings of the study provide inputs for developing a comprehensive child injury prevention policy in the country. Child safe school with age-appropriate measures, a safe home environment, and road safety measures for children should be a three-pronged approach in minimizing the number and the severity of child injuries both in urban and rural areas. [ABSTRACT FROM AUTHOR]

Background Trauma continues to be a common problem affecting global health care systems. Accordingly, different types of trauma have been considered major causes of morbidity and mortality, with approximately five million deaths per year. Road traffic injuries, in particular, have been recognized by the WHO as the sixth leading cause of death in the eastern Mediterranean region. Developed countries have realized the importance of implementing registries across all health care systems to improve service quality. Unfortunately, Egypt has yet to establish a national trauma registry in its hospitals. Although data banks have been available in a few hospitals, they have been inconsistent. Purpose The present study aimed at developing a trauma registry for a major tertiary hospital in Cairo. Patients and methods To this end, data from 202 patients admitted to the emergency department of Ain Shams University Hospital owing to trauma were collected. Procedures and actions used were then described to create a trauma registry from January to December 2017. Results The collected data were statistically analyzed, after which the epidemiological distribution of the trauma patients was described. Accordingly, our results showed that among the included patients, 65% were men, whereas most were single, illiterate, and unemployed. Thereafter, statistics regarding trauma circumstances were generated. Conclusion In conclusion, the present study found that hospital trauma registries can be established, are essential for improving the quality of health care services, and should be used ubiquitously throughout the country's hospitals to establish a national registry. [ABSTRACT FROM AUTHOR]

Road traffic injuries continue to be a major public health concern and are a leading cause of death and injury across the world. Road transport remains the most favoured mode of transport for both freight and passenger movement in India. As per the World Health Organization, approximately 1.35 million people die annually on the world's roads, and another 20 to 50 million sustain nonfatal injuries as a result of road traffic crashes. These injuries and deaths have an immeasurable impact on the families affected, whose lives are often changed irrevocably by these tragedies, and on the communities in which these people lived and worked. India ranks 1 in the total number of traffic-related deaths across the 199 countries reported in the World Road Statistics, 2018, followed by China and the USA due to its large population (India, 21.7, and China, 18.6, fatalities per 100,000), although several Central American and African countries have higher fatality rates. During COVID-19 (coronavirus disease-19) pandemic, a national lockdown was implemented by Government of India from 24 March to 31 May 2020, in four phases to control the spread of SARS CoV-2 (severe acute respiratory syndrome coronavirus-2) infection. In our observational study, we compared the epidemiology of trauma patients of two periods from 1 April to 31 May 2019 and 24 March to 31 May 2020 and found out that unique concept of lockdown with stringent implementation of discipline, alcohol ban, behavioural change in visiting family and friends as minimum as possible, promoting work from home and digital classes for school and colleges lead to phenomenal decrease in traffic-related injuries and fatality. The lockdown has grossly decreased 'disability-adjusted life year'(DALY), an outcome indicator for cost-effective analysis, which is calculated as the value of future years of healthy life lost to morbidity/disability and future years of life lost to premature mortality. [ABSTRACT FROM AUTHOR]

Background: Pre-Hospital Emergency Care (PEC) is a fundamental property of prevention of Road Traffic Injuries (RTIs). Thus, this sector requires a system for evaluation and performance improvement. This study aimed to develop quality indicators to measure PEC for RTIs.Methods: Following the related literature review, 14 experts were interviewed through semi-structured interviews to identify Quality Measurement Indicators (QMIs). The extracted indicators were then categorized into three domains: structure, performance, and management. Finally, the identified QMIs were confirmed through two rounds of the Delphi technique.Results: Using literature review 11 structural, 13 performance, and four managerial indicators (A total of 28 indicators) were identified. Also, four structural, four performance, and three managerial indicators (A total of 11indicators) were extracted from interviews with experts. Two indicators were excluded after two rounds of Delphi's technics. Finally, 14 structural, 16 performance and, seven managerial indicators (A total of 37indicators) were finalized.Conclusion: Due to the importance and high proportion of RTIs compared to other types of injuries, this study set out to design and evaluate the QMIs of PEC delivered for RTIs. The findings of this research contribute to measuring and planning aimed at improving the performance of PEC. [ABSTRACT FROM AUTHOR]

Background and Objective: A significant proportion of spinal cord injuries and physical-motor disabilities are caused by road traffic crashes. The aim of this study was to explore the lived experiences of people with disability due to traffic accidents. Materials and methods: This study was conducted using a qualitative phenomenological approach. The participants were a purposive sample of physical-motor disabled people due to road traffic injuries referred to the rehabilitation centers in East Azerbaijan, Iran. Data were collected using individual in-depth interviews and analyzed with a thematic analysis including holistic, selective and detailed approaches. Results: The main theme extracted from the experience of the participants was “captive of destiny” with three sub-themes including ‘surrender of fate’, ‘living behind the fence’ and ‘drowning in disability and need’. Accordingly, participants considered themselves as the victims of destiny and believed living with disability is like living behind the fences of loneliness, frustration, regret, fear of future, pity and inefficiency. Conclusion: This study revealed that spinal cord disability imposed irreversible restrictions on the participants’ lives, so that as dependent people, they needed support from others and, were desperate to recover their lost power, found them in the fate prison. Social support and empowerment of these people to overcome disability can improve their mental health and help them return to a normal life. [ABSTRACT FROM AUTHOR]

Introduction: Tibia is one of the long bone of the body. Due to its superficial location tibial fractures are common. Due to increasing population and changing human habits the number of accidents and high energy trauma is rising. Management of open fracture tibia is a complex problem and is a challenge for both Orthopaedic and plastic surgeons and requires the widest experience, the greatest wisdom, and the nicest of the clinical judgment in order to choose the most appropriate treatment for particular pattern of injury. This study will give us the latest and updated knowledge about the frequency of tibial diaphysial fractures after motorcycle accident. Our results may vary with other study because of lack of knowledge of traffic rules, excessive use of motorbike, rash driving. The results of this study will be shared with local orthopedic surgeons to devise future research and policy recommendations. Objective: To determine the frequency of tibial diaphysial fractures among patients presenting with motorcycle accidents. Study design: Descriptive cross sectional. Material and methods: In this study a total of 222 patients were observed. Detail patient history and clinical examination was done. Laboratory investigation and X-rays was confirmed the diagnosis of tibial diaphyseal fractures. All the above mentioned information including name, age, gender, socio-economic status, occupation, education level was recorded in a proforma. Strictly exclusion criteria had followed to control confounders and bias in the study results. Results: In this study mean age was 30 years with SD ± 12.33. 93% patients were male while 7% patients were female. More over 34% patients had tibial diaphyseal fracture and 66% patients did not had tibial diaphyseal fracture. Conclusion: Our study concludes that the frequency of tibial diaphysial fractures was 34% among patients presenting with motorcycle accidents. [ABSTRACT FROM AUTHOR]

Background: Unintentional injuries account for 10% of deaths worldwide; the majority due to road traffic injuries, falls, drowning, poisoning and burns. Effective surveillance systems provide evidence for informed injury prevention and treatment and improve recovery outcomes. Our objectives were to review existing sources of unintentional injury data, and quality of the data on the burden, distribution, risk factors and trends of unintentional injuries in India and to describe strengths and limitations of health facility-based data for potential use in injury surveillance systems.Methods: We searched national and international organisations' websites to identify unintentional injury-related mortality and morbidity data sources in India. We reviewed and evaluated data collection methods for surveillance attributes recommended by World Health Organization (WHO). We visited health facilities at all levels from public and private sectors, emergency transport centres, insurance offices and police stations in settings reporting significant number of injuries. In these sites, we interviewed key stakeholders using an explorative approach on current data collection processes and challenges to establishing an injury surveillance system based on WHO guidelines.Results: Major gaps were highlighted in injury mortality and morbidity data in India, including ill-defined causes of injury deaths and lack of standardisation in classification and coding. Site visits revealed that reporting standards of injuries varied, with issues around clarity of definitions, accountability, time points and lack of reporter/coder training. Major challenges were lack of dedicated staff and training.Conclusions: There is an important need to build human resource capacity, integrate data sources, standardise and streamline data collected, ensure accountability and capitalise on digital health information systems including insurance databases. [ABSTRACT FROM AUTHOR]

Alcohol consumption is a well-known risk factor for sustaining road traffic injuries worldwide. Malawi is a low-income country with a large and increasing burden of road traffic injuries. It has generally been viewed as a country with relatively little alcohol consumption. This study investigates the role of alcohol in road traffic injuries in and around the capital Lilongwe. All patients presenting to the emergency department of Kamuzu Central Hospital after being injured in road traffic crashes were asked to participate in the study. Alcohol testing was done with a breathalyzer or a saliva test. Participants were asked about alcohol use before the injury as well as hazardous drinking using the AUDIT-C questionnaire. Of 1347 patients age 18 years or older who were asked to participate, 1259 gave informed consent, and data on alcohol use (alcohol test results and/or self-reported intake) were available for 1251 participants. Of those, 251 (20.1%) tested positive for alcohol, whereas 221 (17.7%) reported alcohol use before the crash; in total 311 (24.9%, 95% CI 22.5–27.3) either tested positive, reported use, or both. Females had a low prevalence of alcohol use (2.5%), while 30.6% of males had consumed alcohol before the injuries. Pedestrians had the highest prevalence at 41.8% (95% CI 35.5–48.4), while car drivers had 23.8% (95% CI 18.2–30.5). Among male pedestrians, 49.5% had used alcohol before the injury. Alcohol-associated injuries had a peak in the evening and at night, especially in the weekends. Of the patients, 63.1% reported that they had not consumed alcohol during the last year, while 21.4% had an AUDIT-C score suggesting hazardous drinking, and 66.2% of those had used alcohol before the injury. A large percentage of road traffic injured patients had been drinking alcohol before their injury, especially male pedestrians. A large proportion of the patients were abstaining from alcohol, but those not abstaining had a high prevalence both of alcohol use when injured and hazardous drinking identified by AUDIT-C. This has important implications for prevention. [ABSTRACT FROM AUTHOR]

In Bogotá, Colombia, motorcyclists represent a concern as the proportion of motorcycle users between 2013 and 2018 has increased from 18% to 35%. Despite available risk reduction strategies, the fatality rates are also growing, notably in young adults (15–29 years old). This study aims at identifying correct helmet use patterns and its relationship with official records of injuries and casualties in the city over time. Between 2015 and 2018, semiannual observational studies of motorcycle users in six randomly selected sites in Bogotá were conducted. Data was collected and analyzed on the number of occupants per vehicle (driver and passengers), gender, approximate age, type of helmet, and whether it was correctly used (strapped) or not. Bivariate and multivariate analyses were performed to identify the determinants of correct helmet use. Additionally, a spatial analysis was conducted to estimate the relationship between motorcycle's casualties and correct use of the helmet (full-face helmet use) prevalence. A total of 77,932 motorcycles were observed, showing a high prevalence of helmet use (99% for drivers and passengers), but only 88% use it correctly (89% drivers and 82% passengers). The presence of enforcement (camera or police personnel) increases the correct use of the helmet, especially in principal roads. Female, adults, and single riders are more likely to correctly wear the helmet. Finally, there is a relationship between the concentration of the fatalities and the incorrect helmet use in 80% of the observational sites. Incorrect helmet use has been found by the study to be related to higher mortality among motorcycle occupants in Bogotá. Our data shows that enforcement increases correct helmet use with the potential to reduce deaths among motorcycle occupants. [ABSTRACT FROM AUTHOR]

Background: Although Injury is a major cause of death in low and middle income countries, its demographic characteristics in such regions is poorly characterized. Aims and Objective: The study aims at determining the demographic pattern of adult injury-related deaths in a metropolitan City in Nigeria. Materials and Methods: This is a 14-year (2003-2016) descriptive retrospective autopsy study of adult injury fatalities in Warri, Nigeria. The gender, age, and causes of death analyzed using SPSS version 22 and the results presented in tables and figures. Results: Of the 975 medico-legal deaths in this city from 2003 to 2016, 860(88.2%) deaths were attributed to adult injury; among 778 (90.5%) males and 82 (9.5%) females. The highest and lowest incidence were among the 21-30 years (39.8%) and 51-60 years (6.6%) age brackets respectively. Homicide, accident and suicide contributed 639 (74.3%), 205 (23.8%) and 16 (1.9%) of the fatalities respectively. Firearm injury (47.4%), road injury (11.7%), sharp weapon injury (18.1%), blunt injury (8.1%), drowning (3.5%), burns injury (2.9%), electrocution (2.3%), hanging (1.5%) and petrochemical gas inhalation (1.3%) and falls (0.9%) were the major causes of death. Conclusion: Adult injury fatality is poorly addressed public health problem in Nigeria. The study showed high vulnerability of victims in the 3rd decade of life and a disproportionately higher male fatality. Homicide is the most common manner of death while is very rare. Proper understanding of causes and manners of these preventable deaths is necessary to public health interventions and policies. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the prevalence and behavioral and psychosocial correlates of road traffic injuries (RTIs) among Chinese university students.Methods: A cross-sectional survey was conducted among fifty universities in China, using a multi-stage sampling methodology. The participants were asked to report their RTIs in the past year. The chi-square test and binary logistic regression analysis were utilized to identify factors associated with RTIs, including specific types of RTIs.Results: Among the 11,770 participants, a total of 1,482 university students reported at least one RTI yielding an overall weighted injury prevalence of 12.96% over the past year. Estimated weighted prevalence by type was 6.10%, 5.94%, 5.12%, and 5.35% for automobile (car, truck, or bus), bicycle, motorcycle, and pedestrian injuries, respectively. Logistic regression analysis found that students who studied at low-level universities, smoked cigarettes, drank alcohol, slept less than 7 hours, went to bed after 12:00 am, or students with psychological distress were more likely to experience overall and four types of RTIs. Students who studied in the eastern universities had a higher likelihood of automobile injury, motorcycle injury and pedestrian injury than those who studied in western universities.Conclusions: Several critical factors associated with RTIs were identified. These findings have implications for the design and implementation of RTI prevention and interventions programs targeted at university students. [ABSTRACT FROM AUTHOR]

Introduction: Despite a high burden of traffic injuries, effective integrated or linked injury surveillance systems are rarely available in many low- and middle-income countries (LMICs). The aim of the current study was to define a conceptual model for developing a national integrated traffic injury registry in Iran. Methods: A mult-method study financially and technically supported by the World Health Organization, Iranian Ministry of Health, Iranian Traffic Police, and the Iranian Legal Medicine Organization was conducted. A theoretical framework, forming the core conceptual components, was developed based on expert reviews. The preliminary conceptual model was developed by a panel of experts and tailored through a national workshop of 50 scientists, authorities and experts from nearly all sectors related to road safety promotion and injury management. It was then sent out to external reviewers in order to assess and improve the content validity of the model. Results: The conceptual model was developed to have six components. These included 1) aims and core definitions; 2) content and core measurements; 3) data flow; 4) data collection routines; 5) organizational matrix; 6) implementation organization. The Haddon's matrix was adapted to be used as the theoretical framework in defining the content and data flow components of IRTIR. Five subcomponents were defined in the content and core measurements component with each having several subcategories. Each subcomponent/subcategory was finally divided into several item groups to guide defining the final data measurement variables. The data flow component was defined with six data sequence stations. Through the organizational matrix component, five major organizations relevant to road traffic safety were defined as core data production contributors. Some organizations also owned several sub-organizations which contributed in this regard. Conclusion: It is concluded that the IRTIR conceptual model includes the required six components for developing a national integrated registry for Iran. Its main component called, content and core measurements, leads the researchers in developing final data collection tools in developing the national registry of road traffic injuries in Iran. [ABSTRACT FROM AUTHOR]

Background and Aim The deaths caused by traffic accidents are one of the three leading causes of death in Iran. Considering that all deaths from traffic accidents in the forensic organization are undergoing autopsy and also in the treatment centers under oral autopsies, the cause of death is determined, we determined that the cause of reported death from oral autopsy and medical autopsy Compare the law. Methods & Materials In this descriptive study, patients who were admitted to the forensic medical center during the year 1395 admitted to the Vali-e-Asr Hospital in Arak, were referred. The causes of death in Vali-asr Hospital were evaluated and compared with the outcome of the forensic oral hearing. Ethical Considerations This study ethcally approved by the ethics committee of the Arak University of Medical Sciences (Code: IR.ARAKMU.REC.1395.226). Results In this study, 109 patients (1.33%) died from a total of 8153 patients with traffic accidents referred to Valiasr hospital in Arak. Of these, 68.8% were male and 31.2% were women. The Mean±SD age of the patients died was 44.03±22.43 years. Also, 59.6% of the dead died during the first 24 hours of the accident. The most common cause of death, according to the results of oral autopsy, was “multiple injuries,” accounting for 49.5% of the patients in 45 patients. Conclusion Abundance of deaths among patients with road traffic accidents and they referred to Valiasr hospital, which was 1.33%. According to the existing standards and considering that the mortality rate in this center is less than 1.5%. It seems that the level of service delivery in this center is favorable. [ABSTRACT FROM AUTHOR]

Purpose: Globally and in the European region, the road traffic injuries (RTI) have emerged as a major public health and development problem, killing the most productive adult members of a population, including women. This study aimed to identify the key socio-demographic determinants of premature and avoidable RTI mortality in reproductive-aged women (15– 49 years) in Georgia. Materials and Methods: The study employed verbal autopsy data from the second national reproductive age mortality survey (RAMOS 2014). Univariate and multivariate logistic regression models were fitted using the Firth method to assess the crude and adjusted effects of each individual level socio-demographic factor on the odds of RTI-attributed death, with corresponding 95% confidence intervals (COR and AOR, 95% CI). Results: Of 843 women aged 15– 49 years, 78 (9.3%) were the victims of fatal traffic crashes. After multivariate adjustment, the odds of dying from RTI were significantly higher in women aged 15– 29 years (AOR=7.73, 95% CI= 4.20 to 14.20), those being employed (AOR=2.11, 95% CI= 1.22 to 3.64) and the wealthiest (AOR=2.88, 95% CI= 1.44 to 5.77) compared, respectively, to their oldest (40– 49 years), unemployed and poorest counterparts. Conversely, there were no statistically significant ethnic, marital, rural/urban, and educational disparities in women's RTI fatalities. Overall, motorized four-wheeler occupants (78.2%), particularly passengers (71.8%), appeared to be the most common victims of fatal road injuries than pedestrians (20.5%). Alarmingly, the vast majority (85.9%) of any type of road users died instantly at the scene of collision, as compared to deaths en route to hospital (1.3%) or in hospital (11.5%). Conclusion: Age, employment, and wealth status appeared to be the strong independent predictors of young women's RTI mortality in Georgia. Future comprehensive research would be advantageous for further deciphering the differential impact of social determinants on traffic-induced fatalities, as a vital platform for evidence-based remedial actions on this predictable and preventable safety hazard. [ABSTRACT FROM AUTHOR]