The Burden of Road Traffic Crashes, Injuries and Deaths in Africa: A Systematic Review and Meta-Analysis/ Incidence Des Accidents, Traumatismes et Victimes De la Route En Afrique: Revue Systematique et Meta-Analyse/ la Tasa De Colisiones, Traumatismos Y Muertes En Las Carreteras Africanas: Una Revision Sistematica Y Un Metaanalisis

By Adeloye, Davies; Thompson, Jacqueline Y. et al. | Bulletin of the World Health Organization, July 2016 | Go to article overview

The Burden of Road Traffic Crashes, Injuries and Deaths in Africa: A Systematic Review and Meta-Analysis/ Incidence Des Accidents, Traumatismes et Victimes De la Route En Afrique: Revue Systematique et Meta-Analyse/ la Tasa De Colisiones, Traumatismos Y Muertes En Las Carreteras Africanas: Una Revision Sistematica Y Un Metaanalisis


Adeloye, Davies, Thompson, Jacqueline Y., Akanbi, Moses A., Azuh, Dominic, Samuel, Victoria, Omoregbe, Nicholas, Ayo, Charles K., Bulletin of the World Health Organization


Introduction

Road traffic injuries are among the leading causes of death and life-long disability globally. (1) The World Health Organization (WHO) reports that about 1.24 million people die annually on the world's roads, with 20-50 million sustaining non-fatal injuries. (1,2) Globally, road traffic injuries are reported as the leading cause of death among young people aged 15-29 years and are among the top three causes of mortality among people aged 15-44 years. (1) The Institute for Health Metrics and Evaluation (IHME) estimated about 907 900, 1.3 million and 1.4 million deaths from road traffic injuries in 1990, 2010 and 2013, respectively. (3)

In Africa, the number of road traffic injuries and deaths have been increasing over the last three decades. (4) According to the 2015 Global status report on road safety, the WHO African Region had the highest rate of fatalities from road traffic injuries worldwide at 26.6 per 100 000 population for the year 2013. (1,2) In 2013, over 85% of all deaths and 90% of disability adjusted life years (DALYs) lost from road traffic injuries occurred in low- and middle-income countries, which have only 47% of the world's registered vehicles. (2,3) The increased burden from road traffic injuries and deaths is partly due to economic development, which has led to an increased number of vehicles on the road. (5,6) Given that air and rail transport are either expensive or unavailable in many African countries, the only widely available and affordable means of mobility in the region is road transport. (1,2,7) However, the road infrastructure has not improved to the same level to accommodate the increased number of commuters and ensure their safety and as such many people are exposed daily to an unsafe road environment. (1,4)

The 2009 Global status report on road safety presented the first modelled regional estimate of a road traffic death rate, which was used to statistically address the underreporting of road traffic deaths by countries with an unreliable death registration system. (5) In the 2009 report, Africa had the highest modelled fatality rate at 32.2 per 100 000 population, in contrast to the reported fatality rate of 7.2 per 100 000 population. (5) The low reported death rate reflects the problem of missing data due to non-availability of road traffic data systems, which has a direct impact on health planning including prehospital and emergency care and other responses by government agencies.

This study aimed to review existing literature on published studies, registry-based reports and unpublished articles on the burden of road traffic injuries and deaths in the African continent to generate a continent-wide estimate of road traffic injuries and deaths for all road users and by road user type (pedestrians, motorized four-wheeler occupants, motorized two-three wheeler users and cyclists).

Methods

We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of road safety agencies and relevant organizations within Africa for articles published between 1980 and 2015 (Fig. 1). The search strategy and terms are presented in Box 1 (available at: http://www.who.int/bulletin/ volumes/94/7/15-163121). There was no language restriction.

Eligibility criteria

We included a study in the review if it met the following criteria: (i) conducted between 1980 and 2015 and that the study was done in an African country; (ii) clearly referred to road traffic crashes, injuries or deaths; (iii) referred data came from a population- or registry-based data system; (iv) registry-based hospital data with the underlying cause of death data coded in the International Classification of Disease and Related Health Problems, 10th revision (ICD-10), with codes V01-V89; (v) directly attempted to estimate the number or rate of road traffic crashes, injuries or deaths in a particular African country or the region as a whole; or (vi) provided any other information (e. …

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The Burden of Road Traffic Crashes, Injuries and Deaths in Africa: A Systematic Review and Meta-Analysis/ Incidence Des Accidents, Traumatismes et Victimes De la Route En Afrique: Revue Systematique et Meta-Analyse/ la Tasa De Colisiones, Traumatismos Y Muertes En Las Carreteras Africanas: Una Revision Sistematica Y Un Metaanalisis
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