Geographical mapping of road traffic injuries in Lilongwe, Malawi.


Journal

Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040

Informations de publication

Date de publication:
Apr 2021
Historique:
received: 17 07 2020
revised: 24 01 2021
accepted: 12 02 2021
pubmed: 14 3 2021
medline: 22 6 2021
entrez: 13 3 2021
Statut: ppublish

Résumé

Road traffic injuries are a leading cause of death and disability, especially in low- and middle-income countries. Identifying injury hotspots are valuable for introducing preventive measures. This is usually accomplished by using police data, but these are often unreliable in low-income countries. This study aimed to identify hotspots for injuries by collecting geographical data in the emergency room. This was a cross-sectional study of adult road traffic injury patients presenting to the Casualty Department in the central hospital in Lilongwe, the capital of Malawi. An electronic tablet with downloaded maps and satellite photos was used to establish the exact location of the injuries. The geographical data were analyzed with geographic information software. We included 1244 road traffic injured patients, of which 23.9% were car passengers or drivers, 18.6% were motorcyclists, 17.8% were pedestrians and 18.0% were cyclists or bicycle passengers. Heatmaps of the injuries identified 5 locations where the incidence of injuries was especially high, and 148 patients were injured in these hotspots during the 90 days of inclusion. Four of these hotspots were along the main road through the capital. Age over 55, rural setting, alcohol use before the injury, high speed limit at the site of injury and being a pedestrian or motorcyclist were significantly associated with a higher degree of injury severity. Around half of the patients that were injured in a four-wheeled vehicle did not use a seat belt, and these patients had a much higher risk of getting a more severe injury. We have identified specific locations with a high incidence of road traffic injuries in Lilongwe, Malawi, with a simple methodology and within a short time frame. The study demonstrates the feasibility of collecting geographical data at admission to hospital.

Sections du résumé

BACKGROUND BACKGROUND
Road traffic injuries are a leading cause of death and disability, especially in low- and middle-income countries. Identifying injury hotspots are valuable for introducing preventive measures. This is usually accomplished by using police data, but these are often unreliable in low-income countries. This study aimed to identify hotspots for injuries by collecting geographical data in the emergency room.
METHODS METHODS
This was a cross-sectional study of adult road traffic injury patients presenting to the Casualty Department in the central hospital in Lilongwe, the capital of Malawi. An electronic tablet with downloaded maps and satellite photos was used to establish the exact location of the injuries. The geographical data were analyzed with geographic information software.
RESULTS RESULTS
We included 1244 road traffic injured patients, of which 23.9% were car passengers or drivers, 18.6% were motorcyclists, 17.8% were pedestrians and 18.0% were cyclists or bicycle passengers. Heatmaps of the injuries identified 5 locations where the incidence of injuries was especially high, and 148 patients were injured in these hotspots during the 90 days of inclusion. Four of these hotspots were along the main road through the capital. Age over 55, rural setting, alcohol use before the injury, high speed limit at the site of injury and being a pedestrian or motorcyclist were significantly associated with a higher degree of injury severity. Around half of the patients that were injured in a four-wheeled vehicle did not use a seat belt, and these patients had a much higher risk of getting a more severe injury.
CONCLUSION CONCLUSIONS
We have identified specific locations with a high incidence of road traffic injuries in Lilongwe, Malawi, with a simple methodology and within a short time frame. The study demonstrates the feasibility of collecting geographical data at admission to hospital.

Identifiants

pubmed: 33712299
pii: S0020-1383(21)00131-5
doi: 10.1016/j.injury.2021.02.028
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

806-813

Informations de copyright

Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Mads Sundet (M)

Diakonhjemmet Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: mads.sundet@icloud.com.

Gift Mulima (G)

Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.

Chifundo Kajombo (C)

Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.

Hallvard Gjerde (H)

Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.

Asbjørg S Christophersen (AS)

Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway.

Jan Erik Madsen (JE)

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.

Sven Young (S)

Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi; College of Medicine, University of Malawi, Lilongwe, Malawi; Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.

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