Individual characteristics associated with road traffic collisions and healthcare seeking in Low- and Middle-Income Countries and territories

Leila Ghalichi*, Dina Goodman-Palmer, John Whitaker, Anne Abio, Michael Lowery Wilson, Lee Wallis, Bolormaa Norov, Krishna Kumar Aryal, Deborah Carvalho Malta, Till Bärnighausen, Pascal Geldsetzer, David Flood, Sebastian Vollmer, Michaela Theilmann, Justine Davies

*Corresponding author for this work

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Abstract

Incidence of road traffic collisions (RTCs), types of users involved, and healthcare requirement afterwards are essential information for efficient policy making. We analysed individual-level data from nationally representative surveys conducted in low- or middle-income countries (LMICs) between 2008-2019. We describe the weighted incidence of non-fatal RTC in the past 12 months, type of road user involved, and incidence of traffic injuries requiring medical attention. Multivariable logistic regressions were done to evaluate associated sociodemographic and economic characteristics, and alcohol use. Data were included from 90,790 individuals from 15 countries or territories. The non-fatal RTC incidence in participants aged 24-65 years was 5.2% (95% CI: 4.6-5.9), with significant differences dependent on country income status. Drivers, passengers, pedestrians and cyclists composed 37.2%, 40.3%, 11.3% and 11.2% of RTCs, respectively. The distribution of road user type varied with country income status, with divers increasing and cyclists decreasing with increasing country income status. Type of road users involved in RTCs also varied by the age and sex of the person involved, with a greater proportion of males than females involved as drivers, and a reverse pattern for pedestrians. In multivariable analysis, RTC incidence was associated with younger age, male sex, being single, and having achieved higher levels of education; there was no association with alcohol use. In a sensitivity analysis including respondents aged 18-64 years, results were similar, however, there was an association of RTC incidence with alcohol use. The incidence of injuries requiring medical attention was 1.8% (1.6-2.1). In multivariable analyses, requiring medical attention was associated with younger age, male sex, and higher wealth quintile. We found remarkable heterogeneity in RTC incidence, the type of road users involved, and the requirement for medical attention after injuries depending on country income status and socio-demographic characteristics. Targeted data-informed approaches are needed to prevent and manage RTCs.
Original languageEnglish
Article numbere0002768
Number of pages17
JournalPLOS Global Public Health
Volume4
Issue number1
DOIs
Publication statusPublished - 19 Jan 2024

Bibliographical note

Funding: The authors received no specific funding to conduct the study. JD and LG were supported to deliver the work using funding from the NIHR Global Health Group on Equitable Access to Quality Health Care for Injured People in Four Low- and Middle-Income Countries: Equi-injury (Award number 133135) and DGP was supported by the innovation funding from Institute for Global Innovation, University of Birmingham. PG is a Chan Zuckerberg Biohub – San Francisco investigator. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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