Injury severity levels and associated factors among road traffic collision victims referred to emergency departments of selected public hospitals in Addis Ababa, Ethiopia: the study based on the Haddon matrix

Baru, Ararso; Azazh, Aklilu; Beza, Lemlem · 2019 · Crossref

DOI: 10.1186/s12873-018-0206-1

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Summary

This study investigates the prevalence of severe injuries and associated risk factors among road traffic collision (RTC) victims in Addis Ababa, Ethiopia. Motivated by the rising burden of RTCs in developing nations and a lack of local data on injury severity determinants, the researchers utilized the Haddon Matrix framework to categorize factors into host, agent, and environmental domains. The primary objective was to identify specific variables influencing injury severity to inform targeted road safety interventions. The researchers conducted a hospital-based cross-sectional study from March to May 2017, involving 363 randomly selected RTC victims from three major public hospitals providing national-level trauma care. Injury severity was measured using the Kampala Trauma Score II (KTS II), with scores of 6 or less classified as severe. Data were collected via structured questionnaires and medical record reviews, then analyzed using bivariate and multivariate logistic regression models to control for confounders. The study population was predominantly male (76.6%) and aged 21–30 years (38.8%). The results indicated a severe injury prevalence of 36.4%. Multivariate analysis identified several significant risk factors. Host-related factors included being a motorbike rider or passenger without a helmet (Adjusted Odds Ratio [AOR] 4.7) and sustaining multiple injuries (AOR 3.88). Agent-related factors included involvement in large heavy vehicles (AOR 2.14) and traveling unrestrained on the back of a truck (AOR 3.9). Environmental factors significantly associated with increased severity included collisions occurring in dark lighting conditions (AOR 1.93) and in cross-city or rural areas (AOR 1.95). Conversely, protective factors included vehicle-to-vehicle collisions compared to pedestrian collisions (AOR 0.48), the presence of traffic safety tools like signals and guardrails (AOR 0.58), strict traffic police control at the scene (AOR 0.49), and extrication by healthcare professionals (AOR 0.33) or police (AOR 0.47). The findings highlight that injury severity in Addis Ababa is strongly influenced by behavioral factors such as helmet non-use and alcohol consumption, as well as environmental deficiencies like poor lighting and lack of traffic control. The study concludes that there is an urgent need for pragmatic road safety interventions, including stricter enforcement of helmet and seatbelt laws, improved infrastructure in rural and dark environments, and enhanced pre-hospital care systems. These measures are critical to reducing the unnecessary loss of lives and mitigating the economic burden of road traffic injuries in Ethiopia.

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Topics

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• demographic disparities
• incidence prevalence
• fatality injury trends
• vru crash typology

Information type

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• Empirical Findings: crash risk outcomes