Profile of unnatural mortalities in Northern part of Ghana; a forensic-based autopsy study

Commercial motorcyclists and road safety measures compliance. A case study of Dodoma city, central Tanzania

Objective

Road traffic accidents have been reported to contribute a greater proportion of deaths. Motorcyclists are among the high-risk group within road users to succumb to road traffic accidents. Road traffic accidents reflect the co-occurrence of multiple causes that involve road infrastructure, vehicle, and people. Understanding the level of compliance with road safety measures and their associated factors among commercial motorcyclists is important approach in the steps towards road traffic accident prevention.

Study design

A cross-sectional study of commercial motorcyclists from two districts in Dodoma region was conducted in 2020.

Methods

Multistage sampling method was used to recruit motorcyclists from registered parking stations. At first stage, purposive sampling was used to select the two districts, while in the second stage simple random sampling by lottery method was employed in the selection of wards and parking stations. Descriptive and Chi-square test analyses determined the compliance level. Bivariate and multivariate logistic regression analyses were performed to determine the associated factors.

Results

A total of 378 male commercial motorcyclists participated in the study. Majority (87.8%) were within the age range of 18-29 years. A significant proportion of participants (61.9%) had adequate knowledge and 59.5% showed positive attitude towards road safety measures. Only 39.7% reported to have good level of compliance with road safety measures. Married motorcyclists and those with good road safety practice regarding road safety measures were more likely to comply with road safety measures than their counterpart.

Conclusion

Good road safety practices and marital status were predictors of good compliance with road safety measures. Coordinated approaches, including continuing provision of road safety education and enforcement of road safety measures are needed to control the way motorcyclist behave on the road.

African particularities of sudden adult death in Togo on autopsy cases

Background

The purpose of the study was to determine the circumstances of occurrence of these sudden deaths, risk factors, to identify the causes of sudden death in adults at autopsy, with a view to improving prevention.

Methods

This is a retrospective study of the cases of sudden death that were the subject of an autopsy in the pathology anatomy department of the University Hospital Sylvanus Olympio in Lomé from 2009 to 2018.

Results

A total of 318 sudden death cases were recorded. The sex ratio (M/F) was 1.8, and the mean age was 43 ± 0.36 years. Sudden deaths were the second most common reason for autopsies after traffic accidents. The place of death was home in 76.7% of cases and in hospitals in 23.3%. Obesity was noted in 59.4%, with an umbilical adipose panicle varying between 7 and 12 cm thick. Cardiovascular causes excluding cerebral involvement (n = 173 cases, 54.40%) followed by pulmonary causes (n = 100 cases, 31.44%) were the most common cause of sudden death. The predominant cardiac pathology was infarction accounting for 32.07% of all causes of sudden death, and pulmonary embolism with 19.49% was the leading cause at the pulmonary level.

Conclusion

The victims of sudden death in Togo are relatively young, predominantly male and predominantly obese. The main causes of sudden death were myocardial infarction followed by pulmonary embolism. The prevention of sudden death remains paramount, especially in the African context, where pre-hospital care is often inadequate.

Unnatural-cause mortality patterns of Northern Finnish men and women diverge in adolescence - A 52-year follow-up

The Finnish population has a long life expectancy but ranks high in unnatural deaths on the European scale. Mortality has historical regional discrepancy in Finland, as Northern Finns are overrepresented in both natural and unnatural deaths. This study aimed to characterize the age- and sex-related trends in unnatural mortality among Northern Finns. Altogether 12 143 individuals, constituting >95% of births in Northern Finland in 1966, were followed up for a median of 52 years. The mortality patterns of this population were studied using death record data. Crude annual mortality rates were calculated and graphed for 10-year age strata (all-cause, natural-cause, and unnatural-cause mortality, as well as accident, suicide, and homicide mortality). Cox regression was used to analyze the sex discrepancy in mortality. A total of 874 deaths (7.2%) occurred during the follow-up period. Women had 47% and 73% lower risks of any death and unnatural death than men, respectively. From the second decade of life onwards, the unnatural mortality of men was 3-5 times that of women. Accident and suicide mortality rates of men were 2-13 and 2-3 times those of women, respectively. Homicides were rare among either sex. We conclude that Northern Finnish women have a substantially lower risk of all-cause mortality and unnatural mortality than men. To aid the development of preventive strategies, future studies should aim to identify the underlying factors behind unnatural mortality. Primarily, emphasis should be placed on the increased mortality of men from the second decade of life onwards.

Epidemiology, Risk Factors and Measures for Preventing Drowning in Africa: A Systematic Review

Background and Objectives: Drowning is a leading cause of unintentional injury related mortality worldwide, and accounts for roughly 320,000 deaths yearly. Over 90% of these deaths occur in low- and middle-income countries with inadequate prevention measures. The highest rates of drowning are observed in Africa. The aim of this review is to describe the epidemiology of drowning and identify the risk factors and strategies for prevention of drowning in Africa. Materials and Methods: A review of multiple databases (MEDLINE, CINAHL, PsycINFO, Scopus and Emcare) was conducted from inception of the databases to the 1st of April 2019 to identify studies investigating drowning in Africa. The preferred reporting items for systematic review and meta-analysis (PRISMA) was utilised. Results: Forty-two articles from 15 countries were included. Twelve articles explored drowning, while in 30 articles, drowning was reported as part of a wider study. The data sources were coronial, central registry, hospital record, sea rescue and self-generated data. Measures used to describe drowning were proportions and rates. There was a huge variation in the proportion and incidence rate of drowning reported by the studies included in the review. The potential risk factors for drowning included young age, male gender, ethnicity, alcohol, access to bodies of water, age and carrying capacity of the boat, weather and summer season. No study evaluated prevention strategies, however, strategies proposed were education, increased supervision and community awareness. Conclusions: There is a need to address the high rate of drowning in Africa. Good epidemiological studies across all African countries are needed to describe the patterns of drowning and understand risk factors. Further research is needed to investigate the risk factors and to evaluate prevention strategies.