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Adjei BN, Nakua EK, Donkor P, Gyaase D, Alhassan MM, Amissah J, Osei Bonsu E, Enuameh Y, Mock CN. Helmet utilisation and its associated factors among motorcyclists in northern Ghana: an analytical cross-sectional survey. Inj Prev 2024:ip-2023-045012. [PMID: 38302285 DOI: 10.1136/ip-2023-045012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 01/18/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Motorcycle crashes are a major source of road traffic deaths in northern Ghana. Helmet use has been low. The last time it was formally assessed (2010), helmet use was 30.0% (34.2% for riders and 1.9% for pillion riders). We sought to determine the current prevalence of helmet use and its associated factors among motorcyclists in northern Ghana. METHODS Cross-sectional observations of motorcycle helmet use were conducted among 3853 motorcycle riders and 1097 pillion riders in the Northern Region at 12 different locations near intersections, roundabouts and motorcycle bays. Modified Poisson regression was used to assess the factors associated with helmet use. RESULTS The prevalence of helmet use was 22.1% overall: 26.7% among motorcycle riders and 5.7% among pillion riders. On the multivariable regression analysis, the prevalence of helmet use among motorcycle riders was 69% higher during the day compared with the night, 58% higher at weekend compared with weekday, 46% higher among males compared with females, but it was 18% lower on local roads compared with highways, 67% lower among young riders compared with the elderly and 29% lower when riding with pillion rider(s). CONCLUSION Despite small increases in motorcycle helmet use among pillion riders, helmet use has declined overall over the past decade. Immediate actions are needed to promote helmet use among motorcyclists in northern Ghana. This calls for a multisectoral approach to address the current low helmet use, targeting young riders, female riders, pillion riders, evening riding and riding on local roads.
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Affiliation(s)
- Benjamin Noble Adjei
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Kweku Nakua
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Donkor
- Deprtment of Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Gyaase
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mohammed Muhib Alhassan
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - John Amissah
- Department of Environmental, Occupational Health and Safety, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Osei Bonsu
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yeetey Enuameh
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles N Mock
- Department of Surgery, University of Washington, Seattle, Washington, USA
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Lee JJ, Kim BW, Kong SY, Park GJ, Chai HS, Kim YM, Park HJ, Kim H, Lee SW, Kim SC. Age-specific characteristics of road traffic injuries among children and adolescents in South Korea. TRAFFIC INJURY PREVENTION 2023:1-6. [PMID: 37216479 DOI: 10.1080/15389588.2023.2212308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 05/06/2023] [Accepted: 02/12/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE Road traffic injuries (RTIs) are the leading cause of mortality among children and adolescents. This study aimed to identify and compare the age-specific epidemiology, clinical characteristics and factors related to severe RTIs among children and adolescents who had RTIs. METHODS This multicenter cross-sectional study was conducted using data collected between January 2011 and December 2018 in the Emergency Department-based Injury In-depth Surveillance registry in South Korea. A total of 66,632 participants younger than 19 years who presented with RTIs to emergency departments (EDs) were classified under three age groups: preschoolers (age 0-6 years, n = 18,694), elementary school student (age 7-12 years, n = 21,251), and middle and high school student (age 13-18 years, n = 26,687). Data on demographic and injury-related factors were analyzed, and multivariate logistic regression was used to determine the factors related to severe RTIs, which were defined as the Excess Mortality Ratio-based Injury Severity Score ≥16. RESULTS RTIs among children and adolescents were more common in boys (71.0%), during weekdays (39.7%), in the summer (31.1%), and between 12 noon and 6 pm (47.9%). The most common type of road users were passengers (preschoolers, 46.4%) and cyclists (age 7-12 years and age 13-18 years, 50.1% and 36.2%, respectively). The proportion of head injury was highest in the preschoolers group (57.3%). The length of ED stay, Excess Mortality Ratio-adjusted Injury Severity Score, and the proportion of intensive care unit admission increased with age. Nighttime (0-6 am), vulnerable road users (motorcyclists, bicyclists, and pedestrians), and use of emergency medical services were significantly associated with severe injury. CONCLUSIONS The three age groups of patients younger than 19 years with RTIs differed in the types of road user, proportions of injured body regions, and clinical outcomes. In an effort to reduce RTIs to children and adolescents, age-specific focused intervention should be considered. Additionally, the injury severity was found to be associated with nighttime occurrence, vulnerable road users, ED visit through emergency medical services, and nonuse of safety devices across all age group.
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Affiliation(s)
- Jung Ju Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Byung Woo Kim
- Department of Paramedic Science, Korea National University of Transportation, Jeungpyeong-gun, Chungcheongbuk-do, Republic of Korea
| | - So Yeon Kong
- Strategic Research, Laerdal Medical, Stavanger, Norway
| | - Gwan-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Hyun-Seok Chai
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Young Min Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Ho-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Hoon Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Suk-Woo Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do, Republic of Korea
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju-si, Chungcheongbuk-do, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Chungbuk National University, Cheongju-si, Chungcheongbuk-do, Republic of Korea
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Ijaz M, Liu L, Almarhabi Y, Jamal A, Usman SM, Zahid M. Temporal Instability of Factors Affecting Injury Severity in Helmet-Wearing and Non-Helmet-Wearing Motorcycle Crashes: A Random Parameter Approach with Heterogeneity in Means and Variances. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10526. [PMID: 36078241 PMCID: PMC9518049 DOI: 10.3390/ijerph191710526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 06/15/2023]
Abstract
Not wearing a helmet, not properly strapping the helmet on, or wearing a substandard helmet increases the risk of fatalities and injuries in motorcycle crashes. This research examines the differences in motorcycle crash injury severity considering crashes involving the compliance with and defiance of helmet use by motorcycle riders and highlights the temporal variation in their impact. Three-year (2017-2019) motorcycle crash data were collected from RESCUE 1122, a provincial emergency response service for Rawalpindi, Pakistan. The available crash data include crash-specific information, vehicle, driver, spatial and temporal characteristics, roadway features, and traffic volume, which influence the motorcyclist's injury severity. A random parameters logit model with heterogeneity in means and variances was evaluated to predict critical contributory factors in helmet-wearing and non-helmet-wearing motorcyclist crashes. Model estimates suggest significant variations in the impact of explanatory variables on motorcyclists' injury severity in the case of compliance with and defiance of helmet use. For helmet-wearing motorcyclists, key factors significantly associated with increasingly severe injury and fatal injuries include young riders (below 20 years of age), female pillion riders, collisions with another motorcycle, large trucks, passenger car, drivers aged 50 years and above, and drivers being distracted while driving. In contrast, for non-helmet-wearing motorcyclists, the significant factors responsible for severe injuries and fatalities were distracted driving, the collision of two motorcycles, crashes at U-turns, weekday crashes, and drivers above 50 years of age. The impact of parameters that predict motorcyclist injury severity was found to vary dramatically over time, exhibiting statistically significant temporal instability. The results of this study can serve as potential motorcycle safety guidelines for all relevant stakeholders to improve the state of motorcycle safety in the country.
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Affiliation(s)
- Muhammad Ijaz
- School of Transportation and Logistics, Southwest Jiaotong University, Chengdu 610031, China
| | - Lan Liu
- School of Transportation and Logistics, Southwest Jiaotong University, Chengdu 610031, China
| | - Yahya Almarhabi
- Center of Excellence in Trauma and Accidents, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Arshad Jamal
- Transportation and Traffic Engineering Department, College of Engineering, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31451, Saudi Arabia
| | - Sheikh Muhammad Usman
- Department of Civil Engineering, CECOS University of I.T. & Emerging Sciences, Peshawar 25000, Pakistan
| | - Muhammad Zahid
- College of Metropolitan Transportation, Beijing University of Technology, Beijing 100124, China
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Urréchaga EM, Kodadek LM, Bugaev N, Bauman ZM, Shah KH, Abdel Aziz H, Beckman MA, Reynolds JM, Soe-Lin H, Crandall ML, Rattan R. Full-face motorcycle helmets to reduce injury and death: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma. Am J Surg 2022; 224:1238-1246. [PMID: 35821175 DOI: 10.1016/j.amjsurg.2022.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND While motorcycle helmets reduce mortality and morbidity, no guidelines specify which is safest. We sought to determine if full-face helmets reduce injury and death. METHODS We searched for studies without exclusion based on: age, language, date, or randomization. Case reports, professional riders, and studies without original data were excluded. Pooled results were reported as OR (95% CI). Risk of bias and certainty was assessed. (PROSPERO #CRD42021226929). RESULTS Of 4431 studies identified, 3074 were duplicates, leaving 1357 that were screened. Eighty-one full texts were assessed for eligibility, with 37 studies (n = 37,233) eventually included. Full-face helmets reduced traumatic brain injury (OR 0.40 [0.23-0.70]); injury severity for the head and neck (Abbreviated Injury Scale [AIS] mean difference -0.64 [-1.10 to -0.18]) and face (AIS mean difference -0.49 [-0.71 to -0.27]); and facial fracture (OR 0.26 [0.15-0.46]). CONCLUSION Full-face motorcycle helmets are conditionally recommended to reduce traumatic brain injury, facial fractures, and injury severity.
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Affiliation(s)
| | | | | | | | - Kaushal H Shah
- Department of Emergency Medicine, Weill Cornell Medicine, USA.
| | | | | | | | - Hahn Soe-Lin
- Department of Surgery, St. Joseph's Medical Center, USA.
| | - Marie L Crandall
- Department of Surgery, University of Florida, Jacksonville, USA.
| | - Rishi Rattan
- Department of Surgery, University of Miami, USA.
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Merali HS, Campbell SC, Inada H, Vecino-Ortiz AI, Bachani AM. 10 city analysis of child passenger helmet use. Injury 2022; 53:2478-2484. [PMID: 35400488 DOI: 10.1016/j.injury.2022.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/08/2022] [Accepted: 03/22/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Road traffic injuries are the leading cause of death in children over age five. Most of these deaths occur in low- and middle-income countries. Vulnerable road users, such as motorcyclists and their passengers, are at higher risk. Helmets have significantly decreased morbidity and mortality for motorcyclists; however, they are often unused. The second phase of the Bloomberg Philanthropies Initiative for Global Road Safety was launched in 2015 to improve road safety in 10 cities. This study focuses on child passenger helmet use data from that study to understand the prevalence of helmet use and factors that are associated with helmet use. METHODS The 10 cities selected were Accra, Addis Ababa, Bandung, Bangkok, Bogota, Fortaleza, Ho Chi Minh City, Mumbai, Sao Paulo, and Shanghai. Eight rounds of roadside observational data were collected from February 2015 to April 2019. Observers noted correct child motorcycle passenger helmet use and other site observations including weather patterns, traffic volume, and road surface conditions. A multivariable Poisson regression model was used to examine correct helmet use trends over time. A multivariable logistic regression model was fitted for correct child passenger helmet use in all cities controlling for weather, observation time, number of passengers, and driver's correct helmet use. RESULTS This dataset contained 99,846 motorcycle child passenger observations across the 10 cities. The highest prevalence of correct child passenger helmet use was in Sao Paulo at 97.33%. Six cities had under 25% correct helmet use for child passengers. Examining helmet use over time, only five cities had a significant increase, four cities had no change, and Ho Chi Minh City demonstrated a decrease. In the multivariable regression model, child passengers had higher odds of wearing helmets in adverse weather conditions, early mornings, if the driver wore a helmet, and if there were fewer passengers. CONCLUSIONS The prevalence of correct child passenger helmet utilization shows large variation globally and is concerningly low overall. Enhanced enforcement in combination with media campaigns may have contributed to increasing helmet use prevalence over time. Further research is needed to understand reasons for low child passenger helmet use in most cities.
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Affiliation(s)
- Hasan S Merali
- Department of Pediatrics, McMaster Children's Hospital, Master University, 1280 Main St W., Hamilton, ON, Canada L8S 4K1; Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
| | - Sachalee C Campbell
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
| | - Haruhiko Inada
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
| | - Andres I Vecino-Ortiz
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States
| | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
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Mohammadi E, Azadnajafabad S, Keykhaei M, Shakiba A, Ebrahimi Meimand S, Hosseini Shabanan S, Mahdavi Sharif P, Asgardoon MH, Shafieian M, Ghodsi Z, Heydari ST, Atlasi R, Ansari-Moghaddam A, Sharif-Alhoseini M, O'Reilly GM, Rahimi-Movaghar V. Barriers and factors associated with the use of helmets by Motorcyclists: A scoping review. ACCIDENT; ANALYSIS AND PREVENTION 2022; 171:106667. [PMID: 35413615 DOI: 10.1016/j.aap.2022.106667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 03/10/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
Road Traffic Injuries (RTIs) have imposed a great global burden on public health. Motorcyclists and pedestrians comprise the most significant proportion of this burden. Several studies have demonstrated a link between helmet wearing and a decline in the impact of RTIs in motorcyclists. In this study, we aimed to review the barriers to helmet utilization by motorcyclists. This scoping review has been conducted in accordance with the guidelines for the systematic review of observational studies and the PRISMA Checklist. The search was conducted by using related keywords in EMBASE, PubMed, Scopus, and Cochrane Library. Four independent reviewers carried out the screening. The main outcomes of interest were barriers to helmet usage among motorcyclists, drawn from the finally included studies. Fifty-three records were selected for data extraction. According to these reports, the barriers and factors associated with helmet usage among motorcyclists were categorized into five entities as: legislations/enforcement strategies, helmet disadvantages (discomfort, visual/auditory blockage, and thermal dysregulation), risky behaviors (riding while drunk or high on drugs), sex and/or age factors, and the location and time of the injury event (rural vs. urban locations, day vs. night riding). From the perspective of policymakers, the findings of this review are of utmost importance and could be used in addressing the challenge of inadequate compliance with helmet use.
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Affiliation(s)
- Esmaeil Mohammadi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Azadnajafabad
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Keykhaei
- Feinberg Cardiovascular Research Institute, Northwestern University, Chicago, IL 60611, USA
| | - Ali Shakiba
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Ebrahimi Meimand
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Pouya Mahdavi Sharif
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Asgardoon
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Iranian Student Society for Immunodeficiencies, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.; Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Mehdi Shafieian
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Rasha Atlasi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gerard M O'Reilly
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Emergency and Trauma Centre, The Alfred, Melbourne, Australia; National Trauma Research Institute, The Alfred, Melbourne, Australia
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran; Universal Scientific Education and Research Network (USERN), Tehran, Iran; Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran; Visiting Professor, Spine Program, University of Toronto, Toronto, Canada.
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Thanavanh B, Hackpaserd S, Inthaphatha S, Kariya T, Suzuki Y, Yamamoto E, Hamajima N. Underlying cause of death at medical facilities in Xaiyabouli Province, Lao People's Democratic Republic. NAGOYA JOURNAL OF MEDICAL SCIENCE 2022; 84:448-461. [PMID: 35967936 PMCID: PMC9350566 DOI: 10.18999/nagjms.84.2.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/11/2021] [Indexed: 11/22/2022]
Abstract
In Lao PDR, Ministry of Health introduced District Health Information Software 2 (DHIS2) in 2013. Although DHIS2 includes cause of death, Lao government did not request to report cause of death through DHIS2, resulting in no information on frequency of underlying cause of death even for the deaths at medical facility. This study aimed to collect the information on the underlying cause of death at all medical facilities in Xaiyabouli province, a rural area in Lao PDR. As well as the point estimate of the proportion, a 95% confidence interval (CI) based on a binomial distribution was calculated for each cause of death. According to the local government request, 226 deaths (128 males and 98 females) in 2019 were reported from all medical facilities in the province. Among them, infectious diseases were the most frequent (33.6%, 95% CI 27.5-40.2%); sepsis (16.8%, 95% CI 12.2-22.3%), pneumonia (8.8%, 95% CI 5.5-13.3%), and meningitis (4.9%, 95% CI 2.5-8.5%). Heart diseases were 15.9% (95% CI 11.4-21.4%) including heart failure and myocardial infarction. Injury was 10.2% (95% CI 6.2-14.4%) including brain injury. Neonatal death was 10.6% (95% CI 6.9-15.4%). Among those, preterm death was common (8.8%, 95% CI 5.3-13.3%). Renal failure was 8.0% (95% CI 4.8-12.3%). According to civil registration covering all deaths both at facilities and outside facilities, deaths at facilities were 16.8% of the whole deaths (1,372 deaths) in Xaiyabouli province. Although deaths outside facilities were not included, this is the first report demonstrating cause of death in one province in Lao PDR.
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Affiliation(s)
- Bounbouly Thanavanh
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
,Xaiyabouli Provincial Health Office, Xaiyabouli, Lao People’s Democratic Republic
| | - Singkham Hackpaserd
- Xaiyabouli Provincial Health Office, Xaiyabouli, Lao People’s Democratic Republic
| | - Souphalak Inthaphatha
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yunosuke Suzuki
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Apiratwarakul K, Celebi I, Tiamkao S, Bhudhisawasdi V, Pearkao C, Ienghong K. Understanding of Development Emergency Medical Services in Laos Emergency Medicine Residents. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Rising death tolls from traffic accidents are quickly becoming an inescapable problem in almost all countries around the world. That being said, the World Health Organization has launched an ambitious campaign aimed at reducing the death rate from traffic accidents by 50% in the next 10 years. Development of emergency medical services (EMSs) was the tool to success the goals, especially in low- to middle-income countries including Laos. However, no studies regard perspective of training EMS in Laos emergency medicine residents.
AIM: The aim of our work is to demonstrate the effect of EMS training for Laos emergency medicine residents to the development of the national policy in Lao’s EMS.
METHODS: A cross-sectional study was conducted in two countries (Laos and Thailand) from January 2020. The project activities were establishment of a command-and-control center, development of EMS support system, and training for emergency care professionals.
RESULTS: The eight Laos emergency medicine residents were enrolled between January and March 2020. After practicing as a dispatcher and emergency medical consultant in Thailand at Khon Kaen University, the participants from Laos found that all personnel gained experience and improved their knowledge of technology in EMS and organization management. This had a direct impact on improving confidence in their return to practice in Laos.
CONCLUSIONS: The human resource development through international collaboration between Thailand and Laos is contributing the effective knowledge and expertise learning in Laos. Moreover, the result of this training may provide the most effective care system resulting in the much-needed drop in the mortality rate of traffic accidents in Laos.
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Jafarian S, Ahmadi A, Amiri M, Biokani R, Abbaspour Z, Mahmoudzadeh M. The Prevalence of Helmet Use and Predictive Factors Among Motorcyclists in Shahrekord, Iran in 2018. INTERNATIONAL JOURNAL OF EPIDEMIOLOGIC RESEARCH 2021. [DOI: 10.34172/ijer.2021.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims: Motorcycle accidents are a major concern for countries. One of the most important risk factors for motorcyclists is the lack of helmet use. This study aimed to measure the rate of the helmet use and predictive factors in Shahrekord, Iran. Methods: Using simple random sampling method, this cross-sectional study was conducted in 2018 with a sample size of 350 motorcyclists. A researcher-made questionnaire was used to collect data, and the SPSS software version 24 was used to analyze the data. Results: The mean age of participants was 28.8 ± 10.1 years. Out of 350 participants, 15.1% and 1.4% of motorcyclists and their passengers used helmets. The most important predictors of helmet use were age more than 35 years, high education, and having a driving license. The most important reason for using the helmet was protection against injuries in accidents. Conclusion: According to our results, the rate of helmet use was low. Thus, more efforts should be made to intervene and train for the helmet use among community members with an emphasis on younger people, individuals with governmental jobs, and people with lower education level.
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Affiliation(s)
- Saleh Jafarian
- MSc of Epidemiology, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ali Ahmadi
- Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Amiri
- Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rahman Biokani
- MSc of Epidemiology, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Zohreh Abbaspour
- MSc of Epidemiology, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Mahmoudzadeh
- MSc of Epidemiology, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Setty NKH, Sukumar GM, Majgi SM, Goel AD, Sharma PP, Anand MB. Prevalence and factors associated with effective helmet use among motorcyclists in Mysuru City of Southern India. Environ Health Prev Med 2020; 25:47. [PMID: 32887547 PMCID: PMC7487705 DOI: 10.1186/s12199-020-00888-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Helmet use reduces the risk and severity of head injury and death due to road traffic crash among motorcyclists. The protective efficacy of different types of helmets varies. Wearing firmly fastened full-face helmet termed as effective helmet use provides greatest protection. This study estimates the prevalence and factors associated with effective helmet use among motorcyclists in Mysuru, a tier II city in Southern India. METHODS Cross-sectional road side observational study of 3499 motorcyclists (2134 motorcycle riders and 1365 pillion riders) at four traffic intersections was done followed by interview of random sample of 129 of the above riders. Effective helmet use proportion and effective helmet use per 100 person-minute of observation was calculated. Multivariate logistic regression analysis was done to identify factors associated with effective helmet use. RESULTS Prevalence of effective helmet use was 28 per 100 riders and 19.5 per 100 person-minute of observation in traffic intersections. Prevalence rates of effective helmet use was higher among riders (34.5% vs pillion riders 18.1%), female riders (51.3% vs male riders 26.8%), and male pillion riders (30.5% vs female pillion riders 13.7%). Riders commuting for work and school and those ever stopped by the police in the past 3 months had significantly higher odds of effective helmet use. CONCLUSION Despite helmet use being compulsory by law for motorcyclists, the effective helmet use was low in Mysore. Strict enforcement and frequent checks by the police are necessary to increase the effective helmet use.
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Affiliation(s)
- Naveen Kikkeri Hanumantha Setty
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Basni phase 2, Jodhpur, Rajasthan, 342005, India.
| | - Gautham Melur Sukumar
- Department of Epidemiology, Centre for Public Health, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Akhil Dhanesh Goel
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Basni phase 2, Jodhpur, Rajasthan, 342005, India
| | - Prem Prakash Sharma
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Basni phase 2, Jodhpur, Rajasthan, 342005, India
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Li Q, Adetunji O, Pham CV, Tran NT, Chan E, Bachani AM. Helmet use among motorcycle riders in Ho Chi Minh City, Vietnam: results of a five-year repeated cross-sectional study. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105642. [PMID: 32580063 DOI: 10.1016/j.aap.2020.105642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/01/2020] [Accepted: 06/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In Vietnam, motorcycle riders comprise about three-quarters of road traffic fatalities, the most common cause of which is head injuries that can be prevented by wearing a helmet. This study aims to assess helmet-wearing behaviors in Ho Chi Minh City, the largest city in Vietnam. METHODS Eight rounds of observational studies were conducted in six randomly selected locations between July 2015 and April 2019. Given the multinomial nature of the outcome measure (not wearing a helmet; wearing a substandard helmet; wearing an unstrapped standard helmet; wearing a strapped standard helmet), a multinomial model was developed to estimate the level and trend of helmet use and identify the related individual and environmental factors. FINDINGS A total of 479,892 motorcycle riders were observed, over 90 % of whom were wearing helmets (range over the eight rounds: 92.5 %-96.0 %). However, the prevalence of correct helmet use (defined as wearing a strapped standard helmet) gradually declined from 80.8 % in round 1-55.6 % in round 8. Results from a multinomial model showed the probability of wearing a strapped standard helmet had declined by 22.4 percentage points from round 3 to round 8 while holding other factors constant (95 % CI: 21.8-23.0). The prevalence of correct use is 11.3 percentage points higher for adults than for children (95 % CI: 10.5-12.1). During the same period, unstrapped standard helmet use increased by 24.5 percentage points (95 % CI: 24.1-24.9); substandard helmet use declined but remained high. CONCLUSION The upward trend of incorrect helmet wearing behaviors and wearing substandard helmets sends a rallying call for multisectoral interventions.
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Affiliation(s)
- Qingfeng Li
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Oluwarantimi Adetunji
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Edward Chan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Abdulgafoor M Bachani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Ali A, Friedman J, Tatum D, Jones G, Guidry C, McGrew P, Schroll R, Harris C, Duchesne J, Taghavi S. The Association of Payer Status and Injury Patterns in Pediatric Bicycle Injuries. J Surg Res 2020; 254:398-407. [PMID: 32540507 DOI: 10.1016/j.jss.2020.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/09/2020] [Accepted: 05/13/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Bicycle injuries continue to cause significant morbidity in the United States. How insurance status affects outcomes in children with bicycle injuries has not been defined. We hypothesized that payer status would not impact injury patterns or outcomes in pediatric bicycle-related accidents. METHODS The National Trauma Data Bank was used to identify pediatric (≤18 y) patients involved in bicycle-related crashes admitted in year 2016. Patients with private insurance were compared with all others (uninsured, Medicaid, and Medicare). RESULTS There were 5619 patients that met study criteria. Of these, 2500 (44%) had private insurance. Privately insured were older (12 y versus 11, P < 0.001), more likely to be white (77% versus 56%, P < 0.001), and more likely to wear a helmet (26% versus 9%, P < 0.001). On multivariate analysis, factors associated with traumatic brain injury included age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.06-1.08; P < 0.001) and helmet use (OR, 0.64; 95% CI, 0.55-0.74; P < 0.001). Patients without private insurance were significantly less likely to wear a helmet (OR, 0.52; 95% CI, 0.44-0.63; P < 0.001). Uninsured patients had significantly higher odds of a fatal injury (OR, 4.43; 95% CI, 1.52-12.92; P = 0.006). CONCLUSIONS Uninsured children that present to a trauma center after a bicycle accident are more likely to die. Although helmet use reduced the odds of traumatic brain injury, minorities and children without private insurance were less likely to be helmeted. Public health interventions should increase helmet access to children without private insurance, especially uninsured children.
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Affiliation(s)
- Ayman Ali
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Jessica Friedman
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Danielle Tatum
- Department of Surgery, Our Lady of the Lake RMC, Baton Rouge, Louisiana
| | - Glenn Jones
- Department of Surgery, LSU Health Baton Rouge, LSU Medical Education and Innovation Center, Baton Rouge, Louisiana
| | - Chrissy Guidry
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Patrick McGrew
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Rebecca Schroll
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Charles Harris
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Juan Duchesne
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana
| | - Sharven Taghavi
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
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Sae-Tae N, Lim A, Dureh N. Determinants of severe injury and mortality from road traffic accidents among motorcycle and car users in Southern Thailand. Int J Inj Contr Saf Promot 2020; 27:286-292. [PMID: 32498604 DOI: 10.1080/17457300.2020.1774616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study aimed to identify factors associated with severe injury and mortality from road traffic accidents (RTA) among motorcycle and car users in southern Thailand. The data were obtained from the Office of Disease Prevention and Control, Thailand, for years 2008-2013. Chi-squared tests were used to assess associations between determinants and outcomes and these associations were then estimated after adjusting for possible confounding with other factors using logistic regression. Severe injury and mortality contributed 11.6% and 5% to RTA of motorcycle users, and 14.3% and 7.5% for car users. Among motorcycle users, male gender, older age, and not wearing a helmet increased severe injury and mortality rates, whereas drivers had more severe injuries than passengers. Older car users had higher severe injury and mortality rates, whereas not fastening seat belts had higher mortality. Safety device use should be made mandatory for both drivers and passengers. Male motorcycle users and the elderly should be focused on.
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Affiliation(s)
- Natthika Sae-Tae
- Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University, Pattani Campus, Pattani, Thailand.,Centre of Excellence in Mathematics, the Commission on Higher Education, Bangkok, Thailand
| | - Apiradee Lim
- Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University, Pattani Campus, Pattani, Thailand.,Centre of Excellence in Mathematics, the Commission on Higher Education, Bangkok, Thailand
| | - Nurin Dureh
- Department of Mathematics and Computer Science, Faculty of Science and Technology, Prince of Songkla University, Pattani Campus, Pattani, Thailand
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Louangpradith V, Phoummalaysith B, Kariya T, Saw YM, Yamamoto E, Hamajima N. Disease frequency among inpatients at a tertiary general hospital in Lao PDR. NAGOYA JOURNAL OF MEDICAL SCIENCE 2020; 82:113-121. [PMID: 32273639 PMCID: PMC7103859 DOI: 10.18999/nagjms.82.1.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In Lao People’s Democratic Republic (Lao PDR), reports on disease frequency are very limited. This study aimed to report frequencies of the main cause of admission among inpatients of a tertiary general hospital (Mittaphab Hospital) in Vientiane. Subjects were inpatients who were admitted from January 3 to February 2 in 2017. The dataset were made as a pilot run to establish hospital statistics. The data on sex, age, address (province), dates of admission and discharge, and main diagnosis were collected from paper-based medical charts. International Classification of Diseases 10 was applied for classifying the main diagnosis. During the 1-month period, 1,201 inpatients (637 males and 564 females) were admitted, including 171 (14.2%) aged <20 years and 254 (21.1%) aged ≥60 years. About 20% patients were from outside of Vientiane. Among them, 67.5% (62.5% in males and 73.8% in females) were admitted within 7 days. The main causes with more than 10% in males were injury and poisoning S00-T98 (49.8%), while those in females were injury and poisoning S00-T98 (25.2%), pregnancy and childbirth O00-O99 (19.0%), and diseases of genitourinary system N00-N99 (13.7%). Injury and poisoning S00-T98 among inpatients aged <20 years was 81.8% in males and 59.0% in females. Among those aged 20–59 years, it was 49.9% and 22.4%, and among those aged ≥60 years it was 22.3% and 16.9%, respectively. This is the first report on the frequencies of main diseases among inpatients in Lao PDR. Injury was the first main cause of admission at the tertiary hospital.
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Affiliation(s)
- Viengsakhone Louangpradith
- Nagoya University Graduate School of Medicine, Nagoya, Japan.,Mittaphab Hospital, Vientiane Capital, Lao PDR
| | | | - Tetsuyoshi Kariya
- Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Yu Mon Saw
- Nagoya University Graduate School of Medicine, Nagoya, Japan.,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Eiko Yamamoto
- Nagoya University Graduate School of Medicine, Nagoya, Japan
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Siebert FW, Lin H. Detecting motorcycle helmet use with deep learning. ACCIDENT; ANALYSIS AND PREVENTION 2020; 134:105319. [PMID: 31706186 DOI: 10.1016/j.aap.2019.105319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/05/2019] [Accepted: 09/26/2019] [Indexed: 06/10/2023]
Abstract
The continuous motorization of traffic has led to a sustained increase in the global number of road related fatalities and injuries. To counter this, governments are focusing on enforcing safe and law-abiding behavior in traffic. However, especially in developing countries where the motorcycle is the main form of transportation, there is a lack of comprehensive data on the safety-critical behavioral metric of motorcycle helmet use. This lack of data prohibits targeted enforcement and education campaigns which are crucial for injury prevention. Hence, we have developed an algorithm for the automated registration of motorcycle helmet usage from video data, using a deep learning approach. Based on 91,000 annotated frames of video data, collected at multiple observation sites in 7 cities across the country of Myanmar, we trained our algorithm to detect active motorcycles, the number and position of riders on the motorcycle, as well as their helmet use. An analysis of the algorithm's accuracy on an annotated test data set, and a comparison to available human-registered helmet use data reveals a high accuracy of our approach. Our algorithm registers motorcycle helmet use rates with an accuracy of -4.4% and +2.1% in comparison to a human observer, with minimal training for individual observation sites. Without observation site specific training, the accuracy of helmet use detection decreases slightly, depending on a number of factors. Our approach can be implemented in existing roadside traffic surveillance infrastructure and can facilitate targeted data-driven injury prevention campaigns with real-time speed. Implications of the proposed method, as well as measures that can further improve detection accuracy are discussed.
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Affiliation(s)
- Felix Wilhelm Siebert
- Department of Psychology and Ergonomics, Technische Universität Berlin, Marchstraße 12, 10587 Berlin, Germany.
| | - Hanhe Lin
- Department of Computer and Information Science, Universität Konstanz, Universitätsstraße 10, 78464 Konstanz, Germany
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Fletcher C, McDowell D, Thompson C, James K. Helmet use among motorcycle accident victims in the north-east region of Jamaica. Int J Inj Contr Saf Promot 2019; 26:399-404. [PMID: 31429368 DOI: 10.1080/17457300.2019.1653931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Currently in Jamaica, motorcyclists account for the largest group of fatalities among all road users. Between 2016 and 2018, a cross sectional study was conducted at the Saint Ann's Bay Regional Hospital involving 155 participants. There were 98.7% males, ages ranged from 14-64 years and more than two thirds of the motorcyclists were under 40 years. Only 29.4% wore helmets, and of those motorcyclists, 52.8% indicated they were only riding for a short distance. Increasing age correlated with increased helmet compliance. Persons with motorcycles greater than 150 cubic centimetres were also more likely to wear a helmet. Interventions to promote increased helmet compliance should take these factors into account in conjunction with enhancing law enforcement.
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Affiliation(s)
- Cary Fletcher
- Department of Orthopaedics, Saint Ann's Bay Regional Hospital, Saint Ann's Bay, St. Ann, Jamaica
| | - Derrick McDowell
- Department of Orthopaedics, Saint Ann's Bay Regional Hospital, Saint Ann's Bay, St. Ann, Jamaica
| | - Camelia Thompson
- Department of Community Health and Psychiatry, University of the West Indies at Mona, Mona, Jamaica
| | - Kenneth James
- Department of Community Health and Psychiatry, University of the West Indies at Mona, Mona, Jamaica
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Kim T, Jung KY, Kim K, Yoon H, Hwang SY, Shin TG, Sim MS, Jo IJ, Cha WC. Protective effects of helmets on bicycle-related injuries in elderly individuals. Inj Prev 2018; 25:407-413. [PMID: 30291153 DOI: 10.1136/injuryprev-2018-042942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/25/2018] [Accepted: 09/01/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE The increasing frequency of bicycle-related injuries is due to the growing elderly population and their increasing physical activity. This study aimed to compare the protective effects of helmets on bicycle-related injuries in elderly individuals compared with those in younger adults. METHODS Data from the Korean emergency department-based Injury In-depth Surveillance database from eight emergency departments during 2011-2016 were retrospectively analysed. The subjects sustained injuries while riding bicycles. Cases with unknown clinical outcomes were excluded. Covariates included mechanism, place and time of injury. The primary outcome was traumatic brain injury (TBI) incidence, and the secondary outcomes were in-hospital mortality and severe trauma. The effects of helmets on these outcomes were analysed and differences in effects were determined using logistic regression analysis. Subsequently, the differences in the effects of helmets use between age groups were examined by using interaction analysis RESULTS: Of 7181 adults, 1253 were aged >65 years. The injury incidents showed a bimodal pattern with peaks around ages 20 and 50 years. Meanwhile, the helmet-wearing rate showed a unimodal pattern with its peak at age 35-40 years; it decreased consistently with age. By multivariate analysis, helmet-wearing was associated with a reduced TBI incidence (OR 0.76; 95% CI 0.57 to 0.99) and severe trauma (OR 0.78; 95% CI 0.65 to 0.93). The effects of helmets increased in elderly individuals (TBI (p=0.022) and severe trauma (p=0.024)). CONCLUSION The protective effects of helmets on bicycle-related injuries are greater for elderly individuals, thus reducing TBI incidence.
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Affiliation(s)
- Taerim Kim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kwang Yul Jung
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyunga Kim
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hee Yoon
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sung Yeon Hwang
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Tae Gun Shin
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Min Seob Sim
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ik Joon Jo
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Chul Cha
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Chong SL, Khan UR, Santhanam I, Seo JS, Wang Q, Jamaluddin SF, Hoang Trong QA, Chew SY, Ong MEH. A retrospective review of paediatric head injuries in Asia - a Pan Asian Trauma Outcomes Study (PATOS) collaboration. BMJ Open 2017; 7:e015759. [PMID: 28821516 PMCID: PMC5724214 DOI: 10.1136/bmjopen-2016-015759] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE We aim to examine the mechanisms of head-injured children presenting to participating centres in the Pan Asian Trauma Outcomes Study (PATOS) and to evaluate the association between mechanism of injury and severe outcomes. DESIGN AND SETTING We performed a retrospective review of medical records among emergency departments (EDs) of eight PATOS centres, from September 2014 - August 2015. PARTICIPANTS We included children <16 years old who presented within 24 hours of head injury and were admitted for observation or required a computed tomography (CT) of the brain from the ED. We excluded children with known coagulopathies, neurological co-morbidities or prior neurosurgery. We reviewed the mechanism, intent, location and object involved in each injury, and the patients' physical findings on presentation. OUTCOMES Primary outcomes were death, endotracheal intubation or neurosurgical intervention. Secondary outcomes included hospital and ED length of stay. RESULTS 1438 children were analysed. 953 children (66.3%) were male and the median age was 5.0 years (IQR 1.0-10.0). Falls predominated especially among children younger than 2 years (82.9%), while road traffic injuries were more likely to occur among children 2 years and above compared with younger children (25.8% vs 11.1%). Centres from upper and lower middle-income countries were more likely to receive head injured children from road traffic collisions compared with those from high-income countries (51.4% and 40.9%, vs 10.9%, p<0.0001) and attended to a greater proportion of children with severe outcomes (58.2% and 28.4%, vs 3.6%, p<0.0001). After adjusting for age, gender, intent of injury and gross national income, traffic injuries (adjusted OR 2.183, 95% CI 1.448 to 3.293) were associated with severe outcomes, as compared with falls. CONCLUSIONS Among children with head injuries, traffic injuries are independently associated with death, endotracheal intubation and neurosurgery. This collaboration among Asian centres holds potential for future prospective childhood injury surveillance.
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Affiliation(s)
- Shu-Ling Chong
- Department of Emergency Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore
| | - Uzma Rahim Khan
- Department of Emergency Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Indumathy Santhanam
- Department of Pediatric Emergency Medicine, Institute of Child Health and Hospital for Children, Madras Medical College, Chennai, Tamilnadu, India
| | - Jun Seok Seo
- Department of Emergency Medicine, Dongguk University Ilsan Hospital, School of Medicine, Dongguk University, Seoul, Republic of Korea
| | - Quan Wang
- Department of Emergency Medicine, Beijing Children’s Hospital, Capital Medical University, Beijing, China
| | | | | | - Su Yah Chew
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National Children’s Medical Institute,, National University Health System, Singapore
| | - Marcus Eng Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Merali HS, Bachani AM. Factors associated with child passenger motorcycle helmet use in Cambodia. Int J Inj Contr Saf Promot 2017; 25:134-140. [DOI: 10.1080/17457300.2017.1345948] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hasan S. Merali
- Centre for Global Child Health, The Hospital for Sick Children, University of Toronto, Toronto, Canada
- Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Abdulgafoor M. Bachani
- Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Impact of Helmet Use on Severity of Epidural Hematomas in Cambodia. World Neurosurg 2017; 100:267-270. [DOI: 10.1016/j.wneu.2016.12.104] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 12/21/2016] [Accepted: 12/23/2016] [Indexed: 11/18/2022]
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Brown J, Schonstein L, Ivers R, Keay L. Children and motorcycles: a systematic review of risk factors and interventions. Inj Prev 2017; 24:166-175. [DOI: 10.1136/injuryprev-2016-042262] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/15/2017] [Accepted: 01/18/2017] [Indexed: 12/15/2022]
Abstract
ObjectiveTo (i) identify person, vehicle and environmental risk factors for injury among children using motorcycles, and (ii) identify and appraise studies of interventions designed to reduce the occurrence or severity of injury among children using these vehicles.MethodA systematic approach was used to collate data from published and grey literature globally on risk factors for motorcycles injury, and studies reporting evaluation of interventions to counter this injury. Academic data sets and public search engines (including Google and Yahoo!) were used. Websites of major conferences, organisations and networks were also searched. Finally, researchers and units working in this area were also contacted by email or phone seeking relevant research. All study types were eligible, excluding clinical case studies. The Haddon Matrix was used as a framework for synthesising the data.ResultsThe review revealed that robust investigations of risk factors for injury among children using motorcycles are relatively scarce, and there are few interventional studies reporting effectiveness of countermeasures to this problem. Epidemiological literature is generally limited to discussion of human factors, and less attention has been given to vehicle and environmental factors. Furthermore, much of the literature is commentaries and descriptive studies. There has been little rigorous study of risk factors unique to children riding motorcycles.ConclusionsThis first attempt at extensively reviewing literature related to risk factors and interventions for children and motorcycles using the Haddon Matrix as a framework clearly highlights need for more rigorous study as information is lacking in all cells of this matrix.
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Phoummalaysith B, Louangpradith V, Manivon T, Keohavong B, Yamamoto E, Hamajima N. Underlying Cause of Death Recorded during 2013 to 2015 at a Tertiary General Hospital in Vientiane Capital, Lao PDR. NAGOYA JOURNAL OF MEDICAL SCIENCE 2017; 79:199-209. [PMID: 28626255 PMCID: PMC5472545 DOI: 10.18999/nagjms.79.2.199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/04/2017] [Indexed: 12/20/2022]
Abstract
In Lao People's Democratic Republic (Lao PDR), the cause of death is not registered in death reports. As a result, the government cannot produce official reports that show mortality according to cause of death. This study aimed to report the underlying cause of death in a tertiary general hospital (Mittaphab Hospital) in Vientiane capital. Mittaphab hospital is a governmental teaching hospital with 300 beds for inpatient services specialized in orthopedics, neurology, and hemodialysis. Since a children hospital exists beside Mittaphab Hospital, severe pediatric cases are referred to the child hospital. HIV-positive cases and sputum positive tuberculosis are also transferred to the other specialized hospitals. All of the subjects in this study were patients who died in 2013-2015 at Mittaphab Hospital. Paper-based medical charts were examined by a medical doctor and staff from the medical records division. This chart review revealed that 1,509 patients (1,006 males and 503 females) died in this hospital during the study period. Of those, the number of patients aged <20 years and >80 years was small (6.2% and 7.7%, respectively). The most common underlying causes were injury (29.7%), cerebrovascular diseases (26.8%), renal disease (13.3%), infectious diseases (12.4%), and malignant neoplasm including brain tumor (4.8%). Among those aged 20-59 years, these percentages were 37.9%, 23.7%, 12.3%, 10.2%, and 5.0%, respectively. Although the patients visiting the hospital did not represent the whole population, the distribution of cause of death in the hospital was the only available information reported in Lao PDR.
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Affiliation(s)
- Bounfeng Phoummalaysith
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
| | | | - Tavanh Manivon
- Mittaphab Hospital, Phonsavang. V, Chanthabuly. D, Vientiane Capital, Lao PDR
| | - Bounxou Keohavong
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
| | - Eiko Yamamoto
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
| | - Nobuyuki Hamajima
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550 Japan
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Murlimanju BV, Krishnaprasad PR, Santosh Rai PV, Dinesh KVN, Prabhu LV. Current state of orthopedic education in India. Indian J Orthop 2017; 51:349-350. [PMID: 28566793 PMCID: PMC5439327 DOI: 10.4103/ortho.ijortho_475_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- B V Murlimanju
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, Karnataka, India,Address for correspondence: Dr. B V Murlimanju, Department of Anatomy, Kasturba Medical College, Manipal University, Mangalore - 575 004, Karnataka, India. E-mail:
| | - P R Krishnaprasad
- Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - P V Santosh Rai
- Department of Radiodiagnosis, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - K V N Dinesh
- Department of Orthopedics, Srinivas Institute of Medical Sciences and Research Centre, Mukka, Mangalore, Karnataka, India
| | - Latha V Prabhu
- Department of Anatomy, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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24
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Aduayi OS, Aduayi VA, Komolafe EO. Patterns of pre-hospital events and management of motorcycle-related injuries in a tropical setting. Int J Inj Contr Saf Promot 2016; 24:382-387. [DOI: 10.1080/17457300.2016.1213300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Victor Adovi Aduayi
- Department of Epidemiology and Community Health, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Edward Oluwole Komolafe
- Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
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