Spatial and temporal analysis of road traffic crashes and ambulance responses in Lagos state, Nigeria
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SUBMITTER: Odusola A
PROVIDER: S-EPMC10656774 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:ObjectivesThe mortality rate from road traffic accidents (RTAs) in Nigeria is almost double that of the USA. In Nigeria, the first emergency medical services (EMS) system was established in March 2001, The Lagos State Ambulance Service (LASAMBUS). The objectives of this study are to (1) determine the burden of RTAs in Lagos, (2) assess RTA call outcomes, and (3) analyze LASAMBUS's response time and causes for delay.MethodologyWe reviewed completed LASAMBUS intervention forms spanning December 2017 to May 2018. We categorized the call outcomes into five groups: I. Addressed Crash, II. No Crash (False Call), III. Crash Already Addressed, IV. Did Not Respond, and V. Other. We further explored associations between the (1) causes for delay and outcomes and (2) response times and the outcomes.ResultsOverall, we analyzed 1352 intervention forms. We found that LASAMBUS did not address 53% of the RTA calls that they received. Of this, Outcome II. No Crash (False Call) accounted for 26% and Outcome III. Crash Already Addressed accounted for 22%. Self-reported causes for delay were recorded in 180 forms, representing 13.7% of the RTA burden. Traffic congestion accounted for 60% of this distribution.ConclusionLASAMBUS response rates are significantly lower than response rates in high-income countries such as the USA and lead to increased RTA mortality rates. Eliminating causes for delay will improve both LASAMBUS effectiveness and RTA victims' health outcomes. Changing the public perception of LASAMBUS and standardizing LASAMBUS' contact information will aid this as well.
| S-EPMC8476380 | biostudies-literature
Project description:IntroductionWe conducted a scoping review of the trauma care situation following road traffic crashes (RTCs) in Bangladesh to inform the design of a comprehensive program for mitigating associated morbidity and mortality.MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis approach to select relevant articles, documents, and reports following a set of inclusion and exclusion criteria. In total, 52 articles and 8 reports and program documents were included in the analysis. We adopted a mixed studies review method for synthesizing evidence and organized information by key themes using a data extraction matrix.ResultsFindings revealed RTC mortality to be 15.3 per 100,000 population in 2019. Pedestrians, cyclists, and motorcyclists were the most vulnerable groups succumbing to moderate to grave injuries. We found that 81% of motorcycle victims did not use any safety device, an estimated 1,844 people per day suffered different degrees of injury, and 29 people per day became permanently disabled. The ambulance-based prehospital care operated in a disjointed and disorganized manner without standard operating procedures and dispatch structure. This disorganization and a lack of a universal communication system led to treatment delay, resulting in chronic disability for the victims. Injury-related patients occupied about 33% of hospital beds, 19% of which were RTC victims. The cost of care for these victims involved substantial out-of-pocket spending, which sometimes reached catastrophic levels. Since 2009, the management of RTCs has deteriorated with a concomitant increase in morbidity and mortality, resulting in a drain on people's lives and livelihoods.ConclusionThe current situation regarding post-crash care in the country, especially when RTCs are on the rise, is not compatible with reaching the SDG targets 3.6 and 11.2 or the government's stated goal of achieving universal health coverage by 2030.
| S-EPMC10141435 | biostudies-literature
Project description:BackgroundAnti-lock Brake System (ABS) helps the equipped vehicles to stop under heavy braking, in a shorter distance and with a better control of direction. It was expected that this technology will reduce the rate of fatal road traffic crashes (RTC); however, the outcome is controversial in the real world. The aim of this study is to compare the claimed annual incidence rate and financial losses due to RTCs in ABS vs. non-ABS personal vehicles in Iran.MethodsA telephone survey among drivers of two similar models of personal vehicles was arranged. The studied vehicles were of the same brand and type; but only one of them was equipped with ABS. The number of RTCs, subsequent financial loss, and drivers' knowledge and perception about ABS were sought. The sample consisted of drivers of 1232 ABS and 3123 non-ABS vehicles.ResultsThe annual incidence rate of RTC involving another vehicle was 145.1 (134.8-155.9) per 1000 vehicle-years and there was not a statistically significant difference between study groups.The incidence of RTC with another vehicle due to brake failure was 50.3 (42.9-58.5) for 1000 non ABS vehicle-years and 30.0 (21.2-41.2) for 1000 ABS equipped vehicle-years. The difference was statistically significant after adjustment for the driver and vehicle's age and the daily driving time. The attributable risk of RTC for non-ABS vehicles was 20/1000 vehicles and the excess fraction was 39.8%. The mean financial loss due to reported RTCs was $987.9 ± $1547.3 US Dollars and there was not a statistically significant difference between study groups. While 61.1% of ABS vehicle drivers reported situations in which they believed the ABS had prevented a crash, 44.1% of them however, they did not know how to use ABS efficiently.ConclusionsLaw enforcement to maintain safe distance and adhere to speed limit while driving, is needed to raise the effectiveness of ABS. This is as necessary as considering mandatory outfitting of ABS. Safety authorities should first consider the global experience and local evidence, before adopting any specific policy in this regard. The drivers need to learn the right way to use ABS for maximum effectiveness.
| S-EPMC3649935 | biostudies-literature
Project description:PurposeTo systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes.MethodsWe conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted.ResultsFive out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured.ConclusionThe finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.
| S-EPMC10533538 | biostudies-literature
Project description:BackgroundRoad traffic crashes (RTCs) are among the eight-leading causes of death globally. Strategies and policies have been put in place by many countries to reduce RTCs and to prevent RTCs and related injuries/deaths.MethodsIn this review, we searched the following databases Ovid Medline, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Web of Science, and LILACS for reviews matching our inclusion criteria between periods January 1950 and March 2020. We did not apply language or publication restrictions in the searches. We, however, excluded reviews that focused primarily on injury prevention and reviews that looked at crashes not involving a motor vehicle.ResultsWe identified 35 systematic reviews matching our inclusion criteria and most of the reviews (33/35) included studies strictly from high-income countries. Most reviews were published before 2015, with only 5 published between 2015 and 2020. Methodological quality varied between reviews. Most reviews focused on enforcement intervention. There was strong evidence that random breath testing, selective breath testing, and sobriety checkpoints were effective in reducing alcohol-related crashes and associated fatal and nonfatal injuries. Other reviews found that sobriety checkpoints reduced the number of crashes by 17% [CI: (- 20, - 14)]. Road safety campaigns were found to reduce the numbers of RTCs by 9% [CI: (- 11, - 8%)]. Mass media campaigns indicated some median decrease in crashes across all studies and all levels of crash severity was 10% (IQR: 6 to 14%). Converting intersections to roundabouts was associated with a reduction of 30 to 50% in the number of RTCs resulting in injury and property damage. Electronic stability control measure was found to reduce single-vehicle crashes by - 49% [95% CI: (- 55, - 42%)]. No evidence was found to indicate that post-license driver education is effective in preventing road traffic injuries or crashes.ConclusionThere were many systematic reviews of varying quality available which included studies that were conducted in high-income settings. The overview has found that behavioural based interventions are very effective in reducing RTCs.
| S-EPMC8925136 | biostudies-literature
Project description:BACKGROUND:Poor health literacy has been associated with poorer physical and mental health function, and higher emergency department and hospital utilizations. The study was conducted to measure the prevalence of health literacy and its determinants among Lagos State residents. METHODS:A descriptive cross-sectional study was conducted in three local government areas in Lagos State. Health literacy was assessed using the Brief Health Literacy Screening tool (BHLS), a three-item tool with possible scores ranging between 3 and 15. Health literacy was classified as inadequate (≤ 9) or adequate (>9). RESULTS:A total of 1831 respondents participated in the study, among whom, 952 (52%) were women. The mean age of respondents was 31.7 (±10.5) years. Three-quarters (74.8%) of respondents had adequate health literacy. Adequate levels of health literacy were associated with being female (OR, 1.35; 95% CI, 1.07-1.71), frequent use of the broad cast media as source of information (OR, 1.33; 95% CI, 1.03-1.70), frequent use of the internet as source of information (OR, 1.49; 95% CI, 1.13-1.96). Adequate health literacy was also associated with having knowledge of a frequently prescribed antibiotic (OR, 1.67; 95% CI, 1.32-2.12) and being more comfortable with the use of the English language (OR, 1.71; 95% CI, 1.32-2.22). CONCLUSION:Gender, the use of broadcast media and the internet are predictive of adequate health literacy and should be taken into consideration in planning health interventions.
| S-EPMC7425911 | biostudies-literature
Project description:The survey data was obtained from a study that investigated factors responsible for the patronage of the traders on the pedestrian bridges along Ikorodu road, Lagos state, Nigeria. Survey research was adopted for this investigation while data were primarily sourced. The sample frame adopted for this study was the average total number of people using the pedestrian bridges per day along Ikorodu road was estimated as 240,380, while the sample size was 384, based on Cochran׳s sample size formula. The convenience, non-probability sampling technique was used for the survey. Data were analyzed using descriptive statistics (frequency tables) and inferential statistics techniques (factor analysis for data reduction and categorization, communalities of variables and KMO) while Likert scale was used as a means of measurement. The datasets can be considered in the commerce and environmental policies of Lagos State and Nigeria with a view to recommending policies that will encourage easy movement of people and the effective uses of the transport facilities.
| S-EPMC6141263 | biostudies-literature
Project description:Strengthening crash surveillance is an urgent priority for road safety in low- and middle-income countries. We reviewed the online availability and completeness of First Information Reports (FIRs; police reports) of road traffic crashes in India. We developed a relational database to record information extracted from FIRs, and implemented it for one state (Chhattisgarh, 2017-2019). We found that FIRs can be downloaded in bulk from government websites of 15 states and union territories. Another 14 provide access online but restrict bulk downloading, and 7 do not provide online access. For Chhattisgarh, 87% of registered FIRs could be downloaded. Most FIRs reported the date, time, collision-type, and vehicle-types, but important crash characteristics (e.g. infrastructure attributes) were missing. India needs to invest in building the crash surveillance capacity for research and safety management. However, in the interim, maintaining a national database of a sample of FIRs can provide useful policy guidance.
| S-EPMC10524357 | biostudies-literature
Project description:BackgroundAs the burden of noncommunicable diseases grows, access to safe medical therapy is increasing in importance. The aim of this study was to develop a method for evaluating the quality of antihypertensive drugs and to examine whether this prevalence varies by socioeconomic variables.MethodsWe conducted a cross-sectional survey of registered pharmacies in 6 local government areas (LGAs) in Lagos State, Nigeria. In each LGA, we sampled 17 pharmacies from a list of all registered pharmacies derived from the Pharmacists Council of Nigeria. We assessed drug quality based on (1) the level of active pharmaceutical ingredients (APIs), which identified falsely labeled drug samples; and (2) the amount of impurities, which revealed substandard drug samples in accordance with the international pharmacopoeia guidelines. Good-quality drugs met specifications for both API and impurity.ResultsOf the 102 drug samples collected, 30 (29.3%) were falsely labeled, 76 (74.5%) were substandard,78 (76.5%) were of poor quality and 24 (23.5%) were of good quality.Among the falsely labeled drugs, 2 samples met standards set for purity while 28 did not. Among the 76 substandard drug samples, 28 were also falsely labeled. Of the falsely labeled drugs, 17 (56.7%) came from LGAs with low socioeconomic status, and 40 (52.6%) of the substandard drug samples came from LGAs with high socioeconomic status. Most of the good-quality drug samples, 14 (58.3%), were from LGAs with low socioeconomic status. Eighteen (60%) of the falsely labeled samples, 37 (48.7%) of the substandard samples, and 15 (62.5%) of the good-quality drug samples were from manufacturers based in Asia. The average price was 375.67 Nigerian naira (NGN) for falsely labeled drugs, 383.33 NGN for substandard drugs, and 375.67 NGN for good-quality drugs. The prevalence of falsely labeled and substandard drug samples did not differ by LGA-level socioeconomic status (P = .39) or region of manufacturer (P = .24); however, there was a trend for a difference by price (P = .06).ConclusionThe prevalence of falsely labeled and substandard drug samples was high in Lagos. Treatment of noncommunicable diseases in this setting will require efforts to monitor and assure drug quality.
| S-EPMC6373917 | biostudies-literature
Project description:BackgroundRegaining good health and returning to work are important for people injured in road traffic crashes and for society. The handling of claims by insurance companies may play an important role in the rate at which health recovers and return to work is actually attained.MethodsA novel approach towards claims handling for people injured in road traffic accidents was compared to the standard approach. The setting was a large insurance company (NRMA Insurance) in the state of New South Wales, Australia. The new approach involved communicating effectively with injured people, early intervention, screening for adverse prognostic factors and focusing on early return to work and usual activities. Demographic and injury data, health outcomes, return to work and usual activities were collected at baseline and 7 months post-injury.ResultsSignificant differences were found 7 months post-injury on 'caseness' of depression (p = 0.04), perceived health limitation on activities (p = 0.03), and self-reported return to usual activities (p = 0.01) with the intervention group scoring better. Baseline general health was a significant predictor for general health at 7 months (OR 11.6, 95% CI 2.7-49.4) and for return to usual activities (OR 4.6, 95% CI 2.3-9.3).ConclusionWe found a few positive effects on health from a new claims handling method by a large insurance company. It may be most effective to target people who report low general health and low expectations for their health recovery when they file their claim.
| S-EPMC3292930 | biostudies-literature