Effectiveness of transverse speed reducers and exploring factors contributing to road traffic crashes on a rural two-lane highway: A mixed methods study

Abstract Background: In Ethiopia, there are an estimated 25.3 road traffic related deaths per 100,000 population, which is much higher than the global average road traffic fatality rate. Speed is the most well-known risk factor influencing both the risk as well as the severity of the resulting injuries. Although there is paucity of data from low-income countries, speed reducers have been widely approved as an effective traffic calming countermeasure in high-income countries. We aimed to (i) explore the effectiveness of transverse vertical speed reducers and, (ii) qualitatively explore stakeholders’ perceptions of the factors that affect the risk of road traffic crashes.Methods: Data on all crashes occurring from September 2010 to August 2015 were obtained. Interrupted time series analysis using Poisson regression was used to estimate the effect of speed reducers on the number of crashes per month before and after their installation in January 2012. Focus group discussions and in-depth interviews were conducted with traffic police, drivers, drivers’ training center owners, and community members to describe their perceptions about the effects of the speed reducers. Quantitative and qualitative results were triangulated.Results: There were 130 crashes during the study period. Of these, 45.4% were property damage only, and 16.9% were fatal. After the speed reducers were installed, there was no statistically significant difference (incidence rate ratio, IRR =1.17, 95% CI[0.60-2.30], p-value =0.644) in the number of crashes per month, but there were changes in the distribution of crash severity (p-value <0.001). Four core themes, with subsequent sub-themes, emerged as perceived contributors to road traffic crashes. Of these core-themes, speedy and reckless driving, were perceived as the strongest force perpetuating road collisions. Qualitative respondents disagreed on whether the speed reducers were effective and expressed concerns such as the lack of signage to warn drivers.Conclusions: Although speed reducers are proven to reduce collisions in high-income settings, this study in Ethiopia was inconclusive. Inappropriate design for the roadway type, sporadic placement, lack of signage and maintenance, and poor stakeholder coordination may have hampered effectiveness. An evidence-based planning process prior to implementing road design interventions is recommended to achieve the desired results.

Download Full-text

Analysis of Pedestrian-Vehicle Crashes Using Artificial Learning Methods: City of Sakarya Case Study

Academic Perspective Procedia ◽

10.33793/acperpro.04.02.54 ◽

2021 ◽

Vol 4 (2) ◽

pp. 221-230

Author(s):

Zeliha Cagla Kuyumcu ◽

Suhrab Ahadi ◽

Hakan Aslan

Keyword(s):

Low Income ◽

Traffic Accidents ◽

Road Traffic ◽

Low Income Countries ◽

Road Traffic Crash ◽

Traffic Crashes ◽

Road Traffic Crashes ◽

Traffic Crash ◽

Artificial Learning

The lives of approximately 1.3 million people are cut short every year as a result of road traffic crashes. Between 20 and 50 million people suffer non-fatal injuries, with many incurring a disability as a result of their injury. The risk of dying in a road traffic crash is more than 3 times higher in low-income countries than in high-income countries [1]. In Turkey, 18% of traffic accidents was related to pedestrian-vehicle collisions in urban roads in 2020. In addition, 20% of death toll caused by accidents is pedestrians in 2020 [2]. This study deals with the some of classifiers to forecast the number of injuries as a result of traffic accidents. The classifier’s performance ratios were also examined.

Download Full-text

Effectiveness of a Drinking and Driving Campaign on Knowledge, Attitudes, and Behavior Among Drivers in Addis Ababa

Frontiers in Sustainable Cities ◽

10.3389/frsc.2020.563350 ◽

2020 ◽

Vol 2 ◽

Cited By ~ 1

Author(s):

Nalin Singh Negi ◽

Karen Schmidt ◽

Irina Morozova ◽

Tigist Addis ◽

Solomon Kidane ◽

...

Keyword(s):

Low Income ◽

Road Traffic ◽

Addis Ababa ◽

Low Income Countries ◽

Drinking And Driving ◽

Traffic Crashes ◽

Road Traffic Crashes ◽

Attitudes And Behaviors ◽

And Behaviors ◽

And Behavior

Background: In Addis Ababa, Ethiopia, road traffic crashes represent a major public health challenge. Driving under the influence of alcohol (drink driving) is a risk factor for road traffic crashes. Mass media campaigns can reduce the prevalence of drink driving. Few studies to date have evaluated the influence of anti-drink-driving campaigns on changes in knowledge, attitudes, and behaviors in low-income countries such as Ethiopia.Objective: This study aims to examine the impact of an anti-drink-driving campaign on knowledge, attitudes, and behaviors around drinking and driving in Addis Ababa, Ethiopia.Methods: The “Never Drink and Drive” campaign ran on media outlets in Addis Ababa and consisted of evidence-informed messages on the consequences of drink driving. Data for this study comes from two representative household surveys conducted among a sample of adult drivers aged 18–55 years in Addis Ababa pre-campaign (n = 721) and post-campaign (n = 721). Multivariate logistic regression is used to estimate the effects of the campaign on knowledge, attitudes, and behavior related to drink driving.Results: After the campaign, participants were significantly more likely to have improved knowledge and attitudes about drink driving: post-campaign participants were significantly more likely to report feeling unsafe about drink driving (OR = 1.51, p < 0.05). Social norms showed a positive shift: post-campaign participants were over six and a half times more likely to report that someone talked to them about drink driving (OR = 6.52, p < 0.05). After the campaign, participants demonstrated improved knowledge and attitudes around drink driving laws and enforcement, including that they were significantly more likely to agree that they would be caught by police for drink driving (OR = 12.66, p < 0.1). Behavior also improved—post-campaign participants reported significantly lower rates of driving soon after drinking alcohol, compared with pre-campaign participants (31 vs. 42%).Conclusion: The anti-drink-driving campaign achieved gains in knowledge, improved attitudes, and reduced drinking and driving, which could help to curb road traffic crashes in Addis Ababa. This study offers some of the first evidence that an anti-drink-driving campaign, combined with enhanced enforcement of road safety laws, can be effective in changing knowledge, attitudes, and behaviors around drink driving in low-income countries.

Download Full-text

Comparative Analysis of Mobile Pain Management Applications in Developed versus Developing Countries (Preprint)

10.2196/preprints.32890 ◽

2021 ◽

Author(s):

Wilson Mupfururirwa ◽

Victoria Nembaware ◽

Jack Morrice ◽

Khuthala Mnika ◽

Gaston Kuzamunu Mazandu ◽

...

Keyword(s):

Pain Management ◽

Uniform Distribution ◽

Mobile Health ◽

Low Income ◽

Cochrane Review ◽

High Income ◽

Low Income Countries ◽

App Store ◽

Significant Difference ◽

The Impact

BACKGROUND The impact of mobile phones and their applications in healthcare (mobile health) is well established for a range of diseases and cross-cutting complications, such as pain. While numerous mobile health (mHealth) pain interventions have been established, an evaluation of their prevalence, adequacy and distribution remains limited. OBJECTIVE This study aims at reviewing and comparing current pain management mHealth tools in high- versus low-income countries. METHODS A literature and application (app) store search was conducted in May 2021 using combinations of the following keywords: “pain management”, “pain”, “mobile health”, “telemedicine”, and “app”. Literature searches were conducted in PubMed, Scopus, Cochrane Review Library, and Google scholar. App store searches were conducted in Google Play and Apple App Store. Data characteristics descriptive analysis was performed using R software to summarize different datasets and compute p-values (P) for testing the significance of different hypotheses with the significance level set to 0.05. RESULTS The search identified 40 publications (literature search) and 230 mHealth applications (app store search), revealing a non uniform distribution of search categories (χ2= 133.7, P < 0.004) with a ratio approximating 1:6 (OR = 5.730, 95%CI:3.745-8.909, P < 0.004). About 86.7% of these 270 applications (apps) are from high-income countries, showing a statistically significant non uniform distribution of country categories: high- and low-income (χ2= 145.2, P < 0.004) approximating the theoretical distribution of a 7:1 ratio (OR = 6.476, 95%CI:4.180-10.222, P < 0.004). Moreover, there is no significant difference in the proportion of search categories between country categories ( χ2= 0.113, P = 0.737) and the difference in pain app prevalence in high- versus low-income countries is not statistically significant. Finally, we have observed that pain-tracking apps are significantly more prevalent in developed countries in comparison to low-income countries. CONCLUSIONS As expected, pain management app prevalence is higher in high-income countries. However, more research is required to readily comprehend the effectiveness of these apps.

Download Full-text

Impact of night travel ban on road traffic crashes and fatalities in Zambia: an interrupted time series analysis

BMJ Global Health ◽

10.1136/bmjgh-2021-005481 ◽

2021 ◽

Vol 6 (12) ◽

pp. e005481

Author(s):

Peter Hangoma ◽

Kantu Moonga-Mukale

Keyword(s):

Time Series ◽

Time Series Analysis ◽

Road Traffic ◽

Interrupted Time Series ◽

Interrupted Time Series Analysis ◽

Annual Average ◽

Traffic Crashes ◽

Road Traffic Crashes ◽

Series Analysis ◽

Data Points

BackgroundThe burden of road traffic crashes (RTCs) and road traffic fatalities (RTFs) has been increasing in low-income and middle-income countries (LMICs). Most RTCs and RTFs happen at night. Although few countries, including Zambia, have implemented night travel bans, there is no evidence on the extent to which such policies may reduce crashes and fatalities.MethodsWe exploit the quasi-experimental set up afforded by the banning of night travel of public service vehicles in Zambia in 2016 and interrupted time series analysis to assess whether the ban had an impact on both levels and trends in RTCs and RTFs. We use annual administrative data for the period 2006—2020, with 10 pre-intervention and 4 post-intervention data points. In an alternative specification, we restrict the analysis to the period 2012—2020 so that the number of data points are the same pre-interventions and post-interventions. We also carry out robustness checks to rule out other possible explanation of the results including COVID-19.ResultsThe night travel ban was associated with a reduction in the level of RTCs by 4131.3 (annual average RTCs before the policy=17 668) and a reduction in the annual trend in RTCs by 2485.5. These effects were significant at below 1%, and they amount to an overall reduction in RTCs by 24%. The policy was also associated with a 57.5% reduction in RTFs. In absolute terms, the trend in RTFs reduced by 477.5 (Annual average RTFs before the policy=1124.7), which is significant at below 1% level. Our results were broadly unchanged in alternative specifications.ConclusionWe conclude that a night travel ban may be an effective way of reducing the burden of RTCs and RTFs in Zambia and other LMICs. However, complementary policies are needed to achieve more gains.

Download Full-text

Reducing the burden of road traffic injury: translating high-income country interventions to middle-income and low-income countries

Injury Prevention ◽

10.1136/ip.2008.018820 ◽

2008 ◽

Vol 14 (5) ◽

pp. 284-289 ◽

Cited By ~ 25

Author(s):

M Stevenson ◽

J Yu ◽

D Hendrie ◽

L-P Li ◽

R Ivers ◽

...

Keyword(s):

Low Income ◽

Road Traffic ◽

Road Traffic Injury ◽

High Income ◽

Income Country ◽

High Income Country ◽

Low Income Countries ◽

Middle Income ◽

Traffic Injury

Download Full-text

Red light cameras for the prevention of road traffic crashes

10.1002/14651858.cd003862 ◽

2002 ◽

Author(s):

A Aeron-Thomas

Keyword(s):

Road Traffic ◽

Red Light ◽

Traffic Crashes ◽

Road Traffic Crashes ◽

Red Light Cameras

Download Full-text

Collaborative research and knowledge translation on road crashes in Burkina Faso: the police perspective 18 months on

Health Research Policy and Systems ◽

10.1186/s12961-020-00654-1 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Christian Dagenais ◽

Michelle Proulx ◽

Esther Mc Sween-Cadieux ◽

Aude Nikiema ◽

Emmanuel Bonnet ◽

...

Keyword(s):

Knowledge Translation ◽

Burkina Faso ◽

Road Traffic ◽

Research Data ◽

Road Traffic Crash ◽

Research Project ◽

Traffic Crashes ◽

Road Traffic Crashes ◽

Road Crashes

AbstractIn this commentary, we present a follow-up of two articles published in 2017 and 2018 about road traffic crashes, which is an important public health issue in Africa and Burkina Faso. The first article reported on a research project, conducted in partnership with local actors involved in road safety, carried out in Ouagadougou in 2015. Its aim was to test the effectiveness, acceptability, and capacity of a surveillance system to assess the number of road traffic crashes and their consequences on the health of crash victims. Several knowledge translation activities were carried out to maximize its impact and were reported in the 2018 article published in HRPS: monthly reports presenting the research data, large-format printed maps distributed to the city’s police stations, and a deliberative workshop held at the end of the research project. The present commentary presents our efforts to deepen our understanding of the impacts of the knowledge translation strategy, based on follow-up interviews, 18 months after the workshop, with the heads of the road traffic crash units in Ouagadougou police stations (n = 5). Several benefits were reported by respondents. Their involvement in the process prompted them to broaden their knowledge of other ways of dealing with the issue of road crashes. This led them, sometimes with their colleagues, to intervene differently: more rapid response at collision sites, increased surveillance of dangerous intersections, user awareness-raising on the importance of the highway code, etc. However, sustaining these actions over the longer term has proven difficult. Several lessons were derived from this experience, regarding the importance of producing useful and locally applicable research data, of ensuring the acceptability of the technologies used for data collection, of using collaborative approaches in research and knowledge translation, of ensuring the visibility of actions undertaken by actors in the field, and of involving decision-makers in the research process to maximize its impacts.

Download Full-text

Lived experiences of inter-urban commercial bus drivers involved in road traffic crashes in Central Region, Ghana

Urban Planning and Transport Research ◽

10.1080/21650020.2018.1545601 ◽

2018 ◽

Vol 6 (1) ◽

pp. 81-94 ◽

Cited By ~ 2

Author(s):

Thomas Ojo ◽

William Agyemang ◽

Francis Afukaar

Keyword(s):

Central Region ◽

Lived Experiences ◽

Road Traffic ◽

Bus Drivers ◽

Traffic Crashes ◽

Road Traffic Crashes

Download Full-text

COVID-19 in children treated with immunosuppressive medication for kidney diseases

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320616 ◽

2020 ◽

pp. archdischild-2020-320616

Author(s):

Matko Marlais ◽

Tanja Wlodkowski ◽

Samhar Al-Akash ◽

Petr Ananin ◽

Varun Kumar Bandi ◽

...

Keyword(s):

Kidney Disease ◽

Immunosuppressive Therapy ◽

Low Income ◽

Kidney Diseases ◽

Low Income Countries ◽

Reference Network ◽

Immunosuppressive Medication ◽

Immunosuppressive Medications ◽

Significant Difference ◽

The Impact

BackgroundChildren are recognised as at lower risk of severe COVID-19 compared with adults, but the impact of immunosuppression is yet to be determined. This study aims to describe the clinical course of COVID-19 in children with kidney disease taking immunosuppressive medication and to assess disease severity.MethodsCross-sectional study hosted by the European Rare Kidney Disease Reference Network and supported by the European, Asian and International paediatric nephrology societies. Anonymised data were submitted online for any child (age <20 years) with COVID-19 taking immunosuppressive medication for a kidney condition. Study recruited for 16 weeks from 15 March 2020 to 05 July 2020. The primary outcome was severity of COVID-19.Results113 children were reported in this study from 30 different countries. Median age: 13 years (49% male). Main underlying reasons for immunosuppressive therapy: kidney transplant (47%), nephrotic syndrome (27%), systemic lupus erythematosus (10%). Immunosuppressive medications used include: glucocorticoids (76%), mycophenolate mofetil (MMF) (54%), tacrolimus/ciclosporine A (58%), rituximab/ofatumumab (11%). 78% required no respiratory support during COVID-19 illness, 5% required bi-level positive airway pressure or ventilation. Four children died; all deaths reported were from low-income countries with associated comorbidities. There was no significant difference in severity of COVID-19 based on gender, dialysis status, underlying kidney condition, and type or number of immunosuppressive medications.ConclusionsThis global study shows most children with a kidney disease taking immunosuppressive medication have mild disease with SARS-CoV-2 infection. We therefore suggest that children on immunosuppressive therapy should not be more strictly isolated than children who are not on immunosuppressive therapy.

Download Full-text