ORCID Profile
0000-0003-0872-9851
Current Organisations
Imperial College London
,
George Institute for Global Health
,
WHO Collaborating Centre on Injury Prevention and Trauma Care
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Publications
Latest results show urgent need to address child restraint use
Publisher: South African Medical Association NPC
Date: 31-01-2019
Patients who reattend after head injury: a high risk group
Publisher: BMJ
Date: 25-11-1995
DOI: 10.1136/BMJ.311.7017.1395
Abstract: To assess risk factors for important neurosurgical effects in patients who reattend after head injury. Retrospective study. 606 patients who reattended a trauma unit after minor head injury. Intracranial abnormality detected on computed tomography or the need for neurosurgical intervention. Five patients died: two from unrelated causes and three from raised intracranial pressure. On multiple regression analysis the only significant predictor for both abnormality on computed tomography (14.4% of reattenders) and the need for operation (5% of reattenders) was vault fracture seen on the skull radiograph (P < 10(-6)) predictors for abnormal computed tomogram were a Glasgow coma scale score < 15 at either first or second attendance (P < 0.0001) and convulsion at second attendance (P < 0.05) predictive for operation only was penetrating injury of the skull (P < 10(-6)). On contingency table analysis these associations were confirmed. In addition significant associations with both abnormality on computed tomography and operation were focal neurological abnormality, weakness, or speech disturbance. Amnesia or loss of consciousness at the time of initial injury, personality change, and seizures were significantly associated only with abnormality on computed tomography. Headache, dizziness, nausea, and vomiting were common in reattenders but were found to have no independent significance. All patients who reattend after head injury should undergo computed tomography as at least 14% of scans can be expected to yield positive results. Where this facility is not available patients with predictors for operation should be urgently referred for neurosurgical opinion. Other patients can be readmitted and need referral only if symptoms persist despite symptomatic treatment or there is neurological deterioration while under observation. These patients are a high risk group and should be treated seriously.
Episodic Alcohol Use and Risk of Nonfatal Injury
Publisher: Oxford University Press (OUP)
Date: 15-03-2004
DOI: 10.1093/AJE/KWH073
Abstract: Usual and acute alcohol consumption are important risk factors for injury. Although alcohol-dependent people are thought to be at increased risk of injury, there are few reports suggesting that their risk is greater than that of nondependent alcohol users in a given episode of alcohol use. The authors conducted a case-crossover analysis of data on 705 injury patients from a hospital emergency department in Mexico City, Mexico, collected in 2002. The majority of the s le was male (60%) and over 30 years old (51%). With use of a multiple matching approach that took into account three control time periods (the day prior to the injury, the same day in the previous week, and the same day in the previous month), the estimated relative risk of injury for patients who reported having consumed alcohol within 6 hours prior to injury (17% of the s le) was 3.97 (95% confidence interval: 2.88, 5.48). This increase in the relative risk was concentrated within the first 2 hours after drinking there was a positive association of increasing risk with increasing number of drinks consumed. These data suggested that relative risk estimates were the same for patients with and without alcohol use disorders.
Intersectionality based policy analysis: Equity in mobility in India
Publisher: Elsevier BV
Date: 02-2021
The Road Traffic Injuries Research Network: a decade of research capacity strengthening in low- and middle-income countries
Publisher: Springer Science and Business Media LLC
Date: 27-02-2016
Injury prevention and the attainment of child and adolescent health
Publisher: WHO Press
Date: 05-2009
Saving lives through vehicle safety
Publisher: Elsevier BV
Date: 06-2020
Global collaboration on road traffic injury prevention
Publisher: Informa UK Limited
Date: 06-2005
DOI: 10.1080/15660970500086130
Abstract: Worldwide, nearly 1.2 million people are killed in road traffic crashes every year and 20 million to 50 million more are injured or disabled. These injuries account for 2.1% of global mortality and 2.6% of all disability-adjusted life years (DALYs) lost. Low- and middle-income countries account for about 85% of the deaths and 90% of the DALYs lost annually. Without appropriate action, by 2020, road traffic injuries are predicted to be the third leading contributor to the global burden of disease. The economic cost of road traffic crashes is enormous. Globally it is estimated that US$518 billion is spent on road traffic crashes with low- and middle-income countries accounting for US$65 billion--more than these countries receive in development assistance. But these costs are just the tip of the iceberg. For everyone killed, injured or disabled by a road traffic crash there are countless others deeply affected. Many families are driven into poverty by the expenses of prolonged medical care, loss of a family breadwinner or the added burden of caring for the disabled. There is an urgent need for global collaboration on road traffic injury prevention. Since 2000, WHO has stepped up its response to the road safety crisis by firstly developing a 5-year strategy for road traffic injury prevention and following this by dedicating World Health Day 2004 to road safety and launching the WHO/World Bank World Report on Road Traffic Injury Prevention at the global World Health Day event in Paris, France. This short article highlights the main messages from the World Report and the six recommendations for action on road safety at a national and international level. It goes on to briefly discuss other international achievements since World Health Day and calls for countries to take up the challenge of implementing the recommendations of the World Report.
Saving lives by improving road safety
Publisher: Elsevier BV
Date: 03-2017
The need for stronger child restraint laws
Publisher: South African Medical Association NPC
Date: 26-07-2019
Save LIVES technical package: 22 interventions that could make a difference
Publisher: BMJ
Date: 04-06-2018
DOI: 10.1136/INJURYPREV-2018-042873
Abstract: The Save LIVES : a road safety technical package was produced and launched in May 2017 by the WHO to support road safety decision makers and practitioners in their efforts to significantly reduce the number of road traffic deaths in their countries. This Special Feature explains the process used to develop the package and how and why the 22 interventions were included. It concludes by encouraging researchers and practitioners to tailor their road safety packages to their own realities by following five practical steps.
Injury surveillance
Publisher: Informa UK Limited
Date: 04-2003
More action needed to protect vulnerable road users
Publisher: Elsevier BV
Date: 03-2013
Health systems research in burn care: an evidence gap map
Publisher: BMJ
Date: 02-08-2023
Abstract: Burn injury is associated with significant mortality and disability. Resilient and responsive health systems are needed for optimal response and care for people who sustain burn injuries. However, the extent of health systems research (HSR) in burn care is unknown. This review aimed to systematically map the global HSR related to burn care. An evidence gap map (EGM) was developed based on the World Health Organization health systems framework. All major medical, health and injury databases were searched. A standard method was used to develop the EGM. A total of 6586 articles were screened, and the full text of 206 articles was reviewed, of which 106 met the inclusion criteria. Most included studies were cross-sectional (61%) and were conducted in hospitals (71%) with patients (48%) or healthcare providers (29%) as participants. Most studies were conducted in high-income countries, while only 13% were conducted in low-and middle-income countries, accounting for 60% of burns mortality burden globally. The most common health systems areas of focus were service delivery (53%), health workforce (33%) and technology (19%). Studies on health policy, governance and leadership were absent, and there were only 14 qualitative studies. Major evidence gaps exist for an integrated health systems response to burns care. There is an inequity between the burden of burn injuries and HSR. Strengthening research capacity will facilitate evidence-informed health systems and policy reforms to sustainably improve access to affordable, equitable and optimal burn care and outcomes.
Looking back on 10 years of global road safety
Publisher: Oxford University Press (OUP)
Date: 30-05-2019
Abstract: Every year more than 1.35 million people lose their lives on the road and tens of millions more are injured, some permanently. Since the early 2000s there has been renewed focus on the issue, with the United Nations, World Health Organization and the World Bank placing the issue higher on their agendas. Guided by the United Nations General Assembly, World Health Assembly resolutions and ministerial-level conferences on the global road safety crisis, multisectoral partnerships have synthesised the evidence, advocated for action (there are two Sustainable Development Goal targets with an ambitious goal of reducing deaths and injuries from road traffic crashes by 50%), raised public awareness, generated funding, piloted interventions and monitored progress. And yet the total number of deaths has plateaued despite some sporadic country-level successes. More needs to be done—more people need to be trained in countries to deliver, monitor and evaluate a systems approach to road safety, more solid evidence of what works in low-resource settings is needed (including sustainable transportation options) and there needs to be a greater focus on optimising care and support for those injured in crashes—if we are to begin to see numbers come down in the next decade.
A new department for injuries and violence prevention at the World Health Organization
Publisher: BMJ
Date: 12-2001
DOI: 10.1136/IP.7.4.331
World report on child injury prevention calls for evidence-based interventions
Publisher: Informa UK Limited
Date: 03-2009
Global childhood unintentional injury surveillance in four cities in developing countries: a pilot study
Publisher: WHO Press
Date: 05-2009
Inequality and road-traffic injuries: call for action
Publisher: Elsevier BV
Date: 12-2003
Pedestrian Safety and the Built Environment
Publisher: SAGE Publications
Date: 12-08-2015
Abstract: Urban and regional planning has a contribution to make toward improving pedestrian safety, particularly in view of the fact that about 273,000 pedestrians were killed in road traffic crashes in 2010. The road is a built environments that should enhance safety and security for pedestrians, but this ideal is not always the case. This article presents an overview of the evidence on the risks that pedestrians face in the built environment. This article shows that design of the roadway and development of different land uses can either increase or reduce pedestrian road traffic injury. Planners need to design or modify the built environment to minimize risk for pedestrians.
Saving Lives Beyond 2020: The Next Steps
Publisher: Springer International Publishing
Date: 2022
DOI: 10.1007/978-3-030-23176-7_48-1
Abstract: Road safety has come a long way in our lifetimes, and there are steps in this progress that mark their place in history. Many of these were technical innovations, such as seat belts, electronic stability control, and geofencing for vehicle speed control. Also important, though perhaps fewer in number, were innovations in strategies to achieve change. These include the public health model of Dr. William Haddon, the introduction of Vision Zero, the World Report on Road Traffic Injury Prevention from WHO and the World Bank, and more recently, the Decade of Action 2011–2020. I am sure that the work and recommendations presented in this report will deserve their place in a “Hall of Fame” for strategic innovation in saving lives across the globe.
Out of the silos: embedding injury prevention into the Sustainable Development Goals
Publisher: BMJ
Date: 11-09-2020
DOI: 10.1136/INJURYPREV-2020-043850
Abstract: Globally, unintentional injuries contribute significantly to disability and death. Prevention efforts have traditionally focused on in idual injury mechanisms and their specific risk factors, which has resulted in slow progress in reducing the burden. The Sustainable Development Goals (SDGs) represent a global agenda for promoting human prosperity while respecting planetary boundaries. While injury prevention is currently only recognised in the SDG agenda via two road safety targets, the relevance of the SDGs for injury prevention is much broader. In this State of the Art Review, we illustrate how unintentional injury prevention efforts can be advanced substantially within a broad range of SDG goals and advocate for the integration of safety considerations across all sectors and stakeholders. This review uncovers injury prevention opportunities within broader global priorities such as urbanisation, population shifts, water safeguarding and corporate social responsibility. We demonstrate the relevance of injury prevention efforts to the SDG agenda beyond the health goal (SDG 3) and the two specific road safety targets (SDG 3.6 and SDG 11.2), highlighting 13 additional SDGs of relevance. We argue that all involved in injury prevention are at a critical juncture where we can continue with the status quo and expect to see more of the same, or mobilise the global community in an ‘Injury Prevention in All Policies’ approach.
Handbook on Drowning
Publisher: Springer Berlin Heidelberg
Date: 2006
Facilitators and barriers to child restraint use in motor vehicles: a qualitative evidence synthesis
Publisher: BMJ
Date: 23-05-2020
DOI: 10.1136/INJURYPREV-2020-043655
Abstract: Road traffic collisions contribute a significant burden of mortality and morbidity to children globally. The improper or non-use of child restraints can result in children sustaining significant injuries in the event of a collision. Systematic reviews on the effectiveness of various interventions to increase the use of child restraints already exist but to the best of our knowledge, there has been no qualitative evidence syntheses on the facilitators and barriers to child restraint usage. This review aims to fill that gap. We searched for qualitative studies, which focused on perceptions, values and experiences of children, parents/caregivers or any other relevant stakeholders on the use of restraints for children travelling in motor vehicles in PubMed, EMBASE and Global Health and screened reference lists of all included studies. We assessed the quality of included studies with the Critical Appraisal Skills Programme (CASP) checklist and used the PROGRESS Plus lens for an equity focused analysis. We identified a total of 335 records from searching the databases and five records from other sources. After screening, we identified 17 studies that met our inclusion criteria. All but one study (which had children as participants) focused on the perceptions, attitudes and barriers of parents or caregivers. The included studies were from three high-income (n=14) and one upper-middle income (n=3) country. In addition, although many focused exclusively on participants from culturally and linguistically erse minorities, the issue of equity was not well addressed. Five major themes emerged from the analysis. (1) perceived risk for injuries and perceived safety benefits of child restraint usage varies in different settings and between different types of caregivers (2) practical issues around the use of child restraints is a major barrier to its uptake as a child safety measure (3) restraint use is considered as a mechanism to discipline children rather than as a safety device by parents and as children became older they actively seek opportunities to negotiate the non-usage of restraints (4) adoption and enforcement of laws shape perceptions and usage in all settings and (5) perceptions and norms of child safety differ among culturally and linguistically erse groups. The results of this systematic review should be considered when designing interventions to promote the uptake of child restraints. However, there is a need to conduct qualitative research around the facilitators and barriers to child restraint usage in low-income and middle-income countries. Furthermore, there is a need for more evidence conducted in semiurban and rural areas and to involve fathers, policy-makers, implementers and enforcement agencies in such studies.
Navigating health systems for burn care: Patient journeys and delays in Uttar Pradesh, India
Publisher: Elsevier BV
Date: 03-2023
The epidemiology of drowning worldwide
Publisher: Informa UK Limited
Date: 12-2003
DOI: 10.1076/ICSP.10.4.195.16772
Abstract: The purpose of this analysis was to quantify the magnitude of death and disability from drowning and near-drowning worldwide and to provide epidemiological data on which to base prevention efforts. All data are from the Global Burden of Disease 2000 (Version 1) estimates in which deaths and disabilities are based on the WHO International Classification of Diseases. Extrapolations were made by age, sex, and WHO region. The six WHO regions of the world were further ided into high-income, and low- and middle-income based on the 1998 World Development indicators. According to the GBD 2000 data, an estimated 449,000 people drowned worldwide (7.4 per 100,000 population) and a further 1.3 million Disability Adjusted Life Years (DALYs) were lost as a result of premature death or disability from drowning. 97% of drownings occurred in low- and middle-income countries. Although 38% of drownings occurred in the Western Pacific Region, Africa had the highest drowning mortality rate (13.1 per 100,000 population). Males had higher drowning mortality rates than females for all ages and in all regions. Children under the age of 5 years had the highest drowning mortality rate for both sexes in all of the WHO regions except for Africa, where children aged 5 to 14 years had the highest mortality rate. Worldwide, for children under the age of 15 years, drowning accounted for a higher mortality rate than any other cause of injury. Drowning is a significant problem worldwide particularly for children under the age of 15 years. Low- and middle-income countries have the highest rates of drowning and account for more than 90% of such fatalities. Primary prevention efforts should thus be focused on these countries where many children who cannot swim drown in large bodies of water.
The epidemiology and characteristics of injuries to under 5's in a secondary city in Uganda: a retrospective review of hospital data
Publisher: Informa UK Limited
Date: 07-07-2022
Mortality and health-related quality of life following injuries and associated factors: a cohort study in Chandigarh, North India
Publisher: BMJ
Date: 04-07-2019
DOI: 10.1136/INJURYPREV-2019-043143
Abstract: Injuries are among the 10 leading causes of deaths worldwide. In recent years, the quality and reporting of injury mortality has improved but little or no data are available on the morbidity burden and impact of non-fatal injuries in India. This study evaluates health recovery status postinjury, identifying predictors of recovery in North India. Prospective cohort study recruiting patients from one tertiary-level and two secondary-level hospitals in North India between April and June 2014 hospitalised due to any injury. Health-related quality of life was assessed at baseline and at 1-month, 2-month, 4-month and 12-month postinjury using the EuroQol five-dimensional (EQ-5D-5L) questionnaire. Multivariable linear regressions with generalised estimating equations were used to examine the relationship between sociodemographic and injury-related factors with the EQ-5D-5L single utility score and the visual analogue scale (VAS) score. A total of 2416 eligible patients aged ≥18 years were enrolled in the study. Of these, 2150 (74%) completed baseline and all four follow-up EQ-5D-5L questionnaires. Almost 7% (n=172) patients died by the first follow-up and the overall mortality at 12 months was 9% (n=176). Both EQ-5D-5L utility and VAS scores dropped significantly at 1-month postinjury but gradually improved at 2, 4 and 12 months. Severe injuries, defined as those requiring a hospital stay of ≥7 days, were associated with lower utility scores at 1-month, 2-month and 4-month follow-ups (p .001). This is the first study to examine health outcomes following injuries in India. The findings highlight the need to understand the social, psychological and biological factors influencing recovery outcomes. High mortality following discharge emphasises the need to invest in secondary and tertiary injury prevention in India.
Cost effectiveness of strategies to combat road traffic injuries in sub-Saharan Africa and South East Asia: mathematical modelling study
Publisher: BMJ
Date: 02-03-2012
DOI: 10.1136/BMJ.E612
The relationship between psychosocial circumstances and injuries in adolescents: An analysis of 87,269 individuals from 26 countries using the Global School-based Student Health Survey
Publisher: Public Library of Science (PLoS)
Date: 28-09-2021
DOI: 10.1371/JOURNAL.PMED.1003722
Abstract: Over a million adolescents die globally each year from preventable or treatable causes, with injuries (intentional and unintentional) being the leading cause of these deaths. To inform strategies to prevent these injuries, we aimed to assess psychosocial factors associated with serious injury occurrence, type, and mechanism in adolescents. We conducted a secondary analysis of cross-sectional survey data collected from the Global School-based Student Health Survey between 2009 and 2015. We used logistic regression to estimate associations between prevalence of serious injuries, injury type (effects of injury), and injury mechanism (cause of injury) and psychosocial factors (factors that relate to in iduals socially, or their thoughts or behaviour, or the interrelation between these variables). Psychosocial factors were categorised, based on review of the literature, author knowledge, and discussion amongst authors. The categories were markers of risky behaviour (smoking, alcohol use, drug use, and physical activity), contextual factors (hunger, bullying, and loneliness), protective factors (number of friends and having a supportive family), and markers of poor mental health (planned or attempted suicide and being too worried to sleep). Models were adjusted for country factors (geographical area and income status, both using World Bank classification), demographic factors (age and sex), and factors to explain the survey design. A total of 87,269 adolescents living in 26 countries were included. The weighted majority were 14–15 years old (45.88%), male (50.70%), from a lower-middle-income country (81.93%), and from East Asia and the Pacific (66.83%). The weighted prevalence of a serious injury in the last 12 months was 36.33%, with the rate being higher in low-income countries compared to other countries (48.74% versus 36.14%) and amongst males compared to females (42.62% versus 29.87%). Psychosocial factors most strongly associated with serious injury were being bullied (odds ratio [OR] 2.45, 95% CI 1.93 to 3.13, p 0.001), drug use (OR 2.08, 95% CI 1.73 to 2.49, p 0.001), attempting suicide (OR 1.78, CI 1.55 to 2.04, p 0.001), being too worried to sleep (OR 1.80, 95% CI 1.54 to 2.10, p 0.001), feeling lonely (OR 1.61, 95% CI 1.37 to 1.89, p 0.001), and going hungry (OR 1.61, 95% CI 1.30 to 2.01, p 0.001). Factors hypothesised to be protective were not associated with reduced odds of serious injury: Number of close friends was associated with an increased odds of injury (OR 1.23, 95% CI 1.06 to 1.43, p = 0.007), as was having understanding parents or guardians (OR 1.13, 95% CI 1.01 to 1.26, p = 0.036). Being bullied, using drugs, and attempting suicide were associated with most types of injury, and being bullied or too worried to sleep were associated with most mechanisms of injury other psychosocial factors were variably associated with injury type and mechanism. Limitations include the cross-sectional study design, making it not possible to determine the directionality of the associations found, and the survey not capturing children who did not go to school. We observed strong associations between serious injury and psychosocial factors, but we note the relationships are likely to be complex and our findings do not inform causality. Nevertheless, our findings suggest that multifactorial programmes to target psychosocial factors might reduce the number of serious injuries in adolescents, in particular programmes concentrating on reducing bullying and drug use and improving mental health.
Patients who reattend after head injury
Publisher: BMJ
Date: 16-03-1996
DOI: 10.1136/BMJ.312.7032.707C
Abstract: Staphylococcus aureus bone infections remain a therapeutic challenge, leading to long and expensive hospitalizations. Systemic antibiotic treatments are inconsistently effective, due to insufficient penetration into the infectious site. In an osteomyelitis model, the single local administration of nanoparticle-encapsulated daptomycin allows sterilization of the infectious sites after 4 and 14 days of treatment, while daily systemic daptomycin treatment for 4 days was not effective. These results demonstrate the great potential of this local antibiotic treatment.
Evaluation of a small trauma team for major resuscitation
Publisher: Elsevier BV
Date: 11-1997
DOI: 10.1016/S0020-1383(97)00133-2
Abstract: There has been a great improvement in the early management of trauma patients, encapsulated by ATLS. Initial in-hospital management of significant trauma is undertaken by a trauma team, the number and content of which varies. No study has demonstrated that large trauma teams per se improve patient survival, compared to smaller teams working in the same tertiary referral centre environment. This is a retrospective study of pedestrian road traffic accident patients, who were major resuscitation cases admitted over a 6-month period to this hospital, which is a Level I Trauma Centre. Most major trauma resuscitations are undertaken by a small trauma team, led by one doctor. The performance of the small trauma team was evaluated by applying TRISS methodology and comparing our patient group with MTOS (US). There were 77 patients. The majority (52 per cent) had polytrauma, 80 per cent required intubation, the median ISS was 27 and the median RTS was 5.03. Ten per cent required resuscitative procedures and 75 per cent required urgent surgery. Using TRISS methodology the Z statistic was +0.54 and the Unit's M statistic was 0.492. There were more unexpected survivors than deaths. Seventy-one per cent were initially treated by one doctor. Only two patients had three or more doctors at the initial resuscitation. The use of small trauma teams within this Level I Trauma Centre does not appear to give results that are any worse than those of units that routinely use larger teams. This could be evaluated in other centres and may have implications for training, manpower and costing.
Road Safety Analysis
Publisher: Springer International Publishing
Date: 12-2023
DOI: 10.1007/978-3-030-76505-7_33
Abstract: Road safety analysis can be used to understand what has been successful in the past and what needs to be changed in order to be successful to reduce severe road trauma going forward and ultimately what’s needed to achieve zero. This chapter covers some of the tools used to retrospectively evaluate real-life benefits of road safety measures and methods used to predict the combined effects of interventions in a road safety action plan as well as to estimate if they are sufficient to achieve targets near-term and long-term. Included are also a brief overview of methods to develop boundary conditions on what constitutes a Safe System for different road users. Further to that, the chapter lists some arguments for the need of high-quality mass and in-depth data to ensure confidence in the results and conclusions from road safety analysis. Finally, a few key messages are summarized.
World report on child injury prevention appeals to Keep Kids Safe
Publisher: BMJ
Date: 12-2008
Affordability and Availability of Child Restraints in an Under-Served Population in South Africa
Publisher: MDPI AG
Date: 17-03-2020
Abstract: Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.
Road Traffic Injuries
Publisher: Elsevier
Date: 2016
The use of non-standard motorcycle helmets in low- and middle-income countries: a multicentre study
Publisher: BMJ
Date: 09-11-2012
DOI: 10.1136/INJURYPREV-2012-040348
Abstract: The use of non-standard motorcycle helmets has the potential to undermine multinational efforts aimed at reducing the burden of road traffic injuries associated with motorcycle crashes. However, little is known about the prevalence or factors associated with their use. Collaborating institutions in nine low- and middle-income countries undertook cross-sectional surveys, markets surveys, and reviewed legislation and enforcement practices around non-standard helmets. 5563 helmet-wearing motorcyclists were observed 54% of the helmets did not appear to have a marker/sticker indicating that the helmet met required standards and interviewers judged that 49% of the helmets were likely to be non-standard helmets. 5088 (91%) of the motorcyclists agreed to be interviewed those who had spent less than US$10 on their helmet were found to be at the greatest risk of wearing a non-standard helmet. Data were collected across 126 different retail outlets across all countries, regardless of outlet type, standard helmets were generally 2-3 times more expensive than non-standard helmets. While seven of the nine countries had legislation prohibiting the use of non-standard helmets, only four had legislation prohibiting their manufacture or sale and only three had legislation prohibiting their import. Enforcement of any legislation appeared to be minimal. Our findings suggest that the widespread use of non-standard helmets in low- and middle-income countries may limit the potential gains of helmet use programmes. Strategies aimed at reducing the costs of standard helmets, combined with both legislation and enforcement, will be required to maximise the effects of existing c aigns.
WHO launches guide to fatal injury data collection
Publisher: BMJ
Date: 09-10-2012
Clinical assessment compared with breathalyser readings in the emergency room: concordance of ICD-10 Y90 and Y91 codes
Publisher: BMJ
Date: 10-2005
Overloaded and Unrestrained: A Qualitative Study with Local Experts Exploring Factors Affecting Child Car Restraint Use in Cape Town, South Africa
Publisher: MDPI AG
Date: 10-07-2020
Abstract: (1) Background: Children in South Africa experience significant impacts from road injury due to the high frequency of road crashes and the low uptake of road safety measures (including the use of appropriate child restraints). The current study aimed to assess the feasibility of a child restraint program and to describe factors influencing child restraint use from the perspectives of clinicians, representatives of non-government agencies, and academics in Cape Town, South Africa. (2) Methods: Qualitative interviews were conducted with 13 experts from government, academic and clinical backgrounds. Findings were analyzed using the COM-B component of the Behaviour Change Wheel and were grouped by the layers of the social-ecological model (in idual, relational, community and societal). (COM-B is a framework to explain behaviour change which has three key components capability, opportunity and motivation), (3) Results: Experts believed that there was a need for a child restraint program that should be staged and multifactorial. Participants described knowledge gaps, perceptions of risk, mixed motivations and limited enforcement of child restraint legislation as key influences of restraint use. (4) Conclusions: The results demonstrate potential areas on which to focus interventions to increase child restraint use in Cape Town, South Africa. However, this will require a coordinated and consistent response across stakeholder groups.
Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019
Publisher: Elsevier BV
Date: 08-2022
Monitoring the Decade of Action for Global Road Safety 2011–2020: An update
Publisher: Informa UK Limited
Date: 24-04-2016
DOI: 10.1080/17441692.2016.1169306
Abstract: The United Nations Road Safety Collaboration (UNRSC) was set up in 2004 in response to the recognised need for the United Nations (UN) system to encourage efforts to address the global road safety crisis. In 2010, the UN General Assembly Resolution 64/255 declared 2011-2020 the Decade of Action for Road Safety with the overarching goal of stabilising and reducing the forecasted number of road traffic deaths by increasing activities at national, regional and global levels. In 2011, a Plan of Action for the Decade of Action, a tool to support the development of national and local plans of action, was launched. Countries are encouraged to implement activities according to the five pillars set out by the Plan of Action. The UNRSC, tasked to evaluate the overall impact of the Decade, developed and populated indicators for each pillar. Currently, 36 of 38 proposed indicators are populated by baseline data for 2010 from the second Global status report for road safety. However, gaps exist in data quality and availability on a global level. Therefore, there is an urgent need for improving data quality and availability to measure the progress of the Decade of Action.
Demographic profile and epidemiology of injury in Mthatha, South Africa.
Publisher: African Journals Online (AJOL)
Date: 03-02-2013
DOI: 10.4314/AHS.V13I4.40
Global road safety 2010–18: An analysis of Global Status Reports
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.INJURY.2022.07.030
Abstract: Road traffic injuries (RTIs) pose a significant health burden with 1.35 million in iduals dying on the world's roads annually. Nearly a decade ago, based on agreed road safety indicators, global commitments were encouraged to dramatically reduce this burden as part of the United Nation's Decade of Action for Road Safety 2011-2020. The analysis was based on global level data from three Global Status Reports on Road Safety published by the World Health Organization in 2013, 2015, and 2018. A total of 161 countries that consistently reported statistics for all three reports were included in the analysis. Descriptive analyses, t-test, Wilcoxon rank-sum test, and Spearman's rank correlation were performed to evaluate past and current trends in road traffic deaths and countries' progress in achieving key road safety indicators. We found no significant decline in global road traffic death rates from 2010 to 2016 and in fact, death rates increased in low-income countries (LICs) and the African Region. Death rates were highly dependent on income level of the country, with deaths higher in low- and middle-income countries (LMICs) when compared to high-income countries (HICs). We found that the strength of enforcement of speed laws and child restraint laws increased from 2011 to 2017. However, we did not find a correlation between enforcement of the five key prevention policies (speeding, drink-driving, seatbelts, helmets, and child restraints) and death rate. In terms of advancement in achieving key road safety indicators, there was slow progress in adopting most of the recommended policies and practices based on the five pillars (road safety management, safer roads and mobility, safer vehicles, safer road users, and post-crash response). Despite global efforts during the past decade, road traffic deaths remain disproportionally high in LMICs and African countries as shown by global reports, and progress in achieving global road safety indicators is slow. Countries need to greatly accelerate the implementation of interventions proven to reduce RTIs in order to meet the goals of the second Decade of Action for Road Safety.
Time to prioritise safe walking
Publisher: Informa UK Limited
Date: 06-2013
DOI: 10.1080/17457300.2013.800121
Abstract: This study draws on information from two recently published documents on pedestrian safety and global status of road safety to draw attention to the need to prioritize safe walking in planning and policy at local, national and international levels. The study shows that each year, more than 270 000 pedestrians lose their lives on the world's roads. The study argues that this situation need not persist because proven pedestrian safety interventions exist but do not attract the merit they deserve in many locations. The study further shows that the key risk factors for pedestrian road traffic injury such as vehicle speed, alcohol use by drivers and pedestrians, lack of infrastructure facilities for pedestrians and inadequate visibility of pedestrians are fairly well documented. The study concludes that pedestrian collisions, like all road traffic crashes, should not be accepted as inevitable because they are, in fact, both predictable and preventable. While stressing that reduction or elimination of risks faced by pedestrians is an important and achievable policy goal, the study emphasizes the importance of a comprehensive, holistic approach that includes engineering, enforcement and education measures.
Child health must include injury prevention
Publisher: Elsevier BV
Date: 2009
Alcohol as a risk factor for unintentional rail injury fatalities during daylight hours
Publisher: Informa UK Limited
Date: 06-2006
DOI: 10.1080/17457300500249582
Abstract: Railway fatalities account for approximately 10% of transport fatalities in Cape Town. The objective of this study was to examine alcohol intoxication as a risk factor during daylight hours by conducting a case - control study to compare rail passenger and pedestrian fatalities (cases) with motor vehicle passenger and pedestrian fatalities (controls). Rail passenger and rail pedestrian fatalities were defined as cases with motor vehicle passenger and pedestrian fatalities as the respective controls. Data were collected from post-mortem reports at two mortuaries from 1994 to 1996. Blood alcohol concentration was the dependent variable. The independent variables were age, gender, date of death, day of week, time of injury and external cause of death. The late afternoon and early evening period from 1600 hours to 1900 hours had the highest frequency of fatalities for all case and control groups. Of the 56 predominately male (89%) railway passenger cases with an average age of 34.5 (SD 12.5) years, Friday (27%) was the most frequent day of death. Railway pedestrian cases (89% male, average age 36.8 years (SD 13.3)) were more likely to be killed on a Monday (11% of cases). Among the controls, motor vehicle passengers (63% male, average age 39.9 (SD 15.5)) were more likely to die on a Sunday (25%) and pedestrians (82% male, average age 41 (SD 14.7)) on a Saturday (21%). The study showed that alcohol consumption is an important risk factor for rail fatalities during daylight hours, with rail passenger fatalities being 4.71 (1.72 - 12.88) and rail pedestrian fatalities 1.62 (0.98 - 2.69) times more likely to be intoxicated than the respective controls. The results provide more evidence for public health c aigners to tackle endemic alcohol abuse and to develop erse interventions that do not exclusively target motor vehicle drivers.
Identifying and validating alcohol diagnostics for injury-related trauma in South Africa: protocol for the mixed-methods AVIRT study (Preprint)
Publisher: JMIR Publications Inc.
Date: 26-09-2023
Alcohol and Road Traffic Injuries in Latin America and the Caribbean: A Case-Crossover Study
Publisher: Wiley
Date: 13-09-2017
DOI: 10.1111/ACER.13467
Injuries as Global Health Risk Factor
Publisher: Springer International Publishing
Date: 2021
Nurses responding to the World Health Organization (WHO) priority for emergency care systems for universal health coverage
Publisher: Elsevier BV
Date: 05-2020
A systematic review of the evidence for effectiveness of interventions to address transport and other unintentional injuries among adolescents
Publisher: Elsevier BV
Date: 06-2023
World report on child injury prevention: A wake-up call
Publisher: Elsevier BV
Date: 05-2009
Alcohol use in South Africa: findings from the South African Community Epidemiology Network on Drug use (SACENDU) Project.
Publisher: Alcohol Research Documentation, Inc.
Date: 07-2002
Abstract: To provide community-level public health surveillance on alcohol misuse in South Africa and the associated negative consequences. A descriptive, epidemiological study of alcohol use based on data gathered biannually from multiple sources over 4 years, including specialist treatment centers, trauma units, mortuaries, psychiatric facilities, and surveys of school students and arrestees. Networks were set up in five sentinel sites to facilitate the collection, interpretation and dissemination of data. Indicators point to the widespread misuse of alcohol. Alcohol consistently dominates the demand for substance use disorders treatment services. In the second half of 2000, 51.1% (Cape Town) to 77.0% (Mpumalanga) of patients reported alcohol as their primary substance of abuse. A high proportion of patients in trauma units tested positive for alcohol in 2000, ranging from 40.3% (Durban) to 91.8% (Port Elizabeth). Similarly, a high proportion of mortality cases tested positive for alcohol, ranging from 40.3% (Durban) to 67.2% (Port Elizabeth). Although treatment demand is dominated by men and older persons, alcohol misuse occurs among all sectors. School surveys reflect harmful drinking patterns among students, with 53.3% and 36.5% of male students in Durban and Cape Town, respectively, reporting heavy-drinking episodes by Grade 11. Alcohol misuse has a number of implications for public health policy, such as the need to develop protocols for the management of alcohol-positive patients in trauma units and to target prevention programs at heavy drinking by young people. Further monitoring of alcohol misuse and its associated negative consequences is required.
Addressing the Implementation Gap in Global Road Safety: Exploring Features of an Effective Response and Introducing a 10-Country Program
Publisher: American Public Health Association
Date: 06-2012
Abstract: Yearly, more than 1.2 million people are killed by road traffic injuries (RTIs) around the globe, and another 20 to 50 million are injured. The global burden of RTIs is predicted to rise. We explored the need for concerted action for global road safety and propose characteristics of an effective response to the gap in addressing RTIs. We propose that a successful response includes domains such as strong political will, capacity building, use of evidence-based interventions, rigorous evaluation, increased global funding, multisectoral action, and sustainability. We also present a case study of the global Road Safety in 10 Countries project, which is a new, 5-year, multipartner initiative to address the burden of RTIs in 10 low- and middle-income countries.
The Step Safely guidelines: a catalyst to address the burden of falls in children and adolescents
Publisher: Elsevier BV
Date: 10-2022
Estimating the South African trauma caseload
Publisher: Informa UK Limited
Date: 03-2006
DOI: 10.1080/15660970500036382
Abstract: A survey of medical superintendents revealed that an estimated 1.5 million trauma cases presented to South Africa's 356 secondary and tertiary level hospitals in 1999. Injury rates for traffic, violence and other injuries showed considerable inter-provincial variation, with violence accounting for more than half of the trauma caseload. This type of survey is a simple low cost alternative for monitoring injury patterns and supplementing burden of disease and injury costing studies.
Counting Road Traffic Deaths and Injuries: Poor Data Should Not Detract From Doing Something!
Publisher: Elsevier BV
Date: 08-2005
Guidelines for conducting community surveys on injuries and violence
Publisher: Informa UK Limited
Date: 12-2004
The political and social contexts of global road safety: challenges for the next decade
Publisher: Elsevier BV
Date: 07-2022
Africa's roads - The deadliest in the world
Publisher: South African Medical Association NPC
Date: 07-03-2013
DOI: 10.7196/SAMJ.6866
How the Covid-19 pandemic has drawn attention to the issue of active mobility and co-benefits in Latin American cities,Cómo la pandemia de Covid-19 ha llamado la atención sobre la cuestión de la movilidad activa y los beneficios colaterales en las ciudades latinoamericanas
Publisher: Instituto Nacional de Salud Publica
Date: 13-06-2022
DOI: 10.21149/12786
Abstract: The Covid-19 pandemic has brought to the fore many issues that will impact public health for years to come –one such impact is on the nexus between transportation and health. Promoting safe, active transport is an activity that has many physical and mental health benefits. During lockdowns, many cities in Latin America imposed infrastructural and legislative changes in order to abide with public health and social measures to reduce virus spread. These ranged from additional bike lanes to reduced speed limits or incentives to purchase bicycles. These cities showed reduced motorized transport, improved air quality and increased active transport, all of which have multiple health and equity benefits. As countries “build back better”, promoting active transport offers the most value for investment and improves health and well-being while continuing to offer social distancing. Quantified case studies are needed to have a more comprehensive understanding of the impact of active transport in various contexts.
World Health Organization dedicates World Health Day to road safety
Publisher: BMJ
Date: 04-2004
Road traffic injuries are a global public health problem
Publisher: BMJ
Date: 11-05-2002
WHO launches second global status report on road safety
Publisher: BMJ
Date: 19-03-2013
World report on child injury prevention appeals for action
Publisher: Wiley
Date: 09-12-2008
Two years into the road safety in 10 countries project: how are countries doing?
Publisher: BMJ
Date: 19-06-2012
World report on child injury prevention says road crashes are a leading cause of child deaths
Publisher: Elsevier BV
Date: 03-2009
Determining child drowning mortality in the Sundarbans, India: applying the community knowledge approach
Publisher: BMJ
Date: 17-09-2020
DOI: 10.1136/INJURYPREV-2020-043911
Abstract: The Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region. A community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child’s household through a structured survey, inquiring on the circumstances around the drowning death. The drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers. Drowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose.
Non-fatal injuries among boys and girls presenting to Red Cross War Memorial Children’s Hospital, Cape Town
Publisher: South African Medical Association NPC
Date: 07-2022
DOI: 10.7196/SAMJ.2022.V112I7.16303
Abstract: Background. In South Africa (SA), road traffic injuries, homicides and burns are the leading causes of injury-related deaths among children. Injury-related deaths are well documented for SA, but this is not the case for non-fatal injuries.Objectives. To describe the non-fatal injuries sustained among children aged 0 - 13 years, to identify any significant sex differences by age group, cause of injury, admission status and injury severity. Methods. The trauma unit database from 1997 to 2016 at Red Cross War Memorial Children’s Hospital, Cape Town, was utilised for this analysis. The prevalence of injuries and the boy/girl ratios with 95% confidence intervals (CIs) were reported.Results. Analysis indicated significant differences by sex for in idual injury causes (transport, assault, burns, falls and other injuries), age group, injury severity and admission status. Moderately severe injuries were largely caused by burns, while severe injuries were mostly transport related. Boys had significantly higher proportions of all injury causes. The boy/girl ratio was lowest for assault (1:18), where significantly more girls aged 1 - 3 and 4 - 6 years were injured. Rape/sexual assault was 5.5 times higher for girls, with a significantly higher proportion of moderate-severity injuries (87% 95% CI 84.7 - 89.4). Conclusion. The study findings call for a more targeted prevention response for boy and girl children. Interventions should be targeted at the prevention of burns, traffic collisions and interpersonal violence, in particular sexual assaults against girls.
Impact of COVID-19 and containment measures on burn care in India: A qualitative exploratory study
Publisher: Elsevier BV
Date: 09-2021
The Importance of Data for Global Road Safety
Publisher: Informa UK Limited
Date: 03-2012
UN General Assembly calls for decade of action for road safety
Publisher: BMJ
Date: 06-2010
How safe are the world’s roads?
Publisher: WHO Press
Date: 10-2009
Introduction: The global challenge of road traffic injuries
Publisher: Informa UK Limited
Date: 04-2003
Media coverage and framing of road traffic safety in India
Publisher: BMJ
Date: 03-2021
DOI: 10.1136/BMJGH-2020-004499
Abstract: Media coverage of road traffic collisions (RTCs) may influence preventative action. India experiences some of the highest RTC mortality and morbidity rates globally, but advocacy and effective action to mitigate this has been limited. We conducted an analysis of Indian media in English to assess whether coverage met the WHO’s Reporting on Road Safety guidelines for evidence-based reporting of RTCs. English-language articles published online between March 2018 and February 2019 were assessed against the seven recommended story angles and seven recommended key elements in the WHO guidelines. 458 articles were included in the analysis. The most common story angle was descriptions of single collisions, which was not a WHO-recommended story angle. These included limited key elements such as use of human story or linking to road safety risks or evidence-based solutions. However, some articles did follow the WHO-recommended story angles, with 22.1% discussing specific road safety solutions and a further 6.3% discussing vulnerable groups. Almost all articles avoided the use of technical language, but only 2.0% explicitly stated that RTCs were preventable. More than half identified at least one evidence-based solution. Very few articles discussed economic or health impacts of RTCs, including the burden they present to the public health system. Indian media in English can improve reporting by focusing on human stories and documenting experiences of those injured in RTCs. Coverage should also focus more on evidence-based solutions, emphasising the systems approach which encourages government action rather than changes to in idual behaviour.
Related Organisations
Imperial College London
Location: United Kingdom of Great Britain and Northern Ireland
Stellenbosch University Faculty Of Medicine And Health Sciences
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George Institute For Global Health
Location: United Kingdom of Great Britain and Northern Ireland
WHO Collaborating Centre On Injury Prevention And Trauma Care
Location: Australia
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