The pattern and trend of motor traffic injuries and their impact on health services in Kibaha district 1996 - 1999.

Abstract

An operational research was conducted in Kibaha district from 6th June to 31 st July 2000, to describe the pattern and factors associated with motor vehicle accidents (MY As) along the Chalinze Dar es Salaam highway in Coast Region, Tanzania The study was based on a retrospective review of records obtained from Kibaha police station and Tumbi hospital from 1996 to 1999. Using a cross sectional study design, additional data were collected from motor related accident victims who attended emergency treatment at Tumbi hospital during the month of June and July 2000. A total of 584-hospital-based accident records and 48 police reports, compiled on monthly basis, were reviewed and 35 accident victims were interviewed. The study revealed that a total of 21 02 MY A~ occurred along the Chalinze - Dar es Salaam highway in Coast Region from the year 1996 to 1999. The average was approximately 525 accidents per year and the trend was almost the same during the four years. Overall MVAs were responsible for: 83% of all accidents, 82.5% of all injuries, and 88.8% of all deaths. A total number of 260 1 subjects were reported to be involved in MY As during the four years. Males were more likely than females to be involved in such accidents, 80% and 20% respectively. The majority (77%) of victims were between the age of20 and 39 years and approximately 20% were reported to have died. Pedestrians were at highest risk of dying of MY As (38.3%) followed by pedal cyclists (17.9%) and motor-cyclists (25%) during the year 1999. Most of the accidents occurred during daytime (51.6%) when the road was dry (86.3%). Victims were significantly more likely to die from motor vehicle

viii accidents occurring at night than during the day, 20.9% and 14.8% respectively (p< 0.05). Driving at night while it is raining was significantly associated with a three- fold increased risk of dying from a MY A than during daytime. The Odds ratio was 3.23, and 95% Confidence Interval l.76, 5.91). Three factors identified to contribute highly to motor accidents were over speeding (32.8%), dangerous / careless driving (23.7%), and mechanical defect of the vehicles 13.3%). Many casualties were caused by vehicle overturn (40.2%), vehicle collision (23.5%), pedestrian being knocked down (19.8%) and tyre burst (1l.9%). The sites that were found to be more prone to accidents than others were Chalinze, Kibaha-Maili moja and Kiluvya. Availability of transport to ferry the road accident victims to hospital was facilitated by privately owned vehicles and police cars in 94.3% and 0.7% of the cases respectively. In all accident victims, first aid that was not available for anyone of them starting from the time of the accident occurred until they arrived at the hospital. Injuries found to be life threatening were head injuries and intraperitonial hemorrhage that resulted in a hospital stay of 5 days and 12 days respectively. The trend of referring accident victims appeared to increase annually, from 3.7% in 1996 to 6.2% in 1999. It is recommended that traffic police, ambulance operators, bus drivers and conductors should be trained on how to give first aid to injured people. Buses should have first aid kits with gloves available. Also to control and prevent road accidents there should be a continuous promotion of public awareness and media campaigns on road safety, improvement of drivers competency, enforcement of road safety regulations and a clear national policy on road safety.