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East African Journal of Public Heath, Vol. 2, No. 1, April, 2005, pp. 10-12 Road Traffic Accidents Along the Kiluvya-Bwawani and Chalinze-Segera Highways in Coast Region: An Epidemiological Appraisal Kilale AM1 , Lema AL, Kunda J, Musilimu F, Mukungu VMT, Baruna M, Noel A, Bachubira S and Rwehabura J Correspondence to : Kilale AM, P. O. Box 3436, National Institute for Medical Research Muhimbili Research Station Code Number: lp05003 Abstract Objective: To ascertain the trends in main indicators and road
users. Key Words: Road Traffic Accidents, Case Fatality Rate Introduction For a long time now global attention has been paid on the currently dangerous disease such as HIV/AIDS, ebola, malaria, tuberculosis and tumors while little attention has been paid to road traffic accidents (RTA) which has been claiming a larger number of lives. In the recent years, the number of RTA and individuals dying have been increasing all over the world. Reports of deaths due to serious accidents from developing countries indicate that RTA is becoming an important public health problem. Besides loosing one’s life or being disabled, an accident victim presents a socio-economic burden to his/her family and the society. Calculation of the total cost of case management is one of the essential tools for planning accident prevention strategies. It is a known fact that risk factors leading to RTA occur in a definable pattern. Studies done in the USA and developing countries (1,2) have identified risk factors such as alcohol use, age, sex, speed etc. However, it is also known that the same risk factors occur in different patterns at different places due to different prevailing local conditions. Tanzania not being an island in the world, has been experiencing alarming number of RTAs with a significant life and property destruction as a result. Kibaha district which is located about 35 km from the capital city of Dar es Salaam is the nearest district to Dar es Salaam. It is easily accessible by other parts of Tanzania as it is situated along the Tanzania – Zambia, Dar es Salaam – Dodoma-Mwanza and Dar es Salaam – Tanga – Arusha Highways. Kiluvya – Bwawani and Chalinze – Segera highways are reported to record a significant number of RTAs in the country. The aim of this study was to outline the pattern of RTAs and its direct impact. Methods A descriptive analysis of road traffic accidents (RTA) along the Kiluvya – Bwawani and Chalinze – Segera was done using routine accident records from the Coast Region Traffic Office and Tumbi Special Hospital. Data of a time series for six years are analyzed to ascertain the trends in main indicators and the relationship of injuries to road users. Results Records from the Coast Region Traffic Office and Tumbi Special Hospital show that a total of 592, 569, 540, 493, 500 and 404 road traffic accidents occurred on the Kiluvya – Bwawani, Chalinze – Segera High Ways in 1995, 1996, 1997, 1998, 1999 and 2000, respectively. The proportion of the various types of the accidents is shown on figure 1. Out of the 592 accidents that occurred in 1995, 102 (17.23%) were fatal (i.e deaths occurred as a result), 169 (28.55%) caused injuries and ordinary accidents (i.e. caused neither death nor injury) were 321 (54.22%). In 1996, out of the 569 accidents, 100 (17.58%) were fatal, 216 (37.96) caused injuries and 253 (44.46%) were ordinary. Similarly, 98 (18.15%) of the 540 accidents that occurred in 1997 were fatal, 225 (41.6%) caused injuries and 217 (40.18%) caused neither death nor injury. Of the 493 accidents that occurred in 1998, 83 (16.88%) caused death, 212 (43%) caused injuries and 190 (38.54%) were ordinary accidents. In 1999 and 2000, fatal accidents were 98 (19.6%) and 91 (22.52%) while injuries and ordinary accidents were 212 (42.4%) and 146 (36.14%) and 190 (38%) and 167 (41.34%), respectively. Looking at the annual deaths due to road traffic accidents, it wa observed that the number of deaths from 1995 to 1998 remained constant. There were 126, 1229, 131 and 128 deaths in 1995, 1996, 1997 and 1998, respectively. From 1998 to 1999 there were a slight increase in the number of deaths from 128 to 152, respectively, then a gradual decrease to 102 in 2000 (Figure 2). It was observed that a total of 114 (90.5%), 115 (89.2%), 115 (87.8%), 101 (78.9%), 126 (82.9%) and 94 (92.2%) males died in 1995, 1996,1997, 1998, 1999 and 2000, respectively. Similarly, the death of females were 12 (9.5%), 14 (10.9%), 16 (12.2%), 27 (21.1%), 26 (17.1%) and 8 (7.8%) in the same period. In the studied period more males died due to road traffic accidents than females. In 1995, 50 (39.68%) of all deaths were passengers while 51 (40.48%), 12 (9.5%) and 41 (8.7%) were pedestrians, driver and cyclists respectively. Noted also in 1995 were the 2 (1.59%) students who died due to road traffic accidents in the area. From 1996 to 1999, passengers died in large numbers than other groups of people. It was noted that 63 (48.8%), 53 (40.5%), 64 (50%) and 72 (47.4%) from 1996 to 1999, respectively The next group to die in large proportion was the pedestrians. Records show that 51 (40.48%), 38 (29.46%), 47 (35.15%) and 50 (32.89%) pedestrians died in the same period. Although the number and proportion of drives and cyclists was relatively low as compared to passengers and pedestrian, their deaths varied significantly between the years (Figure 4). The deaths in these groups show an increase in trend from 1998 to 2000. Contrary to the previous years, the number and proportion of pedestrians that died due to road traffic accidents in 2000 was twice greater than that of passengers. When police and hospital death records were compared, it was noted that hospital reporting of deaths due to RTA was low. It was not clear whether this was due to the fact that even if many people died when accidents occur, not all victims are reported or taken to Tumbi Special Hospital or it is the hospital that under records the accident victims. The anticipated causes to the low number of deaths recorded by the hospital were deaths after referral and those taken for burial by relatives immediately after the accident. Discussion A total of 3,098 road traffic accidents occurred along the Kiluvya – Bwawani and Chalinze-Segera Highway in the six years of the study with an average of 516 accidents per year. This corresponds to 1.4 accidents per day. There was significant variation in total number of accidents between the years. The total number of road traffic accidents was observed to be very high although there was a slight decrease over the study period (from 592 in 1995 to 404 in 2000). The proportion of fatal accidents remained relatively constant from 17.23% in 1995 to 16.88%) in 1998. There was a gradual increase in proportion of the fatal accidents to 19.6% and 22.52% in 1999 and 2000, respectively. Ordinary accidents had the highest toll in the area, whereas injury accidents increased from 28.55% in 1995 to 37.96%, 41.67% and 43% in 1996, 1997 and 1998, respectively. A slight decrease in the proportion of injury accidents was recorded in 1999 and 2000 (42.4% and 36.14%, respectively). An important observation on the trend of accidents in the study areas was the significant decrease in number of accidents in 2000 but with an appreciable increase in fatal accident. There were a total of 768 deaths due to road traffic accidents from the study area between 1995 and 2000. On average, 128 deaths occurred each year. There was a significant variation in number of deaths over the study period (p = 0.00001). A total of 665 males 103 females died due to the accidents in the same period. The number of deaths in both males and females varied significantly (p<0.00000). More males died in road traffic accidents than females. The average annual deaths of males were 111 and 17 for females. The male to female death ratio was 6.5:1. The high number of deaths in males could be a good explanation to the fact that more males are involved in travelling than females. Contrary to the previous years, the number and proportion of pedestrians that died due to road traffic accidents in 2000 was twice greater than that of passengers. From 1996 to 1999, annual case fatality rate (CFR) in passengers was higher than other groups. The overall CFR from 1995 to 2000 passengers was 42.1% while in pedestrians it was 37.8%, 42.1% for passengers, 13% for cyclists and 9% for drivers. In the year 2000, vehicle – pedestrian collisions were most severe and had the highest CFR of 52.94%. These results are in line with a similar study that was done in Kenya (3), which showed that of all traffic fatalities reported, pedestrians comprised 42%, passengers 38%, drivers 12%, and cyclists 8%. Also a review of the problem of RTA in Jordan by Judaan (4) showed that pedestrians constitute over 40% of all injuries. Conclusion The trends of RTA in this study illustrate a rapidly growing problem in the country. The high pedestrian and passenger deaths imply the need to investigate the underlying risk factors, operational and policy issues involved in the transport system, and to develop and implement appropriate responsive road safety interventions. A well planned scientific approach to study the characteristics of injury–producing accidents including trends, distribution patterns, type of vehicles involved, and road-users injured or killed is recommended. As it can be noted in this paper, possible causes of RTA, injuries/deaths resulting from vehicle damage and direct and opportunity cost of RTA was not investigated. References
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