Epidemiology of road traffic injuries in Nepal, 2001-2013: systematic review and secondary data analysis

Objective: To investigate the epidemiology of road traffic injury (RTI) in Nepal for the period 2001-2013. Methods: 2 approaches, secondary data analysis and systematic literature review, were adopted. RTI data were retrieved from traffic police records and analysed for the incidence of RTI. Electronic databases were searched for published articles that described the epidemiology of RTI in Nepal. Results: A total of 95 902 crashes, 100 499 injuries and 14 512 deaths were recorded by the traffic police over the 12-year period, 2001-2013. The mortality rate increased from 4/100 000 population in 2001-2002 to 7/100 000 population in 2011-2012. There were relatively more reported crashes yet fewer deaths in Kathmandu valley than the rest of the country. Of the 20 articles related to RTI, only 11 articles met the eligibility criteria, but these were mainly descriptive case series or cross-sectional hospital-based studies. The majority of RTI were reported to occur among motorcyclists and pedestrians, in males, and in the age group 20-40 years. The common sites of injury were lower and upper extremities. Only 3 articles mentioned possible causes of accidents that include pedestrian road behaviour, alcohol consumption and improper bus driving. Conclusions: Nepal suffers a heavy burden of RTI, with higher fatalities on highways out of Kathmandu valley caused by bus crashes in hilly districts. The majority of published studies on RTI are descriptive and hospital based, indicating the need for more thorough investigation of causes of RTI and systematic recording of crashes for the development of effective interventions.