Impact of transportation policy on injury characteristics in a teaching hospital, Calabar, Nigeria

Introduction: The global burden of road traffic injury(RTI)-related trauma is enormous and has the highest impact in low income economies. Loss of lives in the most productive age groups and the socio-economic costs to these weak economies, coupled with poor infrastructure for management of the severely injured dictate that well executed preventive measures be instituted in these countries. Low and middle income economies account for 90% RTI-related deaths in the world, yet in these regions, public health regulations on road safety hardly exist and where they do, are hardly enforced. Aim: To document variations in injury frequency, severity and outcomes following the ban on the use of motorcycles as a means of public transportation in Calabar. Patients and Methods: A prospective study of RTI patients who presented in our Emergency center over a 12 month period. Information recorded included biodata, anatomic location of injury, injury-arrival time, mode of transportation to hospital and final disposition at discharge. Chest injuries were excluded as there were no data for comparison. Results were analyzed by SPSS version 20 and compared with the 2005 Trauma Study Group results. Results: There were 366 road traffic injuries out of 5612 emergency room presentations during the period. There were 237 males and 99 females (M: F= 2.4: 1), mean age of patients was 30.13 +/- 12.62 years. Businessmen were the most commonly involved occupational group (n= 138; 38.7%) and the mean injury- arrival interval was 16.57 +/- 56.14 hours. Only 12 (3.6%) patients arrived by ambulance and 108 (32.1%) left against medical advice. Conclusion: RTIs constitute a major socioeconomic burden in the developing world. Lack of research, high risk behaviors and lack of enforceable road use regulations contribute to high rates of RTI-related mortality and morbidity. Preventive interventions and appropriate research to identify risk factors will reduce the burden of RTIs in low and middle income economies.