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Published on: September 21, 2017
Pediatric road traffic injuries in Ghana: a cross-sectional study of factors associated with injury severity within
Anthony Baffour Appiah1, Andreas Deckert2, Martin Tangnaa Morna3,4
1Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany anthony.baffour_appiah@stud.uni-heidelberg.de.
Insights
The Haddon Matrix framework identified factors like alcohol use and weather conditions that increase child road traffic injury severity in Ghana. Interventions targeting these factors can help reduce harm.
Area of Science:
- Public Health
- Injury Prevention
- Epidemiology
Background:
- Road traffic injuries (RTIs) are a significant cause of morbidity and mortality in children globally.
- Ghana faces a substantial burden of paediatric RTIs, necessitating targeted prevention strategies.
- The Haddon Matrix framework offers a comprehensive approach to analyzing injury causation and prevention.
Purpose of the Study:
- To apply the Haddon Matrix framework to identify factors associated with paediatric RTI severity in Ghana.
- To inform the development of evidence-based interventions for reducing child injury severity from RTIs.
Main Methods:
- A prospective hospital-based cross-sectional study was conducted in three teaching hospitals in Ghana.
- Data from 484 children and adolescents (0-18 years) with RTIs were collected using questionnaires and medical records.
- Negative binomial regression models were used to identify predictors of injury severity, measured by the Injury Severity Score.
Main Results:
- Increased paediatric RTI severity was associated with frequent alcohol use, Harmattan weather, afternoon crashes, and referral cases.
- Single bicycle crashes and walk-in hospital visits were linked to lower injury severity.
- The final regression model effectively predicted paediatric RTI severity.
Conclusions:
- The Haddon Matrix framework successfully identified modifiable environmental, behavioral, and health system factors influencing paediatric RTI severity.
- Interventions focusing on alcohol consumption, road safety during Harmattan, and improving referral and prehospital care are recommended.
- Targeted interventions can potentially decrease the severity of injuries among children involved in RTIs in Ghana.
Objectives:
To apply the Haddon Matrix framework (HM) to examine factors associated with the severity of paediatric road traffic injuries (RTIs) in Ghana.
Design:
Prospective hospital-based cross-sectional study. Variables were organised according to the three domains of the HM framework. Three negative binomial regression models were developed to identify the best-fitting model for predicting paediatric RTI severity SETTINGS: Three teaching hospitals in the Northern, Ashanti and Central Regions of Ghana.
Participants:
A total of 484 consecutive children and adolescents aged 0-18 years presenting to the emergency department with RTIs between 18 September 2023 and 30 September 2024 were included. Data were collected using interviewer-administered questionnaires and medical record reviews.
Main Outcome Measure:
The primary outcome was injury severity measured using the Injury Severity Score, an anatomical measure based on the sum of the squared Abbreviated Injury Scale scores for the three most severely injured body regions.
Results:
The third model (variable selection threshold p≤0.1) demonstrated the best predictive model for paediatric RTI severity, with the lowest Akaike Information Criterion and the highest log-likelihood. Increased injury severity was independently associated with self-reported frequent alcohol use (β=1.54, p=0.016), Harmattan weather conditions (β=0.21, p=0.024), afternoon crashes (β=0.17, p=0.041) and referral cases (β=0.28, p=0.003). Whereas single bicycle crashes (β=-1.58, p=0.011) and walk-in hospital visits (β=-1.09, p=0.026) were associated with lower injury severity.
Conclusion:
The HM identified modifiable environmental, behavioural and health system factors associated with paediatric RTI severity. Interventions targeting alcohol use, Harmattan-related road safety, timely referral and prehospital care may reduce injury severity among children in Ghana.
