thèse doctorat de l'université bordeaux 2 - ISPED-Enseignement à ...

2.7 Interurban road safety research gaps in LMICsTo our knowledge, no review on the epidemiology of interurban RTC in LMICs wasavailable. As part of a systematic review of original studies published in Medline® withinterurban road settings (Appendix 1), we only found 31 articles from these countries. Most ofthem used police or health data to assess crash burden. We did not find any study comparingdifferences in injury reporting between these types of data. Only one study reported injuryburden per 100 million vehicle-km. Situational factors other than the light or weatherconditions were almost never documented in these studies. None of them assessed theinteractions between driver- and road-related crash factors. Only few studies assessed highriskcrash site identification methods on inter-urban road sections in LMICs. Finally, few roadinterventions were assessed in these countries, mostly by non comparative methods.3. ObjectivesTo contribute to filling the research gaps on RTCs and RTIs in LMICs, the objectives of thisthesis were:1. To assess the road crash and injury burden on selected interurban roads in LMICs–Studies I & II;2. To describe road user groups and situational factors involved in interurban roadcrashes–Studies I & II;3. To assess the association of situational factors with injury crashes on selected roads ofLMICs–Studies III & IV;4. To assess the road hazard perception of the high-risk crash sites in voluntary drivers–Study V.The thesis presents two descriptive studies (I & II) and three analytical studies (III-V) in linewith these objectives. In study I, the crash burden, number of persons who died or wereinjured per vehicle-km was assessed on Yaoundé-Douala road section in Cameroon. Further,associated crash factors and types were described using police reports. In study II, wecompared RTIs per vehicle-km reported to police, ambulance, and hospital on Karachi-Halaroad section during a one-year period. In study III, we assessed situational factors associatedwith injury crash sites using case-control methods on the Yaoundé-Douala road section. Instudy IV, we compared the incidence density rates estimated from events (crash, fatality, andsevere injury) and vehicle-km between highway work zones and other traffic zones onKarachi-Hala road section. In study V, we assessed the hazard perception of high-risk crashsites and those not involved in crashes from the above two road sections by showing theirvideos to voluntary Pakistani drivers. Furthermore, situational factors associated with drivers’hazard perception were assessed using multivariate models. Study I and III have beenpublished whereas manuscript of study IV is under review and those for study II and V are inpreparation.20