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Injury outcome patternsMost of injured road users were aged 15-59 years (93.1%) (Table 5). Those aged 0-14 yearsand 60 years or more accounted for 15% of road fatalities. Females accounted for 15.7% ofthose involved, but 25.1% of those injured and 26.2% of those who died. Pedestriansaccounted for 5.4% of road users involved in crashes, but 18.4% of those who died. Twentyfive pedestrians died while crossing, whereas twelve of them died on the roadside. Nearlyfour out of five injured persons were transported by private means to the hospital.Ambulances were used to transport 4.0% of those injured and 8.4% of those died. Policeforces evacuated 2.0% of those injured and 6.0% of those who died.Table 5. Traffic injury outcome, according to road-user characteristics, on the Yaoundé-Douala road section (2004-2007)Total Injured DiedN % N % N %Age (y)- 0-14 52 2.4 35 3.8 15 6.5- 15-29 563 25.8 284 30.8 68 29.6- 30-44 1 019 46.8 399 43.3 71 30.9- 45-59 485 22.3 175 19.0 58 25.2- ≥ 60 59 2.7 29 3.1 18 7.8Sex- Male 2 322 84.3 952 74.9 262 73.8- Female 431 15.7 319 25.1 93 26.2Profession- Professional drivers 1 049 52.7 230 29.0 46 35.9- Office managers/employees 442 22.2 219 27.6 24 18.8- Self employed 193 9.7 112 14.1 17 13.3- Manual 127 6.4 97 12.2 15 11.7- Students 74 3.7 53 6.7 15 11.7- Other 107 5.4 82 10.3 11 8.6Road user- Driver 1 673 55.1 436 29.2 98 26.2- Vehicle occupants 1 200 39.5 968 64.8 208 55.6- Pedestrian 163 5.4 89 6.0 68 18.2Pre-hospital transport- Not transported 1 297 43.5 116 7.9 63 17.1- Private 1 539 51.7 1 260 85.7 252 68.5- Ambulance 90 3.0 59 4.0 31 8.4- Police force 52 1.7 29 2.0 22 6.0Seat-belt wearing was reported for only three persons out of over three thousand vehicleoccupants. Blood-alcohol concentration of responsible drivers was not systematicallyperformed and no record was available. Apparent DWI was identified in only two drivers. Inabout 9.3% of the drivers no driving permit was available. Twenty pedestrian died at siteswhere no zebra crossing was available.28
4.2 Study II: Differences in police, ambulance, and emergency departmentreporting of traffic injuries on Karachi-Hala road section, PakistanPakistan located at the junction of Middle-East, South-East Asia, China, and Central AsianStates, is the sixth most populous nation of the world [69]. Approximately 1.4 million RTCsoccurred in Pakistan during 1999, resulting in over 7 000 fatalities [76]. A recent WHO reportshowed that actual traffic fatalities could be 4 to 10 times higher than official statistic [2].Similarly, two independent population-based surveys estimated incidence of traffic injuriesaround 15 to 17 per 1 000 persons per year [77, 78]; RTIs contribute significantly to the workload in hospitals [79]. The direct cost of RTIs to Pakistani economy is over 1 billon US$ [80].Interurban road sections are the back-bone of Pakistani economy. Its strategic interurban roadnetwork of approximately 8 000 km plays a significant role in transport, as it carries morethan 80% of inland passenger and freight traffic [76, 81]. Although these road sectionsaccount for 4% of the entire network, a high proportion of traffic fatalities (27%) occur onthese road sections [63]. Similarly, previous research in Pakistan has shown that injuryseverity was higher for crashes in rural areas [82]. However, no distinction has been madewhether this refers to interurban or other rural roads. Higher speeds and inappropriategeometrical design can explain this high fatality ratio, but no comparison indicators wereavailable for these road sections [60].The catchment area for traffic injuries is difficult to define on interurban road sections inLMICs, and police records remain to date the most reliable source of evaluating interurbanroad safety [7]. The use of police statistics alone can lead to underestimation of road burdenin LMICs, as previously illustrated by linking police and ambulance datasets in Karachi,Pakistan [64]. No notable research has been carried out to compare the differences in injuryreporting while linking different datasets with interurban road settings in LMICs [2, 3].ObjectivesThe objectives of this study were:1. To assess differences for crash and injury reporting in police, ambulance, andemergency department (ED) datasets on an interurban road section in Pakistan.2. To estimate variations of traffic fatality and injury per vehicle-km travelled whenlinking these datasets.The manuscript of this study is currently prepared for submission: Bhatti JA, Razzak JA,Lagarde E, Salmi L.-R. Differences in police, ambulance, and emergency departmentreporting of traffic injuries on Karachi-Hala road, Pakistan (Appendix 4).I have been involved in all steps of this study, from conception, to data collection, analysis,interpretation of results, and manuscript writing.29
Page 1: Université Victor Segalen Bordeaux
Page 4 and 5: Publications (peer-reviewed).......
Page 6 and 7: Index of figuresFigure 1. Traffic f
Page 8 and 9: AbbreviationsAKUAVCIBMIEASESSDALYDW
Page 10 and 11: AbstractBackground: Interurban traf
Page 12 and 13: L'objectif de cette thèse était d
Page 14 and 15: 2. Background2.1 Road injury burden
Page 16 and 17: 2.4 Multiple factors involved in tr
Page 18 and 19: Figure 4. Percentage difference of
Page 20 and 21: 2.7 Interurban road safety research
Page 22 and 23: ObjectivesThe objectives of this fi
Page 24 and 25: ResultsCrash burdenA total of 935 R
Page 26 and 27: Figure 7. Monthly trend of traffic
Page 30 and 31: MethodsThe study setting was 196-km
Page 32 and 33: patients. In the ED, those with NIS
Page 34 and 35: Table 6. Traffic injuries reported
Page 36 and 37: 5. Analytical StudiesPrevious liter
Page 38 and 39: under supervision of Dr. Sobngwi-Ta
Page 40 and 41: Table 9. Situational variables at c
Page 42 and 43: MethodsStudy design and settingStud
Page 44 and 45: to Dec 08 were retrieved and photoc
Page 46 and 47: normal zones. However, this associa
Page 48 and 49: MethodsStudy design and settingsThe
Page 50 and 51: Figure 14. Picture extracted of a h
Page 52 and 53: located in built-up area in Pakista
Page 54 and 55: Table 15. Differences in hazard per
Page 56 and 57: 6. Discussion6.1 Originality of stu
Page 58 and 59: Although adjustments are possible,
Page 60 and 61: observational studies on how the de
Page 62 and 63: to understand the deficiencies in t
Page 64 and 65: [24] Damsere-Derry J, Afukaar FK, D
Page 66 and 67: [69] Central Intelligence Agency. T
Page 68 and 69: [111] Geurts K, Wets G, Brijs T, Va
Page 70 and 71: [154] Rosenbloom T, Shahar A, Elhar
Page 72 and 73: 4. Farooq U, Bhatti JA, Siddiq M, M
Page 74 and 75: Appendix 1: Literature review on in
Page 76 and 77: they identified a cluster of long b
Page 78 and 79:
more cost-effective than redesignin
Page 80 and 81:
Table 18. Traffic injury interventi
Page 86 and 87:
Appendix 3: Study I supplementary r
Page 88 and 89:
Appendix 4: Manuscript in preparati
Page 90 and 91:
BACKGROUNDPakistan, located at the
Page 92 and 93:
patients were recorded during their
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This might motivate police officers
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12. Peden M, Scurfiled R, Sleet D,
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Table 1. Traffic injuries reported
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Table 3. Ascertainment of police, a
Page 102 and 103:
Appendix 5: Article published - Stu
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104
Page 106 and 107:
106
Page 108 and 109:
108
Page 110 and 111:
Appendix 6: Article under review -
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1. INTRODUCTIONWith the aging of hi
Page 114 and 115:
A total of 180 crashes were identif
Page 116 and 117:
conspicuity at HWZs in Pakistan. 2
Page 118 and 119:
21. Sobngwi-Tambekou J, Bhatti J, K
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Table 2. Highway work zone crash fa
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122
Page 124 and 125:
ABSTRACTObjectives: Interurban road
Page 126 and 127:
oad). A matched strategy was used t
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SitesOut of 131 crash sites identif
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Similarly, it was shown previously
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Majdzadeh, R., Khalagi, K., Naraghi
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Table 2. Characteristics of Pakista
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Table 4. Factors associated with ha
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Table 21. Situational factors at hi
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Table 23. Situational factors assoc
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