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5. Analytical StudiesPrevious literature from LMICs, and results from the Cameroon study consistently showed alower contribution of situational factors in crashes than those reported in studies from HICs[49]. Nevertheless, we observed that some situational factors were frequently observed atcrash sites. We thought it interesting to assess situational factors associated with injury crashsites on Yaoundé-Douala road section by case-control study, a method never used previouslyto assess such contributions (Study III). Similarly, a high crash fatality associated with roadsection undergoing maintenance, made interesting for us to assess such burden and compare itwith that of normal traffic using historical cohort study methods (Study IV). Both of theabove studies showed that crash circumstances could be better explained when driver- andsituation-related factors are considered simultaneously. This suggested us to develop and testa novel method to assess interactions between hazard perception and situational factors athigh-risk crash sites in voluntary Pakistani drivers (Study V).5.1 Study III: Situational factors at traffic crash sites: a case-control studyon Yaoundé-Douala road section, CameroonSituational factors play an important role in determining risk and severity of an RTC [60].Improving road design for instance, can decrease crash risk by increasing road network abilityto compensate for driving errors [62]. Similarly, installation of side impact barriers at curvesor removal of solid objects reduces crash severity. It is estimated from crash data of HICs thatimplementing road interventions can reduce 20% of the preventable RTCs [49].Installation of road interventions in LMICs is often not effectively advocated, due tounderreporting of involved situational factors at crash sites [50]. As discussed earlier, policereports are the most common RTC surveillance mechanism in LMICs, but they tend to focusonly on road user-related crash factors (Figure 5, page 19). In countries like Botswana, India,and Zimbabwe, road factors were reported in only one percent of crashes [7]. Our results fromCameroon showed that road situational factors were identified in less than 5% of interurbanroad crashes. A similar proportion was observed for interurban crashes in Pakistan [89].These proportions were certainly less than the expected involvement of such factors incrashes as shown in the USA and Great Britain [55].Moreover, previous traffic safety research in LMICs focused more on transient factors such ascrash time or adverse weather conditions [90]. It was observed that, when situational factorswere reported as a crash cause, adverse weather or reduced visibility were identified in overhalf of these crashes [89]. In LMICs, police are not trained to report road factors, informationessential to advocate and implement local as well as area-wide road interventions [7, 91]. Wefound only one cross-sectional study from Brazil, showing that road surface conditions weresignificantly associated with injury crashes on interurban roads [21]. Involvement andcontribution of modifiable situational factors other than weather conditions is rarelyinvestigated in LMICs, particularly using case-control methods [90, 92].36
ObjectivesThe objectives of this study were:1. To assess situational factors associated with injury crashes sites on an interurban roadsection in Cameroon.2. To assess attributable risk proportion for such crash factors.This study has been published as: Bhatti JA, Sobngwi-Tambekou J, Lagarde E, Salmi LR.Situational factors associated with road traffic crashes: A case-control study on the Yaounde-Douala road section, Cameroon. International Journal of Injury Control and SafetyPromotion 2010 Mar 30:1-8 (Appendix 5).I contributed principally in data collection from videos, analysis, interpretation of results, andmanuscript writing.MethodsDesign and settingThis case-control study was conducted on the Yaoundé-Douala road section. This 243-km,undivided, mostly two-lane road connects the two most populated cities (over one millioninhabitants each); Yaoundé at 750 m above sea level and Douala, the port city. This roadsection passes through several smaller towns (
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 28 and 29: Injury outcome patternsMost of inju
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 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
Page 94 and 95:
This might motivate police officers
Page 96 and 97:
12. Peden M, Scurfiled R, Sleet D,
Page 98 and 99:
Table 1. Traffic injuries reported
Page 100 and 101:
Table 3. Ascertainment of police, a
Page 102 and 103:
Appendix 5: Article published - Stu
Page 104 and 105:
104
Page 106 and 107:
106
Page 108 and 109:
108
Page 110 and 111:
Appendix 6: Article under review -
Page 112 and 113:
1. INTRODUCTIONWith the aging of hi
Page 114 and 115:
A total of 180 crashes were identif
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conspicuity at HWZs in Pakistan. 2
Page 118 and 119:
21. Sobngwi-Tambekou J, Bhatti J, K
Page 120 and 121:
Table 2. Highway work zone crash fa
Page 122 and 123:
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
Page 130 and 131:
Similarly, it was shown previously
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Majdzadeh, R., Khalagi, K., Naraghi
Page 134 and 135:
Table 2. Characteristics of Pakista
Page 136 and 137:
Table 4. Factors associated with ha
Page 138 and 139:
Table 21. Situational factors at hi
Page 140 and 141:
Table 23. Situational factors assoc
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