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Appendix 1: Literature review on interurban road injury burden in LMICsMethodsSeveral approaches can be used to review transport safety research such as safety promotionmodel , Haddon’s matrix, and the three ‘E’ (Enforcement, Engineering, and Education) [57,156-158]. For this systematic review, the public health approach was used. Considering, thisinterrelationship of risk factor, crash outcome, trauma care, and their reporting, we reviewedstudies if their objective corresponded with one or more of the following research interests:1. Assessing traffic injury burden (outcome) with respect to age, sex, and road user type.2. Assessing factors associated with outcome.3. Assessing trauma care of crash and injury event and their outcome.4. Assessing reporting mechanism and bias for assessing traffic burden outcomes, riskfactors, and trauma care.5. Assessing the impact of traffic safety interventions.The focus was studies with interurban road settings to document research needs. Originalresearch published in peer-reviewed journals indexed on MEDLINE for a period from Jan1995 to Dec 2009 was included; reviews, editorials, commentaries, and letters to the editorwere excluded. Study title and abstract were searched using the following Medical SubjectHeadings (MeSH): “traffic accident” and “developing countries” or individual names ofLMICs given in “Global Status Report on Road Safety.” Then articles concerning interurbanroads were selected. Articles written in English, French, Portuguese, Spanish, and RomanianLanguage were included if they satisfied the following criteria [159]: objective(s) clearlystated; inclusion criteria given and adequate; ethical standards observed; reliable and validprincipal measures.ResultsA total of 3 663 abstracts were retrieved. After removing double entries and case reports, wewere left with 1 960 study abstracts (Figure 15). After careful search of studies conducted athighway or interurban road settings, 37 abstracts corresponded to our criteria. Full texts of 32studies were available; however, we did not include a study reporting the results of trafficmanagement intervention using simulation methods.Road crash and injury burdenA Kenyan study showed that almost 60% of police-reported injury crashes occurred oninterurban roads [39]. Injuries including fatalities per crash were higher for interurban roads(1.8) than urban roads (1.4). Interurban traffic crash, fatality, and injury per vehicle-km werereported in one Egyptian study only. Average traffic fatality per km was 6 per 100 millionvehicles-km (range 3 to 11) in the precedent three-year period [18]. Injury risk was 35 per 100million vehicle-km (range 29 to 79). Fatality per crash ratio was on average 0.30 (range 0.17-0.43) on Egyptian interurban roads [18]. A Chinese study, where fatalities and daily trafficmeasures were available, showed that fatality could vary from 31.1 to 72.8 per 100 millionvehicle-km travelled on mountainous, un-separated interurban roads [48].Road users involved in these crashes were mostly aged 15-45 years-old and men [22, 31].Although some studies showed that pedestrians [37] and passengers of public transportvehicles [19] were over-involved in highway crashes, road user distribution was almost neverreported.74
Figure 15. Literature available for assessing research needs on interurban traffic safety(1995-2009)Original articlesN=1 960Related to highwayN=37Full text retrievedN=32Qualified for reviewN=31Burden CrashRoad CareN=5 * factors Behaviours EvaluationN=18 * N=9 * N=0InterventionsN=6 ** A research may have been counted for one or more categoriesQuality of RTC reportingOut of 18 studies on crash factors and outcome, nine used police-related sources [18, 19, 21,23, 26, 35, 37, 39, 48]. Among them, crash reports were analyzed in only four studies [19, 21,35, 37]. In three studies, data from traffic agencies was used to assess crash factors, includingtwo where detailed reports were available [28, 40, 45]. Four studies used ambulance-relatedcrash reports which included information on injured patients [30-33]. Emergency department(ED) statistics for assessing RTI burden were used in three studies [22, 40, 43]. Only onestudy used multiple crash data sources but did not assess discrepancies between them [40].Quality of documentation was assessed for ED data, only type of data that showed that seatbeltuse was reported in 27.3%, crash factors in 18.8%, alcohol use in 18.2%, and extricationmethods in 3.1% of crash cases (including highways) reporting to ED [43].Crash types were mostly defined using police or traffic agency specific definitions,international definitions such as the Microcomputer Accident Analysis Package or Externalinjury codes were available in only five studies [19, 30-33]. Further, traffic fatality in all crashburden studies was not defined according to the WHO definition requiring RTI patientfollow-up to 30 days. Similarly, in most studies, injury severity was defined as ‘mild’ mostlywhen treated at crash scene and ‘severe’ when requiring a hospital visit or admission [30-33].Only one study defined injuries by using the New Injury Severity Score (NISS) [36].We found four studies related to identification and reporting of high-risk crash sites oninterurban roads in LMICs [22, 28, 35, 39]. A Kenyan study reported that a total of 145 highrisksites with five or more crashes (N=1 261) were identified on rural road networks in oneyear, but no details were given regarding whether they were defined using Global PositioningSystem (GPS) coordinates or other length measures [39]. A Turkish study showed thatinformation on traffic crashes is mostly recorded in textual form and is not geo-referenced,which could pose problems in their identification and improvement afterwards [28]. Theauthors used GPS coordinates of sites and assessed the usability of this system from a LMICpoint of view. Similarly, the Indian study examined the usefulness of GPS coordinates toidentify specific injury events on a highway [22]. Using hospital data and onsite investigation,75
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Université Victor Segalen Bordeaux
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Publications (peer-reviewed).......
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Index of figuresFigure 1. Traffic f
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AbbreviationsAKUAVCIBMIEASESSDALYDW
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AbstractBackground: Interurban traf
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L'objectif de cette thèse était d
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2. Background2.1 Road injury burden
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2.4 Multiple factors involved in tr
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Figure 4. Percentage difference of
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2.7 Interurban road safety research
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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 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 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
Page 116 and 117: 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
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ABSTRACTObjectives: Interurban road
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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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