Introduction Over 90% of injuries and deaths still occur in low and middle-income countries like Tanzania due to Road traffic accidents. Available literature indicates that Tanzania suffers massive human and economic losses every year from RTAs despite several interventions that have been made to curb this scourge. To gain an insight into the current state of RTAs we examined the pre- historical case fatality rates from RTAs in Ilala and two other municipalities (Kinondoni and Temeke) in Dar es Salaam Region, Tanzania. Methods We conducted a retrospective study using the secondary data on road accidents from Road Accident Information System (RAIS) for the period 2014 to 2018. Results A total of 6,772 road traffic injuries were reported between 2014 and 2018 and the study recorded the highest RTAs in the year 2014 as compared to the other years within the study period. The death rate from RTAs in Ilala Municipality alone was 36.4 per 100,000 population. About 28% of the total fatalities were recorded among the pedestrians, and there was a significant difference (P < 0.05) in the RTAs among the other road users. Conclusion The study recommends the improvement of road transport infrastructure to ensure safety for all the road users by implementing the existing policies, strengthening the enforcement of existing legislation and introducing express penalties on a real-time basis. We encourage the use of this data to develop strategies in Tanzania that protect pedestrians and other vulnerable road users from RTAs.

Road traffic accidents (RTAs) are increasingly becoming a big concern in the public health domain. Globally, RTAs kill 1.35 million people annually, approximately 3700 deaths daily and 20 - 50 million injuries per year. Over 90% of injuries and deaths still occur in low and middle-income countries like Tanzania. Available literature indicates that Tanzania suffers massive human and economic losses every year from RTAs despite several interventions that have been made to curb these. There is need to examine persistent case fatality rates from RTAs in Ilala and other municipalities in Dar es salaam Region in Tanzania to gain an insight into the current state of RTAs. This study was thus, undertaken to assess the challenges of reducing RTAs in in Ilala District, Tanzania from 2014 to 2018 and to assess the progress in curbing road carnage. A cross-sectional research design was employed using questionnaires, interviews and focus group discussions (FGDs) to collect data which was analyzed using both quantitative and qualitative methods. A total of 331 respondents comprising 14 traffic police officers, 102 drivers, 100 motorcyclists, 24 medical personnel, 46 traders, 25 teachers and 20 students provided data for the study. A total of 6772 road traffic injuries were reported between the years 2014 and 2018 and the highest RTAs were recorded for the year 2014. A general downtrend is noted from 15420 accidents in 2014 to 3732 in 2018 in Tanzania; which is equivalent to 76% reduction. In Dar es Salaam city, RTAs reduced from over 6000 in 2014 to almost 2000 in 2018 (67% reduction). About 28% of the total fatalities were recorded for pedestrians, followed by passengers. Responses to timely handling of accidents, community engagement and effects of road accidents were analyzed and four variables age, occupation, education and location were statistically significant at 5% (p<0.05) using a chi square test suggesting that those variables were indeed good explanatory variables. Although significant reduction of RTAs has been recorded in the past four years, there are still substantial number of fatal and non-fatal accidents that can be prevented. Because most of these accidents arise from human errors, concerted efforts are needed in enforcing traffic laws to further reduce this carnage.