ObjectivesTo conduct a community survey to estimate the degree to which road traffic injuries (RTIs) are under reported and to compare the characteristics of RTI reported to the police to those not reported.DesignA cross-sectional population-based study.SettingKandy district, Sri Lanka.ParticipantsRTIs and deaths during the preceding 12 months were identified through a community-based cross-sectional survey with a sample size of 3080 households. A stratified multistage cluster sampling with population proportion to size was used. ‘Events reported’ to the police were cross checked against events in the police records of the given or adjacent police stations, and either were ‘Events found’ or ‘Not found’. ‘Under reported’ included those ‘Not reported’ and those reported but ‘Not found’ in the police dataset.ResultsInformation about 11 724 persons were obtained from 3080 households, identifying 149 persons who suffered an RTI. Of these, 57% were ‘Events reported’, and of these 43.6% (n=65) were ‘Events found’ in police records (95% CI, 36.0 to 51.6). There were 42 events ‘Not reported’ to police while an additional 7 were ‘Not found’ in the police records of the given police station. Although they were claimed to have been reported to the police, 33% (95% CI 25.8 to 40.7) were ‘Under reported’. There were significant differences in age (p=0.02), family income (p<0.001), road user type (p=0.001), injury severity (p<0.001) and injury category (p=0.01) between ‘Events found’ in the police records and ‘Under reported’ events.ConclusionsIn the Kandy district, 33% of RTIs were ‘under reported’. These findings could be used as evidence for policy planning to prevent RTIs, and highlights the need for a nation-wide community-based survey to determine the true rates of RTI for a better understanding of the reasons for under reporting.

Plantation community referred to as the estate population, are the descendants of Indian migrants. They came to Sri Lanka during the British era to work in estates and had been living with poor facilities. 'Line rooms' have been their residence to date. This is the root cause of most health hazards among the plantation community. Health indicators of this population are not in par with the national figures. Poverty and poor cash management, unsatisfactory living conditions, lack of safe water and sanitary facilities, low level of education, difficult terrain, poor transport facilities with poor access to health care services, and language barriers are some of the major factors affecting their economic and social wellbeing negatively. This community is identified as a vulnerable population in the country, as their health system is unique and different from that in the rest of the country. Plantation community partially receives national health services. Curative health services existing in the estate sector are provided through the estate management in most estates. The existing health system in the plantation sector has evolved over time through various legal enactments, and needs further reforms to standardize the health of this community. It is recommended to integrate the health services in plantation sector into the national health system, and thereby enable the system to function under the provincial health authority equitably as in other sectors.