Introduction The aim of this study was to describe the most recent trends and epidemiologic patterns of fatal injuries resulting from explosions in Iraq, one of the countries most affected by violence from explosive devices. Methods Iraqi Ministry of Health (MoH) routine prospective injury surveillance collects information on all fatal injuries recorded by coroners from physical examinations, police reports, and family members in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. This study analyzed explosive-related fatal injuries that occurred from January 1, 2010 through December 31, 2013. Results Analysis included 2,803 fatal injuries. The number of fatal injuries declined from 2010 through 2012, followed by an increase in 2013. One-thousand one-hundred and one explosion-related fatalities were documented in 2013, more than twice as many as in 2012 or in 2011. Most fatalities were among men aged 20–39 years. Of all causalities, 194 (6.9%) were among females and 302 (10.8%) were among children aged less than 18 years. The majority of fatalities were caused by improvised explosive devices (IEDs): car bombs (15.3%), suicide bombs (4.0%), and other IEDs (29.6%). The highest number of fatalities occurred in streets and roads. Of all deaths, 95.6% occurred in three governorates: Baghdad, Ninevah, and Al-Anbar. Conclusions Explosives continue to result in a high number of fatal injuries in Iraq. Following a period of declining violence from explosives, in 2013, fatalities increased. Most explosion-related injuries resulted from IEDs; males aged 20–39 years were at greatest risk.

A secondary data analysis using the Global Status Report on Road Safety (GSRRS) was carried out to assess the epidemiology of road traffic injuries (RTIs) and preventive strategies in the Eastern Mediterranean Region (EMR). EMR countries ranked equal first in the world for the highest number of fatalities due to RTIs (32.2 per 100 000 population). The region had about 4% of the world's vehicles with 0.097 registered vehicles per person. The number of injured cases in EMR was 210.1 per 100 000 population. Only 15% of EMR countries had a funded, independent, multisectoral body for road safety. Only 25% had mandatory seat-belt laws for both front-seat and rear-seat passengers, 60% had mandatory helmet laws for both drivers and passengers of motorized two-wheelers and 10% had child restraint laws. Road safety in EMR countries needs more attention and consideration. RÉSUMÉ Une analyse des données secondaires extraites du Rapport de situation sur la sécurité routière dans le monde a été menée pour évaluer l'épidémiologie des traumatismes dus aux accidents de la circulation et les stratégies de prévention dans la Région de la Méditerranée orientale. Les pays de la Région sont ceux dans lesquels on constate le nombre le plus élevé au monde de décès causés par des traumatismes dus aux accidents de la circulation (32,2 pour 100 000 habitants). La Région possède environ 4 % des véhicules dans le monde avec 0,097 véhicule immatriculé par personne. Le nombre de cas de traumatismes en Méditerranée orientale est de 210,1 pour 100 000 habitants. Seuls 15 % des pays de la Région disposent d'un organisme en charge de la sécurité routière qui soit multisectoriel, indépendant et financé. Ils ne sont que 25 % à avoir promulgué une loi rendant obligatoire le port de la ceinture de sécurité à l'avant comme à l'arrière des véhicules ; 60 % des pays ont une législation sur le port obligatoire du casque pour les conducteurs comme pour les passagers de deux-roues motorisés et 10 % se sont dotés d'une loi sur les dispositifs de retenue pour enfants. Davantage d'attention et de considérations doivent être accordées à la sécurité routière dans la Région de la Méditerranée orientale ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫السابع‬ ‫املجلد‬ ‫العارش‬ ‫العدد‬ 771

BackgroundThe insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. We aimed to describe patterns of road traffic fatalities for all demographic groups and types of road users in Iraq during a period characterized by a resurgence in insurgency activity.MethodsIraqi Ministry of Health routine prospective injury surveillance collects information on all fatal injuries in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. From all injury fatalities documented at the coroner office, we analyzed only those attributed to road traffic that occurred between 1 January 2010 and 31 December 2013. Coroners ascertain information from physical examinations, police reports and family members.ResultsAnalysis included 7,976 road traffic fatalities. Overall, 6,238 (78.2 %) fatalities were male and 2,272 (28.5 %) were children under 18 years of age. The highest numbers of road traffic fatalities were among males 15 to 34 years of age and children of both sexes under 5 years of age. 49.2 % of fatalities occurred among pedestrians. Among children and females, the majority of road traffic fatalities were pedestrians, 69.0 % and 56.6 %, respectively. Fatalities among motorcyclists (3.7 %) and bicyclists (0.4 %) were least common. Rates of road traffic fatalities ranged from 8.6 to 10.7 per 100,000 population.ConclusionsThe injury surveillance system provides the first data from a conflict-affected country on road traffic fatalities disaggregated by type of road user. The highest numbers of fatalities were among children and young men. Nearly half of fatalities were pedestrians, a proportion nearly double that of any neighboring country. As insurgency activity increased in 2013, the number of road traffic fatalities declined.

the present study suggests that RTI is a major cause of childhood death. Injury mortality is higher in boys than in girls. During the period of 1993-2007, there was a dramatic increase in childhood mortality caused by RTI. This study highlights the burden of RTI caused mortalities in children, which requires immediate action.

Smeed's equation is a widely used model for prediction of traffic fatalities but has been found inadequate for use in developing countries. We applied regression analysis to time-series data on vehicles, population and traffic fatalities in the United Arab Emirates (UAE), Jordan and Qatar. The data were fitted to exponential models for fatality prediction, producing an average absolute error of 20.9% for Qatar, 10.9% for Jordan and 5.5% for the UAE. We found a strong linear relationship between gross domestic product and fatality rate.