Do motorcycle helmets reduce road traffic injuries, hospitalizations and mortalities in low and lower-middle income countries in Africa? A systematic review and meta-analysis

Abstract

Background Studies in Africa have examined the association between helmet use and injury prevention, however, there has been no systematic review to synthesize the literature within an African context nor has there been any meta-analysis examining the effect of helmet use on injury prevention. Methods The review was performed in accordance with the Joanna Briggs Institute for Systematic Reviews. Articles were searched using several databases (e.g. CINAHL, OVID Medline) and select gray literature (e.g. TRID) sources. Articles were included if they were quantitative studies published in English between 2000 and 2019 and examined the association between motorcycle helmet use with head injuries, hospitalizations, and deaths in low- and lower-middle income countries in Africa with comprehensive motorcycle helmet laws. A meta-analysis was performed using pooled effect sizes assessing the impact of helmet use on reducing head injuries. Results After screening 491 articles, eight studies met the inclusion criteria. Helmet use ranged from 0 to 43%. The mean age of being involved in a crash was 30 years with males being two times more likely to be involved in motorcycle crashes than females. Drivers (riders) were more likely to be involved in a crash, followed by passengers and then pedestrians. Helmet use reduced injury severity and provided an 88% reduction in serious head injuries (OR 0.118, 95% CI: 0.014–0.968, p = 0.049). Conclusions In our study, helmet usage significantly reduced the likelihood of fatal head injuries. African countries with no helmet laws should consider adopting helmet use policies to reduce severe head related injuries from motorcycle crashes.

Global, Regional, and National Burden of Road Injuries from 1990 to 2019

“…Road injury is a multifield issue. The use of helmets and seat belts [ 53 ], drink driving bans [ 54 , 55 ], speed limitations [ 56 ], and restrictions on children’s usage of transport have been proven to reduce mortality by 20–40% [ 2 ]. Such approaches are critical to low- and middle-income nations, which account for more than 90% of annual road traffic fatalities and incidents [ 2 , 3 ].…”

“…Such approaches are critical to low- and middle-income nations, which account for more than 90% of annual road traffic fatalities and incidents [ 2 , 3 ]. As previously reported, certain African countries without helmet-related laws should implement helmet use policies to reduce RIs related to motorcycle crashes [ 53 ]. We recommend that legislation in low SDI regions and low-middle SDI regions be further developed around these four elements.…”

Trailblazing Road Safety and Commuter’s “Vision Zero Planning” in NH-55 (Angul Sector)

“…Seatbelt lessens injury severity and saves lives during an accident. Head injuries are not as much of severe on wearing an ISIbranded helmet, in RTAs, where skull injuries are high for bicycle users [54,55].…”

Road Safety of Agglomerating Cities in India– Bhubaneswar

“…The strict implementation of safety standards, use of personal protective equipment (PPES) for motorcyclists, and vehicles like Seat Belts, and auto anti-lock braking system are players in the reduction in RTCs [29]. Other actions for minimization of safety on roads are minimizing the speed controls, construction of pedestrians, footpaths, movement across the zebra crossing, closed drains, use of CCTV cameras at all crucial points, zero stray animals, rule of left-hand drive, and proper signaling, and traffic light with police vigilance and public surveillance on PPP mode during peak hours (Fig.…”