Road Traffic Deaths and Injuries Are Under-Reported in Ethiopia: A Capture-Recapture Method

Abstract

In low and middle income countries road traffic injuries are commonly under-reported. This problem is significantly higher among those less severely injured road users. The objective of this study was to determine the incidence and the level of ascertainment of road traffic injuries and deaths by traffic police and hospital registry. In this study two-sample capture-recapture method was applied using data from traffic police and hospital injury surveillance, through June 2012 to May 2013. The study was conducted on one of the busiest highways in Ethiopia, the Addis Ababa – Hawassa highway. Primary data were collected by accident investigators and hospital emergency nurses using a structured checklist. Four matching variables; name of the victim, sex, place and time of the accidents was used to get the matched cases. During the study period the police independently reported 224 deaths and 446 injuries/billion vehicle kilometer while hospitals reported 123 deaths and 1,046 injuries/billion vehicle kilometer. Both sources in common captured 73 deaths and 248 injuries/billion vehicle kilometer. Taking the two data sources into consideration, the capture-recapture model estimated the incidence of deaths and injuries ranged 368–390 and 1,869–1,895 per billion vehicle kilometer, respectively. The police source captured 57.4%–60.9% of deaths and 23.5%–23.9% of injuries while the hospital sources captured 31.5%–33.4% of deaths and 55.2%–56% of injuries. Deaths and injuries among females, younger age victims, cyclists/motorcyclists and pedestrians were under-reported by traffic police. In conclusion neither of the two sources independently provided accurate coverage of road traffic incident related deaths and injuries. Strengthening both systems is necessary to obtain accurate information on road accidents and human causalities.

The epidemiology and hotspots of road traffic injuries in Moshi, Tanzania: An observational study

“…Although alcohol positive, speeding and poor light conditions have been associated with increased risk of injury severity in studies performed in Ethiopia and Kenya 23,27 , these factors were not associated with increased risk of grievous injury in this study. The reasons for this discrepancy are not clear, but could be a reflect of the overall lack of infra-structure of Tanzanian roads and the reporting method, which makes it harder to identify alcohol use, time of crash or driving behavior.…”

“…It is uncertain whether missing data were truly non-random. Previous studies have shown under-reporting of RTIs to police in low and middle income countries 27,35 , but to date there have been no quality assessments of the Moshi, Tanzania police data. Similarly, completeness of the police data was a challenge.…”

The burden of road traffic injuries in an emergency department in Addis Ababa, Ethiopia

“…21 This means that there are no reliable baseline data that can be used to monitor the implementation of measures aimed at reducing RTIs and to monitor the coverage of pre-hospital and hospital care for RTI victims.…”

Estimating mortality from external causes using data from retrospective surveys: A validation study in Niakhar (Senegal)

“…In such countries, CRVS data is frequently incomplete and/or include large numbers of deaths attributed to unknown causes . Other data sources on injuries and accidents include police reports and hospital records, but both sources are affected by under-reporting (Abegaz et al 2014;Sanghavi, Bhalla, and Das 2009;Sango et al 2016). For example, large numbers of accident victims may never be transported to a hospital.…”