Motorcycle injuries as an emerging public health problem in Mwanza city, Tanzania: A call for urgent intervention

Abstract

Motorcycle injuries constitute a major but neglected emerging public health problem in developing countries and are a common cause of road traffic injuries. The aim of this study was to establish the prevalence, injury pattern and treatment outcome of motorcycle injuries in our setting. This was a descriptive cross-sectional study of motorcycle injury patients presenting to the A & E department of Bugando Medical centre between March 2009 and February 2010. After informed consent to participate in the study, all patients were consecutively enrolled in the study. Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS computer software version 11.5. A total of 384 motorcycle injury patients were studied constituting 37.2% of all road traffic injuries. 267 patients (69.5%) were males and 117 (30.5%) were females (Male: Female ratio = 2.3:1). The patients’ ages ranged from 4 to 87 years with a mean of 25.7 years and a peak incidence of 21-30 years. The majority of patients were self employed and students accounting for 68.8% and 42.2% respectively. Motorcyclists accounted for the majority of motorcycle injury patients (212, 55.2%), followed by passengers (130. 33.9%) and pedestrians (42, 10.9%). Helmet use was recorded in 87 patients (22.7%). Most patients (352; 91.7%) sustained blunt injuries. Musculoskeletal (extremities) and head injuries were the most common body region injured affecting 234 (60.9%) and 212 (55.2%) patients respectively. The majority of patients (244; 63.5%) were treated surgically. Wound debridement was the most common procedure performed in 212 (86.9%) patients. The overall length of hospital stay ranged from 1 day to 120 days (mean 19.23 days). The LOS for non-survivors ranged from 1 day to 25 days (mean 5.6 days). Patients with major trauma (ISS > 16), severe head injury (GCS 3-8) and those with long bone fractures stayed longer in the hospital and this was significant (p-value < 0.001). Mortality rate was 16.7% (64 deaths). Age of the patient, non-helmeted patients, major trauma (ISS > 16), admission SBP < 90mmHg, severe head injury (GCS < 9), need for ICU admission and need for ventilatory support significantly influenced mortality (p-value < 0.001). Motorcycle injuries constitute a major but neglected emerging public health problem in Mwanza city and continue to be one of the most common cause or agent of road traffic injuries. The morbidity and mortality can be mitigated by encouraging use of protective gear like helmets and encouraging enforcement of traffic laws.