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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Date: Jul 2012

Road traffic crashes in India are the highest in the world, with more than half a million road traffic injuries and 120,000 related deaths each year. Because of these shocking figures, it is imperative that road safety policies and control programs are implemented at both the national and state levels as quickly as possible.

In order to effectively evaluate current policies, as well as formulate and implement new ones for the prevention of road traffic crashes, researchers must have good quality road traffic data.  John Hopkins International Injury Research Unit (JH-IIRU) team members, including Dr. Shivam Gupta and Shirin Wadhwaiya, along with colleagues from the National Institute of Mental Health and Neurosciences, India, address this issue in “Evidence-Based Road Safety Practice in India: Assessment of the Adequacy of Publicly Available Data in Meeting Requirements for Comprehensive Road Safety Data Systems.”

The researchers used the recently published good practices manual on data collection from the World Health Organization (WHO) to compare current publicly available data sources from the National Crime Records Bureau (NCRB) and the Ministry of Road Transport and Highways (MORTH).  The study found that while data at the national level was more comprehensive than at the state level, there is still an urgent need to improve data collection and documentation at all levels, which will make possible continued effective road safety research.

“Evidence-Based Road Safety Practice in India: Assessment of the Adequacy of Publicly Available Data in Meeting Requirements for Comprehensive Road Safety Data Systems,” is part of “Public Health Burden of Road Traffic Injuries: An Assessment from Ten Low- and Middle-Income Countries,” a special issue of Traffic Injury Prevention published by the JH-IIRU as part of the Road Safety in 10 Countries project (RS-10). This landmark publication includes 11 scientific papers jointly authored with 50 colleagues from JH-IIRU and their in-country collaborators that contribute much-needed new knowledge to the burgeoning issue of road traffic injuries in low- and middle- income countries.

You can access the full article along with the entire special issue here.

To find out more about the Johns Hopkins International Injury Research Unit, contact us at IIRU@jhsph.edu.

On Thursday, July 19, 2012, Dr. Rozina Karmaliani of Aga Khan University (AKU), visited the Johns Hopkins International Injury Research Unit (JH-IIRU) to talk about potential collaborations in injury prevention, violence research and long-term consequences of trauma.

Dr. Karmaliani, who was most recently the Interim Dean at the AKU - School of Nursing and Midwifery (SONAM), is an associate professor at both SONAM and in the Community Health Sciences (CHS) Department of AKU.  Dr. Karmaliani began her career as a Community Health Nurse and Preceptor in the CHS department at AKU in 1988 and completed her MPH in Public Health Administration in 1994, her MScN in Public Health Nursing Administration in 1997 and her PhD in Nursing, with a focus on Health Systems, Ethics and Program Evaluation in 2000; all from the University of Minnesota.

Since re-joining AKU in 2001, Dr. Karmaliani has served as the Director of the Post RN BScN (2 year), BScN (4 year) and MScN programs.

While here, Dr. Karmaliani also met with David Peters, Director of the Health Systems Programs in the Department of International Health, as well as key members of the Johns Hopkins School of Nursing, including Dean Martha Hill.

Dr. Karmaliani’s areas of interest include in violence prevention and women and child health and gender equity.

AKU Prof visit
Dr. Daivd Peters, Dr. Rozina Karmaliani and Dr. Adnan Hyder

While it’s well-known that road traffic injuries (RTIs) are one of the leading causes of death and disability worldwide, estimates on the burden of injury in specific countries, especially those in the developing world, are often inaccurate or insufficient.  This is true in Kenya, where estimates quantifying the burden of road traffic injuries exist, but are more than 10 years old, making it difficult to demonstrate the magnitude of the problem to decision-makers in the country. What’s more, as countries like Kenya develop, the number of vehicles increase with the enhancement of road infrastructure. This increase often leads to higher rates of speed which then leads to more RTIs.

In the paper “Road Traffic Injuries in Kenya: The Health Burden and Risk Factors in Two Districts,” members of the JH-IIRU team, including associate directors Abdulgafoor M. Bachani and Kent Stevens, as well as Hadley Herbert, along with colleagues from the Department of Public Health at Kenyatta University in Nairobi and the Ministry of Public Health and Sanitation aim to address this issue.

The goal of the paper was to assess the current status of RTIs in Kenya using police and vital registration records. The team also conducted observational studies of three risk factors—speeding, helmet use and reflective clothing use—in two districts, Naivasha and Thika.

The assessment revealed that the burden of RTIs continues to increase, highlighting the necessity of a renewed effort to address this burden with a focus on incr
easing helmet and reflective clothing use, while enforcing speed limits.

As part of the Road Safety in 10 Countries project (RS-10), in 2012, the Johns Hopkins International Injury Research Unit (JH-IIRU) published “Public Health Burden of Road Traffic Injuries: An Assessment from Ten Low- and Middle-Income Countries,” a special issue of Traffic Injury Prevention. This landmark publication includes 11 scientific papers jointly authored with 50 colleagues from JH-IIRU and their in-country collaborators that contribute much-needed new knowledge to the burgeoning issue of road traffic injuries in low- and middle- income countries.

You can access the full article along with the entire special issue here.

To find out more about JH-IIRU and road safety, contact us at IIRU@JHSPH.edu

More than 626,000 children under the age of 15 die each year due to injuries, with more than 95% of those fatalities occurring in low- and middle-income countries (LMICs).  In sub-Saharan Africa, injuries are especially high and result in approximately 43 deaths per 100,000 children each year. Yet despite this high burden of pediatric injury, there is little data to explain the epidemiology of injury in LMICs. And without proper understanding of the etiology of injuries, researchers cannot adequately address the risk factors for injury and implement injury prevention interventions.

Recently, members of the JH-IIRU team, including  trauma specialist Hadley K. Herbert, associate directors Kent A. Stevens and Abdulgafoor M. Bachani and director, Adnan A. Hyder, along with their colleagues at Childsafe South Africa and Red Cross War Memorial Hospital in Cape Town and the Virginia Commonwealth University Medical Center’s Department of Surgery, address this issue in “Patterns of Pediatric Injury in South Africa: An Analysis of Hospital Data Between 1997-2006,” published in the Journal of Trauma. The paper looks at the patterns of childhood injuries using hospital-based surveillance system in Cape Town, South Africa.

The results indicated that, between 1997-2006, more than 62,000 children presented to the Trauma Unit of the Red Cross War Memorial Children’s Hospital’s (RCH) Casualty Department with almost 69,000 injuries. The majority of injured were males and injuries included falls, road traffic injuries, burns and assaults.

To read more, you can access the paper
here.

To find out more about the JH-IIRU’s work on childhood injuries, email us at IIRU@jhsph.edu



In 2010, the Johns Hopkins International Injury Research Unit (JH-IIRU ) joined a consortium of six partners  to form the Road Safety in 10 Countries Project (RS-10), a five-year initiative funded by Bloomberg Philanthropies  that is dedicated to reducing the burden of road traffic injuries in ten low- and middle-income countries. The partners, including the World Health Organization (WHO), Global Road Safety Partnership (GRSP), the Association for Safe International Travel (ASIRT), EMBARQ, and the World Bank aim to save lives by providing evidence for stronger road safety interventions around the world.

The project is now just over two years old and countries are at various stages of implementation. Recently, Margie Peden, coordinator,
Unintentional Injury Prevention in the Department of Violence, Injury Prevention and Disability at the WHO and Gayle DiPietro, global manager, GRSP, along with JH-IIRU director Adnan Hyder, published an update in Injury Prevention titled, “Two Years into The Road Safety in 10 Countries Project: How are We Doing?”
The paper details enhanced implementation activities related to four of the five pillars described in the
Global Plan for the Decade of Action for Road Safety, including improving the safety of road users through the modification and enforcement of road safety laws combined with social marketing activities (pillar 4).

 “Good laws are fundamental to improving road safety, but enhanced enforcement is a key ingredient to increasing compliance with laws,” said DiPietro.

In Kenya, for example, the project is beginning to see results. In the first observational study, conducted by JH-IIRU, 69.5% of vehicles along Thika highway were found to be traveling above the posted speed limit. One year later, after receiving training by GRSP and speed monitoring equipment by WHO, police officers are beginning to see results, with speeding rates dropping to 54.3%.

“We hope to see this trend continue in 2012,” said Peden. “We plan further social marketing campaigns to dovetail with existing enforcement enhancements.”

The team is hopeful that the encouraging results seen in the first two years will mean the project can expand and include additional implementation sites in the future. This, the team knows, will increase the populations reached and potential lives saved.

To access the paper, click here.

To find out more about the Road Safety in 10 Countries project, contact
IIRU@jhsph.edu, or go online.

To read more about the first two years of the RS-10 Project, click
here.

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