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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: Aug 2014

Research has shown that the probability of an individual dying or being severely injured in a car crash when not wearing a seatbelt is twice that of an individual who is properly restrained using a seatbelt. Correct usage of a seatbelt can decrease the risk of dying in a vehicle crash by more than 60%, yet the rate of seatbelt-wearing in low- and middle-income countries (LMICs) is dangerously low. This is especially concerning as LMICs experience 90% of all road traffic fatalities. What’s more, the largest proportion of global deaths from road traffic injuries can be found in middle-income countries (MICs). And while four-wheeled vehicle use increases in MICs yearly, seatbelt-wearing rates have not kept pace.

Recently, JH-IIRU team members, as part of the Bloomberg Philanthropies Global Road Safety Program, examined seatbelt wearing rates in four middle-income countries, Egypt, Mexico, Russia and Turkey.

The JH-IIRU team, which included research assistant Andres Vecino-Ortiz, and technical advisor David Bishai, associate director Abdulgafoor Bachani, director, Adnan Hyder, as well as core faculty members Shivam Gupta and Kavi Bhalla, and affiliated members, Aruna Chandran and Ekaterina Slyunkina, examined the prevalence of seatbelt use and associated factors in drivers and front-seat passengers across eight sites within the four countries. The team also established a baseline measurement for future assessments.

Among their results, the team found that the variance of seatbelt use among drivers and front seat passengers may be caused by differences in law enforcement across sites, suggesting that legislation alone is not sufficient to increase seatbelt usage, but rather focus should turn to enforcement as well.

To read all their results, click here.

“Seatbelt wearing rates in middle-income countries: A cross-country analysis,” was published in Accident Analysis and Prevention

On August 6, 2014, JH-IIRU organized and hosted a successful workshop on injury surveillance in Beijing, China as part of the Bloomberg Philanthropies Global Road Safety Program, China.

JH-IIRU team member, research associate Dr. Qingfeng Li, opened the workshop by introducing a few statistical adjustments to the US National Electronic Injury Surveillance System (NEISS), which is a model for the Chinese National Injury Surveillance System (NISS).

The workshop was very well-received, especially the presentation on developing and implementing trauma registries given by Dr. Amber Mehmood, JH-IIRU research associate, as China is in the process of strengthening its trauma registries. Dr. Mehmood’s discussion included a history of the development of trauma registries, their significance as hospital-based injury surveillance tools and examples of trauma registries from high and low income countries. She also discussed challenges in development and implementation of multi-centered registries as well as their role as a quality improvement tool for trauma care.

Bloomberg Philanthropies Global Road Safety Program in-country collaborator, Dr. Leilei Duan was invited to give a lecture on the prospects of a Chinese injury surveillance system.

Twenty-five people from the China CDC, the Suzhou city office, the Dalian city office, and the Zhejiang CDC, as well as Global Road Safety Program consortium partners, the Global Road Safety Partnership (GRPS) and WHO China attended the workshop.

China Workshop
Participants in the Injury Surveillance Workshop

Dr. Qingfeng Li opens the Injury Surveillance Workshop in Beijing, China


For more information on JH-IIRU's work in China, click here

Road traffic injuries (RTIs) are a leading cause of death and disability in Africa. With a rate of 28.3 fatalities per 100,000 population, it’s the highest in the world. What’s more, the economic cost of RTIs on the continent is estimated to be 1-2% of the gross national product. Despite these high numbers, there is little data available on prevention and treatment strategies.  This is true for the central African country of Cameroon, where the number of road traffic deaths has been steadily increasing since the 1970s.

Recently, in an effort to examine road traffic injuries JH-IIRU team members published “Road Traffic Injuries in Yaoundé, Cameroon: A hospital-based pilot surveillance study,” in the journal Injury. The paper looked at patients injured in RTIs who sought care at the main referral hospital in Yaoundé to determine not only the characteristics of those injured but also to identify the associations between these characteristics and outcomes which could be used to improve treatment in Cameroon as well as  other low- and middle-income countries (LMICs). The study provides valuable information about RTIs which the team hopes can be used to improve emergency care in Cameroon and other LMICs and highlights the importance of RTI prevention.

The team included JH-IIRU associate director, Kent Stevens and director Adnan Hyder, and colleagues from WHO Africa, the Ministry of Public Health in Yaoundé, as well as the Department of Surgery at the University of California, San Francisco.  Catherine Juillard, currently in the Department of Surgery at Johns Hopkins Hospital, was a post-doctoral fellow in JH-IIRU when this study was conducted.

This study is part of the unit’s ongoing global work on trauma care.

Read more here

The middle-income countries of Brazil, Russian Federation, India, China, South Africa are collectively known as BRICS and have all recently experienced rapid and considerable economic growth as well as substantial political and social change.

The rapid developments in these countries has led to an increased number of vehicles and an increased complexity of traffic mix which, along with an infrastructure and law enforcement that are struggling to keep pace, appear to be key factors in increasing the number of road traffic injuries (RTIs), both fatal and non-fatal. The BRICS countries already account for approximately 20% of world’s deaths from RTIs and associated economic losses (which are estimated at 1-3% of the countries’ gross domestic products); this number is only expected to increase unless investments in road safety are made.

Recently, JH-IIRU team members, director Adnan Hyder and research assistant Andres Vecino-Ortiz, published, “BRICS: Opportunities to improve road safety” in the Bulletin of the World Health Organization, which examines the relationship between economic growth and road traffic injuries, presents evidence on the current status of road traffic injuries and recommends improvement of road safety monitoring and evaluation.

Their research finds that in order to improve road safety, the five countries must invest in system-wide road safety interventions as well as collect more reliable data in order to track changes in more detail, increase law enforcement and research capacity.   

Read more here.

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