Diakonhjemmet Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
Injury. 2021 Apr;52(4):806-813. doi: 10.1016/j.injury.2021.02.028. Epub 2021 Feb 24.
Road traffic injuries are a leading cause of death and disability, especially in low- and middle-income countries. Identifying injury hotspots are valuable for introducing preventive measures. This is usually accomplished by using police data, but these are often unreliable in low-income countries. This study aimed to identify hotspots for injuries by collecting geographical data in the emergency room.
This was a cross-sectional study of adult road traffic injury patients presenting to the Casualty Department in the central hospital in Lilongwe, the capital of Malawi. An electronic tablet with downloaded maps and satellite photos was used to establish the exact location of the injuries. The geographical data were analyzed with geographic information software.
We included 1244 road traffic injured patients, of which 23.9% were car passengers or drivers, 18.6% were motorcyclists, 17.8% were pedestrians and 18.0% were cyclists or bicycle passengers. Heatmaps of the injuries identified 5 locations where the incidence of injuries was especially high, and 148 patients were injured in these hotspots during the 90 days of inclusion. Four of these hotspots were along the main road through the capital. Age over 55, rural setting, alcohol use before the injury, high speed limit at the site of injury and being a pedestrian or motorcyclist were significantly associated with a higher degree of injury severity. Around half of the patients that were injured in a four-wheeled vehicle did not use a seat belt, and these patients had a much higher risk of getting a more severe injury.
We have identified specific locations with a high incidence of road traffic injuries in Lilongwe, Malawi, with a simple methodology and within a short time frame. The study demonstrates the feasibility of collecting geographical data at admission to hospital.
道路交通伤害是导致死亡和残疾的主要原因，尤其是在中低收入国家。确定伤害热点地区对于引入预防措施非常有价值。这通常通过使用警察数据来实现，但在低收入国家，这些数据往往不可靠。本研究旨在通过在急诊室收集地理数据来确定伤害热点地区。
这是一项在马拉维首都利隆圭中心医院急诊科就诊的成年道路交通伤害患者的横断面研究。使用带有下载地图和卫星照片的电子平板电脑确定伤害的确切位置。使用地理信息软件对地理数据进行分析。
我们纳入了 1244 名道路交通伤害患者，其中 23.9%为汽车乘客或司机，18.6%为摩托车手，17.8%为行人，18.0%为骑自行车者或自行车乘客。伤害热图确定了 5 个伤害发生率特别高的地点，在纳入的 90 天内，有 148 名患者在这些热点地区受伤。其中 4 个热点地区位于首都的主要道路沿线。55 岁以上、农村地区、受伤前饮酒、受伤地点限速高以及行人或摩托车手与更高程度的伤害严重程度显著相关。在四轮车中受伤的患者中，约有一半没有系安全带，这些患者受伤更严重的风险要高得多。
我们已经确定了马拉维利隆圭特定地点道路交通伤害发生率较高的位置，采用了简单的方法，在短时间内完成。该研究证明了在入院时收集地理数据的可行性。
