Research Article
Burden of Road Traffic Injuries in Tanzania: One-Year Prospective
Study of Consecutive Patients in 13 Multilevel Health Facilities
Hendry R. Sawe ,
1,2
Sveta Milusheva,
3
Kevin Croke,
3,4
Saahil Karpe,
5
Meyhar Mohammed,
3
and Juma A. Mfinanga
2
1
Department of Emergency Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
2
Department of Emergency Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania
3
Development Impact Evaluation Group, World Bank, Washington, DC, USA
4
Harvard T. H. Chan School of Public Health, Boston, MA, USA
5
Lyft, San Francisco, CA, USA
Correspondence should be addressed to Hendry R. Sawe; hendry_sawe@yahoo.com
Received 23 September 2021; Revised 14 October 2021; Accepted 27 October 2021; Published 10 November 2021
Academic Editor: Piergiorgio Fedeli
Copyright © 2021 Hendry R. Sawe et al. is is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Road traffic injuries (RTIs) pose a severe public health crisis in Sub-Saharan Africa (SSA) and specifically in Tanzania,
where the mortality due to RTIs is nearly double the global rate. ere is a paucity of RTI data in Tanzania to inform evidence-
based interventions to reduce the incidence and improve care outcomes. A trauma registry was implemented at 13 health facilities
of diverse administrative levels in Tanzania. In this study, we characterize the burden of RTIs seen at these health facilities.
Methods. is was a one-year prospective descriptive study utilizing trauma registry data from 13 multilevel health facilities in
Tanzania from 1 October 2019 to 30 September 2020. We provide descriptive statistics on patient demographics; location; share of
injury; nature, type, and circumstances of RTI; injury severity; disposition; and outcomes. Results. Among 18,553 trauma patients
seen in 13 health facilities, 7,416 (40%) had RTIs. e overall median age was 28 years (IQR 22–38 years), and 79.3% were male.
Most road traffic crashes (RTC) occurred in urban settings (68.7%), involving motorcycles (68.3%). Motorcyclists (32.9%) were
the most affected road users; only 37% of motorcyclists wore helmets at the time of the crash. e majority (88.2%) of patients
arrived directly from the site, and 49.0% used motorized (two- or three-) wheelers to travel to the health facility. Patients were
more likely to be admitted to the ward, taken to operating theatre, died at emergency unit (EU), or referred versus being
discharged if they had intracranial injuries (27.8% vs. 3.7%; p < 0.0001), fracture of the lower leg (18.9% vs. 6.4%; p < 0.0001), or
femur fracture (12.9% vs. 0.4%; p < 0.0001). Overall, 36.1% of patients were admitted, 10.6% transferred to other facilities, and
mortality was 2%. Conclusions. RTCs are the main cause of trauma in this setting, affecting mostly working-age males. ese RTCs
result in severe injuries requiring hospital admission or referral for almost half of the victims. Motorcyclists are the most affected
group, in alignment with prior studies. ese findings demonstrate the burden of RTCs as a public health concern in Tanzania and
the need for targeted interventions with a focus on motorcyclists.
1. Background
Road traffic injuries (RTIs) contribute significantly to the
global burden of diseases posing a particularly severe public
health crisis in Sub-Saharan Africa (SSA) and specifically in
Tanzania, where the mortality due to RTIs is nearly double
the global rate [1]. Unfortunately, the latest multicountry
survey reveals that very few countries in the SSA region have
developed systematic emergency medical services (EMS)
and prehospital care systems at scale; this has the potential to
affect the outcomes for road crash victims [2].
In Tanzania, RTIs contribute significantly to the burden
of disease, with significant morbidity and mortality among
accident victims [3–5]. Like most low- and middle-income
countries (LMICs), Tanzania lacks formal trauma care
systems that further contribute to its challenges in
Hindawi
Emergency Medicine International
Volume 2021, Article ID 4272781, 9 pages
https://doi.org/10.1155/2021/4272781