The epidemiology of road traffic injury hotspots in Kigali, Rwanda from police data

Abstract Background Road traffic injuries (RTIs) are the eighth-leading cause of death worldwide, with low- and middle-income countries sharing a disproportionate number of fatalities. African countries, like Rwanda, carry a higher burden of these fatalities and with increased economic growth, these numbers are expected to rise. We aim to describe the epidemiology of RTIs in Kigali Province, Rwanda and create a hotspot map of crashes from police data. Methods Road traffic crash (RTC) report data from January 1, 2013 to December 31, 2013 was collected from Kigali Traffic Police. In addition to analysis of descriptive data, locations of RTCs were mapped and analyzed through exploratory spatial data analysis to determine hotspots. Results A total of 2589 of RTCs were reported with 4689 total victims. The majority of victims were male (94.7 %) with an average age of 35.9 years. Cars were the most frequent vehicle involved (43.8 %), followed by motorcycles (14.5 %). Motorcycles had an increased risk of involvement in grievous crashes and pedestrians and cyclists were more likely to have grievous injuries. The hotspots identified were primarily located along the major roads crossing Kigali and the two busiest downtown areas. Conclusions Despite significant headway by the government in RTC prevention, there continue to be high rates of RTIs in Rwanda, specifically with young males and a vulnerable road user population, such as pedestrians and motorcycle users. Improvements in police data and reporting by laypersons could prove valuable for further geographic information system analysis and efforts towards crash prevention and targeting education to motorcycle taxis could help reduce RTIs in a severely affected population

Factors That Drive Dentists towards or Away from Dental Caries Preventive Measures: Systematic Review and Metasummary

<div><p>Background</p><p>Dental caries is a serious public health concern. The high cost of dental treatment can be avoided by effective preventive measures, which are dependent on dentists’ adherence. This study aimed to evaluate the factors that drive dentists towards or away from dental caries preventive measures.</p><p>Methods and Findings</p><p>This systematic review was registered in PROSPERO (CRD42012002235). Several databases as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines, yielding 18,276 titles and abstracts, which were assessed to determine study eligibility. Seven qualitative studies and 41 surveys (36,501 participants) remained after data extraction and interpretation. A total of 43 findings were abstracted from the reports and were grouped together into 6 categories that were judged to be topically similar: education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. The main findings for adherence based on their calculated frequency effect sizes (ES) were teamwork (21%) and post-graduation (12%), while for non-adherence were biologicism (27%), and remuneration for preventive procedures (25%). Intensity ES were also calculated and demonstrated low prevalence of the findings. Quality assessment of the studies demonstrated that the methodological quality, particularly of surveys, varied widely among studies.</p><p>Conclusions</p><p>Despite the questionable quality of the included reports, the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general.</p></div

Publication characteristics of the surveys included in the analysis.

<p>NA: Not available.</p><p>*Mixed methods studies: qualitative and survey</p><p>**Same population; number of participants counted only once</p><p>Publication characteristics of the surveys included in the analysis.</p

Abstracting, formatting, grouping in categories, and frequency effect sizes (ES) of findings.

<p>To conserve space, only the first author is listed.</p><p>Abstracting, formatting, grouping in categories, and frequency effect sizes (ES) of findings.</p

Road traffic injury in sub-Saharan African countries: A systematic review and summary of observational studies

<p><b>Objective</b>: The aim of this study is to evaluate, through a systematic review of hospital-based studies, the proportion of road traffic injuries and fatalities in sub-Saharan Africa (SSA).</p> <p><b>Methods</b>: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology guidelines, we searched the following electronic databases: PubMed, Embase, Africa-Wide Information, Global Health, and Web of Science. Articles were eligible if they measured proportion of road traffic injuries (RTIs) in SSA by using hospital-based studies. In addition, a reference and citation analysis was conducted as well as a data quality assessment.</p> <p><b>Results</b>: Up to 2015, there were a total of 83 hospital-based epidemiologic studies, including 310,660 trauma patients and 99,751 RTI cases, in 13 SSA countries. The median proportion of RTIs among trauma patients was 32% (4 to 91%), of which the median proportion of death for the included articles was 5% (0.3 to 41%).</p> <p><b>Conclusion</b>: The number of studies evaluating RTI proportions and fatalities in SSA countries is increasing but without the exponential rise expected from World Health Organization calls for research during the Decade of Action for Road Traffic Injuries. Further research infrastructure including standardization of taxonomy, definitions, and data reporting measures, as well as funding, would allow for improved cross-country comparisons.</p

Factors that drive dentists towards or away from performing preventive measures.

<p>Graph theory-based figure showing the relation among qualitative studies and surveys included in the metasummary model. Squares represent the individual studies included, and circles the emerging factors. Size of each individual marking indicates its effect size (ES) in the model; larger markings being more recurrent. Studies presenting lower intensity ES (prevalence) appear further from the center, while studies with higher intensity ES closer to the center of the figure.</p

Flowchart showing the number of publications identified, retrieved, extracted, and included in the final analysis.

<p>Flowchart showing the number of publications identified, retrieved, extracted, and included in the final analysis.</p

Publication characteristics of the qualitative studies included in the analysis.

<p>*Same population. Number of participants counted only once.</p><p>Publication characteristics of the qualitative studies included in the analysis.</p

Heat map showing a gradient of quality indicators for each individual survey included in the analysis.

<p>Colors vary from white (No), light blue (Not Clear) and blue (Yes) representing the three categories used in the quality assessment.</p