Drivers’ risk profile indicates the need for a graduated driving licence in South Africa

Background. Current driver mortality estimates do not consider the great differences in exposure across the population, giving a false impression that driver deaths are lowest in the youngest age group. Interventions to reduce risk among the younger age group include graduated driver licensing (GDL) . a three-phase licensing system for novice drivers consisting of a learnerfs permit, a provisional license, and a full license.Objectives. We calculated driver fatality rates per 10 000 registereddrivers in each age group and assessed the need for stricter licensingconditions for novice and younger drivers. Methods. Age-specific driver mortality rates were calculated using Western Cape Province 2008 mortuary data. The total number of licensed drivers in each age group served as the denominator. Incidence rate ratios were calculated using the age group of 65 - 79 years as the reference. Chi-square test of trendon incidence rate ratios for the age groups was done. Statistical significance was set as p<0.05.Results. There were 339 driver deaths; mean age was 39.4}13.8 years, and males accounted for 80% of the deaths. Age-specific driver mortality rates were highest in the youngest age group (15 - 19 years). There was a significant progressive decrease (except for the age group 45 - 49 years) in the risk of death from road traffic injuries with increasing age compared with the age group .65 years (chi2 for trend p<0.0001).Conclusion. This study showed a relationship between driverfs mortality risk and younger age, and underscores the need for introduction of a GDL programme in South Africa

Establishment of Trauma Registry at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi and Mapping of High Risk Geographic Areas for Trauma.

BACKGROUND: Less attention is directed toward gaining a better understanding of the burden and prevention of injuries, in low and middle income countries (LMICs). We report the establishment of a trauma registry at the Adult Emergency and Trauma Centre (AETC) at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi and identify high risk geographic areas. METHODS: We devised a paper based two-page trauma registry form. Ten data clerks and all AETC clinicians were trained to complete demographic and clinical details respectively. Descriptive data, regression and hotspot analyses were done using STATA 15 statistical package and ArcGIS (16) software respectively. RESULTS: There were 3,747 patients from May 2013 to May 2015. The most common mechanisms of injury were assault (38.2%), and road traffic injuries (31.6%). The majority had soft tissue injury (53.1%), while 23.8% had no diagnosis indicated. Fractures (OR 19.94 [15.34–25.93]), head injury and internal organ injury (OR 29.5 [16.29–53.4]), and use of ambulance (OR 1.57 [1.06– 2.33]) were found to be predictive of increased odds of being admitted to hospital while assault (OR 0.69 [0.52–0.91]) was found to be associated with less odds of being admitted to hospital. Hot spot analysis showed that at 99% confidence interval, Ndirande, Mbayani and Limbe were the top hot spots for injury occurrence. CONCLUSION: We have described the process of establishing an integrated and potentially sustainable trauma registry. Significant data were captured to provide details on the epidemiology of trauma and insight on how care could be improved at AETC and surrounding health facilities. This approach may be relevant in similar poor resource settings