Epidemiological Study of Road Traffic Accident Cases from Western Nepal

BACKGROUND Road Traffic Accident (RTA) is one among the top five causes of morbidity and mortality in South-East Asian countries.(1) Its socioeconomic repercussions are a matter of great concern. Efficient addressing of the issue requires quality information on different causative factors. RESEARCH QUESTION What are different epidemiological determinants of RTA in western Nepal? OBJECTIVE To examine the factors associated with RTA. STUDY DESIGN Prospective observational. SETTING Study was performed in a tertiary healthcare delivery institute in western Nepal. PARTICIPANTS 360 victims of RTA who reported to Manipal Teaching hospital in one year. STUDY VARIABLES Demographic, human, vehicular, environmental and time factors. STATISTICAL ANALYSIS Percentages, linear and logarithmic trend and Chi-square. RESULTS Most of the victims i.e. 147 (40.83%) were young (15 to 30 years); from low i.e. 114 (31.66%) and mid i.e. 198 (55%) income families and were passengers i.e. 153 (42.50%) and pedestrians i.e. 105 (29.16%). Sever accidents leading to fatal outcome were associated with personal problems (P<0.01, chi(2) - 8.03), recent or on-day conflicts (P<0.001, chi(2) - 18.88) and some evidence of alcohol consumptions (P<0.001, chi(2) - 30.25). Increased prevalence of RTA was also noticed at beginning i.e. 198 (55%) and end i.e. 69 (19.16%) of journey; in rainy and cloudy conditions (269 i.e. 74.72%) and in evening hours (3 to 7 p.m. 159 i.e. 44.16%). Out of 246 vehicles involved; 162 (65.85%) were old and ill maintained. The contributions of old vehicle to fatal injuries were 33 (50%). Head injury was found in 156 (43.33 %) cases and its associated case fatality rate was 90.90%. In spite of a good percentage receiving first aid i.e. 213 (59.16%) after RTA; there was a notable delay (174 i.e. 48.33% admitted after 6 h) in shifting the cases to the hospitals. The estimated total days lost due to hospital stay was 4620 with an average of 12.83 days per each case. CONCLUSION Most of the factors responsible for RTA and its fatal consequences are preventable. A comprehensive multipronged approach can mitigate most of them.