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THE IMPACT OF INTERVENTIONS FOR
PREVENTING INJURIES AND FATALITIES AMONG
MOTORCYCLISTS IN LOW- AND MIDDLE-INCOME
COUNTRIESResults from Systematic Review: Regulatory and Road Engineering
Interventions for Preventing Road Traffic Injuries and Fatalities among Vulnerable Road Users in Low- and Middle-Income
Countries
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
AGENDA METHODS STUDY RESULTS DATA ANALYSIS OUTLINE OF EVIDENCE CONCLUSION
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
POPULATION Vulnerable Road Users:- Non-motorised road users: Pedestrians, cyclists, rickshaws etc- Motorised two-wheel road users (motorcycles, mopeds, and light mopeds) of all ages Low- and Middle-income Countries
COMPARATOR Compared changes in outcomes before and after the
intervention with or without a control group
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
STUDY DESIGN Randomized Control Trials Non-randomized: Uncontrolled before and after,
Controlled before and after, Time series, Controlled cohort, Uncontrolled cohort, and Case control
Road safety audits were considered if a qualifying intervention study met the inclusion criteria
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle-Income Countries
INTERVENTIONSPopulation level interventions:
Traffic Law Enforcement & Regulatory Road Engineering
This review did not look at Education, Information and Media Advocacy Vehicle design and Post crash/trauma care
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
OUTCOMES Mortality measures
- Road traffic death counts/death rates Morbidity measures
- Number of proportion of severe injuries- Number or proportion of moderate injuries- Number or proportion of road traffic accidents
Secondary outcomes- Compliance- Mean vehicular speed- Mean vehicular conflict
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income CountriesDescription of Studies
Bastos 2005
Bhatti 2011
Chiu 2000
Ichikawa 2002
Liberatti 2001
Nguyen 2013
Panichaphongse 1995
Espitia-Hardeman 2008
Radin Umar 1995a
Radin Umar 2005
Mulyadi 2013
Radin Umar 1995b
Time Series Uncontrolled Before and After
Road Engi
-neeringC
onspicuity - Use
of Daytim
e Head
-lightM
andatory H
elmet U
se
Study Sample size
Bastos 2005 6298 motorcyclists
Bhatti 2011742 motorcyclists and 295 pillion riders
Chiu 20008795 cases of motorcycle related head injuries
Ichikawa 2002 12,002 injured motorcyclists
Liberatti 2001 1837 motorcycle victims
Nguyen 2013 665,428 motorcycle riders
Panichaphongse 1995
4035 injured motorcycle accidents
Espitia-Hardeman 2008 Not available
Radin Umar 1995a3662 motorcycle accidents
Radin Umar 2005 4319 motorcycle accidents
Mulyadi 2013 4700 vehicles per 30 green lights
Radin Umar 1995b4865 motorcycle accidents
DATA ANALYSIS Traffic Law Enforcement & Regulatory Interventions
Outcome changes without a control group before and afterFatalities among Motorcycle Riders – Mandatory Helmet Use
Fatalities declined by 6%, absence of substantial heterogeneity
DATA ANALYSIS Traffic Law Enforcement & Regulatory Interventions
Outcome changes without a control group before and afterInjuries among Motorcycle Riders – Mandatory Helmet Use
Injuries (moderate and severe) declined by 26%
Traffic Law Enforcement & Regulatory Interventions
Outcome changes without a control group before and afterSevere injuries among Motorcycle Riders – Mandatory Helmet Use
Severe injuries declined by 9%, statistically significant
Traffic Law Enforcement & Regulatory Interventions
Outcome changes without a control group before and afterCompliance among Motorcycle Riders – Mandatory Helmet Use
Compliance to mandatory helmet enforcement resulted in eight time more compliance. Statistically significant presence of heterogeneity
Traffic Law Enforcement & Regulatory Interventions
Outcome changes in time series before and afterRoad Traffic Accidents among Motorcycle Riders – Day time Running Headlights
The number of accidents declined post intervention period. Mean percent change in accident declined by 38%. A study Espitia-Hardeman 2008 reported fatalities, Log RR -1.79 (CI -2.60, -0.98). Percent change in accidents -500.65 (CI -1248.43, -165.55)
51%
62%
68%
DATA ANALYSIS Road Engineering Interventions
Effect of Exclusive Motorcycle Lanes Intervention A time-series study, Radin Umar 1995b analysed
motorcycle accident outcomes Road traffic accidents declined by 11%, percent change
-111.80 (CI -492.9, 24.34)Effect of Red Motorcycle Box at Intersection Intervention
A before and after study, Mulyadi 2013 analysed traffic-conflicts and traffic flow at intersections
Traffic conflicts (per 1000 vehicle) declined marginally, standard mean difference -0.23 (CI -0.32, -0.15)
Traffic volume (pce/green light) increased marginally, standard mean difference 0.30 (CI 0.25, 0.35)
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
OUTLINE OF EVIDENCETraffic Law Enforcement & Regulatory Interventions Road traffic crashes resulting in fatalities declined by 6% Road traffic injuries resulting in injuries declined by 26% Mandatory helmet law enforcement resulted in eighth
times more compliance among motorcyclists. Conspicuity related road accidents dropped by 38%Road Engineering Interventions In percent change, accidents declined by 11% as a result
of exclusive motorcycle lanes
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
CONCLUSION AND RECOMMENDATIONS The effect of interventions being implemented
by LMICs demonstrate the initial stages of positive developments
Stringent enforcement of traffic laws & regulatory interventions
In road engineering, segregation of motorcycle riders from motorised vehicles can potentially reduce traffic conflicts
Improved injury surveillance systems on road traffic injuries are required
The Impact of Interventions for Preventing Injuries and Fatalities among Motorcyclists in Low- and Middle- Income Countries
The protocol is registered with the Cochrane Public Health Group and published in Cochrane Liberary
The Systematic Review is funded by the Department for International Development