title: Pediatric road traffic accident deaths presenting to a Nigerian referral center.
abstract: BACKGROUND
  Road traffic accident (RTA) is a common cause of pediatric trauma death and disability, constituting a worldwide loss of financial resources and potential manpower. This study was designed to determine the causes, prehospital care, presentation, and injuries that resulted in deaths among pediatric victims of RTA in Nigeria, and to make suggestions, based on the study data, to reduce RTA deaths.
  
  
  METHODS
  This is a retrospective analysis of pediatric RTA presenting to a Nigerian referral center. The records of all pediatric RTA between January 2006 and December 2010 at the University of Benin Teaching Hospital were analyzed for age, gender, causes of death, injury, rescue team prehospital treatment, injury to hospital arrival time, clinical condition on arrival, treatment, duration of hospitalization before death, challenges, and postmortem findings.
  
  
  RESULTS
  Twenty-six (18%) of 143 pediatric RTA, comprising 18 males and 8 females, between less than one and 18 (mean 9.3 ± 5.2) years of age died. There was no significant statistical demographic difference observed when 15 (58%) deaths recorded among 67 (46.9%) children involved in motor vehicle accidents were compared with 11 (42%) involved in 76 (53.1%) motorcycle accidents (P = .31). More severe injuries resulting in the majority of deaths were associated with alcohol intoxication (P < .0001). Fourteen (54%) of the deaths were pedestrians, eight of whom were selling wares on the roadside; six were crossing roads that had no traffic signs or traffic control. Of the eight vehicle passengers who died, only two wore seat belts or used pediatric car seats, with no statistical significance compared to those who did not use seat belts or car seats (P = .37). Four of 14 front seat passengers and four of 32 rear seat passengers died (P = .222). Of motorcycle passengers, none of those who wore protective crash helmets died, while four died who were not wearing helmets. Passers-by and sympathizers served as rescuers provided emergency treatment, and presented the victims between one hour and four days after the accidents. Head injury in 14 (54%) cases was the most common cause of death.
  
  
  CONCLUSIONS
  Pediatric RTA deaths in this study were due mainly to preventable causes. There is a need to stress road safety education to children, drivers, the general public and government policy formulators, and to adopt RTA preventive measures in this region of Nigeria.
authors.affiliation: Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria. leadekso@yahoo.com
authors.forename: Osarumwense David
authors.initials: OD
authors.lastname: Osifo
authors.forename: Theophilus Osasumwen
authors.initials: TO
authors.lastname: Osagie
authors.forename: Pius Ehiawaguan
authors.initials: PE
authors.lastname: Iribhogbe
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers