title: Variations in sub-national road traffic fatality trends in a low-income country.
abstract: BACKGROUND
  In most low- and middle-income countries (LMICs), road traffic fatality (RTF) trends are presented in aggregated form at the national level. This practice omits important information regarding RTF risk at sub-national levels.
  
  
  OBJECTIVE
  This ecological study assesses the extent of RTF variations at different sub-national levels in Pakistan, a low-income country.
  
  
  METHODS
  Based on official statistics, significant variations in three RTF indicators i.e. per population, per registered vehicles, and per crash were compared by regression analyses at two sub-national levels i.e. provincially (2000-2009) and district-wise (2004).
  
  
  RESULTS
  The national RTF counts are based on data from four provinces. From 2000 to 2009, RTF per population and per registered vehicles decreased in all provinces except Balochistan. RTF per crash in Punjab decreased from 0.61 to 0.56 (beta coefficient (β) year = -0.0082, P = <0.001), whereas in Balochistan it increased from 0.40 to 0.58 (β year = 0.0708, P = <0.001) over the same period. District-level comparisons were possible only in Punjab where RTF per crash varied from 0.25 to 2.15 and correlated (β = 0.50, P = 0.003) with RTF per population.
  
  
  CONCLUSIONS
  Sub-national RTF surveillance is necessary in LMICs like Pakistan in order to prioritize available resources on high-risk jurisdictions such as the Balochistan province and districts of Punjab where high RTF per population and per crash exist.
authors.affiliation: Section of Injury and Violence Prevention, Public Health Solutions Pakistan, Lahore, Pakistan ; Addiction Research Program, Douglas Hospital Research Centre, Montreal, Canada.
authors.forename: Junaid A
authors.initials: JA
authors.lastname: Bhatti
authors.forename: Ajmal Khan
authors.initials: AK
authors.lastname: Khoso
authors.forename: Hunniya
authors.initials: H
authors.lastname: Waseem
authors.forename: Uzma Rahim
authors.initials: UR
authors.lastname: Khan
authors.forename: Junaid A
authors.initials: JA
authors.lastname: Razzak
keywords: Balochistan; Punjab; Sindh; Traffic accidents