Pedestrian injuries in the most densely populated city in Nigeria-an epidemic calling for control.
OBJECTIVE
Since the first pedestrian road fatality of 1896, pedestrians still remain vulnerable, with fatalities in Africa being 55% of global statistics. Many previous reports from Nigeria have emphasized passengers and drivers over pedestrians; this study was done in the most densely populated Nigerian city with no previous publication exclusively dedicated to pedestrians-the megacity has been projected by the World Bank to be the third largest in the world by 2015 (after Tokyo and Mumbai), so the study results would aid injury control and reduce morbidity and mortality.


METHODS
This is a one-year prospective study on pedestrians attending the surgical emergency room of the busiest referral hospital in Lagos, Nigeria, detailing age, sex, occupation, regions injured, injury mechanism, incident vehicles, highway collisions, and immediate outcomes.


RESULTS
Some 702 pedestrians were seen, including 494 (70%) males with overall peak incidence in the third decade, but the peak incidence among females is lower and in the first decade. Common injuries sustained were to the head (40%), lower limbs (35%), upper limbs (9%), multiple regions (6%), pelvis (3%), and others (7%). Gender differences also were noted-the predominant injury location in males was the head, followed by lower limbs; the opposite was true for females, though both regional injuries were fewer in females than in males. Students were 20% of the entire pedestrians, with nearly half of them injured by a motorcycle. The mechanism of injury included crossing a highway (63%), walking along the pavement (17%), standing by a bus stop (12%), at a shop/house (5%), and others (3%). However, 76% injuries occurred on highways, 22% on inner city roads, and 2% elsewhere. Vehicles included motorcycles (33%), cars (27%), buses (22%), trucks (6%), tricycles (2.4%), and other (9%). Overall fatality was 10% and about half were due to being knocked down by buses and cars.


CONCLUSIONS
This study suggests a high incidence and significant underreporting of pedestrian injuries. A reduction in morbidity and mortality is possible (from head and lower limb injuries) by traffic calming techniques in crossing the highway, especially injuries due to being struck by motorcycles, cars, and buses.
a Department of Surgery , Lagos State University Teaching Hospital , Ikeja , Lagos State , Nigeria.
Babatunde A
BA
Solagberu
Rufai A
RA
Balogun
Ibrahim A
IA
Mustafa
Nasiru A
NA
Ibrahim
Mobolaji A
MA
Oludara
Abdulwahab O
AO
Ajani
Olufemi E
OE
Idowu
Roland I
RI
Osuoji
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D058872:Epidemics; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000706:statistics & numerical data; D009549:Nigeria / Q000453:epidemiology; D011156:Population Density; D011446:Prospective Studies; D017678:Sex Distribution; D016138:Walking / Q000293:injuries*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult
Nigeria; fatality; injuries; motorcycles; pedestrians