title: A prospective pilot cohort analysis of crash characteristics and pattern of injuries in riders and pillion passengers involved in motorcycle crashes in an urban area in Cameroon: lessons for prevention.
abstract: BACKGROUND
  Low and middle-income countries carry over ninety per cent of the burden of injury related mortality and disability. Motorcycles are gradually becoming a major mode of transportation in Cameroon and other African countries in the absence of an organized public transport. Consequently, the contribution of motorcycle crash to injury-related deaths seems to be on the rise. Currently, data addressing motorcycle crash characteristics, pattern, and severity of motorcycle-related injuries in Cameroon are scarce. We hypothesised that head and limb injuries are the most frequent cause of morbidity and mortality and equally affect riders and pillion passengers.
  
  
  METHODS
  This hospital-based prospective pilot cohort analysis involving 405 motorcycle crashes and 621 injury victims was conducted in Laquintinie Hospital, a large centre located in an urban area in Cameroon. All motorcycle riders and passengers received in the emergency department over a 4 months period with an injury following a traffic related crash were included. Crash characteristics and type, anatomical location and severity of injuries were recorded and analysed comparing the pattern of injuries between riders and pillion passengers involved in motorcyclecrashes. This pilot analysis is expected to propose a snapshot of motorcycle injuries in Douala and will be followed by a larger analysis over a longer period.
  
  
  RESULTS
  We recorded a majority of motorcycle versus car and motorcycle versus motorcycle collisions. Most of these crashes occurred over the week-end and in the night. Helmet use was almost inexistent. We observed that females aged above 40 years represented the majority of pillion passengers. This accounted for the sex-ratio of 1.1/1. A total of 1311 injuries were identified in our patients, giving a mean of 2.1 injuries per victim. The head and the limbs were the most affected anatomical areas. Riders carried a higher risk of sustaining an injury to head and neck than pillion passengers. Riders and pillion passengers carried equal risk of injury to the lower limbs. Emergency room mortality was 4.3 % and riders were more likely to die than pillion passengers.
  
  
  CONCLUSIONS
  This study has identified females aged above 40 years as a special vulnerable group in Douala. It also carries strong messages useful for the implementation of preventive measures and management of patients injured in motorcycle-related crash in general.
authors.affiliation: Faculty of Health Sciences, University of Buea and Regional Hospital Limbe, P.O. Box 25526, Yaoundé, Cameroon. alainchichom@yahoo.com.
authors.forename: Alain
authors.initials: A
authors.lastname: Chichom-Mefire
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon. atashili@yahoo.ie.
authors.forename: Julius
authors.initials: J
authors.lastname: Atashili
authors.affiliation: Surgical Unit, Laquitinie Hospital, Douala, Cameroon. jtsiagad@yahoo.fr.
authors.forename: Jean G
authors.initials: JG
authors.lastname: Tsiagadigui
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon. theclo2007@googlemail.com.
authors.forename: Clovis
authors.initials: C
authors.lastname: Fon-Awah
authors.affiliation: Faculty of Health Sciences, University of Buea, Buea, Cameroon. nkouki2002@yahoo.fr.
authors.forename: Marcelin
authors.initials: M
authors.lastname: Ngowe-Ngowe
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001336:Automobiles; D002163:Cameroon / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D011446:Prospective Studies; D014186:Transportation / Q000379:methods*; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult