title: Road traffic injuries in Baghdad from 2003 to 2014: results of a randomised household cluster survey.
abstract: Around 50 million people are killed or left disabled on the world's roads each year; most are in middle-income cities. In addition to this background risk, Baghdad has been plagued by decades of insecurity that undermine injury prevention strategies. This study aimed to determine death and disability and household consequences of road traffic injuries (RTIs) in postinvasion Baghdad.
  
  
  
  A two-stage, cluster-randomised, community-based household survey was performed in May 2014 to determine the civilian burden of injury from 2003 to 2014 in Baghdad. In addition to questions about household member death, households were interviewed regarding crash specifics, healthcare required, disability, relatedness to conflict and resultant financial hardship.
  
  
  
  Nine hundred households, totalling 5148 individuals, were interviewed. There were 86 RTIs (16% of all reported injuries) that resulted in 8 deaths (9% of RTIs). Serious RTIs increased in the decade postinvasion and were estimated to be 26 341 in 2013 (350 per 100 000 persons). 53% of RTIs involved pedestrians, motorcyclists or bicyclists. 51% of families directly affected by a RTI reported a significant decline in household income or suffered food insecurity.
  
  
  
  RTIs were extremely common and have increased in Baghdad. Young adults, pedestrians, motorcyclists and bicyclists were the most frequently injured or killed by RTCs. There is a large burden of road injury, and the families of road injury victims suffered considerably from lost wages, often resulting in household food insecurity. Ongoing conflict may worsen RTI risk and undermine efforts to reduce road traffic death and disability.
authors: Department of Surgery, University of Washington, Seattle, Washington, USA School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana Surgeons OverSeas (SOS) and Fogarty International Center (R25-TW009345; D43-TW007267).
authors: Barclay T
authors: BT
authors: Stewart
authors: Department of Community Medicine, Al Munstansiriya University, Baghdad, Iraq Department of Global Health, University of Washington, Seattle, Washington, USA.
authors: Riyadh
authors: R
authors: Lafta
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Megan
authors: M
authors: Cherewick
authors: Human Resources Development and Training Center, Iraq Ministry of Health, Baghdad, Iraq.
authors: Sahar A
authors: SA
authors: Esa Al Shatari
authors: Department of Global Health, University of Washington, Seattle, Washington, USA Institute for Health Metrics and Evaluation, Seattle, Washington, USA.
authors: Abraham D
authors: AD
authors: Flaxman
authors: Department of Global Health, University of Washington, Seattle, Washington, USA Department of Health Services, University of Washington, Seattle, Washington, USA.
authors: Amy
authors: A
authors: Hagopian
authors: Department of Health Sciences, Lakehead University, Thunder Bay, Ontario, Canada.
authors: Lindsay P
authors: LP
authors: Galway
authors: Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA.
authors: Tim K
authors: TK
authors: Takaro
authors: Department of International Health, Center for Refugee and Disaster Response, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Gilbert
authors: G
authors: Burnham
authors: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA Surgeons OverSeas (SOS), New York, New York, USA Department of Surgery, Columbia University, New York, New York, USA.
authors: Adam L
authors: AL
authors: Kushner
authors: Department of Surgery, University of Washington, Seattle, Washington, USA Department of Global Health, University of Washington, Seattle, Washington, USA.
authors: Charles
authors: C
authors: Mock
mesh_terms: D000056:Accident Prevention / Q000331:legislation & jurisprudence / Q000592:standards*; D000063:Accidents, Traffic / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002947:Cities; D016000:Cluster Analysis; D017281:Cost of Illness; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000592:standards; D004779:Environment Design; D005191:Family Characteristics; D005260:Female; D005523:Food Supply / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007493:Iraq / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D000069636:Pedestrians; D011050:Policy Making; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D055815:Young Adult