title: Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective surveillance.
abstract: BACKGROUND
  The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. We aimed to describe patterns of road traffic fatalities for all demographic groups and types of road users in Iraq during a period characterized by a resurgence in insurgency activity.
  
  
  METHODS
  Iraqi Ministry of Health routine prospective injury surveillance collects information on all fatal injuries in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. From all injury fatalities documented at the coroner office, we analyzed only those attributed to road traffic that occurred between 1 January 2010 and 31 December 2013. Coroners ascertain information from physical examinations, police reports and family members.
  
  
  RESULTS
  Analysis included 7,976 road traffic fatalities. Overall, 6,238 (78.2 %) fatalities were male and 2,272 (28.5 %) were children under 18 years of age. The highest numbers of road traffic fatalities were among males 15 to 34 years of age and children of both sexes under 5 years of age. 49.2 % of fatalities occurred among pedestrians. Among children and females, the majority of road traffic fatalities were pedestrians, 69.0 % and 56.6 %, respectively. Fatalities among motorcyclists (3.7 %) and bicyclists (0.4 %) were least common. Rates of road traffic fatalities ranged from 8.6 to 10.7 per 100,000 population.
  
  
  CONCLUSIONS
  The injury surveillance system provides the first data from a conflict-affected country on road traffic fatalities disaggregated by type of road user. The highest numbers of fatalities were among children and young men. Nearly half of fatalities were pedestrians, a proportion nearly double that of any neighboring country. As insurgency activity increased in 2013, the number of road traffic fatalities declined.
authors.affiliation: Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F-60, Atlanta, GA 30341 USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Leidman
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road Northeast, Atlanta, GA 30322 USA.
authors.forename: Maret
authors.initials: M
authors.lastname: Maliniak
authors.affiliation: Human Resources Training and Development Center, Ministry of Health, Bab Al Mu'adham Street, Baghdad, Iraq.
authors.forename: Abdul-Salam Saleh
authors.initials: AS
authors.lastname: Sultan
authors.affiliation: Medical Operations and Specialized Services Directorate, Operations Department, Ministry of Health, Al Adham Street, Baghdad, Iraq.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Hassan
authors.affiliation: World Health Organization, International Zone, UNAMI compound, Baghdad, Iraq.
authors.forename: Syed Jaffar
authors.initials: SJ
authors.lastname: Hussain
authors.affiliation: Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F-60, Atlanta, GA 30341 USA.
authors.forename: Oleg O
authors.initials: OO
authors.lastname: Bilukha
keywords: Conflict; Fatal; Injury; Iraq; Road traffic; Surveillance