title: Road accident fatality risks for "vulnerable" versus "protected" road users in northern Ghana.
abstract: Road traffic injuries (RTIs) are a serious epidemic that claims more than a million lives across the globe each year. The burden of RTIs is particularly pronounced in Africa and other low- and middle-income countries. The unfavorable disparity of the burden of road trauma in the world is largely attributable to unsafe vehicles, lack of appropriate road infrastructure, and the predominance of vulnerable road users (VRUs) in developing countries. However, little research exists in northern Ghana to highlight the scale and risk of death among road users.
  
  
  
  The objective of this research was to establish the relative risk of death among road users in northern Ghana.
  
  
  
  Crash data from police reports between 2007 and 2011 were analyzed for the Upper Regions of Ghana. Conditional probabilities and multivariable logistic regression techniques were used to report proportions and adjusted odds ratios (AORs), respectively.
  
  
  
  Generally, crashes in northern Ghana were extremely severe; that is, 35% of all injury related collisions were fatal. The proportion of fatal casualties ranged between 21% among victims of sideswipe collisions and 41% among pedestrians and victims of rear-end collisions. Though males were 6 times more likely to die than females overall, females were more likely to die as pedestrians (90% of all female casualty deaths) and males were more likely to die as riders/drivers (78% of all male casualty deaths). Pedestrians were 3 times more likely to die (odds ratio [OR] = 3.1; 95% confidence interval [CI], 2.4 to 4.1) compared with drivers/riders. Compared with drivers, the odds of death among cyclists was about 4 times higher (AOR = 3.6; 95% CI, 2.3 to 5.6) and about 2 times higher among motorcyclists (AOR = 1.6; 95% CI, 1.2 to 2.2). Compared with casualties aged between 30 and 59 years, children under 10 years and those aged 60 years and above were independently 2 times more likely to die in traffic collisions.
  
  
  
  Provision of requisite road infrastructure is vital for the safety of VRUs in northern Ghana. Cycle paths and lanes (for cyclists) as well as sidewalks (for pedestrians) in particular will separate VRUs from motorists and improve their safety. Enforcement of traffic laws particularly regarding helmet use, speeding, and alcohol use will be beneficial. Introduction of the demerit points system in the enforcement of traffic regulations may have significant deterrent effects on road users who have the penchant for violating traffic regulations. Road safety education is also required to create responsible road users.
authors.affiliation: a Queensland University of Technology (QUT), Centre for Accident Research & Road Safety-Queensland (CARRS-Q) , Brisbane , Australia.|b CSIR-Building & Road Research Institute , Kumasi , Ghana.
authors.forename: James
authors.initials: J
authors.lastname: Damsere-Derry
authors.affiliation: a Queensland University of Technology (QUT), Centre for Accident Research & Road Safety-Queensland (CARRS-Q) , Brisbane , Australia.
authors.forename: Gavan
authors.initials: G
authors.lastname: Palk
authors.affiliation: a Queensland University of Technology (QUT), Centre for Accident Research & Road Safety-Queensland (CARRS-Q) , Brisbane , Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: King
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data; D001642:Bicycling / Q000293:injuries*; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D009049:Motorcycles; D000069636:Pedestrians; D011482:Protective Devices / Q000706:statistics & numerical data*; D012306:Risk
keywords: Vulnerable road user; child–pedestrian; child–pedestrian supervision; cyclists; demerit points; enforcement; protected road users