TY - JOUR
PY - 2016//
TI - Road traffic injury prevention initiatives: a systematic review and metasummary of effectiveness in low and middle income countries
JO - PLoS one
A1 - Staton, Catherine
A1 - Vissoci, Joao
A1 - Gong, Enying
A1 - Toomey, Nicole
A1 - Wafula, Rebeccah
A1 - Abdelgadir, Jihad
A1 - Zhou, Yi
A1 - Liu, Chen
A1 - Pei, Fengdi
A1 - Zick, Brittany
A1 - Ratliff, Camille D.
A1 - Rotich, Claire
A1 - Jadue, Nicole
A1 - de Andrade, Luciano
A1 - von Isenburg, Megan
A1 - Hocker, Michael
SP - e0144971
EP - e0144971
VL - 11
IS - 1
N2 - BACKGROUND: Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world's road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap.
METHODS: In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes.
RESULTS: Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention.
CONCLUSION: Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.
Language: en
LA - en SN - 1932-6203 UR - http://dx.doi.org/10.1371/journal.pone.0144971 ID - ref1 ER -