Call for more research on injury from the developing world: Results of a bibliometric analysis.

Background & objectives: Injury prevention is a daunting health challenge as public health systems particularly in the developing world are least prepared to respond to this issue. In 2005, an estimated 5.4 million people worldwide died from injuries over 90 per cent in low- and middle-income countries. The main objective of this bibliometric analysis was to document injury literature published on low- and middle- income countries, and also to quantify literature on road traffic injuries by countries before and after the World Health Day on Road Safety celebrated in April 2004. Methods: A systematic search was done using MeSH terms on PubMed. Papers on road traffic injuries were assessed by country/cluster and by publication date for two periods (March 2001 - March 2004) and (April 2004 - April 2007). The rate of articles published per million population was calculated. Finally, a comparison was made between disease burden in disability adjusted life years (DALYs) and quantum of papers published. The search was performed on April 29, 2007. Results: PubMed had 8.26 million articles listed; of which, 72 per cent were in English and only 2 per cent were on unintentional injuries. For papers in all languages including English on road traffic injuries, 41 per cent were from US, 36 per cent from Europe (other than Eastern Europe). Two most populous countries, China and India contributed only 0.9 and 0.7 per cent papers on road traffic injuries, respectively. On neoplasm there were 280 articles published per million population whereas for road traffic injuries, rate was 4 articles per million population. Northern Africa, India and China had less than one article on road traffic injuries per 1,000 road traffic related deaths. The percentage change in English papers on road traffic injuries for the period 2004-2007 in comparison to period 2001-2004 was +191 per cent for China, +118 per cent for India, and +106 per cent for Middle East. Unintentional injuries overall represented 18 per cent of the burden in terms of DALYs and represented only 2 per cent of all published articles. Interpretation & conclusion: The results noticeably reflected the small proportion of papers on injuries, the dominance of US, and the apparent increase in percentage of road traffic injuries papers from low- and middle- income countries after World Health Day on Road Safety in 2004. Policies on injury prevention and safety in developing countries will be effective if based on local evidence and research, and designed to suit the social, political, and economic circumstances found in developing countries.