Helmet Use Among Two-Wheeler Riders' Road Accident Victims in Benin.

BACKGROUND: In Benin, some riders of two-wheeled vehicles still do not wear helmets, the main protection against head injuries in road accidents. The objective of this study is to describe the characteristics of two-wheeled users, and to determine the factors influencing helmet use among this group. METHODS: This is a prospective cross-sectional study of 977 two-wheeled road accident victims from a cohort. Proportions or means were calculated for the different variables. Statistical comparisons were made to test the association with helmet use. Logistic regression modelling was performed to identify factors associated with helmet use. RESULTS: Among all subjects, 81.1% [CI95% (78.5; 83.4)] wore a helmet. Factors explaining helmet use were female gender (OR = 2.8 [1.3-6.1]), purpose of trip (OR = 1.7 [1.1-2.6]), possession of health insurance (OR = 3.7 [1.3-10, 5]), having been driving for 15-20 years (OR = 2.6 [1.4-4.7]) or more than 20 years (OR = 3.4 [2.0-5.8]), good road conditions (OR = 3.1 [2.0-4.8]), and good visibility (OR = 1.9 [1.3-3.1]). CONCLUSION: The factors influencing helmet use are gender, reason for travel, length of time as a driver, possession of health insurance, conditions, and visibility of the road on which the subject are driving. These factors are related to experience and appropriation of the notion of risk, but also related to the environment. To increase helmet use among two-wheelers, helmet awareness should take into account the individual factors found in this study. Enforcement actions should be strengthened, and the quality of the roads improved.

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin.

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8-29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Contribution of a Geographic Information System to the Prevention of Crashes Among Vulnerable Road Users in the City of Cotonou: Exploratory Study.

Purpose: The aim of this study was to determine, using geographic information system (GIS), the spatial characteristics and factors associated with injury crashes among vulnerable road users (VRUs) in Cotonou, Benin. Patients and Methods: This study was based on road crash data collected by the police in Cotonou from 2008 to 2017. Spatial analyses were performed using density method of QGIS cartography software to identify road crash hotspot for VRUs. Logistic regression analysis was conducted using Stata 15 software. Finally, field observations were used to assess the physical characteristics of the road environment at each hotspot. Results: From 2008 to 2017, six main crash hotspots involving VRUs were identified on the roads of Cotonou. The majority were located at intersections of main roads. These sites did not meet the standards for traffic safety for VRUs. Factors associated with injury crashes among VRUs were intersections (adjusted odds ratio (aOR) = 3.3; 95% CI: 1.8-6.1) and pavement condition (aOR = 7; 95% CI: 2.9-17.1). Conclusion: The present study has made it possible to identify the locations on Cotonou's road network where road safety interventions could be implemented to protect VRUs.

Implementation of a model of awareness-raising for taxi motorcyclists in Benin in relation to helmet use: a quasi-experimental study.

BACKGROUND: This study aims to test the effectiveness of an awareness-raising model designed based on the theory of planned behaviour regarding helmet use for motorcycle taxi drivers. METHODS: This quasi-experimental study took place in the cities of Parakou (intervention group) and Porto Novo (control group). Over a three-month period, a package of awareness-raising activities, based on the theory of planned behaviour, have been implemented in the intervention area. Data relate to knowledge, attitudes and practices regarding helmet use was collected prospectively before the intervention, at the end, and 6 months later. Stata 15 was used for data analysis. Chi-square or Fisher, Student's or Kruskal-Wallis tests was carried out. The difference-in-difference method was used to determine the specific effect of the awareness activities. RESULTS: After the intervention, there was an improvement in the total score in both groups compared to baseline. The total score increased by 0.2 (0.06-0.3) in the experimental group when the number of sessions attended increased by one (p = 0.005). The difference-in-difference estimator measured among subjects who attended at least one awareness session, controlling for socio-demographic variables, showed a significantly higher difference in the total score of subjects in the experimental group compared to those in the control group both at the end of the interactive sessions and 6 months later. CONCLUSION: This model improves the helmet-wearing behaviour of motorbike taxi drivers in the experimental area. It could be adapted and applied to other socio-professional groups and other types of users.

Évaluation de la mise en œuvre de la sécurité routière au Bénin en 2019.

OBJECTIVE: The study aims to assess the level of implementation of road safety interventions in Benin. METHOD: The research is based on an evaluative study of road safety aimed to analyze the implementation and logic of road safety interventions, conducted in Benin in 2019. It combined a review of the gray literature and a qualitative component. The data were collected through documents and interviews in structures involved in road safety management. RESULTS: Road safety was a national priority with one lead institution and several structures involved. There was a lack of consensus among stakeholders, insufficient framework documents, resources, legislative texts, and study data. Few roads were in good condition and very few allowed the separation of two-wheeled vehicles. The vehicle fleet was outdated. Various activities were carried out to raise awareness, to educate the population and to enforce the texts but they were insufficient and poorly coordinated. Reference hospitals had the minimum service to deal with trauma cases. The interventions had not yet resulted in a reduction in the number of injuries and fatalities by accidents, which was increasing. CONCLUSION: Benin has made great efforts in the area of road safety. However, there are still some shortcomings to take into account.

Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study.

Purpose: Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals. Materials and Methods: An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05. Results: Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36-29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38-3.33), hospitalization (AOR = 1.87, 95% CI 1.21-2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16-8.25), and no return to work (AOR = 3.17, 95% CI: 1.99-5.06). Conclusion: The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin's hospitals.

Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Effect of wearing a helmet on the occurrence of head injuries in motorcycle riders in Benin: a case-control study.

BACKGROUND: In Benin, motorcycles are the main means of transport for road users and are involved in more than half of crashes. This study aims to determine the effect of wearing a helmet on reducing head injuries in road crashes in Benin. METHODS: This case-control study took place in 2020 and focused on road trauma victims. The sample, consisting of 242 cases (trauma victims with head injuries) for 484 controls (without head injuries), was drawn from a database of traffic crash victims recruited from five hospitals across the country from July 2019 to January 2020. Four groups of independent variables were studied: socio-demographic and economic variables, history, behavioural variables including helmet use and road-related and environmental variables. To assess the shape of the association between the independent variables and the dependent variable, a descending step-by-step binary logistic regression model was performed using an explanatory approach. RESULTS: Fewer of the subjects with a head injury were wearing a helmet at the time of the crash 69.8% (95% CI = 63.6-75.6) compared to those without a head injury 90.3% (95% CI = 87.3-92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5-5.7)); the head injury rating was 1.9 (95% CI = 1.2-3.3) times higher in subjects who were fatigued during the crash than among those who were not and 2.0 (95% CI = 1.2-3.3) times higher in subjects with no medical history. CONCLUSION: Failure to wear a helmet exposes motorcyclists to the risk of head injuries during crashes. It is important to increase awareness and better target such initiatives at the subjects most at risk.

Facteurs associes a l'asthme severe chez les patients asthmatiques suivis au Centre National Hospitalier de Pneumo-phtisiologie de Cotonou (Benin) en 2014

Introduction: la presente etude vise a determiner la frequence de l'asthme severe chez les patients asthmatiques suivis au Centre National Hospitalier de Pneumo-Phtisiologie (CNHPP) de Cotonou et identifier les facteurs de risque qui lui sont associes. Methodes: l'etude transversale; descriptive et analytique a porte sur 213 patients asthmatiques de la file active 2013 du CNHPP. Les donnees ont ete collectees par l'exploitation des dossiers et l'entretien individuel avec les patients. Elles ont ete traitees et analysees a l'aide des logiciels EPIINFO7 et STATA11. Le test Chi2 de Pearson; la regression logistique uni variee et multi variee ont ete utilises au seuil de signification de 0;05. Resultats: au total; 154 patients asthmatiques soit 72;7% ont repondu au questionnaire. Parmi eux 20;8% (IC95% :(14;67 ; 28;05)) souffraient d'asthme severe. L'age des patients s'etendait de 10 a 76 ans avec une mediane de 41 ans; 51;3% etaient de sexe feminin; 79;9% avaient des antecedents d'allergie; 61;7% ont commence leur asthme apres l'age de 12 ans et seuls 11% ont consomme ou consommaient du tabac. Les facteurs associes a la survenue de l'asthme severe etaient : l'age de 46 a 55 ans (p = 0;04) ; les troisieme et quatrieme quintiles du bien-etre economique (p = 0;01) et le debut de l'asthme apres l'age de 12 ans (p 0;001). Conclusion: l'etude a montre une frequence elevee de l'asthme severe au Benin et permettra d'ameliorer sa prise en charge au CNHPP