Disability to Admit as a Change of Life after a Road Crash: Estimates and Related Factors in Benin for Prevention

Background: Disability is an underestimated issue in public health, with road crashes as leading cause. In Africa, motorcyclists disproportionately bear the burden of road crash injuries, including disability. To contribute to decision-making for disability prevention, this study aims to determine the prevalence and factors associated with disability at 12 months among motorcyclists involved in road crashes in Benin. Methods: This is a prospective, cross-sectional, analytical study based on 12-month follow-up data from a cohort of road crash victims set up in five hospitals in Benin. Data were collected from November 2020 to January 2021. Sample used for this analysis size was 297 motorcyclists. Disability was assessed using the Washington Group on Disabilities Statistics question set. Logistic regression analysis was used to identify risk factors for disability in victims 12 months after the crash. Results: The prevalence of disability was 12.5% 95% CI (9.2 - 16.7). Disability occurrence was associated with being over 45 years old (OR = 3.1;95% CI = 1.5 - 6.6), severity of initial injury (OR = 3.3;95% CI = 1.5 - 7.3) and hospitalisation of the victim (OR = 6.9;95% CI = 2.0 - 24). Conclusion: Age over 45 years, severity of initial injuries and hospitalisation of the victim were risk factors for the occurrence of disability among motorcyclists who were victims of road crashes in Benin. User awareness, law enforcement, holistic and early management of road crash victims could contribute to reducing the prevalence of disability among victims in Benin.

Key Road Injury Prevention Interventions and Their Effectiveness in Africa: Conclusions and What Can Be Done Better

Introduction: This study aimed to identify road safety interventions implemented in Africa and to analyze their effectiveness in reducing road crashes, injuries, disabilities and deaths. Materials and Methods: This is a systematic review including articles relating to the evaluation of road safety interventions implemented in Africa that were searched on electronic databases: PubMed, Scopus, Lissa, Google Scholar, and African Journals Online. Selection of articles and data extraction was conducted by two pairs of reviewers. Data quality was checked according to the type of study. A qualitative analysis of the data was carried out and a narrative approach was adopted to describe and synthesize the results. Results: A total of twenty-nine articles were selected including one cross-sectional study, seven time series, twenty-one quasi-experimental studies of which six randomised and fifteen non-randomised studies. The type of interventions evaluated was aimed at all types of users and was based on different interventions such as institutional strengthening, law enforcement, awareness raising, training or user education, vehicle maintenance and infrastructure improvements. For fourteen studies all the expected indicators had changed favourably and for twelve the indicators had partially changed. The studies that showed significant change were institutional strengthening, law enforcement, awareness raising, training, or user education interventions, development of Uber transport services, distribution of equipment, and a combination of interventions. Conclusion: This situation is indicative of insufficient policy investment in research but also in the field of road safety in general.

Exploring the Factors Associated with 12-Month Non-Return to Work among Motorcyclists Involved in Road Accidents

Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.

Alcohol, Tobacco and Tramadol Daily Consumption and Road Traffic Crashes among Motorcycle Taxi Drivers in Cotonou (Benin)

Background: In Benin, motorcycle taxi drivers make up a significant portion of road transport. The use of psychoactive substances, a behavior recognized as being at risk of road crashes, is frequent in this group. This study aimed to analyze the association between the consumption of psychoactive substances and the occurrence of road crashes among motorcycle taxi drivers. Methods: This was a cross-sectional study involving 430 motorcycle taxi drivers selected from motorcycle taxi stands in Cotonou (Benin) using a two-stage cluster sampling technique. An interview with a structured questionnaire was used to collect data, which took place in March and April 2019. Alcohol, tramadol, and tobacco were the psychoactive substances considered in this study and their daily use was investigated. A binary logistic regression was used for the analysis. Results: Among the motorcycle taxi drivers surveyed, 27.79% (95% CI = 23.71 - 32.25) were involved in a road crash. The prevalence of psychoactive substances daily use was: 30.41% (95% CI = 26.17 - 35.00) for alcohol, 28.50% (95% CI = 24.37 - 33.02) for tramadol and 4.03% (95% CI = 2.51 - 6.42) for tobacco. Alcohol daily consumption (AOR = 2.09, 95% CI = 1.27 - 3.45, p = 0.004) was associated with a significant risk of road crashes. Conclusion: Interventions aiming to reduce psychoactive substances use should, therefore, be included in road safety policies, especially for this group.

Prevalence and Factors Associated with Psychoactive Substance Misuse among Heavy Goods Vehicle Drivers in Cotonou, Benin

Introduction: In Benin, Heavy Goods Vehicle (HGV) drivers play an essential role in the logistics chain, facilitating the transportation of goods within the country or between other countries in the sub-region. HGV drivers are professionals who experience adverse working conditions, exposing them to risky behaviours, including Psychoactive Substance (PAS) misuse, leading to particularly severe road accidents. This study aimed to determine the prevalence of PAS misuse among HGV drivers and identify associated factors in Cotonou, Benin. Materials and Methods: We conducted a cross-sectional survey involving HGV drivers at parking areas in Cotonou from 26 March to 10 April 2023. The dependent variable was the PAS misuse by HGV drivers, and the independent variables were related to their socio-demographic characteristics, health status and lifestyle habits, and professional characteristics. Data analysis involved determining the prevalence of PAS misuse with a 95% Confidence Interval (95% CI). Subsequently, we identified factors associated with PAS misuse among the participants using multivariate logistic regression. We presented the final regression results as adjusted odds ratios (aOR) with 95% CI. Results: The study included 425 HGV drivers. Among them, 53 (12.47%, 95% CI = 9.64 - 15.98) were misusing PAS. Compared to drivers aged 35 and older, those aged under 25 (aOR = 10.67, 95% CI = 3.56 - 32.03) and those aged 25 to 34 (aOR = 3.47, 95% CI = 1.37 - 8.82) had higher odds of PAS misuse. Drivers with a primary education were less likely (aOR = 0.43, 95% CI = 0.19 - 0.97) to misuse PAS than those with no formal education. Drivers suffering from cardiovascular diseases were also three times more likely (aOR = 3.08, 95% CI = 1.08 - 8.81) to misuse PAS than others. The odds of PAS misuse were also higher among drivers who reported taking breaks than those claiming not to (aOR = 3.11, 95% CI = 1.57 - 6.18). Conclusion: Driving under the influence of PAS is a risk factor for road accidents, associated with other factors highlighted in this study. Addressing these factors in prevention strategies through integrated approaches could lead to more effective results.