Epidemiology of road traffic accidents in Lusaka, Zambia : trends, risk factors and countermeasures
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- Institutt for geografi 
Road traffic accidents are major causes of morbidity and mortality. It is projected that by 2020 they will be 3rd leading cause of global disease burden. Less developed countries like Zambia account for about 85% of the world’s road traffic fatalities and have had increasing trends. The situation is worse in urbanized cities, like Lusaka, characterized by high densities of both vehicle and human population. This is an epidemiological approach to road traffic accidents in Lusaka, Zambia focusing on trends, risk factors and counter-measures. The main objectives of this study were to examine the trends between 2008 and 2012; to identify factors contributing to risk-taking behavior which is associated with causes of road crashes; to investigate how socio-demographic characteristics influence risk taking behavior and to explore counter-measures that can be adopted by relevant authorities in reducing road traffic accidents. Identification of risk factors, data interpretation and discussion are based on knowledge drawn from the System Theory in road traffic accident causation, model for traffic accident causation, Risk Theory of accident causation and Geographical approach to road traffic accidents. The triangulation (quantitative and qualitative ) approach which encompassed multiple methods of data collection included self-reporting questionnaire with 155 stratified and quota sampled respondents, semi-structured interviews with five key informants, register based statistics, video and media text analyses and simple personal observation. This study found that road traffic accident trends increased by about 4% between 2008 and 2012. Pedestrians and passengers, as vulnerable road users, accounted for 82% of total casualties and females had the most involvement in casualties as pedestrian and passengers while males were involved as drivers. This study has also found that road traffic accidents have multiple causation (risk) factors categorized as vehicle element factors: poor brake system, worn out tires, lack of protective devices (air bags and seat belts); human behavior factors: rule violation such as speeding , driving and drinking, non-use of seat belts(drivers and passenger), pedestrians crossing roads at undesignated point, bus drivers picking passengers at places other than bus stops; environmental factors: poor road design which has no pedestrians and cyclist lanes in most places, few or no road signs, lack of traffic calming system (speed limits, humps, narrow roads), general traffic mix of road users and traffic regulation and enforcement factors: weak or inadequate enforcement especially in training of drivers and issuance of driving license, checking vehicle fitness. Specific socio-demographic risk factors identified include being male, young(less than 29 years), being single (never married). Attitude towards rule violation, age and gender were found to be good predictors of drivers’ behavior (watchful and cautious driving, inattentive driving and drinking and driving and non-use of seat belts). Field work limitations include bureaucratic procedures in public institutions which led to delayed access to required data, manually kept OPD records at University Teaching Hospital took more time to sort required data. RTSA and Zambia police service data was based on reported accidents giving possibility of under reporting and non-reporting of some accidents. Self-reporting questionnaire had possibilities of respondents reporting good behavior and yet in reality they could violate traffic rules. To overcome these limitations, this study used multiple methods to explore information and to have a comprehensive picture of risk factors and road traffic accident situation in Lusaka.