Objective: Road traffic injuries (RTIs) are a major public health burden, especially in low- and middle-income countries. There is limited data on RTIs in low-volume, rural African settings. This study attempted to survey all individuals living in households within 200 m of two low-volume rural roads in Tanzania and to collect data on RTIs.
Methods: Local communities and users of the Bago to Talawanda road (intervention site) and Kikaro to Mihuga road (control site) were targeted and received an intensive program of road safety measures tailored using the crash characteristics of the baseline sample. Demographic data on all household members were collected, and those individuals who suffered an RTI in the previous 3 months had comprehensive information collected about the crash characteristics and the socioeconomic impact. The follow-up data collection occurred nine months after the baseline data were collected.
Results: The majority of crashes that caused an RTI involved a motorcycle (71%) and the majority of victims were male (82%) with an average age of 27. Injuries to the legs (55%) were most common and the average length of time away from normal activity was 27 (±33) days. RTI incidence at the intervention site increased during the course of the study (incidence before vs. incidence after) and was unchanged in the community control (incidence before vs. incidence after).
Conclusion: The incidence of RTIs in the low-volume rural setting is unacceptably high and most commonly associated with motorcycles. The change in incidence is unreliable due to logistic restraints of the project and more research is needed to quantify the impact of various RTI prevention strategies in this setting. This study provides insight into road traffic injuries on low-volume rural roads, areas where very little research has been captured. Additionally, it provides a replicable study design for those interested in collecting similar data on low-volume rural roads.
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http://dx.doi.org/10.1080/15389588.2014.973491 | DOI Listing |
JMIR Public Health Surveill
January 2025
National Centre for Healthcare Research & Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy.
Background: The centralization of childbirth and newborn care in large maternity units has become increasingly prevalent in Europe. While this trend offers potential benefits such as specialized care and improved outcomes, it can also lead to longer travel and waiting times, especially for women in rural areas.
Objective: This study aimed to evaluate the association between hospital maternity unit (HMU) volumes, road travel distance (RTD) to the hospital, and other neonatal outcomes.
Am J Emerg Med
January 2025
Samaritan Health Services, 2300 NW Walnut Blvd. Corvallis, OR 97330, United States of America. Electronic address:
Introduction: We investigated the extent to which demographic characteristics, clinical care aspects, and relevant biomarkers predicted sepsis-related mortality among patients transferred from a rural, low-volume emergency department (ED) to an urban, high-volume, level-2 trauma center.
Methods: We conducted an observational study among adult severe sepsis patients (N = 242) who, within a community-based regional healthcare system, presented to one of the four rural, low-volume EDs and were subsequently transferred to the urban, high-volume, level-2 trauma center, and were identified as septic at either location. We evaluated in-hospital and 30 days after discharge mortality.
Curr Probl Cardiol
January 2025
Division of Cardiology and the McAllister Heart Institute, University of North Carolina, Chapel Hill, NC, USA. Electronic address:
Background: The development of ST-segment elevation myocardial infarction (STEMI) in patients hospitalized for non-cardiac indications carries a high mortality rate.
Objectives: Determine the impact of rural vs. urban hospital location and hospital percutaneous coronary intervention (PCI) volumes on clinical outcomes.
J Adv Nurs
January 2025
School of Nursing, University of Northern British Columbia, Prince George, British Columbia, Canada.
Aim: To explore the types of barriers that midwives face when practicing or attempting to practice in rural and remote locations.
Design: An integrative review using the Ecological Systems Theory.
Methods: The review was guided by Whitmore and Knafl.
Curr Opin Obstet Gynecol
November 2024
Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Purpose Of Review: Improving maternal health is a clinical and policy priority in the United States. We reviewed recent literature on access to maternity care and impacts on racial and geographic equity.
Recent Findings: New research indicates a wide range of consequences of obstetric unit closures, as well as health challenges for lower-volume obstetric units and those who travel long distances to care.
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