Geospatial distribution of pedestrian injuries and associated factors in the greater Kampala Metropolitan area, Uganda

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In Uganda, pedestrians constitute the largest proportion (43%) of road traffic injuries. Over 52% of these injuries occur in the Greater Kampala. However, information on geospatial distribution of road traffic injuries involving pedestrians and associated factors is limited. We determined the geospatial distribution of pedestrian injuries and associated factors in Greater Kampala Metropolitan Area, Uganda.
We conducted a cross sectional study using a structured questionnaire to interview 332 injured pedestrians at ten health facilities in the three districts of Greater Kampala from 1st/05/2017 to 31st/07/2017. We defined injured pedestrian as a person who was knocked by a motorcycle/vehicle while moving on foot along the road. We used a context modified Australian Walkability Audit Tool to assess road characteristics at the reported injury locations (outcome). The outcome was categorized into three according to primary land use: ‘residential areas’, ‘commercial/business areas’ and ‘bars/entertainment areas’. Injury hotspots were mapped out using Quantum Geographic Information System to generate heat maps and multinomial logistic regression was used to determine adjusted prevalence ratios (APR) at 95% confidence interval.
Males represented 66.5% (221/332) of the sample. Pedestrian injuries were highest among 15-29-year-olds, 45.5% (151/332). In this 3-months study period, most 47.2% (157/332) injuries occurred in commercial/business areas. Places that had the most pedestrian injuries were Namasuba-Zana, 13% (43/332) followed by Nakawa-Kireka on Jinja road, 9.7% (32/332). Presence of speed humps was protective (APR=0.13, 95%CI 0.01-0.93). However, pedestrians at zebra crossings (APR=6.41, 95% CI: 1.14-36.08) and clear roads with no traffic congestion (APR=6.39, 95%CI: 2.75- 14.82) were most likely to be injured.
Similar to some studies, our findings show that pedestrian injuries mostly occur in business and entertainment areas. These findings also show that speed humps are safer for pedestrians, but zebra crossings and clear roads with no traffic jam have a more than 6-fold risk for injuries. There is need for sensitization of motorists to respect zebra crossings and construction of speed humps in markets and other business areas.

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