dr.munir baghdad road traffic injuries,epidemiological characteristics, 2010-2011
TRANSCRIPT
Epidemiological Characteristics of Road Traffic Injuries in Baghdad, Iraq, 2010-2011
Dr. Munir T. SalmanIFETP student Cohort 2
A.S. SultanFETP Mentor
F. Al LamiPhD, Resident Advisor
Injury :
A bodily lesion at the organic level, resulting from acute exposure to energy, in amounts that exceed the threshold of physiological tolerance.
Accident: is an unexpected occurrence
which happens by chance.
Injury: is a definable, correctable event,
with specific and identifiable risks for occurrence.
Injuries killingmore than
5 millionpeople worldwide
each year and causing more
cases of disability.
Neuropsychiatric disorders 12%
Respiratory infections 6%
Cardiovascular diseases 10%
Source: World Health Report, 1999WHO
Neuropsychiatric disorders 12%
Respiratory infections 6%
Cardiovascular diseases 10%
Neuropsychiatric disorders 12%
Respiratory infections 6%
Cardiovascular diseases 10%
Road traffic injuries RTI
Globally;
Constitute a major public health.
killed more than 1.2 million, and injured more than 50 million.
The vast majority – 90% – of road traffic deaths were in low-income and middle-income countries, including Iraq, (Despite it has only 48% vehicles of world).
1 Lower respiratory infections
2 Diarrhoeal diseases
3 Perinatal conditions
4 Unipolar major depression
5 Ischaemic heart disease
6 Cerebrovascular disease
7 Tuberculosis
8 Measles
9 Road traffic injuries
10 Congenital abnormalities
1 Ischaemic heart disease
2 Unipolar major depression
3 Road traffic injuries
4 Cerebrovascular disease
5 COPD
6 Lower respiratory infections
7 Tuberculosis
8 War
9 Diarrhoeal diseases
10 HIV
Change in rank order of the 10 leading causes of the global burden of disease
1990 2020
Source; Mathers C, Loncar D. Updated projections ofglobal mortality and burden of disease, 2002-2030:data sources, methods and results.Geneva, World Health Organization, 2005.
1 Lower respiratory infections
2 Diarrhoeal diseases
3 Perinatal conditions
4 Unipolar major depression
5 Ischaemic heart disease
6 Cerebrovascular disease
7 Tuberculosis
8 Measles
9 Road traffic injuries
10 Congenital abnormalities
1 Ischaemic heart disease
2 Unipolar major depression
3 Road traffic injuries
4 Cerebrovascular disease
5 COPD
6 Lower respiratory infections
7 Tuberculosis
8 War
9 Diarrhoeal diseases
10 HIV
Source; Mathers C, Loncar D. Updated projections ofglobal mortality and burden of disease, 2002-2030:data sources, methods and results.Geneva, World Health Organization, 2005.
Change in rank order of the 10 leading causes of the global burden of disease
1990 2020
Objectives:
1- determines RTI vulnerable groups and
risk factors.
2- Characterize RTI in term of person, time
and place.
3- Calculate the reclaim cost.
A cross sectional study of RTI from three sourcesFor two years 2010 – 2011:
1 – Iraq Sentinel Injury Surveillance System (ISISS).
2 - Iraq Road Traffic Police(IRTP) Annual Reports.
3 - Iraqi National Insurance Company(INIC)
archives.
Methods
Iraq Sentinel Injury Surveillance System (ISISS)
6.6%
16.3% 18% 19.6%
39.3%
0
5
10
15
20
25
30
35
40
45
Explosions Domestic incidents
RTI Out side Incidents
Others
Injuries by circumstances, Total cases 128 8442010 – 2011
Iraq Sentinel Injury Surveillance System (ISISS)
6.6%
16.3% 18% 19.6%
39.3%
0
5
10
15
20
25
30
35
40
45
Explosions Domestic incidents
RTI Out side Incidents
Others
Injuries by circumstances, Total cases 128 8442010 – 2011
20%
80%
Total
CO
ER
cases 23 192
4 638
18 554
ISISS: RTI registered cases 8 governorates
CO: coroner, dead cases. ER: emergency cases.
*
*
**
year 2010 - 2011
20%
80%
Total
CO
ER
cases 23 192
4 638
18 554
CO: coroner, dead cases. ER: emergency cases.
*
*
**
Baghdad share was 5900 case
ISISS: RTI registered cases 8 governorates year 2010 - 2011
CO ER
Baghdad 5900 RTI cases By Reporting Site
year 2010 - 2011
74%26%
Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
2010
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
No. of deaths/105
Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
No. of deaths/1052010
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
2010
Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
2010
Governorate No. Of deaths Population MR
1- Baghdad 749 7647482 9.7
2- Al-Basra 61 2032495 3
3- Anbar 166 1660123 10
4- Erbil 276 1707260 16
5- Karballa 125 1000546 12.4
6- Misan 114 889440 12.8
7- Mousel 198 3090611 6.4
8- Sulaimaniya 278 2088018 13.3
No. of deaths/105
The average of MR = 10.45/105
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
2011 No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
The average of MR = 12/105
2011
Governorate No. Of deaths Population MR
1- Baghdad 789 7046029 11
2- Al-Basra 98 2526957 4
3- Anbar 187 1553320 12
4- Erbil NA 1609937 NA
5- Karballa 178 1062934 17
6- Misan 168 968801 17
7- Mousel 231 3258180 7
8- Sulaimaniya 306 1875893 16
No. of deaths/105
RTI Mortality rate in Baghdad and other sentinel governorates for the year 2010 -2011
The average of RTI MR for the 8 sentinel governorate
for the tow years 2010 – 2011
= 11.45/105
The average of RTI MR for the Baghdad governorate
for the two years 2010 – 2011
= 10.3/105
Female Male
Baghdad 5900 RTI case Gender distribution
year 2010 - 2011
19% 81%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Female Male
ER
COCO
ER
Female Male
Baghdad 5900 RTI case Gender distribution
year 2010 - 2011
19% 81%0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Female Male
ER
COCO
ER
1
139 17886 135 145 110 126 83 65
1
262
422 423
1337
984
512
315218 162
0
200
400
600
800
1000
1200
1400
1600
0-0 01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
female male
Baghdad RTI cases distributed by Age groups and
gender, year 2010 - 2011
1
139 17886 135 145 110 126 83 65
1
262
422 423
1337
984
512
315218 162
0
200
400
600
800
1000
1200
1400
1600
0-0 01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
female male
45.6%
15 - 34Baghdad RTI cases distributed by Age groups and
gender, year 2010 - 2011
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
ER
CO
Baghdad RTI cases by death or injury percent
and age group, year 2010-2011
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
01-04 05-09 10-14 15-24 25-34 35-44 45-54 55-64 65-100
ER
CO
Baghdad RTI cases by death or injury percent
and age group, year 2010-2011
0
50
100
150
200
250
300
350
400
450
500
c 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Baghdad RTI cases by daily hours, Year 2010 - 2011
0
50
100
150
200
250
300
350
400
450
500
c 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
10 am 2 pm
Baghdad RTI cases by daily hours, Year 2010 - 2011
DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
Baghdad RTI cases (CO and ER) by DAYS of the week
DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
p-value=0.003
Baghdad RTI cases (CO and ER) by DAYS of the week
CO%
22.4
22.0
23.2
24.6
28.0
28.8
29.2
DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
p-value=0.003
Baghdad RTI cases (CO and ER) by DAYS of the week
p-value=0.003
Baghdad RTI cases (CO and ER) by DAYS of the week
CO%
22.4
22.0
23.2
24.6
28.0
28.8
29.2
DAY CO ER TOTAL
Sunday 201 698 899
Monday 200 709 909
Tuesday 195 646 841
Wednesday 218 669 887
Thursday 223 573 796
Friday 219 541 760
Saturday 214 518 732
Total 1470 4354 5824
115 110 116 106
159123 135 116 116
144 132166
320
399
340
392
335
285239
419457 458
362 356
1 2 3 4 5 6 7 8 9 10 11 12
CO
ER
Baghdad RTI cases (ER vs. CO) by monthly distribution,
Year 2010 - 2011
Months
20102011
3 32
349
868
2082
2568
0
500
1000
1500
2000
2500
3000
Unknown Others Bicycle Motorcycle Car Pedestrain
Baghdad RTI cases by accident’s circumstance 2010 - 2011
43.5%
Baghdad RTI cases By Circumstance and CO Vs. ER 2010 -
2011
0 500 1000 1500 2000 2500 3000
Others
Bicycle
Motorcycle
Car
Pedestrain
CO ER
Ambulance3%
Other Vehicle
96%
Others1%
Unknown0%
Baghdad RTI cases Mode of arrival to health facilities 2010 - 2011
Ambulance3%
Other Vehicle
96%
Others1%
Unknown0%
Baghdad RTI cases Mode of arrival to health facilities 2010 - 2011
6 6 7 9 38 62 190
5584
0
1000
2000
3000
4000
5000
6000
Unknown Farm and countryside
Others Market Public gathering
Workplace Home Street/high way/road
Baghdad RTI cases by place of occurrence 2010 - 2011
6 6 7 9 38 62 190
5584
0
1000
2000
3000
4000
5000
6000
Unknown Farm and countryside
Others Market Public gathering
Workplace Home Street/high way/road
Include 20 coroner cases
(deaths)
16 male
4 female
Baghdad RTI cases by place of occurrence 2010 - 2011
0
100
200
300
400
500
600
700
800
900
other upturned Collision Run over
2010
2011
Baghdad RTI Types of crashes 2010 - 2011
0
100
200
300
400
500
600
700
800
900
other upturned Collision Run over
2010
2011
Baghdad RTI Types of crashes 2010 - 2011
0
200
400
600
800
1000
1200
other passengers road pedestrian car drivers
2010
2011
Baghdad RTI by offender Year 2010 - 2011
0
200
400
600
800
1000
1200
other passengers road pedestrian car drivers
2010
2011
71.3%Baghdad RTI by offender Year 2010 - 2011
0 200 400 600 800 1000
2010
2011
Baghdad RTI by type of vehicle 2010 - 2011
Saloon
Station
Tractor
Bus
Pickup
Trailer
Motorcycles
Others
Vans
Agricultural
equipments
0 200 400 600 800 1000
2010
2011
More than tow fold increase in bus Crashes this might explain the raise in deaths Due to RTI ; 749 deaths 2010789 deaths 2011
Saloon
Station
Tractor
Bus
Pickup
Trailer
Motorcycles
Others
Vans
Agricultural
equipments
Baghdad RTI by type of vehicle 2010 - 2011
CaseNo. of
finished
file
Reclaim cost
(Iraqi dinar)
Deaths 66 326 585 000
Disabilities 45 143 100 000
Total 111 469, 685, 000
~ 375 000 000 US $Source ; INIC (Iraq National InsuranceCompany data )
We obtain data and reclaim cost of 111 file out of 188 case ( 77 file
not finished )
Baghdad RTI Reclaim Expenditure : 2010- 2011
The average of death reclaim
~ 5 000 000 ID ~ 4000 US $
The average of disability reclaim
~ 3 500 000 ID ~ 2900 US $
The INIC reclaim less than 6%
of the 5600 RTI incidents occurred
in Baghdad.
Conclusions
Although the RTI mortality rate was increasing in
Baghdad, it is far below the WHO estimate.
Surveillance database lacks information on risk
factors.
Insurance compensation shows a big deficit.
Multisectoral collaboration is recommended.
More in depth study at national level are indicated.
Thank you