Magnitude, trends, and seasonal variations of road traffic accidents in Ogun State, Nigeria, 2017-2019

Adesoji Olatunde Odukoya^1,2, Magbagbeola David Dairo³, Olukemi Titilope Olugbade^1,4, Celestine Attah Ameh¹, Sufiyan Muawiyyah Babale⁵, Olumide Busuyi Oje-Adetule¹, Olayinka Stephen Ilesanmi¹, Muhammad Shakir Balogun⁶, Uchenna Anebonam⁷

 

¹Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria, ²Department of Veterinary Services and Pest Control, Federal Ministry of Agriculture and Food Security, Abuja, Nigeria, ³Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine University of Ibadan, Oyo State, Nigeria, ⁴Department of Community Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria, ⁵Community Medicine Department College of Medical Sciences, Ahmadu Bello University Zaria, Nigeria, ⁶African Field Epidemiology Network, Abuja, Nigeria, ⁷Emergency, Preparedness, Response Division, Africa Centre´s for Disease Control, Addis Ababa, Ethiopia

 

 

^&Corresponding author
Adesoji Olatunde Odukoya, Department of Veterinary Services and Pest Control, Federal Ministry of Agriculture and Food Security, Abuja, Nigeria

 

 

 

 

Globally, Road Traffic Accidents (RTA) are ranked as one of the eight leading causes of death and by 2030 are projected to rise to one of the top five causes of morbidity and mortality [1]. Approximately, 17 road fatalities per 100,000 population per year are reported globally. It is estimated that road traffic crashes are responsible for 1.4 million deaths and up to 50 million injuries yearly [2,3]. The upward trend in motorization and expansion of road construction brings with it, new challenges in traffic management system, prevention mechanism and rescue systems relating to road traffic accidents [4]. RTA are accidents on the roads involving collisions of vehicles, pedestrians, cyclists, animals, road debris or other stationary objects like trees or utility poles on a way or street open to public traffic [5]. RTA are a major public health and development challenge, as they usually result in injury, death, and property damage [4].

 

Globally, 2.1% of total deaths and 21% of total injuries are due to RTA, with developing and underdeveloped countries including Nigeria accounting for 80% of these deaths [6,7]. The World Health Organization (WHO) Global Status Report on Road Safety for 2015 reported the highest proportion of road fatalities occurred in Southeast Asia for the last decade (approximately one-third of the one million global deaths). The highest number of road fatalities was 334,000 witnessed in the year 2013 [7]. Africa had the highest injury and mortality rate of 28.3 per 100,000 population when compared to Europe with 11.0 per 100,000 population [7].

 

RTA in Africa has been projected to increase in almost triple fold, from 59,000 cases in 1990 to 144,000 cases yearly by 2020 while a decline will be seen in developed countries [8]. The most affected are low and middle-income countries. This is because road traffic crashes and injuries are linked to not only the vehicle numbers, conditions of the road, and behavior of drivers but also to the level of economic and social development of a country [2,3,9]. Predominantly, increased road traffic crashes can be due to poor road infrastructure, inappropriate mixing of vehicle types, inadequate traffic law enforcement and delayed implementation of road safety policies [9]. Statistically, the rate of road traffic injury in Nigeria is about 41 per 1,000 population and death from road traffic injury is estimated as 1.6 per 1,000 population [10]. Studies conducted in Abuja and Lagos in Nigeria with data from the Nigeria Watch database (an online data source) revealed 15,090 lives were lost to 3,075 RTAs cases from 2006-2014, with a probability of rising due to insurgency and population growth [11].

 

The Federal Government of Nigeria established the Federal Road Safety Commission (FRSC) in 1988 due to increasing RTA in the country and their catastrophic effect on the economy and population, with responsibilities of policymaking, organizing and administration of road safety in Nigeria [12]. Despite the establishment of FRSC, studies conducted in different states in Nigeria revealed that road traffic accidents still require crucial attention from all stakeholders to characterize and implement timely interventions [6,10,12]. Routine and appropriate evaluation of the road traffic accidents concerning trends, the probable causes, types of vehicles involved, whether private or commercial, number of persons involved as well as severity of accidents is a criterion for the development of measures aimed at reducing the road traffic accident in Nigeria [12].

 

In 2005, the Ogun State government established a paramilitary outfit named Traffic Compliance and Enforcement Corps (TRACE) and placed it under the Public Order and Safety Sector. The outfit is a social service rendering agency of the state apparatus, to provide three levels of road safety management, namely institutional management, interventions, and results. Ogun State, a highly industrial estate and major manufacturing hub with a network of interstate and intra-city roads that has recorded RTA over the years and has RTA cases that might continue to rise. However, studies on the current trends and causes of RTA in the state are limited [13,14]. This study was conducted to determine the magnitude and trends, identify common causes, and predict projected seasonal variations of RTA in Ogun State, Nigeria.

 

 

Study area

 

Ogun State is located in Southwest Nigeria with an estimated population of 5.2 million (projected from the 2016 National Census), coordinates 7°00'N 3°35'E and a total area is 16,980.55 km² with a density of 220/km² [15]. Ogun State borders Lagos State to the south, Oyo State and Osun State to the north, Ondo State to the east, and the Republic of Benin to the west [15]. It is covered predominantly by tropical rain forest and has wooded savanna in the Northwest [15]. Administratively, the State has three senatorial districts namely Ogun Central, Ogun East and Ogun West, with 20 Local Government Areas (LGAs) [15].

 

In terms of the road network, there are three major expressways in Ogun State namely Lagos-Ibadan expressway, Lagos-Abeokuta Expressway, and the Sagamu-Benin expressway. The vehicular movement on the Lagos-Ibadan expressway is about 2,085 vehicles/hour/lane, while the Abeokuta-Lagos expressway is about 820 vehicles/hour/lane, and the Sagami-Benin expressway is about 1,184 vehicles/hour/lane [16]. This shows high human activities and vehicular movement thereby influencing traffic in the state. Ogun state is notable for being a major manufacturing hub in Nigeria with agriculture as the economic mainstay, influencing the influx of people in and out of the state through major routes in the state [15]. Since there are several manufacturing companies located along the Lagos-Ibadan expressway, Sagamu-Benin expressway and the Lagos-Abeokuta expressway, there is high human activities and vehicular movement especially, during the major festive periods.

 

The causalities of most of the road traffic accidents are referred to the two major government tertiary hospitals in the State: Federal Medical Center at Abeokuta and the Olabisi Onabanjo University Teaching Hospital in Sagamu due to their proximity to the major expressway for management of cases [15].

 

High human activities and vehicular movement are noticed at major Christian institutions during weekly/monthly gatherings at these locations on these expressways. The Redeemed Christian Church of God is located on the Lagos-Ibadan expressway in Obafemi Owode LGA while the Living Faith Church International is located off the Lagos-Abeokuta old road in Ado-Odo Ota LGA in Ogun State [15].

 

The Federal Road Safety Commission (FRSC) has a sector command (RS 2.2) in Ogun State that collaborates with the Traffic Compliance and Enforcement Corps (TRACE) and other stakeholders in emergency response services with their ambulances stationed at different locations on major and minor expressways. FRSC and TRACE help with public education on road safety, enlightenment for road users, law enforcement, rescue services, post-crash care, and road safety management.

 

Study Design

 

We used a cross-sectional study with a parallel convergent mixed-methods design comprising both qualitative and quantitative approaches

 

Data acquisition

 

Authorization to obtain RTA data was sought from the Ministry of Health, Department of Public Health Epidemiology unit. This quantitative part of study covered 3 years of records from January 2017 to December 2019 obtained from TRACE database. Data from TRACE database were extracted using a proforma. For the qualitative part, we conducted Key Informant Interview (KII) with staff of FRSC and TRACE data sections to assess the data quality and bridge the gap between missing data collected. Variables abstracted include gender, local government areas where RTA occurred, monthly number of RTA cases, number of people injured, number of people killed and type of traffic offences associated with the RTA (speeding, using mobile phone, non-use of seat belt, no driver´s license). The KII participants were purposively selected.

 

Data Analysis

 

The data was reviewed and cleaned using Microsoft Office Excel 365. Univariate analysis was conducted on the data to generate proportions and frequencies using Microsoft Office Excel 365. The projected population census data per year was used to calculate incidence by LGAs and case fatality rate (CFR). QGIS 3.12.3 software application was used to generate maps to highlight major road network and RTA cases by LGAs. Epi-info 7 was used to calculate Chi-Square, odds ratios and corresponding confidence intervals for linear trends of offences. Prediction of projected seasonal variations was made using the Additive Decomposition Model.

 

 

The total number of cases of road traffic accidents recorded in Ogun State from January 2017 to December 2019 was 4,611. Of these, 3,533 (76.6%) were recorded as injured cases, 625 (13.6%) as deaths and 453 (9.8%) as either unhurt or not hospitalized cases. The cumulative case fatality rate (CFR) of RTA was 13.6% (625/4,611): Ado-Odo/Ota LGA had the highest CFR of 18.7% (76/407) and Ogun Waterside LGA had the lowest CFR of 4.0% (4/100) (Table 1and Figure 1 ). The Incidence of RTA per 100,000 population was 24.9, (2017), 31.1, (2018), and 25.8, (2019) (Table 1). Obafemi Owode LGA had the highest cases of RTA 1,096 (23.8%) and Imeko-Afon LGA had the lowest cases of RTA 90 (2.0%). The gender distribution of injured cases and deaths from RTA reveals that 2,334 males (66.1%) were injured cases, and 453 males (72.5%) were attributed to deaths (Figure 2). Obafemi Owode LGA had the highest injured cases 752 (21.3%) and the highest deaths 203 (32.5%), while Imeko-Afon LGA had the lowest number of injured cases 77 (2.2%) and Waterside LGA had the lowest deaths 4 (0.7%). The month of December had the highest RTA cases of 479 (10.4%) and June had the lowest RTA cases of 301 (6.5%) (Figure 3). The highest number of injured cases was in December (372, 10.5%) and the lowest number of injured cases was in January (198, 5.6%).

 

The highest number of deaths recorded was in July 73 (11.7%) and the lowest deaths was in June 24 (3.9%). The cumulative number of offences in the period under review is 18,933.

 

Among the offences associated with RTA, speeding accounted for 5,570 (29.4%), use of mobile phone 4,995 (26.4%), non-use of seat belt 4,599 (24.3%), no driver´s license 3,769 (19.9%) (Table 2and Figure 4). Obafemi Owode LGA had the highest for speeding 655 (11.8%) and use of mobile phone 388 (7.8%) while Ado-Odo/Ota LGA had the highest for non-use of seat belt 349 (7.6%), and no driver´s license 350 (9.3%). Ipokia LGA had the lowest for speeding 177 (3.2%) and use of mobile phone 157 (3.1%) while Ijebu East LGA had the lowest for non-use of seat belt 164 (3.6%). Imeko-Afon LGA and Ijebu North LGA had the lowest for no driver´s license 148 (3.9%).

 

Only speeding offence was statistically significantly associated with RTA with an odds ratio 1.52 (95%CI: 1.285-1.795) and P-value of <0.001 using Chi-Square for linear trends (Extended Mantel-Haenszel). All the other offences were insignificant (Table 2). The key informants revealed that the issues and challenges with obtaining high-quality data by road safety officials include inadequate training activities on surveillance of road traffic incidence, and low RTA data collection, low commitment to duty and low motivation. Other challenges on the job include lack of funding, inadequate tools, and equipment for capturing RTA data, poor power supply for prompt reporting RTA, poor working environment, and low financial motivation.

 

Trend analysis of the RTA data from January 2017 to December 2019 reveals steady increase in the number of cases over time and prediction based on the existing data confirms, the preservation of the pattern observed with first quarter of the year has the lowest incidence and fourth quarter reporting the highest incidence (Figure 5).

 

 

This study was conducted in Ogun State, Nigeria to determine the burdens and trends of RTA, identify common causes and predict projected seasonal variations of RTA, with a view to identifying the challenges and developing recommendations. Our review of the assessment of RTA in Ogun State from January 2017 to December 2019 revealed a consistent decrease in the number of road crashes, deaths, injured cases as well as unhurt cases from 2017 to 2018 and then a sudden increase in the number of road crashes, deaths, injured cases as well as unhurt cases for 2019. The spike in RTA cases may be attributed to the increase in vehicular movement during the festive season in December and the massive relocation of people due to insurgency and insecurity as well as movement due to religious activities. Our finding is consistent with a study carried out in Abuja which found that an upsurge in the human and vehicular movement contributes to increase RTA [11]. A similar study in Ethiopia -2015-reported this effect of upsurge on RTA [5]. The consistent decline observed from 2017 to 2018 could be due to less vehicular and human movement or activities. The CFR of RTAs in Ogun State was highest in urban areas LGAs (Ado-Odo/Ota and Obafemi Owode LGAs) where Lagos-Abeokuta old road and Lagos-Ibadan expressway passes through, this finding is consistent with a similar study which found that the majority of the road traffic accidents resulting with death occurs in urban areas [17].

 

Offences associated with RTA (such as speeding, using mobile phone, non-use of seat belt, no driver´s license), which can be attributed to human factors show steady decline from 2017 to 2019 as leading cause of RTA. Studies conducted in Owerri, Imo state, and Oyo States in Nigeria reported similar findings [6,12]. Speeding was the only offence that shows significant linear trend over the years. However, the offence can be controlled by enforcing fines and strict regulations for breaking speed limits, which is a norm in most developed countries. Awareness creation by stakeholders of road safety management and compliances by road users to traffic rules and regulations with strict enforcement with fines is paramount for curbing offences associated with RTA. This further supports the WHO global status report on road safety 2015, which reported that leading causes of RTA are both predictable and preventable and that changing user behavior is a critical component of the holistic “safe systems” approach [7].

 

Our findings are consistent with recent studies statistically that show more men were involved in RTA due to frequent travelling, speeding, carelessness and alcohol influence than women, as more men are directly involved in outdoor activities since meeting the financial needs of the family rest on them more often [18,19,20].

 

The issues and challenges in obtaining high-quality data for RTA reveal that lack of funds contribute more, followed by poor power supply with lack of tools and equipment; poor working environment and no challenge was the least. The lack of encouragement of staff involved in data collection was high. Few of the staff were not trained and the provision of stipends was not available for some staff.

 

The trend analysis of RTA cases in Ogun State for a three-year assessment showed a steady increase in the predicted projection of seasonal variations which further supports the projections that RTA will be among the top five causes of morbidity, disability, and mortality in the world by the year 2030 [1].

 

In carrying out this assessment, the limitation encountered was the use of data obtained from the TRACE and some variables in the dataset were uncaptured, variables not captured were not included in data analysis, but a recommendation suggested for capturing missing variables to be included in the database for future purpose and the Haddon matrix was not applied to RTA Case reporting [21].

 

 

In developing countries, like Nigeria, a lot needs to be done to reduce injuries and mortality associated with road traffic accidents. There is an urgent need therefore to prioritize road safety as a public health emergency. The adoption of a holistic and systems-wide approach to road safety is essential to curtailing injuries and mortality. Assessment of RTA in Nigeria is poorly characterized because database from stakeholders involved in road safety are not robust enough to capture all RTA cases. Road safety interventions such as speed limit adherence and speed breakers, road signs, road markings, road lighting, roadside, and central barriers; health education, curriculum development and law enforcement should include all road users and other stakeholders.

 

The issues and challenges in obtaining high-quality RTA data need to be addressed with provision of adequate tools and equipment, funding, and improved provision of good power supply. Employment of dedicated staff with a good working environment and encouragement on the job is paramount. We found that without timely interventions, the incidences and CFR may increase over the projected period of years.

 

Recommendation

 

We recommended strict enforcement of road safety legislation for offences such as speeding, non-use of seat belts, using mobile phones when driving, and not having a valid driver´s license with fines as appropriate. Frequent sensitization of road users on the importance of obeying traffic rules, using seat belts always, and obtaining valid driver's license from authorized government establishments. Road safety agencies should be more alert in monitoring of road usage and sensitization of road users especially during periods of festivities and harsh weather conditions (rainy season / excessive heat period).

 

Public Health Actions

 

We sensitized the TRACE and FRSC workforce on the importance of enforcing strict rules for the safety of road users, continuous education of drivers on safety tips and compliance with traffic rules to reduce injuries and mortality. We prompted the Epidemiology unit of the Ministry of Health on the need to prioritize regular reporting of RTA by their surveillance officer. We engaged the Commissioner of Health on the relevance of harmonization of RTA data with stakeholders involved in road safety management for decisions and policy-making to reduce RTA.

 

 

The authors declare that there are no competing interests in carrying out this investigation.

 

 

Magbagbeola DD: Reviewed and contributed to abstract, method, results, discussion, and conclusion, Olukemi TO: Reviewed and contributed to topic, abstract, introduction, results, discussion, and conclusion, Celestine AA: Reviewed and contributed to the manuscript during, and after manuscript workshop, Sufiyan MB: Reviewed and contributed to the manuscript during, and after manuscript workshop, Olumide BO: Reviewed and contributed to results and trend analysis, Olayinka SI: Reviewed and contributed to the manuscript after manuscript workshop, Muhammad S.B: Reviewed and contributed abstract and results, Uchenna A: Reviewed and contributed to the manuscript after the manuscript workshop.

 

 

We would like to acknowledge, the Nigeria Field Epidemiology and Laboratory Training Program, Nigeria Center for Disease Control, African Field Epidemiology Network, World Bank, The Regional Disease Surveillance Systems Enhancement Project, Ministry of Health, Department of Public Health, Ogun State, TRACE, FRSC, Federal Ministry of Agriculture and Food Security and head of department of data section TRACE Mr M Ajayi for his contribution to the release of RTA data in a proforma.

 

 

Table 1: Incidence and CFR of RTA in Ogun State, Nigeria: 2017-2019 (Supplementary Table)

Table 2. Chi-Square for linear trend of Offences related to RTA from 2017-2019

Figure 1: Map highlighting CFR of RTAs in Ogun State 2017 to 2019

Figure 2: Gender distribution of deaths and injured RTA cases in Ogun State 2017- 2019

Figure 3: Trends of RTA cases in Ogun State from, 2017 - 2019

Figure 4: Offences associated with RTA from 2017-2019

Figure 5: Trend Analysis of RTA with predicted projections and seasonal variations till 2030

 

 

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