Background All 11 countries of WHO South-East Asia (SEA) region have low or middle income. Motorcycle use is increasing and has become family vehicle with children as passengers. Due to scarcity of epidemiologic information, the pattern of transport accidents in children of hi-income country that majority is pedestrians, was taken as true for low and middle income countries by some experts. They hence believe that children are not affected when motorcycle use increases. This presentation aims to provide evidence from SEA countries that children are affected when motorcycle use increases and call for appropriate actions.

Method A template for secondary data collection was sent to all countries in the Region.

Result Proportion of motorcycles among all registered vehicles in SEA countries except Bhutan, ranged from 50% to 80%. Thailand Sentinel Injury Surveillance 2003–2007 revealed a minimum range of 5065–5718 children injured from riding on motorcycle per year. One year data of two cities in India showed 73% of the child transport accident cases were injured while riding on motorcycles, 55% with head injuries. Sri Lanka data revealed that 34% of all child transport injuries were children riding on motorcycles. Children are affected when motorcycle use increases, especially in middle and low income country. These data are significant early warning sign of silent epidemic. Segregation of data by age in national information systems, appropriate standards, law and enforcement on child helmet, age for children to ride as passenger; and increase of eligible age for moped driving license are urgently needed.