Background Road Traffic Injury (RTI) in Africa represents 14% of global RTI deaths. Lack of timely, reliable data undermines road safety interventions. Available fatality data are aggregated, limited in detail or scarce in surveys. This is the first fatal RTI surveillance study in Nigeria.

Objective To pilot a systematic mortuary-based data collection in Ibadan, determine the nature and circumstances of fatal RTI and assess data quality against existing data sources.

Methods Using a draft data collection system developed jointly by WHO and Monash University, the detailed information was prospectively collected on RTI University College Hospital mortuary admissions in Ibadan September 2010 to February 2011. Demographics, road user type, counterpart vehicle, intent, manner and medical cause of death were recorded.

Results Mortuary admissions included 80 fatal RTI cases: 81.3% males. By road user category, 28 (35.0%) were pedestrians; 28 (35.0%) motorised 2-wheeler users; 18.8% car occupants; and 11.3% bus occupants. In 70% of cases, medical cause of death was head injury, including 25 of 28 motorised 2-wheeler users (89.3%). Estimates from this study indicate apparent increased mortuary capture of fatal RTI compared with police data.

Conclusions This study demonstrates the feasibility of collecting detailed, timely RTI fatality data through mortuary-based surveillance in Ibadan. While not all RTI deaths are reported to any authority in Ibadan, this large case series complements existing data sources and suggests that pedestrians and motorised 2-wheeler users die most often in road traffic crashes. Frequent head injuries among motorised 2-wheeler users strongly support the need for helmet wearing interventions.