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Pedestrian injuries in school-attending children: a comparison of injury data sources in a low-income setting
  1. P P S Lee1,2,3,
  2. A Mihailovic1,2,
  3. L Rothman3,
  4. M Mutto4,
  5. M Nakitto4,
  6. A W Howard1,2,3,5
  1. 1
    Department of Surgery, University of Toronto, Toronto, Ontario, Canada
  2. 2
    Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
  3. 3
    Child Health Evaluative Sciences Research Program, Hospital for Sick Children, Toronto, Ontario, Canada
  4. 4
    Injury Control Center, Kampala, Uganda
  5. 5
    Office of International Surgery, University of Toronto, Toronto, Ontario, Canada
  1. Dr W Howard, Room S-107, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; andrew.howard{at}


Objective: To estimate and compare the rate of pedestrian injuries in primary school-attending children of urban Uganda using different data sources.

Design: Data collection from a hospital-based trauma registry, police data, teacher reports, and a cross-sectional community-based survey.

Setting: Kawempe, the largest urban district in the capital Kampala, Uganda.

Patients or subjects: Primary school-attending children aged 4–12 from 39 randomly selected schools were included in the trauma registry, police data, and teacher reports. 1828 households randomly selected from the 39 schools were interviewed for the community survey.

Main outcome measure: A pedestrian injury. For the trauma registry—defined as a pedestrian injury resulting in a visit to the hospital. For the police data—defined as a pedestrian injury reported to the police. For the teacher reports and survey—defined as a pedestrian injury resulting in at least a day off school.

Results: The estimated pedestrian injury rates per 100 000 person-years were 54.0 (95% CI 25.3 to 117.4), <53.97 (95% CI 23.8 to 125.9), 1878.8 (95% CI 1513.1 to 2322.4), and 764.0 (95% CI 523.3 to 1117.2) from the trauma registry, police data, teacher reports, and community survey, respectively.

Conclusions: Pedestrian injury rates differed significantly between different data sources. Users must be aware of the different target populations, definitions, and limitations of the data sources before direct comparisons are made. Injury reports by volunteer teachers may be a feasible source of injury data in other low/middle-income countries.

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  • Funding: The study was funded by a CIHR grant “Child Pedestrian Injuries in Kampala: Data Sources and Determinants.” AM and PPSL were funded by the Department of Surgery at the University of Toronto. PPSL was additionally funded by Auto 21.

  • Competing interests: None.

  • Ethics approval: Ethics approval was obtained from the Hospital for Sick Children and the University of Toronto in Canada.

  • Contributors: AWH conceived and designed the study, and is the guarantor of this paper. AM participated in study design, study implementation, data collection, and data analyses. MM and MN participated in the planning, supervision, and implementation of data collection. PPSL and LR participated in data analyses and manuscript composition. All of the authors critically reviewed the manuscript and approved the final version for publication.