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Original research
Comparing estimates of road traffic deaths and non-fatal road traffic injuries in Cambodia
  1. Hialy Gutierrez1,
  2. Sudeshna Mitra2,
  3. Kazuyuki Neki2,
  4. Leah Watetu Mbugua2,
  5. Ramshankar Balasubramaniyan1,
  6. Mercer Winer1,
  7. Jaeda Roberts1,
  8. Theo Vos3,
  9. Erin Hamilton3,
  10. Mohsen Naghavi3,
  11. James E Harrison4,
  12. R F Soames Job2,
  13. Kavi Bhalla1
  1. 1 Public Health Sciences, University of Chicago, Chicago, Illinois, USA
  2. 2 Global Road Safety Facility, World Bank, Washington, DC, USA
  3. 3 Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
  4. 4 Research Center for Injury Studies, Flinders University, Bedford Park, South Australia, Australia
  1. Correspondence to Dr Kavi Bhalla, Public Health Sciences, University of Chicago, Chicago, IL 60637-5418, USA; kavibhalla{at}gmail.com

Abstract

Introduction Timely, accurate and detailed information about traffic injuries are essential for managing national road safety programmes. However, there is considerable under-reporting in official statistics of many low and middle-income countries (LMICs) and large discrepancies between estimates from the Global Burden of Disease (GBD) study and WHO’s Global Health Estimates (GHE). We compared all sources of epidemiological information on traffic injuries in Cambodia to guide efforts to improve traffic injury statistics.

Methods We estimated the incidence of traffic deaths and injuries and household ownership of motor vehicles in Cambodia from nationally representative surveys and censuses. We compared findings with GDB and GHE estimates.

Results We identified seven sources for estimating traffic deaths and three for non-fatal injuries that are not included as data sources in GBD and GHE models. These sources and models suggest a fairly consistent estimate of approximately 3100 deaths annually, about 50% higher than official statistics, likely because most hospital deaths are not recorded. Surveys strongly suggest that the vehicle fleet is dominated by motorcycles, which is not consistent with GBD estimates that suggest similar numbers of motorcyclist and vehicle occupant deaths. Estimates of non-fatal injuries from health surveys were about 7.5 times official statistics and 1.5 times GBD estimates.

Conclusion Including local epidemiological data sources from LMICs can help reduce uncertainty in estimates from global statistical models and build trust in estimates among local stakeholders. Such analysis should be used as a benchmark to assess and strengthen the completeness of reporting of the national surveillance system.

  • surveillance
  • low-middle income country
  • motorcycle
  • motor vehicle � Occupant
  • pedestrian

Data availability statement

Data may be obtained from a third party and are not publicly available. Survey and census datasets were obtained from the agencies that undertook data collection. Other researchers may obtain the datasets by requesting access from these agencies.

https://doi.org/10.1136/injuryprev-2021-044504

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Survey and census datasets were obtained from the agencies that undertook data collection. Other researchers may obtain the datasets by requesting access from these agencies.

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    Footnotes

    • Contributors SM and KB contributed to the study design and jointly led all aspects of the study. RJ and SM initiated the research into the issue. KN, LWM, HG, LB, MW, RB, and JR searched for data sources, reviewed questionnaires, and conducted data analysis. HG and KB wrote the first draft of the article. All authors contributed to the discussion and interpretation of the results and to the writing of the manuscript. All authors have read and approved the final manuscript. KB is the guarantor responsible for the overall content of the work. He accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.

    • Funding This investigation was conducted by researchers from the University of Chicago and the World Bank Global Road Safety Facility and supported by funding from UKAID (Award/Grant Number: 7197082).

    • Disclaimer UKAID had no role in data analysis, data interpretation or writing of the article.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.