Background Motorcycle helmet use is low in Ghana and many helmets are non-standard. There are limited data on the effectiveness of the different helmet types in use in the real-world circumstances of low-income and middle-income countries. This study assessed the effect of different helmet types on risk of head injury among motorcycle crash victims in northern Ghana.
Methods A prospective unmatched case–control study was conducted at the Tamale Teaching Hospital (TTH). All persons who had injuries from a motorcycle crash within 2 weeks of presentation to TTH were consecutively sampled. A total of 349 cases, persons who sustained minor to severe head injury, and 363 controls, persons without head injury, were enrolled. A semistructured questionnaire was used to interview patients and review their medical records. Multivariable logistic regression was used to estimate odds for head injury.
Results After adjusting for confounders, the odds of head injuries were 93% less in motorcyclists with full-face helmet (FFH) (adjusted OR, AOR 0.07, 95% CI 0.04 to 0.15) or open-face helmet (OFH) (AOR 0.07, 95% CI 0.04, 0.13), compared with unhelmeted motorcyclists. Half-coverage helmets (HCH) were less effective (AOR 0.41, 95% CI 0.18 to 0.92). With exception of HCH, the AORs of head injury for the different types of helmets were lower in riders (FFH=0.06, OFH=0.05 and HCH=0.47) than in pillion riders (FFH=0.11, OFH=0.12 and HCH=0.35).
Conclusion Even in this environment where there is a high proportion of non-standard helmets, the available helmets provided significant protection against head injury, but with considerably less protection provided by HCHs.
- Traumatic Brain Injury
- Health Education
Data availability statement
All data relevant to the study are included in the article.
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Contributors ABA: conceptualisation, methodology, resources, investigation, data curation, visualisation, drafting, reviewing and editing. PA, SOS and EK: supervision, methodology, drafting, reviewing and editing. MTM and SAYD: resources, reviewing and editing. ADB-iB: data curation, writing-reviewing and editing. TKO: reviewing and editing. PD and CNM: conceptualisation, methodology, funding acquisition, reviewing and editing. All the authors have read and agreed to the final revised manuscript. ABA: responsible for the overall content as the guarantor.
Funding This study was supported by grants from the Fogarty International Center at the US National Institutes of Health (D43 TW007267) and from the AO Alliance Paediatric Fracture Solution Project.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The funder played no role in the gathering or interpretation of the data, nor the writing of the manuscript.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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