Introduction There is considerable uncertainty in estimates of traffic deaths in many sub-Saharan African countries, with the Global Burden of Disease (GBD) and the Global Status Report on Road Safety (GSRRS) reporting widely differing estimates. As a case study, we reviewed and compared estimates for Tanzania.
Methods We estimated the incidence of traffic deaths and vehicle ownership in Tanzania from nationally representative surveys. We compared findings with GBD and GSRRS estimates.
Results Traffic death estimates based on the 2012 census (9382 deaths; 95% CI: 7565 to 11 199) and the 2011–2014 Sample Vital Registration with Verbal Autopsy (8778; 95% CI: 7631 to 9925) were consistent with each other and were about halfway between GBD (5 608; 95% UI: 4506 to 7014) and WHO (16 252; 95% CI: 13 130 to 19 374) estimates and more than twice official statistics (3885 deaths in 2013). Surveys and vehicle registrations data show that motorcycles have increased rapidly since 2007 and now comprise 66% of vehicles. However, these trends are not reflected in GBD estimates of motorcycles in the country, likely resulting in an underestimation of motorcyclist deaths.
Conclusion Reducing discrepancies between GBD and GSRRS estimates and demonstrating consistency with local epidemiological data will increase the legitimacy of such estimates among national stakeholders. GBD, which is the only project that models the road-user distribution of traffic deaths in all countries, likely severely underestimates motorcycle deaths in countries where there has been a recent increase in motorcycles. Addressing police under-reporting and strengthening surveillance capacity in Tanzania will allow a better understanding of the road safety problem and better targeting of interventions.
- Motor vehicle - Non traffic
- Motor vehicle - Occupant
Data availability statement
The study analysed secondary data collected by other parties described in the manuscript. These data are not publicly available but may be obtained by contacting these other parties.
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Contributors SM and KB contributed to the study design and jointly led all aspects of the study. RFSJ and SM initiated the research into the issue. KN, LWM, HG, MW, RB and JR searched for data sources, reviewed questionnaires and conducted data analysis. LWM and KB wrote the first draft of the article. All authors contributed to the discussion and interpretation of the results, writing of the manuscript and have read and approved the final manuscript. KB is the guarantor of the manuscript.
Funding This work was supported by the World Bank Global Road Safety Facility, University of Chicago (no award/grant number) and UKAID (Award No. 7197082).
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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