The frequency of road traffic injuries and deaths in Eastern Mediterranean Region: A systematic review and meta-analysis

Document Type : Review

Authors

1 Noncommunicable Diseases Research Center, Bam University of Medical Sciences, Bam, Iran

2 Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Department of Medical Informatics; Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

10.4103/atr.atr_76_22

Abstract

Background and Objectives: Deaths and injuries due to road traffic accidents are important public health problems in the world and the Eastern Mediterranean Region (EMR). The current study aimed to review published articles and registry-based reports on the burden of road traffic injuries and deaths in the EMR for all road users. 
Methods: PubMed, Scopus, Web of Science, and Index Medicos for Eastern Mediterranean Region databases were searched to identify all related articles published until January 9, 2023. The search strategy included a thorough search of the keywords as follows: (burden OR disability-adjusted life years OR DALY OR incidence OR prevalence OR morbidity OR mortality OR death) AND (road traffic accident OR road traffic injury OR road traffic crash) AND (EMRO OR “Eastern Mediterranean Region” OR name of countries in EMRO). The population-based or registry-based data, and hospital-based data with underlying causes of death (codes V01–V99) were included. The death of other transportation, literature reviews, viewpoints, and commentaries was excluded. The quality of papers was assessed using the STROBE checklist. Available data for all road users based on their type were extracted and analyzed. Finally, a random-effects meta-analysis was performed, and pooled rates of road traffic injuries and deaths were estimated. Moreover, meta-regression was performed to identify the potential sources of heterogeneity. 
Results: The review of 69 studies showed that the pooled rate was 173.9/100,000 population (95% confidence interval [CI]: 165.1–182.9). The pooled fatal and crash injury rates were 31.4 deaths (95% CI: 30.3–32.7) and 218.6 injuries (95% CI: 212.5–224.6) per 100,000 population. The highest road traffic crash rates belonged to motorized four-wheeler users at 73.8/100,000 population (95% CI: 70.7–77.0), followed by motorized two–three wheelers/cyclists at 30.2/100,000 population (95% CI: 4.1–64.5). 
Conclusions: The burden of road traffic injury and death was high in EMR. Therefore, the modification of the traffic crash data logging system and active monitoring of the consequences of traffic crashes in this region are required.

Highlights

Seyyed-Mohammad Tabatabaei [Pubmed] [Google Scholar]

 

Keywords

References

1.
World Health Organization. Global Status Report on Road Safety 2018. Geneva: World Health Organization; 2018.  Back to cited text no. 1
    
2.
World Health Organization. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death2016. [Last accessed on 2020 09 Dec].  Back to cited text no. 2
    
3.
World Health Organization. WHO Global Status Report on Road Safety 2013: Supporting a Decade of Action. Geneva: World Health Organization; 2013.  Back to cited text no. 3
    
4.
World Health Organization. Global Status Report on Road Safety: Time for Action. Geneva: World Health Organization; 2009.  Back to cited text no. 4
    
5.
World Health Organization. Regional Office for the Eastern Mediterranean. Eastern Mediterranean Status Report on Road Safety: Call for Action. Cairo, Egypt; WHO Regional Office for the Eastern Mediterranean; 2010.  Back to cited text no. 5
    
6.
Soroosh D, Nematshahi M, Javadinia SA, Hesamifard M. Study of the pattern and frequency of road traffic injuries in car occupants in the eastern part of Iran. International Journal of Medical Toxicology and Forensic Medicine. 2020;10:28112.  Back to cited text no. 6
    
7.
Rezapur-Shahkolai F, Taheri M, Etesamifard T, Roshanaei G, Shirahmadi S. Dimensions of aberrant driving behaviors and their association with road traffic injuries among drivers. PLoS One 2020;15:e0238728.  Back to cited text no. 7
    
8.
Khatibi SR, Dinpanah H, Maajani K, Khodadost M, Khodadost B, Kakhki S, et al. The burden of road traffic injuries in the Northeast of Iran: The result of a population-based registry. J Inj Violence Res 2020;12:63-72.  Back to cited text no. 8
    
9.
Taheri Soodejani M, Mahmudimanesh M, Abedi L, Tabatabaei SM, Ghaderi A. Traffic accident mortality in Najafabad, Iran during 2011-2017. Trauma Monthly. 2020;25 (1):20-6.  Back to cited text no. 9
    
10.
Ghodsi Z, Saadat S, Barzegar A, Alaeddini F, Rahimi-Movaghar V, Zafarghandi M, et al. The completeness of the registration system and the economic burden of fatal injuries in Iran. Ulus Travma Acil Cerrahi Derg 2020;26:671-7.  Back to cited text no. 10
    
11.
Soori H, Khorasani-Zavareh D. Road traffic injuries measures in the Eastern Mediterranean Region: Findings from the global status report on road safety-– 2015. J Inj Violence Res 2019;11:149-58.  Back to cited text no. 11
    
12.
Shahbazi F, Soori H, Khodakarim S, Ghadirzadeh M, M, Nazari S. Analysis of mortality rate of road traffic accidents and its trend in 11 years in Iran. Archives of Trauma Research. 2019;8 (1):17-22.  Back to cited text no. 12
    
13.
Sepandi M, Alimohamadi Y, Mahmud F, Enaami M. Productivity and years of life lost due to fatal traffic injuries in Shiraz Shahid Rajaei Hospital during 2009-2013. Archives of Trauma Research. 2019;8 (3):160-4.  Back to cited text no. 13
    
14.
Roshanfekr P, Khodaie-Ardakani MR, Malek Afzali Ardakani H, Sajjadi H. Prevalence and socio-economic determinants of disabilities caused by road traffic accidents in Iran; a national survey. Bull Emerg Trauma 2019;7:60-6.  Back to cited text no. 14
    
15.
Rahmati F, Doosti M, Bahreini M. The cost analysis of patients with traffic traumatic injuries presenting to emergency department; a cross-sectional study. Adv J Emerg Med 2019;3:e2.  Back to cited text no. 15
    
16.
Roshanfekr P, Khodaie-Ardakani MR, Malek Afzali Ardakani H, Sajjadi H. Prevalence and socio-economic determinants of disabilities caused by road traffic accidents in Iran; a national survey. Bull Emerg Trauma 2019;7:60-6.  Back to cited text no. 16
    
17.
Lotfi S, Honarvar A, Gholamzadeh S. Analysis and identification the hidden relationships between effective factors in the mortality rate caused by road accidents: A case study of fars province, Iran. Chinese Journal of Traumatology. 2019;2222:233-9.  Back to cited text no. 17
    
18.
Jamali-Dolatabad M, Sadeghi-Bazargani H, Sarbakhsh P. Predictors of fatal outcomes in pedestrian accidents in Tabriz Metropolis of Iran: Application of PLS-DA method. Traffic Inj Prev 2019;20:873-9.  Back to cited text no. 18
    
19.
Hashempour R, Tahmasebi A, Veysi M, Amini M, Tavakoli N. Cost analysis of accidents according to demographic factors in Iran. Iran J Public Health 2019;48:1346-53.  Back to cited text no. 19
    
20.
Zangeneh A, Najafi F, Karimi S, Saeidi S, Izadi N. Spatial-temporal cluster analysis of mortality from road traffic injuries using geographic information systems in West of Iran during 2009-2014. J Forensic Leg Med 2018;55:15-22.  Back to cited text no. 20
    
21.
Shahbazi F, Soori H, Khodakarim S, Ghadirzadeh MR, Shojaei A, Hashemi Nazari SS. Investigation of the role of traffic police function in reducing geographical inequalities in mortality from road traffic accidents. Arch Trauma Res 2018;7:92-7.  Back to cited text no. 21
  [Full text]  
22.
Sadeghi-Bazargani H, Samadirad B, Moslemi F. A decade of road traffic fatalities among the elderly in North-West Iran. BMC Public Health 2018;18:111.  Back to cited text no. 22
    
23.
Parvareh M, Karimi A, Rezaei S, Woldemichael A, Nili S, Nouri B, et al. Assessment and prediction of road accident injuries trend using time-series models in Kurdistan. Burns Trauma 2018;6:9.  Back to cited text no. 23
    
24.
Mahdian M, Sehat M, Fazel M, Akbari H, Rahimi H, Mohammadzadeh M. Road traffic deaths in Kashan region, Iran: An eight-year study (2007-– 2013). Chinese Journal of Traumatology. 2018;21:54 -7.  Back to cited text no. 24
    
25.
Lotfi M, Montazer M, Lashkardoost H, Shamsi F, Askari M, Hamedi E, et al., Road traffic accidents in Yazd province, Iran: A longitudinal study (2012–2016). Archives of Trauma Research. 2018;7:68.  Back to cited text no. 25
    
26.
Homayoun SB, Bahram S, Mina G, Nasrin S, Milad J. Analysis of provincial mortalities among bus/minibus users over twelve years, East Azerbaijan, Iran. J Med Life 2018;11:312-9.  Back to cited text no. 26
    
27.
Hasani J, Khorshidi A, Erfanpoor S, Nazparvar B, Hashemi Nazari SS. Comparison of risk factors for pedestrian fatality in urban and suburban traffic accidents. Archives of Trauma Research. 2018;7 (2):39-44.  Back to cited text no. 27
    
28.
Sherafati F, Homaie-Rad E, Afkar A, Gholampoor-Sigaroodi R, Sirusbakht S. Risk factors of road traffic accidents associated mortality in Northern Iran; A single Center experience utilizing Oaxaca blinder decomposition. Bull Emerg Trauma 2017;5:116-21.  Back to cited text no. 28
    
29.
Khoramdad M, Izadi N, Najafi F. Years of life lost due to road traffic injuries in Kermanshah province. Trauma Monthly. 2017;22:64272.  Back to cited text no. 29
    
30.
Izadi N, Najafi F, Khosravi A. The burden of road traffic injuries in Kermanshah Province, Iran, in 2010-2011: GBD 2010 method. Int J Inj Contr Saf Promot 2017;24:435-43.  Back to cited text no. 30
    
31.
Hosseinpour M, Mohammadian-Hafshejani A, Esmaeilpour Aghdam M, Mohammadian M, Maleki F. Trend and seasonal patterns of injuries and mortality due to motorcyclists traffic accidents; a hospital-based study. Bull Emerg Trauma 2017;5:47-52.  Back to cited text no. 31
    
32.
Hatamabadi HR, Shojaee M, Kashani P, Forouzanfar MM, Aghajani Nargesi D, Amini Esfahani MR. Predictive factors of poor outcome in road traffic injures; a retrospective cohort study. Emerg (Tehran) 2017;5:e21.  Back to cited text no. 32
    
33.
Fararouei M, Sedaghat Z, Sadat SJ, Shahraki G. Risk factors for being the at-fault driver: A case-control study. Traffic Inj Prev 2017;18:262-6.  Back to cited text no. 33
    
34.
Fakharian E, Mohammadzadeh M, Saberi HR, Fazel MR, Rejali M, Akbari H, et al. Spinal injury resulting from car accident: Focus to prevention. Asian J Neurosurg 2017;12:180-4.  Back to cited text no. 34
[PUBMED]  [Full text]  
35.
Yousefzadeh-Chabok S, Ranjbar-Taklimie F, Malekpouri R, Razzaghi A. A time series model for assessing the trend and forecasting the road traffic accident mortality. Arch Trauma Res 2016;5:e36570.  Back to cited text no. 35
    
36.
Vakili M, Mirzaei M, Pirdehghan A, Sadeghian M, Jafarizadeh M, Alimi M, et al. The Burden of road traffic injuries in Yazd province – Iran. Bull Emerg Trauma 2016;4:216-22.  Back to cited text no. 36
    
37.
Sargazi A, Sargazi A, Nadakkavukaran Jim PK, Danesh H, Aval F, Kiani Z, et al. Economic burden of road traffic accidents; report from a single Center from South Eastern Iran. Bull Emerg Trauma 2016;4:43-7.  Back to cited text no. 37
    
38.
Rakhshani T, Rakhshani F, Asadi ZS, Hadiabasi M, Khorramdel K, Zarenezhad M. Study of the pattern of mortality caused by traffic accidents (TAs) in the South of Iran. J Pak Med Assoc 2016;66:644-9.  Back to cited text no. 38
    
39.
Rad M, Martiniuk AL, Ansari-Moghaddam A, Mohammadi M, Rashedi F, Ghasemi A. The pattern of road traffic crashes in South East Iran. Glob J Health Sci 2016;8:51677.  Back to cited text no. 39
    
40.
Mirzaei M, Mirzadeh M, Shogaei Far H, Mirzaei M. Trends in road traffic deaths in Yazd, Iran, 2004-2010. Arch Trauma Res 2016;5:e29266.  Back to cited text no. 40
    
41.
Masoumi K, Forouzan A, Barzegari H, Asgari Darian A, Rahim F, Zohrevandi B, et al. Effective factors in severity of traffic accident-related traumas; an epidemiologic study based on the Haddon Matrix. Emerg (Tehran) 2016;4:78-82.  Back to cited text no. 41
    
42.
Khorshidi A, Ainy E, Hashemi Nazari SS, Soori H. Temporal patterns of road traffic injuries in Iran. Arch Trauma Res 2016;5:e27894.  Back to cited text no. 42
    
43.
Ebrahemzadih M, Giahi O, Foroginasab F. Analysis of traffic accidents leading to death using tripod beta method in Yazd, Iran. PROMET Traffic Transp 2016;28:291-7.  Back to cited text no. 43
    
44.
Mohammadi M, Ansari Moghaddam A, Rad M, Hashemi Habybabady R, Tabasi MA. Seatbelt use and related factors among drivers involved in road crashes in Southeast Iran. Health Scope 2015;4:e30782.  Back to cited text no. 44
    
45.
Yazdani-Charati J, Siamian H, Ahmadi-Basiri E. Spatial analysis and geographic variation of fatal and injury crashes in mazandaran province from 2006 to 2010. Mater Sociomed 2014;26:177-81.  Back to cited text no. 45
    
46.
Shams Vahdati S, GhafarZad A, Rahmani F, Panahi F, Omrani Rad A. Patterns of road traffic accidents in North West of Iran during 2013 New Year holidays: Complications and casualties. Bull Emerg Trauma 2014;2:82-5.  Back to cited text no. 46
    
47.
Mohammadi G. Road crash injuries and fatalities in Isfahan, Iran from March 2006 to March 2009. Int J Inj Contr Saf Promot 2014;21:361-6.  Back to cited text no. 47
    
48.
Mehmandar M, Soori H, Amiri M, Norouzirad R, Khabzkhoob M. Risk factors for fatal and nonfatal road crashes in Iran. Iran Red Crescent Med J 2014;16:e10016.  Back to cited text no. 48
    
49.
Hasanzadeh J, Moradinazar M, Najafi F, Ahmadi-Jouybary T. Trends of mortality of road traffic accidents in Fars province, Southern Iran, 2004–2010. Iran J Public Health 2014;43:1259-65.  Back to cited text no. 49
    
50.
Davoudi-Kiakalayeh A, Mohammadi R, Yousefzade-Chabok S, Saadat S. Road traffic crashes in rural setting: An experience of a middle-income country. Chin J Traumatol 2014;17:327-30.  Back to cited text no. 50
    
51.
Ardalan A, Sepehrvand N, Pourmalek F, Masoumi G, Sarvar M, Mahmoudabadi A, et al. Deadly rural road traffic injury: A rising public health concern in I.R. Iran. Int J Prev Med 2014;5:241-4.  Back to cited text no. 51
    
52.
Paravar M, Hosseinpour M, Salehi S, Mohammadzadeh M, Shojaee A, Akbari H, et al. Pre-hospital trauma care in road traffic accidents in Kashan, Iran. Arch Trauma Res 2013;1:166-71.  Back to cited text no. 52
    
53.
Heydari ST, Hoseinzadeh A, Sarikhani Y, Hedjazi A, Zarenezhad M, Moafian G, et al. Time analysis of fatal traffic accidents in Fars Province of Iran. Chin J Traumatol 2013;16:84-8.  Back to cited text no. 53
    
54.
Mohammadi G. Road traffic crash injuries and fatalities in the city of Kerman, Iran. Int J Inj Contr Saf Promot 2013;20:184-91.  Back to cited text no. 54
    
55.
Bahadorimonfared A, Soori H, Mehrabi Y, Delpisheh A, Esmaili A, Salehi M, et al. Trends of fatal road traffic injuries in Iran (2004-2011). PLoS One 2013;8:e65198.  Back to cited text no. 55
    
56.
Mohammadi G. Pattern of deaths and injuries in road crashes on three main entrance roads in Kerman, Iran. Int J Inj Contr Saf Promot 2012;19:384-7.  Back to cited text no. 56
    
57.
Derakhshanfar H, Kalantari Meibodi M, Kariman H, Arhamidolatabadi A, Safari S. Substance abuse among drivers of motor vehicle collisions. Trauma Mon 2012;17:236-8.  Back to cited text no. 57
    
58.
Majdzadeh R, Eshraghian MR, Khalagi K, Motevalian A, Naraghi K. Crash-related factors associated with the severity of road traffic injuries in Iran. Int J Inj Contr Saf Promot 2011;18:175-80.  Back to cited text no. 58
    
59.
Hatamabadi HR, Vafaee R, Haddadi M, Abdalvand A, Soori H. Necessity of an integrated road traffic injuries surveillance system: A community-based study. Traffic Inj Prev 2011;12:358-62.  Back to cited text no. 59
    
60.
Vafaee-Najar A, Esmaeili H, Ibrahimipour H, Dehnavieh R, Nozadi MS. Motorcycle fatal accidents in Khorasan Razavi province, Iran. Iran J Public Health 2010;39:95-101.  Back to cited text no. 60
    
61.
Bigdeli M, Khorasani-Zavareh D, Mohammadi R. Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study. BMC Public Health 2010;10:406.  Back to cited text no. 61
    
62.
Rahimi-Movaghar V, Zarei MR, Saadat S, Rasouli MR, Nouri M. Road traffic crashes in Iran from 1997 to 2007. Int J Inj Contr Saf Promot 2009;16:179-81.  Back to cited text no. 62
    
63.
Mohammadi G. Mobile phone and seat belt usage and its impact on road accident fatalities and injuries in southeast Iran. Int J Crashworthiness 2009;14:309-14.  Back to cited text no. 63
    
64.
Mohammadi G. Road traffic fatalities among pedestrians, bicyclists and motor vehicle occupants in Sirjan, Kerman, Iran. Chin J Traumatol 2009;12:200-2.  Back to cited text no. 64
    
65.
Mohammadi G. The pattern of fatalities by age, seat belt usage and time of day on road accidents. Int J Inj Contr Saf Promot 2009;16:27-33.  Back to cited text no. 65
    
66.
Jan Mohammadi N, Pourhossein M, Hashemi SR. Pattern of motorcyclist's mortality in Mazandran province, Northern Iran. Iran Red Crescent Med J 2009;11:81-4.  Back to cited text no. 66
    
67.
Bhalla K, Naghavi M, Shahraz S, Bartels D, Murray CJ. Building national estimates of the burden of road traffic injuries in developing countries from all available data sources: Iran. Inj Prev 2009;15:150-6.  Back to cited text no. 67
    
68.
Soroush AR, Ghahri-Saremi S, Rambod M, Malek-Hosseini SA, Nick-Eghbal S, Khaji A. Pattern of injury in Shiraz. Chin J Traumatol 2008;11:8-12.  Back to cited text no. 68
    
69.
Moharamzad Y, Taghipour H, Hodjati Firoozabadi N, Hodjati Firoozabadi A, Hashemzadeh M, Mirjalili M, et al. Mortality pattern according to autopsy findings among traffic accident victims in Yazd, Iran. Chin J Traumatol 2008;11:329-34.  Back to cited text no. 69
    
70.
Kadkhodaie MH. Three-year review of facial fractures at a teaching hospital in Northern Iran. Br J Oral Maxillofac Surg 2006;44:229-31.  Back to cited text no. 70
    
71.
Roudsari BS, Sharzei K, Zargar M. Sex and age distribution in transport-related injuries in Tehran. Accid Anal Prev 2004;36:391-8.  Back to cited text no. 71
    
72.
Montazeri A. Road-traffic-related mortality in Iran: A descriptive study. Public Health 2004;118:110-3.  Back to cited text no. 72
    
73.
Bener A, Bener OF. Mobile phone use while driving and risk of road traffic injury: Applying the lorenz curve and associated gini index. Advances in Transportation Studies. 2007;13:77-82.  Back to cited text no. 73
    
74.
Mehmood A, Khan IQ, Mir MU, Moin A, Jooma R. Vulnerable road users are at greater risk during Ramadan -- – Results from road traffic surveillance data. J Pak Med Assoc 2015;65:287-91.  Back to cited text no. 74
    
75.
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Preventive Medicine. 2007;45 (4):247-51.  Back to cited text no. 75
    
76.
World Health Organization. Road Safety in the Eastern Mediterranean Region Highlights from WHO's Global Status Report on Road Safety 2018. Cairo, Egypt; Creative Commons Attribution-NonCommercial-ShareAlike; 2018.  Back to cited text no. 76
    
77.
Sengoelge M, Laflamme L, El-Khatib Z. Ecological study of road traffic injuries in the eastern Mediterranean region: Country economic level, road user category and gender perspectives. BMC Public Health 2018;18:236.  Back to cited text no. 77
    
78.
Heydari S, Hickford A, McIlroy R, Turner J, Bachani AM. Road safety in low-income countries: State of knowledge and future directions. Sustainability. 2019;11 (22):6249.  Back to cited text no. 78
    
79.
Mahmood SO, A Sallam S, H Wahdan I, Hama Ghareeb KA, Adil Hasan Y, Mohialdeen Gubari MI, et al. Survey on the causes of road traffic accidents in Sulaymaniyah, Kurdistan Region, Iraq. Int Electron J Med. 2020;9 (1):31-7.  Back to cited text no. 79
    
80.
Jamieson J. The Development of a Road Safety Strategy for the Gulf State of Qatar. Australasian Road Safety Research, Policing and Education Conference; 2008.  Back to cited text no. 80
    
81.
World Health Organization. Global Status Report on Road Safety 2015. Geneva: World Health Organization; 2015.  Back to cited text no. 81
    
82.
Noland RB. Medical treatment and traffic fatality reductions in industrialized countries. Accid Anal Prev 2003;35:877-83.  Back to cited text no. 82
    
83.
GBD 2015 Eastern Mediterranean Region Transportation Injuries Collaborators. Transport injuries and deaths in the Eastern Mediterranean region: Findings from the global burden of disease 2015 study. Int J Public Health 2018;63:187-98.  Back to cited text no. 83
    
84.
Beckett K, Earthy S, Sleney J, Barnes J, Kellezi B, Barker M, et al. Providing effective trauma care: The potential for service provider views to enhance the quality of care (qualitative study nested within a multicentre longitudinal quantitative study). BMJ Open 2014;4:e005668.  Back to cited text no. 84
    
85.
Abedi L, Sadeghi-Bazargani H. Epidemiological patterns and risk factors of motorcycle injuries in Iran and Eastern Mediterranean region countries: A systematic review. Int J Inj Contr Saf Promot 2017;24:263-70.  Back to cited text no. 85
    
Archives of Trauma Research
Volume 12, Issue 1
March 2023
Pages 1-16

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  • Receive Date: 29 May 2023
  • Accept Date: 29 May 2023

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