Spatial-temporal cluster analysis of mortality from road traffic injuries using geographic information systems in West of Iran during 2009-2014.

INTRODUCTION Road traffic injuries (RTIs) are considered as one of the most important health problems endangering people's life. The examination of the geographical distribution of RTIs could help policymakers in better planning to reduce RTIs. This study, therefore, aimed to determine the spatial-temporal clustering of mortality from RTIs in West of Iran. METHODS Deaths from RTIs, registered in Forensic Medicine Organization of Kermanshah province over a period of six years (2009-2014), were used. Using negative binomial regression, the mortality trend was investigated. In order to investigate the spatial distribution of RTIs, we used ArcGIS. (Version 10.3). RESULTS The median age of the 3231 people died in RTIs was 37 (IQR = 31) year, 78.4% were male. The 6-year average mortality rate from RTIs was 27.8/100,000 deaths, and the average rate had a declining trend. The dispersion of RTIs showed that most deaths occurred in Kermanshah, Islamabad, Bisotun, and Harsin road axes, respectively. The mean center of all deaths from RTIs occurred in Kermanshah province, the central area of Kermanshah district. The spatial trend of such deaths has moved to the northeast-southwest, and such deaths were geographically centralized. Results of Moran's I with respect to cluster analysis also indicated positive spatial autocorrelations. CONCLUSION The results showed that the mortality rate from RTIs, despite the decline in recent years, is still high when compared with other countries. The clustering of accidents raises the concern that road infrastructure in certain locations may also be a factor. Regarding the results related to the temporal analysis, it is suggested that the enforcement of traffic rules be stricter at rush hours.