Pedestrians' injury patterns in Ghana.

OBJECTIVE To establish the associations between pedestrian injury and explanatory variables such as vehicular characteristics, temporal trends, and road environment. METHODS A retrospective analysis of de-identified pedestrian crash data between 2002 and 2006 was conducted using the Building & Road Research Institute's crash data bank. We estimated the odds ratios associated with casualty fatalities using a multinomial logistic regression. RESULTS There were 812 pedestrian casualties reported, out of which 33% were fatal, 45% sustained serious injuries requiring hospitalization, and 22% were slightly injured but were not hospitalized. Crossing the roadway accounted for over 70% of all pedestrians' deaths. Whereas fatalities in 2002 and 2003 were statistically indistinguishable from those of 2004 (p>0.05), in comparison with 2004, there were significantly fewer fatalities in 2005 and 2006 (78% and 65% reduction respectively). According to police report, the probability that a pedestrian fatality occurring in Ghana attributable to excessive speeding is 65%. The adjusted odds ratio of pedestrian fatality associated with speeding compared with driver inattentiveness was 3.6 (95% CI: 2.5-5.2). It was also observed that generally, lighter vehicular masses were associated with lower pedestrian fatalities. Compared with buses, pedestrians were less likely to die when struck by private cars (52%), pick-up trucks (57%), and motorcycles (86%). CONCLUSION Pedestrian death remains the leading cause of fatality among urban road users in Ghana. Risk factors associated with pedestrian fatality include being hit by heavy vehicles, speeding, and roadside activities such as street hawking, jaywalking and nighttime walking. Steps which may contribute to reducing pedestrian fatalities include measures to reduce vehicles speeds in settlements, providing traffic medians and lighting streets in settlements, and discouraging street and roadside activities such as hawking.