Road traffic related mortality in Vietnam: Evidence for policy from a national sample mortality surveillance system

BMC Public Health

Peter S Hill²  Khieu Thi Quynh Trang⁴  Damian G Hoy²  Nguyen Phuong Hoa¹  Chalapati Rao²  Anh D Ngo³ 

[1] Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Vietnam;School of Population Health, University of Queensland, Herston Rd, Herston, Queensland 4006, Australia;Social Epidemiology and Evaluation Research Group, School of Health Sciences, University of South Australia, Room P4-23, Playford Building, City East Campus, Adelaide, SA 5000, Australia (Formerly, Vietnam Evidence For Health Policy Project, School of Population Health, University of Queensland, Health Strategy and Policy Institute, 138 Giang Vo Street, Hanoi, Vietnam;Health Environment Management Agency, Ministry of Health, 1 Nui Truc Lane, Nui Truc Street, Hanoi, Vietnam

关键词: Vietnam;    Verbal autopsy;    Helmet law;    Mortality;    Road traffic injuries;   

Others  :  1163414
DOI  :  10.1186/1471-2458-12-561

 received in 2011-12-22, accepted in 2012-07-11,  发布年份 2012

【 摘 要 】

Background

Road traffic injuries (RTIs) are among the leading causes of mortality in Vietnam. However, mortality data collection systems in Vietnam in general and for RTIs in particular, remain inconsistent and incomplete. Underlying distributions of external causes and body injuries are not available from routine data collection systems or from studies till date. This paper presents characteristics, user type pattern, seasonal distribution, and causes of 1,061 deaths attributable to road crashes ascertained from a national sample mortality surveillance system in Vietnam over a two-year period (2008 and 2009).

Methods

A sample mortality surveillance system was designed for Vietnam, comprising 192 communes in 16 provinces, accounting for approximately 3% of the Vietnamese population. Deaths were identified from commune level data sources, and followed up by verbal autopsy (VA) based ascertainment of cause of death. Age-standardised mortality rates from RTIs were computed. VA questionnaires were analysed in depth to derive descriptive characteristics of RTI deaths in the sample.

Results

The age-standardized mortality rates from RTIs were 33.5 and 8.5 per 100,000 for males and females respectively. Majority of deaths were males (79%). Seventy three percent of all deaths were aged from 15 to 49 years and 58% were motorcycle users. As high as 80% of deaths occurred on the day of injury, 42% occurred prior to arrival at hospital, and a further 29% occurred on-site. Direct causes of death were identified for 446 deaths (42%) with head injuries being the most common cause attributable to road traffic injuries overall (79%) and to motorcycle crashes in particular (78%).

Conclusion

The VA method can provide a useful data source to analyse RTI mortality. The observed considerable mortality from head injuries among motorcycle users highlights the need to evaluate current practice and effectiveness of motorcycle helmet use in Vietnam. The high number of deaths occurring on-site or prior to hospital admission indicates a need for effective pre-hospital first aid services and timely access to emergency facilities. In the absence of standardised death certification, sustained efforts are needed to strengthen mortality surveillance sites supplemented by VA to support evidence based monitoring and control of RTI mortality.

【 授权许可】

   
2012 Ngo; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Injury mortality statistics. Health Environment Management Agency, Ministry of Health, Hanoi; 2011.
• [2]Report on Results of IP/SC Implementation in 1998 and half of the Year 1999. Ministry of Health, Hanoi; 1999.
• [3]The facts: Injury and Violence Prevention in Vietnam.  ,  ;  . Access July 2011 from: [http://www.wpro.who.int/vietnam/sites/dhp/injury/]
• [4]Ngo A, Rao C, Hoa N, Adair T, Chuc N: Mortality patterns in Vietnam, 2006: Findings from a national verbal autopsy survey. BMC Res Notes 2010, 3:78. BioMed Central Full Text
• [5]Hung KV, Huyen LT: Education influence in traffic safety: A case study in Vietnam. IATSS Res 2011, 34(2):87-93.
• [6]Hill P, Ngo A, Khuong T, Dao H, Hoang H, Trinh H, Nguyen L, Nguyen P: Mandatory helmet legislation and the print media in Vietnam. Accid Anal Prev 2009, 41(4):789-797.
• [7] .  ,  ;  . [http://www.baomoi.com/Home/ThoiSu/www.tienphong.vn/Ra-quan-thang-An-toan-giao-thong-2008/1953717.epi]
• [8]Van H, Singhasivanon P, Kaewkungwal J, Suriyawongpaisal P, Khai L: Estimation of non-fatal road traffic injuries in Thai Nguyen, Vietnam using capture-recapture method. Southeast Asian J Trop Med Public Health 2006, 37(2):405-411.
• [9]Ngoc L, Nguyen T: Injury surveillance system in Vietnam. Inj Prev 2011, 16(A118): - .
• [10]Mahapatra P, Shibuya K, Lopez A, Coullare F, Notzon F, Rao C, Szreter S: Civil registration systems and vital statistics: successes and missed opportunities. Lancet 2007, 370(9599):1653-1663.
• [11]Rao C, Osterberger B, Anh T, MacDonald M, Chúc N, Hill P: Compiling mortality statistics from civil registration systems in Vietnam: the long road ahead. Bull World Health Organ 2010, 88(1):58-65.
• [12]Verbal autopsy standards. Acertaining and Attributing Cause of Death. World Health Organization, Geneva; 2007.
• [13]Begg S, Rao C, Lopez A: Design options for sample-based mortality surveillance. Int J Epidemiol 2005, 34(5):1080-1087.
• [14]Chandrasekar C, Deming WE: On a method of estimating birth and death rates and the extent of registration. J Am Stat Assoc 1949, 44:101-115.
• [15]Hoa N, Rao C, Hoy D, Hinh N, Chuc N, Ngo D: Mortality measures from sample-based surveillance: Evidence of the epidemiological transition in Vietnam. Bull World Health Organ 2012,  : - . In press
• [16]Huong DL, Minh HV, Byass P: Applying verbal autopsy to determine cause of death in rural Vietnam. Scand J Public Health 2003, Suppl 62:19-25.
• [17]Joshi R, Kengne AP, Neal B: Methodological trends in studies based on verbal autopsies before and after published guidelines. Bull World Health Organ 2009, 87:678-682.
• [18]Smith G, Barss P: Unintentional injuries in developing countries: the epidemiology of a neglected problem. Epidemiol Rev 1991, 13:228-286.
• [19]Tam NM: Drinking and Driving in Vietnam: Perceptions, risk and cost effective interventions. Queensland University of Technology, School of Population Health,  ; 2010.
• [20]Lin MR, Chang SH, Pai L, Keyl PM: A longitudinal study of risk factors for motorcycle crashes among junior college students in Taiwan. Accid Anal Prev 2003, 35(2):243-252.
• [21]Zambon F, Hasselberg M: Factors affecting the severity of injuries among young motorcyclists–a Swedish nationwide cohort study. Traffic Inj Prev 2006, 7(2):143-149.
• [22]Ross H: Britain’s christmas crusade against drinking and driving. Alcohol and Drugs 1987, 48(5):7-12.
• [23]Vietnam Population and Housing Census 2009 - Education in Vietnam: An Analysis of Key Indicators. Vietnam Ministry of Planning and Investment, Hanoi; 2010.
• [24]Nguyen T, Nguyen T, Morita S, Sakamoto J: Injury and pre-hospital trauma care in Hanoi, Vietnam. Injury 2008, 39(9):1026-1033.
• [25]Lai CH, Huang WS, Chang KK, Jeng MC, Doong JL: Using data linkage to generate 30-day crash-fatality adjustment factors for Taiwan. Accid Anal Prev 2006, 38(4):696-702.
• [26]Sharma B, Harish D, Singh G, Vij K: Patterns of fatal head injury in road traffic accidents. Bahrain Medical Bulletin 2003, 25(1):22-25.
• [27]Keng SH: Helmet use and motorcycle fatalities in Taiwan. Accid Anal Prev 2005, 37(2):349-355.
• [28]Regional report of Road Safety: the South-east Asia Region. World Health Organization, Geneva; 2009.
• [29]Hussan L, Redmond A: Are pre-hospital deaths from accidental injury preventable? Br Med J 1994, 308:1077-1080.
• [30]Passmore J, Tu N, Luong M, Chinh N, Nam N: Impact of mandatory motorcycle helmet wearing legislation on head injuries in Vietnam: results of a preliminary analysis. Traffic Inj Prev 2010, 11(2):202-206.
• [31]Report on activities to ensure traffic order and safety. Ministry of Transport, Hanoi; 2008.
• [32]Peden M, Scurfield R, Sleet D, Mohan D, Hyder A, Jarawan , Mathers C: World report on road traffic injury prevention. World Health Organization, Geneva; 2004.
• [33]Montazeri A: Road-traffic-related mortality in Iran: a descriptive study. Public Health 2004, 118(2):110-113.
• [34]Police Report. Taiwan Ministry of Interior, Taipei; 2003.
• [35]Tsai MC, Hemenway D: Effect of the mandatory helmet law in Taiwan. Inj Prev 1999, 5(4):290-291.
• [36]Wong E, Leong MK, Anantharaman V, Raman L, Wee KP, Chao TC: Road traffic accident mortality in Singapore. J Emerg Med 2002, 22(2):139-146.
• [37]Chao C, Fam K: Traffic accident injuries: a survey of the injured driver, front-seat passenger and motorcyclists. Acad Med Singapore 1979, 8(2):118-127.
• [38]Sarkar S, Peek C, Kraus J: Fatal injuries in motorcycle riders according to helmet use. J Trauma 1995, 38(2):242-245.
• [39]Passmore J, Lan Huong Nguyen , Nam Phuong Nguyen , Olive J: The formulation and implementation of a national helmet law: a case study from Vietnam. Bull World Health Organ 2010, 88:783-787.
• [40]Dinh VH, Analysis of road traffic accidents in Vietnam:  .  ,  ;  . Road Traffic Injuries Research Network. Access August 2011 from: [http://nuce.academia.edu/DinhVanHiep/Papers/136569/Analysis_of_road_traffic_accidents_in_Vietnam]
• [41]Huy TQ, Johansson A, Long NH: Reasons for not reporting deaths: a qualitative study in rural Vietnam. World Health Popul 2007, 9(1):14-23.
• [42]Ha N, Quang L, Duc D, Vu N: Current situation of road traffic accidents and acceptance on helmet and drink-driving laws in Yen Bai, Da Nang, and Binh Duong provinces Hanoi. World Health Organization; Ministry of Health; Hanoi School of Public Health, Hanoi; 2008.
• [43]Rao COB, Anh TD, MacDonald M, Chúc NT, Hill PS: Compiling mortality statistics from civil registration systems in Vietnam: the long road ahead. Bull World Health Organ 2010, 88(1):58-65.