Effects of traffic act enforcement on injury severity among motor vehicle crash victims at Rift valley provincial general hospital, Nakuru
Muguku, Enos Ngungu
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From 1st February 2004, the Traffic Act was rigorously enforced in Kenya. The effects of this enforcement on injury severity are unknown. This study examined the effects of the enforcement of the Traffic Act on the severity of injuries among motor vehicle crash victims admitted at the Rift Valley Provincial General Hospital (RVPGH), Nakuru. This is an ex post facto study that used secondary data from patient's records at RVPGH between 1St February 2003 and 31" January, 2005, that is one year before and one year after the enforcement of the Traffic Act. Using simple random sampling, 276 patients were selected. Data was collected using a coding schedule which measured among others, the patients' bio-data, injury severity and length of stay in hospital. Injury severity was measured using the Abbreviated Injury Scale (AIS). The difference between severities of injuries in the two periods was analyzed using Kolmogorov Smirnov Test. Two Focus Group Discussions (FGDs) with RVPGH health professionals who attend to motor vehicle injury victims were also conducted in order to obtain in-depth data on the effects of the enforcement of the traffic act on injury severity. These qualitative data was content analyzed. Results indicate that three quarters of the sampled patients were males. The mean age of the sampled patients was 31.49 years (Standard Deviation 14.58). The sex profile of patients admitted at RVPGH did not change with the enforcement of the traffic act (x 2 =1.914, df = 1; p = 0.167). There was a drop of 29 percent in admissions due to motor vehicle crashes, after the enforcement of the traffic act. Further, most of the sampled patients sustained injuries with AIS values of 1, 3 and 6 in both policy periods. The frequencies of patients with different injury severity levels remained the same in both policy periods (Most Absolute difference = 0.087, Kolmogorov-Smirnov Z = 0.722, p = 0.674). Therefore, the severity of injuries never changed despite the enforcement of the Traffic Act. The hypothesis that there was no difference in the level of injury severity among patients admitted at the RVPGH before and after the enforcement of the Traffic Act in Kenya was supported. Medical personnel suggested that seatbelt related injuries were emerging after the enforcement of the traffic act. This study has extended our understanding of the patterns of injury severity among motor vehicle crash victims. The study recommends that measures to reduce injury severity should be given priority. Policy makers can prioritize the minimization of minor, serious and fatal injury severity levels and focus on males aged around thirty years in their campaigns. Likewise, medical personnel should be prepared to handle similar profiles of injuries when motor vehicle crashes occur. The study also recommends that more studies should be conducted particularly using different injury severity scales, methods and with different samples.