Factors Associated with Head Injuries Among Motorcycle Crash Victims (Mcvs) Reporting at the Tamale Teaching Hospital

Abstract

Background: Motorcycle crashes contribute 91.2% to all causes of head injury-related deaths in the Northern region. The northern region of Ghana host about 60-70% of the country’s motorcycle population. Motorcycle registrations increased to over 8000 motorbikes annually in the Tamale Metropolis. Despite the reported increase in motorcycle population and head injury-related deaths in the Northern region, little is known about underlying risk factors of traumatic head injuries among motorcycle users in the region. This study examined the factors contributing to head injuries among motorcycle crash victims (MCVs) reported at the Tamale Teaching Hospital. Methods: An unmatched case-control study was employed to understand the factors contributing to head injuries in motorcycle crash victims (≥16 years) reported at the Tamale Teaching Hospital, from December 2019 to May 2020. The study population was all motorcycle crash victims (MCV) of age 16 years and above, with cases being those having moderate/severe head injuries (GCS<13 and AIS-head >1), while those without head injury (GCS ≥13 and AIS-head ≤1) were selected as controls. Consecutive sampling was used to recruit participants. A total of 469 out of 548 MCVs recruited met the inclusion criteria. Of this number, 265 were selected as cases while 204 were selected as controls. A semi-structured questionnaire was used to interview patients and as well as to review their medical records for clinical data. Frequencies, percentages, and mean were used to describe data. Chi-square test was used to assess the difference in proportion between the cases and controls while both bivariate and multivariate logistic regression analyses were used to estimate the crude and adjusted odds ratios respectively, with their corresponding 95% confidence intervals to examine risk factors of head injury in motorcycle crashes. All statistical analyses were considered significant at p-value ≤ 0.05. Results: The overall age range of crashed victims was 16 to 89 years with a mean age of 34.2 (±13.5) years. Most of the crashed victims were in the age group 21–40 (cases: 57.4%, controls: 66.2%) and were mostly males (cases: 84.2%, controls: 63.2%). The proportion of motorcycle crash victims with head injury was high (56.5%, 265/469). A greater proportion of the cases 84.9% (225/265) were not wearing a helmet as compared to 43.1%(88/204) of the controls. The occurrence of motorcycle crashes in the darkness was relatively higher in cases (20.4%,54/265) than in controls (12.7%, 26/204). Only riding experience of 11 to 15 years (aOR = 2.91, 95%CI: 1.01, 8.39), partial helmet use (aOR = 4.78, 95%CI: 1.38, 16.55) and riding in darkness (aOR= 2.69, 95%CI: 1.28, 5.67) remained significant with head injury after controlling for confounders. Conclusion: Significant factors associated with head injuries among motorcycle crash victims were riding experience (between 11 to 15 years), partial helmet use, and nighttime driving (darkness). Education programs on road safety laws (e.g. helmet laws) particularly among young males as well as road safety law enforcement at night time, may result in a reduction of head injuries from motorcycle crashes.