Prevalence and Risk Factors Associated with Road Traffic Crash among Bus Drivers in the Southern Region of Cameroon: A Cross Sectional Study

Research Article

Austin J Public Health Epidemiol. 2023; 10(3): 1148.

Prevalence and Risk Factors Associated with Road Traffic Crash among Bus Drivers in the Southern Region of Cameroon: A Cross Sectional Study

Orogho Malvis Arrey1; Adamu Ndongho Ndifontiayong2; Nde Fon Peter3; Albert Same Ekobe1,3*

¹Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Cameroon

²Research Unit of Microbiology and Antimicrobial Substances, Faculty of Science, University of Dschang, Cameroon

³Department of Parasitology Microbiology & Infectious Pathology, Laboratory of Parasitology, Mycology & Immunology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon

*Corresponding author: Albert Same Ekobe Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, & Department of Parasitology Microbiology & Infectious Pathology, Laboratory of Parasitology, Mycology & Immunology, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Cameroon. Tel: +237694945023 Email: sameekobo@yagmail.com

Received: April 27, 2023 Accepted: June 05, 2023 Published: June 12, 2023

Abstract

Background: Annually, road traffic crash account for more than 1.2 million deaths and up to 50 million injuries worldwide, making it a leading cause of death globally. Given the low rate of vehicle ownership in developing countries, most of the population depends on buses for public transport. In Cameroon, buses are frequently involved in road traffic crashes. The aim of this study was to determine the prevalence of road traffic crashes and risk factors associated with road traffic crash among bus drivers in the South West Region-Cameroon.

Methods: This was a cross-sectional study involving bus drivers with at least 3 years driving experience in passenger transportation. Multi-stage sampling was employed with random selection of six parks from three divisions in the South West Region of Cameroon. Proportionate sampling was done to select the bus drivers at the selected parks. Data was collected using a structured questionnaire. It was inputted and analyzed using EPI info version 3.5.4. Bivariate and multivariate analysis were used to identify risk factors associated road traffic crash history within 3 years prior to the survey with statistical significance set at p<0.05.

Results: Out of the total 422 participants recruited, 98 bus drivers reported, giving an overall crash prevalence of 23.2%. Among the crashed group, 72 drivers (12.1%) were involved in more than one crash within the past 3 years (2014-2017). Multivariate analysis showed excessive speed [AOR 6.98 95% CI; 3.7-12.8], drinking alcohol during driving hours [AOR 10.15, 95% CI; 4.7-21.8], phone distraction (AOR=6.48, 95% CI; 3.8-10.8], passenger distraction [AOR 8.77, 95% CI; 4.6-16.2], violating road traffic rules [AOR=2.13, 95% CI; 1.2-3.5] and fatigue [AOR 0.17, 95 & CI; 0.05-.053] as factors that are significantly associated with road traffic crash among bus drivers within the past 3 years (2014-2017).

Conclusion: Almost a quarter (23.2%) of bus drivers have a history of road traffic crash within the past 3 years. Many factors have been found to be associated with road traffic crash occurrence among these drivers and these calls for urgent sensitization campaigns, amelioration of road conditions and proper law enforcement on road safety issues.

Keywords: Prevalence; Risk factors; Bus drivers; South west region; Cameroon

Introduction

Road traffic crash which is defined as a collision or incident that may or may not lead to injury, occurring on a public road and involving at least one moving vehicle has become a global development and public health crisis requiring great and diverse attention [1,2]. Each year, road traffic crashes account for more than 1.2 million deaths and up to 50 million injuries worldwide, making it a leading cause of death globally.

With a global the risk of dying at 17.4 per 100 000 population in 2015, the African region has the highest rate at 26.6 per 100 000 population and that of Cameroon is at 27.6 per 100,000 population. Increase in the number of vehicles on world’s roads has been identified as one of the factors responsible for high rates of road traffic crashes [3].

However, even though vehicle ownership continues to rise, some regions in developing countries like the African region in particular, remains the least motorized of the six world regions, possessing only 2% of the world’s vehicles but suffers the highest rates of road traffic fatalities and contributes to 16% of global deaths [4]. In Cameroon vehicle ownership is very low, estimated at 20 cars per 1000 persons but the country loses about 3,512 people for every 100,000 cars every year [5,6].

Due to low vehicle ownership, most developing countries depend on public transport, particularly, the road. The road remains the most dangerous of all means of transport especially in SSA. Most of the public transport is mostly through second-hand and accident-prone buses [7]. In Cameroon, bus accidents are very frequent and usually fatal [8].

Human factors have been found to account for more than 80% of road traffic crashes in developing countries than vehicle and environmental factors [9]. WHO global status report for road safety has stated that identifying the risk factors associated with road traffic crashes is very important in developing strategies for its reduction [1]. This is in addition to another report that recommended a major focus on research and interventions for road traffic crash in developing nations [10]. Cameroon has a road safety strategy to stabilize and to reduce road traffic crash deaths by 50% by 2020 [11] but limited work has been published work on risks for RTCs in the country. Thus, well-conducted, scientifically rigorous research on the burden of RTCs, risk factors and effectiveness of interventions are crucial elements that need to be prioritized in order to prevent and control RTCs [12]. Therefore, this study aims to determine the prevalence of RTCs among bus drivers in the SWR as well as the risks factors that are associated with the occurrence of the RTCs.

Methods

Study Setting and Design

The study was conducted in the South West region of Cameroon which is about 54.7km to Douala, the economic capital of Cameroon [13]. The South West region is connected to two other regions of the country through two axes where accidents mostly occur. The South West is linked to that the Littoral region where the economic capital is found through the Tiko- Douala road. Road traffic accidents are very prevalent on this road. Linking to North West Region, is the Buea-Muyuka stretch that also records very fatal accidents particularly along the Mile 29 slope found on this stretch [14]. Road traffic accidents are the second cause of death in Cameroon after malaria [15]. A cross-sectional study was conducted on bus drivers who were randomly selected from six different parks and road traffic accident history with the past three years was obtained. Quantitative techniques were employed.

Study Population and Variables

Bus drivers involved in passenger transport in the South West region with at least 3 years of experience were included in the study. The dependent variable in this study was history of involvement in one or more RTC(s) within the past three years. The independent variables were several factors related to the driver, the environment or the vehicle.

Sample Size and Sampling Techniques

The sample size was determined using Lorentz formula, assumed prevalence of 50%, with 95% two-sided confidence interval, a total sample size of 422 was calculated with an added 10% non-response rate. Multistage sampling was employed with random selection of six parks from three divisions and proportionate sampling of bus drivers at the parks.

Data Collection Process and Data Quality Control

Data was collected using a structured questionnaire and pre-tested to check the consistency and understandability of the questions. Every day, after data collection, data were checked for completeness and coherence.

Data Processing and Analysis

The data were entered and analyzed with EPI Info version 3.5.4. Bivariate logistic regression analysis was carried out to distinguish the independent effect of each variable. Using multivariate logistic regression analysis, 95% CI and Adjusted Odds Ratios (AORs) were computed in order to identify any statistically significant associations between risk factors and RTC involvement. The level of statistical significance was set at P<0.05.

Ethical Considerations

Ethical clearance was obtained from the Institutional Review Board, Faculty of Health Sciences, University of Buea. Administrative authorization was obtained from the Regional Delegation of Public health, Regional Delegation of transport, Divisional Delegations of transport, park managers and bus agency managers. Consent was obtained from all the participants who were also informed that participation was voluntary and were free to withdraw any time during the study.

Results

Socio-Demographic Characteristics

A total of 422 bus drivers participated in the study. The mean age of the drivers was 41.3±8.6 years with respondents ranging from 18 to 60 years old. As seen in Table 1, most of the drivers were between the ages of 31-40 years (n=171, 40.5%), married/living with partner (n=266, 63.1%), Christians (n=345, 81.8%). primary level of education (367, 87.0%), and full time (331, 78.6%). A majority (401, 95%) had more than 3 years driving experience.