Road traffic related mortality in Vietnam: evidence for policy from a national sample mortality surveillance system.
Road traffic related mortality in Vietnam: evidence for policy from a national sample mortality surveillance system.
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DOI：
10.1186/1471-2458-12-561
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发表时间：
2012-07-27
影响因子：
4.5
通讯作者：
Hill PS
中科院分区：
文献类型：
--
作者：
Ngo AD;Rao C;Hoa NP;Hoy DG;Trang KT;Hill PS
道路交通伤害（RTI）是越南死亡的主要原因之一。然而，越南的死亡率数据收集系统，特别是生殖道感染的数据收集系统，仍然不一致和不完整。从常规数据收集系统或迄今为止的研究中无法获得外部原因和身体伤害的基本分布。本文介绍了越南国家抽样死亡率监测系统在两年期间（2008年和2009年）确定的1,061例道路交通事故死亡的特征、用户类型模式、季节分布和原因。为越南设计了一个样本死亡率监测系统，包括16个省的192个公社，约占越南人口的3%。从社区一级的数据来源中确定死亡，并通过死因推断（VA）进行随访。计算RTI的标准化死亡率。对VA问卷进行了深入分析，以得出样本中RTI死亡的描述性特征。生殖道感染的年龄标准化死亡率男性为每10万人33.5人，女性为每10万人8.5人。大多数死亡是男性（79%）。73%的死亡者年龄在15至49岁之间，58%的死亡者是摩托车使用者。高达80%的死亡发生在受伤当天，42%发生在到达医院之前，另有29%发生在现场。446例死亡（42%）的直接死亡原因被确定，头部受伤是最常见的原因，可归因于道路交通伤害（79%），特别是摩托车碰撞（78%）。VA方法可为RTI死亡率的分析提供有用的数据源。摩托车使用者头部受伤的死亡率相当高，这突出表明需要评估越南目前使用摩托车头盔的做法和有效性。大量的死亡发生在现场或入院前，这表明需要有效的院前急救服务和及时利用急救设施。在缺乏标准化死亡证明的情况下，需要持续努力加强死亡率监测点，辅以VA，以支持基于证据的RTI死亡率监测和控制。
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). 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. 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%). 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.
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