Road Traffic Injury Prevention Initiatives: A Systematic Review and Metasummary of Effectiveness in Low and Middle Income Countries.
Road Traffic Injury Prevention Initiatives: A Systematic Review and Metasummary of Effectiveness in Low and Middle Income Countries.
复制标题
DOI：
10.1371/journal.pone.0144971
复制
发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Hocker M
中科院分区：
文献类型：
--
作者：
Staton C;Vissoci J;Gong E;Toomey N;Wafula R;Abdelgadir J;Zhao Y;Liu C;Pei F;Zick B;Ratliff CD;Rotich C;Jadue N;de Andrade L;von Isenburg M;Hocker M
道路交通伤害是一个日益严重但被忽视的全球健康危机，需要有效预防以促进可持续安全。低收入和中等收入国家承担着不成比例的沉重负担，占世界道路交通死亡人数的90%，而且由于快速城市化和机动化，这些国家的道路交通感染正在升级。虽然有几项研究评估了特定干预措施的有效性，但尚未进行系统评价，总结在低收入和中等收入国家环境中专门实施的RTI预防举措的有效性；这项研究将有助于填补这一空白。根据PRISMA指南，我们检索了MEDLINE、EMBASE、Scopus、Web of Science、TRID、Lilacs、Scielo和Global Health等电子数据库。如果文章通过评估与撞车、RTI或死亡相关的预防相关干预措施来考虑中低收入国家的RTI预防，则文章是合格的。此外，还进行了参考文献和引文分析以及数据质量评估。采用定性元汇总方法进行数据分析，并计算效应大小以量化新主题的大小。在文献检索的8560篇文章中，来自11个低收入国家的18篇文章符合资格和纳入标准。在这些研究中，有4项来自撒哈拉以南非洲，10项来自拉丁美洲和加勒比，1项来自中东，3项来自亚洲。一半的研究专门关注立法，而其他研究则关注速度控制措施、教育干预、执法、道路改善、社区项目或多方面的干预。立法是最常见的干预措施，当与强有力的执法举措相结合或作为多方面方法的一部分时，评估结果最好。由于速度控制对预防碰撞和伤害至关重要，在低收入和中等收入国家，道路改善干预措施应仔细考虑改善措施对速度和交通流量的影响。进一步的道路交通伤害预防干预措施应在以患者为中心的低收入国家实施，以指导这些复杂环境中的伤害预防。
Road traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world’s road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap. In accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes. Of the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention. Legislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.