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      Technological solutions for an effective health surveillance system for road traffic crashes in Burkina Faso


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          Background: In the early 2000s, electronic surveillance systems began to be developed to collect and transmit data on infectious diseases in low-income countries (LICs) in real-time using mobile technologies. Such surveillance systems, however, are still very rare in Africa. Among the non-infectious epidemics to be surveilled are road traffic injuries, which constitute major health events and are the fifth leading cause of mortality in Africa. This situation also prevails in Burkina Faso, whose capital city, Ouagadougou, is much afflicted by this burden. There is no surveillance system, but there have been occasional surveys, and media reports of fatal crashes are numerous and increasing in frequency.

          Objective: The objective of this article is to present the methodology and implementation of, and quality of results produced by, a prototype of a road traffic crash and trauma surveillance system in the city of Ouagadougou.

          Methods: A surveillance system was deployed in partnership with the National Police over a six-month period, from February to July 2015, across the entire city of Ouagadougou. Data were collected by all seven units of the city’s National Police road crash intervention service. They were equipped with geotracers that geolocalized the crash sites and sent their positions by SMS (short message service) to a surveillance platform developed using the open-source tool Ushahidi. Descriptive statistical analyses and spatial analyses (kernel density) were subsequently performed on the data collected.

          Results: The process of data collection by police officers functioned well. Researchers were able to validate the data collection on road crashes by comparing the number of entries in the platform against the number of reports completed by the crash intervention teams. In total, 873 crash scenes were recorded over 3 months. The system was accessible on the Internet for open consultation of the map of crash sites. Crash-concentration analyses were produced that identified ‘hot spots’ in the city. Nearly 80% of crashes involved two-wheeled vehicles. Crashes were more numerous at night and during rush hours. They occurred primarily at intersections with traffic lights. With regard to health impacts, half of the injured were under the age of 29 years, and 6 persons were killed.

          Conclusions: This pilot study demonstrated the feasibility of developing simple surveillance systems, based on mHealth, in LICs.

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          Most cited references21

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          The neglected epidemic: road traffic injuries in developing countries.

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            Enhancing spatial detection accuracy for syndromic surveillance with street level incidence data

            Background The Department of Defense Military Health System operates a syndromic surveillance system that monitors medical records at more than 450 non-combat Military Treatment Facilities (MTF) worldwide. The Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) uses both temporal and spatial algorithms to detect disease outbreaks. This study focuses on spatial detection and attempts to improve the effectiveness of the ESSENCE implementation of the spatial scan statistic by increasing the spatial resolution of incidence data from zip codes to street address level. Methods Influenza-Like Illness (ILI) was used as a test syndrome to develop methods to improve the spatial accuracy of detected alerts. Simulated incident clusters of various sizes were superimposed on real ILI incidents from the 2008/2009 influenza season. Clusters were detected using the spatial scan statistic and their displacement from simulated loci was measured. Detected cluster size distributions were also evaluated for compliance with simulated cluster sizes. Results Relative to the ESSENCE zip code based method, clusters detected using street level incidents were displaced on average 65% less for 2 and 5 mile radius clusters and 31% less for 10 mile radius clusters. Detected cluster size distributions for the street address method were quasi normal and sizes tended to slightly exceed simulated radii. ESSENCE methods yielded fragmented distributions and had high rates of zero radius and oversized clusters. Conclusions Spatial detection accuracy improved notably with regard to both location and size when incidents were geocoded to street addresses rather than zip code centroids. Since street address geocoding success rates were only 73.5%, zip codes were still used for more than one quarter of ILI cases. Thus, further advances in spatial detection accuracy are dependant on systematic improvements in the collection of individual address information.
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              The burden of road traffic injuries in developing countries: the 1st national injury survey of Pakistan.

              To assess the burden of road traffic injuries in Pakistan-a developing country in South Asia. A nationally representative household interview survey, to measure the burden of all injuries for all ages and in both genders using a three-month recall period. The overall incidence of injury events was 41 (CI: 39.2-43.8) per 1000 per year and for road traffic injuries 15 (CI: 13.7-16.5) per 1000 per year. The relative risk for road traffic injuries was found to be higher in males, those 16-45 years old, and those in the professional category of laborers and vendors. This first national survey reflects the growing impact of injuries, especially road traffic injuries in Pakistan and portends a challenge for the national health system.

                Author and article information

                Glob Health Action
                Glob Health Action
                Global Health Action
                Taylor & Francis
                2 June 2017
                : 10
                : 1
                [ a ]UMI Résiliences 236, French National Research Institute for Sustainable Development (IRD) , Bondy, France
                [ b ]CNRST, Institut des Sciences des Sociétés (INSS) , Ouagadougou, Burkina Faso
                [ c ]Africasys , Paris, France
                [ d ]Département de Géographie, Université de Ouagadougou , Ouagadougou, Burkina Faso
                [ e ]University of Montreal School of Public Health (ESPUM) , Montreal, Canada
                [ f ]University of Montreal Public Health Research Institute (IRSPUM) , Montreal, Canada
                Author notes
                CONTACT Emmanuel Bonnet emmanuel.bonnet@ 123456ird.fr Institut de Recherche pour le Développement , 32 avenue Henri Varagnat, 93143 Bondy Cedex, France
                © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 5, Tables: 1, References: 28, Pages: 11
                Funded by: Canadian Institutes of Health Research 10.13039/501100000024
                This work was supported by the Canadian Institutes of Health Research (CIHR) [Grant no. ROH-115213]; CIHR-funded Research Chair in Applied Public Health [Grant no. CPP-137901].
                Original Article

                Health & Social care
                road safety,public health,trauma,injury,system
                Health & Social care
                road safety, public health, trauma, injury, system


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