Injury prevention; Motorcyclists Responses and Practices on the Use of Helmets in Mwanza, Tanzania

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1 49 49 ISSN Eat Cent. Afr. J. urg Injury prevention; Motorcyclit Repone and Practice on the Ue of Helmet in Mwanza, Tanzania S. Kilawa 1, O.V. Nyongole 2. 1Medical tudent, School of Medicine, Muhimbili Univerity of Health and Allied Science 2Department of Surgery, School of Medicine, Muhimbili Univerity of Health and Allied Science Correpondence to: Obadia V Nyongole, onyongole@yahoo.co.uk Background: Regarding rik factor for motorcycle injurie, the non-ue of helmet ha been identified a a pecific factor leading to head injurie and fatalitie reulting from motorcycle crahe. Helmet a a protective meaure have been identified to be effective toward head injury prevention. Objective: Thi tudy aimed to determine the knowledge, attitude and practice among motorcyclit on helmet ue in Mwanza region, Tanzania. Method: Thi wa a decriptive cro-ection tudy conducted in Mwanza region at different motorcyclit parking point, uing a tandardized tool, collected data were cleaned, analyzed and proceed by uing SPSS 16. Reult: A total of 200 motorcyclit were involved in the tudy. Knowledge on helmet ue wa high in mot of them (91.5%) with lightly low poitive attitude (87.5%) on helmet ue although poeion of helmet wa good of which 97.5% of them had helmet. Mot of thoe motorcyclit 156(85.2%) with high knowledge had poitive attitude on helmet ue (P-value =0.000 indicating trong aociation between knowledge and attitude. Practice on helmet ue every day at every trip wa alo influenced by knowledge. Thi relationhip i further upported by p-value (0.00), indicate that there i trong aociation. (The chiquare i 0.00) Concluion: The tudy how that majority of motorcyclit in Mwanza region are young adult with formal education, with mot of them having high knowledge and poitive attitude on helmet ue.the conitency of helmet ue in our tudy ubject eem to be influenced poitively by level of education. Key word: Knowledge, attitude, practice, motorcyclit, helmet Introduction Road traffic injurie (RTI) are a leading caue of diability and fatality globally. Motorcyclerelated injurie, mainly head injurie, and related death and diabilitie are a ignificant contributor to the burden of dieae in low- and middle-income countrie (LMIC).Motorcycle accident a among other type of road accident form a fatal category of motor traffic accident. Thi i becaue motorcyclit are more at rik of utaining injury than motor vehicle driver; per mile travelled, motorcycle rider have a 34 time rik of death than the driver of other type of vehicle. They are alo 8 time more likely to be injured 1-4. Road traffic injurie form a ignificant amount of injury related mortality and morbidity around the world with an etimated 1.2 million people killed and about million injured on the road annually, motorcyclit death and injurie are an important public health of concern. Motorcycle uer are vulnerable on the road and repreent an important group to target from reducing road traffic injurie 5-6. In middle and low-income countrie, motorcycle form a common mean of tranport. Motorcyclit form ignificant road traffic accident, due to the rapidly increaing number of motorcycle from 6,700 in 2007 to 85,000 in 2009, and13 fold increae in the period of 2 year 7-8. COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)

2 50 50 ISSN Eat Cent. Afr. J. urg Commercial motorcycle are old at relatively cheaper price than other vehicle and good earning from the motorcycle taxi buine which encourage more people epecially youth to join thi buine and increae the number of motorcycle. Motorcycle in low- and middleincome countrie account for the majority of thee injurie. Nearly 85% of the global burden of road traffic injurie i accounted for by thee countrie. The road traffic injury mortality rate i highet in Africa, 28.3 per 100,000 population when corrected for underreporting, compared with 11.0 in Europe.The rate of road traffic death in Sub-Saharan Africa i 40% higher than that in all other low- and middle-income countrie (28.3 compared to 20.2 per 100,000) and 50% higher than the world level (28.3 compared to 19.0 death per 100,000 population) making traffic injurie the 10th leading caue of death in the region. The majority of the motorcyclit don t wear any protective gear, hence aggravating the rik of getting evere head injurie5, 8-9. Regarding rik factor for motorcycle injurie, the non-ue of helmet ha been identified a a pecific factor leading to head injurie and fatalitie reulting from motorcycle crahe. Helmet a a protective meaure have been identified to be effective toward head injury prevention and reduce the fatality of motorcycle rider. 8 To protect themelve from head injury, motorcyclit need to conitently and properly wear helmet according to the precribed tandard. Depite their effectivene, helmet are not a widely ued a they hould be and when ued, they are not ued properly. 10 Some reaon for non-adherence and non-ue of helmet include feeling of dicomfort due to heat during the hot weather, and lateral viion and hearing ability impairment. 11 According to tudie done in Vietnam, Nigeria and USA, low rate of helmet ue have been evident depite the enactment of helmet law. 23.8% had a helmet on at the time the tudy wa conducted. The majority (67.3%) favoured the enforcement of crah helmet while other would reject the idea. In Eat Africa, The motorcycle, commonly called boda boda in Uganda and Kenya 11. Tanzania and Kenya account for more road traffic death with 34.3 and 34.4 death per 100,000 population repectively. Burundi, Uganda and Rwanda account for 23.4, 24.7 and 31.6 death per 100,000 population repectively 12. Motorcycle accident have drawn great attention from the Tanzanian government authoritie. For example, 2010 Road Safety Week had a theme of Dicourage High Speed; Cyclit Wear Helmet; Accident Kill, Injure 13. Motorcycle ha recently become increaingly popular in Tanzania a a mean of commercial tranport but their operation i characterized by nonhelmet ue by rider and their paenger, paenger overload, lack of certified driver training and valid licening, over peed and reckle driving, poor regulation and law enforcement and poible ue of alcohol and drug a ten year epidemiological appraial urvey done in Tanzania 14 Between 1990 and 2000 road accident roe by 44% for a cumulative total of 10,107. However due to the rapid importation of motorcycle, the contribution of motorcycle to road accident cannot be ignored; in the firt three month of the year 2010, 181 people died in motorcycle accident. 7 Reported that by the end of 2007 will be that peron killed in accident will increae by 30%, the number of reported injurie will increae by 35%, and the cot of reported accident and caualitie will a well increae by 30 % (Tanzania Annual Road convection Report, 2005). Thi tudy aimed to ae the knowledge, attitude toward, and the practice of helmet ue among motorcyclit in Mwanza, Tanzania. COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)

3 51 51 ISSN Eat Cent. Afr. J. urg Method Thi wa a decriptive community baed cro ectional tudy which wa conducted in randomly elected commercial parking point by interviewing commercial motorcyclit in Mwanza uing a tandardized data collecting tool. Included in the tudy were all commercial motorcyclit with a motorcycle at the parking point with and /or without a cutomer to be ridden. Excluded from the tudy were commercial motorcyclit whom did not conent to be part of tudy. Permiion to conduct the tudy wa ought from Muhimbili Univerity of Health and Allied Science (MUHAS), region adminitration and the motorcyclit at parking point. Conent wa ought from the motorcyclit. Data cleaning wa done before feeding it into the computer for analyi, data wa analyzed uing SPSS 16.0 program. Cro-tabulation were generated, and where comparion were made, ignificance wa conidered at p-value of le than Study Limitation Sample drawn may not be repreentative of the tudy population, reluctance of ome motorcyclit to be part of tudy. Limited reource for the tudy and hort tudy period. Reult A total of 200 motorcyclit were involved. Majority were at age group (62.5%) year. Mot of thoe motorcyclit 156(85.2%) with high knowledge had poitive attitude on helmet ue while 6 (75%) of motorcyclit with low knowledge had negative attitude on helmet ue with (P-value =0.000 indicating trong aociation between knowledge and attitude. Majority 71.6% of the motorcyclit who had high knowledge were uing helmet every day at every trip while 75% of thoe who had low knowledge never ued helmet. Thi relationhip i. further upported by p-value (0.00), indicate that there i trong aociation. (The chi- quare i 0.00) (Table 1). Table 1. Ditribution of Study Population by Age Age Number Frequency Percentage % % % % % > % TOTAL % COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)

4 52 52 ISSN Eat Cent. Afr. J. urg Table 2. Ditribution of Study Population by Level of Knowledge Level of Knowledge Number Frequency Percentage Low 8 4% Moderate 9 4.5% High % T0TAL % Table 3. Attitude on Helmet Ue among Motorcyclit in Mwanza Attitude Number Frequency Percentage Poitive % Negative % Total % Table 4. Cro Tabulation Between Knowledge and Attitude Attitude Knowledge Low Moderate High Total Poitive 2 (25%) 8 (89%) 156 (85.2%) 166 (83%) Negative 6 (75%) 1 (11.1%) 27 (14.8%) 34 (17%) Total 8 (100%) 9 (100%) 183 (100%) 200 (100%) Among 200 motorcyclit in Mwanza, majority had completed primary chool 82 (41%) while only 0.5% of our tudy population never went for formal education. Majority of them had high knowledge on helmet ue 183 (91.5%) (Table 2). Majority had the helmet; they ue by (95.5%). Mot of them ued helmet every day at every trip 136 (68%).Small majority of paenger ue helmet every day at every trip 63 (31.5%) and when they anticipate meeting policeman 52 (26%). Mot (85.2%) of thoe motorcyclit with high knowledge had poitive attitude on helmet ue while 6 (75%) of motorcyclit with low knowledge had negative attitude on COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)

5 53 53 ISSN Eat Cent. Afr. J. urg helmet ue. The p value indicate trong aociation between knowledge and attitude (P-value =0.00) (Table 4). Table 5. Cro tabulation of Knowledge and Practice of Helmet Ue among Motorcyclit Do you Wear Helmet? Knowledge Low Moderate High Total Ye 2 (25%) 9 (100%) 180 (98.4%) 191 (95.5%) No 6 (75%) 0 (0%) 3 (1.6%) 9 (4.5%) Total 8 (100%) 9 (100%) 183 (100%) 200 (100%) Table 6. Knowledge and Conitency on Ue of Helmet How Often Do you Wear Helmet? Knowledge Low Moderate High Total Every day at every trip 1 (12.5%) 4 (44.4%) 131 (71.6%) 136 (68%) Every day but not every trip Every long trip not hort trip When anticipate meeting policemen 0 (0%) 2 (22.2%) 26 (14.2%) 28 (14%) 1 (12.5%) 0 (0%) 6 (3.3%) 7 (3.5%) 0 (0%) 3 (33.3%) 17 (9.3%) 20 (10%) Never 6 (75%) 0 (0%) 3 (1.6%) 9 (4.5%) Total 8 (100%) 9 (100%) 183 (100%) 200 (100%) The majority (87.5%)of our participant had poitive attitude on helmet ue. A total of 195 (97.5%) of motorcyclit had helmet (Table3). Mot (98.4%) of motorcyclit with high knowledge ued helmet while 75% of motorcyclit with low knowledge were not uing helmet. Thi relationhip i more upported by p-value, which indicate trong aociation between knowledge and practice of wearing helmet (p value=0.00) (Table 5). COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)

6 54 54 ISSN Eat Cent. Afr. J. urg Majority (71.6%) of the motorcyclit who had high knowledge ued helmet every day at every trip while 75% of thoe who had low knowledge never ued helmet. Thi relationhip i further upported by p-value (0.00), indicate that there i trong aociation. (The chi- quare i 0.00) (Table 6). Dicuion Our tudy aimed to determine the knowledge, attitude and practice among motorcyclit on helmet ue in Mwanza region, Tanzania. Our reult how majority (62.5%) of motorcyclit were at the age group between 20 to 25 year which i imilar to 66.5% the tudy done by Mwakalaa in Tanzania 15. Forty one percent of our participant had primary chool education thi i lightly low compared to what wa found in other tudie. Majority of motorcyclit had low level of education that partly attributed to the fact that they had limited chance of getting other job and thu engage into motorcycling buine a a lat option following unemployment regardle of being a riky job Thi tudy demontrated that 87.5% of our client had poitive attitude on helmet ue, Alo 97.5% of thoe with poitive attitude had helmet, with 95.5% of them uing helmet and mot of them 68% uing helmet conitently at every trip. Thi wa high compared to what wa oberved in one local tudy. 15 Thi wa alo reflected by 85.2% of motorcyclit with high knowledge having poitive attitude on helmet ue. In our tudy, 98.4% of motorcyclit who had high knowledge owned helmet and 71.6% of them were uing helmet every day at every trip. Mot 75% of motorcyclit with low knowledge didn t poe helmet and never ued thi i imilar to what wa reported in other tudy 2. The majority of our participant 95% perceived wearing helmet a neceary even without law reinforcement, Mot of client 98.5% perceived helmet ue a important for both driver and paenger afety although they mentioned a number of limitation uch a hot weather, wearing helmet reduce peripheral viion Concluion The tudy how that majority of motorcyclit in Mwanza region are young and young adult with formal education which influenced poitively their knowledge, attitude and practice on helmet ue. The conitency of helmet ue wa found to be aociated with level of education, knowledge and poitive attitude toward helmet ue. We recommend to provide education on proper and conitency ue of helmet all over the country. Acknowledgement We would like to thank the chairperon of motorcyclit union of Mwanza region a well all motorcyclit who participated in our tudy.we alo thank the Management of the School of Public Health and Social Science of Muhimbili Univerity and allied cience and all taff member for organizing the tudy. Reference 1. National Highway Traffic Safety Adminitration (2007). Traffic Safety Fact 2005: Motorcycle, Wahington, DC. National Highway Traffic Safety Adminitration (2004). 2. Brown V, Hejl K, Bui E, Tip G, CoopwoodB. (2009). Rik factor for riding and crahing a motorcycle unhelmeted. The journal of emergency medicine. 3. Chang, H.L., &Yeh, T.H. Motorcyclit accident involvement by age, gender and rik behaviour in Taipe; Taiwan. Tranportation reearch.2006; COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)

7 55 55 ISSN Eat Cent. Afr. J. urg 4. Hung, D., Stevenon, M., Iver, R. Barrier to, and factor aociated, with oberved motorcycle helmet ue in Vietnam. Accident analyi and prevention.2008; 40, Peden, M., Scurfield, R., Sleet, D., Mohan, D., Hyder, A., Jarawan, E. (2004). World report on road traffic injury prevention Geneva: WHO. 6. Solagberu, B.A., Ofoegbu, C.K.P., Nair, A.A.,Ogundipe, O.K., Adekanye, A.O. &Abdur- Rahman, 7. L.O. Motorcycle injurie in a developing country and the vulnerability of rider, paenger, and pedetrian. Injury prevention.2006; 12, Nkwame, M. (2010). Motorcycle accident claim 181 live in four month. The daily new. Retrieved July 23, 2010.from new.co.tz. 9. World Health Organization (2006). Helmet: A Road Safety Manual for Deciion-maker and Practitioner. WHO, Geneva, Switzerland. 10. Naddumba, E.K. A cro ectional retropective tudy of boda-boda injurie at Mulago Hopital in Kampala, Uganda. Eat and Central African Journal of urgery.2004; 9, Li, L., Li, G., Cai, Q., Zhang, A., Lo, S. Improper motorcycle helmet ue in provincial area of a developing country. Accident analyi and prevention.2008; 40, Dandona, R., Anil G., Dandona. L. Riky behaviour of driver of motorized two wheeled vehicle in India. Journal of afety reearch.2005; 37 (2), Peltzer, K. Road ue behaviour in Sub-Saharan Africa. Public Health.2011; 122 (12). 14. Mutapha, S. (2010). 64 killed in motorcycle accident by June. The Daily New. Retrieved October 15. Mueru, L., Mcharo, C., Lehabari, M. Road Traffic Accident in Tanzania: A Ten Year Epidemiological Appraial. Eat and Central Africa Journal of urgery.2002; 7 (1), Mwakalaa, E.G. (2011).Attitude and knowledge among commercial motorcyclit in Dar e alaam Tanzania 17. Iribhogbe, P., Odai, E. Driver-related rik factor in commercial motorcycle (okada) crahe in Benin City, Nigeria. Pre-hopital Diater Medicine.2009; 24(4): Keng S. Helmet ue and motorcycle fatalitie in Taiwan. Accident analyi and prevention.2005; 31, Brandt, M., Ahrn, K, Corpon, C. Hopital cot i reduced by motorcycle helmet ue. Journal of Trauma.2002; 53, COSECSA/ASEA Publication -Eat and Central African Journal of Surgery. July/Augut 2015 Volume 20 (2)