The Prevalence, Severity And Pattern Of Head Injury Among Motorcycle Crash Victims At Kenyatta National Hospital
Abstract
Introduction. Motorcycles represent the most dangerous form of motorized transportation,
and their increased use has been associated with a rise in motorcycle related crashes. In last
decade, Kenya witnessed an explosion of motorcycle numbers and a concomitant increase in
motorcycle crash-related deaths and injuries has been noted. Head injury is the main cause of
death, severe morbidity and long-term disability among motorcyclists. However, few hospital
based studies have been conducted to evaluate the prevalence and severity of motorcycle
crash related-head injuries (MCR-HIs) and none has determined the pattern of head injuries
in this patient population in Kenya.
Objectives. This study aimed to determine the burden, evaluate severity and describe the
pattern of MCR-HIs at Kenyatta National Hospital (KNH). The rate of helmet use among
MCR-HI patients was also estimated. The desired outcome is prevention and reduction of
motorcycle crash related head injuries, mortality and disability among motorcyclists in
Kenya.
Methodology. Sixty consecutive patients with motorcycle accident related head injury seen
between 5th December, 2017 and 28th February, 2018 were prospectively studied using a predesigned
questionnaire. Data analysis was done using Statistical Package for Social Sciences
(SPSS) version 21.0 software.
Results. Head injury was present in 30.3% (n=60) of the patients with motorcycle crash
injury (MCI) who presented to KNH during the study period. MCR-HI represented 25.0% of
the total head injuries attended during the same period. Motorcycle operators (37, 61.7%)
formed the largest proportion of patients with MCR-HI. Fifty-five (91.7%) subjects were
male and the mean age was 29.4 years (SD 14.4 years, range 4 to 67 years), with majority
(21, 35.0%) falling in the age group 20 – 29 years. More than two-thirds (44, 73.3%) of the
patients were in the economically active age group (i.e. 20 - 49 years). There was a
significant proportion of children younger than 10 years (8, 13.3%) and these made up 61.5%
of the pedestrians. Motorcycle-vehicle collision (21, 35.0%) was the most common accident
type. Thirty-nine (65.9%) of the patients had mild head injury, while seven (11.7%) and
fourteen (23.3%) incurred moderate and severe head injury, respectively. Intracranial
UNIVERSITY OF NAIROBI
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haemorrhage (42, 70.0%) was the most common craniocerebral injury type, with cerebral
contusions (36, 63.2%) constituting the majority. Scalp injury (34, 56.4%), and skull fracture
(31, 51.7%) were the other significant injuries. There was a notable low helmet use rate (11,
23.4%) among motorcyclists with MCR-HI, which was worse among passengers (1, 10.0%).
Helmet use reduced the rate of severe head injury, scalp injury, skull fracture and extradural
hematoma. However, helmets were not protective against cerebral contusions. Limb injuries
represented the most common non-craniocerebral injury associated with MCR-HI.
Conclusion. MCR-HI is an important public health problem in Kenya. Being a preventable
injury, every effort is needed to eradicate it. Helmet use among motorcyclists with MCR-HI
is low, especially amongst passengers. Though protective against head injury, the helmet’s
efficacy has significant limitations. Therefore, measures to prevent MCR-HIs should not
promote helmet use in isolation. Effective prevention efforts must, instead, be more holistic
to include promotion of safe riding habits and behaviour, as well as enforcement of road
traffic regulations.
Limitations. This study has the following important limiting factors; small sample size,
recall bias, single-site study, and pre-hospital deaths.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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