Lower extremity injuries secondary to road traffic accidents in East Africa: A systematic review

Abstract

Background: Road traffic accidents (RTAs) are a significant contributor to morbidity and mortality in East Africa. Lower extremity (LE) injuries are especially debilitating, negatively impacting quality of life and employment prospects. This systematic review characterizes the proportion of LE injuries due to RTAs in four members of the East African Community: Kenya, Rwanda, Tanzania, and Uganda. Methods: Embase, Medline, Web of Science, and PubMed were queried for studies from 2010 to 2022 providing information on lower extremity injuries caused by RTAs in the countries of interest. Proportions of RTA-related LE injuries were extracted from eligible papers. Study quality and bias were assessed using the framework for systematic reviews established by Zaza et al.1 Results: Seven studies met the eligibility criteria–four for Kenya, two for Uganda, and one for Tanzania; however, no eligible studies were found for Rwanda. The proportion of RTA-related injuries affecting the lower extremities ranged from 0.39 to 0.49. In patients presenting with LE injuries, RTAs were the most frequent cause, representing more than 70% of cases in the examined studies. Motorcycle accidents were not more likely to cause LE injuries, but they were the most significant contributor to the overall LE injury burden due to their prevalence. Conclusions: With urbanization and the increased adoption of low-cost motorcycles, RTAs will continue to pose a public health challenge. Investments in traffic enforcement and physical infrastructure will alleviate the risks to both motorists and pedestrians. In addition to primary prevention, there is a significant need for improvements in emergency care and surgical capacity.