Journal of Transport & Health 10 (2018) 186–193
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Prevalence of fatality and associated factors of road traffic accidents among victims reported to Burayu town police stations, between 2010 and 2015, Ethiopia
T
Girma Gemechu Hordofaa, Sahilu Assegidb, Abiot Girmab, ⁎ Tesfaye Dagne Weldemariumc, a
Burayu Town Health Office, Oromia Region, Ethiopia Department of Epidemiology, Institute of Health, Jimma University, Ethiopia c Department of Health Economics, management and policy, Institute of Health, Jimma University, Ethiopia b
A R T IC LE I N F O
ABS TRA CT
Keywords: Fatality Cross sectional Road traffic accidents Burayu Ethiopia
Background: Fatalities of road traffic accidents have become a huge global public health and development problem killing nearly 1.3 million people and disabling between 20–50 million people annually; and lost 518 billion US $ globally. Of these, 85% occurred in low- and middleincome countries. In Ethiopia road traffic accident is considered as manmade disaster. Since fatalities of road traffic accident is highly prevalent in Burayu town but no research was ever under taken; this research is necessary to identify fatalities and associated factors of road traffic accidents. Objective: The aim of this study was therefore to assess the magnitude of fatality and associated factors of road traffic accidents in Burayu Town, Ethiopia. Methods: A cross-sectional study was conducted using relevant police reports obtained from three police stations found in Burayu town. The study included reports from July 2010 to June 2015 and the study period was from June 1st to 15th, 2016. Both quantitative and qualitative techniques were employed. Bivaraite and multivariate analyses were performed to identify the factors associated with fatalities of road traffic accidents. Results: From July 2010 to June 2015, 533 road traffic accidents were registered in Burayu town, though the outcomes of 18 accidents were not recorded. About 462 individuals were affected by these accidents. Among these accidents, 117 (25%) resulted in death, 345 (75%) caused injuries. About 12.4 million birr resource was damaged. Fire following accidents [AOR 6.1, 95% CI; 1.94–19.4, failure to give priority for other vehicle 2.65 times more likely to cause fatality of road traffic accidents with [AOR 2.65, 1.41, 5] and driving without using seatbelt [AOR 2.3, 95% CI; 1.4.–4.7], were the most determinants of fatalities of road traffic accidents in Burayu town. Conclusions: Fatalities of traffic accidents were steadily increased in the studies of five fiscal years. Ensuring fire sting usher for all vehicles as well one car fire fighter as the town, giving priority for other vehicle as recommended by law, ensuring drivers using seatbelt and availing first aid service immediately after the accident occurred appear to be the most critical parts of necessary interventions.
⁎
Corresponding author. E-mail addresses:
[email protected] (G.G. Hordofa),
[email protected] (T.D. Weldemarium).
https://doi.org/10.1016/j.jth.2018.06.007 Received 29 November 2017; Received in revised form 1 June 2018; Accepted 25 June 2018
Available online 03 July 2018 2214-1405/ © 2018 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
Journal of Transport & Health 10 (2018) 186–193
G.G. Hordofa et al.
1. Background Road transport is the most widely used, complex and dangerous because it is highly associated with the rise in road traffic accidents (RTAs) (Paden et al., 2004). Road traffic fatality can be defined as a “death due to traffic crash immediately or within 30 days after traffic accidents. Road Traffic Accident can also be defined as an accident that occurs on a way or street open to public traffic, resulting in one or more persons being killed or injured, and involving at least one moving vehicle (WHO, 2009). Road traffic accidents have become a huge global public health and development problem killing nearly 1.3 million people a year and injuring or disabling between 20–50 million people worldwide annually; thus making the loss of 518 billion US $ globally (WHO, 2013). According to World Health Organization (WHO) report road traffic injuries are “the eighth leading cause of death globally, and the leading cause of death for young people aged 15–29.” The overall global road traffic fatality rate is 18 per 100,000 population among which middle-income countries have the highest annual road traffic fatality rates of 20.1 per 100,000 (WHO, 2013; Odero et al., 1997). Fatality related to road traffic accidents is predicted to increase by 83% in low-income and middle-income countries and to decrease by 27% in high-income countries (Chalya et al., 2012). African countries had the highest mortality rate, with 28.3 deaths per 100,000 populations (Admassie et al., 2010). In the African countries deaths from road traffic injuries are 40% higher than in all other low and middle income countries and 50% higher than the world average (Hailemichae et al., 2014; Population Census Commission of FDRE, 2008; Fekede et al., 2014). In Ethiopia, fatality of road traffic accidents are considered to be a manmade disaster. The Ethiopian National Road Safety Coordination Office cites a road crash fatality rate of 114 deaths per 10, 000 vehicles per year but the actual figure may be higher due to an improper reporting system. It has been regarded that many road accidents can be prevented and that road safety is essentially a development issue for many nations (Mutooro et al., 2010; Tintinalli et al., 2004; United Nation, 2011). Eighty percent of road traffic deaths occur in middle-income countries, which account about 85% of the mortalities and 90% of the disability adjusted life years (DALY) caused by RTAs worldwide. The risk of dying as a result of a road traffic injury is highest in Africa (24.1 per 100,000 population) and 38% of all African road traffic deaths occur among pedestrians (Ogendi and Ayisi, 2012). The problem is increasing in vehicles at a fast rate in African countries due to rapid motorization and other factors. Overall, in Egypt 64%, in Tunisia 58%, and in Morocco 51% were injury-related deaths in 2008. In Libya 43%, in Djibouti 42%, in Namibia 36%, and in Niger 34% have road traffic accident related deaths. The most economically active people (aged 15–59) are at the greatest risk of dying as a result of RTAs. For this age group, road traffic accidents affected more than three times as many males as females. Overall, 5% of deaths among males aged 15–59 are attributable to road traffic accidents, but this percentage rises to 6.5% for males in the 15–29 age group in Sub-Saharan Africa (WHO, 2015). Road traffic accidents have been considered to be one of the primary causes of mortality rates in different countries and Ethiopia is not an exception that the country has one of the world's worst accident records, 170 fatalities per 10,000 vehicles. From the total traffic accidents occurring every year, more than 11% are fatal accidents. Over 20% of the total traffic accident injuries are fatalities. The high percentage of fatalities indicates the critical lack of pre-hospital and emergency medical services. The alarming increasing trend of traffic accidents and fatalities are at 17% and 10% per year respectively. The accident cost analysis was estimated of traffic accident cost between 340–430 million Ethiopian Birr (ETB) which is 0.8–0.9% of the gross domestic product. Besides loss of life traffic accidents is attributed to, medical cost, physical pain, permanent disability and travel anxiety as well as it affects household income and national economy and also reduces quality of life. Therefore, road traffic crashes affect not only the health of individuals but also their family members, as it can drive households into poverty when they struggle to cope with the long term consequences of the events, including the costs of medical care, rehabilitation and loss of family (Chalya et al., 2010; Solagberu et al., 2006; Khare et al., 2012; Muvuringi, 2012). Burayu town, the study area, also has highest traffic movement and no day pass without traffic accidents but no enough intervention has been taken. In the town there is no road transport safety measure such as seat belt, controlling light, walking or cycling paths, road safety audit, speed limit (30 km/h) (WHO, 2008). So despite the growth of road traffic accidents in the town, no research have not yet seriously examined on this problem. Generally the central argument of the study is to assess the prevalence of fatality and associated factors of traffic accidents in Burayu town, and estimated for the whole country. In addition our motivation to carry out this research stemmed from the rise of fatalities of RTAs on the highways of Burayu town and its effect on the life of individuals (Yosef, 2008). As per the authors’ knowledge, there is no research conducted on the topic of interest in the study region and area. Therefore this specific research paper will help other researcher to conduct the study. So this study will assist concerned bodies in identifying the major causes of mortality (fatal) of RTAs. It helps concerned governmental institutions to associate the risk factors for fatal related to RTAs and identifies area of intervention of road traffic users (the community in general). It could also serve as springboard for further studies in the area and put the issue into the ongoing dialogue in the literature. Indeed, this study will help for policy makers and planners to formulate clear policy and legislation, by providing evidence based information.
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2. Methods and materials 2.1. Study setting and period Data was extracted from June 1st to 15th, 2016 from Burayu Town police station, Oromiya regional state, central Ethiopia. Burayu town is located in Oromiya national regional state and in the western direction of capital city (Finfinne town) with a distance of 15 km. The town is a high land area located at an altitude of 2580 m above sea level with an area of 66.5 km2. Burayu town is bounded: in the East by: Finfinne, in West by Walmera district, in Nort by Sululta Woreda and in South by Sebata hawas Wored. Burayu town has a total population of 256,416. There are two asphalt roads crossing the town of which one has 5 m width and length of 15 km. On average it serves 1700 cars and 100 motorcycles per day. The other road has a width of 7 m and length of 20 km which acts as the main road. On average this road serves 5040 cars and 50 motorcycles per day and it has 9 speed breakers. The road crossing the town connects the capital city to the western parts of Ethiopia. The road is the busiest one in the country, and RTAs are very prevalent (WHO, 2008). A retrospective cross sectional study design was used in this study. All road traffic accident victims reported to Burayu police station between 2010 and 2015 were study population. The Sample size was computed with the assumption of Confidence level of = 95%, Critical value z = 1.96 (from significance level α = 5%) and degree of precision, w = 0.05 (p) = 24% from previous study, fatality rate of road traffic accidents prevalence in Oromia (United Nation, 2011). The sample size was calculated using a formula for single population Proportion as follows.
n = (Zα /2)2P (1 − P ) d2 So,
n = (1.96)2*(0.24(1 − 0.24) = 280 (0.05)2 After adding 10% of incomplete and undetermined recorded of fatal accidents, then the final Sample size was 308. But by considering statistical issue such as magnitude of fatality rate per 10,000 vehicles, and to get sufficient candidate variable for multivariate analysis it is necessary to observe at least 5 years fatalities of road traffic accidents. So these statistical issues were focused as criteria to draw sample size for this study (Yosef, 2008). So, 480 documented victims’ registries of RTAs between July 2010 and June 2015 that were in three police stations registries of Burayu towns were identified. But of these, 462 sample victims’ registries that fulfill inclusion were included in sample. So the study was conducted on sample of 462 victims’ registries that recorded from July 2010 to June 2015 in three police stations (District 1, 2 and 3) of Burayu town. Besides, after identification of saturation stage of idea purposively selected four traffic police officers as well as four drivers who were used for key informant interview were also included in the sample. During data collection, documents that had undetermined outcomes and incomplete were excluded. Data were collected on variables like Socio-demographic characteristics of victims and drivers (age, sex, educational status, and driving experience), drivers’ behaviour related factors (traffic rule violation, seat belt use, phone call while driving, speed, failure to give priority for pedestrian and other vehicle, driving license status) vehicle related and other factors (vehicle ownership, type and age, fire following accidents, defect of vehicle, time at which first aid was given) and environmental related factors (poor light condition, poor road condition, road type, poor weather conditions were used as data collection tool). Three data collectors (2 BSc three nurses and 1 Environmental Health officer) were selected based on their previous experience of data collection. Data were collected from three police station's record (book of victim) using a checklist prepared based on the RTA registry format. The data collectors were trained for 2 days. 2.2. Operational definitions 2.2.1. Traffic death (fatal) At least one person (driver, passenger or pedestrian) died, due to road traffic accidents immediately or within 24 h since the police record concerned with 24 h accidents. 2.2.2. Nonfatal (injury) At least one person is injured and need medical care but no deaths occurred and it includes severe injury and slight injury of traffic accidents. 2.2.3. Undetermined outcomes Is the accidents that did not recorded as fatal or nonfatal or as resource damaged by traffic police and not registered on police registration book. 2.2.4. Incomplete record Is record that lack at least place, time, person and cause of fatal and non-fatal. 188
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2.2.5. Road traffic accident (RTA) Is an accidents between two or more vehicles, between vehicles and pedestrians, between vehicles and fixed obstacles. 2.2.6. Accident Is unfortunate incident that happens unexpectedly. 2.2.7. Pedestrian A person involved in an accident who was not at the time of the accident riding in or on any mechanically or electrically powered device. 2.2.8. Fatal accident Is an accident that resulted in at least one person's death. 2.2.9. Fatality Is a number of person died as a result of road traffic accidents (United Nation, 2011). 2.3. Data processing and analysis Data were entered and cleaned using Epi-data Version 3.1, and exported to SPSS Version 20 for analysis. Binary logistic regression was used to assess associations between fatalities of RTAs and its associated factors. Ninety five percent confidence intervals (CI) and P value < 0.05 was considered statistically significant. 2.4. Ethical consideration Ethical clearance was obtained from the Institutional Review Board of Jimma University before the study was conducted and Burayu zonal police officer provided permission. Victims' names were not recorded on the checklist to guarantee confidentiality of the information. The advantages and purposes of the study were explained to staff members of the traffic police officers. Then, for retrieval of individual record and confidentiality of information a verbal consent was given to the record office (statistics unit) of the police station. After completion of data collection, police records were returned back to their original place properly. 3. Results 3.1. Socio-demographic characteristics of road traffic accidents victims and drivers The result of this study shows that, there were 533 RTAs registered in three police stations of Burayu town between July 2010 and June 2015 and the result of 18 accidents were not recorded. Among these accidents, 117 (25%) resulted in death and 345 (75%) caused injuries. Among those resulted in death, 44 (37.6%) were passengers, 39 (33.3%) were pedestrians, and 34 (29%) were drivers. The mean age of the victims was 25 ( ± 8.1) and the mean age of the drivers was 29 ( ± 8.4). Almost all of the drivers were male (98.5%) and only 1.5% were Female. Only 35.9% and 37.4% of the drivers had completed elementary and high school, respectively. About 70% (46% fatal and 41% of nonfatal) were caused by 18–30 years old drivers (Table 1). Total cases of RTAs increased from 89 to 106 in the first three-year period. Eight nine (19%) RTAs occurred during the period of July 2010 to June 2011 (Fig. 1). 3.2. Drivers behaviors and environmental related associated factors of fatality of RTAs from descriptive statistics Ninety seven (83%) of fatalities and 281 (81%) of injuries accidents occurred on the main road (asphalt) and (28%) occurred in the rainy weather condition. Loading trucker considered to be the safer vehicle that caused only around 1% of fatal and about 1% of injury in the town. Twelve percent and 15% of the fatalities and non-fatalities of RTAs occurred respectively because of not using seatbelt while driving (Table 2). 3.3. Factors associated with fatality of RTAs from multivariate analysis In multivariate logistic regression model, it was found that RTAs Fire following accidents is 6 times more likely to cause fatality than accidents occurred without fire [AOR 9, 95% CI; 2.45–21]. Driving without using seatbelt is also 4.7 times more likely to cause fatality than drivers who use it while driving [AOR 4.25, 95% CI; 2.6–8.6]. Failure to give priority for other vehicle is 3 times more likely to cause fatality of road traffic accidents than giving priority with [AOR 3, 1.55, 5.9]. The last determinants factor for fatality of road traffic accident in the town was the time at which first aid given for the victims that is victims who get first aid with 10 min of accidents were 0.99 time less likely to be fatal than those who didn’t get first aid [AOR 0.0045, 95% CI; 0. 923–0.045]. Furthermore, phoning while driving is 0.71 times more likely to cause fatality of road traffic accidents than those drivers who were not phoning while driving [AOR 0.5, 95% CI 0.13–1.2]. Driving in cloudy weather condition is 1.21 times more likely to cause fatality of road 189
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Table 1 Socio-demographic characteristics of Victims and drivers involved in fatal and nonfatal road traffic accidents reported to police stations from 2010 to 2015, Burayu Town, central Ethiopia. Variables
Categories
Frequency of fatalities of RTAs Fatal
Age of the victim
Total Age of driver involved in fatal or nonfatal
Vehicle ownership
Drivers Educational Status Driving license of the driver involved in accidents
< 18 18–30 31–50 50+ < 18 18–30 31–49 50+ Owner Hired Government < grade 4 grade 4–8 > Grade 8 No license 2nd level 3rd level license 5th level license
Nonfatal
N
%
N
(%)
23 69 22 3 117 1 90 23 3 25 89 3
20 59 20 2.8 100 1.9 77 20 2.6 21 76 2.5
83 178 53 31 345 7 235 81 22 150 178 17
24 52 15 9
16 101 26 1 8 87 21
14 64 22 0.8 6.8 74.4 18
65 210 70 1 23 267 45
19 61 20 3 6.7 77.3 13
2 68 24 6.4 44 52 5
Fig. 1. Magnitude of Fatality and Injury of Road Traffic Accidents, Reported to Burayu Town Police stations, central Ethiopia, Over Last Five Years.
traffic accidents than driving in dry whether condition (AOR = 1.21, 95% CI: 1.2, 23). (Table 3).
4. Discussion This study shows that fire following accidents, driving without using seatbelt, weather condition at the time of accident drivers and time at which first aid given for victims are the strong determinants factors of road traffic fatality and injury. Of the total traffic accidents occurring yearly, about 17% were fatal accidents and 25% were fatalities. Thus, fatality rate of 25% and fatal accidents of 17% in this study shows higher than the corresponding average for national fatality rate and fatal accidents in Ethiopia (22%, 11% 190
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Table 2 Characteristics of RTA's Fatal according to time, place, Weather condition, and Type of Vehicles Involved in Accidents, Burayu Town, Ethiopia from June 2010 to July 2015. Variables
Prevalence of fatalities and injuries RTAs
Time at which the accident occurred
Fatal N
Whether Condition
Nonfatal N
(%)
(%)
Early morning to day (12:00 -4:59)
15
13
106
31
Mid-day (5:00–8:59) To Evening 9:00–12:59 Early Evining1:00–3:59) Mid night 4:00 -7:59 To morning 8:00 -11:59 Dry Foggy/cloudy Cold/Icy Rainy
65 24 10 1 2 56 6 11 44
55.6 20.5 9 0.9 1.7 48 5.1 9.4 38
126 77 31 3 2 183 22 55 85
36.5 22.3 9 0.9 0.6 53 6.4 16 25
Traffic Rule Violation Variables Type vehicle involved To accidents
Age of vehicle involved in accident
Road Condition at the time of accidents
NO YES
63 54 Frequency
54 46.2 %
Minibus Taxi Toyota pickup Sino track Land closure **Other 1–4 years 5–9 years 10–14 years 15+ years Straight Little curved Curved Down warded Up warded ***Other
46 13 9 30 1 18 44 26 20 27 15 48 33 19 2
136 209 Frequency 39 11 7.7 26 0.9 15 38 22 17 23 13 41 28 16 2 0
58 48 51 43 10 168 141 81 33 90 115 106 67 48 7 2
39.4 60.6 % 17 14 15 13 3 49 41 23.5 9.5 26 33 31 19 14 2 1
Other** - Bajaj (50), Sino track (30), Isuzu public(44) Isuzu loading (45)Tractor (3), Solid waste loading car(15), Pickup Mitsubishi (37), Pickup Helix (17) Cycle (2), Tiger bus (23), Ambulance (2), Bishoftu Bus (5) Other***- Downhill into the river (1), down fall inside the compound of factory (1)
respectively) (Population Census Commission of FDRE, 2008; Chalya et al., 2010; UNECFA, 2011). Unlike other studies which reported more fatality of RTAs made by 31–40 years of age of drivers and older drivers (Tintinalli et al., 2004; United Nation, 2011), this study shows that majority (about three quarters) of fatalities of road traffic accidents were caused by young drivers (18–30 years of age). This may be due to the lack of experience of young drivers, as well as their high risktaking behavior could be the reason for their dominance. High numbers of nonfatal traffic accidents were registered on straight and little curved road, 115 (33%) and 106 (31%) respectively. However, high numbers of fatal traffic accidents were registered on little curved and curved road 48 (41%,) and 19 (16%) respectively. So, fatal accidents were more likely to occur in curved road than straight road. Around 89% of the fatalities and 83% of injuries of traffic accidents were caused by driver errors, such as over speeding, failing to give priority to other vehicles and pedestrians and only 6% were caused by pedestrian error. Sixty six percent of fatal and 56% of nonfatal accidents were caused by driving above the speed limit alone This is consistent with the finding of study in Kenya which showed 85% of the accidents were caused by human factors (driver and pedestrian errors) and also to the finding from Ethiopia on the road traffic collision between Akaki, and Adama town reported that high speeds and failure to give priority to other vehicles and pedestrians caused five times more fatal collisions than their counterparts. (Fekede et al., 2014; Ogendi and Ayisi 2012). Minibuses (39% of fatal, 58% of nonfatal), Taxi (12% of fatal, 48% of nonfatal), Pickup Toyota (8% of fatal, 51% of nonfatal) and Bajaj (4% of fatal, 53% of injuries) were most frequently involved in the accidents. This is inconsistent with studies in Kenya (Bawah et al., 2010) and Qatar (Chalya et al., 2010) where cars, pick-up trucks and vans were most frequently involved in crashes. In this study, driving experience was not a determinant factor for fatal accidents. However, drivers with only 3–5 years’ experience were frequently involved in the accidents. A study in Qatar noted that drivers who drove for more than five years were more frequently involved in the crashes (Chalya et al., 2010). Educational qualification of drivers were the predictors of fatal accidents in this study because drivers who completed primary levels of education (4–8 grade) caused a large number of fatalities, 65 (56%), but fewer fatalities, 27 (23%), were caused by grade 8 and above and though it was not statistically significance, which is similar to study done in Addis Ababa, Ethiopia (Akinpelu et al., 191
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Table 3 Driver's Behavior related, and Environmental Related Fatality Associated Factors from multivariate logistic regression, Burayu Town, Central Ethiopia from July 2010 to 2015. Variables
Vehicle Deficit Failure to give priority for other vehicle Driver error Not using seatbelt Phoning while driving Fire following accidents Time at which first aid given
Weather Condition
Traffic Rule Violation
Prevalence of accident
Yes NO Yes NO Yes NO YES NO Yes NO Yes NO < 30 min > 30 min Not known Dry Cloudy Rainy Cold/Icy YES NO
Fatal N (%)
nonfatal N (%)
25 (21.4) 92 (79) 71 (61) 46 (39) 104 (89) 13 (11) 57 (49) 60 (51) 9 (8) 108 (92) 17 (5) 96 (82) 7 (6) 27 (23) 94 (71) 56 (48) 6 (5.1) 11 (9.4) 44 (38) 54 (46.2) 63 (53.8)
113 (33) 232 (67) 295 (86) 50 (14) 262 (76) 83 (24) 72 (21) 273 (79) 73 (21) 272 (79) 21 (18) 328 (95) 22 (6) 21 (6) 302 (88) 183 (53) 22 (6.4) 55 (16) 85 (25) 209 (61) 136
Adjusted OR With CI
P value
1.4 [0.3, 1.9] 1 1.5 [0.01,4.4] 1 1.5 [0.6, 3.9] 1 2.3 [1.1, 4.7] 1 0.5 [0.13,1.2] 1 6.1 [1.83,14] 1 1 0.9[0.34] .025[.045,.9] 1 1.44[0.9, 2] 6 [1.4, 25.4] 1.3[.43,4.13] .34 [.2, 1.01] 1
0.414 0.680 0.290 0.030 0.120 0.004
0.001 0.001 0.580 0.005 0.670 0.700
2007). In this study, the majority of the victims were males, aged 18–30 years, which is similar with another study (Majdzadeh et al., 2007). In this study it was found that fire following accidents was 6 times more likely to cause fatalities of road traffic accidents than accidents occurred without fire. This finding is in line with study conducted in Iran which indicated that fire following accidents was 6.95 times more likely to cause fatalities of road traffic accidents than accidents occurred without fire. In addition driving without using seatbelt caused 4.25 times fatality than drivers who use seatbelt while driving. This finding is almost similar with study conducted in Bahir Dar, which revealed that drivers who do not use caused 5.8 times fatality than drivers who use seatbelt while driving. But there was a little difference with study conducted in Iran which reported 1.43 times. This difference is in fact the difference in socio-economic characteristics of the Iran and Ethiopian population. The other determinant factors in this study was failure to give priority for other vehicles, that is drivers who were not give priority for other vehicle while driving was 3 times more likely to cause fatality of road traffic accidents than drivers who respect priority for other vehicle. This finding is almost similar with the research conducted in central Ethiopia on the road from Akiki to Adama town which reported drivers who were not give priority for other vehicle are 5.2 times more likely to cause fatality compared with those who give priority for other vehicle (Fekede et al., 2014). This is actually due to the fact that both study area are surrounding the capital city. The last determinants factor for fatality of road traffic accident in the town was the time at which first aid was given to victims. Victims who get first aid within 30 min of accidents were 0.99 time less likely to be fatal than who didn’t get first aid. Furthermore, fatality of road traffic accidents is 0.71 times more likely to occur to drivers who use phone than those drivers who did not use phone while driving. This is also the fact that drivers should drive with full attention even they do have the responsibility to observe their spekio within every 8 second to reduce fatality.
4.1. Limitation of the study Difficulty of traffic police to record accidents that occurred during night in Burayu town. Social desirability bias of traffic police during the recording of accidents. Lack of standardized and periodic record system each police stations. Lack of recording the outcome of severe injuries and not recording the referred victims.
Financial disclosure Jimma University (the academic institution) has funded the project. There is no conflict of interest between the funder and the study area or the government. 192
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