The Burden of Motorcycle Crash Injuries on the Public Health System in Kisumu City, Kenya

Reliable estimates of motorcycle-related injuries and hospitalization, as well as their impact on the health system, are needed for evidence-based policymaking, advocacy, and priority-setting for appropriate and effective interventions, resource mobilization, and future research. Key Findings Motorcycle crash injuries were the second most common cause of both emergency department visits and hospital admissions. The findings showed that motorcycle injury cases contributed to greater radiological diagnostic service use, operating theater use for minor and major surgical procedures, and intensive care unit admissions, demonstrating the extent to which motorcycle crashes contribute to increased use of public health system resources. Key Implications Documentation of motorcycle-related injuries and hospitalizations and their impact on health services is essential for evidence-based policymaking, advocacy, and priority-setting for interventions, resource mobilization, and future research. Policymakers, hospital administrators, and trauma center managers should consider motorcycle injuries when planning for emergency trauma service delivery, including human resources, bed capacity, equipment and supplies, and operations. Lack of helmet use by more than 80% of motorcycle riders and passengers and their increased usage of hospital resources convey an urgent need for improved preventive strategies and enforcement. ABSTRACT Background: In Kenya, the increased use of motorcycles for transport has led to increased morbidity, mortality, and disability. These injuries exert a burden on the public health system, yet little information exists on health care resource usage by motorcycle crash injury patients. We aimed to estimate the burden of motorcycle crash injuries on the health system in Kisumu City. Methods: We conducted a 6-month prospective study of all motorcycle crash injury patients who presented to 3 Tier III public and private hospitals in Kisumu City between May and November 2019. We collected data on demographics, emergency department (ED) visits, admissions, anatomic injury site, services used, and injury severity. We reviewed hospital records to obtain denominator data on all the conditions presenting to the EDs. Results: A total of 1,073 motorcycle crash injury cases accounted for 2.0%, 12.0%, and 13.6% of total emergency visits, total injuries, and total admissions to the hospitals, respectively. Men were overrepresented (P<.001). The mean age was 29.6 years (±standard deviation [SD] 12.19; range=2–84). The average injury severity score was 12.83. Surgical interventions were required by 89.3% of patients admitted. Of the 123 patients admitted to the intensive care unit, 42.3% were due to motorcycle accident injuries. Conclusion: Motorcycle injuries impose a major burden on the Kisumu City public health system. Increased promotion and reinforcement of appropriate interventions and legislation can help prevent accidents and mitigate their consequences. Focusing on motorcycle injury prevention will reduce accident-related morbidity, hospitalization, severity, and fatalities and the impact on the public health system.