Factors Associated with Injuries among Commercial Motorcyclists: Evidence from a Matched Case Control Study in Kampala City, Uganda

Abstract

Introduction: Road traffic injuries are the eighth leading cause of death globally and the most affected are young people aged 15-29. By 2030 road traffic deaths will become the fifth leading cause of death unless urgent action is taken. Motorcyclists are among the most vulnerable road users and in Uganda they contribute 41% of all road traffic injuries. This paper establishes factors associated with the injuries of commercial motorcycle riders also known as boda-boda riders in Kampala, Uganda's capital city.

Methods: The study was matched case-control with a case being a boda-boda rider that was seen at one of the 5 major city hospitals with a road traffic injury while a control was a boda-boda rider that was at the parking stage where the case operated from before the injury. The sample size was 289 riders per arm and data collection took 7 months. A structured questionnaire was used to collect data on background and exposing factors. Being matched case-control data conditional logistic regression was used in the analysis.

Results: Factors independently associated with injury among motorcyclists were younger age group, being a current alcohol drinker (OR = 2.30, 95%CI: 1.19-4.45), lower engine capacity (<100 cc) (OR = 5.03, 95%CI: 2.91-8.70), riding experience of less than 3 years, not changing a motorcycle in past 1 year (OR = 2.04, 95%CI: 1.19-3.52), riding for a longer time in a day (OR = 6.05, 95%CI: 2.58-14.18) and sharing a motorcycle (OR = 8.25, 95%CI:2.62-25.9). Other factors associated with injury were low level of knowledge of traffic rules, being stopped by police for checks on condition of motorcycle/license/insurance, working till late.

Recommendations: More road safety sensitization is required among riders to raise awareness against sharing motorcycles, working for a longer time and alcohol consumption. Police enforcement of drink-driving laws should include riders of commercial motorcycles. Investigate the validity of motorcycle riding licenses and test the riding competency of all who got licenses in last 3 years.

Fig 1. The first table shows the background characteristics of the cases and controls and tests the significance of the difference between the two groups.

The second table focuses on risky practices and related un-adjusted odds ratios for getting a motor-cycle injury. The rest of the tables have results from multivariable analysis.

Fig 2. The third round of multivariable analysis included level of knowledge of traffic rules, Alcohol Use Disorders Identification Test score (AUDIT) and experience with police checks and riding till late (Table 5).

Results from this analysis show that the odds of having an injury reduced with higher level of knowledge (OR = 2.05 for score 15–16 to OR = 0.09 for highest score-21-27). Police check for licenses, insurance, overloading was strongly associated with boda-boda injuries (OR = 3.19, 95%CI: 1.97–5.17). Odds for higher AUDIT score tended to rise with boda-boda injuries but the relationship slightly fell short of significance at 5% level. The odds of getting injured rose with the time of stopping riding (OR = 0.93 for those stopping at 8-9pm but rose to 3.39 for those stopping 10–12 midnight). The variables adjusted for but which did not significantly change the log likelihood were marital status, income, education and religion.