Pedestrian Injuries in the most densely populated city in Nigeria—an epidemics calling for control.

ObjectivesSince the first pedestrian road fatality of 1896, pedestrians still remained vulnerable, with fatality from Africa being 55% of global statistics. Many previous reports from Nigeria have emphasized passengers and drivers over pedestrians; this study was done in the most densely populated Nigerian city with no previous publication exclusively dedicated to pedestrians—the megacity has been projected by the World Bank to be the third largest in the world by 2015 (after Tokyo and Mumbai) so that study results would aid injury control and reduce morbidity and mortality.<b>Methods</b>This is a one-year prospective study on pedestrians attending the surgical emergency room of the busiest referral hospital in Lagos, Nigeria detailing the age, sex, occupation, regions injured; the injury mechanism, incident vehicles, highway collisions and the immediate outcome.<b>Results</b>Some 702 pedestrians were seen; comprising 494 (70%) males with overall peak incidence in the third decade, but the peak incidence among females is lower and in the first decade. Common injuries sustained were to the head (40%), lower limb (35%), upper limbs (9%), multiple regions (6%), pelvis (3%) and others (7%). Gender differences also were noted— the predominant injury in males was head injury followed by lower limb injuries but vice versa in females even though both regional injuries were fewer in females than in males. Students were 20% of the entire pedestrians, with nearly half of them injured by the motorcycle. The mechanism of injury included crossing the highway (63%), by walking along the pavement (17%), standing by the bus stop (12%), at the shop/ house (5%) and others (3%). However, 76% injuries occurred on the highway, 22% in the inner city roads and 2% elsewhere. Vehicles injuring the pedestrians were motorcycles 33%, cars 27% and buses 22%, trucks 6%, tricycle 2.4% and others 9%. Overall fatality was 10% about half of them were knocked down by buses and cars.<b>Conclusions</b>This study suggests high incidence, and significant underreporting, of pedestrian injury. Morbidity and mortality reduction is possible (from head and lower limb injuries) by traffic calming techniques in crossing the highway especially from the motorcycles, cars and buses.