Extent, causes and impact of road traffic crashes in the Solomon Islands 1993-2012: data from the orthopaedic department at the National Referral Hospital, Honiara.

INTRODUCTION Road traffic crashes constitute a considerable public health burden and represent the eighth leading cause of death and tenth leading cause of disability adjusted life years (DALYs) globally. However, very little is known about the extent, causes and impact of crashes in low- and middle-income countries including those in the Pacific. This lack of data is particularly true for the Solomon Islands. METHODS The study is a retrospective record review of a pre-existing, de-identified dataset. A standardised trauma form is completed for all patients presenting to the orthopaedic department at the National Referral Hospital in Honiara with a suspected fracture following a trauma. Data are coded using one of 27 unique codes. Data related to road traffic crashes were extracted from the larger dataset, cleaned and analysed in Microsoft Excel. RESULTS The database contained 699 records coded with one of seven codes related to road traffic crashes. Patients in the database were most frequently injured whilst a passenger in a car (27.8%), as a pedestrian (24.0%), or as a passenger in an open truck (21.6%). Almost three-quarters of patients were male. Just under half (48.5%) were aged between 10 and 29 years. Alcohol was listed as a contributing factor in 23.8% of presentations. CONCLUSIONS This is one of the first studies to provide data on road traffic crashes in the Solomon Islands. In this database, young males were most likely to be involved in a crash that resulted in a suspected fracture. Young males are in their prime years of productivity, and injuries that remove them from the workforce could have severe socioeconomic implications. This study found that more than half of injuries were borne by vulnerable road users such as pedestrians and motorcyclists, indicating a need for interventions that take these users into account. Finally, the study provides insight into the large impact that alcohol has on the risk of road traffic crashes.