Incidence and outcomes of road traffic crashes among commercial motor tricycle drivers in Kumasi, Ghana: A population-based survey

The injury burden of motorized tricycles in African countries is not well-known despite their increasing use for commercial activities on the continent. To address this gap, we sought to understand the injury burden and crash risk factors for commercial motor tricycles (CMT) in Ghana. We conducted a survey of all CMT drivers at 11 groupings within Kumasi, Ghana. The survey utilized a structured questionnaire based on previous injury questionnaires used extensively in Ghana. The questionnaire sought information about characteristics and modifiable risk factors for road traffic crashes (RTCs) as well as safety-related road signs. The primary outcome was respondents experiencing at least one RTC in the past 1 year. Chi-square tests were used to determine differences between the primary outcome and various covariates. There were 84 RTCs reported by the 710 respondents over the past 1-year with an incidence of 11.8%. Half (48%) of crashes caused injuries. Drivers reported overloading of vehicles (32%), not having a valid license (26%), never wearing a helmet (92%), long work hours (median 10 [range: 3-18] hours/day), and lack of scheduled maintenance (52%). Drivers had low knowledge of road signs (e.g. only 41% could identify a "give way" sign). Consumption of the stimulant "ataya" was higher among drivers with crashes in the past year compared to those without (34% vs 16%, p < 0.001). There is a significant injury burden from CMTs in Ghana. Several risk factors should be addressed: vehicle overloading, low vehicle maintenance, prolonged work hours, low helmet use, low knowledge of safety-related signage, and use of the stimulant "ataya."