Burden and outcomes of road traffic accidents in Rwanda: Analysis of the national WHO trauma Registry, 2019–2024

Background Road traffic accidents (RTAs) are a major global health and transportation safety challenge, causing 1.19 million deaths annually, with most occurring in low- and middle-income countries (LMICs). In Rwanda, rapid urbanization and motorization are changing mobility patterns and road-risk exposure. We To strengthen trauma surveillance and inform evidence-based road-safety strategies, Rwanda’s Ministry of Health adopted the WHO Trauma Registry in 2019. We used registry data to characterise transportation-related RTA patterns and their association with emergency-care outcomes. Methods We conducted a retrospective analysis of RTA cases using data from the WHO Trauma Registry between 2019 and 2024 across eight referral hospitals. We examined road-user characteristics, transport modes, crashes locations, emergency transportation and interventions, and clinical disposition. Descriptive statistics and multinomial logistic regression were used to identify socio-demographic patterns and factors associated with emergency unit disposition. Results A total of 11,520 RTA cases were recorded. Most victims were male (77.5%), with the highest burden among young adults aged 21–40 years (51.4%). The majority of accidents occurred on streets and highways (81.7%) and involved motorcycles or bicycles (50.8%). Ambulances transported the majority of the patients (62.6%), and 97% received emergency interventions. Outcomes showed 44% discharged, 53.6% transferred for high-level care, and 2.4% died in the emergency unit. Conclusion Rwanda’s trauma-registry data demonstrate the value of integrating transportation and health-system perspectives in understanding RTAs. The high burden among young adult males, motorcycle and bicycle users supports transport-mode-specific safety interventions, while frequent transfers highlight the need to strengthen emergency transport and referral systems,. Trauma registries offer a scalable platform for informing coordinated road-safety, emergency-care, and urban-transport planning in LMICs.