Background In the large cities of Benin, motorcycle taxi drivers, mainly between the ages of 20 and 40, are particularly exposed to accidents due to their profession. User awareness, along with legislative reforms and enforcement measures, would reduce the incidence of crashes and injuries. This study aims to test the effectiveness of an awareness-raising model regarding helmet use for motorcycle taxi drivers. Methods This is a quasi-experimental study that will take place in the cities of Parakou (intervention group) and Porto Novo (control group). Over a three-month period, a package of awareness-raising activities will be implemented in the intervention area, targeting a group of motorcycle taxi drivers. The messages to be developed for awareness-raising will focus on the most frequently influencing factors, as identified by the baseline collection. These key messages will be disseminated through various tools and communication channels (banners, motorcycle stickers and motorcycle taxi uniforms, interactive sessions). Data will be collected prospectively via a self-reported questionnaire and observation, carried out before the intervention, at the end, and 6 months later. The data will relate to knowledge, attitudes and practices regarding helmet use. The analysis will compare the indicators between the groups, as well as between the pre- and post-intervention phase. The KoboCollect software will be used for data entry and processing, and Stata 15 will be used for data analysis. Chi-square or Fisher, Student’s or Kruskal-Wallis tests will be used for the comparisons. The difference-in-difference method will be used to determine the specific effect of the awareness activities. Discussion This study will assess the contribution of awareness messages to changing the behaviour of motorcycle taxi drivers by determining the specific effect of the intervention.

Background In Benin, motorcycles are the main means of transport for road users and are involved in more than half of crashes. This study aims to determine the effect of wearing a helmet on reducing head injuries in road crashes in Benin. Methods This case-control study took place in 2020 and focused on road trauma victims. The sample, consisting of 242 cases (trauma victims with head injuries) for 484 controls (without head injuries), was drawn from a database of traffic crash victims recruited from five hospitals across the country from July 2019 to January 2020. Four groups of independent variables were studied: socio-demographic and economic variables, history, behavioural variables including helmet use and road-related and environmental variables. To assess the shape of the association between the independent variables and the dependent variable, a descending step-by-step binary logistic regression model was performed using an explanatory approach. Results Fewer of the subjects with a head injury were wearing a helmet at the time of the crash 69.8% (95% CI = 63.6–75.6) compared to those without a head injury 90.3% (95% CI = 87.3–92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5–5.7)); the head injury rating was 1.9 (95% CI = 1.2–3.3) times higher in subjects who were fatigued during the crash than among those who were not and 2.0 (95% CI = 1.2–3.3) times higher in subjects with no medical history. Conclusion Failure to wear a helmet exposes motorcyclists to the risk of head injuries during crashes. It is important to increase awareness and better target such initiatives at the subjects most at risk.

Background This study aims to test the effectiveness of an awareness-raising model designed based on the theory of planned behaviour regarding helmet use for motorcycle taxi drivers. Methods This quasi-experimental study took place in the cities of Parakou (intervention group) and Porto Novo (control group). Over a three-month period, a package of awareness-raising activities, based on the theory of planned behaviour, have been implemented in the intervention area. Data relate to knowledge, attitudes and practices regarding helmet use was collected prospectively before the intervention, at the end, and 6 months later. Stata 15 was used for data analysis. Chi-square or Fisher, Student’s or Kruskal-Wallis tests was carried out. The difference-in-difference method was used to determine the specific effect of the awareness activities. Results After the intervention, there was an improvement in the total score in both groups compared to baseline. The total score increased by 0.2 (0.06–0.3) in the experimental group when the number of sessions attended increased by one (p = 0.005). The difference-in-difference estimator measured among subjects who attended at least one awareness session, controlling for socio-demographic variables, showed a significantly higher difference in the total score of subjects in the experimental group compared to those in the control group both at the end of the interactive sessions and 6 months later. Conclusion This model improves the helmet-wearing behaviour of motorbike taxi drivers in the experimental area. It could be adapted and applied to other socio-professional groups and other types of users.

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Road traffic accidents are the leading cause of death by trauma. Delays in in first aid due, inter alia, to the long time to transfer traffic accident victims to hospital and the lack of pre-hospital emergency care, contribute to the increase in hospital mortality. This study aims to analyse the referral conditions for severe road traffic injuries and to assess their effect on the occurrence of hospital deaths in Benin. This is an analytical prospective cohort study conducted in road accident victims with a severe injury. Four groups of factors were studied: referral conditions, sociodemographic and victim-specific characteristics, factors related to the accident environment, and factors related to health services. A top-down binary stepwise logistic regression was the basis for the analyses. Nine point eight percent of severe trauma patients died after hospital admission (7.0-13.5). Associated factors were referral time greater than 1 hour (RR=5.7 [1.5-20.9]), transport to hospital by ambulance (RR=4.8 [1.3-17.3]) and by the police or fire department (RR=7.4 [1.8- 29.7]), not wearing protective equipment (RR=4.5 [1.4-15.0]), head injuries (RR=34.8 [8.7-139.6]), and no upper extremity injuries (RR=20.1 [2.3-177.1]). To reduce the risk of hospital death in severe road traffic injuries, it is important to ensure rapid and medicalized referral of severe trauma patients in Benin.

Background: In Benin, motorcycles are the main means of transport for road users and are involved in more than half of accidents. This study aims to determine the effect of wearing a helmet on reducing head injuries in road accidents in Benin.Methods: This cohort-nested case-control study took place in 2020 and focused on road trauma victims. The sample consisted of 242 cases for 484 controls. A logistic regression model was performed.Results: Fewer of the subjects with a head injury were wearing a helmet at the time of the accident 69.8% (95% CI = 63.6 - 75.6) compared to those without a head injury 90.3% (95% CI = 87.3 - 92.8). Adjusting for the other variables, subjects not wearing helmets were at greater risk of head injuries (OR = 3.8, 95% CI (2.5 - 5.7)); the head injury rating was 2.0 (95% CI = 1.2 - 3.2) times higher in subjects who were fatigued during the accident than among those who were not and 2.1 (95% CI = 1.2 - 3.3) times higher than in subjects with no medical history.Conclusion: Failure to wear a helmet exposes motorcyclists to the risk of head injuries during accidents. It is important to increase awareness and better target such initiatives at the subjects most at risk.

Background In Benin, some riders of two-wheeled vehicles still do not wear helmets, the main protection against head injuries in road accidents. The objective of this study is to describe the characteristics of two-wheeled users, and to determine the factors influencing helmet use among this group. Methods This is a prospective cross-sectional study of 977 two-wheeled road accident victims from a cohort. Proportions or means were calculated for the different variables. Statistical comparisons were made to test the association with helmet use. Logistic regression modelling was performed to identify factors associated with helmet use. Results Among all subjects, 81.1% [CI95% (78.5; 83.4)] wore a helmet. Factors explaining helmet use were female gender (OR = 2.8 [1.3–6.1]), purpose of trip (OR = 1.7 [1.1–2.6]), possession of health insurance (OR = 3.7 [1.3–10, 5]), having been driving for 15–20 years (OR = 2.6 [1.4–4.7]) or more than 20 years (OR = 3.4 [2.0–5.8]), good road conditions (OR = 3.1 [2.0–4.8]), and good visibility (OR = 1.9 [1.3–3.1]). Conclusion The factors influencing helmet use are gender, reason for travel, length of time as a driver, possession of health insurance, conditions, and visibility of the road on which the subject are driving. These factors are related to experience and appropriation of the notion of risk, but also related to the environment. To increase helmet use among two-wheelers, helmet awareness should take into account the individual factors found in this study. Enforcement actions should be strengthened, and the quality of the roads improved.