BackgroundRoad traffic injuries (RTIs) are a growing but neglected global health crisis, requiring effective prevention to promote sustainable safety. Low- and middle-income countries (LMICs) share a disproportionately high burden with 90% of the world’s road traffic deaths, and where RTIs are escalating due to rapid urbanization and motorization. Although several studies have assessed the effectiveness of a specific intervention, no systematic reviews have been conducted summarizing the effectiveness of RTI prevention initiatives specifically performed in LMIC settings; this study will help fill this gap.MethodsIn accordance with PRISMA guidelines we searched the electronic databases MEDLINE, EMBASE, Scopus, Web of Science, TRID, Lilacs, Scielo and Global Health. Articles were eligible if they considered RTI prevention in LMICs by evaluating a prevention-related intervention with outcome measures of crash, RTI, or death. In addition, a reference and citation analysis was conducted as well as a data quality assessment. A qualitative metasummary approach was used for data analysis and effect sizes were calculated to quantify the magnitude of emerging themes.ResultsOf the 8560 articles from the literature search, 18 articles from 11 LMICs fit the eligibility and inclusion criteria. Of these studies, four were from Sub-Saharan Africa, ten from Latin America and the Caribbean, one from the Middle East, and three from Asia. Half of the studies focused specifically on legislation, while the others focused on speed control measures, educational interventions, enforcement, road improvement, community programs, or a multifaceted intervention.ConclusionLegislation was the most common intervention evaluated with the best outcomes when combined with strong enforcement initiatives or as part of a multifaceted approach. Because speed control is crucial to crash and injury prevention, road improvement interventions in LMIC settings should carefully consider how the impact of improvements will affect speed and traffic flow. Further road traffic injury prevention interventions should be performed in LMICs with patient-centered outcomes in order to guide injury prevention in these complex settings.

BackgroundGlobally, alcohol is responsible for 3.3 million deaths annually and contributes to 5.9% of the overall global burden of disease. In Sub-Saharan Africa, alcohol is the leading avoidable risk factor accounting for a substantial portion of death and disability. This project aimed to determine the proportion of injuries related to alcohol and the increased risk of injury due to alcohol among injury patients seeking care at the emergency department (ED) of Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania.MethodsA representative cross-sectional sample of adult patients presenting to the KCMC ED with acute injury were enrolled in this study with a nested case-crossover design. Patient demographics, injury characteristics, and severity as well as alcohol use behaviors were collected. Alcohol breathalyzers were administered to the enrolled patients. Data on activities and alcohol use were collected for the time period 6 h prior to injury and two control periods: 24–30 h prior to injury and 1 week prior to injury.ResultsDuring 47 weeks of data collection, 24,070 patients were screened, of which 2164 suffered injuries, and 516 met the inclusion and exclusion criteria, consented to participate, and had complete data. Of the study participants, 76% were male, and 30% tested positive for alcohol on arrival to the ED. Alcohol use was associated with being male and being employed. Alcohol use was associated with an increased risk of injury (OR 5.71; 95% CI 3.84–8.50), and specifically road traffic injuries were associated with the highest odds of injury with alcohol use (OR 6.53, 95% CI 3.98–10.71). For all injuries and road traffic injuries specifically, we found an increase in the odds of injury with an incremental increase in the dose of alcohol.ConclusionsAt KCMC in Moshi, Tanzania, 3 of 10 injury patients tested positive for alcohol on presentation for care. Similarly, alcohol use conveys an increased risk for injury in this setting. Evidence-based prevention strategies for alcohol-related injuries need to be implemented to reduce alcohol misuse and alcohol-related injuries.

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The number of studies evaluating RTI proportions and fatalities in SSA countries is increasing but without the exponential rise expected from World Health Organization calls for research during the Decade of Action for Road Traffic Injuries. Further research infrastructure including standardization of taxonomy, definitions, and data reporting measures, as well as funding, would allow for improved cross-country comparisons.

The seventh author's name is incorrectly spelled. The correct name is Yi Zhao.

BackgroundInjury accounts for 6% of all disability adjusted life years lost. Current research on access to care and injury does not account for injury severity or levels of health care. Our project aims to determine what barriers to injury care arise in Brazil’s universal health care system.MethodsHouseholds were randomly selected in Maringá between May 2015 and September 2015. Demographic information was collected for the household; one individual was randomly selected to provide injury history. A chi-square analysis found the association between care-seeking and demographic variables. A preliminary significance level of α = 0.20 was used for inclusion of variables. A full multivariate logistic regression model and thirty reduced models were run. Mean squared estimate and Akaike Information Criterion were calculated to find the best predictive model.ResultsOf the 2678 households and individuals sampled, 30.3% of individuals reported a lifetime injury. The univariate analysis found that gender (p = 0.034), injury cause (p < 0.001), race (p = 0.051), severity (p = 0.103) and insurance status (p = 0.026) were predictors of seeking care. Income, and age were included in the multivariate model due to significance in the literature. Based on this model, Burn victims had an increased odds of 7.92 of not seeking care compared to road traffic incident victims; this increased odds was also seen when stratifying by gender (OR = 9.49 for women, OR = 8.23 for males). For all injuries, being male had a protective effect on seeking care (OR = 0.64); women had higher odds of not seeking care (OR = 1.30)ConclusionsCause of injury and socioeconomic status factors are a major predictor for seeking care, as are factors related to socioeconomic status. Cause potentially masked the effects of gender on care seeking. More research needs to be done on specific causes of injuries, the role of gender, and why socioeconomic status is still a barrier to care in a universal access system.

Injury is a leading cause of death and disability globally. After an acute hospitalizatio n for an injury, a care transition model has been shown to reduce mortality and morbidity but these are uncommon in a low and middle income setting. When planning a post hospitalization care plan, many health management factors shoul d be taken into account as they can impact outcome. This manuscript delineates a 5 Domains of Healthcare Management or '5 Domains' which sho uld be addressed in this care transition model. The literature behind each of these domains and their impact on post hospitalizatio n outco mes along with a case study of a care transition plan for a low income country is described.Keywords: Transitio n of Care, Global Health, Injury, Health Outcomes, Low and Middle Income Countries Funding: Dr. Staton would like to acknowledge salary support funding from the Fogarty Internatio nal Center (Staton, K01 TW010000 -01A1). Figure 1). Each of these domains will be assessed at individual, institutional, community and culture levels in conjunction with the model propo sed. Functioning, but they also had better scores Rev i sta El etr ôn ic a Ge st ão & PHYSICAL FUNCTION MENTAL HEALTHA myriad of reaso ns including changes in physical and social functioning, and chronic pain can lead to mental health concerns which are very common following an injury. PAINApart from the initial pain tha t occurs during an injury or trauma, long -term pain as a direct result of injury is a majo r concern. Injuries like severe burns can suffering from a severe TBI (GCS < 9) and 75% from a mild TBI (GCS > 13 (Staton et al., 2017). COMORBIDITIESv. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7v. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7 MENTAL H E A L T HWe Currently, this project is been piloted in Brazil with a TBI po pulation. SUBSTANCE USEData was collected fo r two separate cohorts of injury patients and traumatic brain injury This intervention will be applicable for alcohol but we ho pe to adopt it for use fo r other substances as well. PAINOf the trauma patients we have followed up with so far, 14% hav e persistent pain. Medley, A., Seth, P., Pathak, S., Howard, A. A., DeLuca, N., Matiko, E., . . . Makyao, N. (2014). Alcohol use and its association with HIV risk behaviors among a cohort of patients attending HIV clinical care in Tanzania, Kenya, and Namibia. AID S care, 26(10), 1288 -1297. Rev i sta El etr ôn ic a Ge st ão & Soc ied ad ev. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7 Rev i sta El etr ôn ic a Ge st ão & Soc ied ad ev. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7 Rev i sta El etr ôn ic a Ge st ão & Soc ied ad ev. 11 , n . 2 9 , p . 1 70 4 -1 72 9 | Mai o/ Ag os to -20 1 7

BackgroundThe neighbourhood an individual lives in affects their injury risk. In Brazil, males of minority races with low education have the highest risk for injury. Family is an important aspect of Brazilian culture; however there is little research on how family structure affects injury risk. This preliminary analysis investigates the association between household size and risk for types of injuries.MethodsInformation on household demographics was collected in a survey on treatment-seeking behaviour following injury in Maringá, Brazil between May and September 2015. The prevalence of demographic factors, including insurance status, mode of transportation to health care, and education level, as well as reasons for not seeking care, were analysed by three categories of household size: 2 or fewer individuals, 3 to 5 individuals, and 6 or more individuals. Frequencies, range, and odds ratios were reported.ResultsOf 2678 households, the mean household size was 3.39 (r 1–15). As household size increased, enrollment in private insurance decreased; 50.5% of households of 2 or fewer had private insurance compared to only 27.5% with 6 or more. Alcohol usage prior to injury increased with household size; 5.3% of individuals in households of 2 or fewer reporting use, compared and 9.8% in houses of 6 or more. Large households had higher odds of unspecified injuries (OR: 1.85), including acts of violence, compared to households with 5 or fewer members. Odds of burn decreased with household size increase (OR: 0.833).ConclusionsHousehold size is a component of socioeconomic status; our data shows it is associated with insurance and alcohol usage. Risk of certain injuries is associated with household size. Further research needs to assess where these injuries are occurring, such as work or home. More in-depth research is also needed on how household size affects the family member occupations, as this places them at higher risks for different forms of injuries.