PP030 Topic: AS03–Disaster Medicine/Trauma, Triage and Transport/Mass Critical Care/Pandemics/Medicine in War Zones/Other: A MULTILEVEL ANALYSIS OF CHILD RESTRAINT SYSTEM UTILIZATION IN AFRICA AND ASIA: POLICY PATHWAYS TO PREVENT ROAD TRAFFIC DEATHS

Abstract

Aims & Objectives: Road traffic deaths (RTDs) are a major health concern worldwide, especially for children and young adults aged 5–29, with 1.35 million fatalities in 2016, mostly in low- and middle-income countries (93%). Despite child restraint systems (CRS)‘ effectiveness in reducing RTDs, their use is low, with only 33 countries adopting WHO-recommended laws. This study investigates the use of child restraint seats and risk factors for their non-use in LMICs. Methods: We analyzed cross-sectional data of CRS use from The Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS) in 10 cities across Africa and Asia from 2020 to 2022. Sites were randomly selected using a standardized roadside observation collection protocol. We used a multilevel logistic regression model in Stata 18, to explain the CRS use based on individual-level predictors and accounting for random effects at the country and city levels. Results: 7,674 children under 12 years old were observed. Only 2% used CRS. Usage varied by age group: under 5 years (4%), 5-11 years (2%), and 12-17 years (16%). In multilevel regression analysis, children aged 5-11 were less likely to use CRS than those under 5 (OR 0.38, 95%CI 0.27-0.53). CRS was lower on local roads than arterial roads (OR 0.30 IC95% 0.15-0.60). 14.7% of the variability in CRS use can be explained by intra countries’ correlation, while 21% of the variability is due to correlation in cities within the same country.Conclusions: City residence, child age and road type impacts child seat use, guiding policy and fatality reduction strategies. Keywords: road traffic injuries, pediatric trauma, injuries, road safety, Child Restraint System