Introduction:

Figure 3 : Répartition des patients selon la situation matrimoniale

Motorcycles were involved in 182 accidents, making up 72.8% of the cases. Light vehicles accounted for 18.8%, buses 5.2%, bicycles 1.6%, trucks 1.2%, and carts 0.4% (table IV).

Drivers made up 51.6% of the victims. Helmets were the most commonly reported protective gear, worn in 52.9% of cases, ahead of no equipment at all (40.6%) and seat belt usage (6.5%). In 65.0% of situations, the accident was reported without speeding, compared to 35.0% where the speed limits were exceeded.

The total of 269 locations is higher than the 250 patients analyzed. This difference suggests either the presence of multiple lesions in some patients or the use of a different denominator for this variable; the report doesn't allow us to decide between these two possibilities.

The total of 395 therapeutic methods for 250 patients probably shows that several treatments could be assigned to the same patient or that the denominator of this variable differed from that of the main sample. So the percentages are presented as proportions of reported methods rather than as an exclusive breakdown of patients.

Discussion

This study highlights the important role of road traffic accidents in the activity of the Emergency Department at HOGIP. Out of 5,761 patients received during the three-month study, 1,166 had come in because of a road traffic accident, which is 20.24% of admissions.

The observed proportion is higher than the frequencies of 12.95% and 12.01% reported in the comparisons mentioned in the paper, respectively in studies conducted in Thiès and Mali [13, 14].

These differences could be related to the study period, the definition of cases, the recruitment profile of the establishments, traffic density, and the role of motorcycles in local travel.

The high proportion of road traffic accidents seen in this department can also be linked to HOGIP's role as a trauma reference center. The hospital receives victims from urban and suburban areas with heavy traffic, high daily mobility, and a mix of cars, public transport, motorcycles, pedestrians, and non-motorized vehicles. This mix of road users can increase the chances of conflicts on the roads, especially when the infrastructure doesn’t adequately separate the flows.

Sociodemographic profile of the victims 

The average age was 32.8 ± 11.6 years, with the 26 to 35 age group accounting for 38.4% of the victims. This predominance of young adults makes sense given their high mobility, presence in the workforce, and frequent use of personal transportation. Adults in this age range are often on the move for work, business, and social reasons, sometimes under time pressure and in heavy traffic.

The observed proportion is close to that reported in some comparative studies mentioned in the paper, notably a frequency of 37.8%, but it is still lower than the 47.1% reported in another series [15-17].

The differences between studies may be related to the age structure of the populations, the type of institution, the categories of users included, and the observation period.

The male predominance was clear, with men making up 79.6% of the victims, and a sex ratio of 3.9. This matches the results reported in several African contexts and in the comparative studies mentioned in the thesis: 77.3% men in a study by Diarra, 71.9% in Oumarou’s series, 67.7% in a pediatric study conducted in Rabat, and 77% in a series carried out in N’Djamena [13, 17-19].

This overrepresentation of men can be explained by greater exposure to motorized travel, professional or personal driving, and certain risky behaviors. It may also reflect differences in mobility and the use of healthcare facilities. However, it should not be interpreted as proof of inherently more dangerous behavior in men. The study doesn't actually compare how much each gender is exposed to road traffic.

Most of the victims were single, and the most common level of education was secondary school. These data describe the social profile of the patients treated, but they don't allow us to establish a causal effect of marital status or education level on the occurrence of an accident. An analytical study would need to compare the victims to a similar, non-accident-exposed population and gather detailed information on profession, type of travel, and risk exposure.

Accident circumstances                                                                                            

Most accidents happened between 6 a.m. and 6 p.m., a period that accounted for 62% of cases. This daytime concentration could be linked to the high level of work, school, and shopping travel, as well as the increase in traffic density during rush hours. It's similar to the frequencies of 73% and 68.4% reported in comparative studies [20, 21].

The predominance of November, with 45.6% of accidents, should be interpreted with caution due to the short duration of the study and the lack of complete breakdown by month. It could be due to variations in exposure, traffic, weather conditions, or service operations, but no seasonal conclusions can be drawn based on just three months of observation.

Main roads accounted for 35.3% of reported accident sites. These routes carry a lot of traffic and connect different neighborhoods or cities. They can also involve high speeds, overtaking, irregular stops, pedestrian crossings, and local access points. National data mentioned in the report show that 45.8% of accidents happen on paved roads, while studies on road networks highlight how important road design, signage, and maintenance are for user safety [22, 23, 24].

Vehicle-to-vehicle collisions were the most common type, accounting for 46% of cases, followed by vehicle-to-pedestrian collisions at 29.2%. These types of accidents are encouraged by traffic density, lane changes, overtaking, ignoring right-of-way, speeding, and the mix of road users with different levels of vulnerability. Vehicle-to-pedestrian collisions remain particularly worrying because they can cause serious injuries to people without any mechanical protection [25, 26].

Motorcycles were the most involved vehicles, accounting for 72.8% of the cases. This result is an important signal for prevention in Senegal. Two-wheelers are accessible and convenient, but their riders are directly exposed to impact forces. The lack of protective bodywork, the risk of losing control, vulnerability in collisions with heavier vehicles, and irregular use of protective gear can increase the severity of injuries. The proportion of cases reported in this study justifies targeted actions on motorcyclist training, helmet checks, the technical condition of motorcycles, and the limitation of risky behaviors.

The helmet was the most commonly used protective gear, in 52.9% of cases, but 40.6% of victims weren’t wearing any reported gear. This highlights the gap between a rule existing and it actually being followed. Prevention needs to include campaigns tailored to users, regular checks, and ensuring gear is financially and practically accessible. Wearing a helmet doesn’t eliminate the risk of accidents, but it can reduce the likelihood and severity of certain head injuries when worn properly.

Speeding was reported in 35% of cases. This data should be seen as self-reported information collected in the records, not as an objective measure of speed. Still, it aligns with the known role of speed in how serious collisions are. Control devices, appropriate limits for the areas being crossed, and infrastructure designed to encourage controlled speed are all important measures [27, 28].

Clinical profile and management                                                                                     

The lower limbs were the most common site of injuries, followed by the upper limbs. This pattern can be explained by the direct exposure of the limbs during impacts, motorcycle falls, and collisions involving light vehicles. The predominance of fractures, which accounted for 44% of reported injuries, is consistent with the mechanical impact of accidents and the frequency of limb trauma.

The results are similar to some series mentioned in the report, but differ from other studies that found a predominance of head injuries or wounds [13, 20, 29, 30].

These differences can be related to the types of users included, the role of motorcyclists, the accident mechanism, the time to reach the hospital, and the criteria for classifying injuries.

Moderate severity was the most common category, and the life prognosis was favorable in 94.4% of cases. These results may reflect the fact that the victims included were treated in an emergency department and had already undergone some clinical selection, but they should not be taken to mean there are no aftereffects. A favorable life prognosis can coexist with an unfavorable functional outcome, especially when there are fractures, nerve injuries, persistent pain, or joint limitations.

Medical treatment accounted for 60% of the reported modalities, followed by orthopedic treatment and surgical treatment. This distribution is consistent with the frequency of injuries requiring local care, immobilization, pain relief, antibiotic prophylaxis, or monitoring. Since the treatment data are higher than the number of patients, they should be interpreted as occurrences of treatment modalities rather than as an exclusive distribution. Comparison with other studies reported in the thesis shows a proportion of medical treatment higher than that observed by Doumbia (50.5%) but lower than that reported by Traoré B. (91.8 %) [14, 30].

Implications for prevention

The results support a primary prevention strategy focused on motorcyclist safety, speed control, wearing helmets properly, and reducing risky behaviors. Actions should target main roads and high-density areas, with visible signage, proper lighting, safe pedestrian crossings, and separation between motorized traffic and vulnerable users whenever possible [23, 31, 32].

Prevention should also include stronger vehicle and motorcycle inspections, tackling overloading, and consistent enforcement of penalties. Automated systems for speed control and rule enforcement can complement the presence of officers, as long as they're part of a transparent policy that's regularly evaluated [12, 33-35].

Secondary prevention involves the immediate response after an accident. Training first responders, coordinating between security forces, firefighters, and medical teams, having suitable ambulances available, and quickly directing people to trauma care facilities can reduce deaths and long-term damage. Developing prehospital emergency systems should take into account distances, road networks, and the geographic distribution of reference facilities [36].

Finally, tertiary prevention should include functional rehabilitation, pain management, psychological support, returning to school or work, and social assistance. The aftereffects of a road accident aren’t limited to the hospital stay; they can long-term affect the victim’s independence, income, and social involvement.

Study limits

This study has several limitations. First, its retrospective nature exposes it to information bias due to the variable quality of medical records. Some important variables, such as occupation, type of route, blood alcohol level, measured speed, proper helmet use, prehospital delay, and detailed circumstances of the accident, were not documented consistently.

Secondly, the observation period only covered three months, which limits the ability to study seasonal variations and to generalize the results to the whole year. In particular, the proportion of accidents observed in November cannot be considered an annual indicator.

Thirdly, the study reports 1,166 patients who were victims of road traffic accidents out of 5,761 admissions, while the descriptive tables are based on 250 complete files. The exact process between identifying the 1,166 cases and analyzing the 250 files isn’t detailed. This discrepancy needs to be clarified from the original database before publication.

Fourth, the denominators aren’t constant for certain variables: 269 lesion locations, 255 types of lesions, and 395 treatment methods are reported for 250 patients. These discrepancies might correspond to multiple responses, but this hypothesis isn’t explicitly documented in the report. So, the results were presented as counts or reported occurrences, without converting them into individual risks.

Finally, the statistical tests are mentioned in the methodology, but the p-values, measures of association, and confidence intervals are not provided in the available results section. Therefore, the analysis should mainly be considered descriptive. A follow-up study should include an analytical model based on better-documented variables and a clearly defined sample.

Conclusion:

Accidents on public roads accounted for 20.24% of the admissions recorded at the HOGIP Emergency Reception Service between October and December 2024. The victims shown in the available tables were mainly young men, with the 26 to 35 age group being the most represented. Motorcycles were involved in nearly three-quarters of the accidents, vehicle collisions were the main cause, and injuries to the lower limbs, especially fractures, made up the main injury profile.

Treatment was most often medical or orthopedic, and the immediate survival outlook was generally good. However, these results shouldn’t hide the risk of lasting functional and social issues, which is especially significant for a young and active population.

Reducing road accidents in Senegal requires coordinated action on human factors, vehicles, infrastructure, and emergency response organization. The priorities are improving motorcyclist safety, effectively enforcing helmet and seatbelt use, controlling speed, upgrading major roads, road safety education, availability of prehospital emergency services, and developing rehabilitation for victims. The quality of data also needs to be improved through standardizing records, harmonizing definitions, and setting up an integrated accident monitoring system.

Recommendations

Primary prevention:                                                                                                   

It's recommended to improve the quality, lighting, and signage of roads, paying special attention to main roads, intersections, and areas with heavy pedestrian traffic. Separating traffic flows where possible, creating sidewalks and safe pedestrian crossings, as well as regular road maintenance should be strengthened.

Vehicle and motorcycle inspections should be made more systematic, while vehicles that are unfit for traffic should be taken out of passenger transport. Speed control, alcohol checks, overloading, and compliance with traffic rules should be strengthened using appropriate human and technological means.

Wearing helmets for motorcyclists and seat belts in vehicles should be enforced through a combination of education, monitoring, and penalties. Road safety education should be promoted in schools, driving schools, workplaces, and communities, with messages tailored for young drivers and two-wheeler users.

Secondary prevention and management                                                                    

It's important to strengthen prehospital emergency services, improve coordination between firefighters, defense and security forces, and healthcare facilities, and train first responders in basic rescue techniques and victim immobilization. The availability of ambulances and routing to trauma centers also needs to be improved on busy routes.

Healthcare facilities should step up staff training in trauma care, improve the technical equipment, and develop standardized protocols for fractures, head injuries, limb injuries, and life-threatening emergencies.

Tertiary prevention and research                                                                                          

Functional and psychological rehabilitation should be integrated early into the care process. Victims should receive support aimed at helping them regain independence, return to work or school, and reintegrate socially.

It is also recommended to set up a standardized system for monitoring traffic accidents, linking police, transport, rescue, and health services. Year-long prospective studies should specify the factors associated with severity, response times, functional aftereffects, and the socio-economic cost of accidents.