Programa de Investigacion en Accidentes de Transito

Lima, Peru

Programa de Investigacion en Accidentes de Transito

Lima, Peru

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Miranda J.J.,Programa de Investigacion en Accidentes de Transito | Miranda J.J.,Cayetano Heredia Peruvian University | Lopez-Rivera L.A.,Programa de Investigacion en Accidentes de Transito | Quistberg D.A.,University of Washington | And 11 more authors.
PLoS ONE | Year: 2014

Background: The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth. Methods and Findings: Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita Conclusions: The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs. © 2014 Miranda et al.


Miranda J.J.,Programa de Investigacion en Accidentes de Transito | Miranda J.J.,Cayetano Heredia Peruvian University | Rosales-Mayor E.,Programa de Investigacion en Accidentes de Transito | Rosales-Mayor E.,Cayetano Heredia Peruvian University | And 8 more authors.
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2010

Objective. The aim of this study was to ascertain, from patients' perspective, the degree of knowledge and the actual coverage of the Emergency Health Care Law and the Compulsory Insurance against Road Traffic Crashes (SOAT). Material and methods. A cross-sectional, active surveillance of emergency wards of selected health facilities in three Peruvian cities (Lima, Pucallpa y Ayacucho) was conducted. Results. Out of 644 surveyed victims, 77% did not know about the law about provision of emergency health care (81% in Lima, 64% in Pucallpa y 93% in Ayacucho; p<0,001). Following the explanation of what this law entails, 46% reported to have received care according to the law specifications. As for SOAT, the health care related costs of 237 persons (37.2%) were not covered by any insurance scheme (74% in Pucallpa, 34% in Ayacucho and 26% in Lima: p<0,001). Conclusions. In this study, the lack of knowledge about the provision of emergency health care law was important, and the coverage of care was deficient as nearly half of participants reported not to be treated by one or more of the entitlements stated in such law. Road traffic injuriesrelated health care costs were not covered by any insurance scheme in one of three victims. Improvements on citizens' information about their rights and of effective law enforcement are badly needed to reach a universal and more equitable coverage in the health care of road traffic-related victims.


Miranda J.J.,Programa de Investigacion en Accidentes de Transito | Miranda J.J.,Cayetano Heredia Peruvian University | Paca-Palao A.,Programa de Investigacion en Accidentes de Transito | Najarro L.,Programa de Investigacion en Accidentes de Transito | And 7 more authors.
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2010

Objective: A baseline assessment of the structure, dynamics, and monitoring capabilities of the information systems for road traffic injuries was conducted in three Peruvian cities: Lima, Huamanga and Pucallpa. Material and methods. 50 in-depth interviews were performed with key stakeholders, including managers and operators of information systems. The instrument was developed taking into account international standards and recommendations for information systems. Results. Six information systems were identified, some of which contain integrated operational systems enabling the recollection, processing, aggregation and data analysis following automated processes. These systems are considered valuable by different stakeholders because of their ability to present data in an organized manner. A low level of collaboration and exchange of information between institutions in the diverse aspects of data collection, processing and usage was observed. Officially, formal collaboration agreements between institutions do exist, potentially enabling more collaborative work. An interest was expressed in establishing an integrated information system due to the need for detailed and solid/trusted information that maximizes the use of existing resources. Conclusions. Current information systems for road traffic injuries have limitations. The actual use and utility of the information for decision-making for prevention of road traffic injuries nationwide is limited.


PubMed | National Major San Marcos University, University of Washington, Programa de Investigacion en Accidentes de Transito, University of the Pacific of Peru and 3 more.
Type: | Journal: F1000Research | Year: 2013

Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries.To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods.We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima) and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region), between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL) survey. We explored the association between outcomes and city, type of health care facility (HCF), and type of provider.We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial golden hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR) 5.05, 95% confidence interval (CI) 1.88-13.54). This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70).Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall, dissatisfaction was high, mainly at public institutions indicating much need for improvements in service provision.


Huang C.-M.,International Injury Research Unit | Lunnen J.C.,International Injury Research Unit | Miranda J.J.,Programa de Investigacion en Accidentes de Transito | Miranda J.J.,Cayetano Heredia Peruvian University | Hyder A.A.,International Injury Research Unit
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2010

Road traffic injury (RTI) is the leading cause of death in persons aged 10-24 worldwide and accounts for about 15% of all male deaths. The burden of RTI is unevenly distributed amongst countries with over eighty-fold differences between the highest and lowest death rates. Thus the unequal risk of RTI occurring in the developing world, due to many reasons, including but not limited to rapid motorization and poor infrastructure, is a major global challenge. This editorial highlights a number of key issues that must inform programs designed to prevent RTI in the developing world, where the epidemic is all the more insidious. Firstly, road safety is a development issue; secondly, road traffic injury is a major health issue; thirdly, road traffic injuries can be prevented by the implementation of scientific measures; fourthly, pre-hospital and hospital emergency care is needed; and fifthly, research on RTI is neglected in low-income and middle-income countries. The repercussion of such progress to Peru is also discussed.


Quistberg D.A.,University of Washington | Miranda J.J.,Programa de Investigacion en Accidentes de Transito | Miranda J.J.,Cayetano Heredia Peruvian University | Ebel B.,University of Washington
Revista Peruana de Medicina Experimental y Salud Publica | Year: 2010

Pedestrians in Peru are the victims of the greatest proportion of road traffic fatalities in the world. In 2009, pedestrians were involved in 27% of road traffic incidents in Peru. This is a significant public health problem in Peru and it has important economic effects as well. We review the evidence for some of the solutions and interventions implemented in other countries that may work well in Peru to confront this problem via preventing pedestrian-vehicle incidents. Most importantly, deploying interventions such as area-wide traffic calming through speed bumps, roundabouts, better lighting, one-way streets, detours, and blocking some roads has the strongest evidence for reducing injuries and fatalities in pedestrians. Other interventions related to education and enforcement may have a role as well in very specific contexts, but overall designing and modifying the built environment is the most important intervention.


PubMed | National Major San Marcos University, University of the Pacific of Peru, Cayetano Heredia Peruvian University, University of Washington and Programa de Investigacion en Accidentes de Transito
Type: Journal Article | Journal: PloS one | Year: 2014

The epidemiological profile and trends of road traffic injuries (RTIs) in Peru have not been well-defined, though this is a necessary step to address this significant public health problem in Peru. The objective of this study was to determine trends of incidence, mortality, and fatality of RTIs in Peru during 1973-2008, as well as their relationship to population trends such as economic growth.Secondary aggregated databases were used to estimate incidence, mortality and fatality rate ratios (IRRs) of RTIs. These estimates were standardized to age groups and sex of the 2008 Peruvian population. Negative binomial regression and cubic spline curves were used for multivariable analysis. During the 35-year period there were 952,668 road traffic victims, injured or killed. The adjusted yearly incidence of RTIs increased by 3.59 (95% CI 2.43-5.31) on average. We did not observe any significant trends in the yearly mortality rate. The total adjusted yearly fatality rate decreased by 0.26 (95% CI 0.15-0.43), while among adults the fatality rate increased by 1.25 (95% CI 1.09-1.43). Models fitted with splines suggest that the incidence follows a bimodal curve and closely followed trends in the gross domestic product (GDP) per capita.The significant increasing incidence of RTIs in Peru affirms their growing threat to public health. A substantial improvement of information systems for RTIs is needed to create a more accurate epidemiologic profile of RTIs in Peru. This approach can be of use in other similar low and middle-income settings to inform about the local challenges posed by RTIs.


PubMed | Programa de Investigacion en Accidentes de Transito
Type: Journal Article | Journal: Revista peruana de medicina experimental y salud publica | Year: 2010

The aim of this study was to ascertain, from patients perspective, the degree of knowledge and the actual coverage of the Emergency Health Care Law and the Compulsory Insurance against Road Traffic Crashes (SOAT).A cross-sectional, active surveillance of emergency wards of selected health facilities in three Peruvian cities (Lima, Pucallpa y Ayacucho) was conducted.Out of 644 surveyed victims, 77% did not know about the law about provision of emergency health care (81% in Lima, 64% in Pucallpa y 93% in Ayacucho; p<0.001). Following the explanation of what this law entails, 46% reported to have received care according to the law specifications. As for SOAT, the health care related costs of 237 persons (37.2%) were not covered by any insurance scheme (74% in Pucallpa, 34% in Ayacucho and 26% in Lima: p<0.001).In this study, the lack of knowledge about the provision of emergency health care law was important, and the coverage of care was deficient as nearly half of participants reported not to be treated by one or more of the entitlements stated in such law. Road traffic injuriesrelated health care costs were not covered by any insurance scheme in one of three victims. Improvements on citizens information about their rights and of effective law enforcement are badly needed to reach a universal and more equitable coverage in the health care of road traffic-related victims.


PubMed | Programa de Investigacion en Accidentes de Transito
Type: Journal Article | Journal: Revista peruana de medicina experimental y salud publica | Year: 2010

A baseline assessment of the structure, dynamics, and monitoring capabilities of the information systems for road traffic injuries was conducted in three Peruvian cities: Lima, Huamanga and Pucallpa.50 in-depth interviews were performed with key stakeholders, including managers and operators of information systems. The instrument was developed taking into account international standards and recommendations for information systems.Six information systems were identified, some of which contain integrated operational systems enabling the recollection, processing, aggregation and data analysis following automated processes. These systems are considered valuable by different stakeholders because of their ability to present data in an organized manner. A low level of collaboration and exchange of information between institutions in the diverse aspects of data collection, processing and usage was observed. Officially, formal collaboration agreements between institutions do exist, potentially enabling more collaborative work. An interest was expressed in establishing an integrated information system due to the need for detailed and solid/trusted information that maximizes the use of existing resources.Current information systems for road traffic injuries have limitations. The actual use and utility of the information for decision-making for prevention of road traffic injuries nationwide is limited.

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