UCLA

INTRODUCTION: Africa is the least motorized populated continent, yet it experiences the highest traffic fatality rate. Despite laws mandating helmet and seatbelt use, data on protective gear use among Cameroonian road traffic injury (RTI) patients remains sparse. METHODS: We extracted Cameroon Trauma Registry data prospectively collected from 10 hospitals during July 2022 to December 2023. Protective gear users wore helmets in motorcycle and seatbelts/car seats in vehicle crashes. We categorized patients into five economic clusters based on ownership of durable goods using parallel distance matrix computation. We analyzed associations between continuous variables with Wilcoxon rank-sum and categorical variables with χ 2 and multivariate logistic regression. Our primary outcome was in-hospital death or major disability at discharge. RESULTS: Among 3,554 RTI patients, 303 (9%) used protective gear. A larger proportion of patients who did not use protective gear were designated as majorly disabled or dead (20% vs. 16%, p < 0.001). The greatest percentage of protective gear users belonged to the richest cluster, while the poorest cluster patients comprised the smallest proportion of protective gear users (13% vs. 3%, p < 0.001). The richest cluster demonstrated the smallest percentage of major disability or death (13%), while the poorest cluster had the greatest percentage (28%, p < 0.001). When controlling for age, protective gear use, and injury severity, the three poorest clusters showed the greatest odds of major disability or death (cluster 3: adjusted odds ratio [AOR], 2.34; 95% confidence interval [CI], 1.58-3.46; cluster 4: AOR, 2.09; 95% CI, 1.59-2.74; cluster 5: AOR, 2.38; 95% CI, 1.24-4.58). CONCLUSION: Greater economic status is associated with increased protective gear use during RTIs in Cameroon. Despite suffering the most severe outcomes, the poorest patients remain less likely to use protective gear. Enforcement of protective gear laws and economic incentives such as price subsidies for helmets and seatbelts would particularly benefit the most vulnerable population. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level IV.