Factors associated with head injury among survivors of motorcycle crashes: a case-control study in northern Ghana

Introduction: the increasing use of motorcycles in northern Ghana is associated with a high incidence of motorcycle crashes and resultant head injuries. This study sought to determine factors associated with head injuries among survivors of motorcycle crashes in northern Ghana. Methods: a prospective unmatched case-control study was conducted at the Tamale Teaching Hospital (TTH). A total of 326 cases (victims who suffered a head injury with or without other injuries) and 294 controls (persons who suffered various injuries except for head injury) from motorcycle crashes were consecutively sampled at TTH from December 15, 2019, to May 15, 2020. A semi-structured questionnaire was used to interview patients in addition to medical records review. Factors associated with head injury were examined using multivariable logistic regression at p<0.05 and a 95% confidence interval.Results: the prevalence of head injury was 53.03% among of 660 survivors of motorcycle crashes. The majority of the patients were young males aged 15-44 years. The rate of helmet use was lower in cases (12.88%) than in controls (57.82%) (p<0.001). Factors associated with head injury were not wearing helmet (AOR= 9.80, 95% CI: 6.22, 15.43), male (AOR=1.75, 95% CI: 1.07, 2.85), student (AOR=0.38, 95% CI: 0.16, 0.91), and alcohol use within 24 hours (AOR=0.17, 95% CI: 0.04, 0.70). Conclusion: non-use of helmet and male gender significantly increased the risk of head injury risk in this study. Alcohol use and being a student were associated with lower odds of head injuries. Motorcycle safety efforts in the study area should emphasize helmet promotion.